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Diabetic foot syndrome is often associated with inflammation. The aim of this study was to evaluate the impact of improved blood supply on the change in the clinical status and culturable bacteriota of chronic wounds. Patients with diabetic foot and peripheral arterial disease with a Rutherford score of 5 or 6 were included (n = 23). The blood supply to the limb was assessed with laboratory tests and two time-point qualitative cultures using a wound biopsy. The baseline parameters of the blood supply to the limb were Transcutaneous Oxygen Perfusion (TCPO2) of 15.0 mmHg, an Ankle Brachial Index (ABI) of 0.7, and a Toe Brachial Index (TBI) of 0.1, with an average Wound, Infection, Inflammation (WIfI) score of 5.7 (high). The most frequently isolated pathogens were Staphylococcus aureus (26.1%), followed by the Enterobacteriaceae family and Pseudomonas spp. (13.0%, each). Negative cultures were present in 47.8% (n = 11). The control parameters of blood supply improved; TCPO2 was 38.5 mmHg, the ABI was 0.9, and the TBI was 0.3, with a reduction in the average WIfI score to 3.7 (mild), while total colony-forming units (CFUs) increased by 13.5%. No cases of reocclusion or restenosis were observed during the study; however, small amputations were performed in two patients (8.7%). Five (21.7%) ulcers were significantly reduced and two (8.7%) progressed, while a negative culture at follow-up was obtained in five fewer patients than at baseline and nine patients presented growth despite having an initial negative result. Quantitative reduction was obtained in four (17.4%) cases. Pathogen distribution at follow-up resembled baseline findings. Optimizing clinical environments (enhancing blood flow and controlling inflammation) in general over focusing singularly on microbiota composition or revascularization seems to be crucial and arguably outweighed the impact of microbial change alone; in particular, reperfusion may increase the conditions to bacterial growth at the first stage. [ABSTRACT FROM AUTHOR]

During the water dissolution polishing process of soft brittle materials, the pad's groove geometry plays a significant role in determining the performance. This not only affects the flow of the slurry but also directly impacts the overall distribution of the water core on the pad surface, thereby influencing the polishing effect. A trajectory model of the water core on the workpiece surface was established through kinematic analysis and the characteristics and effects of the pad's groove geometry in circular, radial, composite, and grid were studied combined with the trajectory analysis. The coefficient of variation and power spectral density were established to evaluate the trajectory uniformity. The trajectory density distribution was quantitatively analyzed to obtain a better understanding of the material removal uniformity. The simulation and experiment results indicated that the existence of groove geometry will greatly affect the flow of slurry and the surface quality. The grid groove had a better distribution of water core, which means better material removal. There exists a tradeoff between the number of grooves and their spacing. These insights offer a fresh perspective and serve as a valuable reference for further research and analysis into the groove characteristics of pads. • The pad's groove geometry was found to significantly impact slurry flow and water core distribution during water dissolution polishing. • A trajectory model for the water core on the workpiece surface was established through kinematic analysis to study the effects of different groove geometries including circular, radial, composite, and grid. • An optimal balance between the number and spacing of grooves was identified, offering valuable insights for further research and analysis of pad groove characteristics. • A decrease of over 98 % in the surface roughness rms (1.283 nm) of KDP crystal can be obtained by optimizing the design of the pad groove which agrees with the simulation result well. [ABSTRACT FROM AUTHOR]

Research purposes This is: (1) Analyze influence income original (PAD) on capital expenditure in South Halmahera Regency, Central Halmahera Regency, and East Halmahera Regency; (2) Analyzing influence of allocation funds general (DAU) for capital expenditure in South Halmahera Regency, Central Halmahera Regency, and East Halmahera Regency; (3) Analyzing influence of allocation funds special (DAK) for capital expenditure in South Halmahera Regency, Central Halmahera Regency, and East Halmahera Regency; (4) Analyzing The influence of profit sharing funds (DBH) on capital expenditure in South Halmahera Regency, Central Halmahera Regency, and East Halmahera Regency; (5) Analyzing the occurrence phenomenon flypaper effect in South Halmahera Regency, Central Halmahera Regency, and East Halmahera Regency. This study is study studies cases in producing areas mining in North Maluku Province. The analytical tools used in the study is analysis panel data regression. Research results show that income original areas and allocation funds special influential positive towards government spending. While the allocation fund general and profit sharing funds are not influential on government spending area. Research results show that existence phenomenon flypaper effect in Central Halmahera Regency, South Halmahera Regency, and East Halmahera Regency. [ABSTRACT FROM AUTHOR]

The vibration mechanism of railways and urban rail transit is highly intricate, particularly within the railway environment. This study employs a variety of vertical stiffness damping pads to develop an integrated damping system for a floating slab. Through optimization of damper stiffness and arrangement, the modal characteristics of the floating slab are analyzed, resulting in a reduction of the inherent frequency of the track structure and attenuation of vibration transmission. Subsequently, this damping system is implemented in an actual engineering project to assess its effectiveness. The findings indicate that lower stiffness in the vibration isolation pad corresponds to a smaller inherent frequency for the floating slab, thereby enhancing its damping efficacy. Utilizing elastic supports for vibration isolation pads within the track structure can mitigate upper structure vibrations induced by trains. [ABSTRACT FROM AUTHOR]

This research aims to assess the financial independence of the Mamuju Regency Government and determine the factors that influence it. This research uses Mamuju Regency Regional Government Financial Report data for 2013 - 2023. The research method uses a qualitative case study approach by analyzing the development of Regional Original Income (PAD) Mamuju Regency acquisition from 2013 to 2023 as well as the contribution of PAD acquisition to Regional Income, then analyzing the development of Regency Transfer Income acquisition Mamuju and the proportion of its revenues to Regional Revenue from 2013 to 2023 in order to determine the level of dependence on funds from other governments (central and provincial), then calculate the Fiscal Independence Index value and classify the calculation results. The financial independence of the Mamuju District Government in the last 10 years, namely 2013- 2023, is included in the "Not Yet Independent" classification with an average value of 0.0705. Analysis of the IKF trend, there are fluctuations in the IKF value in the Mamuju Regency Regional Government, but in the last three years, the trend shows an increase or is positive. Factors that hinder regional financial independence in the Regional Government of Mamuju Regency are the lack of acquisition of Regional Original Income (PAD) and the high level of dependence on central transfer income. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, attention has been paid to forage cactus as a plant resistant to drought conditions and as an obstacle against desertification and diversification of vegetation in low rainfall ranges. The use of Opuntia ficus-indica pads as forage for cattle in the semi-arid and arid regions of the world, especially in periods of time when there is a lack of quality and quantity of fodder in the ranges, is important. Considering the importance of producing fodder plants and improving their quality under the influence of different fertilizer inputs, this experiment aims to investigate the effect of different proportions of biological, chemical and animal fertilizers and their interaction on the qualitative and quantitative characteristics of forage cactus and determine the optimal fertilizer level for this plant in the city, It was done in Khorram Abad, Lorestan. Materials and Methods: In order to investigate the effect of using biological, chemical and livestock fertilizers on Separate and combined tests were carried out on some forage cactus traits during two cropping years (2019 and 2020). The size of each plot was 6 square meters (4 x 1.5) with 4 crop lines and the plant density was 3.33 per each square meter. The main pad for planting was prepared from a three-year base and were prepared and transferred from the research farm affiliated to ICARDA (International Center for Agricultural Research in Dry Areas) in Mehran city, belonging to the Agricultural Research Center of Ilam province. The experiment was conducted in the research farm of Lorestan University's Faculty of Agriculture as a factorial in the form of a randomized complete block design with 32 treatments and 3 replications. Experimental factors include biological fertilizer (mycorrhiza) at 2 levels (use and non-use of mycorrhiza), manure at 4 levels (0, 10, 20 and 30 tons per hectare) and nitrogen fertilizer at 4 levels(0, 100, 200 and 300 kilograms per hectare). The qualitative traits included NDF, ADF, CF, ASH and CP, which were measured using a near infrared spectrometer)NIR(, (model DA 7250: manufactured by Perten Sweden) measurements were made at wavelengths between 700 and 2500 nm. (All the measurements for the quality of traits were done in the central laboratory of Lorestan University). Quantitative analysis of the data after Bartlett's test was done with SAS software Version (9.4) by compound analysis method for all traits (except wet and dry yield which were one year old), to draw graphs from Excel software and to compare the averages from the test LSD was used at a significant level of 5%. Results and Discussion: The percentage of crude protein, ash, neutral detergent fiber, acid detergent fiber, and crude fiber, fresh and dry yield was influenced by the use of manure and nitrogen fertilizer, and the simple effect and the interaction effect of the combined use of different levels of manure and nitrogen fertilizer on this trait were also significant at the level of one percent. The highest fresh forage yield and dry yield were obtained in the treatment of combined use of 300 kg of nitrogen fertilizer + 30 tons per hectare of manure in comparison with the control treatment (no use of fertilizer) with the lowest amount. The percentage of crude protein and fodder ash increased by 83.05% and 88.26% respectively in this treatment, and the percentage of traits reducing the quality of fodder, including neutral detergent fiber, acid detergent fiber, and crude fiber showed the highest decrease compared to the control treatment, showed. Based on the results of the present research, the combined use of manure and chemical fertilizers led to the improvement of quantitative and qualitative traits in forage cactus. Non significant difference was observed between treatments using mycorrhiza and not using it. The best result was obtained in the M3N3 treatment and then in the M3N2, M2N2 and M2N3 treatments, considering that no significant difference was observed between the characteristics of these treatments, the M2N2 treatment seems to be more economically efficient and more sustainable from the environmental aspect, it is recommended. As it was evident in the test results, no significant difference was observed between the treatments using mycorrhizal biofertilizer and not using this fertilizer. It seems that the beneficial effects of manure last longer compared to chemical fertilizers, and also some organic matter may remain in the soil over the years and its nutrients gradually enter the soil, and less damage is caused by using it, enters the environment. Conclusion: According to the results of this research, the integrated application of manure and nitrogen fertilizer has improved the quantitative and qualitative traits in forage cactus, non significant difference was observed between the treatments of using bio-fertilizer and not using bio-fertilizer. therefore, it is recommended that the study regarding the use of mycorrhizal fungi in multi-year and long-term supplementary experiments be investigated further. The effect of year was significant only on the trait of plant height and it did not show significant results in other traits. The combination of manure and chemical fertilizer can increase vegetative growth and forage yield, because in the integrated system, the presence of some chemical fertilizer at the beginning of growth compensates for the lack of elements in the root environment, and then during the growth period, animal fertilizers release the elements required by the plant increasing the yield of fodder in the plant. [ABSTRACT FROM AUTHOR]

