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In this study, TiC0.5N0.5–60 wt% W and TiC0.5N0.5–70 wt% W cermet cutting tool specimens consisting of Ti(C, N) core, W-rich Ti(C, N) rim, and W-based alloy phases with much higher strengths than conventional heat-resistant tool materials at temperatures above 1673 K were fabricated by spark plasma sintering, electric discharging, and polishing. The cutting performance characteristics of the cermet cutting tool specimens were then examined and compared with those of commercially available NX2525, JX1, and HTi10 cutting tool specimens when cutting S32750 super-duplex stainless steel round bars under dry condition at a cutting speed of 800 m/min. The NX2525, JX1, and HTi10 specimens were TiC–Ni-based cermet containing Mo, Nb, and Co, WC–Al2O3-based composites, and WC–Co cemented carbide, respectively. The TiC0.5N0.5–70 wt% W and TiC0.5N0.5–60 wt% W cermet cutting tool specimens exhibited the first and second longest lifetimes among all the noncoated cutting tool specimens. The lifetime of the TiC0.5N0.5–70 wt% W cermet cutting tool specimen was extended by coating it with TiAlN film by physical vapor deposition. In contrast, the TiC0.5N0.5–60 wt% W and TiC0.5N0.5–70 wt% W cermet specimens exhibited compressive strengths much higher than those of the NX2525, JX1, and HTi10 specimens at 1973 K, whereas all the specimens exhibited similar compressive strengths at room temperature.

Abstract How we move our bodies affects how we perceive sound. For instance, head movements help us to better localize the source of a sound and to compensate for asymmetric hearing loss. However, many auditory experiments are designed to restrict head and body movements. To study the role of movement in hearing, we developed a behavioral task called sound-seeking that rewarded freely moving mice for tracking down an ongoing sound source. Over the course of learning, mice more efficiently navigated to the sound. Next, we asked how sound-seeking was affected by hearing loss induced by surgical removal of the malleus from the middle ear. After bilateral hearing loss sound-seeking performance drastically declined and did not recover. In striking contrast, after unilateral hearing loss mice were only transiently impaired and then recovered their sound-seek ability over about a week. Throughout recovery, unilateral mice increasingly relied on a movement strategy of sequentially checking potential locations for the sound source. In contrast, the startle reflex (an innate auditory behavior) was preserved after unilateral hearing loss and abolished by bilateral hearing loss without recovery over time. In sum, mice compensate with body movement for permanent unilateral damage to the peripheral auditory system. Looking forward, this paradigm provides an opportunity to examine how movement enhances perception and enables resilient adaptation to sensory disorders.

Abstract Supraphysiological doses of anabolic–androgenic steroids (AAS) is popular among recreational weightlifters and bodybuilders due to the performance-enhancing properties but is also associated with adverse cardiovascular effects. The knowledge about how AAS affect the vasculature is limited, although results from previous studies suggest alterations in vasoreactivity and morphology. In the present study we investigate the association between long-term use of AAS and vascular function. Hundred and twenty-three males were included in the study, 56 of them current AAS users and 67 weightlifting controls. Vascular function was evaluated by carotid artery reactivity and flow-mediated dilation. AAS users had significantly reduced carotid artery reactivity (p

Abstract Conjugation to a carrier protein is essential to give rise to the antigenicity of hapten. Three carrier proteins e.g. KLH (Keyhole Limpet hemocyanin), BSA (bovine serum albumin), and OVA (Ovalbumin) were used mostly. KLH is advantageous to the others, majorly owing to its strong immunogenicity and limited usage in other biological assays. However, the cost of obtaining Keyhole Limpet is high and the solubility of KLH is not as well as the other carriers, especially after hapten conjugation. Here, we extracted the shrimp hemocyanin (SHC) from Litopenaeus vannamei (L. vannamei), which is a commonly sea product worldwide. The high pure SHC could be acquired by two-step purification, with a production yield of > 1 g proteins (98% pure) per 1 kg shrimp. Compared to KLH, the peptide-SHC conjugates exhibit higher solubility after hapten conjugation. Meanwhile, compared with KLH, SHC induces comparable antibody production efficiency in mammals, with or without conjugation. Furthermore, rabbit polyclonal antibodies or mouse monoclonal antibodies were generated by immunizing SHC-peptide conjugates, and the subsequent antibodies were confirmed to be used in western blot, immunofluorescence and immunohistochemistry. Therefore, we demonstrated that SHC may be used as a substitute for KLH in future antibody and vaccine development.

Abstract Objective To assess asymptomatic rates and severity of SARS‐CoV‐2 infection in people with epilepsy and their healthcare workers in a long‐term care facility which had implemented weekly surveillance testing between April 2020 and June 2022. Methods Questionnaires focused on objective and subjective COVID‐19 symptoms for people with epilepsy residing in and their healthcare workers at the Chalfont Centre for Epilepsy in June 2022. Demographic information, comorbidities, and seizure frequency were gathered from medical records. We also collected responses on objective and subjective COVID‐19 symptoms from healthcare workers who participated in a prospective study assessing the reaction to COVID‐19 vaccinations (SAFER). Results Fifty‐five out of 89 (62%) residents tested positive at least once on weekly PCR testing for SARS‐CoV‐2 during the period of interest; 20 of those (37%) were asymptomatic. In comparison, of those 63 healthcare workers who tested positive at least once on weekly testing during the same period, only four (6%) were asymptomatic. Of the 159 healthcare workers who also participated in the SAFER study, 41 tested positive at least once, and seven (17%) were completely asymptomatic during infection with SARS‐CoV‐2. Significance People with epilepsy living in a long‐term care facility were more likely to present with asymptomatic SARS‐CoV‐2 infections than healthcare workers at the same facility. Despite possible bias in the reporting of subjective symptoms due to management‐by‐proxy, there is no evidence that vulnerable people living in an epilepsy long‐term care facility showed reduced resilience towards infections. Plain Language Summary People with epilepsy living in care home facilities had a surprisingly high degree of asymptomatic infections with SARS‐CoV‐2. Very few residents had severe or fatal outcomes. This is in stark contrast to the widely reported bad outcomes for people without epilepsy in other care homes. People with epilepsy reported significantly less symptoms than their healthcare workers. No changes in seizure frequency during or after infection were observed.

