Parasomnias are a group of sleep disorders characterized by abnormal and unpleasant motor, verbal or behavioral events that occur during sleep or during transitions between wake and sleep states. They disrupt sleep and can have a detrimental impact on the individual experiencing them. Our goal was to identify types of parasomnias and their prevalence in the post-secondary student population and to explore students' coping strategies for parasomnias they found distressing. Seventy-seven post-secondary students completed the 21-item Munich Parasomnia Screening (MUPS) frequency scale. They also rated, on a 10-point scale, how disturbing each parasomnia was. Not only did 92% percent of students report at least one parasomnia, but our results also indicate that the vast majority of students experienced more than one parasomnia. This led us to investigate the likelihood of the co-occurrence of different parasomnias. With respect to the level of subjectively experienced distress, the most prevalent parasomnias were not always the more disturbing ones. Coded open-ended responses about what students do about the disturbing parasomnias indicate that grounding strategies and physical manipulation of one’s body were the most common, although most participants indicated that in spite of distress, they do nothing to cope. In conclusion, our study found a strikingly high prevalence of parasomnias in this sample of young adults and a lack of knowledge about effective means of dealing with these.

Nitrogen (N) is an essential macro nutrient for crop growth; therefore, N deficit can greatly limit crop growth and production. In the North China Plain (NCP), winter wheat is one of the main food crops, and its yield has increased from approximately 4000 kg ha-1 to 6000 kg ha-1 in the last two decades. Determining the proper N application rates at different growth stages and in all seasons is very important for the sustainable and high production of wheat in the NCP. A field experiment with five N application rates (250, 200, 150, 100, and 40 kgN·ha-1, designated as N250, N200, N150, N100, and N40, respectively) was conducted during the 2017-2018 and 2018-2019 winter wheat seasons to investigate the effects of the N application rate on water- and fertiliz-er-utilization efficiency, and on the crop growth and yield of winter wheat under sprinkler fer-tigation conditions. The results showed that, in the N application range of 40-200 kg ha-1, crop yield and water- and fertilizer-use efficiencies increased as the N application rate increased; however, further increases in the N application rate did not have additional benefits. The N up-take after regreening of winter wheat linearly increased with crop growth. Considering the wheat yield and N-use efficiency, the optimal N application range was 200 kg ha-1, and the best top-dressing strategy was equal amounts of N applied at the regreening, jointing, and grain-filling stages. The results of this study will be useful for optimizing field N management to achieve high wheat yield production in the NCP and in regions with similar climatic and soil environment conditions.

Generative artificial intelligence (GenAI) has been developing with many incredible achievements like ChatGPT and Bard. Deep generative model (DGM) is a branch of GenAI, which is preeminent in generating raster data such as image and sound due to strong points of deep neural network (DNN) in inference and recognition. The built-in inference mechanism of DNN, which simulates and aims to synaptic plasticity of human neuron network, fosters generation ability of DGM which produces surprised results with support of statistical flexibility. Two popular approaches in DGM are Variational Autoencoders (VAE) and Generative Adversarial Network (GAN). Both VAE and GAN have their own strong points although they share and imply underline theory of statistics as well as incredible complex via hidden layers of DNN when DNN becomes effective encoding/decoding functions without concrete specifications. In this research, VAE and GAN is unified into a consistent and consolidated model called Adversarial Variational Autoencoders (AVA) in which VAE and GAN complement each other, for instance, VAE is good at generator by encoding data via excellent ideology of Kullback-Leibler divergence and GAN is a significantly important method to assess reliability of data which is realistic or fake. In other words, AVA aims to improve accuracy of generative models, besides AVA extends function of simple generative models. In methodology this research focuses on combination of applied mathematical concepts and skillful techniques of computer programming in order to implement and solve complicated problems as simply as possible.

: Tunnel instability and lining integrity are intimately tied to the creep properties of the surrounding rock. The acquisition of rock mass creep parameters is critical in ascertaining the appropriate timing for lining construction. Nevertheless, creep tests on rock specimens conducted in a controlled setting cannot be straightforwardly extrapolated to rock mass creep analysis. This study performs laboratory-based creep tests on mudstone samples and establishes the corresponding creep constitutive model. Integration of a Mohr-Coulomb element with the Burgers model in series serves to characterise the yield creep behaviour of the rock mass. Additionally, the research outlines a series of 100 orthogonal experiments utilising randomised creep parameters, and formulates a GA-BP neural network inversion model. Employing long-term deformation measurements from the crown and sidewalls of the project site, this study deduces the creep parameters of the mudstone in the investigated tunnel section and examines the prolonged deformation traits of the surrounding rock. Drawing on the deformation traits of the surrounding rock and the forces impacting the primary support and lining structures, this paper evaluates the earliest and latest viable lining casting periods and pinpoints an optimal timing interval for lining implementation. The methodologies employed herein can serve as a benchmark for analogous endeavors internationally.

The Axillary Seabream Pagellus acarne is of economic importance for recreational and commercial fisheries in the Atlantic and the Mediterranean, but a decline in total landings has been observed and raised some concern. Although biological information on the species has been provided for the Atlantic and Mediterranean, in the Portuguese continental slope data is restricted to the southern part of the country, which points to the relevance of the present work. A total of 520 individuals, between 7.8 cm and 39.9 cm TL, were monthly collected from September 2020 to August 2022 from commercial landings of fishing vessels operating off mainland Portugal, and used to study age and growth, the reproductive strategy and the annual sexual cycle. Age varied between 0 years (7.8 cm TL) and 15 years (34.2 cm TL) and the von Bertalanffy growth parameters were estimated from whole-otolith readings (L∞ = 35.2 cm, k = 0.133 yr–1 and t 0 = –2.78 yr). Pagellus acarne proved to be a protandric hermaphrodite species with males prevailing until 28.0 cm TL and females between 28.0 cm and 34.0 cm TL with a brief sex change phase. Females presented asynchronous oocyte development with a batch spawning pattern. The spawning season occurred from April to October with a spawning peak between June and August aas shown by histological analysis of the gonads and high levels of GSI during the period.

In this paper, the deformation behavior of S32750 duplex stainless steel during low cycle fatigue was studied by controlling number of cycles. The microstructure of the specimens under different cycles was characterized by optical microscope (OM), scanning electron microscope (SEM), electron backscatter diffraction (EBSD) and transmission electron microscope (TEM). Microhardness of two phases was measured by a digital microhardness instrument. The results showed that the microhardness of ferrite increases significantly after the first 4000 cycles, while the austenite shows a higher strain hardening rate after fatigue fracture, and the microhardness of ferrite and austenite increases by 23 HV and 87 HV, respectively. Two-phase kernel average misorientation (KAM) diagram showed that the continuous accumulation of plastic deformation easily leads to the initiation of cracks inside the austenite and at the phase boundaries. The evolution of dislocation morphology in two phases was obviously different. With the increase of cycle number, the dislocation in ferrite gradually transforms from dislocation bundles and dislocation array to sub-grain structure, while the dislocation in austenite gradually develops from dipole array to ordered Taylor lattice network structure.

We present a case of adult-onset systemic chronic active EBV disease (CAEBV) in a 40-year-old woman with chronic HBV hepatitis. Initial symptoms resembled a viral illness, progressing to recurrent fever, transaminitis, and anasarca. Investigations revealed high-level EBV viremia and an abnormal T-cell population in liver and bone marrow, indicative of CAEBV. Liver biopsy showed CD3+ T-cells lacking TCRbeta and displaying dim/negative CD5, with elevated EBV-infected T-cells. Next-generation sequencing identified rare variants in CREBBP, SPEN, TP73, and PLCG2, suggesting potential contributions to disease pathogenesis. This case underscores diagnostic challenges and management complexities of adult-onset CAEBV, particularly with underlying chronic HBV infection. Genomic profiling offers crucial insights into the molecular landscape of rare lymphoid malignancies, highlighting the importance of personalized treatment strategies. The distinct immunophenotypic features underscore the heterogeneity in EBV-associated T-cell LPDs, urging further research for optimized clinical management

Underwater image often exhibit detail blurring and color distortion due to light scattering, impurities, and other influences, obscuring essential textures and details. This presents a challenge for existing super-resolution techniques in identifying and extracting effective features, making high-quality reconstruction difficult. This research aims to innovate underwater image super-resolution technology to tackle this challenge. Initially, an underwater image degradation model was created by integrating random subsampling, Gaussian blur, mixed noise, and suspended particle simulation to generate a highly realistic synthetic dataset, thereby training the network to adapt to various degradation factors. Subsequently, to enhance the network's capability to extract key features, improvements were made based on the symmetrically structured Blind Super-Resolution Generative Adversarial Network (BSRGAN) model architecture. An attention mechanism based on energy functions was introduced within the generator to assess the importance of each pixel, and a weighted fusion strategy of adversarial loss, reconstruction loss, and perceptual loss was utilized to improve the quality of image reconstruction. Experimental results demonstrate that the proposed method achieved significant improvements in Peak Signal-to-Noise Ratio (PSNR) and Underwater Image Quality Measure (UIQM) by 0.85 dB and 0.19, respectively, significantly enhancing the visual perception quality and indicating its feasibility in super-resolution applications.

In this paper, our goal is to perform a virtual restoration of an ancient coin from its image. The present work is the first one to propose this problem, and it is motivated by two key promising applications. The first of these emerges from the recently recognised dependence of automatic image based coin type matching on the condition of the imaged coins; the algorithm introduced herein could be used as a pre-processing step, aimed at overcoming the aforementioned weakness. The second application concerns the utility both to professional and hobby numismatists of being able to visualise and study an ancient coin in a state closer to its original (minted) appearance. To address the conceptual problem at hand, we introduce a framework which comprises a deep learning based method using Generative Adversarial Networks, capable of learning the range of appearance variation of different semantic elements artistically depicted on coins, and a complementary algorithm used to collect, correctly label, and prepare for processing a large numbers of images (here 100,000) of ancient coins needed to facilitate the training of the aforementioned learning method. Empirical evaluation performed on a withheld subset of the data demonstrates extremely promising performance of the proposed methodology and shows that our algorithm correctly learns the spectra of appearance variation across different semantic elements, and despite the enormous variability present reconstructs the missing (damaged) detail while matching the surrounding semantic content and artistic style.

Traditional image steganography conceals secret messages into unprocessed natural images by modifying the pixel value, causing the obtained stego different from the original image in terms of statistical distribution, thereby could be detected by a well-trained classifier for steganalysis. To ensure the steganography is imperceptible and in line with the trend of art images produced by Artificial Intelligence Generated Content (AIGC) becoming popular in social networks, this paper proposes to embed hidden information throughout the process of the generation of an art-style image by designing an image style transformation neural network with steganography function. The proposed scheme takes a content image, an art-style image, and messages to be embedded as inputs, processing them with an encoder-decoder model, and finally generates a styled image containing the secret messages at the same time. An adversarial training technique is applied to enhance the imperceptibility of the generated art-styled stego image with from plain style-transferred images. The lack of the original cover image makes it difficult for the opponent learning a steganalyzer to identify the stego. The recommended approach can successfully withstand existing steganalysis techniques and attain the embedding capacity of 3 bits per pixel for a color image, according to experimental results.

Plato defined a quality as “some degree of perfection” [49]. Studies on quality have unveiled the internal and external quality factors [17] that significantly impact product quality [4]. Internal factors are invisible to the end customer and are dependent on overall work organisation by the development team [17]. This work organisation is called “the process” [11],[33]. In this article, we will discuss how to address the drone-dedicated software development process to support system verification and ensure product quality by supporting quality characteristics and therefore increase software development awareness and control. We will discuss the process's influence on overall work activities and relationships between those activities by addressing the software development process utilised in the drone-dedicated GNSS-denied navigation system development project. The result was observable after three weeks of starting the software development. It was focused on better team awareness, faster task completion, lower number of development mistakes, and better and faster change response than we observed in other projects that didn’t follow the predefined process.

Nowadays, and with the mechanization of life, speech processing has become so crucial for the interaction between humans and machines. Deep neural networks require a database with enough data for training. The more features are extracted from the speech signal, the more samples are needed to train these networks. Adequate training of these networks can be ensured when there is access to sufficient and varied data in each class. If there is not enough data; it is possible to use data augmentation methods to obtain a database with enough samples. One of the obstacles to developing speech emotion recognition systems is the Data sparsity problem in each class for neural network training. The current study has focused on making a cycle generative adversarial network for data augmentation in a system for speech emotion recognition. For each of the five emotions employed, an adversarial generating network is designed to generate data that is very similar to the main data in that class, as well as differentiate the emotions of the other classes. These networks are taught in an adversarial way to produce feature vectors like each class in the space of the main feature, and then they add to the training sets existing in the database to train the classifier network. Instead of using the common cross-entropy error to train generative adversarial networks and to remove the vanishing gradient problem, Wasserstein Divergence has been used to produce high-quality artificial samples. The suggested network has been tested to be applied for speech emotion recognition using EMODB as training, testing, and evaluating sets, and the quality of artificial data evaluated using two Support Vector Machine (SVM) and Deep Neural Network (DNN) classifiers. Moreover, it has been revealed that extracting and reproducing high-level features from acoustic features, speech emotion recognition with separating five primary emotions has been done with acceptable accuracy.