Patients undergoing external beam radiation therapy for the palliative treatment of painful bony metastases may have difficulty maintaining a still position on a rigid uncovered couch top, both during CT simulation as well as during patient setup, image guidance, and treatment on the linear accelerator. For these patients, a thin foam pad or mattress is sometimes used to mitigate patient discomfort. It was desired to quantify the effect of the padding in cases in which the patient is to be treated supine with posterior beams when the majority of the beam weighting traverses both the couch and the pad. Ion chamber measurements in-phantom were acquired with 6 MV, 10 MV, and 15 MV photon beams. At depths of maximum dose, the pad resulted in a difference of signal collected ≤1%. At the phantom surface, the pad resulted in an increase in signal ranging from 1% to 6.5% for the measured beams. CT data of the pad, both with and without applied pressure, indicated that the pad had average HU values close to air. [ABSTRACT FROM AUTHOR]

Oxidative stress plays a crucial role in the pathogenesis of peripheral artery disease (PAD). This study aimed to investigate the effect of clopidogrel on oxidative stress in PAD patients. Seventy subjects were divided into three groups: PAD patients before treatment (B-PAD), PAD patients after treatment with clopidogrel (A-PAD), and healthy controls. Serum levels of superoxide dismutase (SOD), copper (Cu), zinc (Zn), manganese (Mn), and oxidized protein were measured. SOD activities were also determined. The results showed that SOD activities, and SOD specific activities were significantly decreased in PAD patients compared to healthy individuals. After treatment with clopidogrel, SOD activities, and SOD specific activities were continuously decrease in PAD patients. The SOD and oxidized protein concentrations were significantly increased in PAD patients compared to healthy individuals. After treatment with clopidogrel, the oxidized protein concentration was significantly decreased, while SOD concentration was significantly increased in PAD patients. These findings suggest that the treatment by clopidogrel stimulated the production of the enzyme but the ratio of active enzyme remained low. The decrease in oxidized protein can be explained by the treatment having antioxidant efficacy that may have compensated for the deficiency in enzyme activity and led to a decrease in oxidized protein. Additionally, the results of this study provide promising evidence that oxidative stress biomarkers including SOD concentration, T-SOD activity, Mn-SOD activity, and oxidized protein levels have potential utility in the diagnosis and management of PAD. [ABSTRACT FROM AUTHOR]

This study is a quantitative study that examines the influence of Regional Original Revenue (PAD), General Allocation Fund (DAU), and Tax Revenue Sharing on economic growth in East Nusa Tenggara province during the period 2008-2017. Secondary data from the Indonesian Bureau of Statistics (BPS) East nusa tenggara Province were used, with independent variables including PAD, DAU, and Tax revenue Sharing, and the dependent variable was economic growth. The analysis method used is multiple linear regression with the Ordinary Least Square (OLS) technique to determine the relationship between these variables. The results of this study are expected to provide an overview of how much PAD and DAU contribute to economic growth during the research period. [ABSTRACT FROM AUTHOR]

Background: In vascular medicine, peripheral arterial disease (PAD) and diabetic foot syndrome (DFS) are often considered synonymous with respect to the need for revascularization. In PAD patients, clinical symptoms reflect the degree of atherosclerotic disease, since peripheral innervation, including pain sensation, is not usually compromised. In DFS patients, however, symptoms of relevant foot ischemia are often absent and progression of ischemia goes unnoticed owing to diabetic polyneuropathy, the loss of nociception being the main trigger for foot ulcers. This review analyzes the fundamental differences between PAD and DFS against the background of polyneuropathy. Methods: The literature research for the 2014 revision of the German evidence-based S3-PAD-guidelines was extended to 2023. Results: Vascular examination is imperative for both, PAD and DFS. Stage-dependent revascularization is of utmost importance in PAD patients, especially those suffering from critical limb-threatening ischemia (CLTI). Successful therapy of DFS goes further, including infection and metabolic control, wound management, offloading the foot and lifelong prophylaxis in the course of a multidisciplinary treatment concept. Revascularization is not needed in all cases of DFS. Conclusions: There are fundamental differences between PAD and DFS with respect to pathophysiology, the anatomical distribution of arterial occlusive processes, the clinical symptoms, the value of diagnostic tools such as the ankle-brachial index, and classification. Also, therapeutic concepts differ substantially between the two patient populations. [ABSTRACT FROM AUTHOR]

The implementation of regional autonomy by giving broad, real and responsible authority to regions in a proportional manner is realized by regulating, distributing and utilizing national resources as well as balancing central and regional finances. Drinking water services in urban areas, PDAM Tirta Sejuk Gayo Les Regency carries out its operations according to company principles, namely efficiency and seeking profits, in order to meet the target of filling regional government coffers. The aim of this research is to understand the strategic issues of PDAM Tirta Sejuk and formulate management strategies that should be implemented in the era of autonomy in order to be able to increase the PAD of Gayo Lues Regency and to find out strategies for improving services to the community. This research method uses a qualitative descriptive approach. This research uses SWOT analysis. Conclusion Currently only 21% (10,500 connections) of Gayo Lues residents can enjoy clean water facilities from PDAM. This condition is still far from the national target which requires 60% of urban residents to be able to enjoy clean water facilities. Of all employees working at PDAM, it can be seen that the composition of the number of employees who have a D3 educational background or above is very small, only 14.01% when compared with the number of employees who have an educational background below D3 is 85.99%. Such conditions indicate that the quality of employees is still low, and the high number of water leaks certainly has a big impact on the efficiency of the PDAM itself. For the customer community, this condition is clearly detrimental because the quantity, quality and continuity of clean water needed to meet their daily needs does not meet expectations, which means reducing their satisfaction with the services provided by PDAM Tirta Sejuk. [ABSTRACT FROM AUTHOR]

