Mobile health technologies enable continuous, quantitative assessment of mobility and gait in real-world environments, facilitating early diagnosis of gait disorders, disease progression monitoring, and prediction of adverse events like falls. Traditionally, mobile gait assessment predominantly relied on body-fixed sensors positioned at the feet or lower trunk. Here, we investigate the potential of an algorithm utilizing an ear-worn motion sensor for spatiotemporal segmentation of gait patterns. We collected 3D acceleration profiles from the ear-worn sensor during varied walking speeds in 53 healthy adults. Temporal convolutional networks were trained to detect stepping sequences and predict spatial relations between steps. The resulting algorithm, mEar, accurately detects initial and final ground contacts (F1 score of 99% and 91%, respectively). It enables determination of temporal and spatial gait cycle characteristics (among others stride time and stride length) with good to excellent validity at a precision sufficient to monitor clinically relevant changes in walking speed, stride-to-stride variability, and side asymmetry. This study highlights the ear as a viable site for monitoring gait and proposes its potential integration with in-ear vital sign monitoring. Such integration offers a practical approach to comprehensive health monitoring and telemedical applications, by integrating multiple sensors in a single anatomical location.

Human Activity Recognition (HAR) technology enables continuous behavior monitoring, particularly valuable in healthcare. This study investigates the viability of using an ear-worn motion sensor for classifying daily activities, including lying, sitting/standing, walking, ascending stairs, descending stairs, and running. Fifty healthy participants (between 20 and 47 years old) engaged in these activities while under monitoring. Various machine learning algorithms, ranging from interpretable shallow models to state-of-the-art deep learning approaches designed for HAR, were employed for classification. Results demonstrate the ear sensor's efficacy, with deep learning models achieving 98% accuracy rate of classification. The obtained classification models are agnostic regarding which ear the sensor is worn and robust against moderate variations in sensor orientation (e.g., due to differences in auricle anatomy), meaning no initial calibration of the sensor orientation is required. The study underscores the ear's efficacy as a suitable site for monitoring human daily activity and suggests its potential for combining HAR with in-ear vital signs monitoring. This approach offers a practical method for comprehensive health monitoring by integrating sensors in a single anatomical location. This integration facilitates individualized health assessments, with potential applications in tele-monitoring, personalized health insights, and optimizing athletic training regimes.

A multicenter, prospective cohort study conducted in 5 physiotherapy clinics in the UAE from January 2021 to March 2023 to assess coronal lumbar spine radiographic parameters as a predictor of conservative therapy outcomes in patients suffering from low back and leg pain due to lumbar disc herniation (HNP). Ninety patients (mean age 44 yrs., 54% male) with lumbar HNP underwent conservative therapy. All participants received lumbar spine MRI and radiography to assess spine alignment. Interventions included specific exercises, diathermy, traction, education, a home-based exercise pro-gram, and medications. Detailed demographic data was collected. Follow-up was 6-months after discharge. A successful outcome was based on a minimum of the following four outcomes: (1) reduction of pain by 17.5 points (0–100 NRS); (2) fatigue reduction by 7.5 points; (3) distress reduction by 5 points; and (4) interference reduction by 9.5 points. At 6-month follow-up it was found that patient age, education, and radio-graphic determined lumbosacral angle measures significantly affected the odds of a successful outcome. Increasing age 1-year significantly decreased the odds of success of improving pain, fatigue (OR = 0.85, p = 0.016) and interference scores (OR = 0.89, p = 0.042) by 15%, 15%, and 11% respectively. Lower education significantly increased the odds of success for improving pain, fatigue, and interference by 26.18, 26.18, and 7.5 (p = 0.006, = 0.006, and = 0.029 respectively). Increasing (worsening) the radiographic lumbosacral angle by each 1° significantly reduced the odds of success for improving pain, fatigue, distress, and interference by 3.52, 3.52, 27.99, and 2.55, respectively (p < 0.001, < 0.001, = 0.003, = 0.001). Our findings indicate that younger age, less education, and better coronal radiological lumbar spine alignment all had a substantial impact on the likelihood of success of 6-month outcomes in patients suffering from chronic lower back pain and radiculopathy due to HNP.

Flares, sometimes accompanied by coronal mass ejections (CMEs), are the result of sudden changes in the magnetic field of stars with high energy release through magnetic reconnection, which can be observed across a wide range of the electromagnetic spectrum from radio waves to the optical range to X-rays. In our review, we attempt to collect some fundamental new results, which can largely be linked to the Big data era that has arrived due to the expansion of space photometric observations of the last two decades. We list the different types of stars showing flare activity, their observation strategies, and discuss how their main stellar properties relate to the characteristics of the flares (or even CMEs) they emit. Our goal is to focus, without claiming to be complete, on those results that may in one way or another challenge the "standard" flare model based on the solar paradigm.

Introduction Delayed intra-operative neuro-monitoring (IOM) events can be defined as loss of responses, after baseline traces were present upon completion of instrumentation and deformity correction. This study reports this subgroup of events, assesses their incidence and evaluates potential causative factors. Methods We reviewed 1881 consecutive patients who underwent spinal deformity correction between 2011 and 2021. Surgeries were performed using a standardised anaesthetic regimen and multimodal IOM protocol. Results 44 patients (2.4%) had an IOM event. 9 patients (6F:3M) had a true positive delayed event after posterior segmental pedicle screw instrumentation. Mean age was 12.5 (2-17) years with mean thoracic Cobb angle of 78° (51-94°). Mean estimated blood loss was 28%. Titanium beam shaped rods were utilised in 3 patients and 5.5mm titanium rods in 5 patients. Motor evoked potentials were lost on average 18 (10-30) minutes after completion of instrumentation. 7 patients had bilateral loss and 2 patients had unilateral loss of MEP traces. Sensory evoked potential amplitude was preserved in all cases. There was a transient latency shift in one patient. MEPs returned within 20 minutes of rod release. The rod was re-contoured to incorporate more scoliosis in 1 patient. 2 patients had beam rods exchanged to 5.5mm titanium rods. 6 patients had rod removal with retention of pedicle screws and staged completion of instrumentation at mean 5 (1-7) days later. No patients had a postoperative neurological deficit. Conclusion Delayed IOM loss represented 15% of all events. Increased cord tension and hypo-perfusion were considered likely mechanisms. Rod release restored MEPs in all cases. The timing of events emphasises the importance of continued monitoring for minimum 30 minutes after completion of spinal instrumentation or until wound closure.

The overall contribution of otolith receptors to eye movements, postural control and perceptual functions is the basis for clinical testing of otolith function. With such wide range of contributions, it is important to recognize that the functional outcomes of these tests may vary depending on the specific method employed to stimulate the hair cells. In this article, we review common methods used for clinical evaluation of otolith function and how different aspects of physiology may affect the functional measurements in these tests. We compare the properties and performance of various clinical tests with the emphasis on the newly-developed video ocular counter roll (vOCR), measurement of ocular torsion on fundus photography, and subjective visual vertical or horizontal (SVV/SVH) testing.

As the adoption of renewable energy sources grows, ensuring a stable power balance across various time frames has become a central challenge for modern power systems. In line with the "dual carbon" objectives and the seamless integration of renewable energy sources, harnessing the advantages of various energy storage resources and coordinating the operation of long-term and short-term storage have become pivotal directions for future energy storage deployment. To address the complexities arising from the coupling of different time scales in optimizing energy storage capacity, this paper proposes a method for energy storage planning that accounts for power imbalance risks across multiple time scales. Initially, the Seasonal and Trend decomposition using the Loess (STL) decomposition method is utilized to temporally decouple actual operational data. Subsequently, power balance computations are performed based on the obtained data at various time scales to optimize the allocation of different types of energy storage capacities and assess the associated imbalance risks. Finally, the effectiveness of the proposed approach is validated through hourly applications using real-world data from a province in China over recent years.

The impact of the agriculture net carbon effect is crucial for climate change mitigation, yet research on this topic in China is currently insufficient. In this study, the carbon balance ratio (CBR) is used to characterise the net carbon effect of agriculture, and the spatial Durbin model and threshold regression model were used to empirically analyse the CBR with a sample of 30 provincial-level regions in China from 2004 to 2019. The aim was to investigate the mechanism of the influence of the land management scale (SCALE) of farming on the CBR. The results of the study indicate that national farming generally has a net sink effect, with large changes in interannual fluctuations; the expansion of SCALE has an obvious role in increasing sinks and reducing emissions, and has a positive spatial spillover effect on CBR, with significant spatial heterogeneity. Furthermore, as the SCALE expands, the direction of the influence of rural residents’ income and education level on CBR changes in the opposite direction, showing a significant non-linear relationship characteristic. However, in most areas, the SCALE threshold has not yet been reached, suggesting that the improvement in education levels can still offset the negative impact of economic income growth in the short term. The study recommends paying attention to the role of farmers’ human capital, changing production methods, and implementing carbon peaking and carbon neutrality goals to enhance the net sink effect of the farming industry, which would be achieved by increasing land management scale.

Reservoir routing has been a routine procedure in hydrology, hydraulics and water management. It is typically based on the mass balance (continuity equation) and a conceptual equation relating storage and outflow. If the latter is linear, then there exists an analytical solution of the resulting differential equation, which can directly be utilized to find the outflow from known inflow, and to obtain macroscopic characteristics of the process, such as response and residence times, and their distribution functions. Here we streamline the reservoir routing framework and extend it to find approximate solutions for nonlinear cases. The proposed framework can also be useful for climatic tasks, such as describing the mass balance of atmospheric carbon dioxide and determining characteristic residence times, which have been an issue of controversy. Application of the theoretical framework results in excellent agreement with real world data. In this manner, we easily quantify the atmospheric carbon exchanges, and obtain reliable and intuitive results, without the need to resort to complex climate models. The mean residence time of atmospheric carbon dioxide turns out to be no more than four years and the response time is smaller than that, thus opposing the much longer mainstream estimates.

This is a case study of a 55-year-old patient who died four months after receiving the mRNA-vaccine BNT162b2 (Pfizer-BioNTech) against COVID-19 as a second dose, following an initial vaccination with the ChAdOx1 nCov-19 vector vaccine (AstraZeneca) two months earlier. The autopsy diagnosis revealed general atherosclerosis. The histopathologic analyses of cardiac tissue demonstrated the presence of a thrombus occluding the right coronary artery (RCA) without evidence of plaque rupture. As a substitute trigger of clotting, the RCA presented with characteristics of acute lymphocytic vasculitis that extended to vasa vasorum in the adventitia and vessels in adjacent adipose tissue. Microthrombi were occasionally detected in these small vessels. It was obvious that lymphocytic myocarditis had been a chronic ongoing process temporally distinct from acute myocardial infarction. The myocardium contained patchworks of fibrotic areas alongside foci of displaying acute inflammation and fresh myocyte damage. SARS-CoV-2 Spike protein, but not nucleocapsid protein was sporadically detected in vessel walls by immunohistochemical assay. The cause of death was determined to be acute myocardial infarction and lymphocytic myocarditis. These findings indicate that myocarditis, as well as thrombo-embolic events following injection of spike-inducing gene-based vaccines, are causally associated with a injurious immunological response to the encoded agent. Because of the fact that the immune response to a first gene-based vaccination is very low in comparison with the immune response to the second vaccination, the found adverse events has rather to be attributed to the mRNA-based second vaccination as to the initial vector-based one.

HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic progressive neurological disorder and shares many radiological and clinical features with other more prevalent myelopathies. Here, we quantified spinal cord and brain volumes in adults with HAM/TSP in comparison with healthy volunteers (HVs) and participants diagnosed with multiple sclerosis (MS). Clinical disability and MRI were assessed in 24 HVs, 43 HAM/TSP, and 46 MS participants. Spinal cord cross-sectional area (SCCSA) and brain tissue volumes were measured and compared. HAM/TSP participants had significantly lower SCCSA at C2-3 (54.0±8 mm2), C4-5 (57.8±8 mm2), and T4-9 (22.7±4 mm2) and significantly elevated brain white matter hyperintensity (WMH) fraction (0.004±0.008) was compared to HVs (C2-3: 69.4±8 mm2, C4-5: 75.1±9 mm2, T4-9: 34.1±4 mm2; all p &lt; 0.0001; and WMH: 0.0004±0.0007; p &lt; 0.001). In HAM/TSP, SCCSA at all levels but not WMH showed the significant correlation with clinical disability scores. Brain white matter hyperintensities in HAM/TSP, therefore, may not be related to clinical disability. SCCSA and WMH in our limited MS cohort were higher than the HAM/TSP cohort (67.6±8 mm2, 72.7±9 mm2, 33.4±5 mm2; p &lt; 0.0001). Principal component analysis suggested that SCCSA and WMH may be used to differentiated HAM/TSP from MS. Understanding these differences may help establish early diagnostic criteria for HAM/TSP patients.

Reducing GHG emissions is a crucial challenge in urban areas, characterized by high energy consumption and reduced exposure to nature. In this context, the urban green system could play a pivotal role. In the literature, scholars analyzed both the ability of species-specific and layout-specific green infrastructures to increase carbon sequestration and the best location sites of new green infrastructures, to increase the provision of overall ecosystem services. There is a lack of studies helping green urban planners and designers choose where and which green infrastructure to implement, based on vegetation species-specific performance and local carbon emissions of city components. This paper uses tree inventory data from a medium-sized city in central Italy (Perugia) to develop a spatial analysis of the urban parks' performance in carbon sequestration. Then, the method evaluates the carbon emission of a public city building to generate a spatialized balance between buildings’ demand and trees’ supply, to support local decisions about the best locations for new green infrastructures and the choice between species. The paper contributes to GIS-based tools that vary the recommended location sites and species for new green infrastructures based on the demanded ecosystem service.

