Keywords: mHealth; peritoneal dialysis; functionality; usability

Background: Post-acute sequelae of SARS-CoV-2 infection (PASC) is a complicated disease that affects millions of people all over the world. Previous studies have shown that PASC impacts 10% of SARS-CoV-2 infected patients of which 50-70% are hospitalized. It has also been shown that 10-12% of those vaccinated against COVID-19 were affected with PASC and its complications. The severity and the later development of PASC symptoms is positively associated with the early intensity of the infection. Results: The generated health complications caused by PASC involve a vast variety of organ systems. Patients affected by PASC have been diagnosed with neuropsychiatric and neurological symptoms. Cardiovascular system also has been involved and several diseases such as myocarditis, pericarditis, and coronary artery diseases were reported. Chronic hematological problems such as thrombotic endothelialitis and hypercoagulability were described as a condition that could increase the risk of clotting disorders and coagulopathy in PASC patients. Chest pain, breathlessness, and cough in PASC patients were associated with respiratory system in long COVID-19 causing respiratory distress syndrome. The observed immune complications were notable, involving several diseases. Renal system also was impacted and result in raising the risk of diseases such as thrombotic issues, fibrosis, and sepsis. Endocrine gland malfunction can lead to diabetes, thyroiditis, and male infertility. Symptoms such as diarrhea, nausea, loss of appetite and taste were also among reported observations due to several gastrointestinal disorders. Skin abnormalities might be an indication of infection and long-term implications such as persistent cutaneous complaints were linked to PASC. Conclusions: Long COVID is a multidimensional syndrome with considerable public health implications, affecting several physiological systems and demanding thorough medical therapy as well as more study to address its underlying causes and long-term effects.

The Atmospheric Dynamics Mission ADM-Aeolus was successfully launched in August 2018 by the European Space Agency (ESA). The Aeolus mission carried a single instrument, the first-ever Doppler Wind Lidar (DWL) in space, called Atmospheric LAser Doppler INstrument (ALADIN). Aeolus circled the Earth in a polar sun-synchronous orbit at about 320 km altitude with a repeat cycle of 7 days, providing vertical profiles of horizontal line-of-sight (HLOS) winds on a global scale. Exceeding scientific expectations, Aeolus, initially designed for a 3-year lifetime, provided global coverage of wind profiles for almost five years. In this long-term validation study, we assessed the accuracy of the Level 2B (L2B) Rayleigh-clear and Mie-cloudy wind products by collecting radiosonde data from three stations in the Brazilian Amazon: Cruzeiro do Sul (7.62° S, 72.67° W), Porto Velho (8.76° S, 63.91° W), and Rio Branco (10.00° S, 67.80° W). Statistical validation was conducted by comparing Aeolus L2B wind products and radiosonde data, launched daily at 12:00 UTC from October 2018 to March 2023. Considering all data collected during the mission period, Pearson’s coefficient (R) of 0.73 was observed in Rayleigh-clear and 0.85 in Mie-cloudy, revealing a strong correlation between Aeolus and radiosonde winds. No significant biases were detected, with values of -0.14 m/s for Rayleigh-clear and -0.40 m/s for Mie-cloud, fulfilling the mission requirement of having absolute biases below 0.7 m/s. However, when analyzed annually, in 2022, the bias for Rayleigh-clear was -0.95 m/s, exceeding the mission requirements.

The high penetration of distributed energy resources poses significant challenges to the dispatch and operation of power systems. Improving the accuracy of short-term load forecasting (STLF) can optimize grid management, leading to increased economic and social benefits. Currently, some simple AI and hybrid models has issues to deal with and struggle with multivariate dependencies, long-term dependencies, and non-linear relationships. This paper proposes a novel hybrid model for short-term load forecasting (STLF) that integrates multiple AI models with Lasso regression using the stacking technique. The base learners include ANN, XgBoost, LSTM, Stacked LSTM, and Bi-LSTM, while Lasso regression serves as the meta-learner. By considering factors such as temperature, rainfall, and daily electricity prices, the model aims to more accurately reflect real-world conditions and enhance predictive accuracy. Empirical analyses on real-world datasets from Australia and Spain show significant improvements in forecasting accuracy, with a substantial reduction in Mean Absolute Percentage Error (MAPE) compared to existing hybrid models and individual AI models. This research highlights the efficiency of the stacking technique in improving STLF accuracy, suggesting potential operational efficiency benefits for the power industry.

The properties of the annual, semiannual and triennial oscillations (AO, SAO and TO) in the middle atmosphere have been investigated using the TIMED/SABER temperature data. The Lomb-Scargle and wavelet spectra were used to determine the dominant oscillations in the background temperature field. The AO is prominent at the mid-latitudes. The AO amplitudes present an asymmetry between the two Hemispheres, being larger in the mesosphere than in the stratosphere. The SAO dominates the tropical regions, with three amplitude maxima at altitudes of 45, 75, and 85 km. The SAOs in the upper mesosphere (75 km) are out of phase with those in the mesopause (85 km) in the tropical regions, which can generate an enhancement of 11 K at each equinox, contributing to the lower mesospheric inversion layer. The TO is significant in the tropical region, with amplitude being maximum at 35, 45 and 85 km. Result shows that there may be potential interaction by the TO with SAO at 85km at the equator. The relation between ENSO and TO has also been discussed. The ENSO signal may modulate the amplitude of the TO, mainly in the lower stratosphere. The real origin of the TO may lie in the wave-mean-flow interaction.

(1) Background: The RDW-CV has predictive value in many pregnancy-related conditions. Re-search question: Can the RDW-CV be utilized predictively in pregnant patients with thrombo-philia? Aim of the study: To carry out a detailed analysis of the RDW-CV in pregnant patients with treated thrombophilia as compared with pregnant patients without thrombophilia who de-livered via cesarean section at term. (2) Methods: We studied 160 pregnant patients, including 80 pregnant patients with treated thrombophilia in the study group, and another 80 patients of a similar age and parity. The patients were referred to our hospital for delivery at term by means of a cesarean section between 1/10/2017 and 1/12/2021. Every patient received a sonogram during the first 1–2 days after the cesarean section, and their uterine evaluation was interpreted using the PUUS (Postpartum Uterine Ultrasonographic Scale). (3) Results: Our PUUS≥1 pregnant and postpartum patients with treated thrombophilia were the only group with an RDW-CV value over 14. No deep vein thrombosis was observed during hospitalization, showing that the antico-agulant treatment was necessary and effective. An RDW-CV of 14.5 was the highest value in the Rh-negative group of pregnant patients with treated thrombophilia. An RDW-CV of 14.48 was the highest level in the Rh-negative postpartum patients with treated thrombophilia. (4) Conclu-sion: An RDW-CV of ≥14 can predict uterine hematometra (PUUS≥1). The RDW-CV values were higher in Rh-negative patients.

Background: The validation of laser usage during laparoscopic procedures, notably by Camran Nezhat in the late 1980s, has been significant. Lasers offer precision and depth control in tissue vaporization without bleeding. Surgical intervention remains central in managing endometrio-sis-associated pain and infertility, especially for patients unresponsive to hormonal therapy. Methods: This retrospective cohort study included 200 patients with SPE who underwent laparo-scopic laser vaporization. Surgery was performed using a CO2 laser, and histological confirma-tion of endometriosis was obtained for all cases. Pain scores and SF-36 questionnaire domains were assessed preoperatively and postoperatively. Fertility outcomes were evaluated among pa-tients desiring pregnancy. Results: Significant improvements in pain score and SF-36 questionnaire domains were ob-served postoperatively (p-value

To enhance the safety of power grid operations, this study proposes a high-precision short-term photovoltaic power prediction method that integrates information from surrounding pho-tovoltaic stations and the Conv-LSTM-ATT model. In the deep learning prediction model, not only is numerical weather prediction (NWP) data from the target photovoltaic station used as input features, but also highly correlated features from nearby photovoltaic stations are incor-porated. The research begins by analyzing the correlation between irradiance and power se-quences, along with distance factors, to calculate a composite similarity index between the target and other regional photovoltaic stations. Stations with high similarity indices are then selected as data sources. Subsequently, Bayesian optimization techniques are employed to find the optimal data fusion ratios. Ultimately, using the selected data, power prediction mod-eling is conducted via the Conv-LSTM-ATT deep neural network. Experimental results con-firm the superiority of the proposed model, which demonstrates higher predictive accuracy compared to three other classical models. The data fusion strategy determined by Bayesian optimization significantly enhances prediction accuracy, reducing the root mean square error (RMSE) of the test set by 20.04%, 28.24%, and 30.94% for three weather types, respectively.

Sentiment analysis plays a crucial role in understanding customer feedback, guiding product development, and informing business decisions. This paper introduces term sentiment entropy (TSE), a novel weighting method that leverages the distribution of sentiment labels associated with words to enhance text classification accuracy. TSE complements traditional TF-IDF techniques by capturing the nuances of sentiment variation across different contexts. Experiments across diverse public datasets demonstrate TSE's potential to improve sentiment analysis performance, especially in capturing subtle sentiment shifts and adapting to specific domains. While computational cost and label quality pose challenges, TSE offers a promising avenue for refining sentiment analysis and opening new research frontiers.

In many European countries over the last decades, arable fields dominate agriculture landscapes, leading to a very intensive land-use practices. This reason seems to be the main cause of popula-tions declines for numerous farmland species, including the European hare (Lepus europaeus Pallas, 1778). The Research institute for Animal Production (National Agricultural and Food Centre, Luzianky, Slovakia) has been engaged in a long monitoring project (project currently run-ning), collecting certain indicators of hare population dynamics during hunting season since 1987 to 2023 in the Slovak Danubian Lowland. In the same macro-area (Čiližská Radvaň and Lehnice) a study was conducted on the influence of permanent semi-natural vegetation in relation to re-cruitment, population density and production. The whole monitored period was aggregated into 5-years intervals (for a total of 7 time-intervals), with the aim of analyzing the brown hare popu-lation dynamics. Spring hare density in the Danubian Lowland is currently 20.8 hares/km2, with harvests of 4.6 hares/km2. During all the monitoring period, bag’s animals have been examined following the regular hunting operations for the purpose of age determination (weight of eye lenses), sex ratio and productivity. The results of our analysis showed that the proportion of juve-nile in bag (PYB) among those shot varied from 37.0 % of the last 5-years interval (2018-2023), to a maximum of 51.0 % in interval of years 1998-2002. On total average there were 1.86 juveniles per adult female (r). The proportion of adult females in gamebag varied from 22.58 % (years in-terval 1992-1997) to 31.26 % (years interval 2018-2023). Sex-ratio (SI; males : females) among shot hares showed a value of 0.50, ranged from 0.48 in the period 2008-2012 to 0.52 in the first observed period (years 1987-1991) and in the last one (years 2018-2023). Average weight of shot hares was 4.04 kg (juveniles 3.83 kg, adults 4.27 kg, adult males 4.21 kg and females 4.32 kg). There was a large positive effect of set-aside with special mixtures, created for hares in large-scale farmed agrarian landscape, on hare density, bag and recruitment. In model hunting grounds with such set-asides increased the spring stock by 25 %, bag by 100 % and recruitment by 20 %. This study reveals that the management of European brown hare is not sustainable, and the population is decreasing. It is proved through the decline of harvest hares and by population dynamics parameters. Environmental improvements lead to the stabilization and increasing of requested parameters.

The influence of short term water absorption on the mechanical properties of halloysite nanotubes-multi layer graphene reinforced polyester hybrid nanocomposites has been investigated. The addition of nano-fillers significantly increased the flexural strength; tensile strength and impact strength in dry and wet conditions. After short term water exposure; the maximum microhardness; tensile; flexural and impact toughness values were observed at 0.1 wt% MLG. The microhardness increased up to 50.3%; tensile strength increased up to 40% and flexural strength increased up to 44%. Compared to dry samples; the fracture toughness and surface roughness of all types of produced nanocomposites were increased that may be attributed to plasticization effect. Scanning electron microscopy revealed that the main failure mechanism is caused by the weakening of nano-filler-matrix interface induced by water absorption. It was further observed that synergistic effects were not effective at concentration of 0.1 wt% to produce considerable improvement in mechanical properties of produced hybrid nanocomposites.

Most of the mid-high permeability sandstone oilfields in China have entered the ultra-high water cut stage, accompanied with the highly-dispersed residual oil, and the control effect of mi-cro-heterogeneity on the residual oil is increasingly prominent. Understanding the microscopic characteristics of pore structural and its evolution during the long-term waterflooding is critical for enhancing the accuracy and efficiency of oil field exploitation. While the previous insights paid more attention to the geometrical and morphological features of pore structure and ignores the relation of pore structure with the fluid flow capacity. In this study, we propose a microscopic pore structure classification method considering pore size and local permeable capacity, which realizes the physical classification and quantitative evaluation of pore structure characteristics for different permeability rocks. The micro-pore structure is classified into 6 types based on the key evaluation parameters of pore diameter and flow flux area. By taking six mid-high permea-bility sandstone core samples from Daqing oilfield in China, a series of long-term waterflooding experiments are carried out and the interior pore structure was captured using high precision CT scanning technique. The results reveals that high-permeability reservoirs exhibit concentrated pores diameters and finer throats, whereas mid-permeability reservoirs exhibit smaller pores and throats in greater quantity. With the increase of water injection volumes, the permeable ca-pacity and connectivity of the high-connectivity pore space in ultra-high- and high-permeability reservoirs are enhanced, and in mid-permeability reservoirs, the micro-heterogeneity intensifies the increase in low-connectivity small pores. These findings provide new insights for the micro-scopic heterogeneity and a solid theoretical basis for investigating the occurrence of microscopic residual oil and optimising enhanced oil recovery strategies at the late stage of ultra-high water cut.

Long-term safety of a nutraceutical combination based on agnus castus and magnolia extracts combined with soy isoflavones (SI) and lactobacilli, and effectiveness on vasomotor symptoms and sleep disorders in postmenopausal women, were assessed. A controlled study was carried-out in menopausal women comparing this nutraceutical combination (ESP group) with formulation containing isoflavones alone (C group), at the dosage recommended. Kuppermann index, PSQI, and SF-36 were determined at baseline, 3, 6 and 12 months. Endometrial thickness, mammary density and liver function were evaluated at baseline and after 12 months. 180 women (100 in ESP group and 80 in C group, mean age 55.5 years, in menopause for about 36 months) were enrolled in the study. At the treatment end, mammary density, endometrial thickness, and hepatic function did not show substantial differences between groups. Kuppermann index, and particularly hot flushes, were progressively and significantly decreased in frequency and severity during ESP versus C treatment. No adverse events were observed. Agnus castus and magnolia, combined with SI + lactobacilli, can effectively and safely be used in symptomatic postmenopausal women, mainly when quality of sleep is the most disturbing complaint. Endometrium, mammary glands and liver function, were unaffected after 12 months treatment.

