Search

Mutations in the BRCA1 and/or BRCA2 genes (BRCAm) increase the risk of developing breast cancer (BC) and are found in ~5% of unselected patients with the disease. BC resulting from a germline BRCAm (gBRCAm) has distinct clinical characteristics along with increased sensitivity to DNA-damaging agents such as poly(ADP-ribose) polymerase (PARP) inhibitors and platinum-based chemotherapies, and potentially decreased sensitivity to cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors. Given the evolving treatment landscape for gBRCAm BC in early and advanced disease settings, timely determination of gBRCAm status is fundamental to facilitate the most effective treatment strategy for patients. However, many patients with gBRCAm are not identified due to suboptimal referral rates and/or a low uptake of genetic testing. We discuss current evidence for a differential response to treatment in patients with gBRCAm in early and advanced BC settings, including outcomes with PARP inhibitors, platinum-based chemotherapies, and CDK4/6 inhibitors, as well as ongoing treatment innovations and the potential of these treatment approaches. Current genetic testing strategies are also examined, including the latest guidelines on who and when to test for gBRCAm, as well as challenges to testing and how these may be overcome. [ABSTRACT FROM AUTHOR]

Covid-19 posed little danger to children. Nevertheless, the South African government imposed lockdown measures that impeded children's education, play and food. Schools were closed, feeding schemes were halted and organised sports were banned. In this study of South African children's experience during the 2020–22 pandemic, we use the capabilities approach, particularly Nussbaum's ten capabilities, to assess how the lockdown measures affected their development. The one-dimensional nature of the government response was evident in its focus on physical health and safeguarding adults and the health system, at the expense of children's well-being. Children were masked and their voices were not heard. Despite being far less at risk of illness or death than adults, children and young people were disproportionately affected by government regulations. Children from low-income environments were particularly severely affected. [ABSTRACT FROM AUTHOR]

Anterior cruciate ligament reconstruction (ACLR) is one of the more common procedures performed worldwide and perhaps the most widely studied construct in orthopedic literature. Interference screws are reliable and frequently used for ligament reconstruction, providing rigid fixation and facilitates graft incorporation allowing for the physiologic loads of early rehabilitation. The purpose of this study was to determine the bio-integration profile and quality of soft tissue graft when using mineral fiber-reinforced screws in an ACLR interference model. Nine sheep underwent ACLR using harvested autologous tendon graft fixated with 4.75 mm screws made of continuous mineral fibers. Histopathology and imaging evaluation at 28, 52, 104, 132-weeks (W) demonstrated mesenchymal tissue ingrowth into implant wall at 28 W, which increased at 52 W and peaked at 104 W. At 132 W, implants fully replaced by newly remodeled bone. Graft cellularity was evident at 28 W and continued to increase through 132 W as the tendon ossified at sites of bone contact. Pro-healing M2-macrophages and giant cells remained infrequent, with minor increases between 52 W and 104 W, attributed to expected phagocytic response. Pro-inflammatory cells (i.e., M1-macrophages, polymorphonuclears) were absent through the entire study course. In conclusion, bio-integrative screws provide secure soft tissue fixation with replacement by bone demonstrating graft cellularization over time. [ABSTRACT FROM AUTHOR]

Introduction: Lack of knowledge of Early Intervention (EI) is a barrier to developmental delay (DD) management. We aimed to examine the feasibility of measuring pediatricians' knowledge of EI, determine the distribution of EI knowledge, and determine factors associated with increased EI knowledge. Methods: We conducted an exploratory cross-sectional study with a convenience sample from a local American Academy of Pediatrics chapter to administer a survey with 10 multiple-choice questions regarding the EI referral process, evaluation process, eligibility criteria and fee structure. Our outcome variable was a composite score of these 10 multiple-choice questions, Total Knowledge Score (TKS). Our predictor variables included physician characteristics (i.e., years of experience, percentage of patients seen with private insurance, receipt of EI training in the last 5 years) and practice characteristics (i.e., medical home status). Results: Our sample consisted of a total of 194 pediatric residents/attendings. Multivariable regression demonstrated seeing ≥ 50% patients who were privately insured, increased experience, and receiving training in the last 5 years were associated with higher TKS. Discussion: We were able to quantitatively evaluate physician's knowledge of EI and demonstrated that seeing a majority of privately insured patients, having more experience, and having received formal EI training in the last 5 years were associated with higher EI knowledge. This disproportionate distribution of EI knowledge has the potential to contribute to disparities in the management of DD. This may indicate that medical institutions, where physicians see a small percent of privately insured patients, need to hire more experienced physicians, and provide routine EI training. Significance: Physician knowledge of the Early Intervention process has been described as a potential barrier to the management of children with developmental delay. Studies have demonstrated that physician knowledge of this process has the potential to impact physician referral rates and parents' willingness to carry out a physician referral to completion. Our study is the first to quantitatively evaluate physicians' knowledge of the Early Intervention process and determine the physician factors that are associated with knowledge. Additionally, we examined whether the disproportionate distribution of physician knowledge has the potential to contribute to disparities described in the literature for developmental delay management. [ABSTRACT FROM AUTHOR]

Objective: During the advent of laparoscopy, surgeons directly explored the abdominal cavity with a telescope-like device through a small incision. Since then, numerous technological advances have transformed minimally invasive surgery (MIS). Yet, in our wireless world, various devices crowd the surgical field, with long wires and light sources posing fall and fire risks. The primary objective of this study was to analyze the first reported human use of a novel wireless laparoscopy system or WLS (ArthroFree™, Lazurite®, Cleveland, Ohio). Methods: The utility and convenience of the WLS was assessed via two avenues: (1) by analyzing surgical outcomes from first human use and (2) by surveying healthcare professionals regarding its quality and utility. Results: Eighteen patients (mean age 44.2, 83.3% female, mean BMI 33.4) underwent operations with the WLS. Operations included gynecologic and general surgical procedures. There were no intraoperative or postoperative complications, and no conversions to traditional laparoscopy or laparotomy. Mean operating time was 71.94 ± 20.41 min, and estimated blood loss was minimal. Survey results revealed varied individual experiences. Strengths included adequate illumination, improved ergonomics, and simplicity of setup and ease of operation. One respondent criticized the image resolution. Feedback indicated an overall positive impact, and 67% of respondents supported inclusion of the device at their facility. Moreover, its deployment in resource-limited settings abroad has demonstrated its efficacy in global surgery, indicating its potential in various healthcare environments. Conclusions: This is the first reported human use of a novel WLS. Clinical results supported efficiency and safety of the technology. The successful deployment of the WLS in diverse surgical environments, including resource-limited settings, highlights its potential as a universally adaptable tool in global surgery. This report represents a strong first step toward a wireless operating room with the promise of redefining surgical standards as well as bridging gaps in surgical care worldwide. [ABSTRACT FROM AUTHOR]