Large-scale hydrological modeling in China is challenging given the sparse meteorological stations and large uncertainties associated with atmospheric forcing data.Here we introduce the development and use of the China Meteorological Assimilation Driving Datasets for the SWAT model (CMADS) in the Heihe River Basin(HRB) for improving hydrologic modeling, by leveraging the datasets from the China Meteorological Administration Land Data Assimilation System (CLDAS)(including climate data from nearly 40000 area encryption stations, 2700 national automatic weather stations, FengYun (FY) 2 satellite and radar stations). CMADS uses the Space Time Multiscale Analysis System (STMAS) to fuse data based on ECWMF ambient field and ensure data accuracy. In addition, compared with CLDAS, CMADS includes relative humidity and climate data of varied resolutions to drive hydrological models such as the Soil and Water Assessment Tool (SWAT) model. Here, we compared climate data from CMADS, Climate Forecast System Reanalysis (CFSR) and traditional weather station (TWS) climate forcing data and evaluatedtheir applicability for driving large scale hydrologic modeling with SWAT. In general, CMADS has higher accuracy than CFRS when evaluated against observations at TWS; CMADS also provides spatially continuous climate field to drive distributed hydrologic models, which is an important advantage over TWS climate data, particular in regions with sparse weather stations. Therefore, SWAT model simulations driven with CMADS and TWS achieved similar performances in terms of monthly and daily stream flow simulations, and both of them outperformed CFRS. For example, for the three hydrological stations (Ying Luoxia, Qilian Mountain, and ZhaMasheke) in the HRB at the monthly and daily Nash-Sutcliffe efficiency ranges of 0.75-0.95 and 0.58-0.78, respectively, which are much higher than corresponding efficiency statistics achieved with CFSR (monthly: 0.32-0.49 and daily: 0.26 – 0.45). The CMADS dataset is available free of charge and is expected to a valuable addition to the existing climate reanalysis datasets for deriving distributed hydrologic modeling in China and other countries in East Asia.

Some medical professional organizations have advocated for including the menstrual cycle as a vital sign in adolescence, but not in adulthood. However, documenting menstrual cycle patterns is not routine clinical or research practice. Vital signs are used to predict health outcomes, indicate needed treatment, and monitor a clinical course. They can help identify pathologies, affirm wellness, and are responsive to exposures. Here we review the scientific evidence showing how the menstrual cycle meets these criteria and should therefore be treated as a vital sign. Using key words and controlled vocabulary terms, we carried out multiple literature searches, prioritizing the inclusion of systematic reviews, meta-analyses, and clinical practice guidelines. This review describes how the menstrual cycle is a health indicator, can cyclically impact health conditions, and its associations with long-term post-menopausal health outcomes. We review exposures influencing the menstrual cycle, evidence underlying its use to optimize wellness, and available tools for documenting cycles. Supplementary materials include patient handouts on menstrual cycle tracking, and an index of related clinical practice guidelines and reviews by subject. The menstrual cycle is a vital sign from menarche through menopause, an underutilized but powerful tool for understanding gynecological and general health.

The AUC-ROC is a widespread measure to assess the performance of a binary classification model across various discrimination thresholds. Yet, it is not apt for unbalanced class problems and is misleading for early retrieval. For instance, link prediction in complex networks is an unbalanced early retrieval problem, whose goal is to offer a ranking of the nonobserved network links, prioritizing a small cohort of positive links (for which we are sure the labels are reliable) on top of a list largely populated by unlabeled links (for which the labels are uncertain). Differently from binary classification, here the evaluation focuses on how the predictor prioritizes the positive class, because the negative class does not exist and is replaced by an unlabeled class. For decades, scholars have been investigating the necessity to correct and to generalize the AUC-ROC to work for both unbalanced classification and early retrieval evaluation, this is requested in many applied domains of computational science. Here we propose the area under the magnified ROC (AUC-mROC), a new measure that adjusts the standard AUC-ROC to work for unbalanced early retrieval problems such as link prediction. Finally, we introduce the area under the generalized ROC (AUC-gROC), which unifies both AUC-mROC and AUC-ROC to provide a universal and reliable evaluation measure that can work for both classification and early retrieval problems, regardless of class proportion.This discovery represents a critical achievement, culminating in success after decades of contentious research. Its solution promises to significantly impact various domains within applied computational science.

This study explores the public library service evaluation domain through user-generated content on Google Maps, highlighting digital feedback's significant yet underexplored potential in understanding public library patronage across Taiwan's six major cities. Utilizing a mixed-methods research design, this study integrates Google Maps review content analysis with Social Network Analysis to delineate public perceptions and identify areas for service enhancement in public libraries. It innovatively leverages personal experiences extracted from over 60,000 Google Maps reviews to evaluate public library services in cities such as Taipei, New Taipei, Taoyuan, Taichung, Tainan, and Kaohsiung. The research taps into the National Library of Taiwan's National Library Statistics System to provide a robust analysis of library performance and user satisfaction, offering a novel perspective by emphasizing user-centric feedback from Google Maps as a primary data source. This approach provides quantitative data on library usage and geographic distribution and enriches our understanding of the qualitative experiences of library users. In analyzing the keywords from Google Maps reviews of public libraries, we categorize and interpret these under the three core LibQUAL+ dimensions—Affect of Service, Information Control, and Library as Place. The findings expose variances in perceived service quality among the cities, with Kaohsiung and Taichung receiving the highest accolades for service satisfaction. Simultaneously, the study identifies potential areas for improvement, particularly in cities with lower satisfaction ratings like Taipei. This personalized feedback illustrates the intimate relationship between public libraries and their communities, offering invaluable insights for policymakers and library management to enhance service delivery and user experience.

The IDS serves as a security system that maintains constant surveillance over network traffic and host systems in order to identify any security breaches or potentially concerning activities. Recently. the rise in cyber-attacks has driven the necessity for the development of automated and intelligent network intrusion detection systems. These systems are designed to learn the typical patterns of network traffic, allowing them to identify any deviations from normal behaviour, which can be classified as anomalous or malicious. Machine learning methods are widely used to exhibit a satisfactory effectiveness in detecting malicious payloads in the network traffic. While the volume of the data generated from IDS is increasing exponentially results in the emergence of substantial security risks, it highlighted the imperative to strengthen network security. The performance of traditional machine learning methods depends on the dataset and the data balance distribution in it. while most of IDS datasets suffer from unbalancing, this limits the performance of the machine learning method used in the system and results in missed detections and false alarms in the conventional IDSs. To address this issue, this paper presents a new model-based Generative Adversarial Network (GAN) called TDCGAN to enhance the detection rate of less of minor class in the dataset while maintaining efficiency. The proposed model consists of one generator and three discriminators with an election layer at the end of architecture. The UGR’16 data set is used for evaluation purposes. In order to demonstrate the efficacy of our proposed model, various machine learning algorithms have been utilized for comparison. The experimental findings have determined that TDCGAN presents an efficient resolution for addressing imbalanced intrusion detection and surpasses the performance of other oversampling machine learning methods.

Complementary Metal-Oxide-Semiconductor (CMOS) is a typical image sensor that has a wide range of applications. However, considering the limitations of the weather condition and hardware cost, it is hard to capture high-resolution images by CMOS sensor. Recently, Super-Resolution (SR) techniques for image restoration has been gaining attentions due to its excellent performance. Under the powerful learning ability, Generative Adversarial Networks (GANs) have been proved to achieve great success. In this paper, we propose the Advanced Generative Adversarial Networks (AGAN) to efficiently correct these issues; 1) we design a Laplacian pyramid framework as pre-trained module, which is beneficial to provide multi-scale features for our input. 2) at each feature block, a convolutional skip-connections network, which may contain some latent information, is significant for generative model to reconstruct a plausible-looking image; 3) considering that edge details usually play an important role in image generation, a novel perceptual loss function is defined to train and seek optimal parameters. It is effective to achieve excellent and compelling quality captured by CMOS sensor. Quantitative and qualitative evaluations have been demonstrated that our algorithm not only fully takes advantage of Convolutional Neural Networks (CNNs) to improve the image quality, but also performs better than previous GAN algorithms for super-resolution task.

Brain-to-brain communication (B2B-C) is rapidly expanding, integrating communication technology and neuroscience to enable direct neural data transfer between people. Nonetheless, because neural data is susceptible to noise, interference, and hostile attacks, guaranteeing the security and resilience of B2B-C systems continues to be difficult. This work aims to use Adversarial Neural Network Training (ANNT) to improve the security of B2B-C systems by using Steady-State Visually Evoked Potentials (SSVEP) EEG data. We use two large SSVEP datasets for a thorough analysis: Lee2019_SSVEP and Nakanishi2015. We use the Fast Gradient Sign Method (FGSM) to create adversarial instances and ANNT to train the model on clean and adversarially perturbed data. The system's accuracy and resilience are significantly improved by ANNT, as seen by the up to 17% increase in adversarial accuracy and the average 0.03 point improvement in the Area Under the Curve (AUC). This work demonstrates how ANNT may strengthen B2B-C systems against advanced cyberattacks, opening the door for dependable and safe neural communication technologies.

The advancement in network security threats led to the development of new Intrusion Detection Systems(IDS) that rely on deep learning algorithms known as deep IDS. Along with other systems based on deep learning, deep IDS suffer from adversarial examples: malicious inputs aiming to change the prediction of a machine learning/deep learning model. Protecting deep learning against adversarial examples remains an open challenge. In this paper, we propose “NIDS-Defend” a framework to enhance the robustness of Network IDS against adversarial attacks. Our framework is composed of two layers: a statistical test and a classifier that together detect adversarial examples in real-time. The detection process consists of two steps: (1) flagging flows that contain adversarial examples with a statistical test, and (2) extracting individual adversarial examples in the previously flagged flows with a classifier. Our approach is evaluated on binary IDS with the NSL-KDD dataset. To generate adversarial examples, the crafting methods used are (1) Boundary attack and (2) HopSkipJumpAttack. We investigate the vulnerabilities of a Network IDS against adversarial examples, then apply our defense. The statistical test can confidently distinguish adversarial flows with more than 95% accuracy, and the classifier detects individual adversarial examples with more than 80% accuracy. We also show that our framework detects adversarial examples crafted by an adversary aware of the defense and confirm the effectiveness of our solution against adversarial attacks.

Image segmentation is a new challenge prob- lem in medical application. The use of medical imaging has become an integral part of research, as it allows us to see inside the human body without surgical intervention. Many researcher have studied brain segmentation. One stage method is used to segment the brain tissues. In this paper, we proposed the multi-stage generative ad- versarial network to solve the problem of information loss in the one-stage. We utilize the coarse-to-fine to improve brain segmentation using multi-stage generative adversar- ial networks (GAN). In the first stage, our model generated a coarse outline for (i) background and (ii) brain tissues. Then, in the second stage, the model generated outline for (i) white matter (WM), (ii) gray matter (GM) and (iii) cerebrospinal fluid (CSF). A good result can be achieved by fusing the coarse outline and refine outline. We conclude that our model is more efficient and accu- rate in practice for both infant and adult brain segmenta- tion. Moreover, we observe that multi-stage model is faster than prior models. To be more specific, the main goal of multi-stage model is to see the performance of the model in a few shot learning case where a few labeled data are available. For medical image, this proposed model can work in a wide range of image segmentation where the convolution neural networks and one-stage methods have failed.

Real-time strategy (RTS) game has proposed many challenges for AI research for its large state spaces, enormous branch factors, limited decision time and dynamic adversarial environment. To tackle above problems, the method called Adversarial Hierarchical Task Network planning (AHTN) has been proposed and achieves favorable performance. However, the HTN description it used cannot express complex relationships among tasks and impacts of environment on tasks. Moreover, the AHTN cannot handle task failures during plan execution. In this paper, we propose a modified AHTN planning algorithm named AHTNR. The algorithm introduces three elements essential task, phase and exit condition to extend the HTN description. To deal with possible task failures, the AHTNR first uses the extended HTN description to identify failed tasks. And then a novel task repair strategy is proposed based on historical information to maintain the validity of previous plan. Finally, empirical results are presented for the μRTS game, comparing AHTNR to the state-of-the-art search algorithms for RTS games.

Convolutional Neural Networks (CNNs) are often criticized for their lack of transparency, acting as 'black boxes' in decision-making, a challenge compounded by class imbalance in ECG datasets, which limits their clinical application. This study introduces a CNN-based ECG signal classification model that enhances interpretability and addresses class imbalance through the Synthetic Minority Over-sampling Technique (SMOTE). The model also integrates Uniform Manifold Approximation and Projection (UMAP) for dimensionality reduction and SHAP value analysis, facilitating the visualization of decision boundaries and the assessment of feature contributions. Our evaluation using the MIT-BIH Arrhythmia Database highlights the model's high performance, with accuracy and precision nearing 1.00 for Normal ECG (NOR), Left Bundle Branch Block (LBBB), Right Bundle Branch Block (RBBB), and Ventricular Premature Beat (PVC) in the six-class task. In the ten-class task, the model demonstrated robustness, particularly with an accuracy of 0.9846, precision of 0.9783, recall of 0.9736, and F1 score of 0.9760 in Pacemaker Fusion Beat (PFHB), supported by an AUC of 0.9999 and AP of 0.9885. These results underscore the model's efficacy in cardiac rhythm recognition and resilience to class imbalance. Future research will explore sophisticated model architectures and feature extraction methods to enhance the model's generalization and clinical applicability for early heart disease diagnosis and personalized treatment.