(1) Background: Thrombophilia is a tendency towards hypercoagulability, and it is increased by pregnancy, peaking around delivery. Research question: does thrombophilia stimulate the in-flammatory state of the patient, already suppressed by pregnancy? (2) Methods: Eighty thrombo-philia patients admitted for delivery between 1/10/2017 and 1/12/2021 were prospectively stud-ied, together with eighty age- and para-matched control patients. Patients were admitted for de-livery at term by means of cesarean section. The inflammation indexes from the complete blood count values analysis during both the 24 hours before and after labor—extracted from the hospi-tal’s medical records—were calculated and then correlated with uterine involution. (3) Results: Except for the PLR, most of the numerous inflammation indexes studied were not significantly different in treated thrombophilia patients, before and after delivery, compared to non-thrombophilia patients. Only when we split the patients, based on the uterine haematometra in the first 24-48 hours postpartum, we found out that the few treated thrombophilia patients with haematometra (14 with haematometra out of 79 with treated thrombophilia) had elevated SII and AISI antepartum. In pregnant patients treated for thrombophilia, MLR is higher in pa-tients without the Rh factor than in those with the Rh factor. In non-thrombophilia patients, MCVL and NLPR increased with age and before labor, while SII and AISI increased with age postpartum. (4) Conclusions: Thrombophilia did not stimulate the inflammatory state of the pa-tient, already suppressed by pregnancy.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social interaction and communication, anxiety, hyperactivity, and restricted interest for specific subjects. In addition to the genetic factors, multiple environmental factors have been related to the development of ASD. Animal models can serve as crucial tools for understanding the complexity of ASD and identifying potential therapeutic strategies. In this study, a chemical model of ASD has been developed in zebrafish by exposing embryos to valproic acid (VPA) from 4 to 48 hours post-fertilization. After the exposure, embryos were transferred to fish water and the effects on behavior and neurotransmitters profile were analyzed at both larval and adult stages. Larvae from VPA-treated embryos showed hyperactivity and decreased visual and vibrational escape responses, as well as an altered neurotransmitters profile, with increased glutamate and decreased acetylcholine and norepinephrine levels. Adults from VPA-treated embryos exhibited impaired social behavior characterized by larger shoal sizes and a decreased interest for their conspecifics. Neurotransmitter analysis revealed a significant decrease in dopamine and GABA levels in the brain. These results support the interest of this model in the study of ASD.

Oritavancin is a novel long-acting lipoglycopeptide with in vitro activity against methicillin-resistant (MR) Gram-positive pathogens and a good bactericidal activity even in presence of biofilm forming bacteria. It has been approved for acute bacterial skin and skin structure infections (ABSSSI), but recent reports have demonstrated possible off-label uses, as for prosthetic joint infections (PJI), which, in more than half of cases, are caused by MR Gram positive organisms. We reported a case of a man in his eighties with a late shoulder PJI caused by methicillin resistant Staphyloccus epidermidis (MRSE) with contraindications for surgical replacement and few oral therapeutic options for a long term suppressive antibiotic therapy. The prosthesis was retained, and the patient received ten outpatient sequential doses of 1200 mg of oritavancin during 28 weeks, based on therapeutic drug monitoring (TDM) as a guide for correct timing of administration of each dose. During oritavancin administration, the patient achieved clinical cure, with disappearance of the pain and regaining pre-infection joint mobility, with no side effects reported and no further surgery or hospitalization needed. The treatment is ongoing as a long-lasting suppressive antimicrobial therapy. Oritavancin could represent an excellent solution for treating PJI caused by MR organism, especially in patients who need a long-term suppressive therapy.

Deep underground laboratories offer advantages for conducting high-precision observations of weak geophysical signals, benefitting from a low background noise level. It is both valuable and feasible to enhance strong, noisy ground electromagnetic (EM) field data using synchronously recorded underground EM signals, which typically exhibit a high signal-to-noise ratio. In this study, we propose an EM field reconstruction method employing a Long Short-Term Memory (LSTM) recurrent neural network with referenced deep underground EM observations. Initially, a deep learning model was developed to capture the time-varying features of underground multi-component EM fields using the LSTM recurrent neural network. Subsequently, this model was applied to process synchronously observed strong, noisy data from other conventional observation systems, such as those at surface, to achieve noise suppression through signal reconstructions. Both theoretical analysis and practical observational data suggest that the proposed method effectively suppresses noise and reconstructs clean EM signals. This method is efficient and time-saving, representing an effective approach to fully utilizing the advantages of deep underground observation data. Furthermore, this method could be extended to the processing and analysis of other geophysical data.

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.

Background/Objectives: Vitamin B12 deficiency can cause variable symptoms, which may be irreversible if not diagnosed and treated in a timely manner. We aimed to develop a widely accepted expert consensus to guide the practice of diagnosing and treating B12 deficiency. Methods: We conducted a scoping review of the literature published in PubMed since January 2003. Data were used to design a two-round Delphi survey to study the level of consensus among 42 experts. Results: The panelists agreed on the need for educational and organizational changes in the current medical practices for diagnosing and treating B12 deficiency. Recognition of clinical symptoms should receive the highest priority in establishing the diagnosis. There is agreement that the serum B12 concentration is useful as a screening marker, whereas methylmalonic acid or homocysteine can support the diagnosis. Patient lifestyle, disease history and medications can provide clues to the cause of B12 deficiency. Regardless of the cause of the deficiency, initial treatment with parenteral B12 was regarded as the first choice for patients with acute and severe manifestations of B12 deficiency. The use of high-dose oral B12 at different frequencies may be considered for long-term treatment. Prophylactic B12 supplementation should be considered for specific high-risk groups. Conclusions: There is a consensus that clinical symptoms need to receive more attention in establishing a diagnosis. B12 laboratory markers can support the diagnosis. The severity of clinical symptoms, the causes of B12 deficiency and the treatment goals govern decisions regarding the route and dose of B12 therapy.

Background: The effect of COVID-19 infection, versus the indirect effect of the pandemic on body composition remains unclear. This study investigates long-term changes in body composition in COVID–19 survivors compared to a contemporary control group. Method: This is a prospective study involving adults who had a pre-pandemic whole-body DXA scan (DXA#1) performed between 2017 and 2019. Participants were asked to return for a repeat whole-body DXA scan (DXA#2) after the pandemic. Detailed data were collected including medical and COVID history. Inflammation markers and fasting lipids were measured. For those participants who had a COVID-19 infection between the 2 DXAs, DXA#2 was acquired at least one year after COVID-19 infection. Results: Overall, 160 adults were enrolled; 32.5% females, 51.8% non-white, with mean age of 43.2 years. Half (n=80) of the participants had documented COVID infection between their 2 DXA scans (COVID+ group), and the other half never had COVID. COVID-negative participants had an increase in annualized trunk fat (g) [922.5 vs. 159.7; P=0.01], total fat (g) [1564.3 vs. 199.9; P=0.2], and LBM (g) [974.9 vs. -64.5; P=0.0002], when compared to COVID+ group. However, among the COVID+ group, no differences were seen in annualized trunk fat, total fat mass, or LBM between those with PASC and without (p>0.05). Conclusion: During the pandemic, both COVID-19-survivors and COVID-negative groups exhibited increases in weight, and total and trunk fat, likely associated with pandemic-linked lifestyle modifications. However, only COVID-19-survivors had a decline in lean body mass over the same period, regardless of PASC symptoms.

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

(1) Background: Sleep disordered breathing represent a growing public health concern, especially among children and adolescents. Full-night polysomnography is considered the gold standard for diagnosing obstructive sleep apnea. Our goals are to identify personal and environmental risk factors for the onset and persistence of sleep respiratory disorders. We also want to investigate the differences in neuropsychological profiles; (2) Methods: This is an observational, retrospective cohort study. We collected information on adenoidectomy or adenotonsillectomy. We reviewed the clinical history and preoperative visits and collected data through a telephone questionnaire. Pediatric Sleep Questionnaire (PSQ) and the Pediatric Quality of Life Inventory (PedsQL) are questionnaires used for screening sleep respiratory disorders in children. The data were statistically analyzed it using SPSS version 22.0 for Windows (SPSS Inc., Chicago, IL); (3) Results: The study involved 138 patients, but only 100 parents participated. A higher percentage of patients with sleep disordered breathing were observed to have mothers who smoked during pregnancy. A smaller proportion of patients with sleep disordered breathing had a habit of using a pacifier. A rise in physical results is associated with a reduction in the PSQ at follow-up (p=0.051). An increase of overall academic achievement is associated with an average decrease in the PSQ at follow-up (p<0.0001). A more significant proportion of patients undergoing adenotonsillectomy were observed to have a history of prematurity and cesarean birth (4) Conclusions: These results provide essential information on the effectiveness and effects of adenotonsillectomy intervention compared to adenoidectomy intervention and the factors associated with SDB in children undergoing these interventions.

With the global objectives of achieving a ‘carbon peak’ and ‘carbon neutrality’, along with the implementation of carbon reduction policies, China’s industrial structure has undergone significant adjustments, resulting in constraints on high-energy consumption and high-emission industries while promoting the rapid growth of green industries. Consequently, these changes have led to an increasingly complex power system structure and presented new challenges for electricity demand forecasting. To address this issue, this study proposes a 24-step multivariate time series short-term load forecasting algorithm model based on KNN data imputation and BiTCN bidirectional temporal convolutional networks combined with BiGRU bidirectional gated recurrent units and attention mechanism. The Kepler adaptive optimization algorithm (KOA) is employed for hyperparameter optimization to effectively enhance prediction accuracy. Furthermore, using real load data from a wind farm in Xinjiang as an example, this paper predicts the electricity load from January 1st to December 30th in 2019. Experimental results demonstrate that our comprehensive short-term load forecasting model exhibits lower prediction errors and superior performance compared to traditional methods, thus holding great value for practical applications.

The intense motion of a ship can greatly impacts the comfort of crew members and the safety of the vessel. Therefore, accurately estimating and predicting ship attitudes has become an important issue. This paper introduces the latest development in functional deep learning model called DeepOnet. It takes wave height as input and ship motion as output, using a cause-to-result prediction approach. The modeling data used in this study is sourced from publicly available experimental data from the Iowa Institute of Hydraulic Research. Firstly, parameters system tuning was conducted for the neural network's hyperparameters to determine the appropriate combination of parameters. Secondly, the DeepOnet model for wave height and multi-degree-of-freedom motion was established, and the influence of increasing time steps on prediction accuracy was examined. Finally, a comparison was made between the DeepOnet model and the classical time series model LSTM. It was found that the DeepOnet model had a 10-fold improvement in accuracy for roll and heave attitudes. Moreover, as the forecast duration increased, the advantage of DeepOnet showed a trend of strengthening. As a functional prediction model, DeepOnet provides a new promising tool for very short-term prediction of ship motion.

This study introduces a novel method for early prediction of Kimchi cabbage (Brassica rapa subsp. pekinensis (Lour.) Hanelt) height, utilizing drone imagery and a long short-term memory (LSTM) model. The research was conducted on a testbed at the National Institute of Agricultural Sciences (NAS) in South Korea, encompassing two distinct soil types (loam and sandy loam) to investigate their impact on growth. High-resolution drone images were captured throughout the growing season to generate a canopy height model (CHM) for estimating plant height at various stages. Missing height data were interpolated using a logistic growth curve, and an LSTM model was trained on this data to predict the final height of Kimchi cabbage at harvest. Three LSTM models were developed using time-series data collected at 29, 36, and 44 days after planting (DAP). The model trained on data from DAP 44 demonstrated the highest accuracy with a coefficient of determination (R²) of 0.83, a mean absolute error (MAE) of 2.48 cm, and a root mean square error (RMSE) of 3.26 cm, outperforming models trained on earlier data. Color-coded maps were generated to visualize the spatial distribution of predicted Kimchi cabbage heights, revealing variations in growth patterns across the testbed and confirming the model's potential for site-specific management. Considering the trade-off between accuracy and prediction timing, the model trained on DAP 36 data (MAE = 2.77 cm) was deemed optimal for informing cultivation management decisions. This research demonstrates the feasibility and effectiveness of integrating drone imagery, logistic growth curves, and LSTM models for early and accurate prediction of Kimchi cabbage height. The proposed technology enables data-driven decision-making for farmers, facilitating timely interventions based on predicted growth patterns. This could lead to improved crop yields, resource optimization, and a more sustainable agricultural future. Future research will focus on refining the model's accuracy and exploring its applicability to other crops, further expanding the potential of precision agriculture technologies.

Urea cycle disorders (UCDs) are common inborn errors of metabolism, with an incidence of one in 30,000 births. They are caused by deficiencies in any of six enzymes and two carrier proteins, the most common being Ornithine Transcarbamylase Deficiency (OTCD). OTCD results in impairment to excrete nitrogen, causing toxic buildup of ammonia with resultant encephalopathy. Hyperammonemia (HA) induces the conversion of glutamate to glutamine in the brain. Excess glutamine in the brain causes osmotic changes cerebral edema, changes in astrocyte morphology, and cell death. Acute symptoms of HA include vomiting, hyperventilation, seizures, and irritability. Long-term neurological changes include deficits in working memory and executive function. To date, there are no predictors of prognosis of infants with neonatal onset OTCD outside of plasma ammonia level at presentation and duration of hyperammonemic coma. We provide a comprehensive analysis of a 16-year-old male with neonatal onset of OTCD as an example of how brain biomarkers may be useful to monitor disease course and outcome. This male presented at 8 days post natal with plasma ammonia and glutamine of 677 and 4024 micromol/L and had a missense mutation in Exon 4 (p.R129H). Treatment included protein restriction, sodium benzoate, and citrulline, arginine, and iron. He suffered recurrent acute hyperammonemic episodes despite compliance, triggered by infections or catabolic stressors. We discuss the long-term effects of the hyperammonemic episodes by following MRI based disease biomarkers.

This study examines the Soil Organic Carbon (SOC) within Greek croplands, offering a comprehensive understanding of its dynamics. SOC, a cornerstone in soil health, nutrient cycling, and global carbon dynamics, assumes critical significance in sustainable agriculture and climate change mitigation. Drawing on diverse soil properties, including pH, soil texture as well as different drainage and slope categories, the research explores the nuanced relationships shaping SOC dynamics in the diverse agroecological landscape of Greece. The investigation transcends local boundaries, emphasizing SOC's global role in climate change mitigation by sequestering carbon dioxide. Two maps were used as data sources: 1) SOC stock baseline map (2010) by JRC, 2) SOC stock map (2021) by the Institute of Soil and Water Resources, Hellenic Agricultural Organization – DIMITRA in collaboration with FAO. Greek croplands emerge as a mosaic of agroecological diversity, where anthropogenic activities wield transformative influences on SOC stock, demanding a delicate balance between agricultural productivity and soil health. The study unveils the influence of Soil Order, weaving a tapestry of SOC variability. Microscopic factors, from soil texture to cation exchange capacity, further shape SOC dynamics, emphasizing the role of clayey soils and coarse materials in carbon retention. Although soil organic carbon decreased from 2010 to 2021 the degree of carbon loss varied. This scientific endeavor synthesizes existing knowledge and unveils novel insights, offering a narrative woven from diverse soil properties. The findings contribute valuable insights for sustainable land management practices and climate change mitigation strategies, underscoring the importance of region-specific approaches in addressing global challenges.