Lizard species of wide distribution can show differences in morphology and many other characteristics, in particular in the scutelation. In this study, we analyzed the variation of 22 meristic characters between sexes and among populations of Sceloporus variabilis from the state of Hidalgo in central Mexico. The variables such as dorsal scales, scales around the body, ventral scales, femoral pores, interfemoral scales, and lamellae of the fourth digit of the hindlimbs were different among populations; the population of San Pablo Tetlapayac presented the highest average values in these variables. A positive and significant relationship between snout–vent length and the number of ventral scales was found only in the females of San Pablo Tetlapayac and Santa Catarina. The variations recorded in the present study indicate an effect of environmental variation in the pattern of the number of scales, and suggest that both environmental conditions, such as precipitation and temperature, and ecological conditions, such as substrate or microhabitats, may be influencing differences in the number and size of scales among populations. Further studies on physiology and ecomorphology are necessary to determine the direction of variations in scutelation between sexes and populations. [ABSTRACT FROM AUTHOR]

The aim of this paper is to answer one of the open questions raised in Strobin [Qual. Theory Dyn. Syst. 19, 85 (2020)] of whether there exists an invariant (Hutchinson) measure for generalized iterated function systems of any order, consisting of a countably infinite number of maps. Our results likewise strengthen those obtained in Secelean [Mediterr. J. Math. 11, 361–372 (2014)], where the existence of the invariant measure is ascertained only for the case of generalized iterated function systems of order 2, consisting of functions which satisfy a particular contractive condition. [ABSTRACT FROM AUTHOR]

High-density stress can lead to dysbiotic microbiota, affecting the organism's metabolic, and protective functions. Agavin is a fructan with prebiotic properties that regulate the gut microbiota by promoting the growth of beneficial bacteria. This study evaluated the effect of agavin on the gut microbiota using Next-Generation Sequencing (NGS) and its correlation with the growth parameters. Four groups of fish were fed different diets: a control diet (negative and positive control), without agavin supplementation, and two experimental diets supplemented with agavin at 20 g kg−1 and 40 g kg−1. Nile tilapias (1.04 g ± 0.01 g) were fed for 110 days. After 90 days of feeding, fish were subjected to high-density stress (63 kg m−3) for 20 days, except for the negative control. NGS detected 1579 different operational taxonomic units in the samples. In the correlation analysis of growth parameters, the families Vibrionaceae and Methyloligillaceae showed a positive correlation with fish growth parameters, these results may serve to know the relation of agavin and microbiota on the growth performance, as well as the metabolic activities of families in tilapia. Furthermore, high-density stress and agavin supplementation modify the gut microbiota in tilapia. At a low-density, supplementation with 20 g kg−1 agavin promoted the growth of the potentially beneficial families Sphingomonadaceae, Oxalobacteriaceae, and Chitinophagaceae; at high densities, reduced the abundance of pathogenic families (Vibrionaceae and Aeromonadaceae). These results suggest that, under stress conditions, agavin can stimulate the growth of potentially beneficial bacteria and reduce the growth of potentially pathogenic bacteria, suggesting its potential use as a prebiotic in aquaculture. [ABSTRACT FROM AUTHOR]

We consider a Galton–Watson tree where each node is marked independently of each other with a probability depending on its out-degree. Using a penalization method, we exhibit new martingales where the number of marks up to level n - 1 appears. Then, we use these martingales to define new probability measures via a Girsanov transformation and describe the distribution of the random trees under these new probabilities. [ABSTRACT FROM AUTHOR]

Introduction: Obesity is a global health issue that significantly increases morbidity and mortality when the Body Mass Index (BMI) reaches values ≥ 50. While metabolic and bariatric surgery (MBS) is the most effective treatment for severe obesity, it carries risks. Robotic surgery is promising but not extensively studied in Mexico, which presents an opportunity for research at a National Hospital with an academic program. Methods: This retrospective study reviewed 44 patients who underwent robotic MBS using the da Vinci surgical system from January 2018 to August 2023 at Centro Médico Nacional 20 de Noviembre, ISSSTE. Data collected included surgery type, duration, complications, and weight loss metrics over 54 months post-operatively. Results: The study involved 44 patients with severe obesity including BMI ≥ 50–59.9 kg/m2 for group 1 and BMI ≥ 60 kg/m2 for group 2. The average initial BMI was 54.7 kg/m2 for group 1 and 68 kg/m2 for group 2. The average operative times for group 1 were 10.09 min for docking, 86.23 min for robotic console time, and 95.73 min for total intraoperative time. Group 2 had average times of 9.80 min for docking, 82.4 min for robotic console time, and 92.2 min for total intraoperative time. Follow-up showed significant weight loss initially, with weight recurrence after 24 months due to different factors. No serious complications or mortality were observed. Conclusion: Robotic MBS at a national academic medical center in Mexico shows promising outcomes for patients with BMI ≥ 50–59.9 and BMI ≥ 60, with significant weight and BMI improvements at 54 month follow-up. Further studies with larger cohorts and longer follow-up are needed to strengthen these findings. [ABSTRACT FROM AUTHOR]

Background: Aging results in changes in resting state functional connectivity within key networks associated with cognition. Cardiovascular function, physical activity, sleep, and body composition may influence these age-related changes in the brain. Better understanding these associations may help clarify mechanisms related to brain aging and guide interventional strategies to reduce these changes. Methods: In a large (n = 398) sample of healthy community dwelling older adults that were part of a larger interventional trial, we conducted cross sectional analyses of baseline data to examine the relationships between several modifiable behaviors and resting state functional connectivity within networks associated with cognition and emotional regulation. Additionally, maximal aerobic capacity, physical activity, quality of sleep, and body composition were assessed. Associations were explored both through correlation and best vs. worst group comparisons. Results: Greater cardiovascular fitness, but not larger quantity of daily physical activity, was associated with greater functional connectivity within the Default Mode (p = 0.008 r = 0.142) and Salience Networks (p = 0.005, r = 0.152). Better sleep (greater efficiency and fewer nighttime awakenings) was also associated with greater functional connectivity within multiple networks including the Default Mode, Executive Control, and Salience Networks. When the population was split into quartiles, the highest body fat group displayed higher functional connectivity in the Dorsal Attentional Network compared to the lowest body fat percentage (p = 0.011; 95% CI − 0.0172 to − 0.0023). Conclusion: These findings confirm and expand on previous work indicating that, in older adults, higher levels of cardiovascular fitness and better sleep quality, but not greater quantity of physical activity, total sleep time, or lower body fat percentage are associated with increased functional connectivity within key resting state networks. [ABSTRACT FROM AUTHOR]

The in vitro macrophage response on Aloe vera-blended collagen-chitosan (COL-CS-AV) scaffold was studied using Murine Raw 264 macrophage cells. The cells were cultured on 1-cm2 scaffolds in a standard condition; at a predefined period, the cultured constructs were subjected to various experimental studies. The cytocompatibility of the constructs was assessed by dead/live examination by acridine orange/ethidium bromide (AO/EB) fluorescent dyes, and the live cells were quantified by MTT assay. The morphology of macrophages was determined using scanning electron microscopy (SEM). The cellular apoptosis and necrosis were examined by flow cytometer using annexin V FITC conjugate and propidium iodide (PI) fluorescent probes. The cellular total antioxidant level was estimated from the cell lysate of macrophages cultured on the scaffold construct. Matrix metalloproteinase-9 (MMP-9) activity was assessed by the gelatinolytic property of cell lysate by zymography technique. The expression of pro-inflammatory markers TNFα and IL-6 was studied by western blot analysis using its specific antibody. The COL-CS-AV scaffold showed promising results over the collagen-chitosan. Overall, the increased biological property with less activation of macrophage response by downregulating the TNFα and IL-6 was observed in the Aloe vera-blended scaffold construct. In support of this, the active form of MMP-9 disappeared in earlier days than without Aloe vera-blended scaffold. Through these encouraging results, we conclude that the COL-CS-AV scaffold may be used as a better solution for tissue engineering applications. [ABSTRACT FROM AUTHOR]