The upsurge of Generative Adversarial Networks (GANs) in the previous five years has led to advancements in unsupervised data manipulation, sourced feature translation, and precise input-output synthesis through a competitive optimization of the discriminator and generator networks. More specifically, the recent rise of cycle-consistent GANs enables style transfers from a discrete source (input A) to target domain (input B) by preprocessing object features for a multi-discriminative adversarial network. Traditionally, cyclical adversarial networks have been exploited for unpaired image-to-image translation and domain adaptation by determining mapped relationships between an input A graphic and an input B graphic. However, this integral mechanism of domain adaptation can be applied to the complex acoustical features of human speech. Although well-established datasets, such as the 2018 Voice Conversion Challenge repository, paved way for female-male voice transformation, cycle-GANs have rarely been re-engineered for voices outside the datasets. More critically, cycle-GANs have massive potential to extract surface-level and hidden feature to distort an input A source into a texturally unrelated target voice. By preprocessing, compressing, and packaging unique acoustical voice properties, CycleGANs can learn to decompose speech signals and implement new translation models while preserving emotion, the intent of words, rhythm, and accents. Due to the potential of CycleGAN’s autoencoder in realistic unsupervised voice-voice conversion/feature adaptation, the researchers raise the ethical implications of controlling source input A to manipulate target voice B, particularly in cases of defamation and sabotage of target B’s words. This paper analyzes the potential of cycle-consistent GANs in deceptive voice-voice conversion by manipulating interview excerpts of political candidates.

Sparse training (ST) aims to ameliorate deep learning by replacing fully connected artificial neural networks (ANNs) with sparse or ultra-sparse ones, such as brain networks are, therefore it might benefit to borrow brain-inspired learning paradigms from complex network intelligence theory. Here, we launch the ultra-sparse advantage challenge, whose goal is to offer evidence on the extent to which ultra-sparse (around 1% connection retained) topologies can achieve any leaning advantage against fully connected. Epitopological learning is a field of network science and complex network intelligence that studies how to implement learning on complex networks by changing the shape of their connectivity structure (epitopological plasticity). One way to implement Epitopological (epi- means new) Learning is via link prediction: predicting the likelihood of non-observed links to appear in the network. Cannistraci-Hebb learning theory inspired the CH3-L3 network automata rule for link prediction which is effective for general-purpose link prediction. Here, starting from CH3-L3 we propose Epitopological Sparse Meta-deep Learning (ESML) to apply Epitopological Learning to sparse training. In empirical experiments, we find that ESML learns ANNs with ultra-sparse hyperbolic (epi-)topology in which emerges a community layer organization that is meta-deep (meaning that each layer also has an internal depth due to power-law node hierarchy). Furthermore, we discover that ESML can in many cases automatically sparse the neurons during training (arriving even to 30% neurons left in hidden layers), this process of node dynamic removal is called percolation. Starting from this network science evidence, we design Cannistraci-Hebb training (CHT), a 4-step training methodology that puts ESML at its heart. We conduct experiments on 7 datasets and 5 network structures comparing CHT to dynamic sparse training SOTA algorithms and the fully connected counterparts. The results indicate that, with a mere 1% of links retained during training, CHT surpasses fully connected networks on VGG16, GoogLeNet, ResNet50, and ResNet152. This key finding is an evidence for ultra-sparse advantage and signs a milestone in deep learning. CHT acts akin to a gradient-free oracle that adopts CH3-L3-based epitopological learning to guide the placement of new links in the ultra-sparse network topology to facilitate sparse-weight gradient learning, and this in turn reduces the convergence time of ultra-sparse training. Finally, CHT offers the first examples of parsimony dynamic sparse training because, in many datasets, it can retain network performance by percolating and significantly reducing the node network size. Our code is available at: https://github.com/biomedical-cybernetics/Cannistraci-Hebb-training.

M-polynomial of different molecular structures helps to calculate many topological indices. A topological index of graph G is a numerical parameter related to G which characterizes its molecular topology and is usually graph invariant. In the field of quantitative structure-activity (QSAR) quantitative structure-activity structure-property (QSPR) research, theoretical properties of the chemical compounds and their molecular topological indices such as the Zagreb indices, Randic index, Symmetric division index, Harmonic index, Inverse sum index, Augmented Zagreb index, multiple Zagreb indices etc. are correlated. In this report, we compute closed forms of M-polynomial, first Zagreb polynomial and second Zagreb polynomial of Octagonal network. From the M-polynomial we recover some degree-based topological indices for Octagonal network. Moreover, we give a graphical representation of our results.

Graft injury affects over 50% of liver transplant (LT) recipients, but non-invasive biomarkers to diagnose and guide treatment are currently limited. We aimed to develop a biomarker of graft injury by integrating serum metabolomic profiles with clinical variables. Serum from 55 LT recipients with biopsy confirmed metabolic-dysfunction associated steatohepatitis (MASH), T-cell mediated rejection (TCMR) and biliary complications was collected and processed using a combination of LC-MS/MS assay. The metabolomic profiles were integrated with clinical information using a multi-class Machine Learning (ML) classifier. The efficacy of the model was assessed through the evaluation of the Out-of-Bag (OOB) error estimate. Our ML model yielded an overall accuracy of 79.66% with an OOB estimate of the error rate at 19.75%. The model exhibited a maximum ability to distinguish MASH, with an OOB error estimate of 7.4% compared to 22.2% for biliary and 29.6% for TCMR. The metabolites serine and serotonin emerged as the topmost predictors. When predicting binary outcomes using 3 models: Biliary (biliary vs. rest), MASH (MASH vs. rest) and TCMR (TCMR vs. rest), the AUCs were 0.882, 0.972 and 0.96 respectively. Our ML tool integrating serum metabolites with clinical variables shows promise as a non-invasive, multi-class serum biomarker of graft pathology.

Dynamic sparse training is an effective strategy to alleviate the training and inference demands of artificial neural networks. However, current sparse training methods face a challenge in achieving high levels of sparsity while maintaining performance comparable to that of their fully connected counterparts. The Cannistraci-Hebb training (CHT) method produces an ultra-sparse advantage compared to fully connected training in various tasks by using a gradient-free link regrowth method, which relies solely on the network topology. However, its rigid selection based on link prediction scores may lead to epitopological local minima, especially at the beginning of the training process when the network topology might be noisy and unreliable. In this article, we introduce the Cannistraci-Hebb training soft rule (CHTs), which applies a flexible approach to both the removal and regrowth of links during training, fostering a balance between exploring and exploiting network topology. Additionally, we investigate the network topology initialization using several approaches, including the bipartite scale-free and bipartite small-world network models. Empirical results show that CHTs can surpass the performance of fully connected networks with MLP architecture by using only 1% of the connections (99% sparsity) on the MNIST, EMNIST, and Fashion MNIST datasets and can provide remarkable results with only 0.1% of the links (99.9% sparsity). In some MLPs for image classification tasks, CHTs can reduce the active neuron network size to 20% of the original nodes (neurons), demonstrating a remarkable ability to generalize better than fully connected architectures, reducing the entire model size. This represents a relevant result for dynamic sparse training. Finally, we present evidence from larger network models such as Transformers, with 10% of the connections (90% sparsity), where CHTs outperform other prevalent dynamic sparse training methods in machine translation tasks.

Image fusion is the process of combining multiple input images from single or multiple imaging modalities into a fused image, which is expected to be more informative for human or machine perception as compared to any of the input images. In this paper, we propose a novel method based on deep learning for fusing infrared images and visible images, named the LBP-based proportional input generative adversarial network (LPGAN). In the image fusion task, the preservation of structural similarity and image gradient information is contradictory, and it is difficult for both to achieve good performance at the same time. To solve this problem, we innovatively introduce Local Binary Patterns (LBP) into Generative Adversarial Networks (GANs), which effectively utilize the texture features of the source images, so that the network has stronger feature extraction ability and anti-interference ability. In the feature extraction stage, we introduce a pseudo-siamese network for the generator to extract the detailed features and the contrast features. At the same time, considering the characteristic distribution of different modal images, we propose a 1:4 scale input mode. Extensive experiments on the publicly available TNO dataset and CVC14 dataset show that the proposed method achieves the state-of-the-art performance. We also test the universality of LPGAN through the fusion of RGB and infrared images on the RoadScene dataset. In addition, LPGAN is applied to multi-spectral remote sensing image fusion. Both qualitative and quantitative experiments demonstrate that our LPGAN can not only achieve good structural similarity, but also retain rich detailed information.

World Health Organization (WHO) provides the guideline for managing the Particulate Matter (PM) level because when the PM level is higher, it threats the human health. For managing PM level, the procedure for measuring PM value is needed firstly. We use Tapered Element Oscillating Microbalance (TEOM)-based PM measuring sensors because it shows higher cost-effectiveness than Beta Attenuation Monitor (BAM)-based sensor. However, TEOM-based sensor has higher probability of malfunctioning than BAM-based sensor. In this paper, we call the overall malfunction as an anomaly, and we aim to detect anomalies for the maintenance of PM measuring sensors. We propose a novel architecture for solving the above aim that named as Hypothesis Pruning Generative Adversarial Network (HP-GAN). We experimentally compare the several anomaly detection architectures to certify ours performing better.

Automated skin lesion analysis is one of the trending fields that has gained attention among the dermatologists and healthcare practitioners. Skin lesion restoration is an essential preprocessing step for lesion enhancements for accurate automated analysis and diagnosis. Digital hair removal is a non-invasive method for image enhancement by solving the hair-occlusion artefact in previously captured images. Several hair removal methods were proposed for skin delineation and removal. However, manual annotation is one of the main challenges that hinder the validation of these proposed methods on a large number of images or using benchmarking datasets for comparison purposes. In the presented work, we propose a realistic hair simulator based on context-aware image synthesis using image-to-image translation techniques via conditional adversarial generative networks for generation of different hair occlusions in skin images, along with the ground-truth mask for hair location. Besides, we explored using three loss functions including L1-norm, L2-norm and structural similarity index (SSIM) to maximise the synthesis quality. For quantitatively evaluate the realism of image synthesis, the t-SNE feature mapping and Bland-Altman test are employed as objective metrics. Experimental results show the superior performance of our proposed method compared to previous methods for hair synthesis with plausible colours and preserving the integrity of the lesion texture.

Background. Gene rearrangements affecting KMT2A are frequent in acute myeloid leukemia (AML) and are often associated with a poor prognosis. KMT2A gene fusions are often detected by chromosome banding analysis and confirmed by fluorescence in-situ hybridization. However, small intragenic insertions, termed KMT2A partial tandem duplication (PTD), are particularly challenging to detect using standard molecular and cytogenetic approaches. Methods. We have validated the use of a custom hybrid capture based next-generation sequencing (NGS) panel for comprehensive profiling of AML patients seen at our institution. This NGS panel targets the entire consensus coding DNA sequence of KMT2A; to deduce the presence of a PTD we used the relative ratio of KMT2A exons coverage. We sought to corroborate the KMT2A-PTD NGS results using (1) multiplex-ligation probe amplification (MLPA) and (2) optical genome mapping (OGM). Results. We analyzed 932 AML cases and identified 41 individuals harboring a KMT2A-PTD. MLPA, NGS and OGM confirmed the presence of a KMT2A-PTD in 22 of the cases analyzed where orthogonal testing was possible. Two false positive PTD calls by NGS could be explained by the presence of cryptic structural variants impacting KMT2A and interfering with PTD analysis. OGM revealed the nature of these previously undetected gene rearrangements in KMT2A, while MLPA yielded in-conclusive results. MLPA analysis for KMT2A-PTD is limited to exon 4, whereas NGS and OGM resolved KMT2A-PTD sizes and copy number levels. Conclusion. KMT2A-PTDs are complex gene rearrangements that cannot be fully ascertained using a single genomic platform. MLPA, NGS panels and OGM are complementary technologies applied in standard of care testing for AML patients. MLPA and NGS panels are designed for targeted copy number analysis; however, our results show that integration of concurrent genomic alterations is needed for accurate KMT2A-PTD identification. Unbalanced chromosomal rearrangements overlapping with KMT2A can interfere with the diagnostic sensitivity and specificity of copy number based KMT2A-PTD detection methodologies.