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

Responsible, efficient, and environmentally conscious energy consumption practices are increasingly essential for ensuring the reliability of the modern electricity grid. This study focuses on leveraging time series analysis to improve forecasting accuracy, crucial for various application domains where real-world time series data often exhibit complex, non-linear patterns. Our approach advocates for utilizing Long Short Term Memory (LSTM) and Bidirectional LSTM (BiLSTM) models for precise time series forecasting. To ensure a fair evaluation, we compare the performance of our proposed approach with traditional neural networks, time-series forecasting methods, and conventional decline curves. Additionally, individual models based on LSTM, Bi-LSTM, and other machine learning methods are implemented for a comprehensive assessment. Experimental results consistently demonstrate that our proposed model outperforms all benchmarking methods in terms of mean absolute error (MAE) across most datasets. Addressing the imbalance between activations by consumer and prosumer groups, our predictions show superior performance compared to several traditional forecasting methods, such as the Autoregressive Integrated Moving Average model (ARIMA) and Seasonal Autoregressive Integrated Moving Average model (SARIMA). Specifically, the root mean square error (RMSE) of Bi-LSTM is 5.35%, 46.08%, and 50.6% lower than LSTM, ARIMA, and SARIMA, respectively, on the May test data.

Background: Pediatric mallet finger injuries lack specific treatment guidelines, necessitating an exploration of effective techniques. Our aim was to evaluate the outcomes of the extension block technique in adolescent mallet finger management. Methods: A comprehensive retrospective analysis was conducted involving 36 adolescents who underwent surgery between 2014 and 2022. Ishiguro’s extension block pinning technique was the primary method employed. Treatment outcomes were evaluated using Crawford's criteria, and complications were also assessed. Results: Bone union was achieved in all cases with a mean union time of 42 days (range: 30-92 days). According to Crawford's criteria, 27 cases (75%) were classified as excellent, 5 cases (14%) as good, and 4 cases (11%) as fair. Minimal complications were observed, including three cases (8%) of superficial infections, one case (3%) of dermal necrosis, and another rare instance (3%) of osteomyelitis. No cases of poor outcomes or significant long-term complications were noted. The average follow-up period was 8.6 months (range: 2-42 months). Conclusions: Ishiguro’s extension block technique is a promising surgical option for adolescent mallet fingers. Its adoption could enhance pediatric orthopedic care, offering a valuable child-friendly treatment alternative.

Newborn screening (NBS) is hailed as a public health success, but little is known about long-term outcomes following a positive newborn screen. There has been difficulty gathering long-term follow-up (LTFU) data consistently, reliably, and with minimal effort. Six programs developed and tested a core set of minimal LTFU data elements. After an iterative data collection process and the development of a data collection tool, the group agreed on minimal LTFU data elements. The denominator captured all infants with an NBS diagnosis, accounting for children who moved or died prior to the follow-up year. They also agreed on three LTFU outcomes: if the child was still alive, had contact with a specialist, and received appropriate care specific to their diagnosis within the year. The six programs representing NBS public health programs, clinical providers, and research programs provided data across multiple NBS disorders. In 2022, 83.8% (563/672) of the children identified by the LTFU programs were alive and living in the jurisdiction; of those, 92.0% (518/563) saw a specialist, and 87.7% (494/563) received appropriate care. The core LTFU data elements can be applied as a foundation to address the impact of early diagnosis by NBS within and across jurisdictions.

Management of chronic inflammation and wounds has always been a key issue in the pharmaceutical and healthcare sector. Curcumin (CCM) is an active ingredient extracted from turmeric rhizomes that has antioxidant, anti-inflammatory, and antibacterial activities, thus showing significant effectiveness toward wound healing. However, its shortcomings such as poor water solubility, poor chemical stability and fast metabolic rate limit its bioavailability and long-term use. In this context, hydrogels appear to be a versatile matrix for carrying and stabilizing drugs due to the biomimetic structure, soft porous microarchitecture, and pleasant biomechanical properties. The drug loading/releasing efficiencies can also be controlled by use of highly crystalline and porous metal organic frameworks (MOFs). Here, a flexible hydrogel composed of sodium alginate (SA) matrix and CCM-loaded MOFs was constructed for long-term drug release and antibacterial activity. The morphology and physicochemical properties of composite hydrogels were analyzed by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), ultraviolet visible spectroscopy (UV-Vis), Raman spectroscopy and mechanical property tests. The results showed that the composite hydrogel was highly twistable and bendable to mechanically comply with human skin. The as-prepared hydrogel could capture efficient CCM for slow drug release as well as effective killing of bacteria. Therefore, such composite hydrogel is expected to provide a new management system for chronic wound dressings.

During the COVID-19 pandemic, the spread of the SARS-CoV-2 virus forced many individuals to confront their mortality and worry about losing loved ones also because social distancing policies often made it impossible to say goodbye. Those not directly experiencing loss were inundated with information about COVID-19-related deaths through various media, leading to vicarious grief. This study aims to explore the long-term effects of direct and vicarious mourning on people's mental health during the COVID-19 pandemic. A sample of 171 adults (65% female) aged 19 to 66 years (mean age = 25.8, SD = 8.57) voluntarily participated in an online survey assessing self-reported psychological measures of complicated grief, anxiety, stress, depression, dispositional neuroticism, and situational anxiety using the Fear of COVID-19 Scale. MANOVA tests revealed that individuals experiencing direct mourning had extremely severe scores for anxiety, stress, and fear of COVID-19, while those without personal losses had moderate scores. Participants reporting high media exposure had higher scores for depression and stress. In line with Terror Management Theory, the study supported that people during the COVID-19 pandemic engaged more in proximal defenses than distal ones, taking health-protective measures, experiencing increased anxiety levels toward SARS-CoV-2 infection, and feeling more distressed. Additionally, vicarious mourning was more strongly associated with depression due to emotional empathy with others. The discussion also addresses the strengths and limitations of the study.

The European Union Water Framework Directive (2000/60/EC; WFD) aims to achieve a good ecological and chemical status of all bodies of surface water by 2027. The development of an integrated guidance on surface water chemical monitoring (e.g. WFD Guidance Document No. 7/19) has been transferred into national German law (Ordinance for the Protection of Surface Waters, OGewV). For the majority of compounds, this act requires a monthly sampling frequency to assess the chemical water quality status of a surface water body. To evaluate the representativeness of the sampling strategy under the OGewV, high-frequency online monitoring data is investigated under different sampling scenarios and compared with current, monthly grab sampling strategy. About 23 million data points were analyzed for this study, three chemical parameters (dissolved oxygen, nitrate-nitrogen, chloride concentration) and discharge data were selected from four catchment of different sizes ranging from 51391 km² to 84 km² (Elbe, Vereinigte Mulde, Neiße and two stations at Lockwitzbach). In this paper we proposed short-term online-monitoring (STOM) as a sampling alternative. STOM considers the placement of online sensors over a limited duration and return interval. In general we: (I) compare the results of conventional grab sampling with STOM, (II) investigate the different performance of STOM and grab sampling using discharge data as proxy for analyzing event-mobilized pollutants and (III) investigate the related uncertainties and costs of both sampling methods. Results show, that STOM outperforms grab sampling for parameters where minimum/maximum concentrations are required by law as the probability to catch a single extreme value is higher with STOM. Furthermore, parameters showing a pronounced diurnal pattern, like dissolved oxygen, are also captured considerably better. The performance of STOM showed no substantial improvements for parameters with small concentration variability, as nitrogen-nitrate The analysis of discharge events as a proxy parameter for event-mobilized pollutants proved that the probability of capturing samples during events is significantly increased by STOM.

Direct and indirect effects after mine operations cease must ideally be subject to perpetual monitoring routines in order to detect possible risks or avoid adverse effects on the surrounding ecosystems at an early stage. In this contribution, mining subsidence lakes created inside the nature reserve Kirchheller Heide and Hilsfeld Forest are subjected to analysis for a long-term monitoring scheme. For this purpose, we employ high-resolution unmanned aerial system (UAS)-based multispectral and thermal mapping tools to provide a fast, non-invasive and multitemporal environmental monitoring method. Specifically, we propose to monitor vegetation evolution through multispectral analysis, biotypes identification using machine learning algorithms, and water surface extent detection, together with their thermal behavior. The aim of this contribution is to present the proposed workflow and first results to establish a baseline for future analyses and subsequent surveys for longterm multi-temporal monitoring

With the rapid development of technology and the advancement of Internet technology, various social networking platforms are gradually coming into people's view and occupying a higher and higher position. In the recommendation scenario, the user-item interaction naturally forms a bipartite heterogeneous graph structure and with the development of graph embedding and graph neural network technologies based on deep learning to process graph domain information, the combination of graph information and recommendation systems shows strong research potential and application prospects. The methodological improvement of the recommendation algorithm based on collaborative filtering takes advantage of the nature that user-items can form a bipartite graph in the recommendation scenario. The existing methods still have some shortcomings. The methods that only use weights or convolutional recurrent neural networks to implicitly model different historical behaviors lack explicit modeling of video switching relationships in serialized behaviors. The user's interest is changing all the time, so it is not possible to recommend based on the user's history, and it is necessary to consider both the long-term and short-term interest of the user according to the video content in order to achieve accurate recommendation of short videos. In this paper, we design a recommendation model based on graph neural network, which models users' long-term and short-term interests by two vector propagation methods, respectively.

This study introduces a comparative analysis of two deep learning (multilayer perceptron neural networks (MLP-NN) and the long short term memory networks (LSTMN)) models for transit travel time prediction. The two models were trained and tested using one-year worth of data for a bus route in Blacksburg, Virginia. In this study, the travel time was predicted between each two successive stations to all the model to be extended to include bus dwell times. Additionally, two additional models were developed for each category (MLP of LSTM): one for only segments including controlled intersections (controlled segments) and another for segments with no control devices along them (uncontrolled segments). The results show that the LSTM models outperform the MLP models with a RMSE of 17.69 sec compared to 18.81 sec. When splitting the data into controlled and uncontrolled segments, the RMSE values reduced to 17.33 sec for the controlled segments and 4.28 sec for the uncontrolled segments when applying the LSTM model. Whereas, the RMSE values were 19.39 sec for the controlled segments and 4.67 sec for the uncontrolled segments when applying the MLP model. These results demonstrate that the uncertainty in traffic conditions introduced by traffic control devices has a significant impact on travel time predictions. Nonetheless, the results demonstrate that the LSTMN is a promising tool that can has the ability to account for the temporal correlation within the data. The developed models are also promising tools for reasonable travel time predictions in transit applications.

The long-term use of fertilizers and pesticides in conventional cultivation has resulted in a decrease in soil productivity and vegetable yields in greenhouses. However, only a limited number of studies have explored the impacts of organic cultivation on greenhouse soil. Specifically, there is a scarcity of research examining the alterations in soil aggregate mediated organic carbon and microbial communities, which are known to enhance soil productivity. This study investigated the properties of soil aggregates, including the levels of organic carbon fractions, microbial community, and enzyme activity with the three aggregate classes microaggregates (<0.25 mm), small macroaggregates (2-0.25 mm) and large macroaggregates (>2 mm). These investigations were conducted under three different cultivation methods in a greenhouse: conventional cultivation (CC), integrated cultivation (IC), and organic cultivation (OC) in greenhouse. The results showed that (1) OC and IC promoted the formation of small macro-aggregates and enhanced aggregate stability compared to CC, (2) SOC in the three size fractions of OC increased by 98.99%-92.06% compared to CC; EOC increased by 98.47%-117.59%; POC increased by 138.59%-208.70%; MBC increased by 104.71%-230.61%; DOC increased by 21.93%-40.90%, respectively; (3) Organic cultivation significantly increased enzyme activity in all three particle size aggregates and increased the relative abundance of bacteria in micro-aggregates as well as the relative abundance of fungi in small macro-aggregates. Structural equation model (SEM) analysis revealed that organic farming practices fostered the development of smaller macro-aggregates, elevated microbial and enzyme activities within soil aggregates, and facilitated the conversion of soil nutrients and carbon sequestration. consequently, this led to an increase in soil organic carbon content and improved vegetable yield in greenhouse environments. In conclusion, the soil carbon content and vegetable yield are enhanced through long-term organic cultivation in greenhouses, primarily by increasing the proportion of small macro-aggregates.

The statistical analysis of impact of the top 50 solar flares of X-class (1997-2023) on the global seismic activity, as well as on the earthquake preparation zones located in illuminated part of the globe and in the area of 5000 km radius around the subsolar point was carried out. It is shown by a method of epoch superposition that for all cases the increase of seismicity is observed, especially in the region around the subsolar point (up to 38%) during 10 days after the solar flare in comparison with preceding 10 days. The case study of aftershock sequence of strong M=9.1 earthquake (Su-matra-Andaman Islands, 26.12.2004) after the solar flare of X7.2 class (20.01.2005) demonstrated that the number of aftershocks with magnitude M≥2.5 increases more than 20 times after the solar flare with a delay of 7 days. For the case of the Darfield earthquake (M=7.1, 04.09.2010, New Zealand) it was shown that strong solar flares of class X and M probably triggered two strong aftershocks (M>6) with the same delay of 6 days on the Port Hills fault, which is the most sensitive to external electromagnetic impact from point of view of the fault electrical conductivity and orientation. Based on the obtained results the possible application of natural electromagnetic triggering of earthquakes is discussed for a short-term earthquake prediction using confidently recorded strong external electromagnetic triggering impacts on the specific earthquake preparation zones, as well as ionospheric perturbations due to aerosol emission from the earthquake sources recorded by satellites.

Forest resources are renewable,rational exploitation and utilization of forest resources are not only conducive to sustainable development of population, but also can obtain higher economic benefits. Based on actual timber harvesting problems,a combined harvesting model of timber and non-timber with nonlinear harvesting term was established.Firstly, using the qualitative theory of ordinary differential equations, the dynamic behavior of the model is studied, and the existence and stability of the equilibrium point of the model are proved .Secondly, the optimal control solution is obtained by using the optimal control theory.Finally, the optimal harvesting strategy of timber and non-timber products is given based on the numerical simulation results, which provides a certain theoretical basis for the sustainable development of forestry ecological economy.

The main proteinase (Mpro), or 3CLpro, is a critical enzyme in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lifecycle and is responsible for breaking down and releasing vital functional viral proteins crucial for virus development and transmission. As a catalytically active dimer, its dimerization interface has become an attractive target for antiviral drug development. Recent research has extensively investigated the enzymatic activity of Mpro, focusing on its role in regulating the coronavirus replication complex and its significance in virus maturation and infectivity. Computational investigations have identified four druggable pockets, suggesting potential allosteric sites beyond the substrate-binding region. Empirical validation through site-directed alanine mutagenesis targeted residues in both the active and allosteric regions corroborated these predictions. Structural studies of drug target proteins can inform therapeutic approaches, with metadynamics simulations shedding light on the role of H163 in regulating Mpro function and providing insights into its dynamic equilibrium to the wild-type enzyme. Despite the efficacy of vaccines and drugs in mitigating SARS-CoV-2 spread, ongoing viral evolution, selective pressures, and continued transmission pose challenges, potentially leading to resistance mutations. Phylogenetic analyses indicated the existence of several resistance variations predating drug introduction to the human population, emphasizing the likelihood of drug spread. Hydrogen/deuterium-exchange mass spectrometry reveals the structural influence of the mutation, while clinical trials on 3CLPro inhibitors underscore the clinical significance of reduced enzymatic activity and offer avenues for future therapeutic exploration. Understanding the implications of 3CLPro mutations holds promise for shaping forthcoming therapeutic strategies against COVID-19. This review delves into factors influencing mutation rates and identifies areas warranting further investigation, providing a comprehensive overview of Mpro mutations, their categorization, and terminology. Moreover, we examined their associations with clinical outcomes, illness severity, unresolved issues, and future research prospects, including their impact on vaccine efficacy and potential therapeutic targeting.