Background: Injury of the spinal cord causes motor and sensory dysfunction, and pathological reflexes, leading to paraplegia or tetraplegia. The sequelae of traumatic spinal cord injury (SCI) is a significant burden and impact on healthcare systems. Despite constant progress in medicine, traumatic SCI still remains irreversible. Till now, no satisfying treatment that can enable neuronal regeneration and recovery of function at the damaged level has been found. Hundreds of experiments have been conducted on various possibilities of influencing spinal regeneration, some of them have yielded promising results, but unfortunately, the successes obtained in experimental animals have not translated into humans. Methods: This narrative review article presents the application of Extracorporeal Shock Wave Therapy (eSWT) in Spinal Cord Injury. The article has been divided into parts: 1. Use of extracorporeal Shock Wave Therapy for regeneration of the spinal cord after traumatic Spinal Cord Injury. 2. Application of extracorporeal Shock Wave Therapy in spasticity after Spinal Cord Injury. In both cases, the hypotheses of possible mechanisms of action will be described. Results and conclusions: A small number of clinical trials have demonstrated the potential of eSWT to influence the regeneration of the spine, as an innovative, safe, and cost-effective treatment option for patients with SCI. Some reports have shown that eSWT can improve spasticity, walking ability, urological function, quality of life, and independence in daily life.

Objective: This prospective study investigated the feasibility performing laparoscopic pelvic surgery in spinal anesthesia and analyzed their intraoperative side effects like pain and nausea and vomitus of 915 patients. Methods: Implementation and performance of laparoscopic surgery under local anes-thesia of 915 patients out of a total of 3212, who underwent laparoscopic pelvic surgery in spinal anesthesia, were analyzed in relation to BMI (Body Mass Index), obesity, pain during surgery and amount of intraperitoneal mmHg CO2 gas pressure and surgical complications. Results: BMI > 30, intraabdominal adhesions, increased duration of the operation, bleeding and increased intraperitoneal CO2 pressure were statistically significant as the main causes of pain during laparoscopic surgery in spinal anesthesia. Under-weight patients, on the other hand, had less pain when intra-abdominal pressure in-creased compared to those of normal weight. The appearance of pain, nausea and vomitus occurred in 10,3% and was easy to manage and treat. It did not affect the sur-geon's work and the course of the operation. Conclusion: In view of these observations, we are proposing spinal anesthesia for lap-aroscopic surgery as the first choice in those patients, who have no contraindications. In our knowledge this clinical study constitutes the largest clinical observations and dataset that applies spinal anesthesia in laparoscopic pelvic surgery.

Computational fluid dynamics (CFD) modeling has emerged as a valuable tool for investigating complex processes like microencapsulation. This paper aims to validate the ability of CFD simulations to predict particle size distribution in a polymer microencapsulation process. The CFD modeling approach employed an Eulerian multiphase framework, incorporating a discrete population balance model to track the evolution of the droplet population. A realizable k-ε turbulence model and a multiple reference frame strategy were utilized to capture the system’s flow dynamics. The results reveal that while the CFD simulations align well with experimental data at higher agitation speeds (>10000 rpm), discrepancies arise at lower speeds (<7500 rpm), indicating a challenge in accurately capturing turbulent viscous regimes. Despite these challenges, the CFD model demonstrates robust predictive capabilities for droplet formation and distribution in microencapsulation processes, validated by error margins within acceptable limits. The validated model can be used as a reliable tool to guide experimental efforts and optimize process parameters, contributing to an enhanced understanding and control of microencapsulation processes.

The volatility and uncertainty associated with the high proportion of wind and PV output in the new power system significantly impact power and energy balance, making it challenging to accurately assess the risks related to renewable energy abandonment and supply guarante. Therefore, a probabilistic power and energy balance risk analysis method based on distributed robust optimization is proposed. Firstly, the affine factor and the flexible ramp reserve capacity of thermal power are combined to establish a probabilistic index, which serves to characterize the risk associated with power and energy balance. Drawing upon the principles of conditional value at risk theory, the risk indexes of load shedding power and curtailment power under a certain confidence probability are proposed. Secondly, the probability distribution fuzzy sets of uncertain variables are constructed using the distributionally robust method to measure the Wasserstein distance between different probability distributions. Finally, aiming at minimizing the operation cost of thermal power, the risk cost of power abandonment and the risk cost of load shedding, a distributed robust optimal scheduling model based on flexible ramp reserve of thermal power is established.

Presenting a rare case of adult-onset mature cystic teratoma of the spinal cord in the thoracolumbar spinal cord in a 54-year-old male whose chief complaint was lower back pain radiating to both legs while other findings were normal. X-ray images of the thoracolumbar spine showed early degenerative changes and unfused posterior elements noted in lower sacral vertebral levels. Magnetic resonance images of the lumbar spine showed a well-defined non-enhancing intramedullary altered intensity lesion noted at the level of conus at the L1-L2 vertebral level. The resected tumour was histopathologically diagnosed as a mature cystic teratoma. The patient's symptoms improved following the surgery.

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

Aim: The aim of this study was to investigate if tests used to assess core stability could be used to determine success in physiological tests applied to assess dynamic balance and agility for a young active population. Methods: Pearson's r correlation coefficient was used to assess the relationship between the core stability tests and the dynamic balance and agility tests. Evaluation of the tests was established using Cronbach's coefficient of variance as part of intra-rater reliability tests. An analysis of 18 active college aged students was conducted (males: n= 13, females: n= 5). The mean ± SD age for males was 19.2 years ± 3.22 years and for females was 19.4 years ± 1.14 years. Conclusion: The results indicate that there is no significant relationship between tests that assess core stability and tests conducted to assess dynamic balance in active young adults. With the exception of the abdominal flexion test, no significant relationship exists between the remaining core stability tests and agility T-Test. Core stability is not a determinant of balance and agility.

The aim of this report is to evaluate the segmental rib index (RI) from T1-T12 spinal level in mild and moderate idiopathic scoliosis (IS) curves of thoracic, thoracolumbar and lumbar type by gender. The relationship of segmental RI to the frontal plane radiological deformity presented as the Cobb angle and to the posterior truncal surface deformity presented as the scoliometric readings of Angle of Trunk Rotation (ATR) in these patients is also assessed. Any statistical significant rela-tionship of these parameters would be very important for biomechanical relations of the rib cage (RC) deformity presented as the rib hump deformity (RHD) and the deformity in the spine and it would thus provide valuable information about scoliogeny. The segmental rib index (RI) is presented in 83 boys and girls with mild and moderate IS. The measurements include the scoliometric readings for truncal asymmetry (TA), the Cobb angle assessment and the segmental RI from T1-T12. The statistical package SPSS 23 was used for statistical analysis. The TA is documented and the Cobb angle is presented by gender and curve type. The segmental RI of thoracic, thoracolumbar and lumbar curves are presented for the first time. The correlations of the segmental RI to surface deformity presented as the rib hump deformity (RHD) in all IS patients and particularly in thoracic curves, to Cobb angle by gender and age and the comparison of the segmental RI index of asymmetric but not scoliotic children to the scoliotic peers by curve (in thoracic, thoracolumbar, lumbar curves) in boys and girls are presented. The findings emphasize the significant protagonistic role of the thoracic asymmetry in relation to the spinal deformity mainly in girls for the thoracic and in boys for the thoracolumbar curves. The cut-off point of age of the examined scoliotics is 14 years, that is when the RI shows stronger correlation with the spinal deformity, namely when the thoracic deformity is decisively effective to the developing thoracic spinal deformity, in terms of Cobb angle. In summary, the results of this study provide aetiological implications for IS, as far as the role of thorax is con-cerned.

In former times, the spinal cord was considered a hard-wired network for spinal reflexes and a conduit for long-range connections. This view has changed dramatically over the past few decades. It is now recognized as a plastic device whose structures and functions adapt to changing circumstances. While such changes also occur under physiological conditions, the most dramatic alterations take place during or after various pathological events. It is astonishing what mechanisms the musculo-skeletal system has evolved to come to grips with the damages. Many of these changes are maladaptive, but some appear to help adapt to the new conditions. Although myriads of studies, using manifold methods, have been devoted to elucidating the underlying mechanisms, in humans and animal models, the etiology and pathophysiology of various diseases are still little understood, due to a number of reasons. We will here try to summarize some results and remaining problems in a selection of diseases, in particular spinal muscular atrophy (SMA), amyotrophic laterals sclerosis (ALS), and predominantly spinal cord injury (SCI) with occasional relations to stroke. Especially the changes in SCI (and stroke) depend on the cause, site and extent of the afflicted damage and are therefore multifarious. At the end, we will briefly summarize results indicating that operant, classical and instrumental conditioning can be used to produce plastic changes in healthy people, with potentials for applications to patients with spinal cord injury. In order not to overload the article, we will not delve deeply into sub-cellular processes.

Background and Objectives: Metastases are the most common tumors of the spine. As an important increase in the annual incidence of spinal metastases (SM) has been observed in the last decade, the aim of this study was to describe the epidemiology and histopathological types of SM surgically treated in the neurosurgery clinics of a regional hospital in North-Eastern Romania over a period of 5 years, in order to define a certain tumor profile that would benefit from an early screening. Materials and Methods: We retrospectively evaluated 115 adult patients, searching for demographic data (gender and age of the patients), primary tumor characteristics (location and histological type), topography and histopathological type of the spinal metastasis, and the time interval between the diagnosis of the primary tumor and the surgery for the spinal metastasis. Results: The patients were elderly (average age = 58.96 years), with a male predominance (67.82%). Main location of SM was in thoracic region (44.34%), with multiple vertebral metastases in 30.43% patients. Only 33.04% of the patients had a known cancer at the time of admission. Primary tumor was located mainly in lung (47.82%), gastrointestinal tract (15.65%), breast (11.30%), prostate (10.43%) and kidney (9.56%). SM from lung cancer mostly expressed squamous cell carcinoma (19.13%), and those from the digestive system mostly exhibited a moderately/poor colorectal adenocarcinoma (8.69%). Conclusions: Our data suggest the need for close surveillance of patients diagnosed with lung cancer and colorectal cancer because these malignancies most frequently develop spinal metastases. Smoking prevention actions and screening programs for the detection and removal of precancerous colorectal lesions must be developed and expanded.

The postnatal rodent spinal cord in-vitro is a useful model to investigate early pathophysiological changes after injury. While low dose nicotine (1µM) induces neuroprotection, how higher doses affect spinal networks is unknown. Using spinal preparations of postnatal wild-type Wistar rat and Wnt1Cre2:Rosa26Tom double-transgenic mouse, we studied the effect of nicotine (0.5-10µM) on locomotor networks in-vitro. Nicotine 10µM induced motoneuron depolarization, suppressed monosynaptic reflexes, and decreased fictive locomotion in rat spinal cord. Delayed fall in neuronal numbers (including motoneurons) of central and ventral regions emerged without loss of dorsal neurons. Conversely, nicotine (0.5-1µM) preserved neurons throughout the spinal cord and strongly activated the Wnt1 signaling pathway. High-dose nicotine enhanced expression of S100 and GFAP in astrocytes suggesting their response to stress. Excitotoxicity induced by kainate was contrasted by nicotine (10µM) in the dorsal area and persisted in central and ventral regions with no change basal Wnt signaling. When combining nicotine with kainate, the activation of Wnt1 was reduced compared to kainate/sham. The present results suggest that high dose nicotine was neurotoxic to central and ventral spinal neurons as the neuroprotective role of Wnt signaling became attenuated. This also corroborates the risk of cigarette smoking for the foetus/newborn since tobacco contains nicotine.

State-of-the-art augmented-reality (AR) glasses record their position and orientation in space, enabling measurements and analyses of clinical gait-and-balance tests. This study’s objective was to evaluate concurrent validity and test-retest reliability for common clinical gait-and-balance tests in people with Parkinson’s disease: the Five Times Sit-To-Stand (FTSTS) and Timed Up-and-Go (TUG) tests. Position and orientation data was collected in 22 participants with Parkinson's disease using HoloLens 2 and Magic Leap 2 AR glasses, from which test-completion durations and durations of distinct sub-parts (e.g., sit-to-stand, turning) were derived and compared to reference systems and over test repetitions. Regarding concurrent validity, for both tests an excellent between-systems agreement was found for position and orientation time series and test-completion durations. Between-systems agreement for FTSTS (sub-)durations were all excellent, while TUG turning sub-durations were excellent (turn 1) and moderate (turn 2). Regarding test-retest reliability, the within-system test-retest variation in test-completion times and sub-durations was always much greater than the between-systems variation, implying that these (sub-)durations may be derived interchangeably from AR and reference-system data. In conclusion, AR data are of sufficient quality to evaluate gait and balance in people with Parkinson's disease, with valid quantification of test-completion durations and sub-durations of distinct FTSTS and TUG sub-parts.

This article delves into the complex tension between national self-rule and international involvement, in the context of global politics, examining the inherent challenges of upholding both principles when confronted with human rights abuses and the pursuit of global peace. The introduction presents the fundamental dilemma: self-governance versus moral obligations. The problem statement calls for a nuanced approach to address the intricate complexities of sovereignty and intervention, acknowledging the potential misuse by oppressive regimes and the ongoing challenges of determining when and how intervention is warranted. The article advocates for a more responsible and effective approach to global conflicts and human rights violations, balancing national sovereignty with judicious intervention when required. The methodology employs both literature review and case analysis to construct a framework for objectively assessing when international intervention is justified in instances of human rights abuses. The conclusion stresses the criticality of objective intervention criteria, transcending cultural, political, and economic biases, and advocates for a globally accepted approach that celebrates diversity while promoting global stability.