Background: Pediatric obesity treatment is based on high-intensity lifestyle counseling. However, high dropout rates and low effectiveness have been reported even in specialized centers. Mobile health technologies have been used in research settings to overcome these limits with contrasting results. This study aims to evaluate the effectiveness of a six-month intervention with a mobile app for the treatment of pediatric obesity at 6 and 12 months of follow-up. Methods: Patients were randomly assigned to standard care or standard care plus mobile app (2:1). The mobile app delivered high-intensity lifestyle counseling for diet and physical activity. Results: Seventy-five subjects were prospectively enrolled. At six months of follow-up, the m-app group showed significantly lower dropout rates compared to standard care(p=0.01). The risk of dropout was significantly higher in controls compared to the intervention group (OR 3.86,95%C.I. 1.39-10.42,p=0.01). After one year of follow-up, we observed lower albeit non statistically significant dropout rates in the m-app compared to the standard care group(p=0.24). No differences were observed in terms of z-score BMI and percentage of BMI reduction between the two groups. Conclusion: our findings suggest that mobile app might help in the clinical management of children and adolescents with obesity in terms of dropout reduction.

Background/Objectives:The first attempts of posterior lumbar interbody fusion can be traced back to the 1940s, where their performance was marked by animosity due to high rates of failure. Nowadays, the use of interbody fusion involves a much more complicated consideration of factors such as global alignment, disc height, fusion rates, and operative risk, all combined at once.Our study aims to examine all these effects using Flarehawk 9 as a means of interbody fusion.Materials and methods: A total of 58 patients underwent open posterior lumbar surgery using Flarehawk 9 between September 2021 and February 2023 with a mean follow up of 1 year.The mean age was 59.8 years old ( range between 33 and 79 years old), 36 of them are males while 22 of them are females. The diagnostic groups included spinal canal stenosis (n=40), failed back surgery syndrome-revision surgery (n=5),spondylolisthesis with slip percentage 25% (n=4),recurrent herniated disc (n=7) and adjacent segment disease (n=2). Results: The majority of patients demonstrated remarkable improvement based on ODI scores.The rate of union varied based on the fused levels and whether the patients had previous surgery or not.The amount of lordosis postoperatively is increased by 2±0.4 degrees.Conclusions: Even though anterior approaches become more and more popular and advanced nowadays, posterior fusion with interbody cage still remains a safe and effective method to treat various spine surgical pathologies with optimal results.

Introduction: The aim is to investigate the possibility of altering the delusional perceptions of psychotic patients by exposing them to a cognitively flexible virtual environment. A flexible vir-tual reality (VR) environment could challenge and enhance the ability to adapt to changing situa-tions and generate novel solutions to core psychotic symptoms. Materials and methods: A systematic review was conducted using different combinations of keywords in different databases. This study was conducted using the PRISMA statement. Results: There is a growing literature on the use of VR to manipulate and normalise perceptual distortions in psychosis. Over the last decade, the number of published studies on VR in mental health has increased 14-fold. Conclusions: A cognitive flexibility virtual environment can alter delusional perception by ex-posing the person to different scenarios that require them to question their assumptions, test their hypotheses, and revise their beliefs. Commonly used biosensors measure heart rate, skin con-ductance and body temperature in relation to different emotional states. Recently, there has been a major shift towards the use of neuroimaging techniques to better understand the pathophysiology of mental disorders. This is where the new wave of biosensor-integrated virtual reality (VR) sys-tems comes in.

Despite widespread industrial use, the environmental safety of Hydroquinone (HQ), a benzene compound from plants used in processes like cosmetics, remains uncertain. This study evaluated the ecotoxicological impact of HQ on soil and river environments, utilizing non-target indicator organisms from diverse trophic levels: Daphnia magna, Vibrio fischeri, Allium cepa, and Eisenia fetida. For a more environmentally realistic assessment, microbial communities from a river and un-treated soil underwent 16S rRNA gene sequencing, with growth and changes in community-level physiological profiling assessed using Biolog EcoPlate™ assays. The water indicator D. magna exhibited the highest sensitivity to HQ (EC50 = 0.142 µg/mL), followed by V. fischeri (EC50 = 1.446 µg/mL), and A. cepa (LC50 = 7.631 µg/mL), while E. fetida showed the highest resistance (EC50 = 234 mg/Kg). Remarkably, microbial communities mitigated HQ impact in both aquatic and terrestrial environments. River microorganisms displayed minimal inhibition, except for a significant re-duction in polymer metabolism at the highest concentration (100 µg/mL). Soil communities demonstrated resilience up to 100 µg/mL, beyond which there was a significant decrease in population growth and the capacity to metabolize carbohydrates and polymers. Despite microbial mitigation, HQ remains highly toxic to various trophic levels, emphasizing the necessity for en-vironmental regulations.

A useful perioperative nutritional therapy for highly invasive esophageal cancer surgical cases needs to be developed. We clarified the usefulness of amino acid-enriched nutritional therapy using glutamine (Gln)/arginine (Arg)/calcium β-hydroxy-β-methylbutyrate (HMB) products on the short-term postoperative outcomes of minimally invasive esophagectomy for esophageal cancer. Altogether, 114 patients (Gln/Arg/HMB group) received perioperative nutritional therapy with Gln/Arg/HMB products, and we retrospectively investigated the change in nutritional parameters including skeletal muscle mass, occurrence of postoperative complications, and short-term postoperative outcomes in this group. The results were compared between the Gln/Arg/HMB and control groups (79 patients not receiving the Gln/Arg/HMB products). The incidence of all postoperative complications, sputum expectoration disorder, and pleural effusion of grade ≥III was significantly lower in the Gln/Arg/HMB group (62.0% vs. 38.6%, p = 0.001; 44.3% vs. 28.1%, p = 0.020; 27.8% vs. 13.2%, p = 0.011, respectively). The psoas muscle area and postoperative body weight was significantly higher at 1 month and 1 year after surgery in the Gln/Arg/HMB group than in the control group (93.5% vs. 99.9%, p < 0.001; 92.0% vs. 95.4%, p = 0.006). Perioperative amino acid-enriched nutritional therapy may improve the short-term postoperative outcomes, nutritional status, and skeletal muscle mass of esophageal cancer surgical patients.

Many studies utilize sensors to measure foot plantar pressure and analyze gait patterns, often focusing on assessing weight-bearing symmetry or asymmetry compared to control groups. However, a critical question arises: does the selection of the control group significantly impact study outcomes? Does chronic low back pain affect foot plantar pressure measurements? This experimental study involved 23 participants, including healthy individuals and those without foot disorders but with chronic low back pain. Dynamic foot pressure measurements were conducted using the Ortopiezometr, and data were analyzed using the "Steps" program. Participants were divided into two groups: Group 1 comprised completely healthy individuals, while Group 2 consisted of individuals without foot problems but with moderate chronic low back pain. The findings highlight a prevalence of energy release in the forefoot sensors compared to the hindfoot for both the right and left legs in most cases. Even among healthy volunteers, achieving perfect symmetry in the maximum values on the sensors for the right and left feet was a challenge. Results showed no statistically significant differences in energy released on specific sensors or duration of gait phases between the groups. Essentially, this suggests that foot pressure patterns are comparable between healthy individuals and those with low back pain. The use of sensor-equipped inserts for pedobarographic examinations indicates that, in cases of degenerative changes in the lumbar and sacral spine without accompanying acute pain, gait patterns resemble those of the healthy population.

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.

Introduction: Treating elbow fracture-dislocation is a challenge, especially in the situation of basal-coronoid trans-ulnar fracture. The study ams to explain whether or not the minimal invasive surgery (MIS) would be feasible in elbow dislocation with coronoid fracture. Materials & Methods: At Taipei Veterans General Hospital, patients who had elbow dislocations with coronoid process fractures underwent single one surgeon’s MIS techniques which included the fluoroscopy-guided ulnar anteromedial (FGUAM) approach in the stage of reducing coronoid process. When there is a proximal ulnar fracture, the posterior incision should be necessary, followed by the incision over the lateral or medial elbow in treating radial fractures or ligament injuries. Results: The Flow Diagram about approach recommendation was established in base of defining MIS as not to do cross-plane dissection. Anteriorly rigid fixation for the coronoid process was also emphasized. Conclusions: MIS can be achieved by multiple limited surgical incisions. However, if there is an unstable ulnar metaphysis or ligament avulsion fracture, the posterior approach has to be extended and the so-called MIS fails to be established.

Blood stream infections (BSI) due to carbapenem-resistant gram-negative bacilli (CR-GNB), especially Klebsiella pneumoniae carbapenemase (KPC) and New-Delhi metallo-β-lactamase (NDM) producers, are a major concern of public health, as they are associated with high morbidity and mortality. We conducted a single-center, retrospective, observational study at a tertiary-care, teaching Greek hospital, to determine the incidence, 30-day and overall, in-hospital, crude mortality, risk factors and efficacy of best available treatment options in patients with BSIs from KPC- or NDM-producing GR-GNB. During the one-year study period, from 1st January to 31st December 2023, we recorded 133 episodes of BSIs in 118 unique patients; 79 episodes were due to KPC-producing and 54 to NDM-producing CR-GNB. Our study showed relatively high incidence of BSIs by both KPC- and NDM-producing CR-GNB (0.49 and 0.31 episodes per 1000 patient-days respectively). We found high 30-day crude mortality rates for patients with BSIs due to KPC- producing CR-GNB (26.4 %), and NDM-producing CR-GNB (37%), while BSIs due to NDM-producing P. aeruginosa had the highest 30-day (47.1%) and overall (70.6%) in-hospital, crude mortality. Beta-lactam/beta-lactamase inhibitors as monotherapy or in combination with other active agents used to treat KPC-producing CR-GNB were associated with improved survival rates (p=0.009).

Our results demonstrated that SWT stimulates osteoblastogenesis and increase the cell number of osteoblasts, suggesting positive regulatory effects on osteoblast differentiation. However, the effect of SWT on bone formation need further examination, since the expression of alp gene is downregulated. On the other hand, SWT appears to negatively regulate osteoclast differentiation and bone resorption, as number of osteoclasts and the expression of critical bone resorptive genes are all downregulated. Collectively, SWT might change the equilibrium of bone remodeling and increase the bone mass. Our data provided supportive evidences that this medicine formulation can be applied to treat osteoporosis or bone destructive diseases.

Critically ill patients treated in the intensive care unit (ICU) can present many abdominal conditions that need a prompt diagnosis and timely treatment because of their general frailty. Clinical evaluation and diagnostic tools like ultrasound or CT scan are not reliable or feasible in these patients. Bedside laparoscopy (BSL) is a minimally invasive procedure that allows surgeons to assess the abdominal cavity directly in the ICU, thus avoiding unnecessary exploratory laparotomy or incidence related to intra-hospital transfer. We conducted a review of the literature to summarize the state-of-the-art of BSL. Medline, The Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus databases were utilized to identify all relevant publications. Indications, contraindications, technical aspects, and outcomes are discussed. The procedure is safe, feasible, and effective. When other diagnostic tools fail to diagnose or exclude an intra-abdominal condition in ICU patients, BSL should be preferred over exploratory laparotomy.

We study L_2-approximation problems in the weighted Hilbert spaces in the worst case setting. Three interesting weighted Hilbert spaces appear in this paper, whose weights are equipped with two positive parameters $\ga_j$ and $\az_j$ for $j=1,\,2,\dots,\,d$. We consider the worst case error of algorithms that use finitely many arbitrary continuous linear functionals. We discuss the exponential convergence-(t,s)-weak tractability (EC-(t,s)-WT) of these L_2-approximation problems under the absolute or normalized error criterion. In particular, we obtain the sufficient and necessary conditions for EC-(1,1)-WT and EC-(t,1)-WT with t

The European Green Deal poses a two-pronged challenge for the automotive industry: migrating to solutions based in light structures, requiring light weight concepts and light materials, while at the same time avoiding dependence towards the importation of these advanced materials. Aluminium alloys are lightweight and cost-effective materials that can successfully cover the requirements of many structural applications, however their production requires from bauxite and other Critical Raw Materials (CRM), such as Si and Mg. Aluminium alloys are fully recyclable, but scrap is usually contaminated and its use is related to an increment of impurities, tramp element and undesired inclusions. Traditionally, the use of secondary alloys has been restricted to low performance applications. The present work analyses the effect that the use of scrap has in the quantity of inclusions present in the alloy and in other properties relevant for the material processing. The study was carried out for common alloys belonging to 3 of the most common aluminium processes used in the car manufacturing industry: High Pressure Die Casting (HPDC) (EN AC-43500), extrusion (6063) and sheet metal forming (5754 and 6181). Reference alloy were mixed with different level of scrap (0, 20, 40, 60, 80 and 100%) trying to keep the chemical composition as unaffected as possible. The inclusions level of the alloy was characterized with the Prefil Foot-printer® test. In addition, the obtained materials, after being cast in an open mould, were subjected to metallographic characterization. Relevant properties to assess the formability quality of the alloys for the corresponding transforming process, were obtained: flowability test for HPDC alloy and high temperature compression for extrusion alloys. The results obtained suggest that the number of inclusions present in the melt highly increase with the amount of scrap used to produce the alloy. These inclusions are also related with an important lost of flowability, but do not have a noticeable impact on microstructure.

