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Abstract Adopting aggregation techniques in power sector modelling led to disregarding the key characteristics of regions in terms of resource use, which may not completely capture the bottlenecks in the energy transition. This study provides a holistic approach to estimate its impact on the transition of the European power system from the perspective of energy return on investment (EROI) by using six energy transition scenarios based on three different spatial representations. The findings indicate that EROI trends are highly dependent on the spatial representation, technology selection and energy mix. Further additional capacities of complementary technologies along with an upsurge in renewable capacities drive EROI values down. Disregarding the physical distances in the energy modelling results in large EROI enhancement due to the artificial smoothing effect of the aggregation method. EROI values of the aggregated scenarios remain between 18 and 24 by 2050. In the case of 20 independent sub‐regions, the lowest EROI is obtained at about 14 by 2050, due to the limitation on optimal resource utilisation. Interconnection of the sub‐regions, which represents the best proximation to the real situation, increases the EROI to 17 by 2050.

The study aimed to investigate how the number of effector memory cells changes under the influence of a Salmonella vaccine antigen in cows. A homogeneous group of 100 Holstein-Friesian cows, kept under the same conditions, had blood samples taken. The blood was collected at four time points: before the first vaccination, and 7, 45, and 56 days after. The cows also received a booster vaccination on days 8-10. They were immunised with a polyvalent vaccine against livestock salmonellosis in Kazakhstan. Blood was separated into plasma and cellular fractions by centrifugation at 1,500 rpm for 10 minutes. The cellular fraction was then analysed by flow cytometry to determine the number of CD4+, CD8+, and γδ T-cell subpopulations at the four time points: before vaccination, and at 7-, 45-, and 56-days post-vaccination. Analysis of over 10,000 cells from each sample was conducted using FlowJo software. The data showed that the population of CD4+ and CD8+ T-lymphocytes and γδ T-cells increased 1.5 times by day 7 after the initial vaccination. The cows then received a booster dose on days 8-10, and by day 45 after the first vaccination, the CD4+ and CD8+ T-lymphocyte and γδ T-cell populations had increased threefold. CD45RA+ T-lymphocytes and γδ T-cells demonstrated a steady increase by day 45, followed by a decline in the numbers of T-cells across all phylogenetic groups. Thus, it can be concluded that the primary vaccination stimulates the development of long-term immune memory, while the booster dose triples the number of CD4+, CD8+, and γδ T-cell subpopulations. The findings provide insights into the mechanism of adaptive immunity formation in cows against salmonellosis through the use of effector memory cells and may be applied in developing vaccination strategies for cattle

Transcatheter atrial septal defect closure is a prevalent minimally invasive treatment option but still has cerebrovascular accident (CVA) risk. An unusual thromboembolic CVA cause is device-related mechanical atrial injury. We describe the case of a patient with prior transcatheter atrial septal defect closure who had ongoing CVA despite anticoagulation. Echocardiography showed left atrium wall thrombus from mechanical injury. Operative thrombus removal, device explant, and septal reconstruction was performed with no subsequent CVA. Instead of device thrombosis, here the source was repeated contact by 1 prong with the left atrium wall, causing mechanical injury-induced thrombosis. This rare phenomenon is another source of thromboembolism.

Abstract Background Element-equivalent matched theranostic pairs facilitate quantitative in vivo imaging to establish pharmacokinetics and dosimetry estimates in the development of preclinical radiopharmaceuticals. Terbium radionuclides have significant potential as matched theranostic pairs for multipurpose applications in nuclear medicine. In particular, 155Tb (t1/2 = 5.32 d) and 161Tb (t1/2 = 6.89 d) have been proposed as a theranostic pair for their respective applications in single photon emission computed tomography (SPECT) imaging and targeted beta therapy. Our study assessed the performance of preclinical quantitative SPECT imaging with 155Tb and 161Tb. A hot rod resolution phantom with rod diameters ranging between 0.85 and 1.70 mm was filled with either 155Tb (21.8 ± 1.7 MBq/mL) or 161Tb (23.6 ± 1.9 MBq/mL) and scanned with the VECTor preclinical SPECT/CT scanner. Image performance was evaluated with two collimators: a high energy ultra high resolution (HEUHR) collimator and an extra ultra high sensitivity (UHS) collimator. SPECT images were reconstructed from photopeaks at 43.0 keV, 86.6 keV, and 105.3 keV for 155Tb and 48.9 keV and 74.6 keV for 161Tb. Quantitative SPECT images of the resolution phantoms were analyzed to report inter-rod contrast, recovery coefficients, and contrast-to-noise metrics. Results Quantitative SPECT images of the resolution phantom established that the HEUHR collimator resolved all rods for 155Tb and 161Tb, and the UHS collimator resolved rods ≥ 1.10 mm for 161Tb and ≥ 1.30 mm for 155Tb. The HEUHR collimator maintained better quantitative accuracy than the UHS collimator with recovery coefficients up to 92%. Contrast-to-noise metrics were also superior with the HEUHR collimator. Conclusions Both 155Tb and 161Tb demonstrated potential for applications in preclinical quantitative SPECT imaging. The high-resolution collimator achieves

Abstract Nonlinear metasurfaces have experienced rapid growth recently due to their potential in various applications, including infrared imaging and spectroscopy. However, due to the low conversion efficiencies of metasurfaces, several strategies have been adopted to enhance their performances, including employing resonances at signal or nonlinear emission wavelengths. This strategy results in a narrow operational band of the nonlinear metasurfaces, which has bottlenecked many applications, including nonlinear holography, image encoding, and nonlinear metalenses. Here, we overcome this issue by introducing a new nonlinear imaging platform utilizing a pump beam to enhance signal conversion through four-wave mixing (FWM), whereby the metasurface is resonant at the pump wavelength rather than the signal or nonlinear emissions. As a result, we demonstrate broadband nonlinear imaging for arbitrary objects using metasurfaces. A silicon disk-on-slab metasurface is introduced with an excitable guided-mode resonance at the pump wavelength. This enabled direct conversion of a broad IR image ranging from >1000 to 4000 nm into visible. Importantly, adopting FWM substantially reduces the dependence on high-power signal inputs or resonant features at the signal beam of nonlinear imaging by utilizing the quadratic relationship between the pump beam intensity and the signal conversion efficiency. Our results, therefore, unlock the potential for broadband infrared imaging capabilities with metasurfaces, making a promising advancement for next-generation all-optical infrared imaging techniques with chip-scale photonic devices.

In this study, the variant effects of alumina and graphene reinforcing nanoparticle percentages on the tensile and wear properties of the nanocomposites, produced using digital light processing (DLP), were determined by employing SEM images of fracture and worn surfaces to introduce a hybrid (alumina + graphene)/PLA nanocomposite with desirable wear and mechanical properties. With the addition of alumina up to 2 wt%, the tensile strength was initially decreased exhibiting a rapid brittle fracture over the flat fracture surface. However, with a continued increase in the amount of reinforcing particles, the tensile strength eventually increased by 16% compared to the pure resin sample at 8 wt% of alumina while changing the fracture mode with plenty of cleavages accompanied by crack deflections. The specific wear rate in the 8 wt% alumina sample decreased by almost 62% compared to the pure resin sample. Graphene caused a significant drop in tensile strength due to the generation of cavities and porosities around the graphene agglomerates, but it greatly improved the wear properties, with the specific wear rate decreasing by almost 77% at just 1 wt%. Then hybrid nanocomposites of alumina and graphene reinforcements were produced with the aim of optimal tensile and wear properties. The 0.5% graphene +3.5% alumina improved the wear resistance and provided moderate tensile properties; however, the 1% graphene +3% alumina could not increase the wear resistance due to the weakening of graphene plates sticking to the polymer substrate.

