The objectives of the study were to determine the spatial rate of CO₂ flux (Net Ecosystem Exchange) and soil moisture in a wetland ecosystem applying Sentinel-1 IW (Interferometric Wide) data of VH (Vertical Transmit/Horizontal Receive—cross polarization) and VV (Vertical Transmit/Vertical Receive—like polarization) polarization. In-situ measurements of carbon flux, soil moisture, and LAI (Leaf Area Index) were carried out over the Biebrza Wetland in north-eastern Poland. The impact of soil moisture and LAI on backscattering coefficient (σ°) calculated from Sentinel-1 data showed that LAI dominates the influence on σ° when soil moisture is low. The models for soil moisture have been derived for wetland vegetation habitat types applying VH polarization (R² = 0.70 to 0.76). The vegetation habitats: reeds, sedge-moss, sedges, grass-herbs, and grass were classified using combined one Landsat 8 OLI (Operational Land Imager) and three TerraSAR-X (TSX) ScanSAR VV data. The model for the assessment of Net Ecosystem Exchange (NEE) has been developed based on the assumption that soil moisture and biomass represented by LAI have an influence on it. The σ° VH and σ° VV describe soil moisture and LAI, and have been the input to the NEE model. The model, created for classified habitats, is as follows: NEE = f (σ° Sentinel-1 VH, σ° Sentinel-1 VV). Reasonably good predictions of NEE have been achieved for classified habitats (R² = 0.51 to 0.58). The developed model has been used for mapping spatial and temporal distribution of NEE over Biebrza wetland habitat types. Eventually, emissions of CO₂ to the atmosphere (NEE positive) has been noted when soil moisture (SM) and biomass were low. This study demonstrates the importance of the capability of Sentinel-1 microwave data to calculate soil moisture and estimate NEE with all-weather acquisition conditions, offering an important advantage for frequent wetlands monitoring.

Plant leaf area index (LAI) is a key characteristic affecting field canopy microclimate. In addition to traditional professional measuring instruments, smartphone camera sensors have been used to measure plant LAI. However, when smartphone methods were used to measure conifer forest LAI, very different performances were obtained depending on whether the smartphone was held at the zenith angle or at a 57.5° angle. To validate further the potential of smartphone sensors for measuring conifer LAI and to find the limits of this method, this paper reports the results of a comparison of two smartphone methods with an LAI-2000 instrument. It is shown that both methods can be used to reveal the conifer leaf-growing trajectory. However, the method with the phone oriented vertically upwards always produced better consistency in magnitude with LAI-2000. The bias of the LAI between the smartphone method and the LAI-2000 instrument was explained with regard to four aspects that can affect LAI: gap fraction, leaf projection ratio, sensor field of view (FOV), and viewing zenith angle (VZA). It was concluded that large FOV and large VZA cause the 57.5° method to overestimate the gap fraction and hence underestimate conifer LAI, especially when tree height is greater than 2.0 m. For the vertically upward method, the bias caused by the overestimated gap fraction is compensated for by an underestimated leaf projection ratio.

Image stitching is a crucial aspect of image processing. However, factors like perspective and environment often lead to irregular shapes in stitched images. Cropping or completion methods typically result in substantial loss of information. This paper proposes a method for rectifying irregularly images into rectangles using deformable meshes and residual networks. The method utilizes a convolutional neural network to quantify rigid structures of images. Choosing the most suitable mesh structure based on the extraction results, offering options such as triangular, rectangular, and hexagonal. Subsequently, the irregularly image, predefined mesh structure, and predicted mesh structure are input into a wide residual neural network for regression. The loss function comprises local and global, aimed at minimizing the loss of image information within the mesh and global target. This method not only significantly reduces information loss during rectification but also adapting to different images with various rigid structures. Validation on the DIR-D dataset shows this method outperforms state-of-the-art methods in image rectification.

Surface water distribution extracted from remote sensing data has been used in water resource assessment, coastal management, and environmental change studies. Traditional manual methods for extracting water bodies cannot satisfy the requirements for mass processing of remote sensing data; therefore, accurate automated extraction of such water bodies has remained a challenge. The histogram bimodal method (HBM) is a frequently used objective tool for threshold selection in image segmentation. The threshold is determined by seeking twin peaks, and the valley values between them; however, automatically calculating the threshold is difficult because complex surfaces and image noise which lead to not perfect twin peaks (single or multiple peaks). We developed an operational automated water extraction method, the modified histogram bimodal method (MHBM). The MHBM defines the threshold range of water extraction through mass static data; therefore, it does not require the identification of twin histogram peaks. It then seeks the minimum values in the threshold range to achieve automated threshold. We calibrated the MHBM for many lakes in China using Landsat 8 Operational Land Imager (OLI) images, for which the relative error (RE) and squared correlation coefficient (R2) for threshold accuracy were found to be 2.1% and 0.96, respectively. The RE and root-mean-square error (RMSE) for the area accuracy of MHBM were 0.59% and 7.4 km2. The results show that the MHBM could easily be applied to mass time-series remote sensing data to calculate water thresholds within water index images and successfully extract the spatial distribution of large water bodies automatically.

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

As a vital component of the terrestrial ecosystem, grassland accounts for one-third of the global vegetation system. Grassland degradation has been exacerbated due to extreme overgrazing in China's Inner Mongolia Autonomous Region (IMAR). While conservation was carried out as the Ecological Subsidy and Award Program (ESAP) to mitigate grassland degradation, little is known about its effectiveness in improving the biophysical conditions of grassland. This paper integrates the conceptual frameworks of total socio-environmental systems to assess how ecological systems respond to ESAP, investigate spatial heterogeneity of ESAP, and explore the meddling effects of socio-environmental interactions on ESAP. We integrate ecological, climate, and socioeconomic data and developed several hierarchical linear mixed models (HLMM) to investigate how these factors interact with ESAP in IMAR. Our findings prove that the above-ground biomass between 2011 and 2015 responds significantly to variations in socioeconomic conditions and ecological communities. Available land resources, hospital and medical facilities, and net farmer and herdsman income are the most critical factors contributing to grassland productivity. Primary industries like mining, total consumer retail value, farming, forestry, animal husbandry, fishery productions, and GDP are the most damaging factors affecting biomass. Our study recommends a regionally or locally tailored ecological recovery policy, instead of a generalized one, in the future effort to conserve grassland.

Cytologic diagnosis of extra‐adrenal paraganglioma presenting as a peripancreatic mass is challenging with a high rate of diagnostic error. We present a case of a peripancreatic mass identified by radiology as a gastrointestinal stromal tumor. Endoscopic ultrasound‐guided fine needle aspiration (FNA) of the mass showed a moderately cellular tumor composed of small to medium sized neoplastic cells with round to oval nuclei arranged singly and in loose clusters. The cells were positive for neuroendocrine markers (synaptophysin and chromogranin) and negative for CD117. A diagnosis of a neoplasm with a neuroendocrine tumor (NET) was made on FNA cytology. The subsequent surgical resection of the tumor revealed peripancreatic paraganglioma with immunohistochemistry positive for synaptophysin, chromogranin, and S100. The latter delineates the sustentacular cells. Although paraganglioma is a well recognized tumor, a detailed comparison of peripancreatic paraganglioma versus pancreatic/gastrointestinal NET is still lacking.

Timely and accurate acquisition of information on distribution of the crop planting structure in Loess Plateau of eastern Gansu Province, one of the most important agricultural areas in western China, is crucial for promoting fine management of agriculture and ensuring food security. In this study, the Object-Based Image Classification (OBIC), the Random Forest (RF) and Convolutional Neural Network (CNN) models were employed to classify the crop planting structure of four representative test areas in Qingyang City in a precise manner. Firstly, different optimal segmentation scales for various crops were selected using the Estimation of Scale Parameter 2 (ESP2) tool and the Ratio of Mean Difference to Neighbors(ABS) to Standard Deviation (RMAS)model. The images were then segmented through multiresolution segmentation combined with the Canny Edge Detection algorithm. Secondly, the L1 regularized logistic regression model was utilized to select and optimize 39 spatial feature factors including spectral, textural, geometric, and index features, in conjunction with phenological factors. Lastly, under the multi-level classification framework, the Random Forest (RF) classifier and Convolutional Neural Network (CNN) model, combined with object-based multiresolution segmentation, was used to classify the crop planting structure. The findings show that: Thanks to the Canny Edge Detection algorithm, we can obtain a more complete boundary of the segmented objects and improve the separability. The optimal segmentation scales for corn, vegetables, and buckwheat were found to be 55, 70, and 35, respectively, while wheat and apple had optimal segmentation scales of 65. In addition to phenological characteristics, the number of selected spatial features for corn, vegetables, buckwheat, wheat, and apple were 9, 7, 16, 12, and 10, respectively. The CNN model demonstrated high consistency with the RF model in the classification results, but the accuracy of RF model is higher than that of CNN model on the whole. The overall accuracy of classification using RF model in four test areas registered 91.93%, 94.92%, 89.37% and 90.68%, respectively. This paper introduced crop phenological factors, effectively improving the extraction precision of shattered agricultural planting structure in the Loess Plateau of eastern Gansu Province. Its findings have important application value in crop monitoring, management, food security and other related fields.

For multi-sensor integrated systems, such as a mobile mapping system (MMS), data fusion at sensor-level, i.e., the 2D-3D registration between optical camera and LiDAR, is a prerequisite for higher level fusion and further applications. This paper proposes a line-based registration method for panoramic images and LiDAR point cloud collected by a MMS. We first introduce the system configuration and specification, including the coordinate systems of the MMS, the 3D LiDAR scanners, and the two panoramic camera models. We then establish the line-based transformation model for panoramic camera. Finally, the proposed registration method is evaluated for two types of camera models by visual inspection and quantitative comparison. The results demonstrate that the line-based registration method can significantly improve the alignment of the panoramic image and LiDAR datasets under either the ideal spherical or the rigorous panoramic camera model, though the latter is more reliable.

Spatial and temporal variation of the free electron concentration in the ionosphere affects SAR interferograms, in particular at low radar frequencies. In this work the identification, estimation and compensation of ionospheric path delay phases in PALSAR-3 and NISAR-L interferograms is discussed. Both these L-band sensors acquire simultaneously SAR data in a main spectral band and in an additional, spectrally separated, narrower second band to support the mitigation of ionospheric path delays. The methods presented permit separating the dispersive and the non-dispersive phase terms based on the double-difference interferogram between the two available spectral bands and the differential interferogram of the main band. The applicability of the proposed methods is demonstrated using PALSAR-3-like data that was simulated based on PALSAR-2 SM1 mode data.

Background: Escalating climate change concerns have prompted the healthcare sector, particularly anaesthesia, to reassess its practices to align with environmental sustainability. Anesthetic gases like desflurane, sevoflurane, and isoflurane significantly impact the environment due to their high Global Warming Potentials (GWPs) and prolonged atmospheric lifetimes. This manuscript investigates these impacts and advocates for strategies to reduce the carbon footprint of anesthetic care while maintaining patient safety. Methods: We reviewed the environmental impacts of anesthetic gases and explored various strategies for sustainable anaesthesia. These strategies include adopting anesthetics with lower GWPs, enhancing recycling and waste reduction techniques, transitioning to intravenous anaesthesia, and implementing low-flow anaesthesia methods. We also examined barriers to these strategies, such as educational gaps, technological challenges, resistance to change, and policy limitations. Results: Adopting anesthetics with lower GWPs, such as sevoflurane over desflurane, and implementing low-flow anaesthesia can significantly reduce greenhouse gas emissions. Recycling and waste reduction techniques, though challenging, offer additional environmental benefits. Transitioning to intravenous anaesthesia can eliminate the direct GWP contributions from volatile anesthetic gases. However, these strategies require comprehensive education, advocacy for research and innovation, strategic change management, and supportive policies. Conclusions: Continuous monitoring and evaluation are crucial to ensure the effectiveness of sustainable practices in anaesthesia. Establishing robust Key Performance Indicators (KPIs) and utilizing advanced analytical tools will enable the anaesthesia community to adapt and refine practices. Collaborative efforts among clinicians, policymakers, and stakeholders are essential to significantly reduce the environmental impact of anaesthesia and promote ecological responsibility within healthcare.

：Non-Euclidean data, such as social networks, and citation relationships between documents, has node information and structural information. Graph Convolutional Network(GCN) can automatically learn node features and association information between nodes. The core ideology of the graph convolutional network is to aggregate node information by using edge information, thereby generating a new node feature. In the process of updating node features, there are two core influencing factors. One is the number of neighboring nodes of the central node, the other is the contribution of the neighboring nodes to the central node. Due to the previous GCN methods not simultaneously considering the numbers and different contributions of neighboring nodes to the central node, we design the Adaptive Attention Mechanism(AAM). To further enhance the representational capability of the model, we utilize Multi-Head Graph Convolution(MHGC). Finally, we adopt cross-entropy(CE) loss function to describe the difference between the predicted results of node categories and the ground truth (GT). Combined with backpropagation, this ultimately achieves accurate node classification. Based on AAM, MHGC and CE, we contrive the novel Graph Adaptive Attention Network (GAAN). Experiments show that the classification accuracy has achieved outstanding performances on Cora, Citeseer and Pubmed datasets.