Abstract Background Dysfunctional gliding of deep fascia and muscle layers forms the basis of myofascial pain and dysfunction, which can cause chronic shoulder pain. Ultrasound shear strain imaging may offer a non-invasive tool to quantitatively evaluate the extent of muscular dysfunctional gliding and its correlation with pain. This case study is the first to use ultrasound shear strain imaging to report the shear strain between the pectoralis major and minor muscles in shoulders with and without chronic pain. Case presentation The shear strain between the pectoralis major and minor muscles during shoulder rotation in a volunteer with chronic shoulder pain was measured with ultrasound shear strain imaging. The results show that the mean ± standard deviation shear strain was 0.40 ± 0.09 on the affected side, compared to 1.09 ± 0.18 on the unaffected side (p

Decoration of cellular RNAs with modified RNA nucleosides is an important layer of gene expression regulation. Throughout the transcriptome, RNA modifications influence the folding, stability and function of RNAs as well as their interactions with RNA-binding proteins. Although first detected more than 50 years ago, the modified nucleosides N2-methylguanosine (m2G) and N2,N2-dimethylguanosine (m22G) have recently come to the fore through the identification and characterization of the human methyltransferases (MTases) responsible for their installation. In tRNAs, m2G and m22G are present at the junctions between the acceptor stem and the D-arm, and the D-arm and the anticodon stem loop. Here, we review the current knowledge on the effects of mono- and di-methylation of N2 of guanosine on base-pairing and provide an overview of m2(2)G sites in cytosolic and mitochondrial tRNAs. We highlight key features of m2G and m22G MTases, and describe how these enzymes specifically recognize their RNA substrates and target nucleosides. We also discuss the impact of these modifications on tRNA functions, their dynamic regulation and their implications in disease.

Brazilian forestry laws do not provide specifications for the management of bamboo-dominated forests. This study aimed to characterize the bamboo population structure, its spatial distribution and the effects of shoot density on the diversity and density of dominant tree species in the southwest of the Amazon Rainforest. An inventory was carried out in forest with and without anthropogenic interference, and the height and diameter at breast height of the trees were measured, as well as the diametrical, vertical and spatial distribution of the shoots. The bamboo diametrical distribution presented an irregular behavior in the two areas under study and the vertical distribution behaved irregularly in the forest without anthropization, in an asymmetric negative way when compared to the forest that suffered anthropogenic disturbance. The bamboo spatial distribution did not show changes in its aggregate pattern between the studied environments, and its density did not present a significant correlation with the density and diversity of tree species.

Background: Interleukin-2 is being investigated as a potential therapeutic option in systemic lupus erythematosus (SLE), but the current findings regarding its effectiveness remained inconclusive. Objectives: To assess the association between the administration of low-dose interleukin-2 and the SLE Disease Activity Index (SLEDAI) score among SLE patients. Methods: A meta-analysis was conducted by gathering articles from Scopus, Pubmed, and Embase databases (PROSPERO registration ID: 451971). Essential data from each study was extracted, and the impact of administering low-dose interleukin-2 on the SLEDAI score in SLE patients was assessed using the inverse variance method. Results: We conducted an analysis of 7 articles involving 194 patients. Our study revealed that the administration of low-dose interleukin-2 was associated with a decrease in the SLEDAI score, showing an average reduction of −4.3 points from baseline. Furthermore, when comparing SLE patients treated with standard of care plus low-dose interleukin-2 to those receiving standard of care alone, we observed a significantly greater improvement in the SLEDAI score, with an average difference of 2.91 points. Conclusion: Our results indicate the potential beneficial impact of low-dose interleukin-2 in reducing disease activity and enhancing outcomes in SLE management.

Objective The Cancer and Aging Research Group (CARG) score was developed to predict severe chemotherapy-induced toxicity risk in older adults; validation study results have varied. The Tolerance of Anti-cancer Systemic Therapy in the Elderly study sought to evaluate the CARG score prospectively in a chemotherapy-naïve UK population.Methods and analysis This multicentre, prospective, observational study recruited patients aged ≥65 years commencing first-line chemotherapy for any solid organ malignancy or setting. Baseline demographics and established frailty measures were recorded. Follow-up data including toxicity and hospital admissions were collected retrospectively. Baseline CARG score predictive ability was assessed.Results 339 patients were recruited from 19 centres; median age 73 years (range 65–92), 51.9% male and 54.9% gastrointestinal primary. At baseline, 85% of patients were of Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0–1, with median Rockwood Clinical Frailty Scale (CFS) 3 (range 0–8).314 (92.6%) patients had follow-up data; 69 (22.3%) patients experienced Common Terminology for Cancer Adverse Events grade ≥3 toxicity and 84 (27%) required hospital admission during treatment.Increasing CARG risk groups had increased grade ≥3 toxicity (low 19.6%, medium 22.2%, high 28.2%); however, this was non-significant with no evidence of robust predictive performance. Predictive performance of CFS and ECOG PS was superior to CARG. Importantly, patient and clinician perceptions of toxicity risk differed significantly.Conclusions In older UK patients with cancer commencing chemotherapy, baseline frailty was prevalent. CARG score did not robustly discriminate or predict high-grade toxicity risk. ECOG and CFS showed superior, although limited, ability to predict and discriminate. This study highlights the need for the development of tools that better predict toxicity in this population.

Background: RegiSCAR validation criteria for drug reaction with eosinophilia and systemic symptoms (DRESS) includes lymphadenopathy, a frequent feature of both tuberculosis (TB) and human immunodeficiency virus (HIV). TB is the most common HIV-associated coinfection. Advanced HIV is associated with lymph node (LN) fibrosis. It is not clear if this negatively affects case validation in HIV-associated DRESS. To answer this question, we designed a prospective descriptive study to assess lymphadenopathy in various combinations of comorbid HIV, TB, and DRESS. Objectives: We sought to describe the prevalence of DRESS-associated lymphadenopathy and characterize LN quality, size, and distribution in a high HIV-TB burden setting over time. Methods: We prospectively and systematically examined LN in 25 consecutive acute DRESS cases hospitalized at a South African tertiary-care center and 10 hospitalized non-DRESS HIV-TB coinfected controls. Results: Fourteen (56%) of 25 patients were HIV infected, with a median (interquartile range) CD4 count of 254 (66-478) cells/mm³, and 7 of 14 were coinfected with TB. Using RegiSCAR criteria, 12 (46%) of 25 were definite DRESS cases, 8 (31%) of 25 probable, and 5 (23%) of 25 possible. Possible cases were excluded in the analysis. Fifteen (75%) of 20 subjects had LN in ≥2 anatomic sites, including all 7 patients with HIV-TB coinfection. In contrast, 1 (20%) of 5 hospitalized non-DRESS HIV-TB coinfected controls had LN. Cervical LN, in 15 (88%) of 17, was most common, followed by axillary (76%) and inguinal (59%). Cervical LN ranged between 1 and 2 cm in size. Among the 8 (32%) of 25 subjects with follow-up data, LN had regressed in all within 6 weeks of stopping the offending drug and initiating TB treatment. There was no correlation with CD4 cell count and LN. Conclusion: Lymphadenopathy is a common feature of acute DRESS, even among HIV-TB–coinfected patients with advanced immunosuppression.