Abstract The superconducting quantum interference (SQI) patterns of Josephson junctions fabricated from hybrid structures that interface an s-wave superconductor with a topological insulator can be used to detect signatures of novel quasiparticle states. Here, we compare calculated and experimental SQI patterns obtained from hybrid junctions fabricated on cadmium arsenide, a two-dimensional topological insulator. The calculations account for the effects of Abrikosov (anti-) vortices in the superconducting contacts. They describe the experimentally observed deviations of the SQI from an ideal Fraunhofer pattern, including anomalous phase shifts, node lifting, even/odd modulations of the lobes, irregular lobe spacing, and an asymmetry in the positive/negative magnetic field. We also show that under a current bias, these vortices enter the electrodes even if there is no intentionally applied external magnetic field. The results show that Abrikosov vortices in the electrodes of the junctions can explain many of the observed anomalies in the SQI patterns of topological insulator Josephson junctions.

Trisomy 9 is a rare chromosomal abnormality that occurs in both mosaic and non-mosaic states. The present study reports a case of mosaic trisomy 9 detected during pregnancy in a 41-year-old woman in the second trimester screening. Maternal serum screening results were used to diagnose a chromosomal abnormality in utero. The results were validated by karyotyping. High levels of alpha-fetoprotein and low levels of unconjugated estriol (uE3), human chorionic gonadotropin (hCG), and inhibin A indicate a high risk for chromosomal abnormalities, including trisomy 18. Amniotic fluid karyotyping revealed 47, XX, +9 (30)/46, XX (20) in the fetus. Because a high level (60%) of mosaicism for trisomy 9 in the fetus can affect many parts of the body, the pregnancy was terminated. It seems that a significant reduction in the levels of hCG and uE3 is an informative marker for the detection of chromosomal abnormalities such as trisomy 9.

Abstract The power line insulators are permanently exposed to various environmental pollutants such as dust and fine particles. This may lead to flashovers and therefore widespread power blackouts and heavy economic damage. One way to overcome this problem is to make the insulator surface superhydrophobic. In this research, the superhydrophobic properties of the insulators were improved by applying room-temperature cured composite coatings consisting of epoxy and hydrophobic nano-silica particles. Either octadecyl trichlorosilane (ODTS) or hexamethyldisilazane (HMDS) was used to coat the silica nanoparticles and make them hydrophobic. Then, the hydrophobic silica was added to a mixture of epoxy resin and hardener. The suspension was applied on the surfaces of a commercial porcelain insulator and cold cured at ambient temperature. The coating increased the water contact angle from 50° to 149°. Even after 244 h exposure to the UV light, the samples preserved their hydrophobic properties. The adhesion of the coating was rated as 4B according to the ASTM D3359 standard. The coating decreased the leakage current by 40% and increased the breakdown voltage by 86% compared to the uncoated sample and showed promise for making power line insulators self-cleaning.

Introduction: Esophageal varices (EVs) carry a significant risk of rupture and subsequent life-threatening bleeding. While previous research has investigated the effectiveness of the platelet count to spleen diameter ratio (PC/SD) as a non-invasive predictor of EVs in various populations, this study specifically focuses on the Iranian population to assess the applicability and effectiveness of this parameter in this region. Materials and Methods: Upper gastrointestinal endoscopy was performed on 147 cirrhotic patients to screen for EVs. Biochemical tests and ultrasonography were done to measure spleen diameter (SD) and calculate the PC/SD ratio. ROC analysis was done to determine the predictive performance of the parameters. Results: Among the patients, 73% had EVs. The analysis showed the following: platelet count (PC) had an AUC of 0.695 with 78.7% sensitivity and 56.4% specificity; SD had an AUC of 0.750 with 49.1% sensitivity and 89.7% specificity; and the PC/SD ratio had an AUC of 0.734 with 60.2% sensitivity and 79.5% specificity. The PC/SD ratio exhibited a high positive predictive value of 93% but a low negative predictive value of 41.9%. Optimal cutoff values were determined as follows: PC≤ 100,000, SD< 163, and PC/SD ratio≤ 523. Conclusion: By identifying high-risk patients who may benefit from targeted endoscopic screening, this non-invasive method could contribute to improving overall patient care and reducing the need for invasive procedures. However, due to suboptimal performance results, it is crucial to use this approach with caution, as endoscopic screening remains the standard practice for the diagnosis and management of esophageal varices.

Apple cider vinegar is a fermented compound that contains acetic acid, flavonoids, phenolic compounds, organic acids, minerals, and vitamins. Vitamin A is involved in the development of the immune system and plays regulatory roles in cellular immune responses and humoral immune processes. The aim of this study was to investigate the effect of apple cider vinegar and vitamin A on hematological parameters and immunoglobulin G levels in Gezel lambs. 10 healthy Gazel lambs were used for the study. The lambs were randomly grouped into three groups (control (n = 3), Apple cider vinegar (n = 4), and Vitamin A (n = 3) group). Vitamin A was administrated at a dose of 44,000 IU/kg every ten days for four treatments. ACV was administered orally by drenching (0.5 ml/kg of 6% ACV solution (600 mg ACV), every day, for 40 days). Hematological parameters were determined using standard methods. Total immunoglobulin G concentration was assayed using the turbidimetric immunoassay method. The data obtained before and after drug administration were analyzed by paired T-test and the data of different groups were analyzed using Independent-sample T-test.White blood cells, lymphocytes, and IgG in lambs were significantly increased after administration of Apple cider vinegar (p < 0.05). IgG and lymphocytes were significantly higher in lambs under oral administration of Apple cider vinegar compared to the lambs in the control group (p < 0.05). White blood cells, neutrophils, and IgG were significantly increased in lambs after vitamin A administration (p < 0.05). Neutrophils and IgG were significantly higher in lambs under vitamin A injection compared to the lambs in the control group (p < 0.05). Administration of vitamin A and apple cider vinegar in sheep is safe. They also improve the immune system.

IntroductionA National Immunization Technical Advisory Group (NITAG) provides independent guidance to Ministries of Health (MoH) and policymakers, enabling them to make informed decisions on national immunization policies and practices. As of 2022, 50 of the 53 countries in the World Health Organization (WHO) European Region (the Region) had established a NITAG, with 58% of all NITAGs and 66% of those in middle-income countries (MICs) in the Region meeting all six WHO process indicators of NITAG functionality. However, many newly established NITAGs in MICs in the Region experience challenges in terms of their functioning, structure, and outputs.MethodsTo address these challenges and achieve the goal of evidence-informed decision making on immunizations, the WHO Regional Office for Europe and the Robert Koch Institute (RKI) implemented a project to strengthen the functioning of MIC NITAGs of the Region through comprehensive evaluations of nine NITAGs and development and implementation of improvement plans.ResultsAll evaluated NITAGs are formally established and complete the most important aspects of NITAG functioning. The main challenge for all NITAGs is the lack of a well-staffed Secretariat to establish annual workplans and develop NITAG recommendations following a standardized process.DiscussionThe evaluation identified NITAGs' strengths and challenges. Some challenges have been addressed through improvement plan implementation. WHO and RKI will continue to evaluate NITAGs and support development and implementation of improvement plans. WHO and NITAG partners will continue to provide training on the standardized recommendation-making process and advocate increased MoH support to NITAGs, including dedicated Secretariat staff.

IntroductionThe global coronavirus disease 2019 (COVID-19) pandemic necessitated urgent vaccine development, raising concerns about potential vaccine adverse events (AEs).MethodsIn this prospective cohort study, conducted from February 2021 to December 2022, all individuals across Iran who received any COVID-19 vaccine dose and reported adverse events were investigated. Our aim was to evaluate these AEs based on the vaccine types, patients’ age and types of AES, and provide a comprehensive analysis.ResultsIn Iran, 155 million COVID-19 vaccine doses were administered, with Covilo (Sinopharm) being the most commonly vaccine administered (80.35%). Adverse events predominantly affected individuals aged 40-70 (45%). A total of 86,275 adverse events were recorded, with 92.7% classified as non-serious and 6 299 (7.3%) serious and among the serious cases, 279 were confirmed to be vaccine-related, with 46 resulting in fatalities and 233 requiring hospitalizations. The incidence of serious AEs was 0.41 per 10,000 doses. Serious AEs were more frequently associated with Sputnik V and Vaxzevria (AstraZeneca), with 0.73 and 0.64 cases per 10,000 injections, respectively. Coagulation and thrombosis disorders were the most common serious AEs (29%), followed by neurological (24.7%) and cardiovascular AEs (15.8%).DiscussionIn conclusion, the AEs of COVID-19 vaccination were primarily mild and transient, while serious AEs remained exceptionally rare.

