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Complex suicides refer to using two or more suicide modes. In the literature, complex suicides are distinguished into planned and unplanned. Using multiple methods is related to ensuring a fatal result or because the first method appears too painful, time-consuming, or ineffective. The review aims to provide an overview of the critical features of complex suicides in the forensic context. The review was conducted by searching online databases (PubMed Central and Scopus) up to March 2023. We identified 52 articles that met the inclusion criteria, describing 261 cases. Suicides were classified as planned in 136 cases (52.1%); 105 cases (40.2%) were defined as unplanned, while in the remaining 20 cases (7.7%), the authors did not propose any classification. In 2/261 (0.8%) cases, four modes were indicated, three modes were observed in 34/261 cases (13%), and in 224/261 (85.8%) cases the suicides were carried out using a combination of two distinct methods. The method most frequently employed in the first instance in unplanned suicides were sharp-force injuries and stabbing, followed by mechanical asphyxia (hanging, self-strangulation, plastic bag suffocation) and a fall from height. Regarding planned suicide, the most frequent suicide methods were asphyxia, intoxication (drugs, substances of abuse, or alcohol), and poisoning via toxic substances. Complex suicides represent a relatively rare entity in forensic pathology; nevertheless, they can be challenging for the forensic pathologist in terms of differential diagnosis compared to homicides, due to the sometimes multifaceted presentation. Full article

Patients with end stage renal disease (ESRD) display many cognitive and physiological alterations resulting from renal failure and physical inactivity. Caffeine intake has been reported to improve cognitive/physical performance in several studies. However, whether the benefits of caffeine intake apply to patients with ESRD remains unknown. The aim of the present study was to explore the effect of caffeine intake on postural balance, cognitive function and functional capacity in patients with ESRD. In a randomized order, 12 patients with ESRD (age: 33.85 ± 8.57 years; Female: 45.5%) performed a battery of tests after either caffeine (CF) (400 mg) or placebo (PLA) ingestion. Postural balance was evaluated using a stabilometric platform. Functional capacity was assessed with the sit-to-stand and up-and-go tests, and for cognitive performances, reaction time test and a vigilance test were used. Results showed a significant improvement in up-and-go test (p = 0.01) and sit-to-stand test performances with CF compared to PLA (p < 0.01). Time of reaction test and vigilance test (p < 0.01) performances were significantly higher with CF. No significant difference was observed in postural balance between CF and PLA. The results of this study suggest that acute caffeine ingestion positively enhances cognitive function and functional capacity in patients with ESRD. Full article

Predation is an important factor limiting bird populations and is usually the main factor influencing nest survival. In riverine habitats, flooding poses an additional significant challenge. Our study aimed to elucidate the influence of nest location and incubation timing on the survival of common sandpiper nests in a large, semi-natural, lowland river. The survey was carried out in central Poland on the Vistula River, in 2014–2015, 2021, and 2023, along two river sections 2 km and 10 km in length. The nest survival rate was 27%, which is twice as low as that reported on small upland rivers, with flooding being an additional factor causing losses on the Vistula River. Our research showed that mammalian and avian predation accounted for 51% of losses and flooding for 49% of losses. The negative impact of floods on nest survival decreased as the breeding season progressed between May and July, while the chances of being depredated increased during the same period. Nests placed under shrubs were less likely predated than nests located in grass. Moreover, locating the nest in proximity to water increased nesting survival and in fact, more nests found in our study were situated close to the water’s edge. Full article

Empathy can be a powerful catalyst for caring action toward wildlife and nature more broadly. Given the critical developmental period of early childhood, interventions that build the capacity of educators to support empathy development in young children are needed. We report on an evaluation of an empathy-focused Community of Practice (CoP) that engaged 15 regional early childhood professionals (including four zoo preschool staff) in the co-creation of empathy practices that are deepened through a ‘Two-Worlds’ (Indigenous and Western) approach. Ripple effect mapping was the evaluation approach used, as its participatory nature and emphasis on reflection were well aligned with the CoP approach. The results suggest CoP participation influenced teachers’ capacity for supporting empathy development, which rippled outward from teacher-level impacts to positive impacts on children, families, and beyond. We also offer reflections on the use of a CoP approach to build individual, organizational, and community capacity for supporting empathy, as well as on the conduciveness of ripple effect mapping for evaluating capacity-building professional learning in the context of empathy conservation. Full article

