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During 1979–2022, Cameroon recorded 32 laboratory-confirmed mpox cases among 137 suspected mpox cases identified by the national surveillance network. The highest positivity rate occurred in 2022, indicating potential mpox re-emergence in Cameroon. Both clade I (n = 12) and clade II (n = 18) monkeypox virus (MPXV) were reported, a unique feature of mpox in Cameroon. The overall case-fatality ratio of 2.2% was associated with clade II. We found mpox occurred only in the forested southern part of the country, and MPXV phylogeographic structure revealed a clear geographic separation among concurrent circulating clades. Clade I originated from eastern regions close to neighboring mpox-endemic countries in Central Africa; clade II was prevalent in western regions close to West Africa. Our findings suggest that MPXV re-emerged after a 30-year lapse and might arise from different viral reservoirs unique to ecosystems in eastern and western rainforests of Cameroon.

Immune-mediated selection pressures impact the clonal evolution of tumours. Here, in hepatocellular carcinoma the authors map spatio-temporal interactions between tumor and immune cells, highlighting the regulatory substrate of intra-tumoural heterogeneity that correlates with regional adaptive immune responses.

This data article contains eleven tables supporting the research article entitled: Cost-Optimal Design For Nearly Zero Energy Office Buildings Located In Warm Climates [1]. The data explain the procedure of minimum energy performance requirements presented by the European Directive (EPBD) [2] to establish several variants of energy efficiency measures with the integration of renewable energy sources in order to reach nZEBs (nearly zero energy buildings) by 2020. This files include the application of comparative methodological framework and give the cost-optimal solutions for non-residential building located in Southern Italy. The data describe office sector in which direct the current European policies and investments [3,4]. In particular, the localization of the building, geometrical features, thermal properties of the envelope and technical systems for HVAC are reported in the first sections. Energy efficiency measures related to orientation, walls, windows, heating, cooling, dhw and RES are given in the second part of the group; this data article provides 256 combinations for a financial and macroeconomic analysis.

Monkeypox virus (MPXV) is an emerging zoonotic Orthopoxvirus causing mpox in humans, a disease similar to the eradicated smallpox (1). Since identification in a monkey in 1958 (2) and a [...]

KRAS is mutated in about 20-25% of all human cancers and especially in pancreatic, lung and colorectal tumors. Oncogenic KRAS stimulates several pro-survival pathways, but it also triggers the trans-activation of pro-apoptotic genes. In our work, we show t

ContextExposure to secondhand smoke (SHS) has been reduced in the USA by banning smoking in public places. These restrictions have not had the same effect on children's exposure to SHS as adults suggesting that children are exposed to SHS in locations not covered by bans, such as private homes and cars.ObjectivesAssess exposure to SHS in the backseat of a stationary vehicle where a child would sit, quantify exposures to fine particulates (PM2.5), polycyclic aromatic hydrocarbons (PAH), carbon monoxide (CO) and nicotine. Estimate the impact on a child's mean daily exposure to PM2.5.MethodsSHS exposures in stationary vehicles with two different window configurations were monitored. A volunteer smoked three cigarettes in a one-hour period for twenty-two experiments. PM2.5, CO, nicotine and PAH where measured in the backseat of the vehicle. 16 PAH compounds were measured for in gas and particle phases as well as real-time particle phase concentrations.ResultsThe mean PAH concentration, 1325.1 ng/m(3), was larger than concentrations measured in bars and restaurants were smoking is banned in many countries. We estimate that a child spending only ten minutes in the car with a smoker at the mean PM2.5 concentration measured in the first window configuration--1697 mg/m(3)--will cause a 30% increase to the daily mean PM2.5 personal average of a child.ConclusionsEstimates made using the measured data and previously reported PM2.5 daily mean concentrations for children in California showing that even short exposure periods are capable of creating large exposure to smoke.

Abstract The only currently licensed vaccine against tuberculosis (TB), Bacille Calmette Guérin (BCG), is insufficient to control the epidemic. MTBVAC is a live attenuated strain of Mycobacterium tuberculosis (M.tb) and is one the most advanced TB vaccine candidates in the pipeline. It is more efficacious than BCG in preclinical models including non-human primates (NHPs), and has demonstrated safety and immunogenicity in human populations. To better understand the immune mechanisms underlying the superior efficacy conferred by MTBVAC, we characterized M.tb-specific antibody responses in NHPs vaccinated with either BCG or MTBVAC. MTBVAC vaccination induced higher titers of IgG, IgM and IgA, and higher avidity IgG compared with BCG vaccination. IgG avidity correlated with protection following M.tb challenge in the same animals, validating the association previously reported between this measure and protection in the context of intravenous BCG vaccination, suggesting that IgG avidity may represent a relevant marker or correlate of protection from TB.