The existing segmentation-based scene text detection methods mostly need complicated post-processing, and the post-processing operation is separated from the training process, which greatly reduces the detection performance. The previous method, DBNet successfully simplified post-processing and integrated the post-processing into a segmentation network. However, the training process of the model took a long time for 1200 epochs and the sensitivity to texts of various scales was lacking, leading to some text instances being missed. Considering the above two problems, we design the text detection Network with Binarization of Hyperbolic Tangent(HTBNet). First of all, we propose Binarization of Hyperbolic Tangent (HTB), optimized along with which, the segmentation network can expedite the initial convergent speed by reducing the amount of epochs from 1200 to 600. Because features of different channels in the same scale feature map focus on the information of different regions in the image, to better represent the important features of all objects in the image, we devise the Multi-Scale Channel Attention(MSCA). Meanwhile considering that multi-scale objects in the image cannot be simultaneously detected, we propose a novel module named Fused Module with Channel and Spatial(FMCS), which can fuse the multi-scale feature maps from channel and spatial dimension. Finally we adopt cross entropy as the loss function, which measures the difference between predicted values and ground truths. The experimental results show that HTBNet compared with lightweight models has achieved competitive performance and speed on Total-Text(F-measure:86.0%, FPS:30) and MSRA-TD500 (F-measure:87.5%, FPS:30).

The experiences gathered during the past 30 years support the operational use of irrigation scheduling based on frequent multi-spectral image data. Currently, the operational use of dense time series of multispectral imagery at high spatial resolution makes monitoring of crop biophysical parameters feasible, capturing crop water use across the growing season, with suitable temporal and spatial resolutions. These achievements, and the availability of accurate forecasting of meteorological data, allow for precise predictions of crop water requirements with unprecedented spatial resolution. This information is greatly appreciated by the end users, i.e. professional farmers or decision-makers, and can be provided in an easy-to-use manner and in near-real-time by using the improvements achieved in web-GIS methodologies. This paper reviews the most operational and explored methods based on optical remote sensing for the assessment of crop water requirements, identifying strengths and weaknesses and proposing alternatives to advance towards full operational application of this methodology. In addition, we provide a general overview of the tools which facilitates co-creation and collaboration with stakeholders, paying special attention to these approaches based on web-GIS tools.

Mediterranean Diet (MD), rich in minimally processed plant foods and in monounsaturated fats, but low in saturated fats, meat and dairy products, represents one of the most studied diets for cardiovascular health. It has been shown, from both observational and randomized controlled trials, that MD reduces body weight, improves cardiovascular disease surrogates such as waist-to-hip ratio, lipids, and inflammation markers, and even prevents the development of fatal and non-fatal cardiovascular disease, diabetes, obesity, and other diseases. However, it is unclear whether it offers cardiovascular benefits from its individual components or as a whole. Furthermore, limitations in the methodology of studies and meta-analyses have raised some concerns on its potential cardiovascular benefits. MD is also associated with characteristic changes in the intestinal microbiota, mediated through its constituents. These include increased growth of species producing short-chain fatty acids, such as Clostridium leptum and Eubacterium rectale, increased growth of Bifidobacteria, Bacteroides and Faecalibacterium prausnitzii species, and reduced growth of Firmicutes and Blautia species. Such changes are known to be favorably associated with inflammation, oxidative status, and overall metabolic health. This review will focus on the effects of MD on cardiovascular health through its action on gut microbioma.

Introduction: Atrial fibrillation (AF) is a common cardiac arrhythmia whose prevalence rises with age and is linked to increased morbidity and mortality due to the risk of thromboembolism. Management typically involves anticoagulation and rhythm control, but the treatment of elderly patients with multiple comorbidities requires careful consideration of drug side effects and interactions. Cibenzoline, a Vaughan-Williams class IA antiarrhythmic, is effective against AF but has risks of toxicity, especially in older people and those with renal impairment, due to its renal excretion and prolonged half-life in these populations. Discussion: This paper presents a case of an 80-year-old woman with paroxysmal AF who suffered cardiac arrest due to cibenzoline toxicity despite receiving standard adjusted dosages. The patient's cibenzoline blood concentration was significantly higher than the therapeutic range, leading to cardiotoxicity, which was exacerbated by drug interactions with bisoprolol and edoxaban, both metabolized by the CYP3A4 enzyme. Venoarterial extracorporeal membrane oxygenation (V-A ECMO) and intra-aortic balloon pump (IABP) successfully managed the cardiac arrest. This case emphasizes the unpredictable pharmacokinetics of cibenzoline in elderly patients with renal impairment and the need for vigilant therapeutic drug monitoring to avoid adverse events. Conclusions: Cibenzoline can pose a significant risk of severe toxicity in elderly patients with renal impairment, and drug interactions may potentiate this risk. The paper underscores the importance of careful dose adjustment and monitoring of drug levels in this population. In cases of cibenzoline-induced cardiac arrest, V-A ECMO and IABP are effective treatment modalities. The case study serves as a critical reminder for clinicians to remain vigilant for drug-induced complications and to apply aggressive supportive treatments when necessary.

Thoracic aortopathy encompasses a spectrum of conditions affecting the aorta, ranging from aneurysms to dissections, posing significant challenges in management and care. In recent years, remote care, facilitated by telemedicine and digital health technologies, has emerged as a promising approach to overcome barriers in delivering timely and efficient healthcare services. This paper explores the practical considerations and challenges associated with implementing remote care strategies in the management of thoracic aortopathy in India with the largest population in the world. By evaluating existing literature and drawing upon clinical experiences, we discuss the potential benefits, limitations, and best practices for incorporating remote care into the management of patients with thoracic aortopathy. Additionally, we address important factors such as patient engagement, technology integration, privacy concerns, and regulatory requirements to optimize the delivery of remote care in this specialized field.

Smallsats are becoming the predominant electro-optical Earth observation (EO) imaging platforms. While atmospheric correction of smallsat data enhances its utility, an established pathway to do so may constrain accuracy and utility. The alternative, Closed-form Method for Atmospheric Correction (CMAC), developed for smallsat application provides surface reflectance derived solely from scene statistics. In a prior paper, CMAC closely agreed with Land Surface Reflectance Code (LaSRC) software for correction of the four VNIR bands of Landsat-8/9 images for conditions of low to moderate atmospheric effect over quasi-invariant warehouse-industrial targets. Those results were accepted as surrogate surface reflectance to support analysis of CMAC and LaSRC reliability for surface reflectance retrieval in two contrasting environments: shortgrass prairie and barren desert. Reliability was defined and tested through a null hypothesis: the same top-of-atmosphere reflectance under the same atmospheric condition will provide the same estimate of surface reflectance. Evaluated against the prior surrogate surface reflectance, the results found decreasing error with increasing wavelength for both methods. From 58 comparisons across the four bands, LaSRC average absolute error ranged from 0.59% (NIR) to 50.30% (blue). CMAC error was well constrained from 0.01% (NIR) to 0.98% (blue) sustaining the null hypothesis for reliability.

The atmospheric lightning is one of the natural disasters which need to be considered in the sustainable development. The National Remote Sensing Centre (NRSC) has installed 46 lightning detection sensors (LDS) across the country. These sensors work in radio frequencies having their detection range up to 1000 km with more than 98% detection efficiency within 300 km range. The network is put in a way that sensors have about 50% sensor-to-sensor overlap in their detection ranges to enable high geolocation accuracy and maintain redundancy. The NRSC-LDS network (LDSN) estimates the current associated with each cloud to ground (CG) lightning flash which can be utilized for the risk assessment. The current estimates from one network to the other need to be inter-calibrated and harmonized. Present study compares the LDSN current estimates with Lightning Location Network (LLN) estimates and results are discussed with their impact on the estimation of vulnerable zones. A case study of lightning-induced fire event is presented to showcase the importance of the currents associated with lightning for future planning.

With the growing demand for positioning services, angle-of-arrival (AoA) estimation or direction-finding (DF) has been widely investigated for applications in fifth-generation (5G) technologies. Many existing AoA estimation algorithms only require the measurement of the direction of the incident wave at the transmitter to obtain correct results. However, for most of the cellular systems such as Bluetooth indoor positioning system due to multipath and non-line-of-sight (NLOS) propagation, the indoor positioning accuracy is severely affected. In this paper a comprehensive algorithm is investigated that combines radio measurements from Bluetooth AoA local navigation systems with indoor position estimates obtained using particle filtering, which allows us to explore new optimised methods to reduce estimation errors in indoor positioning. First, particle filtering is used to predict the rough position of a moving target. Then, an algorithm with robust beam weighting is used to estimate the AoA of the multipath components. Based on this, a system of pseudo-linear equations for target positioning based on the probabilistic framework of PF and AoA measurement is derived. Theoretical analysis and simulation results show that the algorithm can improve the positioning accuracy by about 25.7% on average.

(1) Background: Cardiorespiratory fitness (CRF) is a prognostic factor regarding long time morbidity and mortality. To assess CRF the well-known gold standard is cardiopulmonary exercise testing (CPET), which is a time consuming and expensive test. Therefore, alternative methods for routine evaluation of CRF are needed for the general population as well as for specific patient groups such as children and young adults with congenital heart disease. The Stair Climbing Test (SCT) is a simple and resource saving test reported in the current literature. This test is used in various settings to assess different health associated risk factors including cardiorespiratory fitness, muscular resilience, therapy effectiveness or pre- and postoperative morbidity and mortality.

Hereditary Hemorrhagic Telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is a rare and inherited vascular disorder, characterized by the development of arteriovenous malformations (AVMs) in various organs and telangiectasia (small AVM) in the mucocutaneous. The majority of HHT patients have haploinsufficiency of genes involved in the transforming growth factor-beta (TGFβ) signaling pathway, including endoglin (ENG), activin receptor-like kinase 1 (ALK1, also known as ACVRL1), or SMAD4. Active angiogenesis is also required for telangiectasia and AVM development. Anti-angiogenic strategies have been tested in patients and animal models extensively. However, the exact mechanisms for telangiectasia and AVM development remain unclear. In this review, we discuss recent advances in identifying disease mechanisms, and potential therapeutic targets.

Fever control is essential in patients with severe traumatic brain injury (TBI). The efficacy of therapeutic hypothermia (TH) in severe TBI has been investigated over the last few decades; however, in contrast to experimental studies showing benefits, no evidence of efficacy has been demonstrated in clinical practice. In this review, the mechanisms and history of hypothermia were briefly outlined, while the results of major randomized controlled trials (RCTs) and meta-analyses investigating TH for adult TBI are introduced and discussed. The retrieved meta-analyses showed conflicting results, with a limited number of studies indicating benefits of TH. Some studies have shown benefits of long-term TH compared with short-term TH. Although TH is effective at lowering elevated intracranial pressure (ICP), reduced ICP does not lead to favorable outcomes. Low-quality RCTs overestimated the benefits of TH, while high-quality RCTs showed no difference or worse outcomes with TH. RCTs assessing standardized TH quality demonstrated the benefits of TH. As TBI has heterogeneous and complicated pathologies, applying a uniform treatment may not be ideal. A meta-analysis of young patients who underwent early cooling and hematoma removal showed better TH results. TH should not be abandoned, and its optimal should be advocated on an individual basis.

Pulmonary complications are frequently observed in patients with ulcerative colitis (UC), with large airway disease being the most prevalent manifestation. In this case study, we explore the potential for Immunosuppressant, a monoclonal antibody, to induce pulmonary hemorrhage—a side effect not previously documented with its use. The subject, a young male in his twenties with a six-year history of UC, tragically died suddenly. Found in a pool of blood without external injuries, extensive post-mortem examinations were required to determine the cause of death. The patient had been on biologic therapy, receiving Immunosuppressant intermittently over the past two years, including an infusion five days prior to death. External examination revealed bloody, pinkish foamy material expelling from his nose and mouth. An autopsy supported an atypical presentation of UC, while histopathology confirmed diffuse pulmonary hemorrhage, marked by edema and emphysematous changes. Additionally, there was a notable lymphomonocytic infiltration around the arterial walls, and signs of bronchiolitis and focal pleural fibrosis were evident. We concluded that the cause of death was Diffuse Alveolar Hemorrhage (DAH), directly associated with the recent administration of Immunosuppressant. This finding underscores the need for vigilant pulmonary monitoring in patients treated with monoclonal antibodies to promptly identify and manage potential fatal adverse reactions.

The nematode Caenorhabditis elegans, with its highly sensitive olfactory system, has emerged as a promising tool for testing chemotaxis. In the field of cancer diagnostics, there is a growing interest in the development of non-invasive screening methods for the detection of volatile organic compounds in a patient's urine. The objective of this study was to contribute to the existing body of knowledge by evaluating the ability of a Caenorhabditis elegans-based chemotaxis assay to discriminate between urine samples from healthy individuals and patients diagnosed with breast or colon cancer. Following synchronization of the developmental stages of C. elegans, nematodes were exposed to the urine of cancer patients and healthy individuals. Subsequently, chemotactic indices were calculated for each urine sample. Our results demonstrated a statistically significant difference in the chemotactic response of C. elegans to urine samples from cancer patients compared to healthy volunteers (p < 0.001). Moreover, the test exhibited promising diagnostic utility, with a sensitivity of 98%, a specificity of 62%, and a detection rate of 78%. Our findings expand on previous observations, confirming the remarkable sensitivity of C. elegans hermaphrodites to discriminating cancer-related volatile organic compounds in urine samples.