Background/Objectives: The global burden of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing at an alarming rate. Cardiovascular disease (CVD) is the leading cause of mortality in MASLD patients, therefore, the therapeutic interventions for MASLD should improve coronary risk factors such as obesity, diabetes and dyslipidemia, in addition to improving liver function. The evidence on effect of sodium-glucose cotransporter 2 inhibitors (SGLT2is) which have beneficial pharmacological properties for MASLD, especially the long-term effects, on the progression of MASLD in Asian population is very limited. Methods: The retrospective longitudinal study was performed by using the medical records at the National Center for Global Health and Medicine, Kohnodai Hospital, Japan. We picked up patients with type 2 diabetes who had taken SGLT2is for at least 3 years or longer between April 1, 2014 and March 31, 2018. We collected the data on metabolic parameters, including blood tests and anthropometric parameters, and compared the data before and after the initiation of SGLT2is treatment. Results: During the observation period, 324 patients had taken SGLT2is for 3 years. The 3-year-SGLT2is treatment significantly reduced body weight, hemoglobin A1c, low-density lipoprotein-cholesterol, triglyceride and non-high-density lipoprotein-cholesterol (HDL-C) and significantly increased HDL-C. Furthermore, this treatment significantly improved liver function and the markers for hepatic steatosis and hepatic fibrosis. Conclusions: Considering that the development of CVD determines the prognosis of MASLD patients, the long-term SGLT2is treatment may be an ideal therapy for MASLD patients.

The NP method was used to elucidate the contributions of vehicles and coal combustion to seasonal and long-term atmospheric PM-bound Pyr and 1-NP concentrations in Kanazawa, Kitakyushu, Shenyang, and Shanghai in the Western Pacific region from 1997 to 2021. Among the four cities, Kanazawa demonstrated the lowest Pyr concentration. The contribution of vehicles to Pyr before and after 2010 were 35% and 5%, respectively. The 1-NP concentration reduced by a factor of more than 1/10. These changes can be attributed to the emission control from vehicles. Kitakyushu revealed the second lowest Pyr and the lowest 1-NP concentrations. Coal combustion was found to be the main contributor to Pyr, while its contribution to 1-NP increased from 9% to 19%. The large contribution of coal combustion is attributed to iron manufactures. Shenyang demonstrated the highest atmospheric Pyr concentration with its largest seasonal change. Vehicles are the largest contributors to 1-NP. However, coal combustion, including winter coal heating, contributed 97% or more to Pyr and more than 14% to 1-NP. Shanghai revealed the second highest Pyr and 1-NP concentrations, but the former was substantially lower than in Shenyang. Coal combustion was the major contributor, but the contribution of vehicles to Pyr was larger before 2010 similar to Kanazawa.

Accurate and reliable mid-long runoff prediction (MLTRP) is of great importance in water re-sources management. However the MLTRP is not suitable in each basin and how to evaluate the applicability of MLTRP is still a question. Therefore, the total mutual information (TMI) index is developed in this study based on the predictor selection method using mutual information (MI) and partial MI (PMI). The relationship between the TMI and the predictive performance of five models is analyzed by applying five models in 222 forecasting scenarios in Australia. The results over 222 forecasting scenarios demonstrate that, compared with the MI, the developed TMI index can better represent the available information in the predictors, and has more significant negative correlation with the RRMSE with the correlation coefficient between -0.62 and -0.85. This means the model's predictive performance will become better along with the increase of TMI, and there-fore the developed TMI index can be used to evaluate the applicability of MLTRP. When TMI is more than 0.1, the available information in the predictors can support the construction of MLTRP models. In addition, the TMI is used to partly explain the difference of predictive performance among five models. In general, the complex models, which can better utilize the contained infor-mation, are more sensitive to the TMI, and have more significant improvement in terms of predic-tive performance along with the increase of TMI. This research can provide support for the study of MLTRP.

The purpose of the evaluation of the Peruvian energy generation system is to project the electricity generation and demand until the year 2050. To achieve this, three alternative scenarios have been defined and analyzed using the LEAP (Long-range Energy Alternatives Planning) software. The scenarios are as follows: the first one, Business-as-Usual scenario, based on normal trends according to historical data and referencing projections made by Peruvian state entities; the second one is focused on Energy Efficiency, the highlighted characteristic is taking into consideration the efficient conditions in transmission and distribution of electric energy; and the third one, centered on Geothermal Energy, focused on the development of this type of energy source and prioritizing it. The primary purpose of this analysis is to identity advantages and disadvantages inherent in each scenario in order to get the best of each one. In this way, the intention is to propose solutions based on Peru’s national reality or possible uses of the country’s energy potential to supply its energy demand. Currently, Peru’s energy demand relies on fossil fuels, hydraulic, and thermal energy. However, there is the possibility of transforming this system into a sustainable one, by strengthening existing and growing energy sources such as solar and wind energy, and new technologies for hydraulic and thermal energy, in addition to considering geothermal energy as the main energy source in the third scenario. The new system mentioned satisfactorily indicate that the CO2 equivalent emissions decrease significantly in the third scenario, with a 15.8% reduction compared to the first scenario and a 9.7% reduction in comparison to the second. On the other hand, the second scenario shows a 5.6% decrease in CO2 emissions compared to the first, resulting from improvements in technology and energy efficiency without requiring significant modifications or considerable investments, as in the third scenario.

The focus of our study was the changes in the composition of semi-natural dry grasslands in Hungary. Since these valuable habitats were created with the help of humans, their preservation also requires regular treatment. Our mowing experiment aimed to investigate the suppression of the native Calamagrostis epigejos L. Roth. In Hungary, in the Cserhát Mountains, eight permanent plots were mowed twice a year. The vegetation was sampled annually between 2001 and 2011. The effects of mowing were investigated with repeated measures analysis of variance (ANOVA). After 10 years, the C. epigejos cover of the mowed plots decreased significantly, from the initial average of 62.38 to 7.50%. Surprisingly, we also experienced a similar decrease in the control plots. Regular treatment also had a positive effect on the number of species and diversity. Species richness increased continuously in both treatment types, which indicates the combined effect of vegetation succession and treatment. The biomass growth of other Poaceae and Fabaceae species, which are important from a grassland management perspective, was also facilitated by mowing. Our results suggest that long-term in situ experiments and continuous botanical studies are needed to establish a reliable utilization of grasslands.

Objective: The long-term care insurance (LTCI) system was introduced in 2000 to provide financial support for long-term care services to older adults. What is known on this topic report focuses on a comparative analysis of how the LTCI system has affected older people in Japan. Methods: We obtained data from the literature about the LTCI system, compared and analysed the collected articles, and concluded. Results: The LTCI system has improved access to long-term care services, with more older adults receiving care than before the system’s implementation. This service has improved the quality of life for many elderly individuals who require assistance with daily activities. Furthermore, the LTCI system has alleviated the financial burden of long-term care services since the insurance covers a large portion of the costs. It has made older adults maintain their independence and dignity, as they can afford the necessary care without relying solely on their savings or burdening their families. Conclusions: Japan’s LTCI system has positively impacted older adults by improving access to long-term care services and alleviating financial burdens. However, challenges such as increasing demand and variations in service quality need to be addressed to ensure the system effectively supports older people in Japan.

Background/Objectives: The purpose of this study was to evaluate the relationship between 1-year mortality and health insurance benefit extension policy items in severe pneumonia pa-tients requiring mechanical ventilation using a South Korean nationwide cohort. Methods: A nationwide population-based retrospective study was conducted using the Korean National Health Insurance database. A total of 1,099 patients (542 patients in the health insurance benefit item group and 557 patients in the control group) were included. The primary outcome was 1-year mortality. Results: Among patients with health insurance benefit extension policy items, 203 patients (37.5%) were diagnosed with hemato-oncological disease, who were categorized as group A, and 339 patients (62.5%) were diagnosed with cerebrovascular, cardiovascular, or rare diseases, who were categorized as group B. Group B had lower 1-year mortality (50.7% vs. 62.5%, P

Ambiguity exists over treatment and surveillance strategies after endoscopic submucosal dissec-tion (ESD) for esophageal squamous cell neoplasia (ESCN) with unfavorable histologic features. This study investigated the long-term outcomes of ESD in high-risk ESCN patients. We retro-spectively included early ESCN patients treated with ESD at two medical centers in Taiwan be-tween August 2010 and December 2023. Demographic, endoscopic, and pathological data were collected. Among 146 patients (mean age 59.17 years) with 183 lesions, 73 (50%) had a history of head and neck cancer (HNC). En bloc and R0 resection were achieved in 100% and 95.6% of the lesions, respectively. The 5-year overall survival (OS), disease-specific survival (DSS) and local recurrence rates were 42.7%, 94.7% and 11%. R0 resection was significantly associated with re-currence in univariate analysis (adjusted OR: 0.23, 95% CI: 0.05-0.99, P=0.05). Alcohol abstinence was independently associated with lower recurrence (adjusted OR: 0.20, 95% CI: 0.08-0.48, P

Objective: The effect of long-term performance of one-bottle or two-bottle bonding agents on the shear bond strength to lithium disilicate ceramics (LDS) were to investigate, and the long-term performance of the bond strength of two-bottle bonding agent (Tokuyama Universal Bond II) was investigated under conditions without hydrofluoric acid solution (abbreviated as HF)-pretreatment of LDS. Methods: Nine resin cements (both self-adhesive and adhesive types) were used. It was investigated 1) the adhesion strength of various resin cements to LDS from the presence or absence of HF-treatment, 2) to determine the effect of the deterioration in three times [after one-day storage (abbreviated as Base), and after 5,000 & 20,000 thermocycles (abbreviated as TC 5k and TC 20k)] of one- and two-component bonding agents. And the difference in degradation between one- and two-component bonding gents consist of the silane coupling agent was performed by chemical analysis (High Performance Liquid Chromatography). Results: The trends of resin cements were statistically not very different for each cement 3 times with HF-conditions. Also ESTECEM II and Super-Bond Universal showed the significant greatest values in two conditions (TC 5k and TC 20k) without HF-condition. In TC 20k, ESTECEM II & Super-Bond Universal showed significantly better results than others when treated with the recommended bonding agents without HF-condition. In TC 20k, there was not much statistically significant difference if pretreated with Tokuyama Universal Bond II without HF-condition. Significance: When using LDS, it was found that long-term durability could be maintained by pretreating with Tokuyama Universal Bond II without pretreating with various hazardous HFs.

Introduction: The environmentally acquired aerobic spore-forming (EAS-Fs) bacteria that are ubiquitous in nature (e.g. soil) are transient colonisers of the mammalian gastro-intestinal tract. Without regular exposure, their numbers quickly diminish. These species of bacteria have been suggested to be essential to the normal functioning of metabolic and immunogenic health. The modern Western lifestyle restricts exposure to these EAS-Fs, possibly explaining part of the pathogenesis of many Western diseases. To date, the only animal studies that address specific microbiome modelling are based around germ-free animals. We have designed a new animal model that specifically restricts exposure to environmental sources of bacteria. Methodology: A new protocol, termed Super Clean, that involves housing mice in autoclaved individually ventilated cages (IVCs), with autoclaved food / water, and strict ascetic handling practice was first experimentally validated. The quantification of EAS-Fs was assessed by heat-treating faecal samples and measuring colony forming units (CFUs). This was then compared to mice in standard-conditions. Mice were housed in their respective groups from birth until 18 months. Stool samples were taken throughout the experiment to assess for abundance in transiently acquired environmental bacteria. Clinical, biochemical, histological, and gene expression markers were analysed for diabetes, hypercholesterolaemia, obesity, inflammatory bowel disease, and non-alcoholic fatty liver disease (the “diseases of the West”). Results: Our results show that stringent adherence to the Super Clean protocol produces a significantly decreased abundance of aerobic spore-forming Bacillota after 21 days. This microbiomic shift was correlated with significantly increased levels of obesity and impaired glucose metabolism. There was no evidence of colitis, liver disease or hypercholesterolaemia. Conclusion: This new murine model successfully isolates EAS-Fs, and has the potential utility for future research allowing for the investigation into the clinical impact living in relative hygienic conditions

With the development of salt cavern gas storage construction technology, the construction of large-scale gas storage salt caverns using sediment voids is expected to solve the problem of low effective volume formation rate and poor construction economy of high-impurity salt mines. There are few studies on the long-term operation mechanical behavior of salt cavern gas storage under the influence of sediment accumulation currently. This paper studies the influence of sediment accumulation height, particle gradation, and operating pressure on the stability of salt caverns by constructing a coupling model of sediment particle discontinuous medium and surrounding rock continuous medium. The continuous-discontinuous coupling algorithm is suitable for analyzing the influence of particle accumulation height and particle gradation on the creep shrinkage of salt caverns. The increase of sediment accumulation height slows down the creep shrinkage of the bottom of the salt cavern, strengthens the restraining effect on the surrounding rock of the cavern, and moves the position of the maximum displacement of the surrounding rock to the upper part of the cavern; the sediment particle gradation has little effect on the cavern volume shrinkage rate, and the greater the coarse particle content, the smaller the cavern volume shrinkage rate; the greater the operating pressure, the more conducive to maintaining the stability of the cavern, slowing down the upward movement of the sediment body and increasing the gas storage space in the upper part of the cavern. This research results can provide a reference for evaluating the long-term operation stability of sediment-type high-impurity salt cavern gas storage.

This study proposes a short- and medium-term electricity consumption prediction algorithm by combining the GRU model suitable for long-term forecasting and the Prophet model suitable for seasonality and event handling. (1) Manufacturing Company B's Electricity consumption data and meteorological data in Naju, Jeollanam-do, South Korea are collected and preprocessed. (2) The preprocessed data proposes the Prophet model in the first step for seasonality and event handling prediction. (3) In the second step, seven multivariate data are experimented with GRU. Specifically, the seven multivariate data consist of six meteorological data and the residuals between the predicted data from the proposed Prophet model in Step 1 and the observed data. These are utilized to predict electricity consumption at 15-minute intervals. (4) Electricity consumption is predicted for short-term (2 days and 7 days) and medium-term (15 days and 30 days) scenarios. The experimental results demonstrate that the proposed method outperforms the conventional Prophet model by more than 23 times and the modified GRU model by more than 2 times in terms of MAPE.