Since the beginning of the 21st century, environmental protection and digital supply chains have increasingly garnered attention. As firms transition to green practices, how to achieve competitive advantage by reducing environmental costs has become one of the key concerns for many business managers. This study aims to examine how supplier and customer integration affect a firm’s environmental cost performance while considering the moderating effect of digital transformation. Following a survey conducted by a professional research agency on 800 Chinese manufacturing firms specializing in green products, the research model was tested using structural equation modeling and hierarchical regression analysis. The results indicate a significant positive relationship between both supplier integration and customer integration with a firm’s environmental cost performance. Additionally, positive digital transformation reinforces the relationship between supplier integration and customer integration. However, there are limitations due to the study’s background, scope, and sample size. This study underscores the impact of supplier integration and customer integration on a firm’s environmental cost performance, as well as the crucial moderating role of digital transformation. It contributes to the growing literature on sustainable supply chain management and provides valuable insights for relevant practitioners. Full article

The first Tunisian national molecular survey of coagulase-positive staphylococci (CoPS) isolated from dogs with pyoderma and otitis externa was conducted to evaluate the prevalence of CoPS and identify its phenotypic and genotypic diversities. A total of 99 out of the 195 samples collected from 39 sick dogs were identified across multiple sites as methicillin-susceptible CoPS belonging to the species S. pseudintermedius (64.4%), S. aureus (20.2%), S. coagulans (10.1%), and S. hyicus (5%). Fifteen sampled dogs carried more than one Staphylococcus species. Their antibiotic resistance and virulence factors were determined using conventional and molecular methods. Of the S. pseudintermedius isolates found, 17.4% were multidrug-resistant, whereas high rates of virulence genes were observed among the S. aureus isolates. On polystyrene surfaces, 75% of S. aureus isolates were biofilm producers, of which 15% were classified as strong producers. The capsular polysaccharide cap8 genotype was predominant among them. A MultiLocus Sequence Typing (MLST) analysis clustered the S.aureus isolates into five distinct sequence types (STs), with four assigned for the first time. Our findings highlight the spread of CoPS among diseased dogs and, especially, the emergence of S. hyicus, S. coagulans, multidrug-resistant S. pseudintermedius and S. aureus isolates with high genetic variability. The precise characterization of these strains, as well as their continuous monitoring, is necessary for the implementation of preventive strategies given the significant public health risk. Full article

Obesity, a chronic, preventable disease, has significant comorbidities that are associated with a great human and financial cost for society. The aim of the present work is to reconstruct the interactomes of non-hereditary obesity to highlight recent advances of its pathogenesis, and discover potential therapeutic targets. Obesity and biological-clock-related genes and/or gene products were extracted from the biomedical literature databases PubMed, GeneCards and OMIM. Their interactions were investigated using STRING v11.0 (a database of known and predicted physical and indirect associations among genes/proteins), and a high confidence interaction score of >0.7 was set. We also applied virtual screening to discover natural compounds targeting obesity- and circadian-clock-associated proteins. Two updated and comprehensive interactomes, the (a) stress- and (b) inflammation-induced obesidomes involving 85 and 93 gene/gene products of known and/or predicted interactions with an average node degree of 9.41 and 10.8, respectively, were produced. Moreover, 15 of these were common between the two non-hereditary entities, namely, ADIPOQ, ADRB2/3, CCK, CRH, CXCL8, FOS, GCG, GNRH1, IGF1, INS, LEP, MC4R, NPY and POMC, while phelligridin E, a natural product, may function as a potent FOX1-DBD interaction blocker. Molecular networks may contribute to the understanding of the integrated regulation of energy balance/obesity pathogenesis and may associate chronopharmacology schemes with natural products. Full article

Trendy high-density olive fields are often monovarietal orchards, mostly using the cultivar Arbequina. However, Arbequina shows a strong self-incompatibility response, and its yields depend on wind cross-pollination, which is not always available. With the aim of finding suitable self-compatible cultivars that can replace Arbequina, we evaluated pollen–pistil interaction, fruit set and seed paternity in Arbosana under different pollination treatments: self-pollination, open-pollination and three cross-pollination treatments: × Arbequina, × Sikitita and × Koroneiki. All these cultivars are low-vigor cultivars suitable for high-density orchards, making them potential pollinizers for Arbosana. The results show that Arbosana is also self-incompatible with a strong reduction in fruit set due to a lower fertilization level caused by a strong inhibition of pollen tube growth in self-pollinated flowers. Seed-paternity analyses confirmed the self-incompatibility response of Arbosana and suggest that some fruit obtained in bagged shoots under self-pollination were, in fact, a product of cross-fertilization. In conclusion, we recommend against the use of Arbosana in large monovarietal orchards. On the contrary, good results were obtained under cross-pollination with Sikitita, Arbequina and Koroneiki pollen, allowing us to recommend them as pollinizers for Arbosana in appropriate pollination designs. This is the first time Arbosana self-incompatibility has been reported. Full article