Mechanical ventilation (MV), used in patients with acute lung injury (ALI), induces diaphragmatic myofiber atrophy and contractile inactivity, termed ventilator-induced diaphragm dysfunction. Phosphoinositide 3-kinase- (PI3K-) is crucial in modulating fibrogenesis during the reparative phase of ALI; however, the mechanisms regulating the interactions among MV, myofiber fibrosis, and PI3K- remain unclear. We hypothesized MV with or without bleomycin treatment would increase diaphragm muscle fibrosis through the PI3K- pathway. Five days after receiving a single bolus of 0.075 units bleomycin intratracheally, C57BL/6 mice were exposed to 6 or 10 mL/kg MV for 8 h after receiving 5 mg/kg of AS605240 intraperitoneally. In wild-type mice, bleomycin exposure followed by MV 10 mL/kg prompted significant increases in disruptions of diaphragmatic myofibrillar organization, transforming growth factor-1, oxidative loads, Masson’s trichrome staining, extracellular collagen levels, positive staining of -smooth muscle actin, PI3K- expression, and myonuclear apoptosis (P &lt; 0.05). Decreased diaphragm contractility and peroxisome proliferator activated receptor- coactivator-1 levels were also observed (P &lt; 0.05). MV-augmented bleomycin-induced diaphragm fibrosis and myonuclear apoptosis were attenuated in PI3K-γ-deficient mice and through AS605240-induced inhibition of PI3K- activity (P &lt; 0.05). MV-augmented diaphragm fibrosis after bleomycin-induced ALI is partially mediated through PI3K-γ. Therapy targeting PI3K-γ may ameliorate MV-associated diaphragm fibrosis.

Background: Current management of COPD is predominantly focused on respiratory aspects. A multidimensional assessment including nutritional assessment, quality of life and disability provides a more reliable perspective of the true complexity of COPD patients. Methods: Prospective observational study of 120 elderly COPD patients at high risk of acute exacerbations. The Mini-Nutritional Assessment (MNA) was administered in addition to the usual respiratory assessment. The primary outcome was a composite of moderate or severe acute exacerbations during 52 weeks of follow-up. Results: The median MNA Short Form (SF) score was 11 (8-12), 39 participants (32.50%) had normal nutritional status, 57 (47.5%) were at risk of malnutrition and 24 (20%) were malnourished. Our multivariate linear logistic models showed that the MNA score was associated with dyspnea and respiratory symptoms severity assessed by the Modified British Medical Research Council (mMRC) and the COPD Assessment Test (CAT) score, with spirometric variables, in particular with the severity of airflow limitation based on the value of FEV1 and with poorer QoL as assessed by the EQ-5D-3 questionnaire. Cox regression analysis according to nutritional status based on the MNA score showed that COPD participants "at risk of malnutrition" and "malnourished" had a higher risk of moderate to severe acute exacerbations with a hazard ratio (HR) of 3.54 (p=0.002) and 8.20 (p=0.0001), respectively. Conclusion: Our study confirms the importance of assessing nutritional status in elderly COPD patients and its prognostic value.

Multidrug resistant organisms (MDROs) outbreaks have been steadilyincreasing in Intensive care units (ICUs). Still, healthcare institutions and workers (HCW) reached no unanimity on how and when implementing infection prevention and control (IPC) strategies. We aimed to provide a pragmatic, physician practice-oriented, resume of strategies towards different MRDOs outbreaks in ICU. We performed a narrative review on IPC in ICUs, investigating patient-to-staff ratios, education, isolation, decolonization, screening and hygiene practices, outbreak reporting, cost-effectiveness, reproduction-number(R0), and future perspectives. The most effective IPC strategy remains unknown. Most studies focus on a specific pathogen or disease, making the clinician losing the big picture. IPC strategies proved their cost-effectiveness regardless typology, country, or pathogen. A standardized, universal, pragmatic protocol for HCW education should be elaborated. Likewise, a rapid outbreak recognition tool elaboration (i.e., an easy-to-use mathematical model) would improve early diagnosis and spreading prevention. Further studies are needed to express in favor or against MDROs decolonization. New promising strategies are emerging and need to be tested in the field. The lack of IPC strategies application has made, and still makes ICUs a major MDROs reservoir into the community. In a not-too-distant future genetic engineering and phage therapies could represent a plot-twist in MDROs IPC strategies.

Outliers seriously affect the accuracy in geometric model fitting. Previous works in coping with outliers involve threshold selection and scale estimation. However most scale estimators suppose the inlier distribution as a Gaussian model, which usually poorly meets the cases in geometric model fitting. Outliers, considered as the points with big residuals to all the true models, share common items with big values in quantized residual preferences, thus making the outliers gather away from the inliers in quantized residual preference space. In this paper we make use of this outlier consensus in quantized residual preference space by extending the usage of energy minimization to combine the model error and the spatial smoothness in quantized residual preference space for outlier detection. The energy minimization based outlier detection process follows an alternate sampling and labeling framework. After the outlier detection, an ordinary energy minimization method is employed to optimize the inlier labels, which also follows the framework of alternate sampling and labeling. The experimental results in this study show that the energy minimization based outlier detection method can detect most of the outliers in the data. Furthermore, the proposed energy minimization based inlier segmentation process segments the inliers into different models quite accurately. Overall, the performance of the proposed method is better than most of the state-of-the-art methods.

In the context of evolving perceptions of sexuality, particularly within the realm of health and disability, this study investigates the impact of multiple sclerosis (MS) on female sexual function and quality of life. A quantitative study involving 130 female MS patients aged 35 to 50 was conducted, employing measures such as The Female Sexual Function Index (FSFI), The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), and The Fatigue Severity Scale (FSS). Results indicate a significant association between greater sexual dysfunction and poorer quality of sex life, alongside the correlation of increased fatigue with diminished sexual satisfaction. Factors such as education level, time of diagnosis, and treatment regimen also influenced outcomes. Findings underscore the importance of supportive interventions, including counseling, to enhance the quality of sex life for women with disabilities, particularly those with MS.

The concept of vulnerable carotid plaques is pivotal in understanding the pathophysiology of is-chemic stroke secondary to large-artery atherosclerosis. At the macroscopic evaluation, vulnera-ble plaques are characterized by one or more of the following features: microcalcification, neo-vascularization, lipid-rich necrotic core (LRNC), intraplaque hemorrhage (IPH), thin fibrous caps, plaque surface ulceration, huge dimension determining stenosis, and plaque rupture. Recognizing these macroscopic characteristics is crucial to estimating the risk of cerebrovascular events, also in case of non-significant (less than 50%) stenosis. Inflammatory biomarkers, such as cytokines and adhesion molecules, lipid-related markers like oxidized low-density lipoprotein (LDL), and proteolytic enzymes capable of degrading extracellular matrix components are among the key molecules that will be scrutinized for their associative roles in plaque instability. Through their quantification and evaluation, these biomarkers reveal intricate molecular cross-talking govern-ing plaque inflammation, rupture potential, and thrombogenicity. Current evidence demonstrates that plaque vulnerability phenotypes are multiple and heterogeneous and are associated with as many highly complex molecular pathways that determine the activation of an immune-mediated cascade that culminates in thromboinflammation. This narrative review provides a comprehen-sive analysis of current knowledge on molecular biomarkers expressed by symptomatic carotid plaques. It explores the association of these biomarkers with the structural and compositional at-tributes that characterize vulnerable plaques

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

Traffic anomaly detection is crucial for urban management, yet current research is often confined to small-scale endeavors. This study collected nine months of real-time Wuhan traffic monitoring data from Amap. We proposed Traffic-ConvLSTM, a multi-scale spatial-temporal technique based on long and short-term memory networks (LSTM) and convolutional neural networks (CNN) to effectively achieve long-term anomaly detection at the city level. First, we convert the traffic flow data into image representation, which enables the capture of the spatial correlation between traffic flow and roads and the correlation between traffic flow and roads, as well as the surrounding environment. Second, The model utilizes convolution kernels of different sizes to extract spatial features at road-level, regional-level, and city-level scales, while incorporating temporal features of different time steps to capture hourly, daily, and weekly dynamics. Additionally, varying weights are assigned to the convolution kernels and temporal features of varying spatio-temporal scales to capture the heterogeneous strengths of spatio-temporal correlations within patterns of traffic anomalies. The proposed Traffic-ConvLSTM model exhibits improved performance over existing techniques in the task of identifying long-term and large-scale traffic anomaly occurrences. Furthermore, the analysis reveals significant traffic anomalies during holidays and urban sporting events. The diverse travel patterns observed in response to various activities offer insights for large-scale urban traffic anomaly management, providing recommendations for city-level traffic control strategies.

Traumatic Brain Injury (TBI) is one of the leading causes of death and disability worldwide. Patient treatment and management pose a challenge for healthcare systems. The prognosis of these patients may be influenced by factors such as sex. This study aims to describe the clinical parameters of patients hospitalized in the Intensive Care Unit (ICU) of a Spanish hospital due to Trauma Brain Injury and to establish differences based on sex. Methodology: An observational, cross-sectional, and analytical study was conducted from March 2015 to December 2019. All patients admitted to the ICU during this period who presented isolated significant Traumatic Brain Injury, defined as an abbreviated injury scale (AIS) ≥ 3, were included. Data on baseline characteristics, mechanism of injury, substance use, and acute management in the prehospital and hospital stages (including the need for hospitalization) were recorded. A descriptive and in-ferential analysis was conducted using the chi-square test. Results: A total of 950 patients were ultimately included. The majority of the patients were men (723) with a mean age of 45.16 (± 17.55). There were statistically significant differences in terms of the mechanism of injury (p

Keywords: Oral health, diabetes, periodontal disease, caries, periodontitis.

This article describes the history of research and development of surface-penetrating radar, starting from the 60s in the USSR, and ending today in Russia and neighboring states formed after the collapse of the USSR. The outstanding role played in the initial period of this technology development by Prof. M.I. Finkelstein and his colleagues is highlighted. Their research had a significant impact on subsequent developments in modern Russia and the neighboring countries.

This study explores the potential of digital technologies for preserving cultural heritage through the case study of the Raya Gopura, an incomplete monument in Melukote, India. Employing a combination of terrestrial photogrammetry, drone-based photogrammetry and terrestrial laser scanning, the research team captured highly detailed 3D models of the structure. This non-destructive approach offers a comprehensive digital record for future research and preservation. Furthermore, for the conjecture for the Raya Gopura two possible purposes: an entrance to a planned fort or a gateway to the temple are perceived through the collective intelligence (CI) approach. These insights inform a conjectural architectural drawing of the potentially completed monument. The 3D models hold significant potential for various applications, including tourism, education, and architectural research, with the potential for immersive experiences through VR and AR technologies. The study demonstrated the effectiveness of digital tools in heritage preservation, not only safeguarding the Raya Gopura but also offering valuable in-sights for future research and public engagements.

This study explores the potential of digital technologies for preserving cultural heritage through the case study of the Raya Gopura, an incomplete monument in Melukote, India. Employing a combination of photogrammetry (terrestrial and drone-based) and terrestrial laser scanning, the research team captured highly detailed 3D models of the structure. This non-destructive approach offers a comprehensive digital record for future research and preservation. Furthermore, consultations with experts yielded two possible purposes for the Raya Gopura: an entrance to a planned fort or a gateway to a temple. These insights inform a conjectural architectural drawing of the potentially completed monument. The 3D models hold significant potential for various applications, including tourism, education, and architectural research, with the potential for immersive experiences through VR and AR technologies. In conclusion, this study demonstrates the effectiveness of digital tools in heritage preservation, not only safeguarding the Raya Gopura but also offering valuable insights for future research and public engagement.

The mineralogical indices, e.g., Quartz Index (QI), Carbonate Index (CI), Mafic Index (MI) for ASTER multispectral thermal infrared (TIR) data have been applied to various geological materials. The indices are proved to be robust in extracting geological information at the local scale. Considering the relatively narrow spatial coverage of each ASTER scene compared to LANDSAT, many scenes are needed when mosaicking the images to be mapped at regional scales. We develop a system to search ASTER data for a target area given the vast and expanding ASTER data archive. The data is then conditioned, prioritized, and the indices are calculated before finally mosaicking the imagery. The maps of the indices covering the very wide region of the central Tibetan Plateau are produced with this system. The characteristic features of the indices relating to their geology in the study area are analyzed and discussed. Many interesting lithological and structural information that are not currently well understood in the central Tibetan Plateau, the highest and most extensive plateau in the world, with an average elevation of over 4,500 meters above sea level, for example, distributions of the mafic-ultramafic rocks along the suture zones, the quarzitic and marine sedimentology accreted to the Eurasian continent and sulfate layers related to the Tethys and neo-Tethys geological setting can be retrieved from the processed ASTER images.

The Microwave Humidity and Temperature sounder (MWHTS) on board the Fengyun (FY)-3C satellite measure the outgoing radiance form the Earth surface and atmospheric constituents. MWHTS makes measurements in the isolated oxygen absorption line near 118 GHz and the vicinity of strong water vapor line around 183 GHz, can provide fine vertical distribution structure of both atmospheric humidity and temperature. However, in order to obtain the accurate soundings of humidity and temperature by the physical retrieval method, bias between the observed radiance and those simulated by radiative transfer model from the background or first guess profiles must be correct. In this study, two bias correction methods are developed through the correlation analysis between MWHTS measurements and air mass identified by the first guess profiles of the physical inversion, one is the linear regression correction (LRC) and the other is neural networks correction (NNC), representing the linear and nonlinear nature between MWHTS measurements and air mass, respectively. Both correction methods have been applied to MWHTS observed brightness temperatures over the geographic area (180° W-180° E, 60° S-60° N). The corrected results are evaluated by the probability density function of the difference between corrected observations and simulated values and the root mean square error (RMSE) with respect to simulated observations. The numerical results show that the NNC method perform better, especially in MWHTS channels 1 and 7-9 whose peak weight function heights are close to the surface. In order to assess the effects of bias correction methods proposed in this study on the retrieval accuracy, a one-dimensional variational system was built and applied to the MWHTS uncorrected and corrected brightness temperatures to estimated atmospheric temperature and humidity profiles, The retrieval results show that the NNC has better performance which is to be expected. An indication of the stability and robustness of NNC method is given which suggests that the NNC method has promising application perspectives in the physical retrieval.