Current therapies for autoimmune diseases are immunosuppressant agents, which have many debilitating side effects. However, dendritic cells (DCs) can induce antigen-specific tolerance. Tolerance restoration mediated by ex vivo-generated DCs can be a therapeutic approach. Therefore, in this review, we summarize the conceptual framework for developing ex vivo-generated DC strategies for autoimmune diseases. First, we will discuss the role of DCs in developing immune tolerance as a foundation for developing dendritic cell-based immunotherapy for autoimmune diseases. Then, we also discuss relevant findings from pre-clinical and clinical studies of ex vivo-generated DCs for therapy of autoimmune diseases. Finally, we discuss problems and challenges in dendritic cell therapy in autoimmune diseases. Throughout the article, we discuss autoimmune diseases, emphasizing SLE.

Abstract Delineation of geochemically distinct domains in Earth’s mantle is essential for understanding large-scale mantle convective flow and dynamics. Previous studies identify possible long-lived (>60 million-year) mantle isotopic domains (i.e. Antarctic-Zealandia, Pacific and Indian) near the Philippine Sea and western Pacific. Here we compile published basalt geochemistry of the Philippine Sea and surroundings and add new Mo isotopic and water content data for Gagua Ridge lavas, northwestern Philippine Sea, to distinguish slab-derived components during subduction. The water content, trace element, and Mo-Sr-Nd isotope compositions of Gagua Ridge arc lavas suggest that slab fluids and sediment melts are responsible for element recycling to the arc. The Philippine Sea basalts show both Indian and Zealandia-Antarctic Pb isotopic signatures; restoration of the basalt locations within a plate reconstruction shows the far-travelled Philippine Sea traversed these mantle domains. We establish the Indian mantle domain eastern boundary at ~120°E under SE Asia and the Indian Ocean. The Antarctic-Zealandia mantle domain lies south of ~10°N within the SW Pacific and has mostly remained in oceanic realms since ~400 Ma with only limited continental material input.

Background: Non-prescribed anabolic androgenic steroid (AAS) use is associated with AAS-induced hypogonadism (ASIH), and metabolic, cardiovascular, and mental health risks. Symptoms of ASIH (fatigue, depression, anxiety, sexual dysfunction) are hard to endure following cessation, but there is no consensus on whether endocrine treatment should be used to treat ASIH. This proof-of-concept study aims to explore safety of off-label clomiphene citrate therapy, whether the treatment will reduce the symptoms of androgen deficiency, and to study changes in health risks after cessation. Methods: In this open-labeled non-randomized off-label hormone intervention pilot study, we shall include males with AAS dependence intending to cease use. The 16-week intervention included clomiphene citrate, transdermal testosterone gel for the first four weeks and optional human chorionic gonadotropin (hCG) from week 4 if low treatment response. Measures of physical and mental health will be examined from ongoing AAS use, during the intervention, and at 6- and 12 months post cessation. Change in self-reported symptoms of hypogonadism and other withdrawal symptoms will be compared with data from a group of men who ended AAS use temporarily without the medical intervention. The study may provide valuable clinical insights and may be used to inform the design of future intervention studies.

A necessidade do desenvolvimento e aprimoramento de sistemas de análise estrutural dos pavimentos asfálticos possibilitou o surgimento de novos instrumentos de avaliação de desempenho mecânico. A instrumentação fundamenta-se na instalação de sensores que possibilitam avaliar o desempenho mecânico da estrutura por meio de leituras de tensão e deformação. Em estruturas de pavimentos em revestimento asfáltico, a temperatura torna-se também um parâmetro importante a ser avaliado na instrumentação. Desse modo, a instrumentação fornece análise aprofundada acerca da estrutura do pavimento e do desenvolvimento dos esforços do tráfego, bem como do entendimento de suas manifestações patológicas. Esta pesquisa teve o objetivo de analisar o desempenho estrutural de um trecho reestruturado da BR-101 na cidade de Recife por meio da instrumentação do pavimento. Foram instalados instrumentos medidores em diferentes camadas do pavimento e desenvolvido um software para a filtragem e organização dos dados recebidos pelas leituras registradas para cada veículo. Por fim, foi realizada a avaliação estrutural não destrutiva por meio do equipamento FWD. Os sensores apresentaram valores de deformação longitudinal foram da ordem de 290 a 380 με, deformação transversal de 270 a 290 με e a tensão vertical determinado pelas células de tensão foram em média de 964 kPa no mesmo horário do levantamento deflectométrico. Verifica-se que existe forte influência da temperatura no comportamento da estrutura. Comparando-se valores médios obtidos na instrumentação com os calculados por meio de retroanálise, observou-se resultados similares entre as deformações e tensões encontradas. Portanto, a utilização da instrumentação de pavimentos mostrou-se como uma importante metodologia para a análise do desempenho estrutural do pavimento estudado, demonstrando valores de tensão e deformação similares aos encontrados na utilização de outros métodos de análise.

Bisphenol A alternatives are manufactured as potentially less harmful substitutes of bisphenol A (BPA) that offer similar functionality. These alternatives are already in the market, entering the environment and thus raising ecological concerns. However, it can be expected that levels of BPA alternatives will dominate in the future, they are limited information on their environmental safety. The EU PARC project highlights BPA alternatives as priority chemicals and consolidates information on BPA alternatives, with a focus on environmental relevance and on the identification of the research gaps. The review highlighted aspects and future perspectives. In brief, an extension of environmental monitoring is crucial, extending it to cover BPA alternatives to track their levels and facilitate the timely implementation of mitigation measures. The biological activity has been studied for BPA alternatives, but in a non-systematic way and prioritized a limited number of chemicals. For several BPA alternatives, the data has already provided substantial evidence regarding their potential harm to the environment. We stress the importance of conducting more comprehensive assessments that go beyond the traditional reproductive studies and focus on overlooked relevant endpoints. Future research should also consider mixture effects, realistic environmental concentrations, and the long-term consequences on biota and ecosystems.

Objective The healthcare burden of alcohol-related liver disease (ARLD) is increasing. ARLD and alcohol use disorder (AUD) is best managed by reduction or cessation of alcohol use, but effective treatments are lacking. We tested whether people with ARLD and AUD admitted to hospital could be recruited to and retained in a trial of Functional Imagery Training (FIT), a psychological therapy that uses mental imagery to reduce alcohol craving. We conducted a multicentre randomised pilot trial of treatment as usual (TAU) versus FIT+TAU in people admitted to hospital with ARLD and AUD.Design Participants were randomised to TAU (a single session of brief intervention) or FIT+TAU (TAU with one hospital-based FIT session then eight telephone sessions over 6 months). Pilot outcomes included recruitment rate and retention at day 180. Secondary outcomes included fidelity of FIT delivery, alcohol use, and severity of alcohol dependence.Results Fifty-four participants (mean age 49; 63% male) were recruited and randomised, 28 to TAU and 26 to FIT+TAU. The retention rate at day 180 was 43%. FIT was delivered adequately by most alcohol nurses. 50% of intervention participants completed FIT sessions 1 and 2. There were no differences in alcohol use or severity of alcohol dependence between treatment groups at day 180.Conclusion Participants with ARLD and AUD could be recruited to a trial of FIT versus FIT+TAU. However, retention at day 180 was suboptimal. Before conducting a definitive trial of FIT in this patient group, modifications in the intervention and recruitment/retention strategy must be tested.Trial registration number ISRCTN41353774.