AbstractThe highly anticipated global Metaverse market presents a burgeoning arena, particularly in shopping and retail. While physical retail environments have long emphasized the details of exterior and interior servicescape design, the shift to online shopping raises questions about applying these traditional retail principles to the Metaverse setting. This research adopts conjoint analysis to delve into the potential of localized Metaverse retail design by merging consumer emotions, market segmentation, and innovative retail technologies. Using the Pleasure, Arousal, Dominance (PAD) model, we examine Metaverse servicescape attributes, based on real-world counterparts, application in segmenting store design based on consumer preferences. Like in physical retailing cases, music, crowding, and noise are the most influential Metaverse attributes affecting consumer emotion. However, three different clusters emerged according to their emotional responses. Our experiment reveals that Metaverse servicescape attributes may evoke emotional responses akin to their physical counterparts while offering a valuable opportunity for customization that better satisfies market segments. Insights are offered for retailers navigating the dynamic Metaverse landscape, where personalization and localization are now more affordable and where multiple store designs can coexist in digital form—reaching larger markets. [ABSTRACT FROM AUTHOR]

The aim of the study is to evaluate the safety and effectiveness of rotational atherectomy-assisted balloon angioplasty (BTK-RA) for the treatment of isolated below the knee (BTK) atherosclerotic lesions and to compare the outcomes to plain old balloon angioplasty (POBA). Between January 2020 and September 2023, 96 consecutive patients with chronic limb threatening ischemia (CTLI) and isolated BTK-lesions underwent POBA (group A) or BTK-RA (group B). The primary outcome measures were: periprocedural technical success, primary patency, postoperative increase of the ankle branchial index (ABI), target lesion revascularization (TLR), limb salvage, minor amputation and death. Both techniques had similar technical success, operative time, intraprocedural complications and bailout stent implantations, independently of the operator's experience. Group B had significantly higher primary patency rates (93.5% vs. 72.0%, respectively, p = 0.006), TLR (2.1% vs. 24%, p = 0.057), lower in-hospital stay (2.0–3.0 vs. 4.0–6.0 days, respectively, p < 0.001) and higher postoperative ABI (0.8–0.2 vs. 0.7–0.1, respectively, p = 0.008), compared to group A. Significant differences (POBA n: 20, 40%, BTK-RA n = 3, 6.5%) were found in minor amputation rates between the two groups (p < 0.001), while the respective limb salvage rates were similar in both groups (94.0% vs. 97.8%, p = 0.35). The use of BTK-RA for the treatment of BTK-lesions in patients with CTLI showed significant clinical advantages in comparison to POBA. [ABSTRACT FROM AUTHOR]

Lower extremity peripheral artery disease (PAD) is common among patients with several risk factors, such as elderly, smoking, hypertension, and diabetes mellitus. Notably, PAD is associated with a higher risk of cardiovascular complications. Non-invasive interventions are beneficial to improve morbidity and mortality among patients with PAD. Traditional risk factors like smoking, diabetes mellitus, hypertension, and dyslipidemia play a significant role in the development of PAD. Still, additional factors such as mental health, glycemic control, diet, exercise, obesity management, lipid-lowering therapy, and antiplatelet therapy have emerged as important considerations. Managing these factors can help improve outcomes and reduce complications in PAD patients. Antiplatelet therapy with aspirin or clopidogrel is recommended in PAD patients, with clopidogrel showing more significant benefits in symptomatic PAD individuals. Managing several risk factors is crucial for improving outcomes and reducing complications in patients with PAD. Further research is also needed to explore the potential benefits of novel therapies. Ultimately, a comprehensive approach to PAD management is essential for improving morbidity and mortality among patients with this condition. [ABSTRACT FROM AUTHOR]

Diabetic peripheral arterial disease (PAD) is strongly associated with cardiovascular and cerebrovascular diseases, contributing to a high risk of mortality and morbidity. Diagnostic tests that can predict the development of diabetic PAD in the asymptomatic period are inadequate, and new potential biomarkers are needed. This study was conducted to investigate the diagnostic values of serum netrin-1, endothelin-1, oxidative stress parameters, and L-arginine/methylarginine derivatives for diabetic asymptomatic PAD. Three hundred and eighty-six type-2 diabetes mellitus patients who were clinically asymptomatic for PAD were screened for PAD by ankle-brachial index (ABI) measurement. At the same time, forty patients with PAD were included in the study group, and forty-one patients without PAD were included in the control group. Ready-to-use commercial kits were used to measure serum netrin-1, endothelin-1, and oxidative stress markers. Serum netrin-1 median values were found to be significantly higher in the group with diabetic PAD than in the group without (OR [CI 95%]: 1.434 [1.136-1.964], p: 0.036). While a significant positive correlation relationship was detected between total oxidative status and netrin-1 and LDL, a negative significant correlation relationship was detected between ADMA and eGFR. No significant difference was detected between the groups regarding serum endothelin-1, oxidative stress parameters, and L-arginine/methylarginine derivatives. As a result, this study showed that serum netrin-1 levels are high in asymptomatic diabetic PAD patients and can be a possible biomarker in the detection of asymptomatic PAD. [ABSTRACT FROM AUTHOR]

The rapid development of the region with the development of tax/fiscal activities that require the allocation of funds from local governments is a reasonable expenditure and development that requires the availability of large amounts of funds to fund these activities. This research to analyze Balancing Funds, namely DAU, DAK, DBH against Regional Expenditures and to analyze Regional Original Income against Regional Expenditures. Balancing Funds are funds sourced from APBN revenues allocated to the Regions, while Original Regional Income is a source of regional income. This research method is descriptive quantitative where data is collected through data. The sample used in this research is 60 data from the 2019-2023 DAU, DAK, DBH, PAD and Regional Expenditure Realization Reports, which are taken per month. The data will then be analyzed using the multiple regression method which meets the classical assumption test. The results of this research are that DAU and DAK do not have a significant effect on Mamasa Regency Regional Expenditures, while DBH and PAD have a significant effect on Mamasa Regency Regional Expenditures. [ABSTRACT FROM AUTHOR]

Color significantly shapes our perceptions of the world, and extensive scientific research has explored various aspects of color, including color linguistics, aesthetics, color and marketing, color therapy, and color psychology. Notably, there has been an increasing interest in understanding the psychological domain of color in recent years. However, limited scholarly attention has been given to studying the changes in color representations and emotions over the decades. To address this gap, we utilized word embedding models of Google Books Ngrams corpus to examine the most strongly associated entities and traits with colors and their evolution in color emotions over 200 years. Analyzing three emotional dimensions—pleasure, arousal, and dominance (PAD), we found that red, green, white, black, orange, purple, brown, and pink were related to the exuberant type (+P + A + D) in PAD emotional space. In contrast, blue was linked to the relaxed type (+P−A + D), and yellow constituted the anxious type (−P + A−D). Among all basic English color terms, the emotion‐driven perceptions associated with white, brown, and pink have significantly changed over time. [ABSTRACT FROM AUTHOR]

Protein citrullination is accomplished by a broad enzyme family named Peptidyl Arginine Deiminases (PADs), which makes this post-translational modification in many proteins that perform physiological and pathologic mechanisms in the body. Due to these modifications, citrullination has become a significant topic in the study of pathological processes. It has been related to some chronic and autoimmune diseases, including rheumatoid arthritis (RA), interstitial lung diseases (ILD), multiple sclerosis (MS), and certain types of cancer, among others. Antibody production against different targets, including filaggrin, vimentin, and collagen, results in an immune response if they are citrullinated, which triggers a continuous inflammatory process characteristic of autoimmune and certain chronic diseases. PAD coding genes (PADI1 to PADI4 and PADI6) harbor variations that can be important in these enzymes' folding, activity, function, and half-life. However, few studies have considered these genetic factors in the context of chronic diseases. Exploring PAD pathways and their role in autoimmune and chronic diseases is a major topic in developing new pharmacological targets and valuable biomarkers to improve diagnosis and prevention. The present review addresses and highlights genetic, molecular, biochemical, and physiopathological factors where PAD enzymes perform a major role in autoimmune and chronic diseases. [ABSTRACT FROM AUTHOR]