The therapeutic impact of royal jelly (RJ) consumption in patients with ischemic stroke is unknown. Therefore, we conducted a randomized, triple-blind, placebo-controlled clinical trial to evaluate the role of RJ supplementation on clinical and biochemical outcomes in patients recovering from ischemic stroke. Out of 64 enrolled patients (45–80 yrs.) with ischemic stroke, 32 were randomized to the RJ group and 32 to the placebo (control) group. Groups completed a 12-week intervention. The intervention group received 1000 mg/d of RJ dragee after breakfast. We evaluated stroke-related disability, quality of life, and inflammatory and oxidative stress markers at baseline and post-intervention. At post-intervention, serum levels of erythrocyte sedimentation rate decreased in the RJ group compared to the control group (adjusted mean difference, −8.65 mm/h [95 % CI, −14.75 to −2.55]). Additionally, serum nitric oxide levels increased in the RJ group (adjusted mean difference, 10.18 nmol/mL [95 % CI, 0.51 to 19.86]) post-intervention compared to the control group. Furthermore, the RJ group exhibited a decreased oxidative status index (adjusted mean difference, −0.003 [95 % CI, −0.006 to −0.0001]) and reduced odds of stroke-related disability (adjusted odds ratio, 0.20 [95 % CI, 0.05 to 0.70]) compared to the placebo group. Moreover, RJ supplementation improved the quality-of-life measures in the RJ group (adjusted mean difference, 16.64 [95 % CI, 1.17 to 32.12]) compared to the control group. Our findings reflect the potential benefits of RJ consumption on clinical and biochemical outcomes of patients recovering from ischemic stroke. Importantly, we acknowledge the necessity of additional studies to verify the efficacy of RJ supplementation in patients recovering from strokes. Trial registration: Iranian Registry of Clinical Trials (IRCT20180818040827N4), registered on October 9, 2021; https://www.irct.ir/trial/59275

There is a need for open-source libraries in emission tomography that (i) use modern and popular backend code to encourage community contributions and (ii) offer support for the multitude of reconstruction techniques available in recent literature, such as those that employ artificial intelligence. The purpose of this research was to create and evaluate a GPU-accelerated, open-source, and user-friendly image reconstruction library, designed to serve as a central platform for the development, validation, and deployment of various tomographic reconstruction algorithms. PyTomography was developed using Python and inherits the GPU-accelerated functionality of PyTorch and parallelproj for fast computations. Its flexible and modular design decouples system matrices, likelihoods, and reconstruction algorithms, simplifying the process of integrating new imaging modalities using various python tools. Example use cases demonstrate the software capabilities in parallel hole SPECT and listmode PET imaging. Overall, we have developed and publicly share PyTomography, a highly optimized and user-friendly software for medical image reconstruction, with a class hierarchy that fosters the development of novel imaging applications.

BackgroundBangladesh is facing a formidable challenge in mitigating waterborne diseases risk exacerbated by climate change. However, a comprehensive understanding of the spatio-temporal dynamics of these diseases at the district level remains elusive. Therefore, this study aimed to fill this gap by investigating the spatio-temporal pattern and identifying the best tree-based ML models for determining the meteorological factors associated with waterborne diseases in Bangladesh.MethodsThis study used district-level reported cases of waterborne diseases (cholera, amoebiasis, typhoid and hepatitis A) obtained from the Bangladesh Bureau of Statistics (BBS) and meteorological data (temperature, relative humidity, wind speed, and precipitation) sourced from NASA for the period spanning 2017 to 2020. Exploratory spatial analysis, spatial regression and tree-based machine learning models were utilized to analyze the data.ResultsFrom 2017 and 2020, Bangladesh reported 73, 606 cholera, 38, 472 typhoid, 2, 510 hepatitis A and 1, 643 amoebiasis disease cases. Among the waterborne diseases cholera showed higher incidence rates in Chapai-Nawabganj (456.23), Brahmanbaria (417.44), Faridpur (225.07), Nilphamari (188.62) and Pirojpur (171.62) districts. The spatial regression model identified mean temperature (β = 12.16, s.e: 3.91) as the significant risk factor of waterborne diseases. The optimal XGBoost model highlighted mean and minimum temperature, relative humidity and precipitation as determinants associated with waterborne diseases in Bangladesh from 2017 to 2020.ConclusionsThe findings from the study, incorporating the One Health perspective, provide insights for planning early warning, prevention, and control strategies to combat waterborne diseases in Bangladesh and similar endemic countries. Precautionary measures and intensified surveillance need to be implemented in certain high-risk districts for waterborne diseases across the country.

BackgroundNon-governmental organisations (NGOs) have the potential to make a significant contribution to improving health system goals through the provision of resources, health services and community participation. Therefore, this paper examines the role of NGOs in achieving health system goals, based on the six building blocks of a health system framework, and identifies strategies to enhance NGO involvement in achieving health system goals.MethodsA scoping systematic review methodology was used to map and synthesise the existing literature on the topic, following the latest JBI six-stage framework. Four databases and one search engine including PubMed, Web of Science (ISI), EMBASE, Scopus and Google Scholar were searched from January 2000 to January 2024. The results were synthesised using a directed content analysis approach, and the findings were categorised according to the dimensions of the six building blocks.ResultsNGO involvement in health system goals can effectively address gaps in service delivery, strengthen the health workforce, improve health information systems, increase access to essential medicines, mobilise resources and promote good governance. In addition, six key strategies were identified, including joint planning, policy development, capacity building, resource allocation, developing collaboration, and improving the quality of health care, to enhance NGO participation in achieving health system goals.ConclusionNGOs can play a critical role in achieving health system goals, alongside government and other key health stakeholders. Governments need to use evidence-based policies and interventions to support NGOs to realise their potential in achieving health system goals.

ABSTRACT Background Peste des petits ruminants (PPR) is a disease with high morbidity and mortality in small ruminants. A clinical report of this disease in camels has been made in Iran; however, no accurate information is available about infection with this virus in the camel population of Iran. Objectives This study was designed and conducted to detect any trace of seroconversion in dromedary camels in Iran. Methods A total of 100 serum samples were collected from a slaughterhouse in Khorasan Razavi Province and analysed using a competitive enzyme‐linked immunosorbent assay to detect antibodies against the PPR virus. Results The results of this study indicated that the frequency of PPR virus exposure in camels in Khorasan Razavi Province was 3% (3 positive cases out of 100 camels). All the positive cases were female. Conclusion The seroconversion without any history of clinical disease among these camels indicated their exposure to the PPR virus in this region and their resistance to clinical disease. The resistance and sensitivity to this disease in camels have yet not been fully determined and require further studies. However, stressful risk factors such as transportation may contribute to the occurrence of clinical forms of PPR in camels. The detection of antibodies against the PPR virus in camels in this study reveals the fact that camels may be considerable contributors to the epidemiology of PPR in Iran.

ABSTRACT Background Pupillary light reflex (PLR) and menace response are among the tests used in neurological and ophthalmic examinations in animals. Objective The intent of this study was to investigate the development of the PLR and menace response in neonatal camel calves. Methods Thirty healthy camel calves were studied after birth until the menace response and PLR were well established. The menace response was assessed by applying a non‐tactile visual threat to each eye. The direct PLR was tested by shining a bright light into each eye and observing constriction of the pupil in the ipsilateral eye. Results PLR was positive in all camel calves in the first test performed after birth. The first menace response developed at the age of 14 days, with 4 camel calves developing a menace response last, at 18 days of age. The menace response developed in most camel calves at 16 days old. The time to develop the menace response was not statistically different between the two sexes. Conclusion The PLR is present in camel calves immediately after birth. Menace response in camel calves develops within 18 days after birth.