A typical consequence of type 2 diabetes mellitus, diabetic kidney disease (DKD) is a significant risk factor for end-stage renal disease. The pathophysiology of diabetic kidney disease (DKD) is mainly associated with the immune system, which involves adhesion molecules and growth factors disruption, excessive expression of inflammatory mediators, decreased levels of anti-inflammatory mediators, and immune cell infiltration in the kidney. Dendritic cells are professional antigen-presenting cells acting as a bridge connecting innate and adaptive immune responses. The anti-inflammatory subset of DCs is also capable of modulating inflammation. Autologous anti-inflammatory dendritic cells can be made by in vitro differentiation of peripheral blood monocytes and utilized as a cell-based therapy. Treatment with anti-inflammatory cytokines, immunosuppressants, and substances derived from pathogens can induce tolerogenic or anti-inflammatory features in ex vivo–generated DCs. It has been established that targeting inflammation can alleviate the progression of DKD. Recent studies have focused on the potential of dendritic cell–based therapies to modulate immune responses favorably. By inducing a tolerogenic phenotype in dendritic cells, it is possible to decrease the inflammatory response and subsequent kidney damage. This article highlights the possibility of using anti-inflammatory DCs as a cell-based therapy for DKD through its role in controlling inflammation.

Adaptive motor behavior depends on the coordinated activity of multiple neural systems distributed across the brain. While the role of sensorimotor cortex in motor learning has been well established, how higher-order brain systems interact with sensorimotor cortex to guide learning is less well understood. Using functional MRI, we examined human brain activity during a reward-based motor task where subjects learned to shape their hand trajectories through reinforcement feedback. We projected patterns of cortical and striatal functional connectivity onto a low-dimensional manifold space and examined how regions expanded and contracted along the manifold during learning. During early learning, we found that several sensorimotor areas in the dorsal attention network exhibited increased covariance with areas of the salience/ventral attention network and reduced covariance with areas of the default mode network (DMN). During late learning, these effects reversed, with sensorimotor areas now exhibiting increased covariance with DMN areas. However, areas in posteromedial cortex showed the opposite pattern across learning phases, with its connectivity suggesting a role in coordinating activity across different networks over time. Our results establish the neural changes that support reward-based motor learning and identify distinct transitions in the functional coupling of sensorimotor to transmodal cortex when adapting behavior.

Abstract Large‐volume therapeutic phlebotomy is the mainstay of hemochromatosis treatment and offers an opportunity to investigate the hemodynamic changes during acute hypovolemia. An otherwise healthy 64‐year‐old male with hemochromatosis participated. On nine separate visits, 1000 mL therapeutic phlebotomy was performed. On one occasion, pre‐ and post‐phlebotomy orthostatic challenge with 27° reverse Trendelenburg position was administered. Mean arterial pressure, heart rate, and stroke volume were measured continuously during the procedures. The patient's tolerance to the interventions was continuously evaluated. The procedures were well tolerated by the patient. Mean arterial pressure was maintained during hemorrhage and following phlebotomy in both supine and reverse Trendelenburg positions, primarily through an increase in heart rate and systemic vascular resistance. The present study found that 1000 mL therapeutic phlebotomy in a patient with hemochromatosis may be acceptably and safely used to model hemorrhage. The approach demonstrates high clinical applicability and ethically robustness in comparison with volunteer studies.

The objective of this work was to develop a bibliometric analysis of academic production related to sustainable projects based on clean, green and renewable alternative energies and their interaction with the health sector and health management on a global scale. To do this, a documentary research process based on bibliometric tools was proposed. The research is limited to the period between 2003 and 2023, executing the following search equation: (TITLE-ABS-KEY ("clean energy" ) OR TITLE-ABS-KEY ( "alternative energy" ) OR TITLE-ABS -KEY ("solar energy" ) OR TITLE-ABS-KEY ( "green energy" ) OR TITLE-ABS-KEY ( "renewable energy" ) AND TITLE-ABS-KEY ( "health sector" ) OR TITLE-ABS-KEY ( "healthcare sector" ) OR TITLE-ABS-KEY ( "public health service" ) OR TITLE-ABS-KEY ( "health management" ) ). The years with the highest production were 2020 (21), 2021 (23), 2022 (30) and 2023 (34), while the countries that have contributed the most to the topic are China (111), the USA (97) and the United Kingdom (71), which together contributed 57.76% of all publications. Of 145 sources found that published on the topic, the 18 main sources concentrate 48% of the publications. The three most cited articles were EMADIAN SM, 2017, WASTE MANAGE, WATTS N, 2018, LANCET and FULLER R, 2022, LANCET PLANET HEALTH, with a total of 1567 citations. Among the most relevant institutions in relation to the topic of study, UNIVERSITY COLLEGE LONDON stands out above all with 19 publications, followed by TSINGHUA UNIVERSITY (9) and WUHAN UNIVERSITY (8); between the three institutions they account for 20.57% of the publications found. This analysis provided critical insights for academics and professionals and underscored the relevance and dynamism of this research area in addressing clean energies and sustainable projects related with health management and health sector worldwide.

Abstract Background Trauma patients frequently receive supplemental oxygen, but its hemodynamic effects in blood loss are poorly understood. We studied the effects of oxygen on the hemodynamic response and tolerance to simulated blood loss in healthy volunteers. Methods Fifteen healthy volunteers were exposed to simulated blood loss by lower body negative pressure (LBNP) on two separate visits at least 24 h apart. They were randomized to inhale 100% oxygen or medical air on visit 1, while inhaling the other on visit 2. To simulate progressive blood loss LBNP was increased every 3 min in levels of 10 mmHg from 0 to 80 mmHg or until hemodynamic decompensation. Oxygen and air were delivered on a reservoired face mask at 15 L/min. The effect of oxygen compared to air on the changes in cardiac output, stroke volume and middle cerebral artery blood velocity (MCAV) was examined with mixed regression to account for repeated measurements within subjects. The effect of oxygen compared to air on the tolerance to blood loss was measured as the time to hemodynamic decompensation in a shared frailty model. Cardiac output was the primary outcome variable. Results Oxygen had no statistically significant effect on the changes in cardiac output (0.031 L/min/LBNP level, 95% confidence interval (CI): − 0.015 to 0.077, P = 0.188), stroke volume (0.39 mL/LBNP level, 95% CI: − 0.39 to 1.2, P = 0.383), or MCAV (0.25 cm/s/LBNP level, 95% CI: − 0.11 to 0.61, P = 0.176). Four subjects exhibited hemodynamic decompensation when inhaling oxygen compared to 10 when inhaling air (proportional hazard ratio 0.24, 95% CI: 0.065 to 0.85, P = 0.027). Conclusions We found no effect of oxygen compared to air on the changes in cardiac output, stroke volume or MCAV during simulated blood loss in healthy volunteers. However, oxygen had a favorable effect on the tolerance to simulated blood loss with fewer hemodynamic decompensations. Our findings suggest that supplemental oxygen does not adversely affect the hemodynamic response to simulated blood loss. Trial registration This trial was registered in ClinicalTrials.gov (NCT05150418) December 9, 2021