With the popularity of solar energy in the electricity market, demand arises for data such as precise locations of solar panels for efficient energy planning, management, and distribution. However, this data is not easily accessible and in some cases, information such as precise locations does not exist. Furthermore, existing data sets for training semantic segmentation models of PV installations are limited, and their annotation is time-consuming and labor-intensive. Therefore, for additional remote sensing (RS) data creation, the pix2pix generative adversarial network (GAN) is utilized, enriching the original resampled training data of varying GSDs without compromising its integrity. Experiments done with the DeepLabV3 model, ResNet-50 backbone, and pix2pix GAN architecture were conducted to find the optimal configuration for an accurate RS imagery segmentation model. The result is a fine-tuned solar panel semantic segmentation model, trained using transfer learning and utilizing an optimal amount – 60% of generated RS imagery for additional training data, increasing model accuracy. The findings demonstrate the benefits of using GAN-generated images as additional training data, increasing the size of small data sets, and improving the capabilities of the segmentation model for solar panel detection in RS images.

In recent years, the unmanned aerial vehicle (UAV) synthetic aperture radar (SAR) has become a highly sought-after topic for its wide applications in the field of target recognition, detection, and tracking. However, SAR automatic target recognition (ATR) models based on deep neural networks (DNN) are suffering from adversarial examples. Generally, non-cooperators rarely disclose any information about SAR-ATR models, making adversarial attacks challenging. In this situation, we propose Transferable Adversarial Network (TAN) to attack these models with highly transferable adversarial examples. The proposed method improves the transferability via a two-player game, in which we simultaneously train two encoder-decoder models: a generator that crafts malicious samples through a one-step forward mapping from original data, and an attenuator that weakens the effectiveness of malicious samples by capturing the most harmful deformations. In particular, compared to traditional iterative methods, our approach is able to one-step map original samples to adversarial examples, thus enabling real-time attacks. Experimental results indicate that the proposed approach achieves state-of-the-art transferability with acceptable adversarial perturbations and minimum time costs compared to existing attack methods, i.e., it excellently realizes real-time transferable adversarial attacks.

Objective: To summarize the prevalence of PASC/Long COVID symptoms among the general population reported in published articles. This narrative review examined 21 PASC symptoms. Methods: A PubMed/manual search returned 114 articles on general PASC/Long COVID symptoms. Manuscripts were excluded if they were not research studies, didn’t report symptom prevalence, or used a pediatric population. Ninety-eight studies were selected for review and 59 met criteria for inclusion. Risk of bias was assessed with the Hoy critical appraisal tool. Results: After excluding studies with high risk of bias, meta-analysis of prevalence for 21 symptom categories ranged from 2.6-28.7% in studies based on surveys to 0.3%-7.1% in studies based on EHR data. Conclusions: PASC symptom studies are limited by variability in study design and representation of the general population. Further research is needed to effectively cluster symptoms in meaningful ways that enable focused treatment.

Lung neuroendocrine tumors (LNETs) and gastroenteropancreatic neuroendocrine tumors (GEPNETs) are two distinct types of neuroendocrine tumors (NETs) that have traditionally been treated as a single entity despite originating from different sources. Although they share certain phenotypic characteristics and the expression of neuroendocrine markers, they exhibit differences in their microenvironment, molecular mutations, and responses to various therapeutic regimens. Recent research has explored the genetic alterations in these tumors, revealing dissimilarities in the frequently mutated genes, role of EGFR in carcinogenesis, presence of transcription factors, and immunogenicity of the tumor and its microenvironment. Spread Through Air Spaces (STAS), a phenomenon unique to lung carcinomas, appears to play a crucial role in LNET prognosis. These distinctions are also evident in the cascade response of lung and GI tract neuroendocrine tumors to somatostatin analogs, Peptide Receptor Radionuclide Therapy (PRRT), chemotherapy, and immunotherapy. Identifying similarities and differences between the two groups may im-prove our understanding of the underlying mechanisms and facilitate the development of more effective treatment strategies.

Healthcare professionals constantly face situations that reflect ecosystems’ degradation. These can negatively affect their mental health. Research suggests that hope and resilience can play an important role in this scenario, since they are related to/predict mental health in highly heterogeneous samples (considering geography, age, profession, health, etc.). In this context, the aims of the present study are: to characterize and explore the relationship between hope, resilient coping and mental health of Portuguese healthcare professionals. Using Google Forms, 276 healthcare professionals answered to the GHQ-28, the (adult) Trait Hope Scale, and the Brief Resilient Coping Scale (cross-sectional study). The minimum and maximum possible scores were reached, with the exception of the maximum score of GHQ-28-Total. Regarding Hope, 19.6% scored below the midpoint (M=43.46, SD=11.97); 29.3% revealed low resilience (M=14.93, SD=4.05); and the average of 4 of the 5 Mental Health scores (exception: Severe Depression) indicates the probability of a psychiatric case. Hope correlated with Social Dysfunction and GHQ-28-Total; resilient coping proved to be a (weak) predictor of 4 of the 5 GHQ-28 indicators (exception: Severe depression). The results support the need to promote the sample's mental health, hope and resilient coping. They also suggest that stimulating resilient coping may contribute to improving healthcare professionals’ mental health.

Proteomics research has become one of the most important topics in the fields of life science and natural science. At present, research on protein–protein interaction networks (PPINs) mainly focuses on detecting protein complexes or function modules. However, existing approaches are either ineffective or incomplete. In this paper, we investigate function module detection mechanisms in PPIN, including open databases, existing detection algorithms and recent solutions. After that, we describe the proposed solution based on simplified swarm optimization (SSO) algorithm and gene ontology knowledge. The proposed solution implements SSO algorithm for clustering proteins with similar function, and imports biological gene ontology knowledge for further identifying function complexes and improving detection accuracy. Furthermore, we use four different categories of species dataset for experiment: Fruitfly, Mouse, Scere, and Human. The testing and analysis result show that the proposed solution is feasible, efficient and could achieve a higher accuracy of prediction than existing approaches.

(1) Background: Multiple alterations of cellular metabolism have been documented in experimental studies of autosomal dominant polycystic kidney disease (ADPKD) and are thought to contribute to its pathogenesis. (2) Methods: To elucidate the molecular pathways and transcriptional regulators associated with the metabolic changes of renal cysts in ADPKD, we compared global gene expression data from human PKD1 renal cysts, minimally cystic tissues (MCT) from the same patients, and healthy human kidney cortical tissue samples. (3) Results: We found PKD1 renal cysts displayed the Warburg effect with gene pathway changes favoring increased cellular glucose uptake and lactate production, instead of pyruvate oxidation. Additionally, mitochondrial energy metabolism was globally depressed, associated with downregulation of gene pathways related to fatty acid oxidation (FAO), branched-chain amino acid (BCAA) degradation, the Krebs cycle, and oxidative phosphorylation (OXPHOS) in renal cysts. Activation of mTORC1 and its two target proto-oncogenes, HIF-1α and MYC, was predicted to drive the expression of multiple genes involved in the observed metabolic reprogramming (e.g., GLUT3, HK1/HK2, ALDOA, ENO2, PKM, LDHA/LDHB, MCT4, PDHA1, PDK1/3, MPC1/2, CPT2, BCAT1, NAMPT); indeed, their predicted expression patterns were confirmed by our data. Conversely, we found AMPK inhibition was predicted in renal cysts. AMPK inhibition was associated with decreased expression of PGC-1α, a transcriptional coactivator for transcription factors PPARα, ERRα, and ERRγ, all of which play a critical role in regulating oxidative metabolism and mitochondrial biogenesis. (4) Conclusions: These data provide a comprehensive map of metabolic pathway reprogramming in ADPKD and highlight nodes of regulation that may serve as targets for therapeutic intervention.

Understanding the dynamics of teamwork and communication among healthcare professionals is crucial in the face of evolving healthcare challenges. This study assessed relational coordination among healthcare professionals in the South Tyrolean healthcare system in Italy, focusing on communication and teamwork dynamics in a cross-sectional survey. Using the validated Relational Coordination Survey (RCS) instrument and 525 completed online responses, the questionnaire aimed to understand the implications of different levels of relational coordination ratings by general practitioners, hospital physicians, nurses, and administrative personnel (response rate 26%). The demographics of the participants revealed a predominance of female professionals (64%), with an average age of 50 and 18 years of service. The resulting RCS scores varied significantly across professional groups, with nurses reporting the highest within-group scores, indicating moderate coordination, and administrators reporting the lowest scores, reflecting areas of weak coordination. Between-group relational coordination was generally perceived as weak across professional groups, with the least weakness observed between general practitioners and nurses. German or Italian language and health district affiliation emerged as significant factors influencing relational coordination ratings, highlighting the need for differentiated understanding and strategies in multilingual and diverse regional settings. Assessments of interdisciplinary feedback and referral practices highlight the variation in teamwork and communication weaknesses and underscore the need for targeted interventions to improve relational coordination. This study provides insights into the complexity of relational dynamics in health care settings. It suggests that improving relational coordination through tailored strategies could significantly improve team effectiveness, quality of patient care, and overall system efficiency.

Augmented Reality (AR) and 3D printing (3DP) are novel technologies in the orthopedic field. Over the past decade, enthusiasm for these new digital applications is driving new perspectives in improving diagnostic accuracy and sensitivity in the field of traumatology. Currently, however, it is still difficult to quantify the value and impact in the medical-scientific field especially in the improvement of diagnostic in complex fractures. Acetabulum fractures have always been a challenge among orthopedics, for volumetric complexity and low diagnostic reliability.Background/Objectives: The goal of this study is to determine whether these methods can improve the learning aspect and diagnostic accuracy of complex acetabulum fractures compared to gold standard CT (computed tomography). Methods: Orthopedic residents of our department have been selected and divided into Junior (JUN) and Senior (SEN) groups. Associated fractures of acetabulum have been included in the study, obtaining : CT-scans, 3DP model, and AR model displayed on a tablet screen. In a double-blind questionnaire, each resident classified every fracture according to methods. Diagnostic accuracy (DA), response time (RT), agreement (R), and confidence (C) were measured. Results: 20 residents (JUN=10, SEN=10) classified five fractures. Overall DAs were 26% (CT), 18% (3DP), and 29% (AR). AR-DA resulted to be superior to 3DP-DA (p=0,04). DA means (JUN vs SEN respectively) were :CT-DA was 20% vs 32% (p<0.05), 3DP-DA was 12% vs 24% (p=0.08), and AR-DA was 28% vs 30% (p=0,80). Overall RT was 61.2 sec (±24,6) for CT, 35.8 sec (±20,1) for 3DP, and 46,7 sec (±20,8) for AR. R was fairly poor between methods and groups. 3DPs resulted to have superior overall C (65%). Conclusions: AR resulted to have the same Overall DA as CT, independent from experience, 3DP has minor DA and R, but it resulted to be the most confident and fast method. Intra and interobserver R between methods remain very poor in residents.

Mitochondria play a significant role in the functioning of the cell, acting both as an intracellular energy source and a signaling organelle. In the heart, mitochondria produce more than 95% of the ATP in addition to regulating the redox state, calcium homeostasis, apoptosis, and lipid synthesis. However, there is also evidence that mitochondria exist outside of cells where they have been observed to mediate cell-to-cell communication, repair, and participate in the immune response. Cardiometabolic disease (CMD) has a complex pathogenesis closely associated with mitochondrial dysregulation, inflammation, and metabolic abnormalities. Because of this metabolic interdependence between the myocardium and the intracellular mitochondria, circulating extracellular mitochondria (CEMI) are being identified as possible regulators of CMD. Outside of the cell, mitochondrial functions are determined by the mitochondrial form, either as whole functional structures (e.g., small extracellular mitochondria) or as mitochondrial components with or without membrane encapsulation. Here, we explore the different forms of CEMI, their role in CMD pathogenesis, their potential therapeutic utility in treating diseases, and their role as biomarkers.

This study explores fault-tolerant consensus in leader-following heterogeneous multi-agent systems, focusing on actuator failures in uncrewed aerial vehicles (UAVs) and uncrewed ground vehicles (UGVs). An optimization-based fault-tolerant consensus algorithm is proposed. The algorithm utilizes the Euler-Lagrange formula to ensure system consistency under actuator failures, with the Lyapunov stability theory proving the asymptotic stability of the consistency error. The algorithm is applied to heterogeneous multi-agent systems of UAVs and UGVs to derive optimal fault-tolerant consensus control laws for each vehicle type. Simulation experiments give evidence for the feasibility of the proposed control strategy.

The interest in the Spark Plasma Sintering (SPS) technique has continuously increased over the last few years. This article shows the possibility of the development of a SPS device used for material processing and synthesis both in both scientific and industrial applications. This work presents an example of processing Arc-Meleted (half-Heusler, cobalt triantimonide) and SHS-synthesized semiconductors (bismuth telluride) materials with SPS device. The system functionalities expansion is presented, showing the possible way of increasing the information amount obtained about SPS processes and using the SPS apparatus for conducting synthesis of materials and increasing reproducibility and accuracy of process parameters control.

Generative adversarial networks (GANs) have become a recent and rapidly developing research topic in Machine Learning. Since their inception in 2014, a significant number of variants have been proposed to address various topics across many fields, and has particularly excelled not only in image and language processing, but also in the medical and data science domains. In this paper, we aim to highlight the significance and advance that these GAN models can introduce in the field of Business Economics, where they have yet to be fully developed. To this end, a review of the literature of GANs is presented in general together with a more specific review in the field of Business Economics wherein only a few papers can be found. Furthermore, the most relevant papers are analysed in order to provide an approach the opportunity to research into GANs in the field of Business Economics.