This paper proposes an optimization method for the scheduling of a multi-energy virtual power plant supply-demand balance in the power market environment of Jiangxi Province. The objective of this method is to enhance the operational efficiency of the power grid, reduce energy costs, and facilitate economical and efficient energy distribution in the power market. The method comprehensively considers the characteristics and uncertainties of renewable energy sources such as solar and wind energy, and incorporates advanced multi-objective optimization algorithms. Additionally, real-time market price feedback is integrated to achieve accurate allocation of power supply and demand. Through a case study of a multi-energy virtual power plant in Jiangxi Province, this paper examines the optimal combination model for various energy sources within VPP, and analyzes the impact of different market environments on supply-demand balance. The results demonstrate that the proposed scheduling optimization method significantly improves economic benefits while ensuring grid stability. Compared with traditional power supply models, it reduces average electricity costs by 15% and increases renewable energy utilization efficiency by 20%.

Here, we present a staged approach for an innovative repurposing of a portable infant humidicrib into a live cell growth, observation, and imaging system. Furthmore, humidicrib can support different variations of “umbilical” bioreactors, and can be used to conduct electrophysiology experiments and in situ immunohistochemistry. Modifications incorporate a closed loop carbon dioxide (CO₂) concentration control system with umbilical CO₂ and heating support for tailored bioreactors. The repurposing cost is inexpensive and allows for the continued observation and imaging of cells. This prototype unit has been used to continuously observe and image live primary neurons for up to 21 days. This demonstrates the repurposed units’ suitability for use in tissue culture based research, particularly where modifications to microscopes are required or where sensitive manipulation outside of a standard incubator is needed.

Sweat rate and electrolyte losses have a large inter-individual variability, a personalized approach to hydration can overcome this issue to meet an individual’s needs. This study aimed to investigate the effects of personalized hydration strategy (PHS) on fluid balance and intermittent exercise performance. Twelve participants conducted 11 laboratory visits including a VO2max test and two 5-day trial arms under normothermic (NOR) or hyperthermic (HYP) environmental conditions. Each arm began with 3-day of familiarization exercise following by two random exercise trials with a either PHS or control (CON). Then, participants crossed-over to the second arm for: NOR+PHS, NOR+CON, HYP+PHS, and HYP+CON. The PHS was prescribed according to participants’ fluid and sweat sodium losses. CON drank ad-libitum of commercially-available electrolyte solution. Exercise trials consisted of two phases: 1) 45min constant workload; 2) high-intensity intermittent exercise (HIIT) until exhaustion. PHS had a significantly greater fluid intake compared to CON. HYP+CON produced the lowest sweat sodium concentration. HYP+PHS had a lower thirst perception and a longer HIIT compared to HYP+CON. Thus, PHS reinforces fluid intake and successfully optimizes hydration status, regardless of environmental conditions. PHS may be or is an important factor to preventing negative physiological consequences during high-intensity exercise in the heat.

The increasing prevalence of spinal disorders and the subsequent rise in spinal fusion surgeries stress the necessity for optimizing spinal fusion cages, crucial for stabilizing the spine and supporting osseointegration. Despite the widespread attempts at material modifications and surface enhancements to improve these devices, failure rates and complications remain significant. This research explores an imaginitive approach to enhancing spinal fusion cages through the application of geometric tiling designs, a method scarcely employed . The study systematically investigates the potential of triangular, diamond, and hexagonal tiling patterns to improve the structural integrity and capability for osseointegration of spinal fusion cages. Through a finite element analysis simulation, each design's ability to withstand multi-directional loads and effectively distribute stress was tested under simulated conditions that mimic the complexities of spinal motion. Preliminary findings in fields of engineering indicate that geometric tiling can significantly enhance the load-bearing capabilities and stress distribution of spinal fusion cages, potentially reducing the likelihood of implant subsidence and failure. The triangular and hexagonal designs, in particular, demonstrate superior performance in maintaining structural stability under axial and anterior compressive forces compared to traditional cage designs. This research opens a new pathway for the development of more durable and efficient spinal fusion cages. By leveraging the structural advantages of geometric tiling, future spinal implants could achieve better clinical outcomes, leading to improved patient recovery and reduced rates of complications.

Spinal Cord Injury in children can be a devastating condition in children with profound implications for their overall health and quality of life. In this review we aim to provide a concise overview of the key aspects associated with SCI in pediatric population. Firstly, we discuss the etiology and epidemiology of SCI in children, highlighting the diverse range of causes. We explore the unique anatomical and physiological characteristics of the developing spinal cord that contribute to the specific challenges faced by pediatric patients. Next, we delve into the clinical presentation and diagnostic methods, emphasizing the importance of prompt and accurate diagnosis to facilitate appropriate interventions. Furthermore, we approach the multidisciplinary management of pediatric SCI, encompassing acute medical care, surgical interventions, and ongoing supportive therapies. Finally, we explore emerging research and innovative therapies in the field and we emphasize the need for continued advancements in understanding and treating SCI in children to improve their functional independence and overall quality of life.

This paper proposes a lightweight joint with bamboo culm cross connection, which is constructed by screwing one side of the screw into the other side of the wooden plug, its simple construction makes it easy to manufacture and cost-effective. This form connects adjacent bamboo culms to form corner joints, and bolt connects adjacent bamboo culm frames to form edge joints, to explore the mechanical properties of the combination joints formed by corner joints and edge joints, by combining experiments and numerical simulations, the method discovered and explained the relationship and mechanism between the number and position of bolts and the stiffness of edge joints. A calculation model for frame-unit bamboo culm members considering semi-stiffness of joints is proposed, and the conversion equations between linear stiffness of corner and edge joint and their rotational stiffnesses are derived. By establishing the series and parallel relationship between the corner and edge joints in the assembled members, a generalized relational equation between the total stiffness of the assembled joint and the stiffness of the corner and edge joints is derived. A numerical simulation method for frame-unit bamboo culm members with semi-rigid joints is proposed, which can obtain the stiffness calculation formula of edge joints and the average rotational stiffness value of semi-rigid corner joints. A finite element analysis method based on semi-rigid joints is proposed for frame-unit bamboo culm members, and the internal force sketches and calculation methods for bamboo culms and joints are presented, which can be used for the internal force analysis and design of frame-unit bamboo culm lattice structures.

While some research supports utilizing plain radiography for measuring biomechanical alignment of the spine for prognosis and treatment, there are contrasting viewpoints regarding both the value and utilization of these procedures in conservative care. Evaluation of both conservative and non-conservative approaches to spinal care revealed vast differences in radiographic utilization and interpretation between orthopedic surgeons, primary care physicians, chiropractic physicians, and physical therapists, which may account for the different viewpoints and rationale in the literature. A research summary is provided regarding the various methods of spinal analysis utilized by these professions to help determine if there is any unique diagnostic or prognostic value associated with radiographic utilization that could assist in advancing conservative spinal assessment and treatment. Understanding any unique value provided through biomechanical assessment utilizing plain radiography of the spine established in the literature may help chiropractic physicians determine the appropriate use of radiographic procedures in clinical practice and how to coordinate efforts with other conservative and non-conservative professions to improve spinal healthcare.

Introduction: The COVID-19 pandemic challenged people with spinal cord injury (SCI) regarding a variety of mental and physical issues. New challenges may arise as the effects of the pandemic continue. The objective of the present study was to explore the social participation of Canadians with SCI during the second wave of COVID-19. Methods: Participants with SCI from two Canadian provinces (Quebec and British Columbia) were interviewed. Results: Eighteen participants completed interviews. Facilitators of social participation remain similar since the first wave of COVID-19, such as the use of technology, help received by relatives and the use of delivery services to obtain groceries and other essentials. Obstacles to mobility due to winter conditions and lack of considerations related to COVID-19 public health measures specific to wheelchair users were also discussed by participants. Conclusions: People with SCI perceived participation restrictions, little changes in life habits, and uncertainty about the future during the second wave of COVID-19. The unique living conditions of people with SCI, ability to adapt life habits, and the lived experiences of people with SCI may have contributed to an overall resilience during the pandemic. Adaptive families, social contacts and technology made a difference during the pandemic.

This study investigated the effects of a ten-visit individual coordinative locomotor training (CLT) program, including both a hands-on and a hands-off approach, on static and dynamic trunk stability in healthy adults with sedentary occupations. During the ten-visit program, the performance of eight subjects was monitored using a modified one-leg stance test in the sprinter and skater position, the Y-balance test, and the scapula and ischial tuberosity control test in the four-legged position. The data were analyzed using parametric and nonparametric statistics at an overall level of significance α=0.05. In the one-leg stance test, all subjects achieved a maximum value of 60 s on all ten visits. The improvement over time in the Y-balance test results was statistically significant for all directions (p<0.001). In addition, a statistically significant improvement in the Y-balance test composite score was observed between the first and the last visit (p=0.015-0.041). Subject-specific patterns were observed in the results of the Y-balance test. Significant improvements were observed over time in the four-legged position test score (p=0.008-0.010). Overall, the CLT program led to a significant improvement in trunk stability and leg extension in the anterior and posterolateral directions, as well as a reduction in instability as determined by the composite score of the Y-balance test.

In order to achieve global climate goals, it is necessary to estimate greenhouse gases (GHG) fluxes from ecosystems. To obtain a comprehensive assessment of CO2, СН4, N2O natural fluxes for the Russian Federation we used the "bottom-up" method according to [1]. We updated estimates for forest ecosystems based on State Forest Inventory data and satellite monitoring of forest disturbances. For grassland ecosystems, it was based on the correct distribution of areas between steppe and non-steppe zones. The estimated net uptake of natural ecosystems of Russia was 1.1 ± 1.8 billion tons of CO2-eq./year. The study shows that if only CO2 is taken into account, the net absorption of terrestrial ecosystems in Russia corresponds to more than -2.5 billion tons of CO2 (35% of forests’ contribution). However, given the emissions of non-CO2 GHGs, total net absorption in Russia’s natural ecosystems is reduced to about -1 billion tons of CO2-eq (with the forests’ contribution increasing to 80%). With regard to anthropogenic fluxes, the overall balance of GHGs in Russia corresponds to net-emissions of 1 billion tons of CO2-eq/year into the atmosphere. To improve reporting under the Paris Agreement, countries should aim to include only anthropogenic ("manageable") GHG fluxes on managed land.

Exoskeleton technology has been shown to be useful for individuals with spinal cord injury (SCI), potentially facilitating their recovery of motor function and social reintegration. However, studies on the safety and usability of exoskeletons are limited. This study aimed to design a powered exoskeleton for SCI and evaluate its safety and usability. Ten healthy adults participated in this study. The prototype exoskeleton featured an adjustable frame, computer-controlled hip and knee joint actuators, and a gait-trigger sensor. The experimental actions included walking, standing, and sitting, with and without the prototype. Safety outcomes included adverse events, vital signs, numerical rating scale (NRS) scores for pain, discomfort, and fatigue, and prototype-human body clearance. Usability outcomes included donning and doffing times, subjective ratings, gait speed, stride length, and kinematic parameters of hip and knee joint angles. Safety outcomes showed no serious adverse events, stable vital signs, minimal NRS scores, and acceptable clearance. Usability outcomes showed high efficiency and received positive ratings. Kinematic parameters showed significant positive correlations between normal walking and walking with the prototype for both hip and knee joint angles, confirming its effectiveness in assisting walking. However, further device improvements and gait parameter tuning are necessary for future clinical application.

Introduction: Low back pain (LBP) is the leading cause of lost productivity, absenteeism, disability, and early retirement worldwide. LBP treatment should be comprehensive, including prevention, education, diagnosis, and various treatment methods. Treatment can be divided into pharmacological and non-pharmacological. The role of physiotherapy in the comprehensive treatment of LBP is very important. Elastic therapeutic tape, also called kinesiology tape or therapeutic kinesiology tape, has been used for about 50 years. Purpose: The aim of this study was to evaluate the effectiveness of Kinesio taping in patients suffering from (LBP) and its possible effect on the swing of the center of pressure (COP), balance, gait, improvement of coordination, and pain reduction. Material and methods: A total of 60 patients aged 20 to 83 years (54% women) were examined, all of whom met the inclusion and exclusion criteria. In the experimental group, in addition to comprehensive rehabilitation, kinesiotaping of the L1-L5 spine was used. The control group underwent balance control training. The research tools used included the Bohannon single-leg standing test, the FAC scale - Functional Ambulatory Category, the Podsiadlo and Richardson Standing and Walking Test - Timed Up and Go (TUG), lumbar spine mobility assessment, Lasegue's sign and examination of neurological deficit symptoms. and self-assessment of pain using the Visual Analogue Scale (VAS). Results: Kinesio taping has a statistically significant effect on postural control, balance, gait, coordination, and pain. The main parameter with a statistically significant effect on the effects of Kinesio taping was age (below 55 years), which was also observed in the control group. Conclusions: Kinesio taping is an effective method in the treatment of LBP. It improves postural control, balance, gait, coordination, and pain.

Spinal muscular atrophy (SMA) is an orphan disease characterized by progressive degeneration of spinal alpha motor neurons. In recent years, nusinersen and several other drugs have been approved for the treatment of this disease. Transcutaneous spinal cord stimulation (tSCS) modulates spinal neuronal networks, resulting in changes in locomotion and posture in patients with severe spinal cord injury and stroke. We hypothesize that tSCS can activate motor neurons that are intact and restored by medication, slow the decline in motor activity, and contribute to the development of motor skills in SMA patients. Thirty-seven children and adults with SMA types 2 and 3 participated in the study. The median duration of drug treatment was over 20 months. Application of tSCS was performed during physical therapy for 20-40 minutes per day for ~12 days. Outcome measures were specific SMA motor scales, goniometry of contractured joints, forced vital capacity. Significant increases in motor function, improved respiratory function, and decreased contracture were observed in both types 2 and 3 SMA participants. The magnitude of functional changes was not associated with participants age. Further studies are needed to elucidate the reasons for the beneficial effects of spinal cord electrical stimulation in SMA.