Pulmonary arterial hypertension (PAH) is a chronic disease characterized by a progressive in-crease in mean pulmonary arterial pressure. Mutations in the BMPR2 and AQP1 genes have been described in familial PAH. The bone morphogenetic proteins BMP9 and BMP10 bind with high affinity to BMPR2. Administration of BMP9 has been proposed as a potential therapeutic strategy against PAH, although recent conflicting evidence dispute the effect of such practice. Considering the involvement of the above molecules in PAH onset, progression, and therapeutic value, we ex-amined the effects of modulation of BMP9, BMPR2, and AQP1 on BMP9, BMP10, BMPR2, AQP1, and TGFB1 expression in human pulmonary microvascular endothelial cells in vitro. Our results demonstrated that silencing the BMPR2 gene resulted in increased expression of its two main ligands, namely BMP9 and BMP10. Exogenous administration of BMP9 caused return of BMP10 to basal levels, while restored the decreased AQP1 protein levels and the decreased TGFB1 mRNA and protein expression levels caused by BMPR2 silencing. Moreover, AQP1 gene silencing also resulted in increased expression of BMP9 and BMP10. Our results might possibly imply that the effect of exogenously administered BMP9 on molecules participating in the BMP-signaling pathway could depend on the expression levels of BMPR2. Taken together, these results may pro-vide insight into the highly complex interactions of the BMP-signaling pathway.

Frequent and excessive consumption of alcohol, be it episodic or sustained misuse, ranks among the top causes of mortality globally. This comprehensive analysis seeks to elucidate how alcohol misuse precipitates death, with a particular focus on associated cardiac anomalies. Notably, the phenomenon of "Holiday Heart Syndrome," linked to binge drinking, is recognized for inducing potentially fatal cardiac arrhythmias. Moreover, persistent alcohol consumption is implicated in the development of alcoholic cardiomyopathy, a condition that underlies heart failure and arrhythmic disturbances of the heart. Additionally, individuals undergoing withdrawal from alcohol frequently exhibit disruptions in normal heart rhythm, posing a risk of death. This review further delves into additional alcohol-related mortality factors, including the heightened likelihood of hypertension, cerebrovascular accidents (strokes), and the connection between excessive alcohol use and Takotsubo syndrome.

This research investigates precision enhancement in regional quasi-geoid refinement through ADS80 tri-linear array scanning stereoscopic imagery for aerial triangulation, coupled with GNSS gravity-potential modeling. Acquiring stereoscopic imagery and analyzing triangulation accuracy with the ADS80 camera, we performed this study over the Qinghai-Tibet Plateau's elevated, desolate terrain, collecting 593 GNSS points following high-precision stereoscopic imagery model. Utilizing 12 gravity satellite models, we computed geoid heights and China 1985 Yellow Sea elevations for 28 benchmarks and GNSS points, thereby refining the Qinghai Province Quasi-Geoid Model (QPQM) using geometric techniques. The findings reveal that POS-assisted ADS80 stereoscopic imagery yields high-precision triangulation with maximal horizontal and elevation accuracies of 0.083/0.116 cm and 0.053/0.09 cm, respectively, across five control point arrangements. The RMSE of normal heights for 1985, processed via these GNSS points, achieved decimeter precision. By applying error corrections from benchmarks to the 1985 elevation data from gravity satellites and performing weighted averaging, the precision of EGM2008, SGG-UGM-2, and SGG-UGM-1 models improved to 8.61 cm, 9.09 cm, and 9.38 cm, respectively, surpassing the QPQM by 9.22 cm to 9.99 cm. This research demonstrates that the proposed methods can significantly enhance the precision of regional quasi-geoid surfaces. Additionally, these methods offer a novel approach for rapidly establishing regional quasi-geoid models in the uninhabited areas of the Qinghai-Tibet Plateau.

Multimodal remote sensing data classification can enhance the model’s ability to distinguish land features through multimodal data fusion. In this context, how to help models understand the relationship between multimodal data and target tasks is the focus of researchers. Inspired by human feedback learning mechanisms, causal reasoning mechanisms, and knowledge induction mechanisms, this paper integrates causal learning, reinforcement learning, and meta learning into a unified remote sensing data classification framework and proposed the causal meta-reinforcement learning (CMRL). First, based on feedback learning mechanisms, we have overcome the limitations of traditional implicit optimization of fusion features and customized a reinforcement learning environment for multimodal remote sensing data classification tasks. Through feedback interactive learning between agents and the environment, we help them understand the complex relationships between multimodal data and labels, thereby achieving full mining of multimodal complementary information. Second, based on the causal inference mechanism we designed causal distribution prediction action, classification reward, and causal intervention reward, capturing pure causal factors in multimodal data and cutting off false statistical associations between non-causal factors and class labels. Finally, based on the knowledge induction mechanism, we designed a bi-layer optimization mechanism based on meta-learning. By constructing a meta training task and meta validation task simulation model in the generalization scenario of unseen data, we helped the model induce cross-task shared knowledge, thereby improving its generalization ability for unseen multimodal data. The experimental results on multiple sets of multimodal datasets show that the proposed method achieved state-of-the-art performance in multimodal remote sensing data classification tasks.

The presence of anti SARS-CoV2-RBD antibody (Anti-RBD) prevents severe COVID-19. We aimed to determine the accuracy of a point-of-care Anti-RBD test implemented in person living with HIV (PLWH), systemic lupus erythematosus (SLE), and chronic kidney disease (CKD). We enrolled 182 non-comorbid subjects and 335 persons with comorbid (PLWH, SLE, CKD) to test anti-RBD assay compared to surrogate viral neutralization (SVNT) as the reference test. We performed linear correlation analysis between anti-RBD vs SVNT and a ROC analyses to ascertain anti-RBD cut-off at 30%, 60%, and 90% inhibition of SVNT to calculate accuracy. Correlations of anti-RBD to SVNT among all groups were excellent with R= 0.7903, R=0.7843, R=0.8153 among non-comorbid, SLE and CKD groups, respectively, with significantly higher correlation among the PLWH group (R=0.8877; p-value=0.0072) compared to non-comorbid group. The accuracy of the anti-RBD test among PLWH and CKD group was similar with the non-comorbid but showed lower sensitivity in the SLE group (p=0.000014). The specificity of the test remained high in all groups. In conclusion, the Anti-RBD test had excellent correlation to SVNT. The persistently high specificity in all groups suggests that this test can be reliably utilized to detect presence of low neutralization capacity, prompting additional vaccination.

Daily maximum surface air temperature (Tamax) is a crucial factor for understanding complex land surface processes under rapid climate change. Remote detection of Tamax has widely relied on the empirical relationship between air temperature and land surface temperature (LST), a product derived from remote sensing. However, little is known about how such a relationship is affected by the high heterogeneity in landscapes and dynamics in seasonality. This study aims to advance our understanding of the roles of land cover and seasonal variation in the estimation of Tamax using the MODIS (Moderate Resolution Imaging Spectroradiometer) LST product. We developed statistical models to link Tamax and LST in the middle and lower reaches of the Yangtze River in China for five major land-cover types (i.e., forest, shrub, water, impervious surface, cropland, and grassland) and two seasons (i.e., growing season and non-growing season). Results show that the performance of modeling the Tamax-LST relationship was highly dependent on land cover and seasonal variation. Estimating Tamax over grasslands and water bodies achieved superior performance; while uncertainties were high over forested lands that contained extensive heterogeneity in species types, plant structure, and topography. We further found that all the land-cover specific models developed for the plant non-growing season outperformed the corresponding models developed for the growing season. Discrepancies in model performance mainly occurred in the vegetated areas (forest, cropland, and shrub), suggesting an important role of plant phenology in defining the statistical relationship between Tamax and LST. For impervious surfaces, the challenge of capturing the high spatial heterogeneity in urban settings using the low-resolution MODIS data made Tamax estimation a difficult task, which was especially true in the growing season.

The early 2-factor (E2F) family of transcription factors, including E2F1-8, plays a critical role in apoptosis, metabolism, proliferation, and angiogenesis within glioblastoma (GBM). However, the specific functions of E2F transcription factors (E2Fs) and their impact on the malignancy of Bevacizumab (BVZ)-responsive GBM subtypes remain unclear. This study used data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) to explore the impact of eight E2F family members on the clinical characteristics of BVZ-responsive GBM subtypes and possible mechanisms of recurrence after BVZ treatment.To predict the possibility of GBM patient survival and progression, we classified and comparedthe expression of E2Fs according to BVZ-responsive subtypes and employed a machine learning method-TreeBagger, one random forest algorithm. Multiple bioinformatics analyses have shown that the significant increased E2F8 post BVZ treatment may enhance the function of angiogenesis and stem cell proliferation, indicating one of the mechanisms of GBM recurrence after treatment. In addition, BVZ treatment in unresponsive GBM patients may potentially worsen disease progression. Our findings suggest that E2F family members play important roles in GBM malignancy and BVZ treatment response, highlighting their potential as prognostic biomarkers and therapeutic targets and recommending precise BVZ treatment for GBM patients.

Aim: The aim of this study is to evaluate the possibility of discriminating between the two sexes through the simultaneous use of cheiloscopy and palatine rugoscopy. Materials and methods: 80 palate and lip impressions (40 male and 40 female) were analyzed. The palate impressions were acquired using both analogue and digital methods. The lip impres-sions were first acquired analogically and then scanned. The morphology of the palatine rugae in the palate impressions was analyzed, with the exclusion of segmental rugae. The lip prints were analyzed in sextants and the morphology of the lip wrinkles was evaluated. Results: Palatine rugoscopy shows that women have more curvy rugae than men and that men have more rugae on the left side than on the right. Cheiloscopy gave no statistically significant re-sults. Discussion: Palatine rugoscopy showed some differences between the sexes, however, these re-sults were not solid enough for reliable sex discrimination. Differences between the results of dif-ferent studies can be attributed to ethnic and methodological variations. Cheiloscopy, on the other hand, did not provide statistically significant results for sex discrimination. Conclusions: Given the scant results obtained from palatine rugoscopy and the lack of statisti-cally relevant results in cheiloscopy, together with a lack of concordance among the data found in literature, it is believed that it is not possible to discriminate between the two sexes by using the two methods contemporarily. Further research is needed.

Several studies have shown that antibiotics, analgesic – sedative, and antiseizure medications are among the most commonly used medications in preterm and sick neonates. These infants are at high risk of developing nosocomial infections, central nervous system complications, and are exposed to numerous painful/stressful procedures. These severe, potentially life-threatening complications may have serious short- and long-term consequences and should be prevented and/or promptly treated. Previous studies and reviews have revealed significant variability in medications used in neonatal intensive care units (NICUs) worldwide, especially concerning the indications and dosages of first-line medications. This variability indicates the lack of adequate studies regarding the effectiveness and safety of these medications in neonates, especially the preterm ones. Important obstacles contributing to inadequate studies in preterm infants include difficulties in obtaining parental consent, physicians’ unwillingness to recruit preterm infants, the lack of license for use in neonates, and other scientific and ethical concerns. This review is an update on the use of antimicrobials – antifungals, analgesics – sedatives, and antiseizure medications used in neonates, focusing on existing evidence or knowledge gaps regarding their pharmacokinetics, indications, safety, dosage regimen (dose, dosing interval, route of administration), and evidence-based guidelines for the optimal use in neonates.

Introduction Emergency laparotomy is a surgical procedure associated with significantly higher mortality rates compared to elective surgeries. Awake laparotomy under neuraxial anaesthesia has recently emerged as a promising approach in abdominal surgery to improve patient outcomes. This study aims to evaluate the feasibility and potential benefits of using lumbar spinal anaesthesia as the primary anaesthetic technique in emergency laparotomies. Methods We conducted a case series involving 16 patients who underwent emergency laparotomy for bowel ischemia, perforation, or occlusion. Lumbar spinal anaesthesia was employed as the main anaes-thetic technique. We analysed patient demographics, clinical characteristics, intraoperative details, and postoperative outcomes. The primary outcome measures included the adequacy of postoper-ative pain control, the incidence of postoperative complications, and mortality rates. Results Among the 16 patients, adequate postoperative pain control was achieved, with only 2 patients requiring additional analgesia. Postoperative complications, including sepsis, wound dehiscence, and pneumonia, were observed in 7 patients (44%). The observed mortality rate was relatively low at 6% (1 patient). Notably, conversion to general anaesthesia was not necessary in any of the cases, and no early readmissions were reported. Discussion Our findings highlight the feasibility and potential benefits of using neuraxial anaesthesia in emergency laparotomies. The observed low mortality rate and the avoidance of conversion to general anaesthesia suggest that lumbar spinal anaesthesia may be a useful alternative in emer-gency settings. However, the occurrence of postoperative complications in 44% of patients indi-cates the need for cautious patient selection and close monitoring. Further research with larger sample sizes is warranted to fully elucidate the efficacy, safety, and potential impact of this tech-nique on patient outcomes in emergency laparotomies.

Wearable technology has been proposed as a potential tool to change the way of human life, such as the smart bracelet and the Google Glass. In the wearable technology, the inertial sensor has great significance in tracking the object movements. The paper focused on detecting the movements of user’s finger based on the inertial sensor to give the control signals. Firstly, the attitude matrix, which represented the transformation relation of carrier coordinate system and the navigation coordinate system, was obtained. Secondly, the attitude matrix was expressed based on the quaternions. Thirdly, the finger gesture was processed by the attitude matrix to get the attitude angle. Finally, the robot was controlled by attitude angle to make the moving action. The experimental results showed the detection of the finger movement is effective.