Chronic constipation is a common gastrointestinal disorder, and its management is critical. However, it is extremely difficult to assess its subjective symptoms when patients are unable to report them due to cognitive or physical disabilities, especially in cases of patients with incurable geriatric, pediatric, palliative, psychiatric, or neurological diseases. We had previously established a protocol for observing and assessing rectal fecal retention using ultrasonography and for classifying cases into three categories based on the rectal findings: no fecal retention, fecal retention without hard stools, and fecal retention with hard stools. However, although the detection of rectal fecal retention using ultrasonography would be expected to lead to better therapeutic management, there is no standard algorithm for selecting specific treatments and defecation care options based on ultrasonographic findings. Therefore, we organized an expert consensus meeting of multidisciplinary professionals to develop such an algorithm based on rectal ultrasonography findings for patients with constipation in both residential and hospital settings. Full article

The aim of this work was to test whether we can treat cholestasis with dietary approaches applied after the onset of the disease. The effects of intermittent fasting and dietary restriction on liver damage caused by common bile duct ligation (BDL) in rats were studied, with particular attention paid to changes in the activity of enzymes of energy metabolism and antioxidant protection. Morphological changes in liver tissue and serum markers of liver damage were assessed in rats with BDL kept for one month on ad libitum diet, intermittent fasting, or 35% dietary restriction. We studied parameters of glucose metabolism (activity of glycolysis and gluconeogenesis enzymes), TCA cycle, and indicators of oxidative stress and redox status of the liver tissue. Dietary restriction resulted in an increase in gluconeogenesis activity, antioxidant capacity, and autophagy activation. When implemented after BDL, none of the dietary restriction protocols reduced the level of oxidative stress, detrimental morphological and biochemical alterations, or the fibrosis progression. Thus, under severe damage and oxidative stress developing in cholestasis, dietary restrictions are not hepatoprotective and can only be used in a pre-treatment mode. Full article

In order to safeguard the health of river ecosystems and maintain ecological balance, it is essential to rationally allocate water resources. This study utilized continuous runoff data from 1967 to 2020 at the Zhouqu Hydrological Station on the Bailong River. Five hydrological methods, tailored to the hydrological characteristics of the Zhouqu hydrological cross-section, were employed. These methods included the improved dynamic calculation method, the NGPRP method, the improved monthly frequency computation method, the improved RVA method, and the Tennant method. Ecological flow calculations were conducted to determine the ecological flow, with analysis carried out through the degree of satisfaction, economic benefits, and the nonlinear fitting of the GCAS model. We established an ecological flow threshold and early warning program for this specific hydrological cross-section. Ecological flow values calculated using different methods for each month of the year were compared. The improved RVA method and Tennant method resulted in small values ranging from 4.05 to 36.40 m³/s and 7.65 to 22.94 m³/s, respectively, with high satisfaction levels and economic benefits, but not conducive to ecologically sound development. In contrast, the dynamic calculation method, NGPRP method, and improved monthly frequency calculation method yielded larger ecological flow values in the ranges of 21.79–97.02 m³/s, 23.90–137.00 m³/s, and 28.50–126.00 m³/s, respectively, with poor fulfillment and economic benefits. Ecological flow thresholds were determined using the GCAS model, with values ranging from 16.72 to 114.58 m³/s during the abundant water period and from 5.03 to 63.63 m³/s during the dry water period. A three-level ecological warning system was proposed based on these thresholds, with the orange warning level indicating optimal sustainable development capacity for the Zhouqu Hydrological Station. This study provides valuable insights into the scientific management of water resources in the Bailong River Basin to ensure ecological security and promote sustainable development. Full article

This longitudinal study examined associations between chronic medical conditions (CMCs) and persistent dietary supplement (DS) use. On two separate occasions, 1.3 ± 0.2 years apart, military service members (SMs) (n = 5778) completed identical questionnaires concerning their DS use in the past 6 months and their demographic and lifestyle characteristics. Medical conditions were obtained from a medical surveillance system six months before the first questionnaire and during the period between questionnaires. Diagnoses were grouped into 19 major (largely systemic) and 9 specific CMCs. Conditions diagnosed in both periods (CMCs) were examined in relation to DS use reported on both questionnaires (persistent DS use). After adjustment for demographic and lifestyle factors, higher odds of persistent DS use were found in 7 of the 19 major CMCs and 5 of the 9 specific CMCs. SMs with a CMC had 1.25 (95% confidence interval [95%CI] = 1.10–1.41) higher adjusted odds of persistent DS use. The three specific CMCs with the highest adjusted odds of persistent DS use were anxiety (odds ratio [OR] = 2.30, 95%CI = 1.36–3.89), depression (OR = 2.12, 95%CI = 1.20–3.73), and gastroesophageal reflux disease (OR = 2.02, 95%CI = 1.02–4.04). Among DS categories, participants with a CMC had higher adjusted odds of persistent vitamins or mineral use (OR = 1.31, 95% CI = 1.12–1.53). Participants with CMCs had a higher prevalence of persistent DS use, especially individual vitamin and mineral use. Full article