Water resources provided by alpine glaciers are an important pillar for people living in the arid regions in the west of China. In this study, the HBV (Hydrologiska Byrans Vattenavdelning) light model was applied to simulate glacier mass balance and runoff in the Koxkar River Basin (KRB) on the south slope of Mt. Tumur, western Tianshan Mts.. Daily temperature and precipitation were calculated by multiple linear regressions and gradient-inverse distance weighting, respectively, based on in-situ observed data by automatic weather stations (AWSs) in the basin (2007–2009) and at four meteorological stations neighbering the basin (1959–2009). Observed daily air temperature and precipitation were taken as input data for the HBV model, which was calibrated using runoff in 2007/08 and 2009/10, and validated in 2008/09 and 2010/11. Generally, the model could simulate runoff very well. The annual glacier mass balance and runoff were calculated using the HBV model driven by interpolated meteorological data for the period of 1959–2009. The simulated glacier mass balance were reasonable when compared with those observed values at nearby glaciers, indicating a decrease trend of mass balance in the basin with an average value of –370.4 mm a^-1 since 1959. The annual runoff showed a slight increase trend (5.51 mm a^-1). Futher analysis indicated that the runoff is more sensitive to temperature than precipitation amuont in the Koxkar river basin.

Background. Sarcopenia and spinal cord injury (SCI) often coexist, but little is known about the associations of these two pathologies. This study aimed to assess the impact of SCI on muscle and bone mass and the correlations between clinical characteristics of SCI patients and sarcopenia. Methods: 136 patients diagnosed with SCI admitted to rehabilitation hospital were included in the study. The type and severity of injury (AIS), the level of spasticity (MAS), bone mineral density and Appendicular Lean Muscle Mass (ALM) were assessed. Sarcopenia was diagnosed according to the recommended EWGSOP2 cut-off points for ALM. Results: There was a statistically significant association between the ALM value and the gender, 75% of women developing sarcopenia. Among men, 42.9% had sarcopenia. Over 55% of AIS Grades A and B cases had sarcopenia. Mean age of sarcopenic patients was 35.8 years and they had multiple comorbidities. 51.6% of the patients with osteoporosis had sarcopenia. 69.7% of MAS level 0 cases had sarcopenia, while this was diagnosed in about 40% of patients with MAS levels 1-4. Conclusions: Gender, type of injury, presence of multiple comorbidities and age were directly associated with sarcopenia, while surprisingly, spasticity level and the presence of immobilization osteoporosis were not.

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

Spinal cord tumors, though rare, present formidable challenges in clinical management due to their intricate nature. Traditional treatment modalities like surgery, radiation therapy, and chemotherapy have been the mainstay for managing these tumors. However, despite significant advancements, challenges persist, including the limitations of surgical resection and the potential side effects associated with radiation therapy. In response to these limitations, a wave of innovative approaches is reshaping the treatment landscape for spinal cord tumors. Advancements in gene therapy, immunotherapy, and targeted therapy are offering groundbreaking possibilities. Gene therapy holds the potential to modify the genes responsible for tumor growth, while immunotherapy harnesses the body's own immune system to fight cancer cells. Targeted therapy aims to strike a specific vulnerability within the tumor cells, offering a more precise and potentially less toxic approach. Additionally, novel surgical adjuncts are being explored to improve visualization and minimize damage to surrounding healthy tissue during tumor removal. These developments pave the way for a future of personalized medicine for spinal cord tumors. By delving deeper into the molecular makeup of individual tumors, doctors can tailor treatment strategies to target specific mutations and vulnerabilities. This personalized approach offers the potential for more effective interventions with fewer side effects, ultimately leading to improved patient outcomes and a better quality of life. This evolving landscape of spinal cord tumor management signifies the crucial integration of established and innovative strategies to create a brighter future for patients battling this complex condition.

Soil water balance (SWB) in woody crops is sometimes difficult to estimate with one-dimensional models because these crops do not completely cover the soil and usually have a deep root system, particularly when cropped under rainfed conditions in a Mediterranean climate. In this study, the actual crop evapotranspiration (ETc act) is estimated with the soil water balance model SIMDualKc which uses the dual-Kc approach (relating the fraction of soil cover with the crop coefficients) to improve the estimation of the water requirements of a rainfed vineyard, using data from a deep soil profile. The actual basal crop coefficient (Kcb act) obtained using the SIMDualKc model was compared with the Kcb act estimated using the A&amp;P approach, which is a simplified approach based on measurements of the fraction of ground cover and crop height. Spectral vegetation indices derived from Landsat-5 satellite data were used to determine the fraction of ground cover (fc VI) and thus, the density coefficient (Kd). The SIMDualKc model was calibrated using soil water content (SWC) measurements down to a depth of 1.85 meters, which significantly improved the conditions for using a SWB estimation model. The test of the model was performed using a different SWC dataset. A good agreement between simulated and field measured SWC was observed for both data sets along the crop season, with RMSE&lt;12.0 mm, NRMSE &lt;13%. The calibrated Kcb values were 0.15, 0.60 and 0.52 for the initial, mid-season, and end season, respectively. The ratio between actual (ETc act) and crop evapotranspiration (ETc) was quite low between veraison and maturity (mid-season), corresponding to 36%, indicating that the rainfall was not sufficient to satisfy the vineyards water requirements. Spectral vegetation indices used to compute fc VI were unable to fully track the plants’ conditions when water stress. However, ingestion of data from remote sensing showed promising results that could be used to support decisions making in irrigation scheduling. Further studies on the use of the A&amp;P approach using remote sensing data are required.

The second article in the series presents the application of the Smoothed Particle Hydrodynamics (SPH) method to modelling of batch crystallisation in stirred tanks. A methodology to integrate the population balance equations (PBE) in parallel and independently from the Navier-Stokes equations is demonstrated. The benefits of the proposed methodology in terms of computational requirements, accuracy and availability of the crystal size distribution are discussed. The specific formulation of the SPH equations where the resulting system of ordinary differential equations is solved using the weighted contributions rather than numerically by solving a linear system of equations allows for massive parallelisation and a very loose coupling of the population balance and the fluid dynamics. It has been demonstrated, that the population balance equations can be solved on a Shared Memory Architecture (SMA) system using the OpenMP interface while the fluid dynamics equations being computed independently on a General Purpose Graphics Processing Unit (GPGPU) using the NVidia CUDA technology. This way, a significant portion of the computational overhead due to the large number of additional transport equations resulting from the discretisation of the population balance was removed: the SPH simulation coupled with 200 population balance equations was only 40% slower compared to SPH-only simulation. Two methods for the solution of population balance equations that preserve full crystal size distribution were implemented: discretised population balance (DPB) and method of characteristics (MOCH). The DPB equations are solved using the high-resolution finite-volume method with flux limiter and the effect of a large number of different flux limiters have been investigated. Both methods were validated using the case studies from the literature where an analytical solution can be derived. The developed models were applied to a numerical solution of coupled computational fluid dynamics and population balance equations to model a batch crystallization process. The effect of the hydrodynamics on the local temperature/supersaturation and the resulting crystal size distribution was captured and compared to the ideal mixing case. The simulation results from the DPB and MOCH methods were compared in terms of computational requirements and accuracy and MOCH selected as computationally more efficient and accurate.

Patients with metastatic epidural spinal cord compression (MESCC) and favorable survival prognoses may benefit from radiation doses exceeding 10 x 3.0 Gy. In a multi-center phase 2 trial, patients receiving 15 x 2.633 Gy (41.6 Gy10) or 18 x 2.333 Gy (43.2 Gy10) were evaluated for local progression-free survival (LPFS), motor/sensory functions, ambulatory status, pain, distress, toxicity, and overall survival (OS). They were compared (propensity score adjusted Cox regression) to a historical control group (N=266) receiving 10 x 3.0 Gy (32.5 Gy10). In the phase 2-cohort, 50 (of 62 planned) patients were evaluable for LPFS. Twelve-month rates of LPFS and OS were 96.8% and 69.9%, respectively. Motor and sensory functions improved in 56% and 57.1% of patients, and 94.0% were ambulatory following radiotherapy. Pain and distress decreased in 84.4% and 78.0% of patients. Ten and two patients experienced grade 2 and 3 toxicities, respectively. Phase 2 patients showed significantly better LPFS than the control group (p = 0.039) and a trend for improved motor function (p = 0.057). Ambulatory and OS rates were not significantly different. Radiotherapy with 15 x 2.633 Gy or 18 x 2.333 Gy was well tolerated and appeared superior to 10 x 3.0 Gy.

The differential expression of transcription factors during embryonic development has been selected as the main feature to define the specific subclasses of spinal interneurons. However, recent studies based on single-cell RNA sequencing and transcriptomic experiments suggest that this approach could not be appropriate in the adult spinal cord, where interneurons show overlapping expression profiles, especially in the ventral region. This constitutes a major challenge for the identification and direct targeting of specific populations that could be involved in locomotor recovery after a traumatic spinal cord injury in adults. Current experimental therapies including electrical stimulation, training, pharmacological treatments, or cell implantation that resulted in improvements in locomotor behaviour, rely on the modulation of the activity and connectivity of interneurons located in the surroundings of the lesion core for the formation of detour circuits. However, very few publications clarify the specific identity of these cells. In this work, we review the studies where premotor interneurons were able to create new intraspinal circuits after different kinds of traumatic spinal cord injury, highlighting the difficulties encountered by researchers to classify these populations.

The study is focused on identifying areas of individualization in those mature organizations in which employees are free to make changes. In addition, factors affecting work-life balance and overlap between the jobs employees do and would like to do are determined. A critical review of the literature and a diagnostic survey, including interviews, questionnaires and observations, were used in the research process, together with the analysis of data concerning working conditions. Employees' opinions (n=300) on individualization areas, job crafting and overlap between performed and preferred jobs were analyzed. Calculations were done using IBM SPSS. According to the results, the maintenance of work-life balance (WLB) and the implementation of job crafting positively affect employee efficiency, counteracting professional burnout and a decrease in motivation. It turns out that employees of mature organizations are familiar with the areas of individualization and in some cases have freedom to implement job crafting. They like the work they do, which translates into well-maintained work-life balance. However, a big challenge for mature organizations is the constantly changing economic environment, the long-term nature of work-life balance programmes and their deferred effects. The results of the research can be an important starting point for extended studies.

In this contribution, we aim to show that opinion dynamics and population balance modeling can benefit from an exchange of problems and methods. To support this claim, the Deffuant-Weisbuch model, a classical approach in opinion dynamics, is formulated as a population balance model. This new formulation is subsequently analyzed in terms of moment equations, and conservation of the first and second order moment is shown. Exemplary results obtained by our formulation are presented and agreement with the original model is found. Also the influence of the initial distribution is studied. Additionally, the Deffuant-Weisbuch model is transferred to engineering and interpreted as mass transfer between liquid droplets which results in a more flexible formulation compared to alternatives from the literature. On the one hand, it is concluded that the transfer of opinion-dynamics problems to the domain of population balance modeling offers some interesting insights as well as stimulating challenges for the population-balance community. On the other hand, it is inferred that population-balance methods can contribute to the solution of problems in opinion dynamics. In a broad outlook, some further possibilities of how the two fields can possibly benefit from a close interaction are outlined.

Traumatic spinal cord injury (SCI) elicits an acute inflammatory response which comprises numerous cell populations. It is driven by the immediate response of macro-phages and reactive M1 microglia, which triggers activation of genes responsible for the dysregulated microenvironment within the lesion site and in the spinal cord parenchyma immediately adjacent to the lesion. Recently published data indicate that microglia induces astrocyte activation and determines the fate of astrocytes. Conversely, astrocytes have the potency to trigger microglial activation and control their cellular functions. Here we review current information about the release of diverse signaling molecules (pro-inflammatory vs anti-inflammatory) in individual cell phenotypes (microglia, astrocytes, blood inflammatory cells) in acute and subacute SCI stages, and how they contribute to delayed neuronal death in a the surrounding spinal cord tissue which is spared and functional but reactive. In addition, temporal correlation in progressive degeneration of neurons and astrocytes and their functional interactions after SCI are discussed. Finally, the review highlight the time-dependent transformation of reactive mi-croglia (M1) and astrocytes (A1) into their neuroprotective phenotypes (M2a, M2c and A2) which are crucial for spontaneous post-SCI locomotor recovery. We also provide sug-gestions on how to increase functional outcome after SCI and discuss key therapeutic approaches.

Pregnancy at advanced maternal age (AMA) is a condition of potential risk for the development of maternal-fetal complications with possible repercussions even in the long-term. Here, we analyzed the changes of plasma redox balance and the effects of plasma on human umbilical cord mesenchymal cells (hUMSCs) in AMA pregnant women (patients) at various timing of pregnancy. One hundred patients and twenty pregnant women younger than 40 years (controls) were recruited, and evaluated at various timings during pregnancy until after delivery. Plasma samples were used to measure the thiobarbituric acid reactive substances (TBARS), glutathione and nitric oxide (NO). In addition, plasma was used to stimulate the hUMSCs, which were tested for cell viability, reactive oxygen species (ROS) and NO release. The obtained results showed that throughout pregnancy until after delivery in patients the levels of plasma glutathione and NO were lower than those of controls, while those of TBARS were higher. Moreover, plasma of patients reduced cell viability and NO release, and increased ROS release in hUMSCs. Our results highlighted alterations in the redox balance and the presence of potentially harmful circulating factors in plasma of patients They could have clinical relevance for the prevention of complications related to AMA pregnancy.