Cardiovascular disease (CVD) is the leading cause of death worldwide. Cardiac rehabilitation (CR) has proven to be effective in reducing the rate of recurrence and disease as secondary prevention (evidence-based intervention) in patients who have suffered from myocardial infarction (MI). CR is a multidisciplinary path in which the patient is followed pharmacologically, from a psychological, nutritional, nursing and physiotherapy point of view. Post-MI patients present a reduction in the performance of the diaphragm muscle, the main inspiratory muscle, and this condition can become a risk factor for further relapses or for the onset of heart failure. Despite the solidity of the international guidelines for CR, the latter are lacking in specifically indicating an evaluation and training path regarding the inspiratory muscles in post-MI patients who have not undergone cardiac surgery. The article reviews the information on the adaptation of the diaphragm post-MI and highlights the need for clearer indications for a rehabilitation process that gives importance to the diaphragm.

Abstract: Endoglin (ENG) is a causative gene of type 1 hereditary hemorrhagic telangiectasia (HHT1). HHT1 patients have arteriovenous malformations (AVMs) in multiple organs, including the brain. In mice, Eng deletion induced by R26RCreER or SM22aCre leads to AVM development in the brain and other organs. We have reported that the severity of brain AVM in mice with activin receptor-like kinase 1 (Alk1, an HHT2 causative gene) mutation is correlated with the number of Alk1 negative endothelial cells (ECs). We hypothesized that increase of Eng negative ECs will enhance AVM severity. To increase EC Eng deletion, we used a codon improved cre (icre), which is more potent in recombination of floxed alleles than the wild type (WT) cre. R26RCreER;Eng^f/f mice that have Rosa promoter driving and tamoxifen (TM) inducible WT cre expression globally and PdgfbiCreER;Eng^f/f that have Pdgfb promoter driving and TM inducible icre expression in ECs were treated with 3 intra-peritoneal injections of TM (2.5 mg/25g of body weight) to delete Eng globally or in the ECs. AAV-VEGF was stereotactically injected into the brain to induce brain focal angiogenesis and brain AVM. We found that iCre caused more Eng deletion in the brain indicated by lower level of Eng proteins (p<0.001) and fewer Eng positive ECs (p=0.01) than mice with WT cre. Mice with iCre mediated Eng deletion have more abnormal vessels (p=0.02), CD68⁺ macrophages (p=0.002), and hemorrhage (p=0.04), and less vascular pericyte and smooth muscle coverage than mice with WT cre. In addition, arteriovenous shunts were detected in the intestines of icre mice, a phenotype that have not been detected in WT cre mice before. RNAseq analysis showed that 8 out of the 10 top upregulated pathways identified by Gene Ontology (GO) analysis are related to the inflammation. Therefore, increase of Eng deletion in ECs exacerbates AVM severity, which is associated with enhanced inflammation. Strategies that can reduce Eng negative ECs could be used to develop new therapies to reduce AVM severity for HHT1 patients.

This article presents a new input device for spastic patients and others with similar symptoms. The sensor consists of a disc used to determine positions and can replace standard joysticks in medical devices such as electric-powered wheelchairs. Using a standard joystick while operating a powered wheelchair can result in dangerous situations when spastic movements occur and extremities cramp making them uncontrollable. To avoid this, a disc was developed that can be controlled with any body part. By shifting weight (x- and y-axis) the disc can tilt in any direction creating a proportional output signal and can also be pushed down in the center (z-axis) to open a menu on a screen for example. When spasms occur it is impossible for users to get stuck on the input device because the disc is flat and can be mounted within a control panel. Body parts coming into contact with the disc would merely slide across the disc without triggering unintentional actions. The sensor presented here is also adaptive and can be adjusted to fit a user’s strength and range of motion. This proposal aims to develop an input device that enables spastic patients to operate sensitive systems safely.

Aerial image classification has become popular and has attracted extensive research efforts in recent decades. The main challenge lies in its very high spatial resolution but relatively insufficient spectral information. To this end, spatial-spectral feature extraction is a popular strategy for classification. However, parameter determination for that feature extraction is usually time-consuming and depends excessively on experience. In this paper, an automatic spatial feature extraction approach based on image raster and segmental vector data cross-analysis is proposed for the classification of very high spatial resolution (VHSR) aerial imagery. First, multi-resolution segmentation is used to generate strongly homogeneous image objects and extract corresponding vectors. Then, to automatically explore the region of a ground target, two rules, which are derived from Tobler’s First Law of Geography (TFL) and a topological relationship of vector data, are integrated to constrain the extension of a region around a central object. Third, the shape and size of the extended region are described. A final classification map is achieved through a supervised classifier using shape, size, and spectral features. Experiments on three real aerial images of VHSR (0.1 to 0.32 m) are done to evaluate effectiveness and robustness of the proposed approach. Comparisons to state-of-the-art methods demonstrate the superiority of the proposed method in VHSR image classification.

The necessity for precise and current data concerning the dynamics of land cover change in Indonesia is crucial for efforts to reduce natural vegetation cover due to agricultural expansion. The functionality of monitoring systems that incorporate Terra-MODIS is currently compromised by the limited availability of data for the immediate future. This study seeks to assess the potential of VIIRS satellite imagery in developing an early warning system for monitoring vegetation cover change in Indonesia. The Normalized Differential Open Area Index (NDOAI) computed from the 8-day’ VIIRS data was employed to detect changes in vegetation cover based on pixel-by-pixel subtraction in the NDOAI data time series. Evaluating the pixel-level accuracy of change detection is complicated due to the fact that we evaluate a change map at a coarser resolution than the Landsat-based reference map. The results revealed that increasing the threshold percentage is associated with improved accuracy. In change detection, there is often a trade-off between accuracy and sensitivity. A threshold that is too low may result in false positives, while a threshold that is too high may lead to missed changes. This study demonstrates that when a threshold value of less than 20% is applied, Landsat can identify vegetation cover changes at an earlier stage. Conversely, when a threshold value greater than 20% is employed, VIIRS will detect the change 4.5 days earlier than Landsat. Additionally, VIIRS is capable of detecting changes 25.4 days and 54.8 days faster than Landsat, respectively, when using thresholds of 40% and 75%.

In this study, we present comprehensive climatologies of effective ultraviolet (UV) quantities and photosynthetically active radiation (PAR) over Cyprus for the period 2004 to 2023, leveraging the synergy of earth observation (EO) data and radiative transfer model simulations. The EO dataset, encompassing satellite and re-analysis data for aerosols, total ozone column, and water vapor, alongside cloud modification factors, to capture the nuanced dynamics of Cyprus's atmospheric conditions. With a temporal resolution of 15 minutes and a spatial of 0.05°x0.05°, these climatologies undergo rigorous validation against established satellite datasets and are further evaluated through comparisons with ground-based global horizontal irradiance measurements provided by the Meteorological Office of Cyprus. This dual-method validation approach not only underscores the models' accuracy but also highlights their proficiency in capturing intra-daily cloud coverage variations. Our analysis extends to investigating the long-term trends of these solar radiation quantities, examining their interplay with changes in cloud attenuation, aerosol optical depth (AOD), and total ozone column (TOC). Significant decreasing trends in the noon ultraviolet index (UVI), of -2 to -4% per decade have been found in Autumn, especially marked on the island’s Northeastern part, mainly originating from the (significant) positive trends in TOC. The significant decreasing trends in TOC, of -2 to -3% per decade that were found in Spring do not result in correspondingly significant positive trends in the noon UVI since variations in cloudiness and aerosols also have a strong impact on the UVI in this season. The seasonal trends in the Daylight Integral (DLI) were generally not significant. These insights provide a valuable foundation for further studies aimed at developing public health strategies and enhancing agricultural productivity, highlighting the critical importance of accurate and high-resolution climatological data.

Recent advancements in deep learning have spurred the development of numerous novel semantic segmentation models for land cover mapping, showcasing exceptional performance in delineating precise boundaries and producing highly accurate land cover maps. However, to date, no systematic literature review has comprehensively examined semantic segmentation models in the context of land cover mapping. This paper addresses this gap by synthesizing recent advancements in semantic segmentation models for land cover mapping from 2017 to 2023, drawing insights on trends, data sources, model structures, and performance metrics based on a review of 106 extracted articles. Our analysis identifies top journals in the field, including MDPI Remote Sensing, IEEE Journal of Selected Topics in Earth Science, and IEEE Transactions on Geoscience and Remote Sensing, IEEE Geoscience and Remote Sensing Letters, ISPRS Journal Of Photogrammetry And Remote Sensing as the leading journals. We find that research predominantly focuses on land cover, urban areas, precision agriculture, environment, coastal areas, and forests. Geographically, 35.29% of the study areas are located in China, followed by USA (11.76%), France (5.88 %), Spain (4%) and others. Sentinel-2, Sentinel-1, and Landsat satellites emerge as the most commonly used data sources. Benchmark datasets such as ISPRS Vaihingen &amp; Potsdam, LandCover.ai, DeepGlobe, and GID datasets are frequently employed. Model architectures predominantly utilize encoder-decoder, and hybrid convolutional neural network-based structures because of their impressive performances, with limited adoption of transformer-based architectures due to its computational complexity issue, and slow convergence speed. Lastly, this paper highlights existing key research gaps in the field to guide future research directions.

Objectives: Female genital mutilation (FGM) is a significant public health problem. It is estimated around 14,700 women affected by FGM live in Switzerland, primarily among women with a history of migration. Our qualitative research investigated the sexual health of immigrant women living with FGM in Switzerland, describing their own perception of health, reproductive life and sexuality. Methods: We conducted semi-structured, in-depth interviews with a group of eight immigrant women of African origin living in Switzerland with Type III FGM (infibulation). Results: Seven of the women were from Somalia and one from Ivory Coast. All of the Somali women were mothers and married (two separated), and the Ivorian woman was a single mother. The women in our study reported a low level of sexual satisfaction and reproductive health. They affirmed their desire to improve, or at least change, their condition. Although they rarely talk with their husbands about sexual subject matter, they would like to include them more and improve dialogue. Conclusions: Specific socio-sexual management is recommended when caring for immigrant women living with FGM in order to respond to their specific health care needs. Multidisciplinary approaches may be able to offer more comprehensive health care, including facilitated communication to improve dialogue between women and health care professionals, and eventually between women and their husbands in discussing sexual matter.

Global warming leads in general to a reduction in precipitations and non-rainfall water contributions such as dew. The present study, carried out in Gujarat (India) for 17 years between 2005 and 2021, shows however a rare increase of the rain falls and dew condensation, the latter related to an increase in relative humidity and a decrease in wind amplitudes. Rain was obtained from meteo stations. Dew was calculated from an energy model and meteo data from 15 meteo stations (14 in India and 1 in Pakistan) and compared to early and dedicated measurements in 13 sites. Maps of dew, rain and their relative contributions during the period are provided. They show that, while rain mainly occurs during the monsoon (June to September), dew forms during the dry season (October to April). This water resource was mapped over the Gujarat state of India by using a kriging process. According to the site, the dew/rain ratios can represent between 4.6% (Ahmedabad) to 37.2% (Jamnagar) on the whole period of 17 years. This positive evolution, which is observed since 2015-2017, is likely to continue in the future.

In Taiwan, remote healthcare was initially limited to telemedicine services, and the systematic development of remote care was relatively delayed. It was not until 2007 that the Department of Health of the Executive Yuan first initiated the 'Remote Care Pilot Program,' followed by the 'Remote Care Service Improvement and Quality Enhancement Plan' in the subsequent year. In 2010, Taiwan officially launched the 'Remote Health Care Services Development Plan' and established a dedicated project office, marking the comprehensive start-up of remote care services. This stage saw significant contributions from artificial intelligence aids and ICT remote transmission technologies, greatly promoting the application of smart healthcare in home care. This study aims to explore the strategic gaps in the application of smart healthcare in home remote care. By analyzing gaps in 'legal regulations,' 'economic factors,' 'user behavior habits,' 'policy and culture,' and 'environment and technology,' this study employs a mixed-methods approach. Particularly, it uses the Analytic Hierarchy Process (AHP) to construct a weighted ranking of these strategic gaps. Through in-depth interviews with doctors and smart healthcare experts and the collection of 16 valid AHP questionnaire samples, which cover both industry and academia with a balanced distribution, the survey results are ensured to be representative and reliable. The findings indicate that 'legal regulations' are considered the most critical strategic gap that needs to be addressed first, followed by 'user behavior habits.' This suggests that when designing smart healthcare applications, greater consideration needs to be given to user acceptance and habits. By systematically analyzing and addressing these strategic gaps, this study not only provides solutions to issues in the application of smart healthcare in home remote care but also offers valuable references for future research and practice, aiming to make home remote care services more comprehensive and efficient.

Cellular senescence is the irreversible growth arrest subsequent to oncogenic mutations, DNA damage or metabolic insult. Senescence is associated with aging and chronic age associated diseases such as cardiovascular disease and diabetes. The involvement of cellular senescence in Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD) is not fully understood however, recent studies suggest that such patients have a higher-than-normal level of cellular senescence and accelerated aging. This study aimed to discover key biomarkers of senescence in AKI and CKD patients compared to other chronic ageing diseases as controls. We show that senescence proteins CKAP4 and PTX3 are upregulated in AKI and CKD patients compared with controls with chronic diseases suggesting they may play in a role in overall kidney disease development. Additionally, CKAP4 was found to be differentially expressed in both AKI and CKD when compared to unhealthy controls hence this biomarker could be prognostic senescence biomarker of both AKI and CKD.