ABSTRACT Rheumatoid arthritis (RA) is a systemic autoimmune disorder with both articular and extra‐articular manifestations, including rare pulmonary complications. We report a case of a 65‐year‐old male with long‐standing RA who developed multiple cavitary pulmonary nodules following prolonged leflunomide therapy. Diagnostic evaluation excluded infectious, neoplastic, and autoimmune causes. Bronchoscopy and biopsy confirmed an acute suppurative inflammatory process with central necrosis. Discontinuation of leflunomide resulted in the resolution of pulmonary nodules. This case highlights the need for vigilance regarding potential pulmonary toxicity in RA patients receiving leflunomide and underscores the importance of prompt recognition and management of drug‐induced complications.

Transitioning industrial heat systems from fossil fuels to electric-based solutions is crucial to mitigate climate change. This research identifies and evaluates various power-to-heat technologies, each technology contributes uniquely to the overarching goal of industrial electrification. Through a rigorous methodology involving categorisation based on technology readiness level (TRL), electrification stage, carbon emission per each kWh of heat delivery, energy efficiency, installation complexity, and life span, a Multi-Criteria Decision Analysis (MCDA) is conducted to assess the performance of each technology. To validate the proposed ranking, the weighted sum method (WSM) was compared to the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). In addition to prioritizing each criterion, six scenarios were investigated using sensitivity analysis to determine the performance of each criterion and ranking of technologies using a scenario based weighting technique. The study indicates Heat Pump and Mechanical Vapor Recompression as the most dependable and high-performing technologies, continuously giving top marks and serving as the finest solutions for a wide range of applications. In contrast, Plasma Technology and Microwave and Radio frequency heaters are regarded as the least effective, with continuously low ratings, making them less desirable alternatives. By synthesizing the results and defining different scenarios, this detailed analysis provides decision-makers, industry stakeholders, and researchers with useful insights into the many alternatives for direct electrification of heat supply. Finally, the MCDA in this study is designed for current and future scenarios, allowing new technologies to be analyzed and ranked with the proposed algorithm.

The circadian clock regulates physiological and biochemical processes in nearly every species. Sexual and reproductive behaviors are two processes controlled by the circadian timing system. Evidence supporting the importance of proper clock function on fertility comes from several lines of work demonstrating that misalignment of biological rhythms or disrupted function of the body’s master clock, such as occurs from repeated shift work or chronic jet lag, negatively impacts reproduction by interfering with both male and female fertility. Along these lines, dysregulation of clock genes leads to impairments in fertility within mammals, and disruption of circadian clock timing negatively impacts sex hormone levels and semen quality in males, and it leads to ovulatory deficiencies in females. Here, we review the current understanding of the circadian modulation of both male and female reproductive hormones—from animal models to humans. Further, we discuss neural circuits within the hypothalamus that may regulate circadian changes in mammalian sexual behavior and reproduction, and we explore how knowledge of such circuits in animal models may help to improve human sexual function, fertility, and reproduction.

The frequency of cyber-attacks has been rising in recent years due to the fact that startup developers have failed to overlook security issues in the core web services. This stated serious concerns about the security of the web. Therefore, this paper proposes a hybrid model built on the base of Convolutional Neural Networks (CNN), Gated Recurrent Units (GRU) and an attention mechanism to detect vulnerabilities in application code. Particularly, the model can help detect attacks based on Structured Query Language Injection (SQLi), Cross-Site Scripting (XSS), and command injection. When using the dataset SXCM1, our model achieved 99.77%, 99.66% and 99.63% for training, validation and testing, respectively. The results obtained on data from the DPU-WVD dataset are even better because it was 99.97%, 99.98% and 99.99% for training, validation and testing, respectively. These results significantly outperform the state-of-the-art models and can strongly identify vulnerabilities in web applications. Through training, on both the SXCM1 and DPU-WVD datasets, the model achieved an accuracy rate of 99.99%. The results show that this combination model is highly effective at recognizing three vulnerability categories and surpasses cutting-edge models that usually specialize in just one type of vulnerability detection.

Abstract Alzheimer’s disease is the most prevalent neurodegenerative disorder characterized by significant memory loss and cognitive impairments. Studies have shown that the expression level and activity of the butyrylcholinesterase enzyme increases significantly in the late stages of Alzheimer’s disease, so butyrylcholinesterase can be considered as a promising therapeutic target for potential Alzheimer’s treatments. In the present study, a novel series of 2,4-disubstituted quinazoline derivatives (6a–j) were synthesized and evaluated for their inhibitory activities against acetylcholinesterase (AChE) and butyrylcholinestrase (BuChE) enzymes, as well as for their antioxidant activities. The biological evaluation revealed that compounds 6f, 6h, and 6j showed potent inhibitory activities against eqBuChE, with IC50 values of 0.52, 6.74, and 3.65 µM, respectively. These potent compounds showed high selectivity for eqBuChE over eelAChE. The kinetic study demonstrated a mixed-type inhibition pattern for both enzymes, which revealed that the potent compounds might be able to bind to both the catalytic active site and peripheral anionic site of eelAChE and eqBuChE. In addition, molecular docking studies and molecular dynamic simulations indicated that potent compounds have favorable interactions with the active sites of BuChE. The antioxidant screening showed that compounds 6b, 6c, and 6j displayed superior scavenging capabilities compared to the other compounds. The obtained results suggest that compounds 6f, 6h, and 6j are promising lead compounds for the further development of new potent and selective BuChE inhibitors.

Access to fresh water has become a headache for many nations around the world today due to water scarcity. Since this aspect is increasing, this paper introduces a system to estimate the households’ water needs in a day taking into consideration, the size of the family, zone, temperature, season, working status, location, and religion. By applying machine learning, the system determines the balance of water distribution between the families by these parameters. The predicted values determine the water requirements for each household hence the distribution of water in the households on a particular day. This includes the use of an Arduino microcontroller, water flow meter, and solenoid valves that make the water supply system to be an automatic system. As a result of this, the system helps to control the wastage of water and also ensures that the amount of water required in each home is assessed accurately.

Category: Ankle; Midfoot/Forefoot Introduction/Purpose: As medical and recreational cannabis use continues to increase in prevalence across the United States, it is important to understand the impacts of sustained cannabis use on one’s health. Previous literature has shown the potential for cannabidiol products to aid in the improvement of some osteoarthritic symptoms. However, there is a paucity of literature examining the relationship between cannabis use and postoperative medical outcomes for end stage osteoarthritis management, including procedures such as foot and ankle arthrodesis. Therefore, the purpose of this study was to investigate the relationship between cannabis use and the incidence of medical complications within 90 days of foot or ankle arthrodesis. Methods: A retrospective review of a national insurance claims database was performed from 2010 to 2022. CPT codes were used to identify patients who underwent arthrodesis of the ankle, subtalar, talonavicular, calcaneocuboid, naviculo-cuneiform, midtarsal, tarsometatarsal, metatarsophalangeal, or interphalangeal joints. Of those patients, those with established diagnoses of cannabis use disorder, cannabis dependency, or cannabis addiction were identified using ICD-9 and -10 codes. This cannabis cohort was matched 1:4 on the basis of age, sex, and Charlson Comorbidity Index (CCI) to a control cohort without a history of cannabis use to remove potential confounding upon comparison. Demographic and comorbidity profiles, as well as medical and surgical post-operative outcomes were compared using Chi-square tests. Results: Out of 192,162 patients undergoing foot or ankle arthrodesis, 6,387 had a documented history of cannabis use. Compared to controls, the cannabis cohort was significantly younger (mean age 44.1 vs. 56.5; p< 0.001), exhibited a higher comorbidity burden (mean CCI 1.59 vs. 1.38; p< 0.001), and had a greater proportion of male patients (48.2% vs. 31.9%; p< 0.001). Post-matching for age, CCI, and sex, cannabis users demonstrated a significantly higher incidence of medical complications within 90 days of their index ankle fracture ORIF procedure. Notably, cannabis users exhibited elevated rates of various complications, including pneumonia, deep venous thrombosis, pulmonary embolism, myocardial infarction, stroke, surgical site infection, cardiac arrest, acute kidney injury, urinary tract infection, sepsis, and hypoglycemia compared to matched controls (all p< 0.001). Conclusion: Cannabis use is associated with increased incidences of many serious medical complications within 90 days of foot or ankle arthrodesis. These results may help better inform physicians and patients about the increased postoperative risks cannabis users may face, which may lead to the implementation of tailored perioperative care. Further, these results emphasize the need for further research on the molecular mechanisms of cannabis to understand the risk-benefit ratio between the therapeutic effects of cannabidiol for arthritic pain relief, and the adverse outcomes that may result following surgical intervention.