This paper investigates portfolio optimization methodologies and short-term investment strate-gies in the context of the cryptocurrency market, focusing on ten major cryptocurrencies from January 2020 to November 2023. We employ high frequency data and utilize the Kurtosis Mini-mization methodology, alongside other optimization strategies, to construct and evaluate port-folios under different rebalancing frequencies. The empirical analysis reveals that cryptocurren-cies exhibit significant volatility, skewness, and kurtosis, necessitating sophisticated portfolio management techniques. We find that the Kurtosis Minimization methodology consistently outperforms other optimization strategies, delivering optimal returns to investors, particularly in shorter-term investment horizons. We demonstrate the diversification benefits of integrating cryptocurrencies into multi-asset portfolios and emphasize the importance of regular portfolio rebalancing in the volatile cryptocurrency market. Our findings offer insights for portfolio man-agers and investors seeking to optimize their investment outcomes in the cryptocurrency market, highlighting the importance of risk management, diversification, and dynamic portfolio man-agement strategies.

The present study examines the long-term care service awareness, needs, and usage intention of elderly male homosexuals in Taiwan and their ideal long-term care service model. This study of five elderly male homosexual subjects aged 66 to 73 years was intended as a preliminary exploration. Interviews were used to collect data. The study determined that the five subjects had high awareness of long-term care services, as they had actual experience of long-term care services or even participated in care service staff training to obtain certificates. Some even had experience in applying for home care services and experienced problems during use. The subjects perceived that they were very likely to require long-term care services in the future and tended to use home care services if they required long-term care services. Due to their personal experiences, the subjects had negative awareness of long-term care services and worried that long-term care service staff had poor attitudes toward homosexuals. The subjects considered the most important aspects of long-term care to be basic medical care and lifestyle care. However, they worried that long-term care staff would delay or refuse to provide such services due to the subjects’ sexual orientation or stereotypes, and they were concerned above all about the “friendly attitude” of long-term care staff. They hoped that long-term care staff were friendly toward homosexuals and did not discriminate against them, and they felt that it would be more appropriate for homosexual long-term care staff to provide assistance. In terms of vision, while preferring organizations with homosexual employees, the subjects worried that they would be stigmatized and discriminated against . With regard to ideal long-term care services, while considering institutions with homosexual staff to be ideal, the subjects also worried that these would be labeled as institutions that were dedicated to homosexuals, potentially resulting in discrimination. Therefore, they hoped that the sexuality sensitivity of long-term care staff could be improved and that they would undergo professional continuing education to learn about homosexuals, the situation and care needs of homosexuals, and care techniques for homosexuals.

This study investigates the long-term stability of the Suomi National Polar-orbiting Partnership (S-NPP) Visible Infrared Imaging Radiometer Suite (VIIRS) moderate-resolution Thermal Emissive Bands (M TEBs; M12 – M16) covering a period from February 2012 to August 2020. It also assesses inter-sensor consistency of the VIIRS M TEBs among three satellites-S-NPP, NOAA-20, and NOAA-21 over eight months spanning from March 18 to November 30, 2023. The field of interesting is limited to the ocean surface between 60°S and 60°N, specifically under clear-sky conditions. Taking radiative transfer modeling (RTM) as the transfer reference, we employed the Community Radiative Transfer Model (CRTM) to simulate VIIRS TEB brightness temperature (BTs), incorporating European Centre for Medium-range Weather Forecasts (ECMWF) reanalysis data as inputs. Our results reveal two key findings. Firstly, the reprocessed S-NPP VIIRS TEBs exhibit a robust long-term stability, as demonstrated through analyses of the observation minus background BT differences (O-B ∆BTs) between VIIRS measurements (O) and CRTM simulations (B). The drifts of the O-B BT differences are consistently less than 0.105 K/Decade across all S-NPP VIIRS M TEB bands. Notably, observations from VIIRS M14 and M16 stand out with drifts well within 0.04 K/Decade, reinforcing their exceptional reliability for climate change studies. Secondly, excellent inter-sensor consistency among these three VIIRS instruments is confirmed through the double-difference analysis method (O-O). This method relies on the O-B BT differences obtained from daily data. The mean inter-VIIRS O-O BT differences remain within 0.08 K for all M TEBs, except for M13. Even in the case of M13, the O-O BT differences between NOAA-21 and NOAA-20/S-NPP have values of 0.312 K and 0.234 K, respectively, which are comparable to the 0.2 K difference between some TEBs among VIIRS and MODIS. These disparities are primarily attributed to the significant differences in the Spectral Response Function (SRF) of NOAA-21 compared to NOAA-20 and S-NPP. Our study confirms the RTM-based TEB quality evaluation method’s versatility and effectiveness in assessing long-term sensor stability and inter-sensor consistency. The double-difference approach effectively mitigates uncertainties and biases inherent to CRTM simulations, establishing itself a robust mechanism for assessing inter-sensor consistency. In addition, we’ve observed that, except for M13, M12 always exhibits larger spatial variations of O-O BT differences with greater uncertainties compared to the other M TEBs. The influence of solar contribution through sea surface reflection on the Top of Atmosphere (TOA) radiance measurements during daytime in M12 should not be underestimated.

This work focuses on short-term forecasting of PV output power. The multilayer perception (MLP), convolutional neural networks (CNN), and k-nearest neighbour (kNN) neural networks have been used singly or in a hybrid (with other algorithms) to forecast solar PV power or global solar irradiance with good success. Their performances in forecasting PV power have been compared with other algorithms but not with themselves. The study aims to compare performance of a number of neural network algorithms in solar PV energy yield forecasting under different weather conditions. The performance of MLPNN, CNN and kNN are being compared using solar PV (hourly) energy yield data for Grahamstown, Eastern Cape, South Africa. The choice of location is part of the study parameters to provide insight into renewable energy power integration in specific areas in south Africa that may be prone to extreme weather conditions. The kNN algorithm was found to have RMSE value of 4.95% and MAE value of 2.74% at its worst performance, and RMSE value of 1.49% and MAE value of 0.85% at its best performance. It outperformed the others by a good margin and kNN could serve as a fast, easy, and accurate tool to forecast solar PV output power.

The response of plasmonic metal particles to an electromagnetic wave undergoes significant features at the nanoscale level. Different properties of the internal composition of a metal, such as its ionic background and the free electron gas, begin to manifest more prominently. As the dimensions of the nanostructures decrease, the classical local theory gradually becomes inadequate. Therefore, Maxwellʹs equations need to be supplemented with a relationship determining the dynamics of current density which is the essence of nonlocal plasmonic models. In this field of physics, the standard (linearized) hydrodynamic model (HDM) has been widely adopted with great success, serving as the basis for a variety of simulation methods. However, ongoing efforts are also being made to expand and refine it. Recently, the GNOR (general nonlocal optical response) modification of the HDM has been used, with the intention of incorporating the influence of electron gas diffusion. Clearly, from the classical description of fluid dynamics, a close relationship between viscosive damping and diffusion arises. This offers a relevant motivation for introducing the GNOR modification in an alternative manner. The standard HDM and its existing GNOR modification also do not include the influence of interband electron transitions in the conduction band and other phenomena that are part of many refining modifications of the Drude‐Lorentz and other models of metal permittivity. In this article, we present a modified version of GNOR‐HDM that incorporates the viscosive damping of the electron gas and a generalized Drude‐Lorentz term. In the selected simulations, we also introduce Landau damping which corrects the magnitude of the standard damping constant of the electron gas based on the size of the nanoparticle. We have chosen a spherical particle as a suitable object for testing and comparing HD models and their modifications because it allows finding precise analytical solutions for the interaction and, simultaneously, it is a relatively easily fabricable nanostructure in practice. Our contribution also includes our own analytical method for solving the HDM interaction of a plane wave with a spherical particle. This method forms the core of calculations of the characteristic quantities, such as the extinction cross‐sections and the corresponding components of electric fields and current densities.

Long-term, multi-decade research on planted tree survival in urban settings is sparse. One understudied urban environment is highway rights-of-way (ROW), lands adjacent to high-speed, unsignalized roadways. We conducted a re-inventory of tree planting cohort in northern Illinois, U.S. on a 48 km-long highway near Chicago which were 10-, 21-, and 30-years old to evaluate long-term patterns of survival and diversity. Using each randomly selected planting site along the highway as a unit of observation and analysis, we compared the number of trees documented in record drawing to the number of trees currently alive to determine percent survival. We evaluated 224 planting sites which originally contained 2,944 trees and collected data about the planting site location. For the oldest cohort, 26% of trees were still alive in 2018 (median survival by species = 16%, Q1 = 0%, Q3 = 48%), while 31% of the 21-year-old cohort (med. = 6%, Q1 = 0%, Q3 = 47%) and 86% of the 10-year-old cohort were still alive (med. = 85%, Q1 = 74%, Q3 = 96%). The survival of the 21- and 30-year-old cohort matches urban tree survival estimates by other researchers, while the 10-year-old survival is higher than expected. The only planting location characteristic that significantly affected survival was traffic islands (areas between the highway and entrance/exit ramps). Species with low drought tolerance were less likely to be alive for the 10-year-old cohort. Waterlogging tolerant species were more likely to be alive in the 10-year-old cohort. Since some species in the 21- and 30-year-old cohorts had very low survival, the tree species richness and diversity s in study areas declined between the initial record drawings and reinventory. This study demonstrates the challenges of maintaining long-term survival and diversity in the highway ROW and emphasizes the importance of species selection.

The optimal surgical approach for thymoma resection is still an object of debate. The increasing experience in robotic-assisted thoracic surgery (RATS) has led to the progressive affirmation of this technique as a valid alternative to Video-Assisted Thoracic Surgery (VATS), sternotomy and thoracotomy in this setting. The present study aims to compare the post-operative and short-term results of RATS Thymectomy for thymoma with those of other main surgical approaches (sternotomy, thoracotomy, and VATS) from a high-volume single center.Between May 2021 - September 2023, 40 consecutive patients underwent RATS Thymectomy for I to limited-stage III thymoma in our center. Three homogenous groups of consecutive patients who received thymic surgery by main alternative approaches (sternotomy, thoracotomy, VATS) over the last 5 years, were identified in order to perform a comparative analysis. Data of operative technique, time of surgery, associated resections, conversion rate, overall morbidity, tumor size, radicality, postoperative pain, length of hospital stay, and cosmetic results were recorded and compared between each control group and the RATS group. Tumor size was higher in the sternotomy group, but not significantly. The mean operative time of RATS interventions was significantly lower than that of sternotomy and VATS. It was significantly shorter compared to thoracotomy if excluding docking-undocking time. Higher rate of associated adjacent structures resection was reported in the sternotomy group (p=0.005). Conversion rate was significantly higher in VATS group (p= 0.026) compared to RATS. Postoperative pain at 24 and 48 hours was significantly lower in RATS group compared to the others. Improved cosmetics results were reported after RATS compared to sternotomy (p= 0.0001) and thoracotomy (p= 0.001) groups, with a trend towards better results compared to VATS (p=0.05). Length of hospital stay was shorter in the RATS group with a significant difference vs. the sternotomy group (p<0.001). These results from a single center confirm the safety and effectiveness of RATS for the treatment of limited stage thymoma. Advantage in terms of operative outcomes, post-operative pain, cosmetic results, and hospital stay was observed if compared to the alternative approaches. Short-term oncologic outcome was excellent based on the high complete excision rate of the tumor.

Simple summary This reassessment of the findings from our Phase I/II study seeks to evaluate the effectiveness of SBRT for treating local intermediate-high risk prostate cancer in the absence of androgen-deprivation therapy due to patient’s refusal, with a median follow-up of 6.5 years. Our primary focus is on analysing the treated areas compared to recurrence patterns in the seven patients who experienced local relapse. Additionally, we provide updated data on late toxicities of grade 2 or higher, both genitourinary and gastrointestinal. Abstract Objectives: We investigated spatial patterns between primary and recurrent tumor sites and assessed long-term toxicity after dose escalation stereotactic body radiation therapy (SBRT) to the dominant intraprostatic nodule (DIN). Materials and methods: In 33 patients with intermediate-high risk prostate cancer (PCa), doses up to 50 Gy were administered to the DIN. Recurrence sites were determined and compared to the original tumor development sites through multiparametric MRI and 68Ga-labelled prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (68Ga-PSMA-PET/CT) images. Overlap rates, categorized as 75% or higher for full overlap, and 25-74% for partial overlap, were assessed. Long-term toxicity is reported. Results: All patients completed treatment, with only one receiving concomitant androgen deprivation therapy (ADT). Recurrences were diagnosed after a median of 33 months (range: 17-76 months), affecting 13 out of 33 patients (39.4%). Intraprostatic recurrences occurred in 7 patients (21%), with ≥ 75% overlap in two, a partial overlap in another two, and no overlap in the remaining three patient. Notably, 5 patients with intra-prostatic recurrences had synchronous bone and/or lymph node metastases, while six patients had isolated bone or lymph node metastasis without intraprostatic recurrences. Extended follow-up revealed grade 2 or higher late GU and GI toxicity in 18% (n=6) and 6% (n=2) of the patients. Conclusions: Among patients with intermediate-high risk PCa undergoing focal dose-escalated SBRT without ADT, DIN recurrences were infrequent. When present, these recurrences were typically located at the original site or adjacent to the initial tumor. Conversely, relapses beyond the DIN and in extra-prostatic (metastatic) sites were prevalent, underscoring the significance of systemic ADT in managing this patient population. Advances in knowledge: focal dose escalated prostate SBRT prevented recurrences in the dominant nodule, however extra-prostatic recurrence sites were frequent.

By tonnage, corn (Zea Mays L.) is the #1 crop produced globally, and recent research has suggested that no-till (NT) systems can lead to reduced yields of this important crop. Additionally, there is a lack of long-term data about the effects of tillage and N management on cropping systems. Corn is the most nitrogen (N)-fertilized crop in the USA, and N losses to the environment contribute to significant impacts on air and water quality. We conducted long-term studies on conventionally tilled (CT), and conservation tillage systems such as strip tillage (ST) and NT, under different N rates. We found that immediately after conversion to NT, yields from NT were significantly lower than yields from CT (P&lt;0.1), but after five years of NT, the NT yields were 1.5% higher than the CT yields (P&lt;0.1). Initially, the NT yields were lower than the ST (P&lt;0.01), but after seven years of NT, the NT yields were comparable to ST grain yields. Although the total aboveground N uptake with NT immediately after conversion to NT was lower than with CT and ST, these differences were not significant in the long run. The nitrogen use efficiency (NUE) with NT increased over time. The present work highlights the importance of long-term research for determining the cumulative impacts of best management practices such as NT. We found that NT becomes a more viable practice after five or seven years of implementation, demonstrating the high importance of long-term research.

Abstract: Early life gut microbiota have been increasingly recognized as major contributors to short and/or long-term human health and diseases. Numerous studies have demonstrated that human gut microbial colonization begins at birth but continues to develop a succession of taxonomic abundances for two to three years until the gut microbiota reaches adult-like diversity and proportions. Several factors, including gestational age (GA), delivery mode, birth weight, feeding types, antibiotic exposure, maternal microbiome and diet influence the diversity, abundance and function of the early life gut microbiota. Gut microbial life is essential for assisting with the digestion of food substances to release nutrients, exerting control over pathogens, stimulating or modulating the immune system and influencing many systems such as the liver, brain, and endocrine system. Microbial metabolites play multiple roles in these interactions. Furthermore, studies provide evidence supporting that imbalances of the gut microbiota in early life, referred to as dysbiosis, are associated with specific childhood or adult disease outcomes, such as asthma, atopic dermatitis, diabetes, allergic diseases, obesity, cardiovascular diseases (CVD) and neurological disorders. These findings support that the human gut microbiota may play a fundamental role in the risk of acquiring diseases that may be programmed during the early life stage. In fact, it is critical to explore the role of the human gut microbiota in early life. In this review, we summarize the general understanding of the colonization and development of the gut microbiota in early life, highlighting the recent findings regarding the relationship between the gut microbiota composition and their metabolites, and immune functions, which could significantly influence long-term health and disease. We then review known pathophysiological interactions of the early gut microbiome with a number of well characterized diseases and pose potential etiological mechanisms.