Background: The aim of this experimental work was to evaluate cheiloscopy potential: to confirm the individual uniqueness of lip prints, to verify the presence of recurrent patterns according to the Suzuki and Tsuchihashi classification and to search for characteristics that can be used in establishing the sex of a subject, with a focus on assessing the method's limitations. Methods: Lip prints were taken from a sample of 172 volunteers using liquid lipstick and transparent adhesive tape and were digitally analyzed. Results: 59 prints (35.3%) were not considered for Suzuki and Tsuchihashi classification due to quality errors and the impossibility of visualizing lip wrinkles in one or more sextants. All the digitized prints revealed themselves to be unique after having been analyzed using superimposition. Qualitatively valid prints indicated a prevalence of Type II in both male and female. A major problem was that the analysis of the same print by different operators often resulted in a different attribution of a Type. Conclusions: The potential of cheiloscopy lies mainly in the matching of prints, given their uniqueness, but the absence of a database greatly limits its use. Additionally, its use for sex identification does not seem to be reliable. It is necessary to establish an acquisition protocol for taking and analyzing prints that could reduce the errors committed by the operator.

Background: The aim of this experimental work was to confirm the individual uniqueness of lip prints, to verify the presence of recurrent patterns according to the Suzuki and Tsuchihashi classification and to search for characteristics that can be used in establishing the sex of a subject. Methods: Lip prints were taken from a sample of 172 volunteers using liquid lipstick and transparent adhesive tape and were digitally analyzed. Results: 59 prints (35.3%) were not considered for Suzuki and Tsuchihashi classification due to quality errors and the impossibility of visualizing lip wrinkles in one or more sextants, all the digitized prints revealed themselves to be unique after having been analyzed using superimposition. Qualitatively valid prints indicated a prevalence of Type II in both male and female and the presence of sex-linked features. A major problem was that the analysis of the same print by different operators often resulted in a different attribution of a Type. Conclusions: The potential of cheiloscopy lies mainly in the matching of prints, given their uniqueness, and can be a valid tool in gender determination but the absence of a database greatly limits its use. It is necessary to establish an acquisition protocol for taking and analyzing prints that could reduce the errors committed by the operator.

Abstract Introduction: Long COVID (LC) affects multiple systems and has a significant health impact on patients and society. Therefore, long COVID services should address patients’ needs through a holistic assessment and monitoring of patients’ symptoms. Aim: The aim was to understand which of the symptoms were most and least likely to improve, after our rehabilitation intervention so that the rehabilitation measures in the clinic could be modified to meet patients’ needs. At the same time, we wanted to assess the feasibility of using C19-YRS ELAROS application in monitoring of LC symptoms during and after the rehabilitation clinic attendance. Methodology: In this study, a total of 50 patients who have attended long COVID rehabilitation clinic in Salford, UK; were assessed by using digitalised C19-YRS ELAROS application. A total of 100 eligible initial and final post rehabilitation assessments were analysed. Conclusion: Pain and anxiety symptoms were the two most likely symptoms to improve after intervention at LC rehabilitation clinic, whereas swallowing difficulty is least likely to improve. Issues with caring for family/ social life (symptoms affecting social role) are likely to worsen even after treatment. It is feasible to monitor and track Long COVID symptoms utilising the digitalised version of C19-YRS via the ELAROS App. This also allows the tracking of symptoms overtime.

Volcanic activity essentially consists of the transfer of heat from the Earth’ interior to the surface. The precise signature of this heat transfer relates directly to the processes underway at and within a particular volcano and this can be observed, at a safe distance, remotely, using infrared sensors that are present on Earth-orbiting satellites. For over 50 years, scientists have perfected this art using sensors intended for other purposes, and they are now in a position to determine the particular sort of activity that characterizes different volcanoes. This review will describe the theoretical basis of the discipline and then discuss the sensors available for the task and the history of their use. Challenges and opportunities for future development in the discipline are then discussed.

Floods are among the most serious natural disasters worldwide; they cause enormous crop losses every year and threaten world food security. There are many studies focused on flood impact assessments for administrative districts but fewer on postdisaster impact assessments for specific crops. Therefore, this study used remote sensing data, including the normalized difference vegetation index (NDVI), elevation data, slope data, and rainfall data, combined with crop growing season data to construct a crop flood damage assessment index (CFAI). First, an analytic hierarchy process (AHP) was used to assign weights to the impact factors; then, the weighted composite score method was used to calculate the CFAI; and finally, the impact was classified as slight, moderate, or severe based on the magnitude of the CFAI . This method was used for the Missouri River floods of 2019 in the U.S. Due to the lack of measured data, the disaster vegetation damage index (DVDI) was used to validate the results. The combined approach achieved a high degree of consistency in spatial distribution. The CFAI can respond well to the degree of crop impact after flooding, providing new ideas and reference standards for agriculture-related departments.

Evapotranspiration is a critical component of the hydrological cycle, and it has a decisive impact on the ecosystem balance in arid and semi-arid regions. The Yinchuan Plain, located in the Gobi of Northwest China, has a strong surface ET. In order to assess the ET pattern in this region, we obtained the ETa of Yinchuan Plain between 1987 and 2020 using the GEE platform. We employed the Surface Energy Balance Model (SEBAL), specifically geeSEBAL, to analyze the change pattern of ET over different seasons, years, and land types. The results show that: ① In spring, the daily ETa of the Yinchuan Plain is highest in the central lake wetland area, with a maximum value of 4.32 mm day-1. In summer, it is concentrated around the croplands and water bodies, with a maximum value of 6.90 mm day-1; In Autumn and winter, it is mainly concentrated around the water bodies and impervious areas, with maximum values of 3.93 and 1.56 mm day-1, respectively. ② From 1987 to 2020, the ET of the Yinchuan Plain showed an obvious upward and downward trend in some areas with significant land use changes, but the overall ET of the region remained relatively stable without dramatic fluctuations. ③ The evapotranspiration of different underlying land use types in the Yinchuan Plain region is as follows: water body&gt;cultivated land&gt;impervious&gt;grassland&gt;bare land. Our results showed that geeSEBAL is highly applicable in the Yinchuan Plain area. It allows for the accurate and detailed inversion of ET in the study area, which facilitates the study of regional hydrological cycle and water governance.

This mini-review explores the comparative efficacy, safety, and clinical outcomes of high-dose proton pump inhibitor (PPI) intravenous infusion versus oral acid pump inhibitor therapy following endoscopic treatment for bleeding peptic ulcers. Recent evidence suggests that intravenous PPIs can significantly reduce the rebleeding rates within the critical first 72 hours post-intervention, with a noted rebleeding rate of 6% compared to 14% in patients receiving oral Vonoprazan (VPZ) therapy. Additionally, the rapid onset of action associated with intravenous administration leads to faster stabilization of vital signs and a reduced need for subsequent blood transfusions. Safety profiles for both intravenous and oral VPZ were favourable, with minimal adverse effects, the most common being transient headaches.However, the findings from our single-centre study with a moderate sample size prompt consideration of more extensive, multicentre trials to enhance the generalizability of the results. Current limitations include potential biases, short-term focus, missing data issues, and a need for long-term outcome data, necessitating further research. Future studies should also explore the cost-effectiveness of intravenous versus oral VPZ and the impact on patient quality of life and long-term mortality rates.This review underscores the importance of tailored PPI therapy in managing bleeding peptic ulcers post-endoscopy. It suggests a potentially pivotal role for intravenous PPIs in high-risk patient groups, advocating for a shift towards more aggressive and immediate care protocols in specific clinical settings.

YOLOv8, as an efficient object detection method, can swiftly and precisely identify objects within images. However, traditional algorithms encounter difficulties when detecting small targets in remote sensing images, such as missing information, background noise, and interactions among multiple objects in complex scenes, which may affect performance. To tackle these challenges, we propose an enhanced algorithm optimized for detecting small objects in remote sensing images, named HP-YOLOv8. Firstly, we design the C2f-D-Mixer (C2f-DM) module as a replacement for the original C2f module. This module integrates both local and global information, significantly improving the ability to detect features of small objects. Secondly, we introduce a feature fusion technique based on attention mechanisms, named Bi-Level Routing Attention in Gated Feature Pyramid Network (BGFPN). This technique utilizes an efficient feature aggregation network and reparameterization technology to optimize information interaction between different scale feature maps, and through the Bi-level Routing Attention (BRA) mechanism, it effectively captures critical feature information of small target objects. Finally, we propose the Smooth Mean Perpendicular Distance Intersection over Union (SMPDIoU) loss function. The method comprehensively considers the shape and size of detection boxes, enhances the model's focus on the attributes of detection boxes and provides a more accurate bounding box regression loss calculation method. To demonstrate our approach's efficacy, we conduct comprehensive experiments across the RSOD, NWPU VHR-10, and VisDrone2019 datasets. The experimental results show that the HP-YOLOv8 achieves 95.11%, 93.05%, and 53.49% in the [email protected] metric, and 72.03%, 65.37%, and 38.91% in the more stringent [email protected]:0.95 metric, respectively.

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

.Bacground: Sepsis remains a major health challenge worldwide, characterized by a dysre-gulated host response to infection, leading to high mortality and morbidity in intensive care units (ICUs). The Fibrosis 4 (FIB-4) index, originally developed to assess liver fibrosis in hepatitis C patients, has recently been explored for its potential prognostic value in sepsis patients. Method: This study retrospectively analyzed 309 sepsis patients admitted to the Internal Me-dicine and Anaesthesia ICUs between December 12, 2021, and December 15, 2023, to inves-tigate the relationship between FIB-4 levels, Acute Physiology and Chronic Health Evaluation (APACHE), and Sequential Organ Failure Assessment (SOFA) and clinical outcomes. Results: The study found that higher FIB-4 measurements were statistically significantly asso-ciated with increased 28-day mortality, with a cut-off value of 4.9 providing a sensitivity of 54.92% and specificity of 74.25%. Logistic regression analysis indicated that elevated Conclusion:FIB-4 levels were a significant predictor of early mortality, suggesting that the FIB-4 index could serve as a valuable prognostic tool in assessing the severity and prognosis of sepsis patients.

Rapid and accurate detection of road cracks is of great significance for road health monitoring, but currently this work is mainly completed through manual site surveys. Low-altitude UAV remote sensing can obtain images with centimeter or even subcentimeter ground resolution, which provides a new efficient and economical approach for rapid crack detection. Nevertheless, crack detection networks face challenges such as edge blurring and misidentification due to the heterogeneity of road cracks and the complexity of the background. To address these issues, we propose a real-time edge reconstruction crack detection network (ERNet) which adopts multi-level information aggregation to reconstruct crack edges and improve the accuracy of segmentation between the target and background. To capture global dependencies across spatial and channel levels, we propose an efficient bilateral decomposed convolutional attention module (BDAM) that combines depth separable convolution and dilated convolution to capture global dependencies across spatial and channel levels. To enhance the accuracy of crack detection, we use a coordinate-based fusion module that integrates spatial, semantic, and edge reconstruction information. In addition, we propose an automatic measurement of crack information for extracting the crack trunk and its corresponding length and width. Experimental results demonstrate that our network achieves the best balance between accuracy and inference speed.

: Suicide is a serious public health problem, with a global mortality rate of 1.4% of all deaths worldwide, and the leading cause of unnatural death in Spain. The use of clinical simulation has proven to be a beneficial tool in the training of nursing students. Such experiences allow them to develop cognitive and affective skills that are fundamental for the detection of warning signs and use of interventions in cases of people who want to take their own lives. Working in a mental health environment can be difficult for nursing students; therefore, the purpose of this study was to explore the perceptions of nursing students on the approach, management and intervention of suicidal crisis through clinical mental health simulation. Methods: qualitative descriptive phenomenological study through focus groups and reflective narratives in a sample of 45 students. A thematic analysis was performed using ATLAS-ti. Results: After the analysis, three themes were obtained: (a) management and handling of emotions (b) identification of suicide motives (c) intervention in suicidal crisis. Discussion: Clinical simulation in mental health allows students to exercise clinical judgment reasoning, detect warning signs for a better treatment approach, and provide tools for effective intervention and management of patient care. The results of this study indicate that nursing students face challenges in approaching mental health clinical simulation due to lack of prior exposure.

A previous report showed that the urine output of HPLBII-P in patients with diabetes mellitus and SARS-Cov-2 infection was increased as a sign of glomerular dysfunction. . The aim of this report was to investigate the relation of urine output of HPLBII-P to diabetes mellitus in two large community-based elderly populations i.e. the ULSAM and PIVUS cohorts. Methods HPLBII-P was measured by ELISA in the urine of a community-based cohort of 839 men (ULSAM) collected at 77 years of age and in urine of a community-based cohort of 75-year-old men, n=387, and women, n=401 (PIVUS). KIM-1, NGAL and Albumin were measured in urine and Cathepsin S and Cystatin C in serum. Results HPLBII-P was significantly raised among males with diabetes in the ULSAM (p

Immunotherapy, particularly Immune Checkpoint Blockade (ICB), has demonstrated significant efficacy in treating melanoma in recent years. However, accurately predicting treatment success and avoiding ineffective therapies remains an unresolved challenge. Therefore, this study aims to develop statistical models utilizing neural networks to forecast the effectiveness of immune checkpoint therapies for melanoma patients. Our models primarily rely on Artificial Neural Networks (ANN) to anticipate both Overall Survival (OS) and Progression-Free Survival (PFS) among melanoma patients undergoing anti-CTLA4 and anti-PD1/anti-PDL1 therapy. We incorporate gene expression data, measured in Transcripts per Million (TPM), derived from bulk tumor RNA-sequencing datasets. Additionally, clinical variables such as gender, age, and treatment type are factored into our analysis. The ANN underwent optimization to attain the highest feasible precision in anticipating the predetermined survival outcome. Issues stemming from high-dimensional data, such as overfitting, were tackled through regularization and feature selection methods. Consequently, the ANN-based model incorporating feature selection exhibited the capacity to forecast survival (PFS) in response to ICB therapy with a maximal precision of 86%. Conversely, the ANN lacking feature selection but incorporating regularization achieved accuracies of up to 72% for PFS and 71% for OS, correspondingly. In order to confront the challenge posed by limited patient samples and to assess replicability, the model underwent training and validation based on the amalgamation of all five datasets. However, this amalgamation failed to enhance predictive performance, necessitating further investigations.