A novel ultramarine blue single crystal of bis[4-(2-aminoethyl) morpholine-K2 N, N′] diaquanickel(II) dichloride (AEMNC) was synthesized using a slow-evaporation solution-growth technique. Single-crystal X-ray diffraction analysis (XRD) confirmed the monoclinic structure, with unit-cell parameters of a = 8.6495 Å, b = 8.6593 Å, c = 13.1882 Å, and β = 107.415°. The molecular structure consists of one Ni2⁺ ion coordinated with two 4-(2-aminoethyl) morpholine ligands and two water molecules. The FTIR analysis verified the presence of key functional groups, while UV–Vis studies revealed a cutoff wavelength of 249 nm and an optical band gap of 4.5 eV, highlighting its potential for optical applications. Thermal analysis indicated that AEMNC is stable up to 115 °C, and the Vickers hardness number of 113.3 kg/mm2 confirmed its mechanical robustness. Dielectric studies showed a high dielectric constant at low frequencies, decreasing with frequency, indicating space-charge polarization. Most notably, Z-scan measurements demonstrated a significant third-order nonlinear optical susceptibility (χ3) of 6.54 × 10⁻11 esu, surpassing that of well-known materials like potassium hydrogen phosphate (KDP). These findings establish AEMNC as a promising candidate for nonlinear optical applications, with superior mechanical and optical properties. [ABSTRACT FROM AUTHOR]

Commonly comprised of cyanobacteria, algae, bacteria and fungi, hypolithic communities inhabit the underside of cobblestones and pebbles in diverse desert biomes. Notwithstanding their abundance and widespread geographic distribution and their growth in the driest regions on Earth, the source of water supporting these communities remains puzzling. Adding to the puzzle is the presence of cyanobacteria that require liquid water for net photosynthesis. Here we report results from six-year monitoring in the Negev Desert (with average annual precipitation of ~ 90 mm) during which periodical measurements of the water content of cobblestone undersides were carried out. We show that while no effective wetting took place following direct rain, dew or fog, high vapor flux, induced by a sharp temperature gradient, took place from the wet subsurface soil after rain, resulting in wet-dry cycles and wetting of the cobblestone undersides. Up to 12 wet-dry cycles were recorded following a single rain event, which resulted in vapor condensation on the undersides of the cobblestones, with the daily wet phase lasting for several hours during daylight. This 'concealed mechanism' expands the distribution of photoautotrophic organisms into hostile regions where the abiotic conditions limit their growth, and provides the driving force for important evolutionary processes not yet fully explored. [ABSTRACT FROM AUTHOR]

The study explores the use of surface plasmon resonance (SPR)-based fiber optic sensors, coated with alternating layers of metal and semiconductor sulfide materials, for detecting methanol adulteration of ethanol. Gold, silver, and copper are chosen as the metal layers for the excitation of SPR, with cadmium sulfide (CdS)/zinc sulfide (ZnS) as the semiconductor sulfide materials. Sensors with varying thicknesses of metal layers, i.e. 40 nm, 45 nm and 50 nm, are considered while the thickness of the material varies from 0nm (only the metal layer) to 3 nm in 0.5 nm increments. The sensor with a 40 nm gold layer and 3 nm CdS layer showed a maximum sensitivity of 1.47 nm/vol.% of methanol adulteration in ethanol. Apart from sensitivity, the figure of merit (FOM) and detection accuracy (DA) of all the sensors are computed and compared. Multiple machine learning approaches, such as logistic regression (LR), K-nearest neighbours (KNN), support vector machine (SVM), linear discriminant analysis (LDA), random forest (RF), and decision tree (DT), with the stratified K-fold cross-validation method of train/test split, are used for the detection of methanol adulteration of ethanol using the sensor outputs. The CV splits and the hyperparameters are tuned to achieve maximum performance for the models. DT achieves an accuracy of 91% of prediction with 87.1% of F1_score at max_depth=5 and CV=7, when trained with the outputs of all the sensors, and KNN shows 92% accuracy of prediction with 86.6% F1_Score at n_neighbours= 15 and CV=10 for the selected sensors. [ABSTRACT FROM AUTHOR]

Introduction: Whole gut transit scintigraphy (WGTS) can detect delayed colonic transit (CT), different types of CT delays, and assess upper GI tract transit. Aim: To delineate the frequency of different types of CT patterns in patients with chronic constipation (CC), determine the relationship between these CT patterns and upper GI tract transit abnormalities, and assess how symptoms relate to different colonic transit patterns. Methods: Retrospective review of patients who had WGTS for CC. Patients completed a modified PAGI-SYM questionnaire to assess symptoms. Patients ingested a standard solid (Tc-99m egg sandwich)–liquid (In-111 water) meal to assess solid meal gastric emptying (GE), liquid GE, small bowel transit (SBT), and geometric center of colonic activity at 24, 48, and 72h. Results: One hundred and eighty six patients underwent WGTS. Main symptoms were constipation (41%), nausea (24%), and bloating (22%). CT assessment showed 32% of patients had normal transit, 31% colonic inertia (CI), 28% functional rectosigmoid obstruction (FRS0), and 9% generalized slow colonic transit (GSCT). GE was delayed in 36%; more commonly in CI and FRSO. SBT was delayed in 19%; more commonly in GSCT and CI. Patients with CI had less bowel movements per week whereas patients with normal CT had more bm/week. Conclusions: In this series of patients with symptomatic constipation, WGTS assessment showed delayed colonic transit in 68% of patients, with 31% having colonic inertia, 28% a functional rectosigmoid obstruction pattern, and 9% generalized delay in colonic transit. Abnormalities in GE and SBT were present in 36 and 19%. WGTS is helpful to document delayed colonic transit (CT), assess the pattern of the delay in CT, and determine if there are upper GI transit abnormalities. [ABSTRACT FROM AUTHOR]