In the present research, the metallurgical and mechanical analysis along with the corrosion behaviour of Inconel 625 alloy formed by wire arc additive manufacturing-cold metal transfer (WAAM-CMT) based process were assessed with and without post heat treatments. Mechanical analysis was carried out with the help of impact and tensile strength analysis. Metallurgical analysis was conducted via. Electron Backscatter Diffraction (EBSD), SEM-EDS, and XRD. While, corrosion analysis was conducted with the help of cyclic polarization test. Cyclic polarization test unveils variations in corrosion resistance among as prepared and heat-treated samples, with water quenched showing potential for enhanced corrosion protection. Moreover, the fractured surface analysis after tensile and impact strength tests was also conducted with the help of SEM images. Overall, the designated material after heat treatment at 1100 °C for 2 h along with water quenched presents the best mechanical, metallurgical and corrosion performance for Inconel 625 developed by WAAM-CMT process.

Abstract In recent years, the identification of endogenous substrates as biomarkers became an uprising topic. Particularly coproporphyrins (CPs), byproducts of heme biosynthesis, are intensely investigated as biomarkers for predicting interactions with the organic anion transporting polypeptide (OATP) 1B transporters. In the context of drug–drug interactions, several preclinical and clinical studies assessed the effect of the OATP1B‐index inhibitor rifampin on CPI levels. However, rifampin is not only a “perpetrator” drug of transporters but is also known for its interaction with the nuclear receptor pregnane X receptor (PXR) leading to the efficient induction of PXR‐target genes. These include hemoproteins like cytochrome P450 enzymes but also the δ‐aminolevulinate synthase 1, which is the rate‐limiting enzyme in heme biosynthesis. In this study, we showed that quantification of CPs in clinical serum samples was possible after long‐term storage at −20°C. We quantified CPI, CPIII, and heme levels in clinical serum samples (at selected timepoints) that originated from a trial investigating the interaction potential of repeated rifampin administration in 12 healthy participants. In samples collected at the assumed time to maximum concentration of rifampin, higher CP levels were observed compared to baseline. Increased levels persisted even 14 h after discontinuation of rifampin. No impact on heme serum levels was observed. We found a correlation between CP isomers at baseline and at 14 h after rifampin intake. In summary, we show that multiple doses of rifampin affect CP levels. However, besides inhibition of hepatic OATP function there is evidence for an interaction with CP levels beyond the transporter level.

Coproporphyrin I (CPI) and III (CPIII) are discussed as biomarkers for organic anion transporting polypeptides (OATPs). We report on CPI and CPIII levels in wildtype, rSlco2b1-knockout, and SLCO2B1-humanized rats at baseline and after administration of atorvastatin, an inhibitor of the CPIII-specific rOATP2B1/hOATP2B1 and the CPI/CPIII-transporting rOATP1B2. OATP-inhibition by atorvastatin leads to significantly increased CPI and CPIII serum levels. However, basal CP serum levels in rSlco2b1-knockout animals were significantly lower (CPI), or unaffected (CPIII). In the presence of atorvastatin, this genotype effect was abolished. In conclusion, our results indicate an unexpected impact of OATP2B1 on CP serum levels in rats.

Pleuroperitoneal leak as a cause of pleural effusions in peritoneal dialysis is a rare but important complication to consider in continuous ambulatory peritoneal dialysis (CAPD) patients presenting with recurrent progressive dyspnoea. Generally, these effusions are unilateral and right-sided, resulting in shortness of breath and reduced ultrafiltration volume, which are initially managed by peritoneal rest. We describe a case of bilateral pleural effusions in a 57-year-old female on chronic CAPD who developed recurrent progressive dyspnoea but maintained adequate dialysis output. A chest radiograph revealed bilateral pleural effusions with high glucose content, and scintigraphy confirmed the existence of a definite pleuroperitoneal communication. She was managed by temporary substitution to haemodialysis, followed by suturing of the shunt and successful video-assisted thoracoscopic surgery (VATS) pleurodesis with an aldehyde-based surgical glue. Unexplained recurring dyspnoea in chronic CAPD should raise the suspicion of a possible pleuroperitoneal leak, even in patients without an apparent loss of ultrafiltration. Pleurodesis using an aldehyde-based adhesive was effective and tolerated well by our patient and may be considered in managing cases of recurrent pleural effusion.

Selenium is a trace mineral that participates in the body's homeostasis as an antioxidant by forming selenoproteins. In aquaculture, supplementation with this mineral influences zootechnical parameters and blood biochemistry while strengthening the immune system. This work aimed to evaluate the effect of organic selenium on physiological and zootechnical parameters in males of the catfish Sorubim cuspicaudus. Male breeders of S. cuspicaudus (n=56) with an average weight and length of 485.6 g and 39.3 cm, respectively, were distributed in 6.5 m3 pools in four treatments by triplicate. The fish were fed diets enriched with Se: 0.07 (control), 1.57, 2.07, and 2.57 mg Se/kg diet for 14 weeks. Length, weight, condition factor, and survival were recorded. In blood samples transaminases and cortisol were measured. Also, liver, kidney, and gonad histological analyses were realized. The zootechnical parameters and blood chemistry between treatments showed no significant difference (p>0.05). At the histological level, the fish fed 2.0 and 2.5 mg Se/kg diet showed moderate to severe kidney and mild liver lesions associated with selenium toxicity. The results of this study allow us to conclude that selenium doses of 2 mg or more generate toxicity in male breeders of the catfish S. cuspicaudus.

Forecasting the maximum pressure exerted by cast-in-place self-compacting concrete (SCC) is a major concern for formwork designers, researchers, and site engineers to accurately design the bearing capacity of the formwork and control the casting rate for safe and fast construction. This article aims to utilize the ARX-Laguerre model, which is a data-driven model to forecast the maximum form pressure. A laboratory instrumented setup was used to cast a 2-m column using SCC made with two different types of cement. A pressure system consisting of four sensors was used to document the pressure during casting. The data were sent to the cloud at every 1-min interval for real-time monitoring. The data were used to develop the model. The results demonstrated that forecasting with the ARX-Laguerre model is highly accurate. The model can forecast the maximum pressure exerted by SCC with less complexity. The model performance was also found to be consistent with insignificant differences between actual experimental results and predicted results. With a recursive and straightforward representation, the resulting model, known as the ARX-Laguerre model, ensures the parameter number reduction. Providing fast prediction of the maximum pressure. The model enables formwork designers to forecast the form pressure to design safe formwork and also helps to control the casting rate when SCC is used.