In this paper, we draw attention to the profound lack of racial diversity as well as the prevalence of whiteness within Canadian faculties of Kinesiology and Physical Education. In support of our argument that there exists an immediate need for equity programming within physical education in higher education, we present the results from two interconnected studies designed to make transparent: (1) the demographic character of faculties of Kinesiology and Physical Education across Canada; as well as (2) the delivery of content related to race, diversity and whiteness within the curriculum. In the first study, we collected website representations of faculty and staff (i.e. photos) as well as lists of curricular offerings for each of the member institutions of the Canadian Council of University Physical Education and Kinesiology Administrators. Website documents were downloaded, analyzed and organized according to criteria related to race and diversity. The follow-up study consisted of interviews with 40 faculty members across Canada where we asked questions pertaining to their perceptions of the faculty setting (i.e. the demographic make-up of their faculty including faculty, staff and students as well as the culture within the faculty) and the curriculum. As a method of triangulation, interview data was used to confirm and inform our analysis of the initial website data; when combined, the analyses provide a comprehensive picture of the cultures of whiteness that exist within physical education in higher education. In order for physical education to be truly inclusive, we call for the development of greater alliances across disciplines and geographic borders such that the hegemony of whiteness within the (physical education) academy can be disrupted. (Contains 4 figures and 1 note.)

Artificial Intelligence (AI) has revolutionized various industries by learning from data, mimicking human behavior, and making autonomous decisions. However, despite AI's advancements in data processing and decision-making, it cannot fully replicate human attributes such as emotional understanding and ethical judgment. This paper explores the intersection of AI and Human Intelligence (HI) within the audit profession, focusing on the implications for the auditor’s professional judgment and skepticism. The integration of AI in auditing promises enhanced efficiency, precision, and data processing capabilities beyond human limits. However, it also raises ethical concerns regarding data privacy, algorithmic bias, and accountability. These concerns highlight the importance of maintaining human oversight and ethical standards in audit practices. Through a comprehensive literature review, this study compares the cognitive abilities, functional capabilities, and ethical implications of AI and human auditors. Key findings underscore AI's potential to complement human auditors by improving accuracy and uncovering anomalies, while recognizing the irreplaceable role of human judgment in complex decision-making processes. The study provides insights into the transformative impact of AI on the audit profession, advocating for a balanced approach that harnesses AI's capabilities while preserving the integrity and critical thinking of human auditors. The findings contribute to a deeper understanding of AI's integration into auditing, informing best practices and guiding future research in maintaining the profession's standards amidst technological advancements.

Abstract Background Formal assessment of a surveillance system’s features and its ability to achieve objectives is crucial for disease control and prevention. Since the implementation of the mpox surveillance system in Cameroon, no evaluation has been conducted. Methods In a cross-sectional study, we assessed the performance of the mpox surveillance system in accordance with the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) guidelines. We collected mpox surveillance data from 2018 to 2022 and conducted a survey with key stakeholders of the surveillance program. The survey results were summarized. The rates of complete reporting and mpox detection, as well as the time lag between the different stages of surveillance were analyzed using R version 4.1. Results The mpox detection rate was 21.6% (29/134) over the five years under review. Surveillance indicators revealed that a combination of sample types, including vesicles, crust, and blood, was associated with higher case confirmation. Overall, the mpox surveillance system was effective. Weaknesses in terms of simplicity were identified. Most components of the assessed system failed to meet the timeliness and data quality goals, except for the laboratory component, which was commendable. The lack of a computerized shared database and the system’s non-sustainability were a course of concern. Conclusions Despite all identified bottlenecks in the mpox surveillance system in Cameroon, it was found to meet it stipulated goals. Recommendations are made for training on surveillance system features, particularly at the facility/field level. Therefore, there is a crucial need to globally improve the mpox surveillance system in Cameroon for better disease control.