Otomycosis is a commonly encountered otological disorder in otorhinolaryngology practice. It has several predisposing factors such as habitual use of cotton buds, water in the ear, hot humid atmospheric condition or high temperature. Diagnosis of otomycosis frequently relies on the patient's history, otoscopic examination and ascertained clinical features and therefore posing diagnostic and therapeutic challenges. Data on otomycosis in Tanzania are scarce. A hospital based descriptive cross-sectional study was conducted at a private hospital from January to June 2022 in Dar es Salaam, Tanzania. All the clinically diagnosed cases were enrolled in the study with typical symptoms and characteristic fungal debris in the external auditory canal. Data was collected using semi-structured questionnaires and analyzed using Statistical Package for Social Sciences version 23. A total of 250 patients were recruited in this study. Majority were females, 153(81.2%) while males were 97(38.8%). Otomycosis was found to be predominantly unilateral in 203 (81.2%) patients. The commonest presenting complaint was ear itching (94.0%) followed by earache (78.6%), hearing loss (75.6%), ear fullness (74.4%), ear discharge (61.2%) and ringing sensation (14.0%). Based on the type of fungal debris on Otoendoscopy, whitish debris was more predominant in 191 (76.4%) patients followed by yellowish debris, 37 (14.8%), blackish debris, 15 (6.0%) and mixed (whitish-black) debris in 7 (2.8%) patients. The commonest risk factor was earbud use (40.8%) and the least one was comorbid conditions (4.4%). Females were more affected by otomycosis. The commonest otological complaint was ear itching while the least one was ringing sensation. Unilateral presentation of otomycosis predominated and the left ear was more affected. The commonest type of fungal debris was whitish debris and the least one was the mixed type (whitish-black). The commonest risk factor for otomycosis was earbud use and the least was comorbid conditions. [ABSTRACT FROM AUTHOR]

Multiple myeloma (MM) has witnessed significant therapeutic advancements through the introduction of proteasome inhibitors and immunomodulators, leading to improved treatment outcomes. However, infections remain a formidable challenge for MM patients. The objective of our research is to investigate the factors that can forecast infection risk in MM patients. In pursuit of this, we conducted a thorough retrospective examination of medical records from Kidwai Memorial Institute of Oncology, Bangalore, involving 145 MM patients. Out of the 145 patients analyzed, almost half (47.5%; n = 69) encountered at least one infection during the course of their disease. Respiratory-related infections were the most prevalent (76.2%), followed by urinary tract infections (10%) and instances of diarrhea (8.8%). Notably, gram-positive bacteria constituted the majority of identified causative organisms, accounting for 48.2% of isolated pathogens, while gram-negative bacteria comprised 37.9% of the isolated organisms. Most infections were observed either at the time of presentation or during the first month (40.5%). Overall mortality during the study period was 4.8% (n = 7). Infections contributed to 57.1% (n = 4 out of 7 deaths) of the mortality. Moreover, patients in advanced stages exhibited an elevated risk of infection at presentation. Infections remain a major cause of morbidity and mortality in patients with MM. Nearly half of MM patients experience an episode of infection during treatment.Gram-positive bacteria are the most common pathogens, with respiratory infections being the most common foci. Prompt identification and treatment of infections is essential, but can be challenging due to atypical or absent symptoms. Antibacterial prophylaxis is an important preventive strategy, but further research is needed to develop innovative approaches to infection prevention and targeted therapeutic interventions. We must strive to develop innovative approaches to infection prevention in MM patients. Also we need to advance our understanding of the interplay between infections and MM to improve quality of care and outcomes for these individuals. By addressing these challenges, we can aspire to offer MM patients a brighter and healthier future. [ABSTRACT FROM AUTHOR]

Globally, overall survival (OS) of older patients with AML continues to be suboptimal with very little data from India. In a multicenter registry analysis, we evaluated 712 patients with AML older than 55 years. Only 323 (45.3%) underwent further treatment, of which 239 (74%) received HMAs, and 60 (18%) received intensive chemotherapy (IC). CR was documented in 39% of those receiving IC and 42% after HMAs. Overall, 100 (31%) patients died within 60 days of diagnosis, most commonly due to progressive disease (47%) or infections (30%). After a median follow-up of 176 days, 228 (76%) of patients had discontinued treatment. At one year from diagnosis, 211 (65%) patients had died, and the median OS was 186 days (IQR, 137–234). Only 12 (3.7%) patients underwent stem cell transplantation. Survival was significantly lower for those older than 60 years (p < 0.001). Patients who died had a higher median age (p =.027) and baseline WBC counts (p =.006). Our data highlights suboptimal outcomes in older AML patients, which are evident from 55 years of age onwards, making it necessary to evaluate HMA and targeted agent combinations along with novel consolidation strategies to improve survival in this high-risk population. [ABSTRACT FROM AUTHOR]

Background: Inflammatory Bowel Disease (IBD) is an early onset condition that affects individuals of all ages. Approximately 15%–25% of patients present before the age of 20 years, with peak onset occurring during adolescence. Aims: To evaluate transition readiness among adolescents diagnosed with IBD and identify barriers to transition. Methods: We conducted a cross-sectional study of patients with IBD aged 12–21 years. Patients were stratified by age into three groups: A (12–14 years), B (14–17 years), and C (17 + years). Patients were asked to complete a questionnaire which assessed patient knowledge in three areas of transition: 'Taking Charge,' 'My Health,' and 'Using Health Care.' Fisher's Exact and Chi-Square tests were used to evaluate the associations between age and transition readiness. Results: A total of 127 participants (68 males and 59 females) with a mean age of 16.14 years were included. Transition readiness increased with age from 60.7% in Group A to 63.2% and 77.9% in Groups B and C, respectively (p < 0.001). Patient confidence and the importance of transition increased with age, with means of 5.51, 6.17, and 6.94 in Groups A, B, and C (p = 0.02). Patient-reported knowledge of their health condition was > 70%, with no statistical differences between the groups (p = 0.65). Patient knowledge regarding 'Using Health Care' increased from 52% in Group A to 79% in Group C (p < 0.001). The greatest barriers to transitioning were carrying health information for Group A (100%) and obtaining provider referrals for Groups B (75%) and C (51%). Conclusion: This study demonstrated that transition readiness increases with age in adolescents with IBD. [ABSTRACT FROM AUTHOR]

The response of mesozooplankton is critical in assessing the health of an estuarine ecosystem. Reports on the spatial and temporal dynamics of mesozooplankton community in estuarine and backwaters of the Southern parts of India are scanty. In this scenario, we appraised the community structure of mesozooplankton and their spatio-temporal dynamics based on various multivariate statistical assessments. A total of 31 taxa were identified and the abundance was principally dominated by Copepoda followed by Luciferidae during three sampling seasons. The most abundant species were: Paracalanus parvus parvus, Pseudodiaptomus aurivillii, Temora stylifera, and Pseudodiaptomus serricaudatus. Canonical correspondence analysis and Spearman's correlation coefficients underlined that salinity, turbidity, conductivity, temperature, dissolved oxygen, chlorophyll a (Chl-a), and nutrients were the principal environmental variables strongly linked with mesozooplankton dynamics in Munroe Island. The highest abundance of mesozooplankton was recorded in MoN (monsoon), followed by PrM (pre-monsoon), and PoM (post-monsoon). Hierarchical clustering confirmed that the grouping of sampling stations is based on the estuarine and freshwater influences on mesozooplankton abundance. During the entire investigation, various ecological indices were observed in good condition. Moreover, the optimum environmental conditions during the PoM season are marked with the highest indices values. Overall, multivariate investigations undoubtedly proved the suitability of mesozooplankton communities as potential bioindicators for spatial and seasonal ecological assessments. Our investigation emphasizes the high assemblages of mesozooplankton and their responses to various environmental variables and highlights the significance of long-term ecological monitoring in a threatened ecosystem like Munroe Island. [ABSTRACT FROM AUTHOR]