This study examined preboundary lengthening and other kinematic characteristics of articulatory gestures in CV.CV and CV.CVC before prosodic boundaries in Korean. Preboundary lengthening was found to be extended to initial syllables in both CV.CVand CV.CVC, while its magnitude was largest on the final syllable. The preboundary lengthening effect was also reflected in the time-to-peak velocity (acceleration duration), but only on gestures of the final syllable. Preboundary lengthening was accompanied by substantial increase in both displacement and peak velocity, showing domain-final articulatory strengthening. This articulatory strengthening effect on preboundary gestures (at the right edge of prosodic constituent) was largely dovetailed with the notion of an edge-prominence language where boundary marking is assumed to be closely related with prominence lending. These results were compared in two different conditions driven by information structure (‘new’ vs. ‘given’) and were discussed to understand the observed kinematic pattern in dynamical terms in the theoretical framework of the π-gesture model.

Abstract We conducted two‐dimensional numerical simulations to investigate the mechanisms underlying the strong spatiotemporal correlation observed between submarine landslides and gas hydrate dissociation due to glacial sea‐level drops. Our results suggest that potential plastic deformation or slip could occur at localized and small scales in the shallow‐water portion of the gas hydrate stability zone (GHSZ). This shallow‐water portion of the GHSZ typically lies within the area enclosed by three points: the BGHSZ–seafloor intersection, the seafloor at ∼600 m below sea level (mbsl), and the base of the GHSZ (BGHSZ) at ∼1,050 mbsl in low‐latitude regions. The deep BGHSZ (>1,050 mbsl) could not slip; therefore, the entire BGHSZ was not a complete slip surface. Glacial hydrate dissociation alone is unlikely to cause large‐scale submarine landslides. Observed deep‐water (much greater than 600 mbsl) turbidites containing geochemical evidence of glacial hydrate dissociation potentially formed from erosion or detachment in the GHSZ pinch‐out zone.

The global energy industry fundamentally transformed towards renewable energy sources, driven by the sustainability paradigm. This shift was crucial in addressing the challenges of climate change and resource scarcity. Machine Learning (ML) played a pivotal role in enhancing the efficiency and reliability of renewable energy systems. This study conducted a comprehensive analysis of scientific production at the intersection of ML and renewable energy generation, focusing on Latin America. Employing a methodology based on documentary research and bibliometric processes, utilizing the Scopus database with the support of R and VOSviewer software, our research revealed a significant increase in interest and investment in research related to ML and renewable energies since 2020. This exponential growth scenario in this knowledge area had significant implications for Latin America and the world, fostering technological advancements and the adoption of renewable energies. Countries such as China, India, the United States, South Korea, and Saudi Arabia represented 61% of the global scientific production in this field, underscoring its global relevance. This growth indicated a growing interest and investment in ML applications in renewable energies, aligning with the 2030 Agenda for Sustainable Development. This research aligns with the Sustainable Development Goals (SDGs), particularly SDG 7 (Affordable and Clean Energy) and SDG 9 (Industry, Innovation, and Infrastructure). It contributed to progress toward a more sustainable future, benefiting society through more efficient and sustainable energy systems, the energy industry through increased innovation and the adoption of clean technologies, and Latin America, which could leverage these findings to sustainably drive its economic and environmental development.

Ticks are obligate hematophagous parasites that can transmit to vertebrate hosts several pathogens, including viruses, bacteria, protozoa and helminths. Among these agents, some Borrelia species some Borrelia species cause disease in humans and other vertebrate hosts; therefore, they have medical and veterinary health importance. To gather additional information on Borrelia species in Brazil, the current study aimed to detect the presence of these species in Ornithodoros cavernicolous ticks collected in September 2019 from cement pipes that are used by bats as shelter in a farm located in the midwestern region of Brazil. DNA samples obtained from 18 specimens of O. cavernicolous were subjected of two polymerase chain reactions, targeting a segment of the Borrelia fla B gene. Of the samples tested, only one (6 %, 1/18) showed amplification. The nucleotide sequence of the amplified DNA showed more than 97 % (293/300) identity with a sequence of a Borrelia sp. detected in blood collected from a bat from Macaregua Cave, Colombia, and more than 97 % (292/300) detected in lungs from vampire bats from northeastern Brazil. The deduced amino acid sequences were identical to each other. Phylogenetic analysis indicated that these sequences formed a group of Borrelia species (putatively associated with bats) that is closely related to sequences of Borrelia species of the Lyme borreliosis group. Further investigations should be carried out in order to determine whether the sequence of the Borrelia sp. we found belongs to a new taxon. It will also be of great importance to determine which vertebrate hosts, besides bats, O. cavernicolous ticks can parasitize in order to investigate whether the Borrelia sp. we found may be transmitted and cause disease to the other vertebrate hosts.

Objectives To assess the effect of high-intensity interval training (HIIT) delivered in physiotherapy primary care on the primary outcome of cardiorespiratory fitness (CRF) in patients with inflammatory arthritis (IA). Additionally, to explore the effects of HIIT on secondary outcomes, including cardiovascular disease (CVD) risk factors and disease activity.Methods Single-blinded randomised controlled trial with 60 patients randomly assigned to either a control group receiving usual care or an exercise group receiving usual care and 12 weeks of individualised HIIT at 90%–95% peak heart rate. Outcomes were assessed at baseline, 3 months and 6 months post baseline and included CRF measured as peak oxygen uptake (VO2peak), classic CVD risk factors, disease activity, anthropometry and patient-reported physical activity, pain, fatigue, disease impact and exercise beliefs and self-efficacy.Results Intention-to-treat analysis demonstrated a significant between-group difference in VO2peak at 3 months (2.5 mL/kg/min, 95% CI 0.9 to 4.0) and 6 months (2.6 mL/kg/min, 95% CI 0.8 to 4.3) in favour of the exercise group. A beneficial change in self-reported physical activity in favour of the exercise group was observed at 3 and 6 months. The HIIT intervention was well-tolerated with minimal adverse events and no apparent impact on disease activity. Differences in secondary outcomes related to CVD risk factors, disease impact, pain, fatigue and exercise beliefs and self-efficacy were generally small and non-significant.Conclusion After 12 weeks of supervised HIIT delivered in physiotherapy primary care, patients with IA demonstrated a favourable improvement in CRF, with sustained effects at 6-month follow-up.Trial registration number NCT04922840.

This study provides a comprehensive review of the engineering challenges of formwork in concrete construction. The paper investigates different formwork systems, their design based on form pressure, and the difficulties of form stripping. Alternative binders are gaining more and more interest by opening new opportunities for sustainable concrete materials and their impact on form pressure and concrete setting is also investigated in this paper. The discussion involves several engineering challenges such as sustainability, safety, and economy, while it also explores previous case studies, and discusses future trends in formwork design. The findings pinpoint that choosing an appropriate formwork system depends significantly on project-specific constraints and that the development of innovative materials and technologies presents significant benefits but also new challenges, including the need for training and regulation. Current trends in formwork design and use show promising possibilities for the integration of digital technologies and the development of sustainable and ‘smart’ formwork systems. Continued research within the field has the possibility to explore new formwork materials and technologies, which will contribute to the implementation of more effective and sustainable practices in concrete construction.