Following an initial mechanical insult, traumatic spinal cord injury (SCI) induces a secondary wave of injury, resulting in a toxic lesion environment inhibitory to axonal regeneration. This review focuses on the glial cell line-derived neurotrophic factor (GDNF) and its application, also in combination with other factors and cell transplantations, for repairing the injured spinal cord. As recent decades of studies strongly suggest combinational treatment approaches hold the greatest therapeutic potential for the central nervous system (CNS) trauma, future directions of combinational therapies will also be discussed.

In recent years, the digital economy has played an increasingly important role in enhancing productivity, fostering growth, and facilitating the emergence of digital banking. With the widespread adoption of digital financial services for financial inclusion, the banking sector is experiencing a demand for digital transformation. It is important to note that despite the many advantages of this change, it also disrupts the familiar banking experience that customers have grown to expect, as well as introducing potential risks to maintaining customer protection at previous levels. Many critics have raised concerns regarding customer protection and potential exposure to various risks that may arise from digital financial services, which may result in both financial and non-financial losses. These risks can impact customer retention as dissatisfied customers may switch to alternative service providers. Additionally, reputation can be affected since merely offering digital financial services may not sufficiently safeguard customers. To remain competitive, financial institutions must deliver a secure experience that aligns with customer expectations while considering economic factors and societal needs. This is why it is essential to comprehend the severity of the risk factors that influence the protection of customers in the realm of digitalized banking services and products. In this study, five factors have been identified that influence customer protection when using digital financial services in Pakistan. Based on the analysis conducted using SmartPLS, it appears that all the factors proposed in this study have a significant and positive impact on the protection of customers. In particular, the information provided remains of paramount importance when it comes to determining the level of protection that a customer is entitled to within digital financial services, followed by responsiveness, privacy, authentication, and encryption mechanisms. Due to these findings, the implementation of enhanced information security management principles becomes imperative for the development and progress of the Pakistani digital banking industry.

Balance is important in lifesaving competitions. We aimed to investigate the relationship between dynamic balance and physical function in elite lifesavers by measuring the foot muscle cross-sectional area, ankle joint muscle strength, toe grasp strength, plantar superficial sensation, and dynamic balance. In this observational study, we measured the foot muscle cross-sectional area, ankle dorsiflexion, plantar flexion, external flexion, isometric muscle strength, toe grasp strength, and superficial foot sensation of 15 adult lifesavers (12 males). The results showed that toe grasp strength and ankle plantar flexion isometric muscle strength are particularly important for the dynamic balance function of elite lifesavers working on sandy surfaces. Sand training improves intrinsic muscle training and dynamic balance function. However, high training intensity may cause a decrease in plantar surface sensation, which needs to be verified with sand training interventions in the future.

The mechanism of immune activation and de-activation is very important. Host should trigger effective immunity against pathogen infection. And, host cannot trigger immunity against self-antigens that will lead to detrimental autoimmune disorders. Spleen and liver have opposite roles in mediating immune responses. Spleen is the organ involving in immune activation, and liver is the organ involving in immune de-activation. Sympathetic nerve system and parasympathetic nerve system have opposite roles in mediating immune responses. Sympathetic nerve system is involving in pro-inflammatory, and parasympathetic nerve system is involving in anti-inflammatory. ACTH and glucocorticosteroid have opposite roles in mediating immune responses. ACTH is involving in activating adaptive immunity with inhibiting innate immunity, and glucocorticosteroid is involving in activating innate immunity with inhibiting adaptive immunity. The molecular chaperons, heat shock proteins, which are induced by fever, have the vital roles in immune activation. On the contrary, IgD B cells and gamma-delta T cells are causing immune de-activation via the mechanism of clonal anergy. These mechanism can help us the know the work of immunological pathways better for better control of infectious diseases and autoimmune disorders.

Afghanistan is overwhelmed with food insecurity that is a large percentage of the population lacks reliable access to food supplies. Grains play a vital role in the country's food security due to their importance in terms of consumption and production quantity. This paper estimates cereal self-sufficiency and then makes a food balance forecast of the three major food crops cultivated in Afghanistan over six-decades. Descriptive statistics and coarse metric techniques were employed to determine cereal self-sufficiency and food balance forecast. The econometric analysis demonstrated that (1) Afghanistan is not yet self-sufficient in meeting grain consumption, and the production and consumption ratio declined from 0.9 to 0.55 from 1979 to 2030. (2) The gap of theoretical food imbalance will increase, and by the year 2030, cereal production will likely be sufficient for only 49.8 percentage of inhabitants, leaving a high shortage equivalent to the amount required by 24.4 million people. By evaluating the quantitative food balance and the growing population change, this study presents an analysis of the emerging threat to Afghanistan's food security and suggests a solution for food security, should increase the size of public agricultural expenditure, improve the level of agriculture infrastructure, and continue to introduce a policy to achieve higher yield.

Background: Caring for a loved one can be rewarding but also associated with substantial caregiver burden, developing mental outcomes and affecting happiness. Eventually, these physical and psychological disorders can lead to an imbalance of the autonomic nervous system. Meditation has been found to offer multiple benefits to relieve these disorders and reduce the risk of cardiovascular disease. The aim of this study was to determine the effects of a four-week 16-hour presential meditation program on physiological and psychological parameters and vagal nerve activity in high-burden caregivers, comparing the results with those not receiving this program. Methods: A non-randomized repeated-measures controlled clinical trial was conducted, dividing participants between intervention and control groups by convenience allocation because random assignment was ethically inappropriate. Results: After the meditation program, the experimental group showed a significant reduction in anxiety levels (F= 24.92, p<0.001), a non-significant amelioration of depression levels (F= 1.75, p=0.19), and significantly improved heart rate variability (F= 8.40, p<0.05) and SDNN (F=15.59, p<0.05). Conclusions: Meditation can be a useful therapy to enhance the mental health and autonomic nervous system balance of informal caregivers, improving symptoms of physical and mental overload.

Mangroves and salt marshes are among the most productive ecosystems in the global coastal ocean. Mangroves store more carbon (739 Mg CORG ha-1) than salt marshes (334 Mg CORG ha-1), but the latter sequester proportionally more (24%) net primary production (NPP) than mangroves (12%). Mangroves exhibit greater rates of gross primary production (GPP), above-ground net primary production (NPP) and plant respiration (RC) with higher PGPP/RC ratios, but salt marshes exhibit greater rates of below-ground NPP. Mangroves have greater rates of subsurface DIC production and, unlike salt marshes, exhibit significant microbial decomposition to a soil depth of 1 m. Salt marshes release more soil CH4 and export more dissolved CH4 , but mangroves release more CO2 from tidal waters and export greater amounts of POC, DOC and DIC to adjacent waters. Both ecosystems contribute only a small proportion of GPP, RE (ecosystem respiration) and NEP (net ecosystem production) to the global coastal ocean due to their small global area, but contribute 72% of air-sea CO2 exchange from the world’s wetlands and estuaries and contribute 34% of DIC export and 17% of DOC + POC export to the world’s coastal ocean. Thus, both wetland ecosystems contribute disproportionately to carbon flow of the global coastal ocean.

Introduction:In this study we evaluated the connivance of oxidative and antioxidative parameters in the pathogenesis of spinal cord injury (SCI). Although the etiology and pathogenesis of SCI remain to be fully understood, it has been suggested that reactive oxygen species (ROS) and oxidative stress may play a significant role in the pathophysiology of SCI. Furthermore, there is little information available in scientific literature about oxidative and antioxidative parameters in SCI patients. Methods:Oxidative stress was determined by measuring the levels of Lipid Peroxides (LPO) and Protein carbonyl in plasma and antioxidative parameters like Glutathione Reductase (GR), catalase and Glutathione peroxidase (GPx) in lysate in 40 SCI patients and 40 healthy subjects without SCI. However, pain was measured by McGill pain questionnaire. Results: Concentrations of catalase (p<0.01), GR (p<0.01) and GPx (p<0.01) were significantly lower in patients with SCI than in controls, and levels of oxidative stress parameters, LPO (p<0.01), Protein carbonyl (p<0.01) were significantly higher in patients than in controls. A significant positive correlation was found between LPO and pain score among SCI patients group. Furthermore, a significant positive correlation was also found between Protein carbonyl and pain score among SCI patients group than in control group. Conclusion: The present results indicate that SCI patients are exposed to oxidative stress and this escalated oxidative stress may play a role in the etiopathogenesis of the disease. Moreover, our results also show that increased oxidative stress parameters are more strongly amalgamated with pain in SCI patients.

As an uncommon cause of spinal cord infarction, anterior spinal cord syndrome can manifest with motor paralysis, loss of pain, and temperature sensation distal to the site of the lesion. The main pathogenesis of this syndrome is the disruption of blood flow in the anterior spinal artery. Mortality and morbidity differ with the etiology of the syndrome. So knowing the etiology of blood flow disruption is essential for patient management. This review article highlights the important clinical manifestation of Anterior spinal artery syndrome. Also describes etiology, pathogenesis, diagnosis, prognosis, possible management, and complications.

Background: Prediction of neurorehabilitation outcomes after a Spinal Cord Injury (SCI) is crucial for healthcare resource management and improving prognosis and rehabilitation strategies. Arti-ficial neural networks (ANNs) have emerged as a promising alternative to conventional statistical approaches for identifying complex prognostic factors in SCI patients. Materials: a database of 1256 SCI patients admitted for rehabilitation was analyzed. Clinical and demographics data and SCI characteristics, were used to predict functional outcomes using both ANN and linear regression models. The former was structured with input, hidden, and output layers, while the linear regression identified significant variables affecting outcomes. Both ap-proaches aimed to evaluate and compare their predictive accuracy for rehabilitation outcomes measured by the Spinal Cord Independence Measure (SCIM) score. Results: Both ANN and linear regression models identified key predictors of functional outcomes, such as age, injury level, and initial SCIM scores (correlation with actual outcome: R=0.75 and 0.73, respectively). When alimented also with parameters recorded during hospitalization, the ANN highlighted the importance of these additional factors like motor completeness and compli-cations during hospitalization, showing an improvement in its predictive accuracy (R=0.87). Conclusion: ANN seemed to be not widely superior to classical statistics in general, but, taking into account complex and non-linear relationships among variables, emphasized the impact of complications during the hospitalization on recovery, particularly respiratory issues, deep vein thrombosis, and urological complications. These results suggested that the management of com-plications is crucial for improving functional recovery in SCI patients.

Keywords: Spine surgery 1; Metastatic spinal cord compression 2; Spinal metastasis 3; Cancer treatment.

Background and Objectives: C-arm free MIS techniques can offer significantly reduced rates of postoperative complications such as blood loss and hospitalization time. Another advantageous long-term aspect is the notably diminished exposure to radiation which is known to cause ma-lignant changes. This study emphasizes that, in some cases of spinal conditions which require a procedural intervention, C-arm free MIS techniques hold stronger indications than open surgeries guided by image intensifier. Materials and Methods: In this research, a retrospective analysis and review of various cervical and thoracic spinal procedures, performed in our hospital, by applying C-arm free techniques. The course of the study explains the basic steps of the procedures and demonstrating postoperative or intra-operative results. For anterior cervical surgery, we performed OPLL resection, while for posterior cervical surgery, we performed posterior fossa decompression for Chiari malformation, minimally invasive cervi-cal pedicle screw fixation (MICEPS) and modified Goel technique with C1 lateral mass screw for atlantoaxial subluxation. Re-garding the thoracic spine, we performed anterior correction for Lenke type 5 scoliosis, and transdiscal screw fixation for DISH fractures. Results: C-arm free techniques are safe procedures that offer precise and high-quality postoperative results by offering sufficient spine alignment and adequate decompression depending on the case. Blood loss, postoperative pain and wound infection are other important aspects of spine surgery that must be always taken into consideration. Conclusions: Navigated C-arm free techniques are safe and precise procedures implemented in the treatment of surgically demanding conditions. They can significantly increase accuracy while decreasing the operative time. They represent the advancement in the field spine surgery and are hailed as the future of the same

Abstract: Considering the significance of postural balance in shooting ability, and consequently soldiers’ occupational performance and survivability, it is of importance to promote the use of balance training programs to improve shooters' efficiency. This study explored how a balance training program affects shooting performance. Twenty participants were divided into two equal groups. They all performed 60 shots in a shooting simulator while standing. The participants went through this process twice, before and after a 4-week balance training program. The shoot-ing was done under four different conditions: without load on a stable surface, with load on a stable surface, without load on an unstable surface, and with load on an unstable surface. The training program had a significant impact on the experimental group, improving their balance by 76 ± 9% (p < 0.01). Additionally, in the experimental group, shooting score increased by 47% and the % center of gravity by 20% (p < 0.01). The stability of the shots, measured by holding time in the target, doubled from 2.2 to 4.5 seconds (p < 0.01). These improvements were more pronounced when participants had a load and/or were on an unstable surface. In conclusion, a balance training program can be beneficial for improving shooting performance.

Unpaid family caregivers might suffer losses in income as a result of care provision. Here we used data from the baseline survey of the China Health and Retirement Longitudinal Study to assess the relationship between hours of weekly caregiving provided to grandchildren/parents/parents-in-law and individual’s monthly employment income. Our study sample comprised 3,718 middle-aged Chinese adults who were of working age (45-60 years). For women and men separately, we used a likelihood-based method to determine a caregiving threshold in a two-stage Heckman selection procedure. Instrumental variables were used to rule out the endogeneity of caregiving hours. Our analysis revealed a negative association between caregiving and income for women that depended on a caregiving threshold of 63-hours per week. There was an absence of caregiving-income relationship among men. These results offer new insights into the opportunity costs of unpaid caregiving and support tailored policies to protect the financial well-being of female caregivers.