The severest form of muscular dystrophy (MD) termed Duchenne MD (DMD) remains to this day an incurable disease, hence the continued effort to further develop supportive therapies. Perturbation of autophagy, a degradative yet protective mechanism activated when tissues face severe and persistent stress, is critically involved in DMD, consequently, treatments harnessing autophagic capacities represent an amenable therapeutic strategy. We studied the effects of the protective osmolyte ectoine in the standard mouse model of DMD, the MDX, zooming in on the autophagy-related proteome. From birth, mice were treated with ectoine in the drinking water (150mg/kg) or through daily intraperitoneal injection (177mg/kg) until 5 weeks old. Hind limb muscles were dissected, performing western blotting for protein quantification and immunofluorescence to investigate tissue distribution. We report significant alterations of total levels of autophagy related 5 (ATG5), Ser366 phosphorylated sequestosome 1 (SQSTM1) and heat shock protein 70 (HSP70), and of activated microtubule-associated protein 1A/1B-light chain 3 (LC3 II) in mitochondrial fractions. Ectoine tends to restore the shifted balance between LC3 II and SQSTM1 levels observed in MDX muscle, and LC3 II upregulation was most pronounced on muscle fibers of MDX treated with ectoine in the drinking water. Findings from this explorative study support a possible beneficial effect of ectoine on the autophagic deficit in the MDX, which warrants its further exploration as a therapeutic supplement for DMD.

Grazing exclusion has been proved to be one of the main measures for rehabilitating degraded arid steppes. However, the effect of this management practice on plant species diversity and composition is ambiguous, specially under prolonged droughts. Concurrently considering the responses of individual plant species, diversity of functional groups, α-diversity, and β-diversity (and its components) may be crucial to the holistic understanding of grazing exclusion effects on plant communities under drought conditions. Here, we investigated the response of these diversity measures to short-term sheep exclusion under severe drought episode in arid steppes of Alfa-grass (Stipa tenacissima) with a long evolutionary history of livestock grazing. Individual species responses were tested based on species occurrence and abundance in either grazed or grazing-excluded steppes, in addition, we used indicator species analysis to assess the strength of the association between plant species and management type. Likewise, α-diversity, abundance- and incidence-based β-diversity, as well as the functional groups’ diversities were quantified using Hill Numbers and compared between the two management types. Sheep grazing exclusion enabled the recovery of various Alfa-steppe indicator species and improved the size of regional species pool, overall α-diversity, and the diversity of therophytes. This management practice decreased the abundance-based β-diversity and the nestedness-resultant fraction of the incidence-based β-diversity at the local scale, while at the landscape scale increased the abundance-based β-diversity and its balanced variation fraction and reduced the incidence-based β-diversity and its turnover component. Furthermore, protection from grazing altered β-diversities scaling patterns by maintaining higher balanced variation in species abundance at large spatial scale and greater abundance-gradient in species composition at the fine-scale. Our results suggest that the implementation of short-term grazing exclusion in degraded arid steppes would be the appropriate management practice for vegetation restoration and plant diversity conservation during prolonged drought periods.

The mathematical structure underlying a sentence is made of two independent processing units in series. The conditional probability density function of sentence length (measured in words) recordable in the extended short–term memory (E–STM) buffer made of CF cells is Gaussian. The number of sentences that authors of Italian and English Literatures have written is compared to that theoretically available to them. The multiplicity factor α describes this comparison. α&gt;1 is more likely than α&lt;1 and often α≫1, therefore the same sentence pattern is reused many times. These texts are easier to read. Very few novels show α&lt;1. In these cases, there are enough diverse sentence patters to convey meaning, but most of them are not used. Texts are more difficult to read, as measured by a universal readability index GU. A mismatch index IM synthetically describes the process. α, GU. and IM increase with year of publication. Future work will concern other literatures – including ancient ones as Greek and Latin – to confirm what, in our opinion, is general feature of human mind.

Ensuring safe and continuous autonomous navigation in long-term mobile robot applications is still challenging. To ensure a reliable representation of the current environment without the need for periodic re-mapping, updating the map is recommended. However, in case of incorrect estimation of robot pose, updating the map can lead to errors that prevent the robot localisation and jeopardize map accuracy. In this paper, we propose a safe LIDAR-based occupancy grid map updating algorithm for dynamic environments taking into account the uncertainties in the estimation of the robot’s pose. The proposed approach allows robust long-term operations as it can recover the robot’s pose, even when it gets lost, to continue the map update process providing a coherent map. Moreover, the approach is robust also to temporary changes in the map due to the presence of dynamic obstacles such as humans and other robots. Results highlighting map quality, localisation performance, and pose recovery, both in simulation and experiments, are reported.

We investigated the role of the human medio-temporal complex (hMT+) in the memory encoding and storage of a sequence of four coherently moving RDKs by applying repetitive transcranial magnetic stimulation (rTMS) during an early or late phase of the retention interval. Moreover, in a second experiment we also tested whether disrupting the functional integrity of hMT+ during the early phase impaired the precision of the encoded motion directions. Overall, results showed that both recognition accuracy and precision were worse in middle serial positions, suggesting the occurrence of primacy and recency effects. We found that rTMS delivered during the early (but not the late) phase of the retention interval was able to impair not only recognition of RDKs, but also the precision of the retained motion direction. However, such impairment occurred only for RDKs presented in middle positions along the presented sequence, where performance was already closer to chance level. Altogether these findings suggest an involvement of hMT+ in the memory encoding of visual motion direction. Given that both position sequence and rTMS modulated not only recognition but also precision of the stored information, these findings are in support of a model of visual short-term memory with a variable resolution of each stored item, consistent with the assigned amount of memory resources, and that such item-specific memory resolution is supported by the functional integrity of area hMT+.

Virtual reality (VR) describes a family of technologies which immerse users in sensorily-stimulating virtual environments. Such technologies have increasingly found applications in the treatment of neurological and mental health disorders. Depression, anxiety, and other mood abnormalities are of concern in the growing elderly population – especially those who reside in long-term care facilities (LTCFs). The transition from the familiar home environment to the foreign LTCF introduces a number of stressors that can precipitate depression. However, recent studies reveal that VR therapy (VRT) can promote positive emotionality and improve cognitive abilities in the elderly, both at home and in LTCFs. VR thus holds potential in allowing elderly individuals to gradually adapt to their new environments – thereby mitigating the detrimental effects of place attachment and social exclusion. Nevertheless, while the current psychological literature is promising, the implementation of VR in LTCFs faces many challenges. LTCF residents must gain trust in VR technologies, care providers require training to maximize the positive effects of VRT, and decision makers must evaluate both the opportunities and obstacles in adopting VR. Here, we concisely review the implications of depression related to place attachment in LTCFs, and explore the potential therapeutic applications of VR.

This study reports multivariate statistical techniques applied including cluster analysis to evaluate and classify the river pollution level in Taiwan, and principal component analysis-multiple linear regression (PCA-MLR) to identify the possible pollution source. Water quality and heavy metal monitoring data from Taiwan Environmental Protection Administration (EPA) was evaluated for 14 rivers in the four regions of Taiwan. The Erren River was classified as the most polluted River in Taiwan. Biochemical oxygen demand, ammonia, and total phosphate concentration in this river were the highest of the 14 rivers evaluated. In addition, heavy metal levels of the following rivers exceeded the Taiwan EPA standard limit: lead - in the Dongshan, Jhuoshuei, and Xinhuwei Rivers; copper - in the Dahan, Laojie, and Erren Rivers; and manganese - in all rivers. Water pollution in the Erren River was estimated to originate 72% from industrial sources, 16% from domestic black water, and 12% from natural sources and runoff from other tributaries. Our research showed that PCA-MLR and the cluster analysis model accomplished our study objectives and will be helpful tools to evaluate water quality in rivers and we suggest that the continuous monitoring should be conducted to monitor water pollution from anthropogenic activities.

An entrepreneur is a business-able physical person who performs activities to gain the profit and who is registered according to law. Starting from the national and theoretical and legal solutions and court practice from comparative law, the authors analyze the concept and the legal position of an individual entrepreneur noticing the problems and inconsistencies in legal regulations. The authors of the work make a few conclusions and suggestions: 1) terminology is not coordinated with legal terminology from comparative law. In our law, the legal term is “entrepreneur”, which is a too wide and unspecified term because in economic profession this term represents the genus term for individual and collective entrepreneurship; 2) analyze all forbidden activities for entrepreneurs, judge the reasons pro et contra and work on eliminating prohibitions and favouring legal entities; 3) set by law the bankruptcy of an individual entrepreneur i.e. the individual bankruptcy of a physical person; 4) work on passing a separate legislation in the field of the individual entrepreneurship, especially on passing and changing the laws which would regulate handicrafts (including old crafts and jobs of home industry), free professions as well as agricultural activity.

In recent years, transformer-based models have gained prominence in multivariate long-term time series forecasting (LTSF), demonstrating significant advancements despite facing challenges such as high computational demands, difficulty in capturing temporal dynamics, and managing long-term dependencies. The emergence of LTSF-Linear, with its straightforward linear architecture, has notably outperformed transformer-based counterparts, prompting a reevaluation of the transformer's utility in time series forecasting. In response, this paper presents an adaptation of a recent architecture termed extended LSTM (xLSTM) for LTSF. xLSTM incorporates exponential gating and a revised memory structure with higher capacity that has good potential for LTSF. Our adopted architecture for LTSF termed as xLSTMTime surpasses current approaches. We compare xLSTMTime's performance against various state-of-the-art models across multiple real-world datasets, demonstrating superior forecasting capabilities. Our findings suggest that refined recurrent architectures can offer competitive alternatives to transformer-based models in LTSF tasks, potentially redefining the landscape of time series forecasting.

Refractive surgery is an increasingly popular procedure to decrease spectacle or contact lens dependency. The two most commonly used surgical techniques to correct myopia is Photorefractive keratectomy (PRK) and Femtosecond- Lasik (FS-LASIK)There are few publications that gathers such a long term follow up of both surgical techniques (2) Methods It has been performed a retrospective non-randomized study 509 PRK eyes and 310 FS-LASIK surgeries were followed for 10 years for the treatment of myopia and compound myopic astigmatism. Patients were followed up three months, one year, 2 years, 5 and 10 years. The safety index of both procedures was defined as a quotient between the postoperative BCVA (Best Corrected Visual Acuity) and the preoperative BCVA. The predictability is calculated as difference between the expected spherical equivalent and the achieved spherical equivalent. The efficacy index was calculated as a quotient between postoperative UCVA divided by the preoperative BCVA (3) Results. The results were: a safety index higher than 100% (109%) and an efficacy index of 82.4% after 10 years of PRK surgery in both groups. FS-LASIK was the safest surgery after 10 years and the most efficacy technique although in this case there were no statistically significant differences (4) Conclusions. All these data demonstrated better indexes for FS-LASIK

Banks are normally offered two kinds of deposit accounts. It consists of deposits like current/saving account and term deposits like fixed or recurring deposits. For enhancing the maximized profit from bank as well as customer perspective, term deposit can accelerate uplifting of finance fields. This paper focuses on likelihood of term deposit subscription taken by the customers. Bank campaign efforts and customer detail analysis can influence term deposit subscription chances. An automated system is approached in this paper that works towards prediction of term deposit investment possibilities in advance. This paper proposes deep learning based hybrid model that stacks Convolutional layers and Recurrent Neural Network (RNN) layers as predictive model. For RNN, Gated Recurrent Unit (GRU) is employed. The proposed predictive model is later compared with other benchmark classifiers such as k-Nearest Neighbor (k-NN), Decision tree classifier (DT), and Multi-layer perceptron classifier (MLP). Experimental study concludes that proposed model attains an accuracy of 89.59% and MSE of 0.1041 which outperform well other baseline models.

In this paper we study the initial boundary value problem for logarithmic Higher Order Wave equation. Introducing the Logarithmic Sobolev inequality and using the combination of Galerkin method, we consider the theorem of existence of a global weak solution to problem for the initial boundary value problem of the logarithmic wave equation. By constructing an appropriate Lyapunov function, we obtain the decay estimates of energy for logarithmic Higher Order Wave equation. The proof of the main theorem is given.

The land subsidence occurring in goafs after coal mining is a protracted process. The accurate prediction of long-term land subsidence in goafs relies heavily on the availability of long-term monitoring data. However, the scarcity of continuous long-term land subsidence monitoring data subsequent to the cessation of mining significantly hinders the accurate prediction of long-term land subsidence in goafs. To address this challenge, this study proposes an innovative method based on Interferometric Synthetic Aperture Radar (InSAR) for predicting long-term land subsidence of goafs following coal mining. The proposed method employs a concatenation approach that integrates multiple short-term monitoring data from different coal faces, each with distinct cessation times, into a cohesive and uniform long-term sequence by normalizing the subsidence rates. The method was verified using actual monitoring data from the Yangquan No.2 mine in Shanxi Province, China. Initially, coal faces with same shapes but varying cessation times were selected for analysis. Using InSAR monitoring data collected between June and December of 2016, the average subsidence rate corresponding to the duration after coal mining cessation of each coal face was back-calculated. Subsequently, a function relating subsidence rate to the duration after coal mining cessation was fitted to the data. Finally, the relationship between cumulative subsidence and the duration after coal mining cessation was derived by integrating the function. The results indicated that the relationship between subsidence rate and duration after coal mining cessation followed an exponential function for a given coal face, whereas the relationship between cumulative subsidence and duration after coal mining cessation conformed to the Knothe time function. Notably, after the cessation of coal mining, significant land subsidence persisted in the goaf of the Yangquan No.2 mine for a duration ranging from 5 to 10 years. The cumulative subsidence curve along the long axis of the coal face ultimately exhibited an inclined W-shape. The proposed method enables the quantitative prediction of residual land subsidence in goafs, even in cases where continuous long-term monitoring data are insufficient, thus providing valuable guidance for construction decisions above the goaf.