In this study, we aim to explore whether rephrasing enhances the performance of advanced question answering systems in terms of accuracy. Initially, we analyze the effectiveness of Bidirectional Encoder Representations from Transformers (BERT)—a widely used pre-trained language model—when presented with rephrased questions and documents containing distracting details. Our findings reveal that BERT exhibits excessive sensitivity to such instances, prompting us to investigate potential strategies for mitigating this sensitivity. To address the observed decline in performance, we propose a refinement approach for BERT, incorporating techniques such as data augmentation and multitask learning. Specifically, given a question and its context, we generate a series of paraphrases through back-translation. Alongside minimizing the loss between the predicted answer distributions for the original questions—we also minimize the supervised loss associated with the augmented questions. Furthermore, we introduce an auxiliary objective aimed at minimizing the unsupervised loss between the answer distributions of the original and augmented questions. Notably, this auxiliary loss is unsupervised, as it does not directly rely on labels corresponding to the augmented examples. To compute this unsupervised loss, we employ measures such as symmetric Kullback-Leibler divergence and the Jensen-Shannon distance, serving as regularization techniques for the model. The findings revealed that the supervised model exhibited superior performance compared to both the original and our proposed model. However, our proposed model demonstrated a nearly 2% enhancement in both Exact Match (EM) and F1 scores when tested on a paraphrased development set that we formulated. This suggests the potential effectiveness of our proposed approach in enhancing model accuracy and performance.

Invasive Candida infections represent a significant cause of morbidity and mortality in the neonatal intensive care unit (NICU), particularly among preterm and low birth weight neonates. The nonspecific clinical presentation of invasive candidiasis, resembling that of bacterial sepsis with multiorgan involvement, makes the diagnosis challenging. Given the atypical clinical presentation and the potential detrimental effects of delayed treatment, empirical treatment is often initiated in cases with high clinical suspicion. This underscores the need to develop alternative laboratory methods other than cultures, which are known to have low sensitivity and a prolonged detection time, to optimize therapeutic strategies. Serum biomarkers, including mannan antigen/anti-mannan antibody and 1,3-β-D-glucan (BDG), both components of the yeast cell wall, a nano-diagnostic method utilizing T2 magnetic resonance and Candida DNA detection by PCR-based techniques have been investigated as adjuncts to body fluid cultures and have shown promising results in improving diagnostic efficacy and shortening detection time in neonatal populations. This review aims to provide an overview of the diagnostic tools and the current management strategies for invasive candidiasis in neonates. Timely and accurate diagnosis followed by targeted antifungal treatment can significantly improve the survival and outcome of neonates affected by Candida species.

In GNSS/IMU integrated navigation systems, factors such as satellite occlusion and non-line-of-sight conditions can lead to degradation of satellite positioning results, Subsequently affecting the overall accuracy of the integrated navigation system. To address this issue and ef-fectively utilize historical pseudorange information from satellites, this paper proposes a graph optimization-based GNSS/IMU model with virtual constraints. These virtual constraints are con-structed using satellite ‘s position from previous time step, the rate of change of pseudoranges, and ephemeris data. This virtual constraint can serve as an alternative solution for individual satellites in case of signal anomalies, ensuring the integrity and continuity of the graph optimi-zation model. Additionally, this paper conducts an analysis of the graph optimization model constructed using these virtual constraints, comparing it with traditional integrated navigation graph optimization model, and analyzes and reconstructs the marginalization process based on these virtual constraints. The experimental results, compared with tightly coupled Kalman fil-tering and the original graph optimization method on a set of real-world data, demonstrate that the introduction of virtual pseudoranges maintains high positioning accuracy. The RMSE error between it and the original graph optimization remains within 5%, affirming the high feasibility of this approach.

Detecting and monitoring changes in soil salinity through remote sensing provides an opportunity for field assessment in regions where on-site measurements are limited. This investigation, carried out in Siwa Oasis, Egypt, aimed to assess the efficacy of several soil salinity indices derived from Landsat 5 and 7 satellite images. To achieve this, 56 on-site ground measurements were utilized for evaluation purposes. The study aimed to improve the correlation between EC and index values and explore the relationship between salinity and changes in land cover. Eleven spectral indices were calculated for nine scenes captured in different months from August to December. The first approach involved stacking the data to identify the index with the strongest correlation with ground EC values, without the need for complex analysis or EC value ranging. In the second approach, the ground EC measurements were classified into seven different salinity categories, and the correlation coefficient was calculated between each index and each salinity category. The third approach analyzed the data temporally, considering different salinity levels. Lastly, a spatial correlation analysis was conducted between EC and index values in the fourth scenario. The initial approach revealed a weak correlation due to substantial variation in EC values. However, the SI index demonstrated the highest correlation coefficient of 0.38. In the second scenario, the S2 index exhibited the highest correlation of 0.96 for moderate salinity samples. The third scenario showed that the S1 index achieved the highest correlation value of 0.99 for moderately saline areas. In the fourth scenario, the SI index exhibited the strongest correlation among all four ponds with correlation coefficients of 0.23, 0.23, 0.18, and 0.61. Notably, the correlations observed in the second and third scenarios demonstrated higher correlation coefficients compared to both the first and fourth scenarios. The study highlighted significant variations in EC levels related to land cover types and pond elevation. Additionally, remote sensing methods detected a 48% increase in total vegetated area over 17 years, showing the potential of remote sensing techniques in salinity monitoring for expanding agriculture and improving land management.

Acute and chronic respiratory diseases impose a significant economic and health burden. Distal small airway assessment requires invasive procedures such as a bronchoscopy and bronchoalveolar lavage. The Particles in Exhaled Air (PExA) device provides a non-invasive means of assessing small airways; it captures distal airway particles sized around 0.5-7m and contains particles of respiratory tract lining fluid (RTLF) that originate during airway closure and opening. The PExA device can measure particle count and mass according to particle size. Subsequent capture of particles in a thin membrane enables application of various analytical methods to assess a broad range of biomolecules including phospholipids, proteins, inflammatory profile, and other metabolites to characterise inflammation and diseases processes such as asthma, chronic obstructive pulmonary disease, acute respiratory distress syndrome, lung cancer, and more recently acute infections such as COVID-19. PExA analysis provides a promising alternative to traditional investigative methods in the assessment, diagnosis, and management of respiratory conditions. By evaluating specific biomarkers in the RTLF associated with airway inflammation, PExA may offer a more accurate and comprehensive understanding of the molecular-level changes in the small airways of patients with acute and chronic lung diseases.

Phyllanthus emblica (P. emblica) has been described in many studies to have multiple therapeutic activities and is considered an important part of Ayurvedic and Unani medicinal systems. This study successfully synthesized P. emblica loaded polyvinylalcohol/gelatin based cryogels (PVA/Gel/P.emblica) to examine their potential in wound dressing applications. Swelling tests, Brunauer-Emmett-Teller (BET) and morphology analysis were conducted within the scope of characterization studies. In vitro cell culture studies were performed using HaCaT cells to illustrate the suitability of the synthesized cryogels as wound dressing material. The swelling tests and BET analysis results showed that swelling and surface area properties of cryogels increased with increasing P. emblica amounts. Morphological results displayed that the cryogels had a dense, interconnected pore morphology and a macroporous structure. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), trypan blue exclusion and live-dead assay results revealed that adding of P. emblica into cryogels led to enhanced cell proliferation, increased cell number, and improved cell viability. Based on the phase contrast microscope, scanning electron microscope (SEM), immunofluorescence and giemsa staining images, it was observed that P. emblica promoted cell attachment, proliferation and penetration. In conclusion, it has been shown that PVA/Gel/P.emblica cryogels are suitable for use as wound dressing materials and can be developed with further studies.

Ecosystem physical structure, defined by the quantity and spatial distribution of biomass, influences a range of ecosystem functions. Remote sensing tools permit the non-destructive characterization of canopy and root features, potentially providing opportunities to link above- and belowground structure at fine spatial resolution in functionally meaningful ways. To test this possibility, we employed ground-based portable canopy lidar (PCL) and ground penetrating radar (GPR) along co-located transects in forested sites spanning multiple stages of ecosystem development and, consequently, of structural complexity. We examined canopy and root structural data for coherence at multiple spatial scales ≤ 10 m within each site using wavelet analysis. Forest sites varied substantially in vertical canopy and root structure, with leaf area index and root mass more evenly distributed by height and depth, respectively, as forests aged. In all sites, above- and belowground structure, characterized as mean maximum canopy height and root mass, exhibited significant coherence at a scale of 3.5-4 meters, and results suggest that the scale of coherence may increase with stand age. Our findings demonstrate that canopy and root structure are linked at characteristic spatial scales, which provides the basis to optimize scales of observation. Our study highlights the potential, and limitations, for fusing lidar and radar technologies to quantitatively couple above- and belowground ecosystem structure.

Abstract: Laryngoscopy for tracheal intubation has been developed for many decades. Among various conventional laryngoscopes, videolaryngoscopes (VL) have been applied in different patient populations, including difficult airways. The safety and effectiveness of VL have been repeatedly studied in both normal and difficult airways. The superiority of VL then has been observed and is advocated as the standard of care. In contrast to laryngoscopy, the development of video-assisted intubating stylet (VS, also named as styletubation) has been noticed two dec-ades ago. Since then, sporadic clinical experiences of use have appeared in literature. In this re-view article, we presented our vast use experiences of the styletubation (more than 55,000 pa-tients since 2016). We found this technique is swift (the time to intubate: from 3 s to 10 s), smooth (first-attempt success rate: 100%), safe (no airway complications), and easy (high subjective satis-faction and fast learning curve for the novice trainees) in both normal and difficult airway sce-narios. We therefore propose styletubation technique can be feasibly applied as universal rou-tine use for tracheal intubation.

Chlorophyll-a (Chl-a), a proxy for phytoplankton biomass, is one of the few biological water quality indices detectable using satellite observations. However, models for estimating Chl-a from satellite signals are currently unavailable for many lakes. The application of Chl-a prediction algorithms may be affected by the variance in optical complexity within lakes. Using Lake Winnipeg in Canada as a case study, we demonstrated that separating models by the lake’s basins [north basin (NB) and south basin (SB)] can improve Chl-a predictions. By calibrating more than 40 commonly used Chl-a estimation models using Landsat data for Lake Winnipeg, we achieved higher correlations between in situ and predicted Chl-a when building models with separate Landsat-to-in-situ matchups from NB and SB (R² = 0.85 and 0.76, respectively; p &lt; 0.05), compared to using matchups from the entire lake (R² = 0.38, p &lt; 0.05). In the deeper, clearer waters of the NB, a green-to-blue band ratio provided better Chl-a predictions, while in the shallower, highly turbid SB, a red-to-green band ratio was more effective. Our approach can be used for rapid Chl-a modeling in large lakes using cloud-based platforms like Google Earth Engine with any available satellite or time series length.

Determining precise boundaries and protective zones for historical and cultural objects enables their effective preservation. This is particularly crucial in the face of increasing tourism, urbanization, and natural disasters. Accurately defining boundaries and protective zones can aid in the planning of scientific research, archaeological excavations, and other studies aimed at exploring the history and cultural significance of these objects. The article presents the framework for establishing protective zones around historical and cultural heritage sites existing in Ukraine, using the example of the Citadel defensive complex located in Lviv (Ukraine). It proposes general and detailed conceptual models for the combined application of remote and non-invasive methods for investigating historical and cultural heritage sites. This conceptual article introduces the theory of integrating radar satellite imaging with ground-based georadar imaging. Additionally, it presents a software module that has been developed to analyze collected data on two-dimensional historical and cultural heritage objects, refine their boundaries, and establish protective zones around them.

With the rapid developments that have been made in computer vision and computer technology, semantic segmentation of high-resolution images has emerged as a mainstream and challenging task. The, segmentation of water areas remains a complex task due to the similar features between water areas or between water areas and other land objects. Meanwhile, since coastlines and riverbanks are typically presented in irregular shapes, it is difficult to obtain the categories of pixels at boundaries. This paper proposed the use of a Water-Land Boundary Attention Network (WLBANet) to improve the accuracy of pixels at boundaries between water and land. This network also reinforced the performance of contextual information extraction into distinguishing between water areas and other land objects. To prove the validity of this proposed network, WLBANet was performed on the Water Land Dataset (WLD), which is also by this paper, and which contains water areas and other land objects categories. The results demonstrates that the proposed method has significant effectiveness.

Monitoring of clients living with HIV encompasses a specific array of activities that routinely check on various aspects of ART following its initiation depending on the availability of resources in that particular state, among other factors as per guidelines from the World Health Organisation. This is a significant practice as it promotes positive health outcomes for patients and efficient utilisation of ART regimens to reduce resistance to the medication – hence it is a measure to guard avoidable costs. It also forms a basis on which decisions are made from. It can be done clinically by assessing for signs e.g., skin rash and symptoms e.g., nausea and vomiting, checking vital organ function and measuring weights across all populations, or can be also be done by assessing specimens for their respective viral loads, white blood cell count, pregnancy status or other infections such as hepatitis B. There have not been any special indications required for one to be eligible for monitoring during ART in developing countries; all qualify for routine monitoring even though some may be more frequent than others in cases of comorbidities such as renal failure where medications can be attributed to exacerbating the condition.