Objectives Dupilumab, an anti-IL-4 receptor monoclonal antibody (mAb), was recently approved for the treatment of severe chronic rhinosinusitis with nasal polyps (CRSwNP). The main objective of this study was to assess whether previous exposure to biological treatment affected the clinical outcomes in CRSwNP and asthma patients, treated with dupilumab over time. A collateral secondary objective was to analyse the effects over time of dupilumab in patients with and without aeroallergen sensitization.Methods Single-centre retrospective observational study on severe CRSwNP patients treated with dupilumab. Nasal polyp score (NPS), visual analogue scale (VAS) symptom score, sinonasal outcome test (SNOT-22), aeroallergen sensitization, total serum IgE levels, and blood eosinophil counts were assessed at baseline and after 4, 6 and 12 months.Results 42 patients were included, 40 (95.2%) had asthma. Twenty-one (50%) patients received dupilumab without prior biological treatment (Group A: naive) and 50% switched to dupilumab from previous biological treatment (Group B: pre-treated). NPS, VAS symptoms, SNOT-22 improved significantly after 12 months treatment in both groups of patients (p

Purpose: To study the treatment and outcomes of children with retinoblastoma (RB) with extraocular tumor extension (RB-EOE) and compare them with RB without extraocular tumor extension (RB-w/o-EOE). Design: Multicenter intercontinental collaborative prospective study from 2017 to 2020. RB-EOE cases included those with overt orbital tumor extension in treatment-naive patients. Cases with microscopic orbital extension detected postenucleation were excluded from the study. Participants: A total of 319 children with RB-EOE and 3116 children with RB-w/o-EOE. Intervention: Chemotherapy, enucleation, exenteration, radiotherapy. Main Outcome Measures: Systemic metastasis and death. Results: Of the 3435 RB patients included in this study, 309 (9%) were from low-income countries (LIC), 1448 (42%) from lower-middle income, 1012 (29%) from upper-middle income, and 666 (19%) patients from high-income countries. There was an inverse relationship between the percentage of RB-EOE and national income level, with 96 (31%) patients from LIC, 197 (6%) lower-middle income, 20 (2%) upper-middle income, and 6 (1%) patients from high-income countries (P = 0.0001). The outcomes were statistically significant for RB-EOE compared with RB-w/o-EOE: systemic metastasis (32% vs. 4% respectively; P = 0.0001) and metastasis-related death (63% vs. 6% respectively; P = 0.0001). Multimodal treatment was the most common form of treatment (n = 177; 54%) for RB-EOE, with most cases undergoing a combination of intravenous chemotherapy and enucleation (n = 97; 30%). Adjuvant external beam radiotherapy (EBRT) after surgery (enucleation/orbital exenteration) was given in only 68 (21%) cases. Kaplan–Meier analysis for systemic metastasis and metastasis-related death in RB-EOE was 28% and 57% at 1 year, 29% and 60% at 2 years, and 29% and 61% at 3 years, respectively. Cox regression analysis revealed that the risk of death from RB-EOE was greater in patients aged >4 years than

In supporting the phase-out of the fossil fuels, Roof Top Photovoltaic (RTPV) deployment has been adopted worldwide as an important step of a bottom-up driving pathway of citizens’ transformation to become net energy producers within the community of their localized building environment. However, the diverse bioclimatic conditions of this environment may affect the best RTPV implementation. This is facilitated by climate-related characterization and regional adaptation. Hence, the built environment globally as a function of the global horizontal irradiation (GHI), the local environmental parameters of the different climatic zones and the associated technological developments are surveyed.In this work, we have critically assessed the RTPV effect on the building's overall energy performance and found beneficial over a diverse range of moderate and warm climates. By applying adequate insulation beneath the RTPVs, the increased heating needs in winter in cold climates or higher nighttime cooling needs in summertime can be avoided. To design low-energy buildings, we propose an analytical framework based on the space energy coverage by RTPV and the global horizontal irradiation. Moreover, RTPV cooling at elevated temperatures improves the efficiency up to 20 % and increases the generated electricity up to 15 %. Increasing the RTPV efficiency with emerging technologies could extend the decarbonization of high-rise buildings with energy efficiency and RTPV measures. To accelerate the clean energy transition, rooftop PVs should be widely adopted for sustainable solar building applications. Combined with electrical storage, this will allow renewable energy resources to cover a large fraction of future building energy needs worldwide.