Background. Carotid artery disease is prevalent among patients with coronary heart disease. The concomitant severe lesions in the carotid and coronary arteries may necessitate either simultaneous or staged revascularization, involving coronary bypass and carotid endarterectomy. However, there is presently a lack of consensus on the optimal choice of surgical treatment tactics for patients with significant stenoses in both carotid and coronary arteries. The aim of the current study was to compare the 30-day and long-term outcomes of coronary and carotid artery revascularization surgery based on the simultaneous or staged surgical tactics. Material and Methods. The single-center, non-randomized retrospective study involved 192 patients with concurrent coronary artery disease and carotid artery stenosis ≥70%, of whom 106 patients underwent simultaneous intervention (CABG+CEA), and 86 patients underwent staged CABG/CEA. The mean time between stages ranged from 1 to 4 months (mean 1.88±0.9 months). Endpoints included death from any cause, nonfatal stroke, nonfatal myocardial infarction (MI), and major adverse cardiovascular events (MACE) (death + nonfatal MI + nonfatal stroke) within 30 days after the last intervention and in the long-term follow-up period (median follow-up - 6 years). Results: The 30-day all-cause mortality, incidence of postoperative nonfatal MI, nonfatal stroke, and MACE did not exhibit differences between the groups after single-stage and staged interventions. However, the overall risk of postoperative complications (adjusted for the risk of any complication per patient) (OR 2.214, 95% CI 0.214-0.954, p=0.034), as well as the duration of ventilatory support (p=0.004), were elevated in the group after simultaneous interventions compared with the staged intervention group. However, this difference did not result in an increased incidence of death and MACE in the group after simultaneous interventions. In the long-term follow-up period, there were no significant differences observed when comparing simultaneous or staged surgical tactics in terms of overall survival (54.9% and 62.6% in groups 1 and 2, respectively, P log-rank = 0.068), nonfatal stroke-free survival (45.6% and 33.6% in groups 1 and 2, respectively, P log-rank = 0.364), nonfatal MI-survival (57.6% and 73.5% in groups 1 and 2, respectively, P log-rank = 0.169), and MACE-free survival (7.1% and 30.2% in groups 1 and 2, respectively, P log-rank = 0.060). Risk factors associated with an unfavorable outcome included age, smoking, BMI, LV EF, and atherosclerosis of lower limb arteries. Conclusions: This study revealed no significant difference in the impact of simultaneous CABG+CEA or staged CABG/CEA on the incidence of death, stroke, MI, and MACE over a 30-day and long-term follow-up period. Although the immediate results indicated an increased risk of a complicated course (attributable to overall complications) after simultaneous CABG+CEA compared with staged CABG/CEA, this did not lead to an increase in fatal complications. Therefore, performing both tactics is deemed safe and eligible after a meticulous postoperative risk assessment.

Understanding whether the long-term follow-up (LTFU) system is working for families is critical to measuring the success of newborn screening (NBS) and understanding why some families are lost to follow-up. Caregivers were recruited from six pediatric specialty care clinics. Data was gathered from caregivers via six focus groups (n=24) and open-ended responses on a survey (n=33). Caregiver participants represented a wide range of NBS-related conditions and children’s ages. While this is not the first study to gather caregivers’ input, it is unique in its breadth of perspectives (e.g., metabolic, endocrine, hemoglobinopathy, etc.) and its focus on LTFU. When asked about goals for their children, caregivers identified health-related goals (i.e., ability for children to care for themselves, not being hindered by diagnosis) and non-health related goals (i.e., defining themselves outside of disease, participating in sports, making friends). In qualifying the LTFU care they want and need for their child and the key factors that influence access and engagement, caregivers identified three themes: communication and relationships with providers; care team roles and factors; and care access and utilization factors. The themes identified are not disjoint; they are intertwined and collectively illustrate the lived experiences of families at the epicenter of LTFU care.

The new class of mRNA vaccines is studied extensively, leading to many novel prospects based on the pivotal success of vaccines against the SARS-Cov-2 virus. Many novel mechanisms of immune response discovered have led to the possibility of mutation-resistant vaccines by combining multiple conserved epitopes as antigens to manipulate the T-cell and B-cell responses; these antigens can also come from different organisms, providing protection against numerous diseases and of most tremendous significance is the utility of mRNA vaccines in preventing and treating more than 100 autoimmune disorders. This is a significant humanitarian breakthrough given the ease and faster and low cost of mRNA vaccines, being a chemical entity. This paper provides a prospective analysis of mRNA vaccines with much broader applications than anticipated when these vaccines entered treating SARS-Cov-2 infections.

Coronavirus infection disease -2019 (COVID-19) was a global pandemic with high mortality and morbidity, that lead to an increased health burned all over the world. Although the virus affects mostly pulmonary tract, cardiovascular implications were often among COVID-19 positive patients, and are predictive for poor outcomes. Increased values of myocardial biomarkers such as Troponin I or NT-proBNP were proven to be risk factors for respiratory failure (26). Although the risk of acute coronary syndromes (ACS) was greater in acute-phase of COVID-19, there were lower rates of hospitalization for ACS, due to patient’s hesitation for presenting at the hospital (22). Hospitalized ACS patients with COVID-19 infection, had a prolonged symptom-to-first medical contact time, and longer door-to-balloon time. The mechanisms of myocardial injurie in COVID -19 patients are not still not clear, most often is incriminated: the down-regulation of ACE2 inhibitors, endothelial disfunction, pro-coagulant status, increased levels of pro-inflammatory cytokines. The aim of this paper is to evaluate the long-term outcomes of COVID-19 survivors that presented an acute myocardial infarction by reviewing existing data.

This article presents an analysis of monthly precipitation totals based on the Global Precipitation Climatology Centre database and monthly mean temperatures based on National Oceanic and Atmospheric Administration data for 377 catchments located around the world. Data sequences covering 110 years from 1901 to 2010 were analysed. The long-term sequences of precipitation and temperature were used to assess the variability of climate extremes, referred to here as polarisation. Measures of polarisation used in the natural sciences are discussed. A simple measure of polarisation was presented and applied to long-term sequences of monthly precipitation totals and monthly mean temperatures. Due to the nature of the proposed polarisation measure, other characteristics of precipitation and temperature sequences are also presented as a background for the discussion of the polarisation index. The study showed the existence of trends related to the polarisation of temperature and precipitation phenomena. As a result of the analysis, trends of polarisation factors in the area of precipitation and temperature were identified in 11 catchments out of the 377 analysed catchments. The trend analysis used Mann-Kendall tests at a level of significance of 5%. The Pettitt test was used to determine the point of trend change for precipitation and temperature data. The whole investigation is supported by rich graphical analyses, and the results are presented in tabular form.

This brief commentary challenges the use of the term "energy deficiency" in nutrition and metabolism, providing a critical examination of its scientific and philosophical aspects. It emphasizes the need to consider rare diseases associated with actual energy deficiency, which extend beyond the scope of everyday tiredness or fatigue. By analyzing energy balance and its complexities, this critique underscores the oversimplification associated with the term and its potential for misleading implications. It highlights the dynamic nature of energy metabolism and the intricate mechanisms involved in maintaining energy equilibrium, including the impact of rare genetic and physiological abnormalities. In addition to the discussion on energy balance, this commentary explores the manifestation of rare diseases that disrupt energy production, utilization, or hormonal regulation. Conditions such as mitochondrial diseases, glycogen storage diseases, adrenal insufficiency, and Prader-Willi syndrome are examined, shedding light on their profound impact on individuals' energy levels and overall health. The distinct time courses, underlying mechanisms, and clinical implications of protein deficiency, energy deficiency, and vitamin C deficiency are also compared, further emphasizing the complexity of energy metabolism and its relationship with various nutrient deficiencies. To foster a more comprehensive understanding of energy metabolism and enhance clarity in communication within the field, the commentary proposes the adoption of alternative terminology, such as "energy flux," to capture the multifaceted nature of energy balance more accurately. By reevaluating the terminology employed, researchers and healthcare professionals can better convey the intricate dynamics of energy metabolism and address the unique challenges faced by individuals with rare diseases causing actual energy deficiency. In conclusion, this commentary serves as a thought-provoking exploration of the concept of energy deficiency in nutrition and metabolism. It highlights the limitations of the term in capturing the complexities of energy balance, particularly in the context of rare diseases. By broadening the discussion to include these rare conditions, it encourages a more comprehensive understanding of energy metabolism and calls for precise and nuanced terminology to facilitate effective communication and advancements in the field.

Microbial communities play a key role in sustainable agriculture. However, we still need more in-formation, to understand the complex response of the microbial community to long-term organic farming, which aims to reduce synthetic fertilizer and pesticide use in order to produce sustainably and improve soil quality. We have assessed the long-term effect of two organic cropping systems and a conventional system on the microbial soil community structure using high-throughput se-quencing analysis. We analyzed the link between these communities and changes in soil properties and crop yield. Results showed that the crop yield was similar among the three cropping systems. Soil properties, such as total organic carbon, nitrogen, ammonium, magnesium and boron, influ-enced changes in the bacterial community structure. A linear discriminant analysis effect size (LEfSe) showed different bacteria and fungi as key microorganism of each of the three different cropping systems, in addition, our results reflected that fungal community were more sensitive than bacteria to cropping system. This research provides an insight about changes occurred in soils, especially in microbial communities considering the effect of that changes in crop yield which were remained stable among the different cropping systems.

In general, remote sensing has proven to be a powerful tool in the overall understanding of natural and anthropogenic phenomena. Satellites have become useful tools for tasks such as characterization, monitoring, and the continuous prospecting of natural resources. This research aims to analyze spatial dynamic and destructive on coral reefs area and correlation between live coral reduction and population on small islands. Landsat MSS, TM, ETM, and OLI-TIRS are used to spatial analyze of coral reef dynamics from 1972 to 2016. The image processing includes gap-filling, atmospheric correction, geometric correction, image composite (true color), water column correction, unsupervised classification, reclassification, accuracy assessment. The statistical analysis identifies the relationship between dynamic population data with a reduction of live coral, namely Principal Component Analysis (PCA) and Multiple Regression Analysis. The effect of the population shows a positive correlation with the reduction in the area of live coral, although it is significant. The fact is the practice of coral destruction on an island; it is usually not only caused or carried out by residents who live on the island but also carried out by other residents of different islands.

We study the short−term memory capacity of ancient readers of the original New Testament written in Greek, of its translations to Latin and modern languages. To model the short–term capacity, we have considered the number of words per interpunctions, the “word interval” , because this parameter can model how the human mind memorizes “chunks” of information. Since can be calculated for any alphabetical text, we can perform experiments − otherwise impossible − with ancient readers by studying the literary works they used to read. The “experiments” compare the of texts of a language/translation to those of another language/translation by measuring the minimum average probability of finding joint readers (those who can read both texts because of their similar short–-term memory capacity) and by defining an “overlap index”. We also define a population of universal readers who can read any the New Testament written in alphabetical language. More than 50% of the readers of specific languages overlap with the universal readers with probability . Future work is vast, with many research tracks, because alphabetical literatures are very large and allow many experiments, such as comparing authors, translations or even texts written by artificial intelligence tools.

The role of pregnancy in multiple sclerosis (MS) is of importance because many patients with MS are young women in the childbearing age who require information to inform their reproductive decisions. Pregnancy is now well-known to be associated with fewer relapses of MS and reduced activity of autoimmune encephalomyelitis (EAE). However, in women with multiple sclerosis, this benefit is not always sufficient to protect against a rebound of disease activity if disease modulating therapy is ceased for pregnancy. There is reason to be concerned that use of assisted reproductive therapies can be associated with relapses of MS. It is thought that the beneficial effects of pregnancy are due to the pregnancy-associated changes in the maternal immune system. There is some evidence of this in human studies and studies of EAE. There is also evidence that having been pregnant leads to better long-term outcome of MS. The mechanism for this is not fully understood but it could result from epigenetic changes resulting from pregnancy or parenthood. Further studies of the mechanisms of the beneficial effects of pregnancy could provide information that might be used to produce new therapies.

Tobacco use is bad for your health in many ways, not just your lungs. It affects many other parts of your body, including your nervous system. This abstract looks at the link between smoking and the nervous system and shows how smoking affects the nerve system in specific ways. There are a lot of different diseases and risks that can come from smoking. By weakening blood vessels and making it easier for blood clots to form, smoking makes the chance of having a stroke much higher. Using tobacco is also linked to a drop in brain function and memory problems, as well as a higher chance of neurodegenerative diseases like Alzheimer's disease and dementia. Also, people who smoke have a higher chance of getting multiple sclerosis, which is a long-term autoimmune disease that affects the central nervous system. It can also cause peripheral neuropathy, which can damage nerves and cause tingling, pain, and stiffness in the limbs. Nicotine, the substance that makes tobacco addicting, changes the brain's reward circuits. This makes it hard to stop smoking because it leads to addiction. In addition to these effects on the body, smoking also has effects on the mind. It makes mood disorders like sadness and anxiety more likely, making the symptoms worse and hurting general health. Understanding the effects of smoking on the brain is important for improving overall health and getting people to stop smoking. Public health efforts, education, and targeted interventions are needed to make people aware of these risks and help them make choices about smoking that are based on accurate information. By looking at how smoking affects the brain, we can try to make people's lives better and protect their and their communities' well-being.

The astroclimatic conditions characterize the quality of astronomical site. The Terscol Observatory (coordinates 430 16 ‘29’’N, 420 30’ 03’’E) was founded over 42 years ago in 1980. The paper presents the results of analysis of long-term variations (1980-2022) of astroclimatic parameters as total cloud cover, precipitable water vapor, and wind speed at 200mbar level above the Terscol Observatory using ECMWF-ERA5 atmospheric reanalysis data. Long-term trends of the astroclimatic parameters are study statistical significantly trend analysis method using Mann–Kendall and Sen’s slope to estimate the magnitude of the changes. In result the site show not significant decreases of 200-hPa wind speed and increases of precipitable water vapor, but significant (99 per cent confidence level) long-term changes of total cover cloud above the Terscol Observatory.

Objectives: To examine the long term impact of COVID-19 on sleep patterns and development of sleep disorders. Methods: Using the centralized Massachusetts General Brigham (MGB) Research Patient Data Registry (RPDR), SARS-CoV2 positive patients were surveyed about their sleep patterns before and after the viral infection. Information related to co-morbid conditions and medications were obtained through chart review. Results: Two hundred and forty five completed surverys were analysed. Average age was 53.3 ± 16.3 years, and participants were predominantly Non-Hispanic White (84.1%) and female (74.3%). Average BMI (kg/m2) was 29.9 ± 6.9, and a greater proportion was non-smokers (63.2%). After COVID-19, there was an increase in the percentage of participants reporting difficulty initiating (31 ± 46% vs. 39 ± 49%, P=0.01), and maintaining sleep (43 ± 49% vs. 57 ± 49%, P<0.001), and use of sleep aids (24 ± 43% vs. 30 ± 45% P=0.003) with an incidence rate of 24.3%, 37.4%, and 12.3% respectively. In addition, there was an increase in daytime fatigue and the need for napping (58 ± 49% vs. 36 ± 48%, P <0.0001) with an incidence of 8% and 23% respectively. The sleep symptoms persisted beyond 12 months among 28% of the participants and were predominantly seen among women. Conclusions: Infection with SARS-CoV2 has negative effects on sleep, and a significant proportion of adults experience insomnia and daytime sleepiness beyond 12 months after recovering from the initial infection.

The prospective study enrolled 144 patients after surgical treatment of biliary atresia in early infancy. We analyze the immediate effectiveness of the surgery and the age-related structure of complications in the up to 16-year follow-up. The immediate 2-year survival rate after the surgery constituted 49.5%. At the time of this writing, 17 of the patients have celebrated their 10th birthdays with good quality of life and no indications for LT. The obtained results underscore the critical importance of surgical correction of BA by Kasai surgery during the first 60 days of life and subsequent dynamic follow-up of the patients for the purpose of the early detection and timely correction of possible complications.