This project employs artificial intelligence, including machine learning and deep learning, to assess COVID-19 readmission risk in Malaysia. It offers tools to mitigate healthcare resource strain and enhance patient outcomes. This study outlines a methodology for classifying COVID-19 readmissions. It starts with dataset description and pre-processing, while the data balancing was computed through Random Oversampling, Borderline SMOTE, and Adaptive Synthetic Sampling. Nine machine learning and ten deep learning techniques are applied, with five-fold cross-validation for evaluation. Optuna is used for hyperparameter selection, while the consistency in training hyperparameters is maintained. Evaluation metrics encompass accuracy, AUC, and training/inference times. Results were based on stratified five-fold cross-validation and different data-balancing methods. Notably, CatBoost consistently excelled in accuracy and AUC across all tables. Using ROS, CatBoost achieved the highest accuracy (0.9882 ± 0.0020) with an AUC of 1.0000 ± 0.0000. CatBoost maintained its superiority in BSMOTE and ADASYN as well. Deep learning approaches performed well, with SAINT leading in ROS and TabNet leading in BSMOTE and ADASYN. Decision Tree ensembles like Random Forest and XGBoost consistently showed strong performance. Full article

Zn²⁺ has a crucial role both in biology and the environment, while Pb²⁺ presents serious hazards in the same areas due to its toxicity, and the need for their analysis often exceeds available instrumental capacity. We report, herein, a new high-throughput optochemical screening method for Zn²⁺ and Pb²⁺ in various solutions. Moreover, we also introduced a new and generalizable three-step-microplate-modification technique, including plasma treating, linker-docking and photocatalytic copolymerization. The surface of a commercially available 96-well-cycloolefin-microplate was treated with atmospheric plasma, and then, the bottoms of the wells were covered by covalently attaching a methacrylate-containing linker-monolayer. Finally, the preactivated microplate wells were covalently functionalized by immobilizing bis(acridino)-crown ether-type sensor molecules, via photocatalytic copolymerization, to a polymethacrylate backbone. This sensing tool can be used in all microplate readers, is compatible with liquid handling platforms and provides an unprecedently fast monitoring (>1000 samples/hour, extrapolated from the time required for 96 measurements) of dissolved Zn²⁺ and Pb²⁺ among recent alternatives above the detection limits of 8.0 × 10⁻⁹ and 3.0 × 10⁻⁸ mol/L, respectively, while requiring a sample volume of only 20 µL. Full article

In the southern Xinjiang region of China, developing efficient irrigation and fertilization strategies to enhance resource utilization and prevent desertification is of critical importance. This study focuses on jujubes in Xinjiang, China, and involves a three-year field experiment aimed at exploring the optimal application strategy of magnetically treated water combined with microbial organic fertilizer to provide scientific support for high-quality jujube production. The experiment included a control group (using only fresh water, denoted as CK) and combinations of magnetically treated water drip irrigation with varying amounts of microbial organic fertilizer: in 2021, treatments included M0 (only irrigating with magnetically treated water), M6 (0.6 t/ha), M12 (1.2 t/ha), M18 (1.8 t/ha), and M24 (2.4 t/ha); in 2022 and 2023, treatments included M0, M6 (0.6 t/ha), M12 (1.2 t/ha), M24 (2.4 t/ha), and M48 (4.8 t/ha). This study investigated the effects of magnetically treated water drip irrigation combined with microbial organic fertilizer on soil physical properties, hydraulic parameters, enzyme activity, aggregate stability, and jujube yield and quality. The application of microbial organic fertilizer significantly reduced the soil bulk density by 3.07% to 11.04% and increased soil porosity by 1.97% to 14.75%. Soil saturated hydraulic conductivity gradually decreased with the increasing amount of microbial organic fertilizer, with a reduction range of 5.95% to 13.69%, while the water-holding capacity significantly improved (from 0.217 cm³/cm³ to 0.264 cm³/cm³). Additionally, microbial organic fertilizer significantly enhanced the activities of urease, catalase, and sucrase in the soil and significantly increased the proportion of large soil aggregates. Jujube yield increased by 3.66% to 21.38%, and the quality significantly improved, as evidenced by the increase in soluble sugar and flavonoid content. The Gauss model calculation results recommended 3.09 t·hm² as the optimal amount of microbial organic fertilizer for comprehensively improving jujube yield and quality. These findings indicate that magnetically treated water drip irrigation combined with high amounts of microbial organic fertilizer significantly improved soil physical properties, hydraulic parameters, enzyme activity, aggregate stability, and jujube yield and quality, providing scientific evidence for desert soil improvement and agricultural production. Full article