Category: Ankle; Trauma Introduction/Purpose: As medical and recreational cannabis use continues to increase in prevalence across the United States, it is important to understand how cannabis can impact health. Though prior studies have shown that cannabis use can result in delayed bone healing, there is a paucity of literature examining the relationship between cannabis use and postoperative medical outcomes following fracture fixation. Therefore, the purpose of this study was to investigate the relationship between cannabis use and the incidence of medical complications within 90 days of surgical fixation of ankle fractures. Methods: A retrospective review of a national insurance claims database was performed from 2010 to 2022. Patients who underwent open reduction and internal fixation (ORIF) procedures for medial malleolus fractures, lateral malleolus fractures, distal fibula fractures, bimalleolar fractures, and trimalleolar fractures were identified using CPT codes. Of those patients, those with established diagnoses of cannabis use disorder, cannabis dependency, or cannabis addiction were identified using ICD-9 and -10 codes. This cannabis cohort was matched 1:4 on the basis of age, sex, and Charlson Comorbidity Index (CCI) to a control cohort without a history of cannabis use to remove potential confounding upon comparison. Demographic and comorbidity profiles, as well as medical and surgical post-operative outcomes were compared using Chi-square tests. Results: Out of 788,702 patients undergoing ankle fracture open reduction and internal fixation (ORIF) during the study period, 46,105 had documented cannabis use. Cannabis cohort, compared to controls, exhibited significant differences: younger age (mean 38.8 vs. 52.7 years; p< 0.001), lower comorbidity-burden (mean CCI 1.58 vs. 1.68; p< 0.001), and a higher proportion of male patients (51.1% vs. 33.2%; p< 0.001). Following age, CCI, and sex matching, patients with cannabis use histories showed a significantly increased incidence of medical complications within 90 days post ankle fracture ORIF. Cannabis users displayed elevated rates of various complications compared to matched controls, including pneumonia, deep venous thrombosis, pulmonary embolism, myocardial infarction, stroke, surgical site infection, cardiac arrest, acute kidney injury, urinary tract infection, sepsis, and hypoglycemia (all p< 0.001). Conclusion: Cannabis use is associated with increased incidences of many serious medical complications within 90 days of ankle fracture fixation procedures. These results underscore the importance of eliciting cannabis use history during preoperative patient evaluations so that physicians and patients can be better informed about the increased postoperative risks they may face, and so tailored perioperative care can be appropriately implemented. Further, these results emphasize the need for further research on the molecular mechanisms of cannabis to explain interactions that may predispose heavy cannabis users to this profile of adverse surgical outcomes.

Category: Ankle; Ankle Arthritis Introduction/Purpose: Obesity is an ongoing public health epidemic with wide-ranging implications for orthopaedic surgery. Bariatric surgery has been shown to be an effective method for weight reduction. This retrospective cohort study aimed to compare rates of reoperation between patients who underwent primary ankle arthrodesis (AA) and those who underwent total ankle arthroplasty (TAA) after undergoing bariatric surgery. Methods: Utilizing data from PearlDiver, patients who received primary AA or TAA with prior history of bariatric surgery to a cohort without prior bariatric surgery were retrospectively analyzed for reoperations. Both cohorts were propensity-matched based on age, sex and Charlson Comorbidity Index in a 1:4 ratio. Indications for reoperation included revision, prosthetic joint infection (PJI), hardware removal, adjacent joint fusion, and local open reduction internal fixation (ORIF). Kaplan-Meier survival analysis and hazard ratios were calculated for five years after the procedure. Results: Of the 801 patients with prior history of bariatric surgery, 519 (65%) underwent AA, while 282 (35%) underwent TAA. At 5 years post-operatively, patients who had undergone AA showed a higher incidence of adjacent joint fusion if they had prior history of bariatric surgery (Hazard ratio: 1.79, 95% Confidence Interval: 1.23 - 2.61, P-value < 0.001). No differences in reoperation rates were observed for PJI, hardware removal and ORIF. At 5 years, patients who had undergone TAA with history of bariatric surgery showed no difference in the incidence of revision, PJI, hardware removal, ORIF and adjacent joint fusion as compared to patients who underwent TAA with no history of bariatric surgery. Conclusion: Our findings suggest that patients undergoing primary TAA displayed comparable reoperation rates regardless of prior bariatric surgery history over a five-year post-procedure period. In contrast, patients undergoing primary AA exhibited an increased risk of adjacent joint fusions if they had history of bariatric surgery, although the rates of reoperation due to PJI, ORIF, and hardware removal remained comparable. Notably, our results do not position a prior history of bariatric surgery as a significant determinant in reoperation rates. These insights offer valuable guidance for orthopedic surgeons navigating the complexities of surgical interventions in the context of bariatric surgery.

Abstract Objective Total laryngectomy (TL) is a standard induction treatment for laryngeal cancer. Patients have shown decreased quality of life (QOL) following laryngectomy potentially due to its impact on communication. This study is a systematic review of the effects of TEP on QOL in TL patients. Methods Data was extracted from PubMed, Ovid Medline, and Web of Science. A systematic review of literature assessing QOL after TEP within the last decade was conducted using PRISMA methodology. The initial search yielded 71 publications filtered to 15 after removing duplicates, non‐English publications, and title screening. Two researchers independently reviewed abstracts, and 11 articles were retained. After a full article review, 6 examined QOL in TEP patients. Results The studies concluded that post‐TL, patients with TEP experienced improved QOL than before the procedure or non‐TEP alternatives for speech. The collective sample size yielded 253 patients. Meta‐analysis demonstrated significant improvement in QOL described by the University of Washington—Quality of Life Index (p

Background:. Successful nipple–areolar complex (NAC) reconstruction greatly influences patient outcomes for transgender patients undergoing chest masculinization. Despite the recent rise in case volume, little is known on designing the ideal NAC that maintains its aesthetics in dynamic settings. This study aimed to examine the characteristics of male NACs and their dimensional variability to help develop guidelines on designing the neo-NAC. Methods:. Thirty cisgender male participants were enrolled. NAC height and width, sternal notch-to-nipple distance, and internipple distance (IND) were measured in standing and supine positions with stable room temperature to prevent measurement bias. Other variables recorded included chest circumference, NAC angulation, body mass index, weight, height, age, and ethnicity. Results:. Mean standing and supine measurements were as follows: NAC height, 21.2 mm (SD, 3.9) versus 23.4 mm (SD, 4.7); NAC width, 29.0 mm (SD, 5.1) versus 29.7 mm (SD, 5.6); sternal notch-to-nipple distance, 20.8 cm (SD, 2.1) versus 19.3 cm (SD, 1.8); and IND, 22.4 cm (SD, 2.3) versus 23.5 cm (SD, 2.5). NAC height-to-width ratio decreases from supine to standing, as well as IND, indicating a medialization of the NACs when upright. Conclusions:. Our findings suggest that during chest masculinization surgery, the design of the male neo-NAC has a risk of being positioned too medial and elliptical with upright positioning. Care must be taken intraoperatively to account for changes in neo-NAC dimensions that occur with body position changes. We strongly recommend that surgeons determine the final position of the neo-NAC intraoperatively while having the patient in upright sitting position.