The long term sustainability and longevity of the business life cycle depends on correct understanding of the contextual constituents, triggers and dynamics, pre-startup planning, strategy and financial forecasting where business plans are developed to understand and forecast project viability, pitch ideas and secure funding. At the same time there is a lack of one page startup business model. Identifying this need, a ‘startup business strategy frame’ has been developed through learnings and encompassing design thinking, the business canvas and other strategy models and approaches. It provides a logical sequential flow and connects value drivers on environmental, strategic including operational and financial levels of proposed startup in a sequential format. To arrive at the frame as a logical conclusion a website www.strategizestartup.com is developed to build startup business model and plans in a time and cost effective process. The website assists the startups at each stage through a work and guidebook. The website takes the user from creative ideation by charting the context to build the strategy and measuring the financial impact. This startup strategy model will alleviate the problems for the first and second stage entrepreneurs to ideate creatively and strategizing. It also eradicates the issues related to reading and understanding long plans which could be an exhaustive and cumbersome process.

The predictability of wind information in a given location is essential for the evaluation of a wind power project. Predicting wind speed accurately improves the planning of wind power generation, reducing costs and improving the use of resources. This paper seeks to predict the mean hourly wind speed in anemometric towers (at a height of 50 meters) at two locations: a coastal region and one with complex terrain characteristics. To this end, the Holt-Winters (HW), Artificial Neural Networks (ANN) and Hybrid time-series models were used. Observational data evaluated by the Modern-Era Retrospective analysis for Research and Applications-Version 2 (MERRA-2) reanalysis at the same height of the towers. The results show that the hybrid model had a better performance in relation to the others, including when compared to the evaluation with MERRA-2. For example, in terms of statistical residuals, RMSE and MAE were 0.91 and 0.62 m/s, respectively. As such, the hybrid models are a good method to forecast wind speed data for wind generation.

Despite increased protection globally, climate change and other anthropogenic factors have caused a significant decline in seagrass cover. Identifying the specific causes of this decline is paramount if they are to be addressed. Therefore, we identified the causes of long-term change in seagrass/submerged aquatic vegetation (SAV) percentage cover and extent in the Bluefields Bay Special Fish Conservation Area (BBSFCA), a marine protected area on Jamaica’s southern coast. We used two random forest regression (RFr) models that included 2013 hydroacoustic survey SAV percentage cover data (dependent variable), and auxiliary data, reflectance data from level 2 processed 2013 Landsat 7 and 8 images and image band texture statistics maps (mean and variance) as predictors to generate 24 SAV percentage cover maps for the period 1984 – 2021 (37 years) using data from Landsat 4-5, 7 and 8 images., from which benthic features maps (SAV present, absent and coral reef) were created. Rainfall and map data were used to determine if SAV extent/area (km2) and average percentage cover and annual rainfall changed significantly over time and to evaluate the influence of rainfall. Rainfall impact on the overall spatial patterns of SAV loss, gain, and percentage cover change was assessed using a pixel-based regression. Finally, the most important spatial pattern predictors (two rainfall proxies (distance and direction from river mouth), benthic topography, depth, and hurricane exposure (a measure of hurricane disturbance)) of SAV loss, gain, and percentage cover change during 23 successive 1-to-4-year periods were identified using spatial Bayesian INLA generalized linear mixed models. SAV area/extent was largely stable with &gt; 70% mean percentage cover for multiple years. However, Hurricane Ivan (in 2004) caused a significant decline in SAV area/extent (by 1.62 km2, or a 13%) during 2002 – 2006 and a second hurricane (Dean) in 2007 delayed recovery until 2015. Additionally, rainfall declined significantly by &gt;1000 mm since 1901, and mean monthly rainfall positively influenced SAV percentage cover change. The pixel-based regression highlighted areas where mean monthly rainfall had a positive overall effect on SAV cover percentage change (across the entire bay) and gain (closer to the mouth of a river). The most frequently selected important spatial pattern predictors were the two rainfall proxies (areas closer to the river mouth were more likely to experience SAV loss and gain) and depth, with shallow areas generally having a higher probability of SAV loss and gain. Three hurricanes had significant but different impacts depending on their distance from the southern coastline. Hurricane Gilbert, which made landfall in 1988, resulted in higher SAV percentage cover loss in 1987 - 1988. Benthic locations with a northwestern/northern facing aspect (the predominant direction of Ivan’s leading edge wind bands) experienced higher SAV losses during 2002 – 2006. Although some locations impacted by Ivan and not by Dean recovered during 2006 – 2008, exposure to Ivan explained percentage cover loss during 2006 – 2008 and average exposure to (the cumulative impact of) Ivan and Dean (both with tracks close to the southern coastline) explained SAV loss during 2013 – 2015. Therefore, despite historic lows in annual rainfall, overall, higher rainfall was beneficial, multiple hurricanes impacted the site, and despite two hurricanes in three years SAV recovered within a decade. Hurricanes and a further reduction in rainfall may pose a serious threat to SAV persistence in the future.

Abstract. Introduction: BMD study gives partial information on bone health in patients with TSH suppression therapy due to Differentiated Thyroid Cancer (DTC). TBS, a new parameter of bone microarchitecture is propose for bone quality study. This study analyze their long-term use in patients with DTC. Methods: BMD was measured by DXA and TBS with iNsigth software in 145 postmenopausal DTC patients. Vertebral Fractures (VFs) with a semi-quantitative x-ray method. Results: BMD at the end study was not different from initial. TBS decreased from 1.35±0.1 to 1.27±0.1 (p=0.002). PTH, Osteocalcin, and BAP were increased, suggesting increased bone remodeling. There was an increase in osteoporosis and osteopenia (40.6% and 16.5% to 46.6% and 18.6%); 31% had partially degraded and 15.1% degraded TBS changed to 48,9% and 24,8% at the end study. VFs in 30 patients, was not different in age, BMI, calcium and alcohol ingestion, smoking, radioiodine, or thyroid parameters vs. without VFs. Odds ratio for VFs increased with osteopenia (OR 2.63). Combination of TBS plus TBS did not improve discrimination. Conclusions: TBS was lowered while BMD did not differ. Percentage of osteoporosis and osteopenia and of partially degraded and degraded TBS was higher at the end study. Predominant discordance rate was found in partially degraded microarchitecture, in which the proportion of osteopenia was higher than normal or osteoporotic patients. AUC of TBS plus BMD did not improve discrimination. TBS, radioactive iodine, and sedentary lifestyle were the main differential data for patients with DTC and VFs.

Demographic studies have revealed a strong association between exposure to high ambient temperatures during pregnancy and increased risks of preterm birth (PTB). The mechanism underlying this association is unclear, but it is plausible that altered placental function may contribute. In this study, we conducted differential gene expression analysis, gene set enrichment analysis (GSEA), and gene ontology (GO) analysis on bulk RNA-seq data from human placentas delivered at term and preterm during the warmer months compared to placentas delivered at term and preterm during the colder months in the UK. We detected 48 differentially expressed genes in preterm placentas delivered during the warmer months compared to preterm placentas delivered during the colder months, the majority of which were inflammatory cytokines and chemokines, including SERPINA1, IL1B, CCL3, CCL3L3, CCL4, CCL4L2, CCL20, and CXCL8. The GSEA positively enriched 17 signalling pathways, including the NF-κB, IL17, toll-like receptor, and chemokine signalling pathways, in warm-exposed preterm placentas, which were not observed in warm-exposed term placentas. The GO analysis revealed several biological processes, including neutrophil, granulocyte, monocyte, and lymphocyte chemotaxis, as well as inflammatory and humoral immune responses in warm-exposed preterm placentas, but not in warm-exposed term placentas. We conclude that maternal exposure to warm environmental temperatures during pregnancy alters the placental transcriptome towards inflammation and immune regulation, potentially leading to PTB.

Understanding the optimal strategy for a real estate investment and how performance changes based on characteristics is crucial for optimising the achievable return. This is prominent in tourist areas such as Paphos where there is no clear distinction as to whether short or long-term approaches are optimal. The study aimed to develop a model for predicting the optimal rental strategy whilst assessing which model performed best and which property attributes impacted its return the greatest. Short-term data was collected from AirDNA and long-term data was manually collected from real estate agents websites. Furthermore, Random Forest, K-Nearest Neighbour and Multiple Linear Regression models were created to predict the highest and best use for each property. Model accuracy varied between data sets with the best performing model for short-term properties being Random Forest (R-Squared: 0.843), and Distance-Based Multiple Linear Regression for long-term approach (R-Squared: 0.843). The study demonstrated that accurate models could be created to predict the optimal rental strategy with the number of bedrooms being the main driver for rental income, followed by luxury finishes and the presence of a pool. It found that locational characteristics didn’t impact the returns significantly assuming that the property was located within a tourist area.

The author attempts to reconstruct the climatic vicissitudes of the Mediterranean to explain why only broadly distributed Eurasian forest species have penetrated the Mediterranean peninsulas. He has carried out a bibliographic survey of the status of breeding forest birds in Italy over 15 decades (1872-2022) in order to establish an objective long-term trend (stable, increasing, decreasing, etc.). The number of breeding forest birds in Italy amounts to 61; their distribution, with a few exceptions, indicates that they are widespread in Eurasia, but only a small percentage of Eurasian forest species have colonized Italy and the other Mediterranean peninsulas, namely 49 in Iberian, 61 in Italian and 64 in Balkan peninsulas; a small percentage of them (between 10.9 and 14.3%) belongs to trans-Saharan migrants. The similarity between the forest species on the three peninsulas (Iberian, Italian and Balkan) results between 0.45 and 0.48, indicating a certain differ-ence in the overall fauna on the three territories. Not all species have penetrated southwards into the three peninsulas; for example, some that stopped in the Italian Alps have instead arrived to the forests of Greece, at a latitude corresponding to southern Italy, or species that in Italy stopped in the northern Apennines in the other two peninsulas have instead arrived far south. Iberian peninsula and the island of Corsica hold three endemic species among breeding forest birds, Italian and Balkan peninsulas have not endemic species. Overall, the Mediterranean presently hosts mainly neo-endemic taxa among forest bird species; the only paleo-endemics can be considered the three species of nuthatches living in Corsica, Algeria, and Turkey (other than Caucasus and the islet of Lesvos) and Le Vaillant’s woodpecker in the Maghreb (North Africa). Italian forests cover ca. 40% of land surface and since 1980’ are increasing, but 22% of them do not have a natural origin. However, it is difficult to know the true increase of forests, because some of them are fired every year. The presence of some ecologically demanding forest birds depends on the age of the trees, permanent open spaces and other characteristics at the edge of woodland.

ST-segment elevation myocardial infarction (STEMI), a major cause of mortality worldwide, has been shown through epidemiological studies to have a relationship with short-term exposure to air pollutants; however, the association between air pollutants and the outcome of STEMI has not been well studied. The aim of this study was to estimate the impact of air pollutants on the outcomes of STEMI. Data on particulate matter <2.5 μm (PM2.5), <10 μm (PM10), nitrogen dioxide (NO2), and ozone (O3) at each of the 11 air monitoring stations in Kaohsiung City were collected between January 1, 2012, and December 31, 2017. Medical records of non-trauma patients aged > 20 years who had visited the ED with a principal diagnosis of STEMI were extracted. The primary outcome measure was in-hospital mortality. After adjusting for potential confounders and meteorological variables, we found that an increase in the interquartile range (IQR) in NO2 was associated with an elevated risk of in-hospital mortality in patients with STEMI. Moreover, during the warm season, an IQR increase in NO2 corresponded to a higher risk of in-hospital mortality in patients with STEMI on lag 3 (OR=3.266; 95% CI:1.203–8.864, p=0.02). Conversely, an IQR increase in PM10 was associated with an increased risk of in-hospital mortality in patients with STEMI on lag 3 (OR=2.792; 95%CI:1.115–6.993, p=0.028) during the cold season. Our study suggests that exposure to NO2 (during warm season) and PM10 (during cold season) may contribute to a higher risk of poor prognosis in patients with STEMI.

The article presents an analysis of monthly precipitation totals based on the GPCC database, and monthly mean temperatures (NOAA data) for 377 catchments distributed across the globe. The analysis included 110-year data sequences from 1901 to 2010 calculated from grid data with a spatial resolution of 0.5°x 0.5° longitude and latitude. Long-term sequences of precipitation and temperature were used to assess the polarization of climatic phenomena. The noticeable impact of polarization in the area of extreme changes in temperature and precipitation is related to anthropogenic factors such as greenhouse gas emissions, deforestation and pollution, which affect ecosystem functioning, biodiversity, water resources and economies. The paper demonstrates the existence of trends related to the polarization of temperature and precipitation phenomena. The measures of polarization used in science are discussed. A simple measure of polarization was proposed and applied to both long-term sequences of monthly precipitation totals and monthly mean temperature. Due to the nature of the proposed polarization measure, other characteristics of the precipitation and temperature sequences are also presented as background for the discussion of the polarization index. The paper presents, for a selection of several hundred catchments from around the world, analyses of the assessment of precipitation and temperature trends using non-parametric tests. The trend analyses use Mann -Kendall tests at the 5% significance level. A Pettitt test was used to determine the trend change point for precipitation and temperature data. The whole is supported by rich graphical analyses and the results are presented tabularly.

Chorioamnionitis (CA) at term of pregnancy can have infectious and/or inflammatory origin and is associated with adverse outcomes. Triple I (Intrauterine Inflammation, Infection or both, TI) has been proposed to reduce the overdiagnosis of infection and the neonatal overtreatment. The aim of the study is to identify clinical and histological variables predicting adverse outcomes when TI has been suspected and/or confirmed. This retrospective cohort study included 404 pregnancies ≥37 g.a. that were divided into 5 all-inclusive and mutually exclusive groups. TI was defined according to NICHD definition of 2015 and it could be confirmed (TI+) or not (TI-) by histological examination. Signs of infection/inflammation not respecting the definition of TI were classified as “Clinical suspicion”, supported (CS+) or not (CS-) by histology. Histological chorioamnionitis (HCA) without clinical manifestation represented fifth group. Whole Placental Involvement (WPLI), was defined as a histological inflammation involving maternal and fetal side. There were 113 TI+, 30 TI-, 186 CS+, 35 CS- and 40 isolated HCA. WPLI was diagnosed in 133 cases (39.2%). Composite neonatal outcome (CNO) occurred in 114 cases (28.2%) while composite maternal outcome (CMO) occurred in 192 cases (47.5%). TI+ compared to CS+ was more predictive of CNO (p=0.001), CMO (p<0.001) and WPLI (p=0.005). WPLI was related both to CNO (p<0.001) and CMO (p=0.046). TI+ and WPLI showed similar sensitivity but different specificity in predicting CNO. At logistic regression, CNO was independently predicted by TI+ (OR 2.21; p=0.001) and by WPLI (OR 2.23; p=0.001). TI, compared to CS, is a better predictor of CNO and can be useful for the identification of newborns at risk.