The importance of cognitive health for academic success is well-recognized. However, longitudinal data regarding the associations of body fatness, physical fitness and cognition are relatively scarce and mixed. The purpose of this study was to investigate whether body fatness, cardiorespiratory fitness (CRF) and muscular fitness (MF) in preschool are associated with cognitive skills in first grade at school. 133 South Estonian children aged 6-7 years were recruited from 13 kindergartens and again at 7-8 years when they had entered school. Body fat percentage (BF%), CRF, MF as the mean of z-scores of relative handgrip strength and standing long jump tests, and cognitive skills (verbal, conceptual, perceptual) were studied. There were no associations between BF% and CRF in pre-school with perceptual, conceptual or verbal skills in school in boys and girls. In boys, higher MF in preschool predicted higher verbal skills (β = 0.293, p = 0.021) in school after adjustment for con-founders. Cognitive skills at baseline seemed predominantly predict later cognitive performance in school. In conclusion, higher muscular fitness in preschool predicted better verbal skills in first grade at school in boys but not in girls. Body fatness and cardiorespiratory fitness in preschool were not associated with cognitive skills in school.

We report the case of a 44-year-old woman who suffered gastric perforation after receiving bag-valve-mask (BVM) ventilation in the setting of alcohol intoxication. She had a markedly distended abdomen and cold, dusky lower extremities upon arrival to the emergency department. Imaging revealed a large volume intraabdominal accumulation of air with compression of the aorta. Needle decompression relieved symptoms of lower extremity arterial insufficiency. However, the patient quickly decompensated and subsequent exploratory laparotomy confirmed gastric rupture. A subtotal gastrectomy was performed but the patient ultimately passed on post-operative day two due to multi-organ dysfunction. Although BVM ventilation is commonplace in both the hospital and field, there is a lack of awareness of the serious complications of abdominal air accumulation due to their rareness in the adult population. Checking for abdominal distention during resuscitation ought to be routine in all patients. Signs of arterial insufficiency accompanying abdominal distention, once confirmed by diagnostic imaging that shows extensive pneumoperitoneum, are indicators of having reached a life-threatening level of air accumulation, calling for immediate needle decompression and exploratory laparotomy.

Oral squamous cell carcinoma (OSCC) is a highly prevalent and aggressive malignancy, with mortality rates that reach 60%, mainly due to an excessive diagnostic delay. MiRNAs, a class of crucial epigenetic gene-expression regulators, have emerged as potential diagnostic biomarkers, with >200 molecules reported to be dysregulated in OSCC. We had previously established an in silico methodology for the identification of the most disease-specific molecules by bridging genetics and epigenetics. Here, we identified the stage-specific miRNAs that govern the asymptomatic early stages of oral tumorigenesis by exploiting the reverse interplay between miRNA-levels and their target-genes’ expression. Incorporating gene expression data from our group’s experimental hamster model of sequential oral oncogenesis, we bioinformatically detected the miRNAs that simultaneously target/regulate >75% of the genes that are characteristically upregulated or downregulated in the consecutive stages of hyperplasia, dysplasia and early-invasion OSCC, while exhibiting the opposite expressional dysregulation in OSCC-derived tissue and/or saliva specimens. We found that all stages share the downregulation of miR-34a-5p, miR124-3p, and miR-125b-5p, while miR-1-3p is underexpressed in dysplasia and early-invasion. Malignant early-invasion stage is distinguished by the downregulation of miR-147a and the overexpression of miR-155-5p, miR-423-3p and miR-34a-5p. The identification of stage-specific miRNA molecules may facilitate their utilization as biomarkers for presymptomatic OSCC diagnosis.

Endothelin-1 (ET-1) is a potent vasoconstrictor produced by endothelial cells and cleared from circulating blood mainly in the pulmonary vasculature. In a healthy pulmonary circulation, the rate of local production of ET-1 is less than its rate of clearance. In the present study we aimed to investigate whether abnormal pulmonary circulatory handling of ET-1 relates to poor clinical outcomes in patients with COVID-19-induced ARDS. Plasma ET-1 levels were measured in 18 mechanically ventilated COVID-19-induced ARDS patients, with simultaneous central venous and systemic arterial blood sampling on Days 1 and 3 following ICU admission. Two age- and sex-matched non-COVID-19 control groups were also used [mechanically ventilated non-COVID-19 critically ill and ARDS patients]. On ICU admission, COVID-19-induced ARDS patients had higher systemic arterial and venous ET-1 levels compared to non-COVID-19 ARDS and critically ill patients (p< 0.05). The arterial:venous (A:V) ET-1 ratio was higher in the non-COVID-19 ARDS patients [1.06 (0.93-1.20)] compared to the other two groups (p< 0.05). The A:V ratio was 0.63 (0.49-1.02) in the COVID-19-induced ARDS patients and 0.79 (0.52-1.11) in the non-COVID-19 critically ill patients. On Day 3, the A:V ratio in all three groups was < 1. The COVID-19 patient group was then divided based on 28-day ICU mortality. Although arterial and venous levels did not differ, the A:V ratio was statistically significantly higher on ICU admission in the non-survivors [0.95 (0.78-1.34)] vs 0.57 (0.48-0.92), p= 0.027]. Measurement of ET-1 clearance via A:V plasma ET-1 levels on ICU admission may assist in predicting outcomes in COVID-19 critically ill patients.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) persists throughout the world with over 65 million registered cases of survivors with post-COVID-19 sequelae, also known as LongCOVID-19 (LongC). LongC survivors exhibit various symptoms that span multiple organ systems, including the nervous system. To search for neurological biomarkers of LongC, we investigated the soluble proteins present in the plasma and the proteins associated with plasma neuronal-enriched extracellular vesicles (nEVs) in 33 LongC patients with neurological impairment (nLongC), 12 COVID-19 survivors without any LongC symptoms (Cov), and 28 pre-COVID-19 healthy controls (HC). COVID-19 positive participants were infected from 2020-2022, not hospitalized, and were vaccinated or unvaccinated before infection. IL-1b was significantly increased in both nLongC and Cov and IL-8 elevated in only nLongC. Both brain-derived neurotropic factor and cortisol were significantly elevated in nLongC and Cov compared to HC. nEVs from people with nLongC had significantly elevated protein markers of neuronal dysfunction, including amyloid beta 42, pTau181 and TDP-43. This study shows chronic peripheral inflammation with increased stress after COVID-19 infection. Additionally, differentially expressed nEV neurodegenerative proteins were identified in people recovering from COVID-19 regardless of persistent symptoms.

Introduction: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection may cause acute respiratory failure but also remains responsible for many other pathologies, including electrolyte disorders. SARS-CoV-2 infection can cause dysfunction of the renin-angiotensin-aldosterone system and disrupt water hemostasis with thirst and appetite abnormalities. Dysnatremia affects prognosis and may be associated with mortality in patients admitted to SARS-CoV2 intensive care. Patients and Methods: The study included 209 patients admitted to the Intensive Care Unit between April 12, 2021, and March 1, 2022 who were over 18 years old and diagnosed with SARS-CoV-2 infection by clinical and thoracic tomography findings or with a positive reverse transcription polymerase chain reaction (RT-PCR) test result. The laboratory markers, treatment modalities, nutritional, and respiratory support also for outcome evaluation, length of stay in the ICU, total hospitalization duration, and mortality in ICU were recorded.The laboratory marker comparison was made admission with the final assessment performed before the time of mortality in ICU or discharge. Results: Inotropic requirements among patients were high which was reflected in the first-month mortality. Hypernatremia presence was associated with an increase in enteral support and inotropic support requirement and mortality. Hypernatremia was correlated with diabetes mellitus, chronic renal failure, and a longer duration under mechanical ventilation. Discussion: Hypernatremia was an important risk factor in ICU patients hospitalized for SARS-CoV-2 infection, which was also affected by the treatment regimens given itself. This complex relationship underlies the importance of proper electrolyte management, especially in patients who were under severe stress and organ failure.

Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

Background: During the stay in the neonatal intensive care unit, parents play a crucial role in the care of their infants. Recent studies reported a decrease in parental participation due to Coronavirus Disease (COVID-19) pandemic that determined restricted access policies in hospitals. The aim of this study is to describe the barriers to a good parents’ participation during the stay in the neonatal intensive care unit in the COVID-19 era. Methods: A quantitative observational study was carried out. Results: 270 parents participated in this study. Mothers’ participation in care seems to be higher as compared to fathers (p = 0.017). Parents who lived the birth of their first child reported a better level of participation in care when compared to those who lived the birth of their second born (p = 0.005). Parents of extremely preterm neonates reported a lower interaction with their infant if compared to parents of term newborns (p &lt; 0.001). Conclusions: Some more disadvantaged categories have reported lower scores: cultural and linguistic minorities, parents of multiple children and fathers. COVID-19 pandemic made several Family Centred Care activities not possible with a higher impact on those who benefited the most of these facilities. This study was prospectively registered by the IRB-CRRM of the University “G. d’Annunzio” Chieti-Pescara on the 23/01/2024 with registration number CRRM;2023_12_07_01.

The rapid advancements in satellite technology have led to a significant increase in high-resolution remote sensing (RS) images, necessitating advanced processing methods. Additionally, a patent analysis revealed a significant increase in deep learning and machine learning applications in remote sensing, highlighting the growing importance of these technologies. Therefore, this paper introduces the Kolmogorov-Arnold Network (KAN) model to remote sensing, aiming to enhance efficiency and performance in RS applications. We conducted several experiments to validate KAN's applicability, starting with the EuroSAT dataset, where we combined the KAN layer with multiple pretrained CNN models. The optimal performance was achieved with ConvNeXt, leading to the development of the KonvNeXt model. KonvNeXt was evaluated on the Optimal-31, AID, and Merced datasets for validation, and it achieved accuracies of 90.59%, 94.1%, and 98.1%, respectively. The model also showed fast processing speed, with the Optimal-31 and Merced datasets completed in 107.63 seconds each, while the bigger and more complicated AID dataset took 545.91 seconds. This result is meaningful since it achieved faster speeds and comparable accuracy compared to the existing study which utilized VIT and proved KonvNeXt's applicability for remote sensing classification tasks. Furthermore, we investigated the model's interpretability by utilizing Occlusion Sensitivity and by displaying the influential regions, it validated its potential use in a variety of domains including medical imaging and weather forecasting. This paper is meaningful in that it is the first use of KAN in remote sensing classification, proving its adaptability and efficiency.

The COVID-19 pandemic has triggered seismic shifts in how we work, and organizations behave. It has caused many organizations to transition from an office-centric culture to more flexible ways of working. This shift is necessitated by health conditions and the need for controls. It is also driven by the assumption that remote work or working from home offer a certain assurance of safety for employees against the threat of infection in highly vulnerable office conditions. The shift to remote work has so far been mainly experimental as most businesses continue to learn about what works and what doesn’t. There is also the assumption that all that matters for the efficient operability of a remote work regime is the availability and effectiveness of computing technologies and internet connectivity. Thus, once those supplies are in place remote work is expected to be fully functional and without problems. As learning continues about what works and what doesn’t, it has also become increasingly clear that beyond the threat of covid-19 and the relative safety that individual homes may offer, there are other vulnerabilities which are ignored or underestimated in the process. In most instances, the home environment of the employee, the conditions under which employees operate from home and the health and safety such environments provide (or not) are either ignored or underestimated in discussions around remote work practices. This paper highlights remote work as an emergent practice while exploring associated, but ignored, health and safety issues in employee homes.

The objective of image super-resolution is to reconstruct a high-resolution (HR) image with the prior knowledge from one or several low-resolution (LR) images. However, in the real world, due to the limited complementary information, the performance of both single-frame and multi-frame super-resolution reconstruction degrades rapidly as the magnification increases. In this paper, we propose a novel two-step image super resolution method concatenating multi-frame super-resolution (MFSR) with single-frame super-resolution (SFSR), to progressively upsample images to the desired resolution. The proposed method consisting of an L0-norm constrained reconstruction scheme and an enhanced residual back-projection network, integrating the flexibility of the variational model-based method and the feature learning capacity of the deep learning-based method. To verify the effectiveness of the proposed algorithm, extensive experiments with both simulated and real world sequences were implemented. The experimental results show that the proposed method yields superior performance in both objective and perceptual quality measurements, compared to the baseline super-resolution algorithms in the cascade model. In addition, the experiment indicates that this cascade model can be robustly applied to different SFSR and MFSR methods.

Ecological city is currently a hot topic in urban planning research. How to balance urban development and ecological environment protection has become a focus and difficulty of research. Traditional urban planning is mainly based on experience, but its disadvantage is that it is easy to overlook key geographical factors such as terrain and vegetation, and cannot fully reflect the actual spatial characteristics of the city. Therefore, this article applied the combination of urban and rural planning and environmental remote sensing technology to urban planning and design, obtaining a massive amount of data. Through the actual analysis of Langfang, this paper monitored the vegetation, water, land and landscape data of Langfang through environmental remote sensing technology. By using these data to identify existing problems, this article proposed reasonable planning for the problems, in order to achieve the effective goal of ecological city planning and design. It provided a more accurate analysis of urban structure, including urban planning and urban ecological landscape planning. Among them, ecological landscape planning includes renovating ecological embankments, protecting ecological green belts around the city, and creating characteristic landscape areas, thereby providing more scientific basis for urban planning and design, making urban planning and design more reasonable and scientific. This paper investigated the planned Langfang City, and the average errors of vegetation, soil, water quality, and landscape data obtained from traditional field surveys were 0.35, 0.33, 0.34, and 0.31, respectively. The average errors of remote sensing technology in obtaining vegetation, soil, water quality, and landscape data were 0.16, 0.15, 0.17, and 0.15, respectively. The total suspended solids content of waterscape 1-10 before planning was 5.51mg/L and 7.41mg/L, respectively. After planning, the total suspended solids content of waterscape 1-10 was 3.60mg/L and 4.47mg/L, respectively. From this, it can be seen that the error in obtaining data after planning has decreased, and the total suspended solids content has also decreased.