Abstract Background Mosquito-specific viruses (MSVs) comprise a variety of different virus families, some of which are known to interfere with infections of medically important arboviruses. Viruses belonging to the family Mesoniviridae or taxon Negevirus harbor several insect-specific viruses, including MSVs, which are known for their wide geographical distribution and extensive host ranges. Although these viruses are regularly identified in mosquitoes all over the world, their presence in mosquitoes in Germany had not yet been reported. Methods A mix of three MSVs (Yichang virus [Mesoniviridae] and two negeviruses [Daeseongdong virus and Dezidougou virus]) in a sample that contained a pool of Coquillettidia richiardii mosquitoes collected in Germany was used to investigate the interaction of these viruses with different arboviruses in Culex-derived cells. In addition, small RNA sequencing and analysis of different mosquito-derived cells infected with this MSV mix were performed. Results A strain of Yichang virus (Mesoniviridae) and two negeviruses (Daeseongdong virus and Dezidougou virus) were identified in the Cq. richiardii mosquitoes sampled in Germany, expanding current knowledge of their circulation in central Europe. Infection of mosquito-derived cells with these three viruses revealed that they are targeted by the small interfering RNA (siRNA) pathway. In Culex-derived cells, co-infection by these three viruses had varying effects on the representative arboviruses from different virus families (Togaviridae: Semliki forest virus [SFV]; Bunyavirales: Bunyamwera orthobunyavirus [BUNV]; or Flaviviridae: Usutu virus [USUV]). Specifically, persistent MSV co-infection inhibited BUNV infection, as well as USUV infection (but the latter only at specific time points). However, the impact on SFV infection was only noticeable at low multiplicity of infection (MOI 0.1) and at specific time points in combination with the infection status. Conclusions Taken together, these results are important findings that will lead to a better understanding of the complex interactions of MSVs, mosquitoes and arboviruses. Graphical Abstract

Toni Rahmat Jaelani,1 Kusman Ibrahim,1 Jonny Jonny,2 Sri Hartati Pratiwi,1 Hartiah Haroen,1 Nursiswati Nursiswati,1 Bunga Pinandhita Ramadhani2 1Faculty of Nursing, Padjadjaran University, Bandung, West Java, Indonesia; 2Nephrology Division, Department of Internal Medicine, Gatot Soebroto Indonesia Army Central Hospital, Jakarta, IndonesiaCorrespondence: Toni Rahmat Jaelani, Faculty of Nursing, Padjadjaran University, Jalan Ir. Soekarno Km. 21 Jatinangor, Sumedang, West Java, 45363, Indonesia, Tel +62-813-2211-0115, Fax +62-022-7795596, Email toni15003@mail.unpad.ac.idBackground: Peritoneal dialysis (PD) training is essential to ensure patient independence and prevent life-threatening complications, such as peritonitis. The International Society for Peritoneal Dialysis (ISPD) recommends that every PD unit worldwide implement local PD training programs with the goal of improving self-care capabilities. This scoping review aims to give an overview of recent literature and recommendations on PD training programs aiming to improve the quality of care and outcomes for PD patients.Methods: The literature search was conducted using the PC (Population, Concept) approach. The population of interest in this study is PD patients, and the study concept is the PD training program. Several databases were used to conduct the literature search, including PubMed, Science Direct, and CINAHL. The search process began from July 2022 until January 2023. The inclusion criteria for the search included research articles and recommendations.Results: The search yielded 22 articles recommending training programs lasting from 5– 8 days, with 1– 3-hour sessions and a nurse-to-patient ratio of 1:1. A cumulative training time of 15 hours or more is recommended to enhance patient independence and reduce peritonitis rates. Home-based or in-unit PD training, conducted by experienced nurses using adult learning strategies, has shown significant value in improving self-care and preventing peritonitis. Evaluating training outcomes should encompass knowledge, skills, and attitudes, and the impact on peritonitis rates. Training programs should be flexible and consider physiological and psychosocial barriers to achieving the best results.Conclusion: There are a variety of strategies for dialysis training concerning duration, session length, patient-to-trainer ratio, timing, methods, location, compliance, and the need for retraining. More evidence is needed to assess the impact of PD patient training programs on self-care capabilities and peritonitis incidence. Future studies should investigate the effects of training programs on compliance, self-efficacy, and patient and nurse perspectives.Keywords: training program, peritoneal dialysis, chronic kidney disease, patient education, nursing

Abstract South Africa’s urban population is increasing, and in parallel, urban green infrastructure has shown an increase in alien tree species, e.g., mulberry (Morus sp.), oak (Quercus spp.) and plane trees (Platanus spp.) to name a few. This causes ecological problems since alien trees are often more water-demanding and competitive than indigenous trees, but they also increase the abundance of respiratory diseases often triggered by an allergic reaction towards the pollen of those alien taxa. In the current study, utilizing 7-day volumetric spore traps, we illustrate that the most abundant tree pollen in the two largest cities of South Africa, Cape Town and Johannesburg, is produced by alien trees with a high risk of allergenicity. This adds another aspect related to public health when evaluating plant species composition in urban forestry and urban ecology, which underlines the urgency of more intense monitoring. More importantly, this—for South Africa—newly emphasized risk for public health underlines the applicability of current directives [i.e., Spatial Development Frameworks (SDFs), localized Precinct Plans, Land Use Schemes (LUSs)] and implementation options in urban planning. Here, we present ideas that may be implemented in such a framework. From both a public health and an ecological perspective, it is recommended to plant indigenous trees like Combretum erythrophyllum, Vachellia and Senegalia spp. that have fewer ecosystem disservices, like a lower impact on public health due to lower allergenicity/lower pollen occurrence and providing more ecosystem services such as lower water needs.

This paper conducts a comprehensive literature review on the administration of intradialytic parenteral nutrition (IDPN) for patients undergoing hemodialysis (HD) in Indonesia. The objective is to assess the current status and challenges associated with IDPN in the country and propose potential strategies for enhancement. The review, encompassing articles published between 2013 and 2023 from databases such as PubMed, Scopus, and Google Scholar, exposes significant risks and the prevalence of malnutrition, particularly protein-energy wasting (PEW), among patients undergoing HD. This patient cohort often necessitates nutritional therapy, and IDPN emerges as a viable option for both prevention and definitive treatment. However, detailed data on malnutrition among HD patients in Indonesia are limited. Challenges include a shortage of nutrition experts in kidney care, low patient adherence to dietary advice, and the inability of Indonesian hospitals to provide IDPN to malnourished hemodialysis patients. The non-uniform cost coverage by the National Health Insurance further complicates matters, despite consumable costs for HD being uniform across all hospitals. The payment system by BPJS does not accommodate the provision of parenteral IDPN with varying prices, as listed in the e-catalog by the national public procurement agency. To offer IDPN to patients, hospitals must achieve cost-efficiency within their HD units, or they risk financial losses. Currently, IDPN is exclusively administered to HD patients with acute conditions in an inpatient setting. A recommendation for policymakers is to explore the adoption of distinct tariffs for HD patients undergoing outpatient care, particularly those managing complex conditions such as PEW. This approach can contribute to improved nutritional support for hemodialysis patients in Indonesia.