Introduction: Functional popliteal artery entrapment syndrome is a subtype of popliteal artery entrapment syndrome (PAES) without vascular disease or musculotendinous anomaly behind the knee. Symptoms are induced by popliteal artery extrinsic compression, leading to calf pain during lower limbs exercise. Non-invasive tests are still required to improve the diagnostic management of functional PAES. Exercise transcutaneous oxygen pressure (Ex-tcpO2) is of interest to provide objective arguments for the presence of regional blood flow impairment. Objectives: The aim of the study was to analyze whether Ex-tcpO2 could serve as a non-invasive technique for detecting ischemia resulting from PAES. Methods: Patients with suspected PAES were recruited between 2017 and 2020. The diagnosis was confirmed or rejected, according to the surgical decision based on our diagnosis management involving a multidisciplinary team. Each patient underwent Ex-tcpO2 with specific maneuvers. The decrease from rest of oxygen pressure (DROP) index served for the interpretation of exercise results. Results: Sixty-five legs with suspected PAES were recruited. Diagnosis was confirmed in 34 (52.3%) and rejected in 32 (47.7%). The average DROP values found in confirmed and rejected group at left leg were − 21.6 ± 15.4 mmHg and − 10.9 ± 11.1 mmHg, respectively (p for Mann–Whitney 0.004), and − 15.8 ± 11 mmHg and − 11.1 ± 7.5 mmHg, respectively, at right leg (p = 0.088). Ex-tcpO2 sensitivity and specificity were 52.9% and 78.1%, respectively. Conclusion: Ex-tcpO2 is an original non-invasive investigation for patients with claudication of doubtful arterial origin. The sensitivity and specificity are 52.9% and 78.1% in functional PAES diagnosis using 15 mmHg as threshold to detect ischemia during tiptoeing elevations. [ABSTRACT FROM AUTHOR]

Aims/Hypothesis: Post-bariatric hypoglycemia (PBH) is caused by postprandial hyperinsulinemia, due to anatomical alterations and changes in post-prandial metabolism after bariatric surgery. The mechanisms underlying the failing regulatory and compensatory systems are unclear. In this study, we investigated the differences in post-prandial hormones and metabolic profiles between patients with and without PBH. Methods: We performed a mixed meal test (MMT) in 63 subjects before and 1 year after Roux-en-Y gastric bypass (RYGB) surgery. Blood was withdrawn at 0, 10, 20, 30, 60, and 120 min after ingestion of a standardized meal. Glucose, insulin, GLP-1, FGF-19, and FGF-21 were measured and untargeted metabolomics analysis was performed on blood plasma to analyze which hormonal and metabolic systems were altered between patients with and without PBH. Results: Out of 63, a total of 21 subjects (33%) subjects developed PBH (glucose < 3.1 mmol/L) after surgery. Decreased glucose and increased insulin excursions during MMT were seen in PBH (p < 0.05). GLP-1, FGF-19, and FGF-21 were elevated after surgery (p < 0.001), but did not differ between PBH and non-PBH groups. We identified 20 metabolites possibly involved in carbohydrate metabolism which differed between the two groups, including increased carnitine and acylcholines in PBH. Conclusion: Overall, 33% of the subjects developed PBH 1 year after RYGB surgery. While GLP-1, FGF-19, and FGF-21 were similar in PBH and non-PBH patients, metabolomics analysis revealed changes in carnitine and acyclcholines that are possibly involved in energy metabolism, which may play a role in the occurrence of PBH. [ABSTRACT FROM AUTHOR]

Purpose: Cancer registries offer an avenue to identify cancer clusters across large populations and efficiently examine potential environmental harms affecting cancer. The role of known metal carcinogens (i.e., cadmium, arsenic, nickel, chromium(VI)) in breast and colorectal carcinogenesis is largely unknown. Historically marginalized communities are disproportionately exposed to metals, which could explain cancer disparities. We examined area-based metal exposures and odds of residing in breast and colorectal cancer hotspots utilizing state tumor registry data and described the characteristics of those living in heavy metal-associated cancer hotspots. Methods: Breast and colorectal cancer hotspots were mapped across Kentucky, and area-based ambient metal exposure to cadmium, arsenic, nickel, and chromium(VI) were extracted from the 2014 National Air Toxics Assessment for Kentucky census tracts. Among colorectal cancer (n = 56,598) and female breast cancer (n = 77,637) diagnoses in Kentucky, we used logistic regression models to estimate Odds Ratios (ORs) and 95% Confidence Intervals to examine the association between ambient metal concentrations and odds of residing in cancer hotspots, independent of individual-level and neighborhood risk factors. Results: Higher ambient metal exposures were associated with higher odds of residing in breast and colorectal cancer hotspots. Populations in breast and colorectal cancer hotspots were disproportionately Black and had markers of lower socioeconomic status. Furthermore, adjusting for age, race, tobacco and neighborhood factors did not significantly change cancer hotspot ORs for ambient metal exposures analyzed. Conclusion: Ambient metal exposures contribute to higher cancer rates in certain geographic areas that are largely composed of marginalized populations. Individual-level assessments of metal exposures and cancer disparities are needed. [ABSTRACT FROM AUTHOR]

Polymer nanocomposites have become a quickly growing area of study, fueling the advancement of sophisticated materials in recent years. Adding nanoparticles to a polymer matrix greatly improves the characteristics of the resulting nanocomposites. These improvements play a crucial role in a wide range of applications, including dental restorations, biosensors, food packaging, electronic devices, and various biomedical uses. This review offers a thorough examination of various techniques for synthesizing polymer-based nanocomposites, such as melt intercalation, sol–gel processes, in situ polymerization, and emulsion techniques. Moreover, it is essential to characterize these nanocomposites to comprehend their mechanical properties, structure, and morphology. Methods like atomic force microscopy (AFM), X-ray diffraction (XRD), scanning electron microscopy (SEM), and transmission electron microscopy (TEM) are widely utilized for the examination of these attributes. The thermal properties of polymer nanocomposites are highly interesting, along with their mechanical properties. Differential Scanning Calorimetry (DSC), Thermogravimetric Analysis (TGA), and Fourier Transform Infrared Spectroscopy (FTIR) are used to assess these thermal and chemical characteristics. In general, the review seeks to summarize the methods of combining and analyzing polymer nanocomposites, giving a thorough insight into how these processes enhance the improvement and refinement of materials for various industrial and medical uses. [ABSTRACT FROM AUTHOR]