Unmanned aerial vehicles (UAVs) have been employed extensively for remote-sensing missions. However, due to their energy limitations, UAVs have a restricted flight operating time and spatial coverage, which makes remote sensing over huge regions that are out of UAV flight endurance and range challenging. PAD is an autonomous wireless charging station that might significantly increase the flying time of UAVs by recharging them in the air. In this work, we introduce PADs to simplify UAV-based remote sensing over a huge region, and then we explore the UAV route planning problem once PADs have been predeployed throughout a huge remote sensing region. A route planning scheme, named PAD-based remote sensing (PBRS), is proposed to solve the problem. The PBRS scheme first plans the UAV's round-trip routes based on the location of the PADs and divides the whole target region into multiple PAD-based subregions. Between adjacent subregions, the UAV flight subroute is planned by determining piggyback points to minimize the total time for remote sensing. We demonstrate the effectiveness of the proposed scheme by conducting several sets of simulation experiments based on the digital orthophoto model of Hutou Village in Beibei District, Chongqing, China. The results show that the PBRS scheme can achieve excellent performance in three metrics of remote sensing duration, the number of trips to charging stations, and the data-storage rate in UAV remote-sensing missions over huge regions with predeployed PADs through effective planning of UAVs. [ABSTRACT FROM AUTHOR]

Disparities by sex, race, socioeconomic status, and geography exist in diagnosis, treatment, and outcomes for people with lower extremity peripheral artery disease (PAD). PAD prevalence is similar in men and women, but women have more atypical symptoms and undergo lower extremity revascularization at older ages compared to men. People who are Black have an approximately 2-fold higher prevalence of PAD, compared to people who are White and have more atypical symptoms, greater mobility loss, less optimal medical care, and higher amputation rates. Although fewer data are available for other races, people with PAD who are Hispanic have higher amputation rates than White people. Rates of amputation also vary by geography in the United States, with the highest rates of amputation in the southeastern United States. To improve PAD outcomes, intentional actions to eliminate disparities are necessary, including clinician education, patient education with culturally appropriate messaging, improved access to high-quality health care, science focused on disparity elimination, and health policy changes. [Display omitted] • Women present for revascularization at older ages, compared to men. • The prevalence of PAD in Black people is approximately twice that of White people. • PAD amputations are more common in Black and Hispanic people, than in White people. • Eliminating disparities in PAD requires interventions that include improvements in education, access to care, and health policy. [ABSTRACT FROM AUTHOR]

Evidence increasingly shows that the risk of thrombotic complications in COVID-19 is associated with a hypercoagulable state. Several organizations have released guidelines for the management of COVID-19-related coagulopathy and prevention of VTE. However, an urgent need exists for practical guidance on the management of arterial thrombosis and thromboembolism in this setting. What is the current available evidence informing the prevention and management of arterial thrombosis and thromboembolism in patients with COVID-19? A group of approved panelists developed key clinical questions by using the Population, Intervention, Comparator, and Outcome (PICO) format that address urgent clinical questions regarding prevention and management of arterial thrombosis and thromboembolism in patients with COVID-19. Using MEDLINE via PubMed, a literature search was conducted and references were screened for inclusion. Data from included studies were summarized and reviewed by the panel. Consensus for the direction and strength of recommendations was achieved using a modified Delphi survey. The review and analysis of the literature based on 11 PICO questions resulted in 11 recommendations. Overall, a low quality of evidence specific to the population with COVID-19 was found. Consequently, many of the recommendations were based on indirect evidence and prior guidelines in similar populations without COVID-19. The existing evidence and panel consensus do not suggest a major departure from the management of arterial thrombosis according to recommendations predating the COVID-19 pandemic. Data on the optimal strategies for prevention and management of arterial thrombosis and thromboembolism in patients with COVID-19 are sparse. More high-quality evidence is needed to inform management strategies in these patients. [ABSTRACT FROM AUTHOR]

Background and aim: The recruitment process in a randomized trial can be challenging. Poor recruitment can have a negative impact on the allocated budget and estimated completion date of the study and may result in an underpowered study. We aimed to perform a Study Within A Trial (SWAT) to evaluate the impact of same-day consent or delayed consent on recruitment and retention in the host trial. Methods: This SWAT is designed as a prospective cohort design. The host trial was a randomized controlled trial evaluating the effectiveness of an intensive lifestyle modification programme in participants with peripheral arterial disease. Researchers screened the participants for inclusion and exclusion criteria. Informed consents were obtained from the participants who were willing to participate in the study on a standardized consent form. Participants were given the option to consent on the same day or to delay their consent. Following the consent, the participants were allocated to two groups (same-day consent vs. delayed consent) based on pre-determined criteria for SWAT. One hundred sixteen participants were consented to take part in the host trial. Seventy-five participants were randomized to the host trial. The primary outcome was the proportion of participants who withdrew consent at the recruitment phase. Secondary outcomes were reasons for consent withdrawal and dropout, attrition rate, and adherence with the host trial intervention. Results: There was a significantly lower consent-withdrawal rate in same-day consent (17.4%, n = 8/46), compared to the delayed consent group (47.1%, n = 33/70), p = 0.001. There was a significantly lower dropout rate in participants randomized following same-day consent (10.5%, n = 4/38), compared to those randomized after delayed consent (29.7%, n = 11/37), p = 0.038. Transport was the main reason mentioned for consent withdrawal and dropout. In participants randomized to the host trial intervention arm, there was a significant difference in adherence (percentage of the 12-week programme completed) between same-day consent (96.7% ± 4.9) and delayed consent participants (86.4% ± 11.2), p = 0.003, as well as number of weeks completed (mean difference = − 1.547, 95% confidence intervals (− 2.237 to − 0.85)), p = 0.02. Conclusion: This SWAT found evidence that participants who gave consent on the same day seemed to have better adherence and fewer-withdrawal and dropout rates. SWAT registration: The SWAT was registered on the Northern Ireland Network for Trials Methodology Research, SWAT 84. [ABSTRACT FROM AUTHOR]

We present a synthetic augmentation approach towards improving monocular face presentation–attack–detection (PAD) robustness to real-world noise additions. Face PAD algorithms secure authentication systems against spoofing attacks, such as pictures, videos, and 2D-inspired masks. Best-in-class PAD methods typically use 3D imagery, but these can be expensive. To reduce application cost, there is a growing field investigating monocular algorithms that detect facial artifacts. These approaches work well in laboratory conditions, but can be sensitive to the imaging environment (e.g., sensor noise, dynamic lighting, etc.). The ideal solution for noise robustness is training under all expected conditions; however, this is time consuming and expensive. Instead, we propose that physics-informed noise-augmentations can pragmatically achieve robustness. Our toolbox contains twelve sensor and lighting effect generators. We demonstrate that our toolbox generates more robust PAD features than popular augmentation methods in noisy test-evaluations. We also observe that the toolbox improves accuracy on clean test data, suggesting that it inherently helps discern spoof artifacts from imaging artifacts. We validate this hypothesis through an ablation study, where we remove liveliness pairs (e.g., live or spoof imagery only for participants) to identify how much real data can be replaced with synthetic augmentations. We demonstrate that using these noise augmentations allows us to achieve better test accuracy while only requiring 30% of participants to be fully imaged under all conditions. These findings indicate that synthetic noise augmentations are a great way to improve PAD, addressing noise robustness while simplifying data collection. [ABSTRACT FROM AUTHOR]

Background and aim: The recruitment process in a randomized trial can be challenging. Poor recruitment can have a negative impact on the allocated budget and estimated completion date of the study and may result in an underpowered study. We aimed to perform a Study Within A Trial (SWAT) to evaluate the impact of same-day consent or delayed consent on recruitment and retention in the host trial. Methods: This SWAT is designed as a prospective cohort design. The host trial was a randomized controlled trial evaluating the effectiveness of an intensive lifestyle modification programme in participants with peripheral arterial disease. Researchers screened the participants for inclusion and exclusion criteria. Informed consents were obtained from the participants who were willing to participate in the study on a standardized consent form. Participants were given the option to consent on the same day or to delay their consent. Following the consent, the participants were allocated to two groups (same-day consent vs. delayed consent) based on pre-determined criteria for SWAT. One hundred sixteen participants were consented to take part in the host trial. Seventy-five participants were randomized to the host trial. The primary outcome was the proportion of participants who withdrew consent at the recruitment phase. Secondary outcomes were reasons for consent withdrawal and dropout, attrition rate, and adherence with the host trial intervention. Results: There was a significantly lower consent-withdrawal rate in same-day consent (17.4%, n = 8/46), compared to the delayed consent group (47.1%, n = 33/70), p = 0.001. There was a significantly lower dropout rate in participants randomized following same-day consent (10.5%, n = 4/38), compared to those randomized after delayed consent (29.7%, n = 11/37), p = 0.038. Transport was the main reason mentioned for consent withdrawal and dropout. In participants randomized to the host trial intervention arm, there was a significant difference in adherence (percentage of the 12-week programme completed) between same-day consent (96.7% ± 4.9) and delayed consent participants (86.4% ± 11.2), p = 0.003, as well as number of weeks completed (mean difference = − 1.547, 95% confidence intervals (− 2.237 to − 0.85)), p = 0.02. Conclusion: This SWAT found evidence that participants who gave consent on the same day seemed to have better adherence and fewer-withdrawal and dropout rates. SWAT registration: The SWAT was registered on the Northern Ireland Network for Trials Methodology Research, SWAT 84. [ABSTRACT FROM AUTHOR]