Conventional cancer clinical trials can be time-consuming and expensive, often yielding results with limited applicability to real-world scenarios and presenting challenges for patient participation. Real-world data (RWD) studies offer a promising solution to address evidence gaps and provide essential information about the effects of cancer treatments in real-world settings. Defining RWD based on its original intent, which is the collection of data at the point of care for clinical purposes, can distinguish it from conventional clinical trial data. RWD can be generated using experimental designs that resemble those used in conventional clinical trials, but with several advantages, such as improved efficiency and a better balance between internal and external validity. RWD can support pharmacovigilance, insights into disease progression, and the development of external control groups. Prospective RWD collection enables evidence generation based on pragmatic clinical trials (PCTs) that support randomized study designs and expand clinical research to the point of care. To ensure the quality of real-world studies, it is crucial to implement auditable data abstraction methods and develop new incentives to capture clinically relevant data electronically at the point of care. The treatment landscape is constantly evolving, with the integration of front-line immune checkpoint inhibitors (ICIs), either alone or in combination with chemotherapy, affecting subsequent treatment lines. Real-world effectiveness and safety in underrepresented populations, such as the elderly, patients with poor performance status (PS), hepatitis, or human immunodeficiency virus-infected patients, are still largely unexplored. Similarly, the cost-effectiveness and sustainability of these innovative agents are important considerations in the real world.

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

The most prevalent musculoskeletal disorder of childhood with unclear aetiology is Growing Pains (GPs). Anatomic deformities and factors that change bone turnover are implicated in GPs pathophysiology. Perinatal risk factors alter the bone metabolism affecting the bone mineral density and content. The aim of our study was to analyze the relationship between GPs, knock knees and perinatal factors. The examined population consisted of 276 children aged 3-7 years. Among them 10 pairs of dizygotic twins were evaluated. The data were collected by using a combination of semi-structured questionnaires, clinical examinations and medical charts of the children and the obstetric history of the mothers. 78 children presented GPs meeting Peterson’s criteria. Genu valgum severity was a significant factor for GPs manifestation and for their increased frequency and intensity. Subsequently, perinatal factors regarding gestational age, Apgar score, head circumference (lower than 33cm) and birth length or weight (smaller than 50 cm and 3000gr, respectively) made a remarkable contribution to the development of GPs. Conversely, antenatal corticosteroid treatment, increased maternal age and maternal smoking during pregnancy were not predictive for the disorder. Our data are potentially supportive for the “bone strength” theory and for the contribution of anatomical disturbances in GPs appearance.

Plantar fasciitis is one of the most common causes of foot pain; in a significant percentage it is also associated with bone edema of the heel. A prospective randomized clinical trial was designed, in which 48 patients suffering from plantar fasciitis, with or without bone edema, were treated with temperature controlled high energy adjustable multi-mode emission laser and exercises (laser group) or with exercises only (control group). Patients were evaluated at recruitment (T0), at 2 (T1) and 6 months (T2), monitoring pain (with Visual Analogue Scale), functionality (with Foot Function Index) and perception of improvement (with Roles and Maudsley Score) and fascia thickness (with ultrasound examination). In both groups there was a significant improvement in pain, functional recovery, perception of remission and a reduction in plantar fascia thickness at T1 and T2. The laser group presented statistically better values at T2 for the Roles and Maudsley Score (z: 2.21; 0.027). Regression analysis showed that a greater reduction in fascia thickness occurred in the laser group (p-value: 0.047). In conclusion, the two conservative treatments were effective in patients suffering from plantar fasciitis, even in the presence of bone edema, but with lesser results.

Background: The laryngeal mask airway Vision Mask (LMA VM) is a supraglottic airway device (SAD) with vision guidance system. The ideal head and neck position for direct laryngoscopy is known, but the ideal position for placing a LMA is not. The objective of this study is to evaluate and compare the optimal position for placement of a video laryngeal mask airway. Methods: This was a prospective observational, transversal and analytical study of 72 consecutive patients. In the same patient, laryngeal vision was first assessed with the head and neck in the sniffing position and then with the head in the neutral position. Procedures were filmed and performed by the same investigator. Assessment of the laryngeal view was performed using two classifications: modified Cormack-Lehane classification and Brimacombe classification. Device placement was considered adequate when the Cormack-Lehane rating was scored from 1 to 2 and the Brimacombe rating was from 2 to 4. Results: 72 patients were included in this study. In the assessment of the glottis using the Cormack Lehane classification for fiberoptic view, laryngeal visibility was adequate in 64 (88.89%) patients in the neutral position and in 65 (90,28%) patients in the sniffing position (p>0,05). In the fiberoptic view of the glottis, assessed using the Brimacombe classification, laryngeal visibility was adequate in 68 (93%) patients in the neutral position and in 69 (95%) patients in the sniffing position, (p>0,05). There was no statistically significant difference in the rate of success between the sniffing position (70 patients, 97.22% success rate) and the neutral position (67 patients, 93.06% success rate) during the first insertion attempt. Two patients required a second attempt in the sniffing position, while five patients required a second attempt in the neutral position. Conclusion: An adequate sniffing position did not result in a better glottic view than neutral position, and the number and type of additional maneuvers were equal in both positions.

(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.

The climate change constitutes nowadays an enormous global threat for human health and environmental sustainability. The expanding world population and the increased global needs for food production have an important negative impact upon environment. Diet can link human health with environmental sustainability. Food production systems are closely related to anthropogenic greenhouse gas emissions and the aggravation of climate change, and current western type, animal-based, dietary patterns may lead to adverse environmental footprints. In the present narrative review, we address the interconnection of the Mediterranean diet (MD) with climate change and sustainability. MD is a highly recommended dietary intervention for the prevention and management of various endocrine and cardiometabolic diseases. Beyond its evidence-based, health-promoting effects, it also has beneficial environmental impact, reducing greenhouse gas emissions and enhancing biodiversity, food security and sustainability. Based on the evidence reviewed herein, MD should be incorporated within the framework of a “One Health” model, which involves the improvement not only of human health but also of planetary health and food system sustainability. Our review aims to provide a stimulus for health pro-fessionals to strongly recommend the implementation of MD under the current pressure of climate change, despite all barriers, targeting both human health preservation and the planetary well-being.

Recent studies have proven that synthetic aperture radar (SAR) automatic target recognition (ATR) models based on deep neural networks (DNN) are vulnerable to adversarial examples. However, existing attacks are easily failed in the case where adversarial perturbations cannot be fully fed to victim models. We call this situation perturbation offset. Moreover, since background clutter takes up most of the areas in SAR images and has low relevance to recognition results, fooling models with global perturbations is quite inefficient. This paper proposes a semi-whitebox attack network, called Universal Local Adversarial Network (ULAN), to generate universal adversarial perturbations (UAP) for the target regions of SAR images. In the proposed network, we calculate the model’s attention heatmaps through layer-wise relevance propagation (LRP), which is used to locate the target regions of SAR images that have high relevance to recognition results. In particular, we utilize a generator based on the U-Net to learn the mapping from noise to UAPs and craft adversarial examples by adding the generated local perturbations to target regions. Experiments indicate that the proposed method fundamentally prevents perturbation offset and achieves comparable attack performance to conventional global UAPs by perturbing only a quarter or less of SAR image areas.

Pulmonary hypertension (PH) is a progressive and potentially fatal complication of sickle cell disease (SCD) affecting 6-10% of adult SCD patients. Various mechanisms and theories have been evaluated to explain the pathophysiology of the disease. However, questions remain, particularly regarding the clinical heterogeneity of the disease in terms of symptoms, complications, and survival. Beyond the classical mechanisms that have been thoroughly investigated and include hemolysis, nitric oxide availability, endothelial disorders, thrombosis, and left heart failure, attention is focused nowadays on the potential role of the genes involved in such processes. Potential candidate genes are investigated through next-generation sequencing, with the TGF-β pathway being the initial target. This field of research may also provide novel targets for pharmacologic agents in the future as is already the case with idiopathic PH. The collection and processing of data and samples from multiple centers can yield safe results that will allow a better understanding of SCD-related PH as a part of the disease’s clinical spectrum. The following review attempts to capture the most recent findings of studies on gene polymorphisms that have been associated with PH in SCD patients.

In this very personal hunt for the meaning of the bacterial cell cycle, the snark, I briefly revisit and update some of the mechanisms we and many others have proposed to regulate the bacterial cell cycle. These mechanisms, which include the dynamics of calcium, membranes, hyperstructures and networks, are based on physical and physico-chemical concepts such as ion condensation, phase transition, crowding, liquid crystal immiscibility, collective vibrational modes, reptation, and water availability. I draw on ideas from subjects such as the ‘prebiotic ecology’ and phenotypic diversity to help with the hunt. Given the fundamental nature of the snark, I would expect that its capture would make sense of other parts of biology. The route therefore followed by the hunt has involved trying to answer questions like “why do cells replicate their DNA?”, “why is DNA replication semi-conservative?”, “why is DNA a double helix?”, “why do cells divide?”, “is cell division a spandrel?” and “how are catabolism and anabolism balanced?”. Here, I propose some relatively unexplored, experimental approaches to testing snark-related hypotheses and, finally, I propose some possibly original ideas about DNA packing, about phase separations, and about computing with populations of virtual bacteria.

This research ventures into the critical public health challenge of childhood obesity by exploring the dynamic interplay between psychological well-being and Body Mass Index (BMI) throughout various developmental stages of childhood. It delves into how emotional regulation, attachment dynamics, and social relationships correlate with obesity from early childhood to adolescence. Highlighting key findings, such as the negative correlation between psychological resilience and higher BMI in young children, the impact of social relationships on obesity risk during pre-adolescence, and the link between adaptive emotional strategies and higher BMI in adolescents, this study brings to the fore the nuanced relationship between psychological factors and obesity. Utilizing the interdisciplinary process of bioinformatics, this research synergizes psychometric and biomedical data to unearth psychological markers critical for crafting targeted, age-appropriate interventions. This study advocates for a holistic healthcare approach, emphasizing the integration of psychological support within obesity prevention and management strategies, thereby underscoring the indispensable role of psychological factors in the fight against childhood obesity. The application of bioinformatics methods to analyze complex datasets demonstrates how collaboration across medical specialties can enrich our understanding and response to childhood obesity, contributing significantly to the development of comprehensive, bioinformatics-enhanced healthcare solutions.

With the rapid growth of large language models (LLMs), there is increasing demand for memory and computation in LLMs. Recent efforts on post-training pruning of LLMs aim to reduce the model size and computation requirements, yet the performance is still sub-optimal. In this paper, we present a plug-and-play solution for post-training pruning of LLMs. The proposed solution has two innovative components: 1) Relative Importance and Activations (RIA), a new pruning metric that jointly considers the weight and activations efficiently on LLMs; and 2) Channel Permutation, a new approach to maximally preserve important weights under N:M sparsity. The two proposed components can be readily combined to further enhance the N:M semi-structured pruning of LLMs. Our empirical experiments show that RIA alone can already surpass all existing post-training pruning methods on prevalent LLMs, e.g., LLaMA ranging from 7B to 65B. Furthermore, N:M semi-structured pruning with channel permutation can even outperform the original LLaMA2-70B on zero-shot tasks, together with practical speed-up on specific hardware. Our code is available at: https://github.com/biomedical-cybernetics/Relative-importance-and-activation-pruning

Background: Tibial shaft fractures are the most common of long bone fractures. The gold standard for management is locked intramedullary nailing. The freehand method under fluoroscopic monitoring is the most often utilized method for distal screw locking. Electromagnetic guidance-based distal screw locking methods have gained popularity recently. The study's objective is to evaluate the system using electromagnetic tracking data against the free-hand technique. Methods: Sixty-three patients who received intramedullary nailing for tibial shaft fractures at our institute between January 2018 and May 2022, were included in this study. Two groups of patients were distinguished: Group FH underwent freehand distal locking and intramedullary nailing, while Group SS underwent electromagnetically guided locking. Radiation exposure period, as well as dose area product, were noted and statistically compared. Results: In terms of dose area product, a mean value of 43.57±31.57 cGy/cm2 in group FH and a mean value of 27.62±11.20 cGy/cm2 in group SS (p < 0.05) was assessed. Concerning the duration of surgery a mean value of 128.83±26.51 minutes was reported in group FH and a mean value of 126.42±48.31 minutes in group SS (p > 0.05). Conclusions: This study confirms the use of electromagnetic-guided locking distal screws reduces the total time of exposure to ionizing radiation, with no difference in operating time.