Zinc oxide and nickel oxide nanocomposite was successfully synthesized using the co-precipitation technique and evaluated for their photocatalytic efficiency in the degradation of hexavalent chromium. The synthesized nanocomposite was characterized using various techniques such as X-ray diffraction, Fourier transform infrared spectroscopy, ultraviolet–visible spectroscopy, scanning electron microscopy, and energy-dispersive X-ray spectroscopy to analyze its structure, morphology, chemical bonding, photoabsorption properties, and elemental composition. X-ray diffraction exhibits the presence of zinc oxide, nickel oxide, and zinc oxide and nickel oxide nanocomposite, with average crystallite sizes of 37.92 nm, 56.23 nm, and 41.77 nm, respectively. Fourier transform infrared spectroscopy was used to analyze the chemical composition of zinc oxide and nickel oxide nanocomposite. The ultraviolet–visible spectroscopy exhibited an absorption peak at 447 nm, indicating a bandgap of 2.77 eV. A novel industrial-oriented photoreactor was designed for the reduction of hexavalent chromium under ultraviolet–visible illumination with varying operational parameters. The effectiveness of the experiment was assessed using response surface methodology based on central composite design, which demonstrated a remarkable 95% reduction of hexavalent chromium under optimized conditions. This study validates the accuracy of central composite design in predicting levels of hexavalent chromium reduction. The rate constant for the degradation kinetics of hexavalent chromium was studied to be 0.00450 min−1, indicating adherence to pseudo-second-order kinetics. Additionally, the prepared nanocomposite exhibited significant antibacterial activity against Bacillus subtilis, Escherichia coli, and Pseudomonas putida at different concentrations. [ABSTRACT FROM AUTHOR]

Gaucher Disease (GD) is an autosomal recessive, lysosomal storage disease caused by pathogenic variants in the glucocerebrosidase gene, leading to the loss of β-glucocerebrosidase (GCase) enzymatic activity. Enzyme replacement therapy (ERT) with recombinant GCase is the standard of care in GD patients. Our study investigates the combined use of in silico molecular evolution, synthetic biology and gene therapy approaches to develop a new synthetic recombinant enzyme. We engineered four GCases containing missense mutations in the signal peptide (SP) from four selected mammalian species, and compared them with human GCase without missense mutations in the SP. We investigated transcriptional regulation with CMV and hEF1a promoters alongside a GFP control construct in 293-FT human cells. One hEF1a-driven mutant GCase shows a 5.2-fold higher level of transcription than control GCase. In addition, this mutant exhibits up to a sixfold higher activity compared with the mock-control, and the predicted tertiary structure of this mutant GCase aligns with human GCase. We also evaluated conserved and coevolved residues mapped to functionally important positions. Further studies are needed to assess its functionality in a GD animal model. Altogether, our findings provide in vitro evidence of the potential of this engineered enzyme for improved therapeutic effects for GD. Article highlights. Conservation and coevolution analysis of amino acid frequencies in GBA1 homologs of pathogenic variants associated with Gaucher disease, Parkinson’ disease risk or Dementia with Lewy bodies risk.Article Highlights: A novel synthetic recombinant GCase enzyme engineered with missense mutations in the signal peptide from selected mammalian species Correlation between transfection efficiency and catalytic activity indicates possible intrinsic sequence features influencing DNA uptake and gene expression [ABSTRACT FROM AUTHOR]

Alkaloids are a complex class of biologically active compounds with a broad spectrum of health-related applications. Particularly the alkaloids of indole, steroidal, terpenoids, isoquinoline, and bisbenzylisoquinoline have been extensively investigated. Ultimately, substantial advancement has been highlighted in the investigation of chemical constituents and the therapeutic benefits of plant alkaloids, particularly during the last ten years. A total of 386 alkaloids have been isolated from over 40 families, including Apocynaceae, Annonaceae, Rubiaceae, Menispermaceae, Ranunculaceae, Buxaceae, Papaveraceae, Magnoliaceae, Rutaceae and Phyllanthaceae. This paper will investigate several alkaloids that have been isolated from botanical medicines as well as offer an in-depth analysis of their cytotoxic properties. [ABSTRACT FROM AUTHOR]

Introduction: Schwannomas are rare benign neurogenic tumours. About 25–45% of extracranial schwannomas are found in the head and neck region. In the head and neck, they can arise from various cranial, peripheral and autonomic nerves. Due to this, they have varied clinical presentations. Material and Methods: This retrospective cohort includes 97 patients diagnosed with extra cranial head and neck schwannoma, and operated in the Otolaryngology and Head & Neck Surgery department, from 2013 to 2022. The parameters observed were the age and gender distribution, location, nerve of origin, size, pressure symptoms, cranial palsies, post-operative symptoms, recurrence and complications. The data were collected from the institute's electronic records. Results: The median age of the study population was 36 years; among them, 51 were men and 46 were women. The most common tumour location was parapharynx. The patients had varied head and neck symptoms, of which 23.7% had nerve paresis at presentation. Transcervical surgical approaches was most used. New onset cranial nerve paresis immediately post-surgery was noted in 22.7%. Recurrence was noted in 2% of cases. Conclusions: Extra cranial schwannomas are uncommon neoplasms and have varied presentations. Comprehensive evaluation with appropriate imaging should be done in all cases. Though benign, patients can present with nerve paresis. Recurrence is uncommon after complete resection. [ABSTRACT FROM AUTHOR]

Machine learning and medical diagnostic studies often struggle with the issue of class imbalance in medical datasets, complicating accurate disease prediction and undermining diagnostic tools. Despite ongoing research efforts, specific characteristics of medical data frequently remain overlooked. This article comprehensively reviews advances in addressing imbalanced medical datasets over the past decade, offering a novel classification of approaches into preprocessing, learning levels, and combined techniques. We present a detailed evaluation of the medical datasets and metrics used, synthesizing the outcomes of previous research to reflect on the effectiveness of the methodologies despite methodological constraints. Our review identifies key research trends and offers speculative insights and research trajectories to enhance diagnostic performance. Additionally, we establish a consensus on best practices to mitigate persistent methodological issues, assisting the development of generalizable, reliable, and consistent results in medical diagnostics. [ABSTRACT FROM AUTHOR]

The International Roughness Index (IRI) is closely related to pavement distress. However, previous studies employing statistics and machine learning approaches would present challenges in comprehensively analyzing the influence of pavement distress on IRI considering their severities. This study introduces interpretable machine learning to investigate the influence of pavement distress on IRI, with a particular focus on the severity of pavement distress. The pavement distress and IRI data for flexible pavements obtained from the long-term pavement performance (LTPP) program were meticulously preprocessed. The developed random forest (RF) model demonstrated satisfactory predictive performance, with an RMSE of 0.2191 and an R2 of 0.7874. The relationship between pavement distress and IRI, as captured by the developed model, was further analyzed using the SHapley Additive exPlanations (SHAP) method. The model interpretation identified the transverse crack, rutting, and alligator crack as the key factors influencing IRI. Notably, both transverse and alligator cracks exhibited significant contributions to IRI increment at medium and high severity levels, highlighting the importance of proactive maintenance for these distress types at lower severity levels. Additionally, a threshold in rutting depth was observed, which could increase IRI. A comparative analysis with the AASHTO MEPDG smoothness model demonstrated that the predictive performance of the RF model was notably superior. [ABSTRACT FROM AUTHOR]