Background: Spinal schwannomas and meningiomas are the most common spinal cord benign tumors in adults and total excision is the goal of the treatment. The traditional surgical approach is performed by total laminectomy, but recently unilateral hemilaminectomy has been recognized as a valuable surgical alternative. We report the clinical results of patients affected by spinal schwannoma and meningioma in whom total laminectomy or unilateral hemilaminectomy were performed. Material and Methods: A retrospective study of patients who underwent resection of spinal meningioma or schwannoma by laminectomy or unilateral hemilaminectomy approaches in our Institute from January 2013 to January 2023 was made. The baseline data of these patients, operative approach and postoperative outcome were compared. Results: The study was performed on 41 patients with mean age of 62.5 ±14.6 years. Our series included 24 (59%) cases of schwannomas and 17 (41%) cases of meningiomas, with a prevalent location in the thoracic spine. The average schwannomas volume was 3,6 ±2,7 cm3, whereas the average meningiomas volume was 1.1 ±0.5 cm3. Total excision was achieved in all cases. Operative time of schwannomas was longer (p=0.001) respect to meningiomas with higher intra-operative blood loss (p=0.000). Total laminectomy approach was performed in 24 out of 41 patients (59%) and unilateral hemilaminectomy approach in 17 out of 41 (41%) patients. Unilateral hemilaminectomy was associated with shorter postoperative bed rest (p=0.003), shorter hospitalization (p=0.028) and lower postoperative pain (p=0.02) respect to total laminectomy. Conclusions: Both spinal schwannomas and spinal meningiomas in various size can be safely and effectively treated with unilateral hemilaminectomy approach. This approach grants more advantages compared with standard total laminectomy, including shorter postoperative bed rest, shorter hospitalization and reduced postoperative pain.

Reactive oxygen species (ROS) are essential signaling molecules involved in almost all metabolic processes. In the present study, a HepG2 insulin resistant cell model (HepG2/IRM) was chosen to investigate the efficacy of hydroxyhydroquinone (HHQ), quassinoids from Picrasma crenata and flavonoids from Rourea cuspidata as potential glycemic controlling agents for insulin sensitization. HHQ was synthetized and extracts from P. crenata and R. cuspidata were tested in hepatic cell line, which were evaluated through cytotoxic activity, levels of ROS, ATP, mitochondrial membrane potential and expression of FoxO1 protein in a high glucose environment. Our results demonstrate that the HHQ, quassinoids and flavonoids were not toxic to cells at concentrations up to 50mM and 50 mg/mL in HepG2/IRM and HepG2. ROS activity was increased for all groups with insulin induction upon glucose consumption. HHQ and quassinoids downregulate the expression of FoxO1 in comparison to cells exposed to flavonoids. The results here presented suggests that quassinoids may act on nuclear glucocorticoid receptors to inhibit FoxO1 expression by competing with cortisol and HHQ can act as ROS scavenger to ameliorate mitochondria activity and modulate ATP generation. This study provides a pharmacological basis for the application of HHQ, quassinoids from P. crenata and flavonoids from R. cuspidata in the treatment of metabolic diseases such as type 2 diabetes mellitus.

The formation of inclusion complexes between alkylsulfonate guests and a cationic pillar[5]arene receptor in water was investigated by NMR and ITC techniques. The results show the formation of host-guest complexes stabilized by electrostatic interactions and hydrophobics effects with binding constants of up to 107 M-1 for the guest with higher hydrophobic character. Structurally, the alkyl chain of the guest is included in the hydrophobic aromatic cavity of the macrocycle while the sulfonate groups are hold in the multicationic portal by ionic interactions.

The EigenAnt algorithm has been proposed to find the shortest path between two nodes with a proof of convergence. Two novel features are noticeable in EigenAnt compared to the conventional ant colony optimization algorithms. Pheromone evaporation in the EigenAnt algorithm is done locally for the selected path and it does not use heuristic information in its selection phase. On the other hand, a simple version of ant colony optimization that also does not use heuristic information has been used for analyzing convergence, considering parameter impact analysis, in the problem of finding the shortest path for 1-node binary chain problems. In this paper, we propose to improve the EigenAnt algorithm by adding additional parameters in such a way as to be able to take advantage of the analysis developed for the simple ant colony optimization algorithm. We demonstrate through our analysis that since the Improved EigenAnt algorithm has one parameter more than ant colony optimization algorithms, tuning of convergence speed is decoupled from tuning of convergence features in the algorithm. Thus, IEigenAnt, which can be interpreted as having two uncorrelated intensification and diversification components, makes it possible to achieve a balance between intensification and diversification. In order to illustrate the advantages of this decoupling, we present experimental results for the routing network problem.

Studies on N balance due to N inputs and outputs and soil N retention to measure cropping system performance and environmental sustainability are limited due to the complexity of measurements of some parameters. We measured N balance based on N inputs and outputs and soil N retention under dryland agroecosystem affected by cropping system and N fertilization from 2007 to 2011 in the northern Great Plains, USA. Cropping systems were conventional tillage barley (Hordeum vulgaris L.)-fallow (CTB-F), no-tillage barley-fallow (NTB-F), no-tillage barley-pea (Pisum sativum L.) (NTB-P), and no-tillage continuous barley (NTCB). Nitrogen rates to barley were 0, 40, 80, and 120 kg N ha-1. Total N input due to N fertilization, pea N fixation, soil N mineralization, atmospheric N deposition, nonsymbiotic N fixation, and crop seed N and total N output due to grain N removal, denitrification, volatilization, N leaching, gaseous N (NOx) emissions, surface runoff, and plant senescence were 28 to 37% greater with NTB-P and NTCB than CTB-F and NTB-F. Total N input and output also increased with increased N rate. Nitrogen sequestration rate at 0 to 10 cm averaged 22 kg N ha-1 yr-1 for all treatments. Nitrogen deficit ranged from 5 to 16 kg N ha-1 yr-1, with greater deficits for CTB-F and NTB-P and higher N rates. Because of increased grain N removal and reduced N loss to the environment and N fertilizer requirement, NTB-P with 40 kg N ha-1 can enhance agronomic performance and environmental sustainability while reducing N inputs compared to other management practices.

Keywords: spinal muscular atrophy (SMA); survival of motor neuron 1 (SMN1); SMN2; SMN protein; antisense oligonucleotide (ASO); nusinersen; gene therapy; onasemnogene; risdiplam; small molecule, combination therapy

Wear simulation aims to assess wear rates and their dependence on factors like load, kinematics, temperature, and implant orientation. Despite its significance, there's a notable gap in research concerning advancements in simulator control systems and the testing of clinically relevant waveforms. This study addresses this gap by focusing on enhancing the conventional proportional-integral-derivative (PID) controller used in joint simulators through the development of a fuzzy logic-based controller. Leveraging a single-input-multiple-output (SIMO) fuzzy logic control system, the study aimed to improve displacement control, augmenting the traditional Proportional-Integral (PI) tuning approach. Implementation and evaluation of a novel Fuzzy-PI control algorithm were conducted on the Leeds spine wear simulator. The study also included testing of daily-living (DL) profiles, particularly from the hip joint, to broaden the scope of simulation scenarios. While both the conventional PI controller and the Fuzzy-PI controller met ISO tolerance criteria for the spine flexion-extension (FE) profile at 1Hz, the Fuzzy-PI controller demonstrated superior performance at higher frequencies and with DL profiles due to its real-time adaptive tuning capability. The Fuzzy-PI controller represents a significant advancement in joint wear simulation, offering improved control functionalities and a more accurate emulation of real-world physiological dynamics.

Gamma-aminobutyric acid (GABA) and glycine act as inhibitory neurotransmitters. Three types of inhibitory neurons and terminals, GABAergic, GABA/glycine co-releasing, and glycinergic, are orchestrated in the spinal cord neural circuits and play key roles in the regulation of pain, locomotive movement, and respiratory rhythms. Herein, we first describe GABAergic and glycinergic transmission and inhibitory networks, which consist of three types of terminals, in the mature mouse spinal cord. Second, we describe the developmental formation of GABAergic and glycinergic networks, with specific focus on the differentiation of neurons, formation of synapses, maturation of removal systems, and changes in their action. GABAergic and glycinergic neurons are derived from the same domains of the ventricular zone. Initially, GABAergic neurons are differentiated and their axons form synapses. Some of these neurons remain GABAergic in lamina I and II. Many of GABAergic neurons convert to co-releasing state. The co-releasing neurons and terminals remain in the dorsal horn, whereas many of co-releasing ones ultimately become glycinergic in the ventral horn. During the development of terminals and the transformation from radial glia to astrocytes, GABA and glycine receptor subunit compositions markedly change, removal systems mature, and GABAergic and glycinergic action shifts from excitatory to inhibitory.

The aim of the study was to assess the relationship between the shape of the anterior-posterior curvature of the spine and body composition in school-children. The study included 257 children, aged 11-12. Correct spinal curvature was established in 106 (41.08%) subjects. Other types included: decreased kyphosis and correct lordosis - 40 participants (15.50%), correct kyphosis and decreased lordosis - 24 individuals (9.30%), increased kyphosis and correct lordosis - 17 subjects (6.59%), correct kyphosis and increased lordosis - 22 children (8.53%), decreased kyphosis and decreased lordosis - 32 people (12.40%), decreased kyphosis and increased lordosis - 4 of the examined subjects (1.55%), increased kyphosis and lordosis - 13 people (5.04%). In addition, 134 (51.94%) demonstrated scoliotic posture and 8 (3.10%) scoliosis. There were significant relationships between the shape of the anterior-posterior curvatures and body composition in school-children. Those with a strong body build (predominance of mesomorphs) were generally characterised by the correct formation of these curvatures. In contrast, lean people (with the predominance of ectomorphic factors) were more likely to experience abnormalities. No correlations with body composition were observed in the group with scoliotic posture or scoliosis.

The paper proposes a methodological way to compensate the imbalance between energy generation and consumption using the battery block of electric vehicles as energy reservoir through the well-known Vehicle to Grid system (V2G). The method is based on a simulation process developed by the authors that take into consideration the daily fluctuations of energy consumption as well as the power level generated by an energy source, either conventional, renewable or hybrid. The study shows that for very large electric vehicle fleet the system renders non-viable, since the remaining energy in the battery block to let the electric vehicle usable for running during daytime avoids to compensating for the energy grid imbalance, only allowing to cover a percentage of the energy imbalance, which the proposed methodology may optimize. The analysis of the proposed methodology also shows the viability of the system when being applied to a small fleet of electric vehicles, not only compensating for the energy imbalance but also preserving the required energy in the battery of the electric vehicle to make it run. The method allows predicting the optimum size of electric vehicle battery, which depends on the energy generation level, coverage factor of the energy imbalance and size of the electric vehicle fleet.

Brown-Séquard Syndrome (BSS) is a rare spinal cord injury characterized by asymmetrical motor and sensory dysfunction. Trauma to the spinal cord, particularly the hemi section, is the primary cause. Diagnosis involves a thorough medical history, physical examination, and imaging studies. Treatment focuses on stabilization, rehabilitation, and potential emerging therapies. This article provides a comprehensive overview of BSS, including its causes, symptoms, diagnosis, and treatment.

Transcutaneous electrical stimulation of the spinal cord is used to restore locomotion and body weight support in patients with severe motor disorders. We studied effects of this non-invasive stimulation on postural control in healthy subjects. Stimulation at the L1-L2 vertebrae was performed to activate the extensor muscles of the lower limbs. Because postural regulation depends on the cognitive style, the effects of the stimulation were analyzed separately in field-dependent (FD) and field-independent (FI) participants. During the study young adults (N=16, half FD and half FI participants, all right dominant leg) stood on a force platform in a soundproof chamber with their eyes closed. Stimulation was applied in the midline between the L1-L2 vertebrae or over the left or right dorsal roots of the spinal cord; under control condition there was no stimulation. Stimulation destabilized posture in healthy subjects, whereas patients with movement disorders usually showed an improvement in postural control. In FD participants, left dorsal root and midline stimulation increased several postural parameters by up to 30%. Dorsal root stimulation on the side of the supporting leg reduced postural control, while stimulation on the side of the dominant leg did not. No significant changes were observed in the FI participants.

Background Main treatment modality for spinal meningiomas (SM) is gross total resection (GTR). However, optimal timing of surgery, especially in cases with absent or mild neurological symptoms remains unclear. The aim of this study is to assess the impact of early-stage resection on neurological outcome, quality of life (QoL) and quality of care. The primary objective was a favorable neurological outcome (McCormick scale 1); Methods: We retrospectively analyzed data from patients operated on SM between 2011 and 2021. Patients with mild neurological symptoms preoperatively (McCormick scale 1 and 2) were compared to those with more severe neurological symptoms (McCormick scale 3-5). Disabilities and QoL were assessed according to validated questionnaires (SF36, ODI, NDI). Results: Age, spinal cord edema, thoracic localization, and spinal canal occupancy ratio were associated with more severe neurological symptoms (all p<.05). Patients presented with mild symptoms were associated with favorable neurological outcome (OR: 14.778 (95%CI 3.918-55.746, p<.001), which is associated with shorter hospitalization, better QoL and less disabilities (p<.05). Quality of care was comparable in both cohorts; Conclusions: Early surgical intervention of SM, before the development of severe neurological deficits, should be considered as it is associated with a favorable neurological outcome and quality of life.

The study assessed the impact of different diets on gastrointestinal pH, intestinal microbiota, digestive tract morphometry, and productive performance in guinea pigs. A total of 160 improved genotype guinea pigs were used, distributed into three groups with different diets: alfalfa (T1), alfalfa + concentrate (T2), and concentrate (T3), to which a mixture of probiotics combined with vitamins, minerals was added and amino acids in T2 and T3. Gastrointestinal pH showed significant differences between treatments in the various segments of the digestive tract. The intestinal microbiota varied according to the diet, with Escherichia coli being the predominant bacterium in weaned guinea pigs. Intestinal morphometry was significantly altered with the addition of a reinforced probiotic mixture, improving the length and density of intestinal villi. Productive parameters such as weight gain, feed consumption, and feed conversion were better in guinea pigs fed a mixed diet with 0.5% probiotic mixture. These results indicate that intestinal pH may influence microbial composition, which impacts productive efficiency and immune health, highlighting the importance of balanced nutrition and supplementation to optimize the health and performance of guinea pigs.