Category: Ankle; Midfoot/Forefoot Introduction/Purpose: With the rising prevalence of cannabis consumption among individuals undergoing foot and ankle procedures, there is a critical need for a comprehensive investigation into the impact of cannabis use on post-operative outcomes. The shifting societal attitudes towards cannabis, coupled with legislative changes promoting increased accessibility, underscore the urgency of understanding the implications for both patients and surgeons. This study aims to address this gap in knowledge and provide insights that can guide pre-operative evaluations and post-operative care planning. Methods: Utilizing data from PearlDiver, patients who underwent interphalangeal fusion, arthrodesis, arthroscopy, total ankle arthroplasty, ankle fracture repair, lateral ankle ligament reconstruction, calcaneal tendon repair, bunionectomy and calcaneal osteotomy were identified. These patients with prior history of cannabis use were propensity-matched with a cohort without prior history of cannabis use based on age, sex and Charlson Comorbidity Index in a 1:4 ratio. Both cohorts were evaluated for 90-day occurrence of medical complications using univariate analysis. Results: In this study, we matched 59,797 patients with a history of cannabis use undergoing foot or ankle procedures with 239,086 without such history. Those with prior cannabis use showed significantly elevated rates of medical conditions compared to controls: pneumonia (6.1% vs. 2.2%, p < .001), deep vein thrombosis (1.5% vs. 0.8%, p < .001), pulmonary embolism (0.4% vs. 0.2%, p < .001), myocardial infarction (1.6% vs. 0.5%, p < .001), stroke (1.8% vs. 0.8%, p < .001), surgical site infections (4.0% vs. 2.2%, p < .001), acute kidney injury (6.8% vs. 3.0%, p < .001), urinary tract infections (9.0% vs. 3.5%, p < .001), sepsis (4.6% vs. 2.0%, p < .001), and hypoglycemia (1.2% vs. 0.5%, p < .001). Conclusion: This study highlights a compelling correlation between prior cannabis use and heightened risks of medical complications post foot and ankle surgeries. The findings emphasize the imperative for healthcare professionals to include cannabis use history in pre-operative assessments and post-operative care planning. Acknowledging the evolving landscape of cannabis use among surgical patients, further research is essential to refine clinical approaches and enhance patient outcomes in this context.

Guru SMPN 4 Kubung sudah memiliki kompetensi dasar yang baik namun kurang dalam memaksimalkan teknologi dengan keterbatasan pelatihan-pelatihan. Selain dari pada itu sekolah sudah memiliki sarana kelas yang dilengkapi dengan proyektor dan layar infocus, serta ketersediaan perangkat lainnya seperti komputer 15 unit, crome book 15 unit dan tablet 82 unit. Sehingga dengan ketersediaan sarana tersebut yang belum dimaksimalkan penggunaannya dalam proses pembelajaran. Proses, melalui program PKM yang dilaksanakan yaitu pemanfaatan teknologi didukung dengan adanya smart board dan AI maka akan terciptanya pembelajaran era digitalisasi yang lebih interaktif.Metode pelaksanaan pengabdian sosialisasi, pelatihan kepada 15 orang guru, penerapan teknologi AI dalam proses pembelajaran di SMPN 4 Kubung, pendampingan dan evaluasiPelaksanaan program pengabdian di SMPN 4 Kubung dengan fokus pada peningkatan dokumen aksi nyata menunjukkan hasil yang signifikan. Hasil analisis data yang akurat dari pelaksanaan pengabdian di SMPN 4 Kubung menunjukkan bahwa penerapan teknologi AI secara signifikan meningkatkan kualitas dokumen aksi nyata yang disusun oleh para guru. Dengan memanfaatkan aplikasi seperti ChatGPT, Gemini, Canva, Quizizz, dan Wordwall, guru-guru dapat menghasilkan dokumen yang lebih terstruktur dan informatif. Kegiatan pengabdian masyarakat dengan judul "Peningkatan Kualitas Aksi Nyata pada Plafon Merdeka Mengajar melalui Pemanfaatan Artificial Intelligence (AI)" di SMPN 4 Kubung telah berhasil mencapai beberapa tujuan. meningkatkan pemahaman guru tentang AI, meningkatkan kemampuan guru dalam mengintegrasikan AI dalam pembelajaran, meningkatkan kualitas aksi nyata guru, meningkatkan efektifitas dan efisiensi proses pembelajaran di SMPN 4 Kubung.

Indonesia is a tropical country with potential plants that have been used as traditional medicine for generations. One of them is bajakah. This study aims to determine the phenolic content and antioxidant activity of yellow bajakah extract and the relationship between phenolic content and antioxidant activity. The study began with making yellow bajakah extract using maceration method. The bajakah extract obtained then analysed the phenolic content quantitatively using the Folin-Ciocalteu method. Antioxidant activity was tested using the DPPH and ABTS methods. The results showed that yellow bajakah extract contained phenolic compounds with levels of 27.15 ± 1.28 mg/g GAE. IC50 measurements to determine antioxidant activity obtained a value of 47.01 ± 1.16 µg / ml in the DPPH method and 61.21 ± 0.83 µg / ml in the ABTS method. Based on these results, yellow bajakah skin is known to have antioxidant activity with a strong category and phenolic content in yellow bajakah skin has an influence on antioxidant activity.

Purpose: To highlight the utility of ganglion cell layer (GCL) analysis in early diagnosis of optic neuropathy secondary to copper deficiency and emphasize the importance of timely repletion for visual recovery. Observations: A 67-year-old woman presented with four months of gradually decreasing vision bilaterally. Medical history was significant for Stage I duodenal and Stage III colon cancer treated with Whipple surgery and hemicolectomy. Her visual acuity at presentation was counting-fingers vision in both eyes (OU). No relative afferent pupillary defect was noted. Fundus exam revealed a questionable trace temporal optic disc pallor with symmetric cup-to-disk ratio of 0.4 OU. Intraocular pressures were within normal limits OU. On initial optical coherence tomography (OCT) analysis, retinal nerve fiber layer (RNFL) measurements were normal OU; however, GCL loss was noted in both eyes, left eye (OS) being worse than right eye (OD). On subsequent formal visual field testing, she had cecocentral scotoma and large nasal step in both eyes, again worse in OS. Laboratory investigations revealed a significantly depleted copper level at less than 500 μg per liter (normal limit of 810–1990), while levels of B1 (thiamine), B9 (folic acid), and B12 (cobalamin) levels were within normal limits. She was started on oral copper supplementation. At 2-year follow-up, her best corrected visual acuity improved to 20/25 OD and 20/40 OS while maintained on oral copper repletion. Conclusions and importance: Optic neuropathy secondary to copper deficiency is a rare but treatable cause of vision loss. In early stages of disease, early GCL loss may precede changes in the RNFL thickness or even appearance of obvious disc pallor on fundus exam. Visual recovery post repletion may be favorable if detected in a timely fashion.

Abstract In this study, the aim is to investigate the effect of engineering the cell size and porosity of 3D‐printed poly lactic acid (PLA) porous scaffolds from the Kelvin model for bone tissue engineering applications. The Kelvin model is used as a bone tissue scaffold with different cell sizes and porosities. PLA, as a biodegradable and biocompatible polymer, is used to fabricate these scaffolds using the FDM technique. A compression test is used to evaluate the mechanical properties of scaffolds. The MTT assay has been used to investigate cell viability. For osteogenic differentiation studies, ALP activity and ARS assays are used. Increasing the porosity reduces the mechanical properties of the scaffold. While increasing the cell size at constant porosity increases the Young's modulus and yield stress in the samples, it is also observed that, in high porosities, the increase in cell size weakens the mechanical properties. Also, Kelvin model scaffolds help the proliferation and osteogenic differentiation of cells and have no toxic effect. It is demonstrated that this approach promotes the effectiveness of the Kelvin architecture for bone tissue engineering. As a result, designing the most suitable model based on cell size and porosity for the treatment process in the targeted area could be promising.