Background: Peripheral artery disease (PAD) is an advanced atherosclerotic disease-causing augmented risks of hospitalization and death. So, several studies tried to detect novel biomarkers for PAD diagnosis. The study is aimed to explore the role of plasma miRNA 323b-5p and miRNA 486-5p levels to diagnose PAD. Methods: The research was performed in Medical Biochemistry & Cardiology Departments - Zagazig Faculty of Medicine. It included 100 volunteers categorized into 2 groups; Group (1): included 50 healthy volunteers served as control group with ankle brachial index (ABI) > 0.9. Group (2): included 50 PAD patients with ABI < 0.9. Plasma 323b-5p and miR 486-5p expression level were measured via real time PCR. Color Doppler was performed to calculate ABI, which was correlated with miRNA levels. Results: There was a highly significant difference between groups as regards miR 323b-5p. Furthermore, miR 486-5p expression level showed significant variance between groups. Regarding miRNA 323b-5p expression level, cutoff value was 2.55, sensitivity was 89.3% and specificity was 72.7%. Concerning miR 486-5p expression level, cutoff value was 1.92, sensitivity was 82.1% and specificity was 81.8%. As regards combined miR 323b-5p and miR 486-5p ROC curve, it was 96.4% sensitivity and 95.5% specificity. Each miRNA showed a negative correlation with ABI. Conclusion: miRNA 323B-5P and miRNA 486-5P can be a novel and potent biomarker for PAD diagnosis, particularly for risky patients. [ABSTRACT FROM AUTHOR]

Circadian rhythm disruption is a core symptom of bipolar disorder (BD), also reflected in altered patterns of melatonin release. Reductions of grey matter (GM) volumes are well documented in BD. We hypothesized that levels and timing of melatonin secretion in bipolar depression could be associated with depressive psychopathology and brain GM integrity. The onset of melatonin secretion under dim light conditions (DLMO) and the amount of time between DLMO and midsleep (i.e. phase angle difference; PAD) were used as circadian rhythm markers. To study the time course of melatonin secretion, an exponential curve fitting the melatonin values was calculated, and the slope coefficients (SLP) were obtained for each participant. Significant differences were found between HC and BD in PAD measures and melatonin profiles. Correlations between PAD and depressive psychopathology were identified. Melatonin secretion patterns were found to be associated with GM volumes in the Striatum and Supramarginal Gyrus in BD. Our findings emphasized the role of melatonin secretion role as a biological marker of circadian synchronization in bipolar depression and provided a novel insight for a link between melatonin release and brain structure. [ABSTRACT FROM AUTHOR]

Background: Peripheral artery disease (PAD) is a common circulatory disorder associated with increased hospitalizations and significant health care-related expenditures. Among patients with PAD, insurance status is an important determinant of health care utilization, treatment of disease, and treatment outcomes. However, little is known about PAD-costs differences across different insurance providers. In this study we examined possible disparities in length of stay and total charge of inpatient hospitalizations among patients with PAD by insurance type. Methods: We conducted a cross-sectional analysis of length of stay and total charge by insurance provider for all hospitalizations for individuals with PAD in South Carolina (2010–2018). Cross-classified multilevel modeling was applied to account for the non-nested hierarchical structure of the data, with county and hospital included as random effects. Analyses were adjusted for patient age, race/ethnicity, county, year of admission, admission type, all-patient refined diagnostic groups, and Charlson comorbidity index. Results: Among 385,018 hospitalizations for individuals with PAD in South Carolina, the median length of stay was 4 days (IQR: 5) and the median total charge of hospitalization was $43,232 (IQR: $52,405). Length of stay and total charge varied significantly by insurance provider. Medicare patients had increased length of stay (IRR = 1.08, 95 CI%: 1.07, 1.09) and higher total charges (β: 0.012, 95% CI: 0.007, 0.178) than patients with private insurance. Medicaid patients also had increased length of stay (IRR = 1.26, 95% CI: 1.24,1.28) but had lower total charges (β: -0.022, 95% CI: -0.003. -0.015) than patients with private insurance. Conclusions: Insurance status was associated with inpatient length of stay and total charges in patients with PAD. It is essential that Medicare and Medicaid individuals with PAD receive proper management and care of their PAD, particularly in the primary care settings, to prevent hospitalizations and reduce the excess burden on these patients. [ABSTRACT FROM AUTHOR]

The possibility of injectable biomaterials being used in the therapy of peripheral artery disease (PAD) is investigated in this article. We conducted a thorough review of the literature on the use and efficacy of biomaterials (BMs) and drug-coated balloons (DCBs). These BMs included hydrogels, collagen scaffolds, and nanoparticles. These BMs could be used alone or in combination with growth factors, stem cells, or gene therapy. The treatment of peripheral artery disease with DCBs is increasingly common in the field of interventional angiology. Studies have been carried out to examine the effectiveness of paclitaxel-coated balloons such as PaccocathTM in lowering the frequency with which further revascularization operations are required. PCB angioplasty and angioplasty without paclitaxel did not significantly vary in terms of mortality, according to the findings of a recent meta-analysis that included the results of four randomized controlled studies. On the other hand, age was found to be a factor that predicted mortality. There was a correlation between the routine utilization of scoring balloon angioplasty along with DCBs and improved clinical outcomes in de novo lesions. In both preclinical and clinical testing, the SelutionTM DCB has demonstrated efficacy and safety, but further research is required to determine whether or not it is effective and safe over the long term. In addition, we reviewed the difficulties involved in bringing injectable BMs-based medicines to clinical trials, including the approval processes required by regulatory bodies. Injectable BMs have a significant amount of therapeutic promise for PAD, which highlights the need for more research and clinical studies to be conducted in this field. In conclusion, this research focuses on the potential of injectable BMs and DCBs in the treatment of PAD as well as the hurdles that must be overcome in order to translate these treatments into clinical trials. In this particular field, there is a demand for further research as well as clinical trials. [ABSTRACT FROM AUTHOR]

Peripheral artery disease (PAD) affects more than 230 million people worldwide. PAD patients suffer from reduced quality of life and are at increased risk of vascular complications and all-cause mortality. Despite its prevalence, impact on quality of life and poor long-term clinical outcomes, PAD remains underdiagnosed and undertreated compared to myocardial infarction and stroke. PAD is due to a combination of macrovascular atherosclerosis and calcification, combined with microvascular rarefaction, leading to chronic peripheral ischemia. Novel therapies are needed to address the increasing incidence of PAD and its difficult long-term pharmacological and surgical management. The cysteine-derived gasotransmitter hydrogen sulfide (H2S) has interesting vasorelaxant, cytoprotective, antioxidant and anti-inflammatory properties. In this review, we describe the current understanding of PAD pathophysiology and the remarkable benefits of H2S against atherosclerosis, inflammation, vascular calcification, and other vasculo-protective effects. [ABSTRACT FROM AUTHOR]

The 2018-2020 Budget Realization Report will be used in this study's analysis of the regional government of Pare-Pare Municipality's financial standing. A tool for evaluating financial performance is ratio analysis, which includes measures of decentralization, financial independence, regional financial dependence, effectiveness and efficiency of local revenue, and spending efficiency. This study's statistical analysis followed a descriptive quantitative methodology. According to the study's findings, Pare-Pare City's regional financial independence ratio in 2018-2020 averaged 20.03%, and the degree of decentralization was 16.63%, the ratio of PAD effectiveness for the City Government of Pare-Pare for the 2018-2020 fiscal year was of 96.57%, i.e. <1 or 100, the average PAD efficiency ratio for the Municipal Government of Pare-Pare for the 2018-2020 fiscal year is 20.60%, the average expenditure realized during 2018-2020 is 94.06%. the average spending efficiency ratio of the City Government of Pare-Pare for the 2018 - 2020 fiscal year is 93.10%. [ABSTRACT FROM AUTHOR]