This paper presents a comprehensive cost-benefit analysis of producing alternative phosphorus (P) fertilizers from recycled water treatment residuals (Fe-WTR) and cowshed effluents, under the umbrella of circular economy approach. Fe-WTR is compared to a synthetic adsorbent, layered double hydroxide (LDH). Dairy wastewater is used as a P source for both adsorbents. The cost of 1 ton P-Fe-WTR sums up to 329 Euro. In contrast, the use of synthetic adsorbents (P-LDH) incurs significantly higher costs, amounting to 3329 Euros per ton, underscoring the economic advantage of utilizing waste-derived materials. Adopting Fe-WTR fertilizer not only offers substantial cost savings by avoiding landfill fees (40-150 Euros per ton) and wastewater discharge fines (500 Euros per ton) but also reduces environmental impacts. This sustainable method mitigates eutrophication and pollution, presenting a dual benefit of cost-effectiveness and environmental protection. Although our results are based on a specific case study, they reflect the potential value of extending the circular economic approach to P production worldwide: Recycling P from waste streams can be economically viable and environmentally preferable at large, aligning with global sustainability goals and demonstrating the practicality of circular economy principles in environmental management.

The bipolar mitotic spindle drives accurate chromosome segregation by capturing the kinetochore and pulling each set of sister chromatids to the opposite poles. In this review, we describe recent findings on the multiple pathways leading to bipolar spindle formation in fission yeast and discuss these results from a broader perspective. Roles of four mitotic kinesins (Kinesin-5, Kinesin-6, Kinesin-12 and Kinesin-14) in spindle assembly are depicted, and how a group of microtubule-associated proteins, sister chromatid cohesion and the kinetochore collaborates with these motors is shown. We have paid special attention to the molecular pathways that render otherwise essential Kinesin-5 to become non-essential: how cells build bipolar mitotic spindles without the need for Kinesin-5 and where the alternate forces come from are considered. We highlight the force balance for bipolar spindle assembly and explain how outward and inward forces are generated by various ways, in which the proper fine-tuning of microtubule dynamics plays a crucial role. Overall, these new pathways have illuminated remarkable plasticity and adaptability of spindle mechanics. Kinesin molecules are regarded as prospective targets for cancer chemotherapy and many specific inhibitors have been developed. However, several hurdles have arisen against their clinical implementation. This review provides insight into possible strategies to overcome these challenges.

A new model predictive control (MPC) algorithm is used to select optimal air conditioning setpoints for a commercial office building, considering variable electricity prices, weather, occupancy and lighting. This algorithm, Cost-Comfort Particle Swarm Optimization (CCPSO), is the first to combine a realistic, smooth representation of occupants’ willingness to pay for thermal comfort with a bottom-up, non-linear model of the building and air conditioning system under control. We find that using a quadratic preference function for temperature can yield solutions that are both more comfortable and lower-cost than previous work that used a ``brick wall'' preference function with no preference for further cooling within an allowed temperature band and infinite aversion to going outside the allowed band. Using historical pricing data for a summer month in Chicago, CCPSO provided a 3\% reduction in costs vs. a ``brick-wall'' MPC approach with similar comfort and 13\% reduction in costs vs. a standard night setback strategy. CCPSO also reduced peak-hours demand by 3\% vs. the ``brick-wall'' strategy and 15\% vs. standard night-setback. At the same time, the CCPSO strategy increased off-peak energy consumption by 15\% vs. the ``brick-wall'' strategy. This may be valuable for power systems integrating large amounts of renewable power, which can otherwise become uneconomic due to saturation of demand during off-peak hours.

Nowadays, all the stakeholders, policy makers, regulators, aircraft designers, producers, operators, etc.) are intensively working on development of the aircraft with full electric and hybrid propulsion systems. However, the technical, technological constrains (like limit on accumulator energy density) require introducing a new approach to conceptual design of such aircraft. The new methods is based on energy and mass balance evaluation. This paper analyses the identified constrains; integrates the energy and mass balance equations into the preliminary definition and calculations of the aircraft performance. By this way, the technological constrains might be transferred into the limitation on the aircraft energy and mass breakdown, that initiates a new approach to aircraft conceptual design uses the knowledge based multidisciplinary optimization. The paper describes the developed methodology for conceptual design of aircraft. It show results of implementing this new development philosophy to conceptual design of a four-seat small electric/hybrid aircraft and a special hybrid cargo UAV. The discussion of the results including got by using the emerging and enabling new technologies and new methods and solutions (including for example distributed propulsion system, unconventional forms, morphing, biomimics, etc.), demonstrates the possible implementation of the new development philosophy, new approach to aircraft conceptual design.

Background: The incidence of spinal metastatic disease has risen with improved cancer survivorship. Separation surgery, the current standard surgical treatment, does not fully address spinal deformity. Advances in operative management warrant reevaluating maximal tumor resection and anterior column reconstruction with corpectomy. Methods: An IRB-approved retrospective single-center review of 63 patients was performed. Demographics, tumor characteristics, clinical and radiographic data, treatments, and neurological and survival outcomes were analyzed. Results: The mean age at presentation was 63.5 ± 9.6 years (range, 37-84 years) and 28 patients (44.4%) were female. Functional outcomes, measured by KPS, RAND-36 survey scores and Oswestry Disability Index all improved postoperatively (pre- vs postop: 70 to 80 (p=0.0056), 26.5 to 46.4 (p=0.0081), and 28.9 to 16.9 (p=0.0613), respectively). Spinal alignment also improved, with Cobb angle measurements showing a reduction in spinal kyphosis from -5 to 0 (p=0.021). Nine patients (14.5%) had non-fatal postoperative complications. The median OS for this cohort was 14.4 months (range, 0.6-145.0 months) with median follow-up time of 15.5 months. Conclusion: In oligometastatic spinal disease patients with good functional status, corpectomy for decompression of neural elements, deformity correction, and spinal stabilization is associated with improvements in pain and functional outcomes without overwhelming morbidity.

The interplay between Diffuse Idiopathic Skeletal Hyperostosis (DISH) and the gut microbiota represents a compelling area of research, offering insights into the relationship between spinal degenerative diseases and the gut's microbial inhabitants. This comprehensive review seeks to unravel the complex connection, shedding light on its implications for human health and potential therapeutic avenues. A crucial section dives into the world of gut microbiota (GM), exploring its impact on human health, featuring its defining characteristics, and highlighting its role in metabolism, immunomodulation, host interaction, and how its composition changes over time. The subsequent portion delves into the relationship between microbiome composition and pathological bone development, including the link between Intervertebral Disc Degeneration (IDD) and gut inflammation, emphasizing how gut inflammation and GM dysbiosis play pivotal roles. Further dissecting the interconnections, various axes of influence, including the gut-spine axis, gut-bone axis, gut-joint axis, gut-disc axis (specific to DISH), gut-ligament axis, and gut-muscle axis, are discussed. Of particular interest is the section on the impact of GM on DISH-derived pain, addressing a critical aspect of the condition's manifestation. The review discusses the potential of GM modulation as a treatment for DISH, providing hope for therapeutic advancements. Additionally, it highlights the positive impact of lifestyle interventions, such as dietary modifications, sleep optimization, and exercise regimens, in mitigating GM dysbiosis and potentially improving DISH outcomes. Lastly, the intriguing prospect of fecal microbiome transplant and its implications for DISH management is examined, opening new avenues for research and therapeutic interventions. In conclusion, this comprehensive review underscores the intricate interplay between DISH and the gut microbiota, offering a fresh perspective on the impact of GM on spinal degenerative diseases. It emphasizes the potential for innovative treatments, such as GM modulation and lifestyle interventions, and presents fecal microbiome transplant as an exciting area for future exploration.

Background: In spinal cord injury, radical treatment is still a persistent hope for patients and clinicians. Our study aimed to determine the different histological changes in central, cranial and caudal sites of compressed spinal cord as a result of neuroectodermal stem cells (NESCs) transplantation in rats. Material and methods: For extraction of NESCs, future brains were extracted from mice embryos (10-days old) and cultured. Eighty, male rats were divided randomly into control, sham (20 rats each); while 40 rats were subjected to compressed spinal cord injury (CSCI). Seven days after spinal cord injury, rats were subdivided into 2 groups (20 rats each); an untreated and treated with NESCs injected cranial and caudal to the site of the spinal cord injury. Rats were sacrificed 4 weeks after transplantations of NESCs and specimens from the spinal cord at the central, cranial and caudal to site of spinal cord injury were proceeded to be stained with haematoxylin & eosin, osmic acid and Immunohistochemistry of glial fibrillary acidic protein (GFAP). Results: Sections of CSCI revealed areas of hemorrhages, necrosis and cavitation limited by reactive astrocytosis, with upregulation of GFAP expression. Evidence of remyelination and mitigation of histopathological features, reactive astrocytosis in CSCI sections were more pronounced in cranial than in caudal region. Conclusions: NESCs transplantation ameliorated the pathological changes, promoted remyelination.

We recently reported that in the spinal cord of PPMS or SPMS patients, large areas of periplaque demyelinating lesions extend distance away from plaque borders. Such lesions are characterized by a progliotic TGF-beta 1 signature accompanied by: i) a low-grade inflammatory reaction, ii) an extensive astrocytosis and iii) a process of incomplete demyelination. It was proposed that, while efficiently dampening inflammation in MS spinal cords, TGF-beta 1 could promote astrocytosis, prevent remyelination and possibly trigger alterations of myelin synthesis. In light of these findings, a re-interpretation of two large neuropathological studies performed on MS brains and spinal cords is provided here. While results from these studies clearly showed that active plaques do not display any region-specific distribution, an important point was apparently overlooked and not discussed by the authors: a significantly higher percentage of inactive plaques was found in MS spinal cords as compared to brains and, conversely, the percentage of slowly-expanding (or smoldering) lesions was significantly lower in the spinal cord as compared to the brain. These data indicate that the spinal cord environment may be more favorable to the resolution of inflammation. Downstream of the autoimmune process leading to plaque formation, region-specific mechanisms may thus drive the outcome of active plaques. While inflammation triggers tissue destruction, inflammation may also be needed for effective tissue repair and an inappropriate dampening of inflammatory events may possibly translate into a poor level of remyelination in MS spinal cords. It is proposed here that TGF-beta 1 is involved in such a brain-spinal cord dissociation of active plaques outcome.

Recent satellite measurements of glacier mass balance show mountain glaciers all over the world had generally negative mass balances in the first decades of the 21st century. Mean summer temperatures all over the world rose from 1961-90 to 1991-2020, implying increasingly negative mass balances. We study archived annual balances for 38 Northern Hemisphere glaciers to assess changes within in the 19612020 period. We use a modified doublemass curve to visualize mass balance changes occurring around 1990. Mean balances 196190 were already small negative for many of the studied glaciers and became even more negative in 19912020 for glaciers in the Alps, at high latitudes and in western North America. The largest mass balance changes are for some glaciers in the Alps. We are unable to explain the lack of change in mean balance for one glacier in High Mountain Asia. We find complex changes for eight glaciers in Scandinavia, even including one glacier with positive balance. We explain these changes by visualizing deviations of winter and summer balances from their respective 1961-90 mean values. High winter balances in the 1990s for Scandinavia partly obscured the emerging trend of increasingly negative summer balances, which we expect to continue in the future.

On the basis of the findings of this paper, the theories of quantum mechanics and general relativity can be expressed in a comprehensive theory. The events were surveyed length of the time, in the Euclidean six-dimensional space-time (R6=x1+x2+x3+t1+t2+t3). Previous studies have not studied the relationship between the origin of matter's inherent properties, fundamental constants, and quantum mechanics phenomenon with space-time geometry. This theory prediction the with certainty obtained probabilistic results of quantum mechanics. This prediction is on the basis of metric resulting from the Eccentricity of the Ellipse due to the object density, in the length of time. The cause and nature of dark matter and dark energy are the findings of this article.

Study design : Technical note. Objectives: To present a new spinal shortening technique for tethered cord syndrome. Background : Tethered cord syndrome (TCS) is a debilitating condition of progressive neurological decline. Surgical detethering for TCS is a gold standard. However, symptomatic retethering of TCS has been reported in 5%–50% of patients after initial release. To solve this problem, posterior spinal shortening osteotomy has been reported. This technique has risks of massive blood loss and neurological deterioration. The authors hereby report a new safe spinal shortening technique for tethered cord syndrome. Materials and Methods : A 31-year-old man with gait disturbance was referred to our hospital. After the delivery, he underwent surgical untethering of spinal cord in another hospital. He had hyperreflexia of Achilles tendon reflex and muscle weakness of bilateral legs (MMT 3-4). He also had urinary and bowel incontinence, and total sensory loss below L5.Anteroposterior lumbar radiogram indicates partial laminectomy of L3 and L4. Lumbar MRI showed retethering of spinal cord. Results: He underwent new spinal shortening technique for tethered cord syndrome under the guidance of O-arm navigation. First, from anterior approach disectomy from T12 to L3 was performed. Second, from posterior Ponte osteotomy was done from T12 to L3, shorten the spinal column 15 mm. The patient was successfully treated surgically. Postoperative lumbar MRI showed the tension of spinal cord was released. Manual muscle testing results and sensory function of the left leg had recovered almost fully on final follow-up at one year. Conclusions/Level of Evidence: Retethered spinal cord after initial untethering was difficult to treat. This new spinal shortening technique was effective and very safe technique to release the tension of spinal cord. Level V.