Background: Medical uncertainty may cause distress and challenge medical decision-making for patients with rare diseases and their caregivers. Few studies have examined the experience and management of medical uncertainty in rare disease and the dynamics of multiple medical uncertainty sources, issues, and management strategies. Objective: We explored the experience and management of uncertainty in individuals with telomere biology disorders (TBDs), a set of rare cancer-prone bone marrow failure syndromes, and their caregivers. Design: Participants (N = 32) in this qualitative-descriptive study were individuals with a TBD (n = 17) and/or their caregivers (n = 15). We thematically analyzed transcripts to describe the presence and dynamics of medical uncertainty in TBDs using categories from a previously published taxonomy. Results: Individuals with TBDs and caregivers described medical uncertainty as a chronic burden embodied amidst a range of interrelated sources and issues. Scientific uncertainty included diagnostic and prognostic ambiguity. Practical uncertainty focused on logistical challenges of building and maintaining medical care teams. Personal uncertainty included difficulty realigning self-identity, goals, and relationship expectations post-diagnosis. Scientific, practical, and personal uncertainty issues were entangled. The rarity of TBDs resulted in limited scientific knowledge, which gave rise to practical and personal uncertainties affecting medical decision-making and relationship formation (e.g., creating trusted care teams where patient knowledge of TBDs may exceed that of clinicians). Participants used multiple strategies for uncertainty management, particularly information-seeking and community-building. However, these management strategies could intensify, rather than resolve, participants’ medical uncertainty. Conclusion: In TBDs, medical uncertainty manifests as a network of multiple, interrelated, sources and issues, which require evolving management strategies. Researchers must be mindful that complex, synergistic uncertainty networks contribute to psychosocial challenges in TBDs. Additional research is warranted to address scientific uncertainty in TBDs, including clinical manifestations and underlying biology, and to develop psychosocial interventions that recognize and anticipate evolving uncertainty.

ObjectivesFusobacterium nucleatum is a gram-negative anaerobic bacillus associated with colorectal cancer (CRC). We aimed to determine the abundance of F. nucleatum and other CRC-associated bacteria using quantitative real-time polymerase chain reaction (qPCR) analysis to detect the possible correlations between tumor and normal tissues and the relationships between patients’ clinical characteristics, diet, and CRC-associated bacteria.MethodsA total of 249 biopsy samples of tumor and paired normal tissues were collected from patients with CRC. Biopsy samples were screened for detection of F. nucleatum using qPCR targeting nusG gene. Bacteroides fragilis, Escherichia coli, and Streptococcus gallolyticus were also detected in the samples using species-specific genes.ResultsThe frequencies of detection of F. nucleatum in the tumor and normal tissues of patients with CRC were 43.37 and 24.1%, respectively (P < 0.05). Statistical analysis using cycle threshold (Ct) values from qPCR data and clinical characteristics showed that tumor size, tumor location, and processed meat consumption were significantly correlated with the abundance of F. nucleatum (P < 0.05). The significance of the prevalence of B. fragilis and E. coli in tumor tissues was marginally higher than that in normal tissues (P < 0.1), and the consumption of processed/red meat affected the prevalence of these bacteria (P < 0.05).ConclusionsOur results showed an association between the presence of F. nucleatum in tumor tissues and CRC, indicating that F. nucleatum may be a potential marker for CRC diagnosis. F. nucleatum is enriched in CRC tissues and is associated with CRC development.

Considering the mechanized modern living in restricted indoor spaces, aggression and mental disorders among young people and adults and their negative consequences in Iran, in-depth studies of this issue are important. The purpose of this article is to understand the meaning of combat sports for Iranian athletes and to understand how it drives them to action. Following an Interpretative Phenomenological Analysis (IPA) approach, 17 male kickboxing and muay Thai athletes in the Kurdistan province in western Iran were surveyed through semi-structured interviews. Four main themes and 12 sub-themes were extracted from analyzing the experiences of the research participants: (1) Increasing existential capacity, (2) cultivating a moral personality, (3) enhancing one’s health and (4) improving one’s lifestyle. Our research suggests that, for these participants, kickboxing and muay Thai have a positive effect in many mental, social and moral dimensions of existence. Moreover, because of the potential positive impact on the individual behavior, these sports are also very effective in reducing societal problems such as hooliganism, destructiveness and vandalism, suicide, inappropriate lifestyle, decline of values and violence.

Abstract. Objectives:. To develop and validate a prediction model for a deep surgical site infection (SSI) after fixation of a tibial plateau or pilon fracture. Design:. Pooled data from 2 randomized trials (VANCO and OXYGEN). Setting:. Fifty-two US trauma centers. Patients:. In total, 1847 adult patients with operatively treated tibial plateau or pilon fractures who met criteria for a high risk of infection. Intervention:. We considered 13 baseline patient characteristics and developed and externally validated prediction models using 3 approaches (logistic regression, stepwise elimination, and machine learning). Main Outcomes and Measures:. The primary prediction model outcome was a deep SSI requiring operative debridement within 182 days of definitive fixation. Our primary prognostic performance metric for evaluating the models was area under the receiver operating characteristic curve (AUC) with clinical utility set at 0.7. Results:. Deep SSI occurred in 75 VANCO patients (8%) and in 56 OXYGEN patients (6%). The machine learning model for VANCO (AUC = 0.65) and stepwise elimination model for OXYGEN (AUC = 0.62) had the highest internal validation AUCs. However, none of the external validation AUCs exceeded 0.64 (range, 0.58 to 0.64). Conclusions:. The predictive models did not reach the prespecified clinical utility threshold. Our models' inability to distinguish high-risk from low-risk patients is likely due to strict eligibility criteria and, therefore, homogeneous patient populations.

Endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNA) of the pancreas is performed routinely in many endoscopic centers as part of the diagnostic set-up for suspected pancreatic cancer. The use of transesophageal bronchoscopic ultrasound-guided fine needle aspiration (EUS-B-FNA) by pulmonologists has expanded significantly, since it enables effective diagnosis of lesions in the mediastinum and upper abdomen. The following case demonstrates the safety and feasibility of EUS-B-FNA in a patient with non-small cell lung cancer (NSCLC) cancer and a pancreatic mass of unknown origin. A patient who was previously diagnosed with NSCLC was referred to the Department of Respiratory Medicine, Odense University Hospital due to suspected recurrence of NSCLC. The patient underwent endobronchial ultrasound guided (EBUS)-FNA from several suspected mediastinal lymph nodes and combined EUS-B-FNA from a pancreatic mass during the same procedure. Pathology results from the pancreatic mass and from the mediastinal lymph nodes showed squamous-cell carcinoma, metastasis from the previous NSCLC. We here by demonstrated that EUS-B-FNA is a feasible and safe technique to obtain tissue samples from pancreatic lesions in patients under investigation for lung cancer.

Background: The aim of this cross-sectional study was to investigate the prevalence of sleep disturbance and its possible associated factors among Iranian medical students. Additionally, a national meta-analysis was conducted to provide a comprehensive overview of sleep disturbance in this population. Methods: A sample of medical students from Guilan University of Medical Sciences, Iran was included in the study. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep disturbance. Demographic and lifestyle factors, as well as academic performance, were collected through a self-administered questionnaire. The data collected from this study were combined with existing studies through a meta-analysis to estimate the overall prevalence of sleep disturbance among Iranian medical students using the random effects model. Results: A total of 249 medical students participated in the study. The prevalence of sleep disturbance among Guilan University of Medical Sciences medical students was found to be 71.1%. A significant difference was observed in total PSQI means regarding medical students’ residency (p

Background The haplotypes from Northern, Southern, Eastern, and Western Kazakhstan, analysed for 27 Y-STR loci, have been contributed to the Y-Chromosome STR Haplotype Reference Database, while the genetic profile of Central Kazakhstan remains inadequately explored.Aim To investigate the genetic diversity of 27 Y-STR loci in the Kazakh populations from Central Kazakhstan.Subjects and methods A total of 112 unrelated Central Kazakh males were genotyped via the Yfiler Plus kit. Data analysis yielded haplotype and allele frequencies, and forensic parameters. Genetic distances were graphically represented by a multidimensional scaling plot, with genetic linkages further elucidated through Nei’s distance dendrograms and Median-joining networks.Results A total of 102 haplotypes were detected, of which 96 were unique. The haplotype diversity and discrimination capacity were 0.997 and 0.91, respectively. Central Kazakhstan displays a unique cluster in analyses, underscoring its distinct Y-chromosome diversity compared to other Kazakh regions. The analysis of the Naiman tribe, predominantly residing in Central, Southern and Eastern Kazakhstan, revealed three genetic clusters of distinct haplogroups associated with their clans.Conclusions The identified haplotypes will enhance the existing reference database for Y-chromosomal studies in Kazakhstan, offering a robust tool for future research in population genetics, forensic science and genetic genealogy.