This paper presents a new and innovative examination method designed to foster creativity, problem-solving, and collaboration in mathematics education. Traditional assessment practices often focus on rote memorization and fail to engage students in the exploration of mathematical concepts and connect the content to real-world problems. In contrast, the proposed examination approach requires students to invent and solve their own mathematical tasks based on their personal interests and experiences. By actively engaging with mathematical concepts and relationships, students deepen their understanding while developing essential skills such as communication, self-assessment, and peer feedback. Anonymized peer correction is also introduced as a means of minimizing bias and promoting objectivity and a wider understanding. The study investigates student perceptions of the examination based on their experiences regarding its effects on creativity and problem-solving skills. The findings suggest that the new way of examining may not only enhance students’ mathematical understanding and problem-solving abilities but also foster a collaborative learning environment that encourages communication and peer support. The paper concludes that the adoption of this new method has the potential to transform traditional assessment practices and promote more engaged, creative, and collaborative learning experiences for students in a wide range of subjects.

Jelly palm (Butia capitata) is a species of palm tree endemic to the Brazilian Savannah (Cerrado) Biome, which stands out for its use as food, which has resulted in a predatory exploitation of its natural populations. This study aimed to characterize fruits and diaspores of natural populations of jelly palm (‘Arinos’, ‘Mirabela’ and ‘Serranópolis’), in addition to developing ex situ conservation strategies of the species, through the storage of zygotic embryos at ultra-low temperatures of liquid nitrogen (LN). Initially, fruits, seeds and embryos were evaluated for their morphological characteristics. For conservation, hydrated zygotic embryos were desiccated for up to 12 h in a laminar-flow chamber and immersed directly in LN with different moisture contents. As a result, we observed morphological differences among the studied populations. The population ‘Arinos’ showed more expressive results for most of the evaluated characteristics, such as length, width of fruits and seeds. The cryopreservation of zygotic embryos proved to be efficient for the conservation of the species reaching germination rates between 70 and 86%, when the moisture content of the embryos immersed in LN were between 10 and 14%. The plants that reached the stage of the greenhouse had a rate of more than 80% survival. The variability in the characteristics of fruits and diaspores of the analyzed populations allow for establishing divergent groups for the definition of conservation strategies or genetic improvement. The developed cryopreservation protocol can be considered simple and efficient for the conservation of the genetic variability of the species.

Abstract Background The Systems Analysis and Improvement Approach (SAIA) is an evidence-based package of systems engineering tools originally designed to improve patient flow through the prevention of Mother-to-Child transmission of HIV (PMTCT) cascade. SAIA is a potentially scalable model for maximizing the benefits of universal antiretroviral therapy (ART) for mothers and their babies. SAIA-SCALE was a stepped wedge trial implemented in Manica Province, Mozambique, to evaluate SAIA’s effectiveness when led by district health managers, rather than by study nurses. We present the results of a qualitative assessment of implementation determinants of the SAIA-SCALE strategy during two intensive and one maintenance phases. Methods We used an extended case study design that embedded the Consolidated Framework for Implementation Research (CFIR) to guide data collection, analysis, and interpretation. From March 2019 to April 2020, we conducted in-depth individual interviews (IDIs) and focus group discussions (FGDs) with district managers, health facility maternal and child health (MCH) managers, and frontline nurses at 21 health facilities and seven districts of Manica Province (Chimoio, Báruè, Gondola, Macate, Manica, Sussundenga, and Vanduzi). Results We included 85 participants: 50 through IDIs and 35 from three FGDs. Most study participants were women (98%), frontline nurses (49.4%), and MCH health facility managers (32.5%). An identified facilitator of successful intervention implementation (regardless of intervention phase) was related to SAIA’s compatibility with organizational structures, processes, and priorities of Mozambique’s health system at the district and health facility levels. Identified barriers to successful implementation included (a) inadequate health facility and road infrastructure preventing mothers from accessing MCH/PMTCT services at study health facilities and preventing nurses from dedicating time to improving service provision, and (b) challenges in managing intervention funds. Conclusions The SAIA-SCALE qualitative evaluation suggests that the scalability of SAIA for PMTCT is enhanced by its fit within organizational structures, processes, and priorities at the primary level of healthcare delivery and health system management in Mozambique. Barriers to implementation that impact the scalability of SAIA include district-level financial management capabilities and lack of infrastructure at the health facility level. SAIA cannot be successfully scaled up to adequately address PMTCT needs without leveraging central-level resources and priorities. Trial registration ClinicalTrials.gov, NCT03425136 . Registered on 02/06/2018.

Cold weather conditions pose significant challenges to the performance and durability of concrete materials, construction processes, and structures. This paper aims to provide a comprehensive overview of the material-related challenges in cold weather concrete construction, including slow setting, reduced curing rate, and slower strength development, as well as frost damage, early freezing, and freeze–thaw actions. Various innovative materials and technologies may be implemented to address these challenges, such as optimizing the concrete mix proportions, chemical admixtures, supplementary cementitious materials, and advanced construction techniques. The paper also examines the impact of weather-related challenges for personnel, equipment, and machinery in cold environments and highlights the importance of effective planning, communication, and management strategies. Results indicate that the successful implementation of appropriate strategies can mitigate the challenges, reduce construction time, and enhance the performance, durability, and sustainability of concrete structures in cold and freezing temperatures. The paper emphasizes the importance of staying updated about the latest advancements and best practices in the field. Future trends include the development of smart and functional concrete materials, advanced manufacturing and construction techniques, integrated design, and optimization of tools, all with a strong focus on sustainability and resilience.

Abstract Global advances in digital technology are facilitating corresponding rises in digital entrepreneurship and its startup manifestation. There are many uncertainties on the road to digital startup evolution, some of which may be successfully navigated with the assistance of business incubators. While these organisations provide valuable guidance and support to the startup community, their efforts are at least partly constrained by the lack of a consistent, coherent roadmap to guide both them and their incubatees. T0 help efforts to develop such a map, this paper seeks to identify factors that influence digital startup evolution within an incubator setting through a multiple-case study focusing on digital startups under the umbrella of three business incubators in the Swedish city Umeå. Sets of enabling and inhibitory factors are identified through literature searches and the case studies. The latter may include inertia and possibly attitudes towards failure. In addition, present the Ideation Dynamics Model as a guide for both incubators and digital startups is proposed.