The operating theatre represents a key contributor to healthcare-derived emissions. Here, we outline the carbon footprint of a lumbar microdiscectomy at our regional unit in Greater Manchester, with the use of AI technology. In doing so, we aim to define the extent of the environmental impact and identify carbon hotspots for sustainable change. Our unit of analysis covered the start of the patient journey into hospital through to the final outpatient appointment. Publicly available and locally sourced data was used. An inventory analysis of two lumbar microdiscectomies was conducted. Each item was categorised reconciled against our AI-powered ‘CO2 analysis’ database. Kilograms of carbon dioxide equivalent (kg CO2e) was chosen as the primary measure of impact. An average lumbar microdiscectomy at our trust generates 477.73kg CO2e. The operation (173.89kg CO2e, 36.40%) and the inpatient stay (144.67kg CO2e, 30.28%) constituted the biggest contributors. Single-use intraoperative equipment contributed to over three-quarters of the total emissions from the operation. By defining the environmental burden of elective spinal surgery, we have identified carbon hotspots to target for sustainable change. Substituting polluting elements for carbon-friendly alternatives and challenging the single-use culture, modern healthcare systems can help pave the way to a ‘net zero’ healthcare system.

Background: The diagnosis of metabolic syndrome (MetS) is a challenge in people with spinal cord injury (SCI). We aimed at identifying clinical risk factors or early markers of MetS in SCI that would facilitate a timely diagnosis and implementation of preventive/therapeutic strategies. Methods: 168 patients with chronic (>1 year) SCI underwent clinical and biochemical evaluations. MetS was diagnosed according to modified criteria of the International Diabetes Federation validated in people with SCI. Results: MetS was diagnosed in 56 of 132 men (42.4%) and 17 of 36 women (47.2%). At univariate regression analyses, putative predictors of MetS were an older age, a higher number of comorbidities, a lower insulin-sensitivity, the presence and intensity of pain, a shorter injury duration, a poorer leisure time physical activity (LTPA) and an incomplete motor injury. At the multiple regression analysis, a significant independent association with MetS only persisted for a poorer LTPA in minutes/week (OR: 0.998, 95%CI: 0.996, 0.999) and more severe pain symptoms as assessed by numeral rating scale (OR: 1.353, 95%CI: 1.085, 1.793). Conclusions: In patients with SCI, intense pain symptoms and poor LTPA may suggest a high likelihood of MetS, regardless of age, SCI duration, motor disability degree, insu-lin-sensitivity and comorbidities.

Classifying spinal tumors can be challenging due to nonspecific clinical and radiological qualities, and a precise biopsy is crucial for an accurate diagnosis and treatment planning. This study aimed to enhance the accuracy and efficiency of spinal biopsies integrating Cone Beam Computed Tomography (CBCT) and magnetic resonance imaging (MRI) modalities using an O-arm CT navigation system. Eighteen patients with diverse spinal lesions underwent 18 biopsies following the Stealth Station navigation system Spine 8 protocol. Preoperative MRI scans were merged with intraoperative CT navigation systems for continuous monitoring during the biopsy process. The combined imaging technique accurately identified the diseased lesion type in all biopsies, demonstrating 100% sensitivity and specificity. In conclusion, combining MRI and CT imaging modalities significantly improved spinal biopsy accuracy and efficiency, differentiating between pathological entities. However, large-scale studies are desired to validate these findings and investigate potential benefits in different clinical scenarios. Although this method requires general anesthesia, its potential profits in avoiding misdiagnosed lesions and decreasing the need for further invasive procedures make it a promising approach for improving spinal biopsy accuracy and efficiency.

Background/Objectives: The aim of the project is a longitudinal assessment of body image and mental health in scoliosis females pre-, postoperatively and in a follow-up, and implementation (one group-CBT scoliosis sample, CBTSS) or not (second group-control scoliosis sample, CSS) of CBT interventions. A healthy female sample (HFS) was also selected for comparative purposes. Methods. 36 in total AIS patients participated in the 1st and 2nd study phases, whereas 23 were eligible in the follow-up. Regarding HFS, 18 participants were included in the study. The CBT intervention took place pre- and postoperatively, during the patients' stay in hospital. Participants completed the Spinal Appearance Questionnaire (SAQ), Body Esteem Scale (BES) and Strengths and Difficulties Questionnaire-25 (SDQ-25). Body image was also assessed using a virtual reality-based application “Avatar Scoliosis 3D”. Results: The difference between the desired and objective, actual body shape is significant preoperatively both in the CBTSS and CSS at p

Our research assesses the effects of four forest species, namely Swietenia macrophylla King, Swietenia mahogany (L.) Jack., Pinus occidentalis Swartz, and Pinus caribaea Morelet var. Caribaea, on organic carbon (OC) dynamics and carbon dioxide equivalent balance (BCO2 Eq.) in the soils beneath these species. Reforestation projects in the study region cover 1,200, 543, 770, and 1,152 hectares, with these four species, respectively, being the most relevant species in reforestation projects within the country. To determine the BCO2 Eq. per unit area, we compared the greenhouse gas (GHG) fluxes of carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O) with the OC reserves found in the mineral soil to a depth of 30 cm and in the forest litter. For 18 months, we conducted field measurements in sixteen stands, four for each species. Our results indicate that S. macrophylla absorbed the highest amount of CO2, while S. mahogany released the highest amount into the atmosphere. BCO2 Eq. from S. macrophylla soils was -23.19 metric tons of CO2 Eq. ha-1 year-1, while for P. occidentalis, S. mahogany, and P. caribaea, the corresponding quantities were -3.838, -2.299, and +0.982, respectively. During the measurement period, soils under S. macrophylla, P. occidentalis, and P. caribaea were net sinks of CO2 Eq., while soils under S. mahogany behaved as a source. The absorption rate of CO2 Eq. from the atmosphere was approximately 6, 10, and 24 times higher in S. macrophylla when compared to the respective rates of P. occidentalis, P. caribaea, and S. mahagony.

Despite the overall extension of the Amazon basin (approximately 6,000,000),which encompasses such a complex ecosystem and territories belonging to seven different nations, it is worth mentioning that environmental assessment related to changes in land use and land cover (LULC) in this region are often conducted respecting geopolitical boundaries associated with each country or taking into account the so-called Amazon biome. With the purpose of prospecting the intricate and hidden hydrological patterns, we undertake an in-depth evaluation of the water balance along the 2001-2021 time span across the whole basin, whose behavior depends on the features deriving from the metamorphoses in land use and land cover. To accomplish that task, the influence of the components of the water balance, namely rainfall and evapotranspiration, jointly with the terrestrial topographic mapping, are examined to investigate the interactions among the physical mechanisms that make up the hydrological cycle and the corresponding physical hydrological processes triggered by deforestation and reforestation in the region. More specifically, the modeling approach was rigorously designed to also consider, separately or not Negro, Solimões, Madeira, Tapajós and Xingu hydrographic sub-basins, which are the most important ones of the Amazon basin. The results highlight that, in the southern region of the Amazon, specifically within the Madeira river sub-basin, the lowest forest coverage is observed (56.0%), whereas in the northern Negro river sub-basin, the most notable forest coverage is observed (85.0%).The most preserved forest areas, such as the Negro and Solimões river sub-basins, with percentages of 81.9% and 74.2%, respectively, have higher annual rates of precipitation and evapotranspiration over time. On the other hand, regions that suffered the most intense deforestation along the time period studied, such as the Madeira, Tapajós and Xingu sub-basins, have lower annual rates of precipitation and evapotranspiration, with a preservation percentage of 54.6%, 62.6% and 70, 7%, respectively. As the pace of deforestation slowed between 2003 and 2013, annual precipitation rates increased by 12.0%, while evapotranspiration decreased by 2.0%. The hydrological findings of this paper highlight th predominant role of the forest in the context of the global water balance of the Amazon basin and the potential to also produce distinct impacts within different parts of the basin in terms of having more or less rainfall and evaporation. In addition, those variabilities in the hydrological operational components and mechanisms due to changes in land cover and land use also reveals the potential impacts that could be expected in the surrounding areas, closer or farther, notably beyond the limits of the Amazon basin.

Excessive neutrophil influx and activation in lungs during infections, such as manifest during the ongoing SARS CoV-2 pandemic, have brought neutrophil extracellular traps (NETs) and the con-comitant release of granule contents that damage surrounding tissues into sharp focus. Neutro-phil proteases, which are known to participate in NET release, also enable the binding of the viral spike protein to cellular receptors and assist in the spread of infection. Blood and tissue fluids normally also contain liver-derived protease inhibitors that balance the activity of proteases. In-terestingly, neutrophils themselves also express the protease inhibitor alpha-1-antitrypsin (AAT), the product of the SERPINA-1 gene, and store it in neutrophil cytoplasmic granules. The absence of AAT or mutations in the SERPINA-1 gene promote lung remodeling and fibrosis in diseases such as chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS) and increase the risk of allergic responses. Recent observations point to the fact that re-duced activity of AAT presents a major susceptibility factor for severe COVID-19. Here, we focus attention on the mechanism of neutrophil elastase (NE) in NET release and its inhibition by AAT as an additional factor that may determine the severity of COVID-19

Ankle sprains are the most frequently occurring musculoskeletal injuries among recreational athletes. Ankle support through bandages following the initial orthotic treatment might be beneficial for rehabilitation purposes. Since hardly any study has investigated the impact of bandages in the acute phase of ankle sprains, our study examined the immediate effects of wearing an ankle bandage on fine coordination, proprioception, and motor performance in subjects five weeks after an acute ankle injury. In total, 70 subjects with acute unilateral supination trauma were tested. All subjects completed several rating questionnaires and biomechanical investigations, including a fine coordination and proprioception test, single leg stances, the Y-Balance test and gait analysis. All biomechanical investigations were conducted for the subject's injured leg with and without a bandage (MalleoTrain® Bauerfeind AG) and the healthy leg. Subjects reported moderate to strong improvements in ankle stability and pain when wearing the bandage. Wearing the bandage significantly normalized subjects’ single leg stance performance, as well as the stance phase duration, and the vertical ground reaction forces during walking. However, the bandage did not have a clear effect on fine coordination and proprioception. Wearing a bandage in the acute phase of an ankle sprain may immediately improve motor performance, including standing and walking.

The accuracy of star position simulation is the key factor affecting the accuracy of ground calibration test of spacecraft attitude measurement system. To solve the impact of nonimaging polarized stray light on the simulation accuracy of star position in the optical engine of the system, the generation mechanism of non-imaging polarized stray light has been investigated, and an optimization method for polarization balance of the optical engine is proposed. The mathematical model of the incident light aperture angle and the ideal polarization parameter of the optical engine thin film is established, and the optimization evaluation function of polarization balance of the optical engine is constructed. An optical engine polarization balance film with the corresponding full-band binomial attenuation is <0.001 and the phase delay is <1°. Experimental results show that the simulation accuracy of the weak starlight simulation system is improved by 1.64 times using polarization balanced optical engine.

Serotonergic neurons constitute one of the main systems of neuromodulators, whose diffuse projections regulate the functions of the cerebral cortex. Serotonin (5-HT) is known to play a crucial role in the differential modulation of cortical activity related to behavioral contexts. Certain aspects of the 5-HT signaling framework hint at its potential role as a modulator of activity-dependent synaptic changes within the critical period of the primary visual cortex (V1). Cells of the serotonergic system are among the first neurons to differentiate and operate. During postnatal development, ramifications from raphe nuclei become massively distributed in the visual cortical area, remarkably increasing the availability of 5-HT for the regulation of excitatory and inhibitory synaptic activity. A substantial amount of evidence has demonstrated that synaptic plasticity at pyramidal neurons of the superficial layers of V1 critically depends on a fine regulation of the balance between excitation and inhibition (E/I). Therefore, 5-HT could play an important role in controlling this balance, providing the appropriate excitability conditions that favor synaptic modifications. In order to explore this possibility, the present work used in vitro intracellular electrophysiological recording techniques to study the effects of 5-HT on the E/I balance of V1 layer 2/3 neurons, during the critical period. Serotonergic modulation of the E/I balance has been analyzed on spontaneous activity, evoked synaptic responses, and long-term depression (LTD). Our results pointed out that the predominant action of 5-HT implies a reduction of the E/I balance. 5-HT promoted LTD at excitatory synapses while blocking LTD at inhibitory synaptic sites, thus shifting the Hebbian alterations of synaptic strength towards lower levels of E/I balance.

An integration between the principles in supply change management in sport tourism and sustainability balanced scorecard leads to development of guidance and assessment criteria for a city to be a sustainable sport tourist destination. This paper aims to present a sport tourism sustainability management model (STSM), consisting of 5 perspectives, namely financial perspective, customer perspective, internal process perspective, learning and growth perspective and sustainability perspective. By using Delphi technique to obtain a consensus from experts, university lecturers, independent organization/association and business entities in relation to sport tourism management, the researcher defines elements to assess complex perspective for sustainable development of sport tourism. The result shows that there are 5 perspectives and 18 elements in relation to sustainable development of sport tourism. All perspectives and elements have high consensus as measured by Kendall’s Coefficient of Concordance (W) of .488. To validate the model, the researcher examines correlation among the five perspectives with structural equation model and finds that the absolute fit is satisfactory, with the value of CMIN/DF at 1.830, RMSEA at .046, GFI at .951, AGFI at .919 and RMR at .038. In addition, the incremental fit also demonstrates positive result with the value of NFI at .962, CFI at .982, TLI at .973 and IFI at .982. As the model aligns and explains empirical data, it can support decision making for management team, effective and efficient strategy drafting for sustainable development in sport tourism and improving livelihoods of residents.