Background: Sovateltide (IRL-1620), an endothelin B receptor agonist, has previously demonstrated neuroprotective and neuroregenerative effects in animal models of acute ischemic stroke. Recently, clinical trials indicated that it could also be effective in humans with stroke. Here, we systematically investigate whether IRL-1620 may be used for the treatment of ischemia-induced brain injury. Methods: A systematic review was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. MEDLINE (PubMed) and Scopus databases were searched for eligible studies up to December 2022. The databases ClinicalTrials.gov and Pharmazz Inc. were screened for unpublished or ongoing trials. Only studies in English were evaluated for eligibility. Meta-analysis of the included studies was also conducted. Results: Finally, seven studies were included in the review, all in animal rat models because of scarcity of clinical trials. Six studies, all in middle cerebral artery occlusion (MCAO) models, were selected for meta-analysis. In the two studies assessing mortality, no deaths were reported in the IRL-1620 group 24 h after MCAO, whereas the vehicle group had almost a five times higher mortality risk (risk ratio 5.3, 95% confidence interval 0.7–40.1, I2 = 0%). In all five studies evaluating outcome on day 7 after MCAO, IRL-1620 was associated with statistically significantly lower neurological deficit and improved motor performance compared with the vehicle. Infract volume, differentiation potential of neuronal progenitor cells, and mitochondrial fate also improved with IRL-1620 administration. Conclusions: According to the above, in animal MCAO models, IRL-1620 enhanced neurogenesis and neuroprotection and improved outcome. Future studies are needed to expand our understanding of its effects in human study participants with acute ischemic stroke as well as in other common causes of cerebral ischemia including cardiac arrest. [ABSTRACT FROM AUTHOR]

It is well known that the digastric posterior belly is one of the essential landmarks for facial nerve identification during parotid surgery. While there were multiple reports about variations of the digastric anterior belly, only a few anatomical variations of the posterior belly of the digastric muscle have been described. In this article, we describe an anatomical variation of the posterior belly of digastric muscle found during superficial parotidectomy of a patient with pleomorphic adenoma. This anatomical variation also led to an anatomical variation in the position of the facial nerve. To our knowledge, this is the first report of an absent posterior belly of digastric muscle found during live parotid surgery. The knowledge of current anatomical variation may help to avoid facial nerve injury during parotid surgery and preserve the function of muscles of facial expression. [ABSTRACT FROM AUTHOR]

This research endeavored to provide an analysis of the barriers related to the agri-food supply chain in the context of the Indian agro-industry. The methodology used is based on an Interpretive Structural Modeling with a Matrix of Cross Impacts-Multiplication Applied to a Classification (MICMAC) technique. There is a need for specificity in defining Agro-food supply chain barriers before they can be eliminated. Therefore, the goal of this study is to look at the factors which are emerging as constraints to the growth of the agri-food supply chain. The findings show that transparency and traceability, inadequate infrastructure, difficulty in implementing government schemes, and inadequate risk management measures constitute important barriers to agri-food supply chains. This study provides an understanding of supply-chain barriers related to the agro-food industry. Managers/owners of agricultural enterprises can use the findings of this study to more easily identify the prominent barriers which affect agri-food supply chains. Furthermore, this study can be used as a guide to deal with the supply chain problems facing agri-enterprises in the face of high demand for agri-products. [ABSTRACT FROM AUTHOR]

We report on the last four editions of the reactive synthesis competition (SYNTCOMP 2018–2021). We briefly describe the evaluation scheme and the experimental setup of SYNTCOMP. Then we introduce new benchmark classes that have been added to the SYNTCOMP library and give an overview of the participants of SYNTCOMP. Finally, we present and analyze the results of our experimental evaluations, including a ranking of tools with respect to quantity and quality—that is, the total size in terms of logic and memory elements—of solutions. [ABSTRACT FROM AUTHOR]

High density polyethylene (HDPE) waste accumulation in the environment is one among the major threats faced globally for the last quarter of century. The current study deals with isolation, characterization and mycodegradation analysis of the HDPE strips by a potential fungus isolated from garbage dump yard. Based on morphological characterization, the isolated strain was identified and designated as Talaromyces liani strain JA2HS. Until now, there have been no reports of HDPE degradation using T. liani. The HDPE strips were subjected to degradation by the fungal isolate JA2HS for 90 days after optimization of growth and environmental parameters. The extent of degradation was confirmed by measuring the weight of the residual strip and the amount of CO2 evolution by Sturm test. A partial 72.7% degradation of the HDPE strip was observed, followed by the evolution of 18.5 g/L CO2. Enzyme studies were conducted to test the presence of ligninolytic enzymes (laccase, manganese peroxidase and lignin peroxidase) responsible for the biodegradation of the plastic strip. The fungal biomass estimation and hydrophobicity test were also performed. Mycodegradation analysis of the HDPE strip was further confirmed using analytical techniques such as FTIR, SEM, and AFM. This is the first study revealing the HDPE degradation using T. liani mediated by ligninolytic enzymes. [ABSTRACT FROM AUTHOR]

This research explores the antimicrobial resistance (AMR) profiles and prevalence of extended-spectrum beta-lactamase (ESBL) and non-ESBL-producing Escherichia coli in Ojerame Dam and Ovokoto Spring, Edo State, Nigeria. Over 12 months, water was systematically sampled to accommodate seasonal variations and analyzed by employing an ESBL-selective medium for bacterial species. Additionally, bacterial isolates underwent identification and characterization using polymerase chain reaction (PCR) and disk diffusion methods to evaluate their susceptibility to antimicrobials. Results indicated significant prevalence of ESBL-producing E. coli, which exhibited complete resistance to common antimicrobials like ceftriaxone, ceftazidime, cefotaxime, and ampicillin while demonstrating 100% sensitivity to ertapenem, imipenem, meropenem, and nitrofurantoin. Non-ESBL-producing E. coli were resistant to ampicillin but sensitive to other antimicrobials mentioned earlier. Furthermore, both ESBL and non-ESBL-producing E. coli displayed multidrug resistance to varying degrees. Specific ESBL genes, including blaTEM, blaCTX-M-1, and blaCTX-M-15, were identified, alongside resistance genes like tetA, tetM, sul1, sul2, sul3, qnrA, qnrB, and qnrS in E. coli. This study pioneers the documentation of ESBL-producing E. coli in surface water in the region. This signals impending health risks associated with water being a reservoir of resistant genes while emphasizing the urgency for further research and public awareness concerning the quality of surface water. [ABSTRACT FROM AUTHOR]