SUMMARY: This experiment aimed to assess the effects of combining early or late feeding programs with prebiotics on the growth performance, carcass characteristics, blood metabolites, mucin-2 gene expression, and intestinal morphology of broiler chickens. A total of 720 day-old male and female (50:50) broiler chicks were randomly assigned to a 2 × 3 factorial arrangement with 24 experimental units (pens) and 30 birds/pen for 6 wk. Six treatments consisted of 2 feeding programs (early: fed at hatchery; or late: 48 h feed deprivation) and 3 levels of prebiotic supplementation (none, recommended dosage, or 3 times the recommended dosage). Late access to feed during the starter phase resulted in decreased feed intake (FI) and weight gain (WG), as well as increased feed conversion ratio (FCR) (P < 0.05). During the entire rearing period, broilers in the early feeding program, fed diets without prebiotics had higher mortality rates compared to other treatment groups (P < 0.05). Also, the feeding programs and inclusion of prebiotics in the diets did not have a significant effect on FI, WG, or FCR. In both feeding programs, the supplementation of prebiotic resulted in improved ileal morphology indicators and increased mucin-2 gene expression (P < 0.05). The use of prebiotic in both the early and late access to feed groups led to decreased serum levels of triglycerides and uric acid (P < 0.05). In conclusion, late access to feed negatively affected the early growth performance of broiler chicks. Prebiotic supplementation positively influenced mucin-2 gene expression, especially in early feeding programs. Early feed access combined with prebiotics improved intestinal health compared to late access. While prebiotic did not affect overall growth performance, it reduced mortality rates. Further studies are recommended.

Introduction: Carpal Tunnel Syndrome (CTS) is one of the most common problems in the upper extremities caused by the narrowing of the carpal tunnel, which results in pressure on the median nerve. Increased pressure in the carpal tunnel causes compression and damage to the median nerve. Objective: determinants associated with carpal tunnel syndrome . Methods: quantitative research with a cross-sectional research design. The sampling technique in this study used a total sampling technique in which the entire population is equal to the number of samples, namely 36 people. Data obtained by using a questionnaire. The analytical method used was univariate and bivariate analysis using the chi-square test. Result: showed that there was a relationship between length of work and carpal tunnel syndrome (p-value = 0.0190. There is a relationship between age and complaints of carpal tunnel syndrome (p-value = 0.032. There is no relationship between personal protective equipment and complaints of carpal tunnel syndrome (p-value = 0.759). There is no relationship between repetitive movements and carpal tunnel syndrome (p-value = 0.787. Conclusion: It was concluded that there is a relationship between length of service and carpal tunnel syndrome complaints, there is a relationship between age and carpal tunnel syndrome complaints and there is no relationship between body mass index and carpal tunnel syndrome complaints . In this study, researchers suggest to companies to pay more attention to employees who have a long working period so as not to do excessive work and for employees to take advantage of adequate rest time to minimize the occurrence of complaints of Carpal Tunnel Syndrome (CTS).

Sulawesi Island is one of the largest Ni ore producers in Indonesia. It is also expected to be a significant potential source of some critical metals (e.g., Co, Sc, rare-earth elements, and platinum-group elements). However, few studies show the post-mining impact on some heavy metal elements concentrated in this area. Therefore, improving the efficiency and effectiveness of soil organization and its effect on soil reclamation after mining is helpful. This study aimed to determine the accuracy in estimating the thickness of the overburden covering the nickel ore body profile from lateritic nickel post-mining areas by magnetic susceptibility measurements to discrepancy the overall laterite horizon, whereas χLF and χFD are used to distinguish the overburden zona and limonite and saprolite zone. The lateritic profile studied consists of soil formation of Fe-rich material in the Morowali, and Pomalaa block. We also evaluated the chemical element content of the soil and understood the relationship between the magnetic and geochemical properties of the soil. This study reveals the superparamagnetic (SP)-enriched soils indicated with the increase of the FD% values into the upward horizon, where the maximum values of FD are generally found at ranges 1 to 4m, indicating the overburden layers. Meanwhile, in the depth of 4m to 6m, the values of FD vary only slightly in the lower part initiated by the limonite layers, and then > 6m decreases sharply to the bottom, indicating the saprolite layers. The chemical element mobility trends indicate that Fe, Co, Cr, Mn, and Ti increase toward the layers, which is the same pattern as in FD. Due to this, parameters magnetics may also be a new geophysical approach for estimating the distribution of economically valued minerals on lateritic soils. The strong correlation of Co with Fe, Mn, and Cr in all layers indicates the influence of weathering o n these ultramafic rocks. This suggests an increasing trend toward prolonged pedogenesis.

Abstract Background Intravenous administration of magnesium sulfate (MgSO4) to expectant individuals before childbirth, has been evaluated to reduce the likelihood of mortality and occurrence cerebral palsy in their offspring. Therefore, this systematic review and meta-analysis conducted to determine if were the prophylactic use of magnesium sulfate in women at risk for preterm delivery leads to decrease in the incidence of death or cerebral palsy. Methods A comprehensive search of electronic databases was done to identify relevant studies. Selection of eligible studies was based on predetermined inclusion criteria. Data extraction was performed, and the methodological quality of the selected studies was assessed using appropriate evaluative tools. A meta-analysis was carried out to estimate the overall effect of intravenous administration of magnesium sulfate on the incidence of death or cerebral palsy. Results A total of 7 studies met the inclusion criteria and were included in the final analysis. No significant publication bias was observed. The risk of fetal neurological impairment was significantly lower in the MgSO4 group compared to the control group relative risk (RR = 0.70, 95% CI: 0.56 to 0.87; I20%). However, neonatal mortality was not significantly associated with MgSO4 injection. (RR = 1.03, 95% CI: 0.88 to 1.21; I2 = 42%). Subgroup analysis was done based on the bolus dosage of MgSO4 and the duration of the trial follow-up. revealing a non-significant differences between-group. Conclusion This study demonstrated that MgSO4 administration can improve fetal neurological impairment and cerebral palsy but is not linked to reducing mortality. Further studies are necessary to strengthen the evidence and clarify the underlying mechanisms.

Whipple disease is a rare systemic illness associated with weight loss, diarrhea, and arthralgia. Asymptomatic carriage is common, but the disease can be complicated by cardiac involvement and may result in culture-negative endocarditis. Cardiac manifestations of the disease can lead to death. This report presents the case of a 66-year-old man with Whipple disease and biventricular heart failure with cardiogenic shock. Medical therapy followed by successful replacement of the aortic and mitral valves resulted in substantial improvement.

Abstract Improper use of social media during the COVID-19 outbreak, leading to fear and misunderstanding, can contribute to psychological disorders in vulnerable populations. This descriptive and analytical cross-sectional study was conducted in 2023 on 511 medical students of Babol University of Medical Sciences. Data were collected using demographic, psychological distress, fear and misunderstanding questionnaires related to COVID-19 and social media dependency. A total of 511 medical students, with an average age of Mean and S.D; 23.57 ± 3.03 participated in the study. The average psychological distress score was 23.82 ± 7.73 (out of 54), the average score of social media dependency was 17.53 ± 3.09 (out of 30), for the fear of COVID-19 was12.63 ± 2.56 (out of 35), and for the misperception of COVID-19 was 0.53 ± 0.09 (out of 18). Path analysis results) showed that direct path from improper use of social media to psychological distress is significant (P