Contrast arteriography (CA) is considered the gold standard to evaluate any phase in peripheral arterial disease (PAD) interventions, from diagnostics to final results. Nevertheless, duplex ultrasonography (DUS) mostly used for the pre/postoperative phase and follow-up control, could be a potential intraoperative adjunctive imaging tool to assess the effects of endovascular revascularization in patients with iliac and femoropopliteal lesions. The PAD "duplex-assisted" protocol includes a preoperative DUS control followed by an intraoperative and a postoperative control. The most important parameters are pulsed doppler spectral analysis and waveform changes, which are impossible to detect with intravascular ultrasound (IVUS). By using a similar acronym, the intraoperative DUS has been previously described as extravascular ultrasound (EVUS). B-mode imaging, color flow, and peak systolic velocity (PSV) are considered. EVUS could be very useful to evaluate the effects of endovascular treatment, mainly in cases of unclear CAs, severe calcifications and/or dissections. In the context of the "leaving nothing behind" strategy, EVUS can drive the physician to evaluate the absence of flow-limiting dissections and decide which target lesion should be treated with antirestenotic therapy, further vessel preparation, or stenting. The EVUS protocol could be a safe and feasible option to improve the completion assessment of endovascular PAD treatment. A better ultrasound waveform is a sign of improved luminal gain and compliance, which is extremely important to finalize the results of new peripheral device technology, such as intravascular lithotripsy. [ABSTRACT FROM AUTHOR]

Deep vein arterialization (DVA) is a therapeutic option in "no option" for revascularization chronic limb-threatening ischemia patients, creating an arteriovenous bypass between a proximal artery and a distal deep venous target at the ankle. Imaging plays a crucial role in peripheral arterial disease (PAD) patient management. We present the case of a 71-year-old PAD patient (Rutherford class 5) with focal gangrene of the first and second toes of the right foot, who was admitted to the vascular surgery department to undergo revascularization surgery by femoro-tibial artery bypass. During surgery a DVA was performed because of an unsatisfactory distal artery target. The post-operative computed tomography angiography showed the saphenous graft patency and opacification of distal foot veins. Subsequent angiography documented the presence of a large venous collateral, responsible for extensive early wash-out to leg venous vessels, which was then embolized. After two months, the patient underwent amputation of the right first and second necrotic toes at the level of the metatarsophalangeal joints. The post-operative course was excellent, with disappearance of pain at rest and good trophism of the surgical wound. [ABSTRACT FROM AUTHOR]

The sporting goods sector can serve as a proving ground for new technologies. We propose that climbing shoes are an excellent case study for showcasing a systematic approach to bio-inspired design. Foot adaptations to climbing have been described before in some animals and have even been incorporated into bio-inspired products. However, there has not yet been a systematic description of climbing adaptations in mammals, and especially in rock climbing species. We present a description of foot morphology in mammals and compare rock climbing species to those with other locomotion types. Our results show that rock climbing species in our sample had fewer digits and larger anterior pads than arboreal species. Rock climbing species often had hooves or, if they had foot pads, these were relatively smooth. These examples look a bit like current climbing shoe designs, perhaps suggesting convergent evolution. However, there was also variation, with rock climbing species having pads varying in shape, placement and texture. Much of this variation is likely to be dependent on the relatedness of species, with those that are more related having more similar feet. We suggest that incorporation of novel textures and compliant pads might be an interesting focus for future climbing shoe designs. [ABSTRACT FROM AUTHOR]

Period poverty, characterized by inadequate access to menstrual health resources and education, detrimentally affects school attendance, academic performance, and individual health. Recent studies have revealed nearly one-fifth of college-enrolled women experienced period poverty in the past year, highlighting the urgency of addressing this issue. Through our study at Purdue University, we evaluated the effectiveness of a free pad and tampon program aimed at reducing period poverty. Findings from our survey, which included responses from 766 university student participants, revealed many utilized the program due to not having products with them (43.2%). In contrast, others cited early or late periods (33.4%) and financial constraints (5.2%) as reasons for usage. In addition, 81.7% of respondents reported they were aware of the program’s existence, indicating a need for more tailored promotional efforts to reach the entire student body. These insights contribute to a deeper understanding of the program’s impact and provide actionable recommendations for improving accessibility and addressing the diverse needs of menstruating individuals within the university community. Leveraging these findings, university administrators can play a vital role in advancing menstrual equity initiatives and fostering supportive environments for all menstruators on campus. [ABSTRACT FROM AUTHOR]

Patients undergoing hemodialysis (HD) experience serious cardiovascular complications, through malnutrition, inflammation, and atherosclerosis. Amputation for peripheral arterial disease (PAD) is more prevalent in patients undergoing HD than in the general population. In addition, revascularization procedures in dialysis patients are often associated with subsequent amputation and high mortality rates. To improve the prognosis of dialysis patients, malnutrition and inflammation must be properly treated, which necessitates a better understanding of the characteristics of dialysis membranes. Herein, the characteristics of several dialysis membranes were studied, with a special reference to the AN69 membrane, noting several similarities to low-density lipoprotein (LDL)-apheresis, which is also applicable for the treatment of PAD. Both systems (LDL-apheresis and AN69) have anti-inflammatory and anti-thrombogenic effects because they use a negatively charged surface for extracorporeal adsorptive filtration from the blood/plasma, and contact phase activation. The concomitant use of both these therapeutic systems may have additive therapeutic benefits in HD patients. Here, we reviewed the characteristics of dialysis membranes and benefits of the AN69 membrane in dialysis patients. [ABSTRACT FROM AUTHOR]

Introduction: Repetitive minor amputations carry the concomitant risks of multiple surgical procedures, major amputations have physical and economical major drawbacks. The aim of this study was to evaluate whether there is a distinct number of minor amputations predicting a major amputation in the same leg and to determine risk factors for major amputation in multiple minor amputations. Materials and methods: A retrospective chart review including 429 patients with 534 index minor amputations between 07/1984 and 06/2019 was conducted. Patient demographics and clinical data including number and level of re-amputations were extracted from medical records and statistically analyzed. Results: 290 legs (54.3%) had one or multiple re-amputations after index minor amputation. 89 (16.7%) legs needed major amputation during follow up. Major amputation was performed at a mean of 32.5 (range 0 – 275.2) months after index minor amputation. No particular re-amputation demonstrated statistically significant elevated odds ratio (a.) to be a major amputation compared to the preceding amputation and (b.) to lead to a major amputation at any point during follow up. Stepwise multivariate Cox regression analysis revealed minor re-amputation within 90 days (HR 3.8, 95% CI 2.0-7.3, p <0.001) as the only risk factor for major amputation if at least one re-amputation had to be performed. Conclusions: There is no distinct number of prior minor amputations in one leg that would justify a major amputation on its own. If a re-amputation has to be done, the timepoint needs to be considered as re-amputations within 90 days carry a fourfold risk for major amputation. Level of evidence: Retrospective comparative study (Level III). [ABSTRACT FROM AUTHOR]

Introduction: amputation of the lower limb is an unwanted, but not the final outcome of treatment in patients with peripheral arterial disease. Unfortunately, a certain number of patients have local complications that indicate re-amputation, which significantly increases morbidity and mortality. Until some time ago, it was considered that a wrong assessment in planning the level of amputation was the only reason for re -amputation, but in practice it is shown that there are additional risk factors that can be marked as predictors of re-amputation. Aim: to determine risk factors that have a direct or indirect impact on the occurrence of local complications, which will ultimately result in re-amputation. Materials and methods: research was designed as prospective collection of variables, and subsequently, according to the model of a cohort study, a retrospective analysis of the data of patients hospitalized in the Clinical Center of the University of Sarajevo between January 2021 and December 2022 was performed. Results: the sample consisted of 165 patients who underwent below-the-knee or above-the-knee amputation. Out of that number, 65 (39.4%) patients were female and 100 (60.6%) were male patients. The average age was 70.92 (±10.95) years. The age range was 29-90 years. Re-amputation was performed in a total of 54 (32.7%) subjects, namely in 36 (32.4%) subjects who underwent below-the-knee amputations, and in 18 (33.3%) patients who underwent above-the-knee amputations. Conclusion: as predictors that carry the significantly highest risk of re-amputation are records of diabetes (p=0.012), hyperlipidemia (p=0.001), smoking addiction (p=0.001), and stump trauma (p=0.045). [ABSTRACT FROM AUTHOR]