En el artículo se propone una estrategia para la capacitación de los tutores de la práctica pedagógica en el adiestramiento laboral en el Instituto Superior de Ciencias de la Educación (ISCED) en la provincia Huambo-Angola, que responde a las insuficiencias detectadas durante el adiestramiento laboral de los estudiantes de quinto año de la carrera Matemática. A través de la aplicación de métodos empíricos se logró identificar que una de los causales fundamentales que propician estas insuficiencias está dada por la falta de preparación de los profesores que asumen el rol de tutores durante esta etapa para orientar, acompañar y evaluar a los estudiantes en formación. La propuesta fue sometida al criterio de expertos y fue valorada de pertinente y factible, lo que permite a estos estudiantes apropiarse de los conocimientos y las habilidades necesarias para enfrentar esta labor en el nuevo contexto en que se desarrolla la Educación en Angola.

In today's rapidly evolving world, the importance of sustainability and circularity has become more prominent than ever. Businesses and economies worldwide are recognizing the need to transition towards a circular model, where resources are used efficiently and waste is minimized. This transition necessitates changes across all sectors, including financial auditing. While the main object of financial audit is to provide an opinion on financial statements to ensure that it gives true and fair view of the accounts, the auditor will also need to assess an organization's sustainability by evaluating its environmental and social impact, resource efficiency, and circularity performance. It becomes more and more important that the financial auditor should provide a comprehensive assessment of the organization's sustainability practices, enabling stakeholders to understand its commitment to environmental responsibility, social equity, and economic resilience. Auditing sustainability reporting involves different challenges compared to those encountered in auditing financial statements. The independent audit report issued by the financial auditor on sustainability reporting plays an essential role in building confidence in the robustness of non-financial information, providing benefits such as: ensuring the credibility of ESG information presentations within the annual report; creating a positive impact on the company's reputation; strengthening the company's awareness of material ESG risks and facilitating the improvement of internal systems, processes and controls and the company's performance in the ESG area; better positioning of the company in ESG rating rankings. Hence, auditing sustainability reporting goes beyond financial metrics and includes non-financial indicators that reflect the organization's triple bottom line – people, planet, and profit. Henceforth, by expanding the scope of financial audits to incorporate sustainability metrics, audit companies can demonstrate their commitment to the circular economy and provide transparency regarding their clients’ environmental and social performance. Henceforward, auditing sustainability reporting not only enables stakeholders to make informed decisions, but also promotes accountability and incentivizes organizations to adopt circular practices. In this context, to effectively track, measure, and assess the sustainability performance of organizations, emerging technologies play a crucial role. This paper explores the role of emerging technologies in facilitating the transition of financial auditing towards a circular economy by employing a Reflexive Thematic Analysis (RTA). Analyzing the literature on the subject is the first step in the process, which is followed by a reflective study of the underlying themes and their consequences for financial auditing procedures. Several important themes emerged, highlighting the benefits, difficulties, as well as moral and social ramifications of integrating modern technology. These themes draw attention to the topic's complexity and shed light on the opportunities and difficulties that come with incorporating emerging technologies into an audit engagement on sustainability reporting.

Background/Aims New prognostic markers are needed to identify patients with hepatocellular carcinoma (HCC) who carry a worse prognosis. Ultra-low-pass whole-genome sequencing (ULP-WGS) (≤0.5× coverage) of cell-free DNA (cfDNA) has emerged as a low-cost promising tool to assess both circulating tumor DNA (ctDNA) fraction and large structural genomic alterations. Here, we studied the performance of ULP-WGS of plasma cfDNA to infer prognosis in patients with HCC. Methods Plasma samples were obtained from patients with HCC prior to surgery, locoregional or systemic therapy, and were analyzed by ULP-WGS of cfDNA to an average genome-wide fold coverage of 0.3x. ctDNA and copy number alterations (CNA) were estimated using the software package ichorCNA. Results Samples were obtained from 73 HCC patients at different BCLC stages (BCLC 0/A: n=37, 50.7%; BCLC B/C: n=36, 49.3%). ctDNA was detected in 18 out of 31 patients who received systemic treatment. Patients with detectable ctDNA showed significantly worse overall survival (median, 13.96 months vs not reached). ctDNA remained an independent predictor of prognosis after adjustment by clinical-pathologic features and type of systemic treatment (hazard ratio 7.69; 95%, CI 2.09–28.27). Among ctDNA-positive patients under systemic treatments, the loss of large genomic regions in 5q and 16q arms was associated with worse prognosis after multivariate analysis. Conclusions ULP-WGS of cfDNA provides clinically relevant information about the tumor biology. The presence of ctDNA and the loss of 5q and 16q arms in ctDNA-positive patients are independent predictors of worse prognosis in patients with advanced HCC receiving systemic therapy.