The use of herbal products for the treatment of malaria, has increased globally. However, inadequate scientific studies about the safety and effectiveness of such herbal products have been raised. Also, the reduced sensitivity of the malaria parasites to artemisinin-based combination therapies is of concern. There is therefore the need for new antimalarial medications including those from alternative sources such as herbal medicinal products. In this study, a prospective, comparative parallel group randomized, clinical study was done to assess the safety and effectiveness of Mist Amen Fevermix and Mist Edhec Malacure with Artemether/Lumefantrine as control at the Tafo Government Hospital, Kumasi between July and November 2019, after Committee on Human Research, Publication and Ethics approval (CHRPE/AP/424/19). The study was conducted in accordance with Good Clinical and Laboratory Practice (GCLP) and registered with the Pan African Clinical Trials Registry with trial number PACTR202109664146698. Participant completed an informed consent form. Randomization was based on a single sequence to allocate participants to a group. SPSS version 19. One-way ANOVA test and exploratory statistics was used for data analysis. Total sample size was 150 participants with 50 on each arm of the group. Male and female patients aged 15–45 years and meet inclusion criteria with clinically established malaria were treated with Mist Amen Fevermix and Mist Edhec Malacure, at the specified doses of 45 mls (0.1063 g) and 30 mls (0.0521 g) three times daily after meals for three days. Artemether/Lumefantrine was administered at a dose of 80/480 mg/kg twice daily after meals for three days. Baseline data was taken on day 0. Patients were then followed up on Day 3, 7 and 28 to establish treatment outcomes and any side effect using a checklist for signs and symptoms and Karnofsky's scale to assess the quality of life. Mist Amen Fevermix was effective with a cure rate of 95.89%. Mist Edhec Malacure was also effective with a cure rate of 91.87%. The cure rate of Artemether/Lumefantrine was 97.25%. Kidney and liver panels were within normal reference range at the end of the 28-day study. This study supports the use of Mist Amen Fevermix and Mist Edhec Malacure, two multi-component products as safe and effective for the treatment of uncomplicated malaria. Both products achieved a comparable clinical treatment outcome with Artemether/Lumefantrine. [ABSTRACT FROM AUTHOR]

Incremental sheet metal forming is a highly versatile die-less forming process for manufacturing complex sheet metal components. Robot-assisted incremental sheet forming, or roboforming, allows a wider range of tool motion, providing the capability to shape intricate components. This makes roboforming the most flexible variant of the incremental forming method. However, the serial arrangement of links and joints in a robotic manipulator results in low positional accuracy under forming loads due to insufficient structural stiffness. The stiffness of the machine frame and tool directly impacts the accuracy of the final formed profile. The impact of machine compliance on component shape in incremental sheet forming is substantial in roboforming. This work presents a methodology for systematic analysis of the factors contributing to the errors in the geometric shape of robot-based forming. Experimental and numerical methods are used to estimate the material springback, tool/tool holder deflections, and errors due to machine compliance. The CNC machine frame is relatively stiffer than the industrial robots, such that material springback is estimated based on the experimental trials on CNC for cone and variable wall angle cone profiles. Tool and tool holder deflections are estimated using finite element simulations. The analytical method using the Virtual Joint Model is used to model the joint stiffness, and consequently, the robot Cartesian stiffness is estimated to predict path deviation contributing to geometric shape errors. The proportional contribution of each factor in the overall deviation in the Roboforming is also quantified. [ABSTRACT FROM AUTHOR]

Introduction: There are a lack of data describing outcomes and follow-up after hospital discharge for patients with newly diagnosed cirrhosis with complication on index admission. This study examines factors that influence outcomes such as readmission, follow-up, and mortality for patients with newly diagnosed cirrhosis. Methods: We conducted a single-center retrospective chart review study of 230 patients with newly diagnosed cirrhosis from January 1st, 2020 through December 31st, 2021. We obtained demographics, clinical diagnoses, admission, and discharge MELD-Na, disposition, mortality, appointment requests rate, appointment show rate, and readmission. Results: The primary complications on admission were GI bleed (27%), ascites (25.7%), and hepatic encephalopathy (HE) (10.4%). Overall, the median length of stay (LOS) was 6 days, and the readmission rate was 27%. Out of 230 patients, 25 (10.9%) patients died while hospitalized while another 43 (18.6%) died after initial discharge within the two-year study period. Although there was a significant reduction of the MELD-Na from admission to discharge (p < 0.05), admission MELD-Na did not correlate with LOS and discharge MELD-Na did not predict readmission. Patients with HE had the highest median LOS, while patients with ascites had the highest readmission rate. The median time to an appointment was 32 days. When comparing discharge destinations, most patients were discharged to home (63%), to facilities (13.9%), or expired (10.9%). The average appointment show rate was 38.5%, although 70% of patients had appointment requests. Readmission rate and mortality did not differ based on appointment requests. No significant differences in outcomes were observed based on race, sex, or insurance status. Conclusion: New diagnosis of decompensated was found to have high mortality and high readmission rates. Higher MELD-Na score was seen in patients who died within 30 days. Routine appointment requests did not significantly improve readmission, mortality, increase appointment show rate, or decrease time to appointment. A comprehensive and specialized hepatology-specific program may have great benefits after cirrhotic decompensation, especially for those with newly diagnosed cirrhosis. [ABSTRACT FROM AUTHOR]

The Biak tsunami event on February 17, 1996, was triggered by a Mw 8.2 earthquake at 5:59 UTC (14:59 local time). Based on the field survey, the maximum tsunami height was not located on the coast that directly faces the earthquake epicenter. The maximum tsunami of up to 7.7 m was recorded at Farusi village on the opposite coast. In addition to the high tsunami hit, the fast arrival time in this village was an anomaly that raised questions regarding the multiple tsunami sources. Previous studies suspected a landslide when a rupture occurred, but no one had yet identified the dimensions and mechanism of the landslide. The purpose of this research is to increase understanding of tsunami generators and answer that question. The COMCOT software is used to perform tsunami simulations, integrating fault and landslide sources simultaneously. This study obtains the Biak tsunami generator from a fault source model with a length of 272 km, a width of 110 km, an average dislocation of 8 m, and a maximum slip of 10.6 m. Also, there are three landslides occurred in the south coast. One of the major landslide source model has dimensions length and width of 5.629 km and 14.595 km, respectively, and a thickness of landslide material of 50 m, with an average slope of the slip plane of 10° located in the Ramardori. These two source models answer the particular questions of the Biak tsunami incident. [ABSTRACT FROM AUTHOR]

The information on land use/land cover (LULC) is indispensable in regional planning, policy formulation and tracking land use/land cover changes (LULCC). The rapid urbanization of hilly terrains, driven by population growth, has significant implications for landslide risk reduction. Recognizing the need for an innovative approach for extracting LULC information, the present study uses a random forest (RF) classifier to develop a novel, pre-trained and universal tool that automatically generates LULC classification maps based on natural colour satellite imagery without any training input from the end-user. The proposed framework with an overall accuracy of 0.75 and an area under the curve (AUC) score of 0.95 in the receiver operating characteristic curve (ROC) approach was used for mapping built-up area expansion in regions susceptible to rainfall-induced landslides in Idukki block panchayat (administrative division), Kerala, India. By comparing the LULC information for the years 2012 and 2022, it was understood that the built-up area in the location has increased from 12.76% of the total area in 2012 to 26.48% in 2022. It is important to consider the rapid increase in built-up area expansion in the 'very high' landslide susceptibility zones in the study area. This clearly demonstrates the need for hazard inclusive planning and tracking of LULCC, for disaster risk reduction. Research Highlights: A pre-trained Land Use/Land Cover (LULC) classification tool is developed using the Random Forest (RF) classifier. Based on natural colour satellite imagery, the tool automatically generates LULC maps for various landscapes worldwide. The tool demonstrates a satisfactory performance, achieving an overall accuracy of 0.75 and an overall ROC AUC score of 0.95. The tool was used to understand the LULC changes in Idukki block panchayat between 2012 and 2022. [ABSTRACT FROM AUTHOR]