Peripheral artery disease (PAD) is caused by atherosclerotic buildup in the lower extremities, leading to obstruction and inadequate perfusion to the peripheral vasculature. Impenetrable plaques initially treated with percutaneous vascular intervention (PVI) have led to worse secondary bypass outcomes and amputation in patients. In this case report, we discuss the importance of using magnetic resonance imaging (MRI) histology in PVI planning in a patient with critical limb ischemia. PVI attempts to recanalize the limb failed because of an impenetrable occlusion in the popliteal artery that was not identified on routine preoperative imaging. Subsequent bypass occluded multiple times eventually requiring an above-knee amputation. An MRI-histology protocol--using ultrashort echo time (UTE) and T2-weighted (T2W) sequences--that was performed prior to the index PVI identified the occlusion as a dense collagen plaque. Histology analysis of the amputated specimen confirmed the MRI finding. This imaging modality offers a novel approach to characterize plaque composition and morphology, thereby identifying lesions at greatest risk of PVI failure and potentially playing an important role in selecting the right candidates for an endovascular-first approach. [ABSTRACT FROM AUTHOR]

The braking phenomenon is an aspect of vehicle stopping performance where with kinetic energy due to the speed of the vehicle is transformed into thermal energy via the friction between the brake disk and its pads. The heat must then be dissipated into the surrounding structure and the airflow around the brake system. The frictional thermal field during the braking phase between the disk and the brake pads can lead to excessive temperatures. In our work, we presented numerical modeling using ANSYS software adapted in the finite element method, to follow the evolution of the global temperatures for the two types of brake disks, full and ventilated disk during braking scenario. Also, numerical simulation of the transient thermal and the static structural analysis were performed here sequentially, with coupled thermo-structural method. Numerical procedure of calculation relies on important steps such that the computational fluid dynamic (CFD) and thermal analysis have been well illustrated in 3D, showing the effects of heat distribution over the brake disk. This CFD approach helped in the calculation of the values of the heat transfer coefficients (h) that have been exploited in the 3D transient evolution of the brake disk temperatures. Three different brake disk materials were tested and comparative analysis of the results was conducted in order to derive the one with the best thermal behavior. The current numerical results were in good agreement with the previous experimental results available in literature. Finally, the resolution of the coupled thermomechanical model allows us to visualize other important results of this research, such as; the deformations, and the equivalent Von Mises stresses of the disk, as well as the contact pressure distribution on the brake pads. According to the results presented in this investigation, several conclusions can be drawn. The choice allowed us to deliver the excellent rotor design to ensure and guarantee the better braking performance of the vehicles. [ABSTRACT FROM AUTHOR]

Background: We tested a screening algorithm of lower extremity arterial disease (LEAD) for general practitioners (GPs) with a 1-year follow-up examination. Besides, patients were referred for vascular specialists to verify the presence of LEAD with specific tools. Method: 327 patients were followed-up. We recorded the differences in the anamnesis. Ankle brachial index was re-measured. Patients repeated walking-test. We compared our results to the specialist control. Results: Specialists confirmed LEAD in 73.7%. 63.1% reported IC symptoms. Our screening algorithm had a sensitivity of 92%, and a specificity of 96%, positive and negative predictive values were 91% and 96%. Most LEADpositive patients received LEAD-specific medications (94.2%) and antiplatelet therapy (91.7%). Improvement in walking test were shown in 96 cases (29.3%). Conclusion: Our screening algorithm combined with specialist control has proven to be an easy-to-apply, and efficient methodology for GPs with excellent sensitivity and specificity in identifying individuals at risk of LEAD. [ABSTRACT FROM AUTHOR]

Aims: Cardiac contractile dysfunction is prevalent in rheumatoid arthritis (RA), with an increased risk for heart failure. A hallmark of RA has increased levels of peptidyl arginine deaminases (PAD) that convert arginine to citrulline leading to ubiquitous citrullination, including in the heart. We aimed to investigate whether PAD‐dependent citrullination in the heart was linked to contractile function in a mouse model of RA during the acute inflammatory phase. Methods: We used hearts from the collagen‐induced arthritis (CIA) mice, with overt arthritis, and control mice to analyze cardiomyocyte Ca2+ handling and fractional shortening, the force‐Ca2+ relationship in isolated myofibrils, the levels of PAD, protein post‐translational modifications, and Ca2+ handling protein. Then, we used an in vitro model to investigate the role of TNF‐α in the PAD‐mediated citrullination of proteins in cardiomyocytes. Results: Cardiomyocytes from CIA mice displayed larger Ca2+ transients than controls, whereas cell shortening was similar in the two groups. Myofibrils from CIA hearts required higher [Ca2+] to reach 50% of maximum shortening, ie Ca2+ sensitivity was lower. This was associated with increased PAD2 expression and α‐actin citrullination. TNF‐α increased PAD‐mediated citrullination which was blocked by pre‐treatment with the PAD inhibitor 2‐chloroacetamide. Conclusion: Using a mouse RA model we found evidence of impaired cardiac contractile function linked to reduced Ca2+ sensitivity, increased expression of PAD2, and citrullination of α‐actin, which was triggered by TNF‐α. This provides molecular and physiological evidence for acquired cardiomyopathy and a potential mechanism for RA‐associated heart failure. [ABSTRACT FROM AUTHOR]

Despite the long history of fingerprint biometrics and its use to authenticate individuals, there are still some unsolved challenges with fingerprint acquisition and presentation attack detection (PAD). Currently available commercial fingerprint capture devices struggle with non-ideal skin conditions, including soft skin in infants. They are also susceptible to presentation attacks, which limits their applicability in unsupervised scenarios such as border control. Optical coherence tomography (OCT) could be a promising solution to these problems. In this work, we propose a digital signal processing chain for segmenting two complementary fingerprints from the same OCT fingertip scan: One fingerprint is captured as usual from the epidermis ("outer fingerprint"), whereas the other is taken from inside the skin, at the junction between the epidermis and the underlying dermis ("inner fingerprint"). The resulting 3D fingerprints are then converted to a conventional 2D grayscale representation from which minutiae points can be extracted using existing methods. Our approach is device-independent and has been proven to work with two different time domain OCT scanners. Using efficient GPGPU computing, it took less than a second to process an entire gigabyte of OCT data. To validate the results, we captured OCT fingerprints of 130 individual fingers and compared them with conventional 2D fingerprints of the same fingers. We found that both the outer and inner OCT fingerprints were backward compatible with conventional 2D fingerprints, with the inner fingerprint generally being less damaged and, therefore, more reliable. [ABSTRACT FROM AUTHOR]

There is a strong need for biomarkers of rheumatoid arthritis (RA) in all phases of the patient's journey and to enable the implementation of precision medicine strategies to improve patient care. The objective of this study was to evaluate the presence of anti-protein-arginine deiminase (PAD) 4 IgG and IgA in the sera of RA patients and disease controls, and to investigate their association with joint erosion and biological treatment use. Sera from 104 RA and 155 controls were tested for the presence of anti-PAD4 IgG and IgA using a new particle-based multi-analyte technology (PMAT). Information on the erosive disease and biological treatment use was available for 54 of the RA patients, who were also tested for anti-citrullinated protein antibodies (ACPA). An association between the autoantibodies and these clinical features was investigated. Anti-PAD4 showed sensitivity and specificity values of 25.0% and 94.2% for IgG and of 21.2% and 94.8% for IgA for RA, respectively. The levels of these antibodies were also significantly higher in RA patients vs. controls, in erosive RA vs. non-erosive disease, and in patients under biologics vs. patients that were not on this treatment regimen. The anti-PAD4 IgG and IgA levels were correlated (rho = 0.60, p < 0.0001), but individuals that were positive for only one of the two isotypes were also observed. Anti-PAD4 IgG and IgA are associated with severe RA, and they represent valuable biomarkers for prognosis prediction and patient stratification. [ABSTRACT FROM AUTHOR]