The increased prevalence of obesity worldwide has been implicated for the alarming rise of the incidence of gestational diabetes and preeclampsia as well, both considered as threatening conditions for both mother and fetus. We studied gene polymorphisms of the proinflammatory cytokine Interleukin 6 (IL-6) and the gene expression levels of VEGF and VEGF-receptor all known to be involved in pregnancy complications aiming to identify possible predisposing risk factors in pregnancies with obesity. G allele of IL-6 was found to correspond with an increased risk for gestational diabetes and preeclampsia occurrence. Furthermore, in obese pregnant mothers with either gestational diabetes or pre-existing type 2 diabetes and to those developed preeclampsia it was confirmed that gene expression levels of VEGF were reduced while they were increased for VEGF receptor. We conclude that the genetic profile of the obese pregnant woman shares a common background with that of a pre-existing type 2 diabetes mellitus and therefore predisposes to complications in pregnancy.

In this paper glass crystallization behavior of 50ZnO:47B2O3:3Nb2O3:0.5Eu2O3 (G-0h) glass has been investigated in detail by DSC, XRD and TEM analysis. The luminescent properties of resulted glass-ceramics were also investigated. By XRD and TEM analysis crystallization of several crystalline phases have been proved (α-Zn3B2O6, β-Zn3B2O6 and ZnNb2O6). By calculating of crystal parameters it was found that europium ions are successfully incorporated in the β-Zn3B2O6. Photo-luminescent spectra show an increased emission in the resulting glass-ceramic samples as compared with the parent glass sample because of the higher asymmetry of Eu3+ ions in the crystalline phases obtained. It was established that the optimum emission intensity is registered for glass-ceramic sample obtained after 25 hours heat treatment of the parent glass.

Percutaneous aortic valve replacement (TAVI) has become the treatment of choice for elderly patients with severe aortic valve stenosis because of its less invasiveness compared to surgery. However, it introduces new complications, such as vascular lesions, access site problems, paravalvular leaks, and aortic dissection. Aortic dissection after TAVI is rare but serious, occurring in 0.2% to 0.3% of cases, with both intraprocedural and late cases reported. This case study concerns a 68-year-old woman who developed Stanford B aortic dissection, external iliac artery dissection, and right common femoral artery occlusion after TAVI. Treatment included stenting of the iliac and common femoral arteries, followed by a staged procedure: debranching, thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR), with satisfactory results. This case, underscores the importance of vigilance in the management of TAVI-related complications to optimize patient care and outcomes.

(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.

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

Network Function Virtualization (NFV) allows for the dynamic provisioning of Virtualized Network Functions, adapting services to the complex and real-time network environment for enhanced network performance. Despite the benefits of NFV, virtual network functions (VNFs) migration and the energy consumption pose significant challenges due to the dynamic nature of the physical network, especially in the edge-cloud continuum network. Currently, people tackle this challenge by predicting the network traffic and then proactively migrating the VNFs using the predicted values. There are two challenges here. First, when SFCs belong to different network service providers, the historical network traffic data is held by the service providers, and they are reluctant to share the historical data due to privacy concerns. Without the historical network traffic data of each SFC, the resource provider that owns the underlying network cannot effectively predict the network traffic; in addition, without the feedback of the migration results of the underlying physical network, the network traffic prediction will be difficult to match the needs of the physical network. In this manuscript, we solve the problem of network traffic prediction in the NFV-based edge-cloud continuum network for multiple network service providers. We aim to improve migration performance and reduce energy consumption while ensuring resource and latency requirements. To protect the privacy of each network service provider, we apply an FL algorithm. After that, to improve the migration performance, we tailor the loss function. In the loss function, factors such as the number of migrations, the number of migration failures, and the energy consumption of the NFV-based edge-cloud continuum network are added. Additionally, to obtain the results of the SFC migration, we develop a mathematical model for the problem of multiple network service providers in the NFV-based network. The effectiveness of our algorithm is evaluated through extensive simulations, and the results show a significant reduction in the number of migrated nodes and energy consumption while improving the SFC acceptance ratio compared to state-of-the-art schemes which only use the difference between predicted and actual flows to define the loss function.

Background and Objectives: Knee osteoarthritis (KOA) is a degenerative disease that is targeting continuously people of different ages, but especially the elderly population, the number of which tends to increase continuously at the global level. Apart from age, excess weight can influence the evolution of the disease, with obesity being associated with a weak inflammation stage, and an imbalance between pro-inflammatory and anti-inflammatory cytokines. The present work aimed to identify specific biomarkers alike ACRP-30, IL-10, TNF-α, and IL-6 in synovial fluid and correlate them with patients’ clinical data. Materials and Methods: 24 subjects with KOA and over 50 years of age are involved in the present study. All patients performed a supine X-ray at the target knee. Ultrasound was performed using an ESAOTE MyLab Omega (ESAOTE Spa, Italy) ultrasound device and a 6-19 MHz linear array transducer. Results: The obtained results highlighted a significant correlation between age and adiponectin level (p=0.0451, r=-0.412). Also, the IL-10 values are lower in cases where the intensity of the pain is more pronounced (p=0.0405, r=-0.421). In addition, analyzing the data by gender, it was observed that in the case of males, stiffness is more related to age (p=0.0079, r=0.7993), compared to women (p=0.0203, r=0.6223). In the case of women, the progression of the disease tends to increase more intensively total WOMAC score’s values (p=0.00031, r=0.8342), compared with men (p=0.0289, r=7013). Regarding interleukins and BMI, significant correlations were observed only in the case of men. Conclusions: A significant correlation between age and adiponectin, and adiponectin and IL-6, suggests that advanced age may contribute to adiponectin reduction. Comparing men with women, it was observed that men's age is more related to rigidity, and IL-6 and IL-10 are directly correlated to BMI and women seem to be more sensitive to pain and stiffness.

Background and Objectives: The purpose of the study was to analyze the relationships between several clinical and biological factors, but also the tumor topography and surgical strategies used in patients with colorectal cancer. Materials and Methods: We designed an analytical, observational, retrospective study that included patients admitted to our emergency surgical department and diagnosed with colorectal cancer. The study group inclusion criteria were: patients admitted during 2020-2022; patients diagnosed with colorectal cancer (including the ileocecal valve); patients who benefited from a surgical procedure, either in emergency or elective. Results: In our study group, consisting of 153 patients, we accounted for 56.9% male patients and 43.1% female patients. The most common clinical manifestations were pain (73.2% of the study group), followed by abdominal distension (69.3% of the study group) and absence of intestinal transit (38.6% of the study group). A number of 69 patients were operated in emergency (45.1%), while 84 patients (54.9%) benefited from elective surgery. The most frequent topography of the tumor was the sigmoid colon, with 19.60% of the patients, followed by the colorectal junction, with 15.68% of the patients and superior rectum and inferior rectum, with 11.11% of the patients in each subcategory. The most frequent type of procedure was right hemicolectomy (21.6% of the study group), followed by rectosigmoid resection (20.9% of the study group). The surgical procedure was finished by performing an anastomosis in 49% of the patients, an ostomy in 43.1% of the patients, while for 7.8% of the patients, a tumoral biopsy was performed. Conclusions: Colorectal cancer remains one of the most frequent cancers in the world, with a heavy burden that involves high mortality, alterations in the quality of life of the patients and their families, and also the financial costs of the medical systems.

Developing effective cognitive training tools for older adults, specifically addressing executive functions such as planning, is a challenging task. It is of paramount importance to ensure the implementation of engaging activities, which must be tailored to the specific needs and expectations of older adults. Furthermore, it is essential to provide the appropriate level of complexity for the planning task. A human-centred approach was employed to address the issues identified in the design of the tool. Two pilot studies were conducted with older adults to fine-tune the training task and optimise its suitability for them. This also led to an enhancement of the underlying planning engine, transitioning from simple fast-forward planner (PDDL4J) to an advanced heuristic search planner (ENHSP). The results show that conducting user studies enabled the development of a cognitive training system that gradually increases the proposed difficulty levels of the planning task while maintaining usability and satisfaction among older adults. This highlights the importance of conducting user studies when implementing cognitive training tools for older adults.

In this study we have investigated the effect of the addition of Nb2O5 (up to 5 mol%) on the structure and luminescent properties of ZnO-B2O3 glass doped with 0.5 mol % Eu2O3 by using of infrared (IR), Raman and photoluminescence (PL) spectroscopy. Physical properties as molar volume, oxygen packing density and glass transition temperature were determined using the results of differential thermal analyisis (DTA) and Archimedes principle for density. IR and Raman spectra revealed that niobium ions incorporate into the base zinc borate glass as NbO4 trtraherda and NbO6 octahedra. A strong red emission from the 5D0 level of Eu3+ ions was registered under near UV (392 nm) excitation using the sharp 7F0 - 5L6 transition of Eu3+. The integrated fluorescence intensity ratio R (5D0 → 7F2/5D0 → 7F1) was calculated to estimate the degree of asymmetry around the active ion, suggesting a location of Eu3+ in non-centrosymmetric sites. The higher Еu3+ luminescence emission observed in zinc borate glasses containing 1÷5 mol% Nb2O5 compared to the Nb2O5-free zinc borate glass evidences that Nb2O5 is suitable component for modification of host glass structure and improving the emission intensity.

(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.

There is evidence that kidney involvement is frequently observed in COVID-19 patients, and can manifest as mild proteinuria to advancing acute kidney injury (AKI). One of the mechanisms is microvascular and macrovascular thrombosis caused by the hypercoagulation phase of the disease. Thromboelastography (TEG) is a valuable examination to detect significant hemostatic abnormalities, including the hypercoagulable state. This study analyzed the coagulation profiles, including TEG parameters, in COVID-19 patients who developed AKI compared to those who did not during their intensive care unit (ICU) stay, to identify predictors of AKI. Our single-center cohort retrospective study involved adult patients of COVID-19 in the ICU of Sardjito Hospital in Yogyakarta, Indonesia between May and September 2021. Patients were divided into two groups of AKI and non-AKI based on 2012 KDIGO definition and the elaboration by Indonesian Society of Nephrology. Variables showing a significant difference in the two groups were then analyzed using univariate and multivariate binary logistic regression. A total of 60 COVID-19 patients were included in the study, and 35% of them developed AKI. Compared to non-AKI patients, those with AKI exhibited a greater prevalence of diabetes mellitus (66.7% versus 35.9%, P = 0.023), higher D-Dimer levels (970 versus 685 ng/mL, P = 0.045), and higher values in TEG parameters of maximum amplitude/MA (74.6 versus 65.9 mm, P = 0.001) and coagulation index/CI (2.3 versus 1.0, P = 0.033). TEG parameter of MA emerged as the sole significant predictor for the development of AKI (OR, 6.33; 95% CI, 1.56 to 25.64). Our study validated the kidney involvement of COVID-19 infection, and showed that diabetes mellitus, high D-Dimer levels, and hypercoagulability serve as prominent risk factors in the development of AKI. Furthermore, TEG parameter of MA exceeding 70 mm is the single independent significant predictor of AKI.

In this paper, the integrated performance of a modular biomass boiler with an existing industrial Rankine steam heat and power cycle and a supplementary supercritical-CO2 (sCO2) Brayton cycle is analyzed. The aim is to leverage the high efficiency supplementary sCO2 cycle to increase net generation and energy efficiency from the existing biomass boiler. Two sCO2 heater configurations situated within the flue gas flow path are investigated, namely a single convective-dominant heater, and a dual heater configuration with a radiative and a convective heater. A quasi-steady-state 1D model was developed to simulate the integrated cycle, including detailed component characteristics for the Rankine and Brayton cycles. The model solves the mass, energy, momentum, and species balance equations. The system is analyzed for three cases: (i) the existing Rankine cycle without the sCO2 integration, (ii) with the single convective-dominant sCO2 heater configuration, and (iii) the dual sCO2 heater configuration. The results show the required rate of overfiring for the sCO2 configurations, with a 15.3% increase in fuel flowrate resulting in an additional 21.2% in net power output. The model quantifies the impact of the sCO2 heaters, with reduced heat uptakes for downstream boiler heat exchangers. Furnace water wall heat uptake increased due to overfiring, offsetting the reduced heat uptakes at downstream evaporative heat exchangers. The dual configuration has more impact on Rankine cycle operation due to the radiative sCO2 heater placement in front of the second superheater, absorbing some of the direct radiation from the furnace.

Greek roots: "phos" (φῶς) - means "light" and "dynamis" (δύναμις) - means "force" or "power". Photodynamic therapy (PDT) is an innovative treatment method based on the ability of photosensitizers to produce reactive oxygen species after exposure to light of a specific wavelength range, either in the visible or near infrared range. This process results in damage to pathological cells, such as cancer cells, while minimizing the impact on healthy tissues. PDT is a promising direction in the treatment of many diseases, with particular emphasis on the fight against cancer and other diseases asso-ciated with excessive cell growth. The power of light contributed to the creation of phototherapy, whose history dates back to ancient times. It was then noticed that some substances exposed to the sun have a negative effect on the body, while others have a therapeutic effect. This work provides a detailed review of photodynamic therapy, from its origins to the present day. It is surprising how a seemingly simple beam of light can have such a powerful healing effect, which is used not only in dermatology, but also in oncology, surgery, microbiology, virology, and even dentistry. However, despite promising re-sults, photodynamic therapy still faces many challenges. The availability of this thera-py is limited due to the small number of centers offering this type of treatment and the high costs, which may be unaffordable for many patients. Moreover, photodynamic therapy requires further research and improvement.