In the context of globalization, the transactions between business partners become more and more diverse and require special attention from commercial banks and factoring companies, both with regard to settlement, in order to avoid possible financial blockings, and with regard to the security and protection of the interests of parties, by using funding techniques, specific products and services. Factoring provides companies the possibility of funding based on trading receivables received from third parties. The aim of the article is to shed light on the accounting and tax approach of this funding technique that, although it has lots of advantages, is too little known and employed in the Romanian business environment.

Raymond Williams' concept of 'structures of feeling' is used to analyze the way racism shapes the feelings, beliefs, and practices of Whites as evident in dominant fan, player, administrator, and media responses to tennis stars Venus and Serena Williams. The analysis surrounding the Williams sisters additionally demonstrates the limits of symbolic inclusion as these liberal white gestures frequently cover the discursive forces that sustain racial injury and inequality.

This paper presents the manner of teaching, developing and continuously improving the chapter called “Ruled Surfaces with a Director Plane” taught to first-year students of the Faculty of Civil Engineering of Cluj-Napoca. The aim of this effort lies in making undergraduates familiar with the representation of various types of surfaces, while also developing the ability of space sight and stimulating creativity.

Building energy regulations are essential for reducing energy consumption in the European Union (EU) and achieving climate neutrality goals. This data article supplements the “Overview of EU Building Envelope Energy Requirement for Climate Neutrality” by presenting a detailed dataset on building regulations across all 27 EU member states, with a focus on building envelope efficiency. The data include thermal transmittance limits for windows, walls, floors, and roofs, offering insights into regulatory differences and potential opportunities for harmonization. Information was sourced from the Energy Performance of Buildings Directive (EPBD) database, national reports, and scientific literature to ensure comprehensive coverage. Key aspects of each country’s regulations are summarized in tables, covering both new constructions and renovations. The inclusion of Köppen–Geiger climate classifications allows for climate-specific analyses, providing valuable context for researchers, policymakers, and construction professionals. This dataset enables comparative studies, helping to identify best practices and inform policy interventions aimed at enhancing energy efficiency across Europe. It also supports the development of tailored strategies to improve building performance in different environmental conditions, ultimately contributing to the EU’s energy and climate targets.

Background: Spontaneous remission of cancer is a rare and poorly understood phenomenon characterized by complete or partial remission of a malignancy in the absence of or with inadequate treatment. The underlying mechanism for such occurrences is poorly understood, however, immune mechanisms seem to play an important role in such cases. In recent years increasingly more data have become available in favor of the clinical benefit of low levels of chimerism in hematologic malignancies. One such instance of naturally occurring low-level chimerism is feto-maternal microchimerism which has been shown to influence cancer progression and, in some instances, to be a protective factor against malignancy. Case report: We report a case of a young female patient with aggressive primary mediastinal large B cell lymphoma refractory to two lines of chemo-immunotherapy achieving sustained complete metabolic remission of tumor while pregnant with twins. Results: A focus on feto-maternal microchimerism during and after pregnancy revealed transient levels of feto-maternal microchimerism in the peripheral blood of the patient as measured by quantifying the Y-chromosome-linked SRY gene. Conclusions: Microchimerism presents significant potential for enhancing our comprehension of disease mechanisms, uncovering novel therapeutic targets, and refining diagnostic and treatment approaches, especially concerning cancer.

Capillary leak syndrome is a rare complication of cancer, particularly of hematologic malignancies. The syndrome was first described as an idiopathic entity; however, increasingly, more cases are being reported in association with cancers and other conditions. Diagnosis stems from the recognition of the double paradox, consisting of severe generalized oedema and hypotension, accompanied by hallmark laboratory modifications. Concurrent conditions in patients with malignancies can alter laboratory findings and make the diagnosis a challenge. This report presents the case of a patient with capillary leak syndrome and an atypical presentation, with generalized skin rash and transcutaneous exudation occurring concurrently with anaplastic large T cell lymphoma, macrophage activation syndrome, and cytopenias. Symptom-specific treatment with diuretics and albumin was ineffective in the case of our patient; however, the CLS remitted promptly with cancer-specific therapy. No treatment has proved to be generally effective against CLS up to date, as is the case for this patient. Thus, the rapid recognition of cancer-associated capillary leak syndrome and the initiation of cancer-specific treatment proves to be the better approach and is key to avoiding unnecessary delays and ineffective treatments targeted specifically at CLS.