In this paper, numerical simulation of transient thermal and static structural analysis was performed here sequentially with coupled thermo-structural method. Numerical procedure of calculation was based on important steps such as the Computational Fluid Dynamics (CFD) and thermal analysis which were well illustrated in 3D. Two different rotor designs and three different brake disc materials were tested and comparative analysis of the results was here conducted in order to get the one with the best thermal behaviour. The current numerical results were in good agreement with the previous experimental results available in the literature. Finally, the resolution of the thermo-mechanical coupling model allows us to visualise other important results of this research. According to the results presented in this study, several conclusions can be drawn. The choice will allow us to deliver the excellent rotor design to ensure and guarantee the good braking performance of the vehicles. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has forced governments all around the world to impose lockdowns. As schools were closed and the students could attend schools physically, online education apps were used by the students to continue their education. The purpose of the study was to analyze the students' intentions to use online education apps (OEAs) in the post-pandemic scenario. Purposive sampling was used to collect data from 327 first-time users of OEAs for their standard XII education. Various scales related to OEA's aesthetics, students' emotional response to OEAs, and the intentions to use OEAs in the post-pandemic scenario were used in the survey questionnaire. Correlations were analyzed to find answers to the research questions. The findings reflect that the aesthetics of OEA like the app design, graphics, structure, etc. significantly influence the emotional response and the intention of the students to use OEAs in the post-pandemic scenario. The emotional response of the students toward the OEAs, in itself, also influences the intention of the students to use OEAs in the post-pandemic scenario. When the students get pleasure, become excited, and feel in control of the app, their intention to use the OEAs in the post-pandemic scenario is positively influenced. The research adds to the literature related to OEAs, the aesthetics of OEAs, the emotional response to OEAs, and the intention to use OEAs. The OEA industry can use the finding to grow their consumer base in the post-pandemic scenario. The context of OEA and the results are original in nature. [ABSTRACT FROM AUTHOR]

Background: Sleep dysfunction is a core symptom in bipolar disorder (BD), especially during major mood episodes. This study investigated the possible link between subjective and objective sleep disturbances in inter-episode BD, changes in melatonin and cortisol levels, and circadian melatonin alignment. The study included 21 euthymic BD patients and 24 healthy controls. Participants had to wear an actigraphy device, keep a weekly sleep diary and take salivary samples: five samples on the last evening to determine the dim light melatonin onset (DLMO) and one the following morning to measure rising cortisol. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) and Regensburg Insomnia Scale (RIS), and circadian alignment by the phase angle difference (PAD). Results: In comparison to healthy controls, BD patients had: (1) higher PSQI (5.52 ± 3.14 vs. 3.63 ± 2.18; p = 0.022) (significant after controlling for age and gender), and higher RIS scores (8.91 ± 5.43 vs. 5.83 ± 3.76; p = 0.031); (2) subjective a longer mean TST (p = 0.024) and TIB (p = 0.002) (both significant after controlling for age and gender), longer WASO (p = 0.019), and worse SE (p = 0.036) (significant after controlling for gender); (3) actigraphically validated earlier sleep onset (p = 0.002), less variation in sleep onset time (p = 0.005) and no longer TST (p = 0.176); (4) no differing melatonin levels (4.06 ± 2.77 vs. 3.35 ± 2.23 p = 0.352), an 1.65 h earlier DLMO (20.17 ± 1.63 vs. 21.82 ± 1.50; p = 0. 001) (significant after controlling for gender), and a phase advance of melatonin (6.35 ± 1.40 vs. 7.48 ± 1.53; p = 0.017) (significant after controlling for gender); and (5) no differing cortisol awakening response (16.97 ± 10.22 vs 17.06 ± 5.37 p = 0.969). Conclusions: Patients with BD, even in euthymic phase, have a significantly worse perception of their sleep. Advanced sleep phases in BD might be worth further investigation and could help to explain the therapeutic effects of mood stabilizers such as lithium and valproate. [ABSTRACT FROM AUTHOR]

Significance: The production of antibodies to posttranslationally modified antigens is a hallmark in rheumatoid arthritis (RA). In particular, the presence of citrullination-associated antibodies, targeting both citrullinating enzymes (the peptidylarginine deiminases [PADs]) and citrullinated antigens (anticitrullinated protein antibodies [ACPAs]), has suggested that dysregulated citrullination is relevant for disease pathogenesis. Antibodies to other protein modifications with physicochemical similarities to citrulline, such as carbamylated-lysine and acetylated-lysine, have also gained interest in RA, but their mechanistic relation to ACPAs remains unclear. Recent Advances: Recent studies using RA-derived monoclonal antibodies have found that ACPAs are cross-reactive to carbamylated and acetylated peptides, challenging our understanding of the implications of such cross-reactivity. Critical Issues: Analogous to the classic antibody response to chemically modified proteins, we examine the possibility that antibodies to modified proteins in RA are more likely to resemble antihapten antibodies rather than autoantibodies. This potential shift in the autoantibody paradigm in RA offers the opportunity to explore new mechanisms involved in the origin and cross-reactivity of pathogenic antibodies in RA. In contrast to citrullination, carbamylation is a chemical modification associated with oxidative stress, it is highly immunogenic, and is considered in the group of posttranslational modification-derived products. We discuss the possibility that carbamylated proteins are antigenic drivers of cross-reacting antihapten antibodies that further create the ACPA response, and that ACPAs may direct the production of antibodies to PAD enzymes. Future Directions: Understanding the complexity of autoantibodies in RA is critical to develop tools to clearly define their origin, identify drivers of disease propagation, and develop novel therapeutics. Antioxid. Redox Signal. 36, 389–409. [ABSTRACT FROM AUTHOR]

Background/purpose: The transradial approach has been proposed as an alternative to traditional transfemoral access for diagnostic and therapeutic purposes in several catheterization procedures. Historically, extended length devices for lower limb endovascular interventions have been limited. The aim of this study was to investigate the acute clinical outcomes of orbital atherectomy (OA) via transradial access (TRA) for the treatment of lower extremity peripheral artery disease (PAD).Methods/materials: REACH PVI was a multicenter, prospective, observational study (NCT03943160) including subjects with PAD and target lesion morphology appropriate for OA. All patients were followed post-procedure through the first standard of care follow-up visit.Results: A total of 50 patients were enrolled. In most cases the indication for intervention was disabling claudication (74.0%). Overall, 50 target lesions were treated, 92.0% of lesions were femoropopliteal and 8.0% were infrapopliteal. The average lesion length was 98.3 ± 87.5 mm and 78.0% of the lesions were severely calcified. Balloon angioplasty was performed in 98.0% of target lesions, while a stent was deployed in 16.0%. Treatment success was 98.0%; in only one case the result was sub-optimal (>30% stenosis with stent placement) and a significant dissection was reported. No serious distal embolization, serious thrombus formation or serious acute vessel closure were observed intra- or post-procedurally.Conclusions: Transradial OA followed by percutaneous transluminal angioplasty for lower extremity PAD is feasible and demonstrates a favorable safety profile. Extended length devices such as the Extended Length Orbital Atherectomy System could further facilitate transradial endovascular procedures by increasing its spectrum of application. [ABSTRACT FROM AUTHOR]

Motivated by the need to prepare for the next generation of fingerprint spoofing, we applied the "proactive forensic science" strategy to the biometric field. The working concept, already successful in a few fields, aimed at adopting the sophisticated criminals' way of thinking, predicting their next move so that the crime‐fighting authorities can be one step ahead of them and take preventive measures, against biometric spoofing in this instance. This strategy involved the design, production, and characterization of innovative polymeric materials that could possibly serve in advanced fingerprint spoofs. Special attention was given to materials capable of fooling fingerprint readers equipped with spoof‐detecting abilities, known as "Presentation Attack Detection" (PAD) systems and often referred to as liveness detection. A series of direct cast fake fingerprints was produced from known commercially available spoofing materials, and was functionally tested to compare their performance with that of spoofs produced from the new polymers. The novel materials thus prepared were hydrogels based on polyethylene glycols (PEGs) that were chain‐extended. They showed good performance in deceiving security systems, considerably better than that of spoofs produced from commercial materials, and are, therefore, good spoofing candidates that law‐enforcement authorities should be aware of. [ABSTRACT FROM AUTHOR]