As Artificial Intelligence (AI) technology, particularly Machine Learning algorithms, becomes increasingly ubiquitous, our abilities to understand and interpret AI and machine learning algorithms are becoming increasingly desirable. Visualization has been used as a common tool to view and understand complex machine learning processes. In this paper, we will focus on developing a general framework for the visualization of machine learning models as a scalar valued multi-dimensional function to help users understand how the models behave over different viewing spaces. We first give a formal definition of the visualization problem. Interpolation-based morphing and subspace sampling techniques are applied to generate various renderings through projections and cross-sections of the model space as 3D surfaces or heatmap images. This method will be applied to two real-world datasets and applications: the diagnosis of Alzheimer's Disease (AD) using a human brain networks dataset and a real-world benchmark dataset for predicting home credit default risks. The visualizations show that different machine learning algorithms can behave quite differently under different conditions.

Complexity science studies physical phenomena that cannot be explained by the mere analysis of the single units of a system but requires to account for their interactions. A feature of complexity in connected systems is the emergence of mesoscale patterns in a geometric space, such as groupings in bird flocks. These patterns are formed by groups of points that tend to separate from each other, creating mesoscale structures. When multidimensional data or complex networks are embedded in a geometric space, some mesoscale patterns can appear respectively as clusters or communities, and their geometric separability is a feature according to which the performance of an algorithm for network embedding can be evaluated. Here, we introduce a framework for the definition and measure of the geometric separability (linear and nonlinear) of mesoscale patterns by solving the travelling salesman problem (TSP), and we offer experimental evidence on embedding and visualization of multidimensional data or complex networks, which are generated artificially or are derived from real complex systems. For the first time in literature the TSP’s solution is used to define a criterion of nonlinear separability of points in a geometric space, hence redefining the separability problem in terms of the travelling salesman problem is an innovation which impacts both computer science and complexity theory.

The life cycle of a microgrid covers all the stages from idea to implementation, exploitation until its end of life, but with a lifespan of around 25 years. Covering them usually requires several software tools, which can make integration of results from different stages very difficult and may imply costs hard to estimate from the beginning of a project. This paper proposes a single platform of four modules developed in Matlab to assist all the processes a microgrid passes during its lifetime. The authors detail the architecture, functions and the development of the platform, either by using existing tools available in Matlab, or by developing new ones and designing new user interfaces linked with scripts based on its complex mathematical libraries. A proof-of-concept for this platform was presented by applying the life-cycle assessment process on a real-case study, a microgrid consisting in a photovoltaic plant, an office building as consumer and energy storage units.

Polycentric governance, as conceptualized by the Nobel Laureate Elinor Ostrom, has been widely celebrated as a promising approach to fostering inclusive innovation ecosystems in the Global South. By emphasizing the coordination of multiple decision-making centers and the engagement of diverse stakeholders, polycentric systems are believed to enhance the inclusivity and responsiveness of innovation processes, crucial for addressing societal challenges and promoting equitable development. However, this article argues that the theoretical and practical application of polycentric governance may not adequately address the inherent power structures and complexities within inclusive innovation ecosystems. Drawing on critical analysis, empirical evidence, and complementary theoretical perspectives, this paper interrogates the limitations of polycentric governance and proposes a more nuanced, multidimensional framework for inclusive innovation governance in the context of the Global South.

Artificial intelligence (AI) is a current trend in computer science, which extends itself its amazing capacities to other technologies such as mechatronics and robotics. Going beyond technological applications, the philosophy behind AI is that there is a vague and potential convergence of artificial manufacture and natural world although the limiting approach may be still very far away, but why? The implicit problem is that Darwin theory of evolution focuses on natural world where breeding conservation is the cornerstone of the existence of creature world but there is no similar concept of breeding conservation in artificial world whose things are created by human. However, after developing for a long time until now, AI issues an interesting concept of generation in which artifacts created by computer science can derive their new generations inheriting their aspects / characteristics. Such generated artifacts make us look back on offsprings by the process of breeding conservation in natural world. Therefore, it is possible to think that AI generation, which is a recent subject of AI, is a significant development in computer science as well as high-tech domain. AI generation does not help us to reach near biological evolution even in the case that AI can combine with biological technology but, AI generation can help us to extend our viewpoint about Darwin theory of evolution as well as there may exist some uncertain relationship between man-made world and natural world. Anyhow AI generation is a current important subject in AI and there are two main generative models in computer science: 1) generative model that applies large language model into generating natural language texts understandable by human and 2) generative model that applies deep neural network into generating digital content such as sound, image, and video. This technical report focuses on deep generative model (DGM) for digital content generation, which is a short summary of approaches to implement DGMs. Researchers can read this work as an introduction to DGM with easily understandable explanations.

Following the adoption of the Kunming-Montreal Global Biodiversity Framework (KM-GBF), with the Convention on Biological Diversity serving as its guiding treaty, the European Union (EU) has just reached an agreement on an EU Nature Restoration Regulation. This study carries out a systematic cross-walk between the restoration regulation and the KM-GBF, focusing on their implications for forest ecosystems. This paper identifies areas of alignment, divergence, and potential gaps related to habitat restoration, species protection, climate resilience, and the sustainable use of natural resources. The methodology adopts a grounded approach, starting with the 23 targets outlined in the KM-GBF and proceeding to the 28 articles set out in the restoration regulation. The results highlight the need for better alignment between the KM-GBF, the restoration regulation, and other forest-relevant EU policy instruments. The study stresses the need for a coherent and integrated EU policy approach that can address the diverse challenges and policy objectives facing forests. It concludes that amendments to the restoration regulation have significantly diluted its potential impact, limiting the EU Members States accountability and ability to meet KM-GBF goals and targets. It further stresses the need for strategies that can reconcile divergent EU policy pathways, support forest management and restoration efforts, while aligning with global biodiversity objectives.

Despite global efforts to improve vaccination coverage, the number of zero dose and under immunized children has increased in the African continent, particularly in Nigeria where more than 2.3 million unvaccinated children currently reside, making it the country with highest number of unvaccinated children on the African continent. It is thus imperative to identity barriers and facilitators of immunization in Nigeria with a view to formulate and design targeted interventions that can effectively bridge the immunization gap in Nigeria. In this review, we systematically mapped and summarized existing literature and data on key barriers to vaccine uptake, and facilitators influencing immunization practices in Nigeria. The electronic databases were systematically searched and articles that reported determinants of routine immunization uptake in Nigeria from inception of the databases up till October 2023 were included. The eligible articles were evaluated using a set of pre-defined criteria and the extracted data were analysed and visualized. This scoping review identified barriers spanning logistical, socio-economic, cultural, and healthcare system-related aspects, highlighting the need for a multi-pronged approach to address these challenges. While considerable progress has been made over the years, persistent barriers like distance between area of residence of caregivers and immunization centers, vaccine shortages, poor interpersonal relationship between healthcare workers and caregivers and cultural/religious influences persist. Lastly, collaborative efforts among stakeholders and communities remain paramount in ensuring improved routine immunization coverage across the Nigeria’s diverse socio-cultural landscape.

Photovoltaic (PV) technologies are developing rapidly as a result of their ability to reduce energy consumption from conventional sources as well as the growth of global energy expenditures. Nevertheless, several impact categories during the PV panel life cycle occur and some principal sectors are affected. These impact categories are assessed by applying life cycle analysis (LCA) techniques through various software programs, databases and methods. Such analyses of energy technologies are crucial, as they can reveal the occurrence of hazardous emissions at distinct life cycle stages. In the present paper, a PV panel impact assessment through life cycle analysis is carried out. More precisely, a combination of PV technologies—monocrystalline, multicrystalline, copper indium gallium selenide (CIGS), amorphous, and ribbon—is studied. The impact categories of ozone depletion, human toxicity, particulate matter, ionising radiation, photochemical ozone formation, acidification, eutrophication, and ecotoxicity, as well as the sectors of human health, ecosystem quality, and environment, are assessed using the openLCA software, the ecoinvent database, the eco-indicator 99, IMPACT 2002+, ReCiPe, and TRACI methods.

Aim: To evaluate the panmacular subthreshold micropulse laser treatment results among patients with central serous chorioretinopathy (CSC) and their correlation with functional and morphological parameters. Material and methods: The examined group included 10 non-treated and 41 treated patients with acute, recurrent, and chronic CSC (13 F, 38 M, mean age 44.11±6.5) and 14 healthy controls (6 F, 8 M, mean age 45±9.3). The BCVA examination, ophthalmoscopy, microp-erimetry, angio-OCT and OCT were performed. The medical history regarding chronic general disorders and known risk factors were recorded. Results: Complete resorption of SRF was obtained in 100% aCSC, 86.66% cCSC, and 63.63% r CSC. BCVA and RetSens significantly improved most of the patients treated in aCSC. The lowest BCVA and RetSens, but the largest pachyvessel and disease duration, were found in rCSC. A strong negative correlation between final BCVA and disease duration was found. No patient demonstrated laser lesions following treatment. Conclusions: The panmacular MPLT therapy leads to long-term enhancement of functional and morphological parameters in all CSC patients. The acute CSC patients showed the most significant improvement. The procedure is safe and could be considered a preferred treatment option for all active CSC cases. Timely treatment is crucial for beneficial outcomes.

Adversarial Classification (AC) is a major subfield within the increasingly important domain of adversarial machine learning (AML). Most approaches to AC so far have followed a classical game-theoretic framework. This requires unrealistic common knowledge conditions untenable in the security settings typical of the AML realm. After reviewing such approaches, we present alternative perspectives on AC based on Adversarial Risk Analysis.

Climate change is challenging the agricultural sector worldwide. The pressure exerted by the altered thermal conditions drives the zonal shift for various cultivations. This study presents the multiyear analysis of the Growing Degree Days (GDD) index over the Northern Mediterranean Basin (NMB), focused on the high-value vine cultivation derived from the E-OBS dataset. To handle this extensive environmental dataset, R-language scripts and packages were applied, along with the capabilities of the GIS software. The investigated time period spans from 1969 to 2018, and the performed analysis indicates a broad shift/expansion in areas of GDD exceeding 2000 heat units. The extracted results specify the viticultural areas where the GDD index surpasses the suitable values for vine cultivation, owing to the increase of the thermal stress risk. In addition to mapping areas with GDD ≥ 2000, spatial calculations of the surface of areas meeting this criterion per country in the study area were made. In the northern parts of the NMB, the rise of the GDD index values indicates the establishment of vine plantations in the future.

Smoking a cigarette before bed or first thing in the morning is a common habit. In this review the relationship between smoking and sleep is investigated, based on the existing literature. Tobacco smoking disrupts sleep architecture by reducing slow wave and rapid eye movement (REM) sleep and undermining sleep quality. Furthermore, smoking affects sleep-related co-morbidities, such as obstructive sleep apnoea-hypopnea syndrome (OSAHS), insomnia, parasomnias, arousals, bruxism, restless legs but also non-sleep-related conditions such as cardiovascular, metabolic, respiratory, neurologic, psychiatric, inflammatory, gynecologic and pediatric. This review aims to consolidate all the existing knowledge about the relationship between smoking and sleep.

Thyroid surgery rates have tripled over the past 3 decades making it one of the most frequently performed procedures within general surgery. They are associated with the possibility of serious postoperative complications having a significant impact on the patient's quality of life. The recurrent laryngeal nerve (RLN) palsy and the external branch of the superior laryngeal nerve (EBSLN) palsy are, next to hypoparathyroidism and bleeding after operation, one of the most common complications. The introduction of neuromonitoring into thyroid surgery, enabling both confirmation of anatomical integrity and assessment of laryngeal nerve function, was a milestone that has begun a new era in thyroid surgery. The International Neural Monitoring Study Group made standardization of the technique of RLN and EBSLN monitoring during thyroid and parathyroid surgery which increased prevalence of neural monitoring during thyroidectomy. Current status of IONM and benefits of its use have been presented in this publication.

Aerobic vaginitis (AV) is a distinct clinical entity characterized by inflammation and abnormal vaginal microflora. Often mistaken for bacterial vaginosis, AV remains relatively unknown and underdiagnosed. AV's understanding is evolving, with some experts suggesting it may primarily be an immunological disorder, the prevalence of which ranges from 7-13% in non-pregnant women and 4.1-8.3% during pregnancy. Pregnancy can affect susceptibility to vaginal infections, leading to adverse outcomes for the woman and the newborn. This review summarizes the correlation between AV and adverse pregnancy outcomes, particularly preterm birth, the leading cause of morbidity and mortality among neonates. Improved understanding of AV's impact on pregnancy outcomes can lead to early recognition, proper management, and effective interventions. While some studies support an association between AV and preterm labor, the existing knowledge of this relationship remains limited. The evidence suggests that AV may contribute to adverse pregnancy outcomes, mainly preterm birth, but further research is needed to establish a definitive link. Further studies are needed to investigate the underlying mechanisms and clarify AV's role in premature labor. A comprehensive understanding of AV's impact on pregnancy outcomes is crucial for early recognition, appropriate management, and effective interventions.

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