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Purpose: This study examines the impact of enhanced recovery after surgery (ERAS®) on patient recovery after elective colorectal surgery. The innovative PostopQRS™ tool was used for the analysis of patient recovery. Methods: This single-center study compares three cohorts: two retrospective cohorts before (A) and after (B) ERAS® implementation and a prospective cohort post-ERAS® implementation (C) using PostopQRS™. The present study was prospectively registered in the German Register of Clinical Trials (DRKS00026903). Results: A total of 153 patients were included from June 2020 to February 2022. Significant differences were observed in bowel function, oral food intake, opioid use, and PONV (postoperative nausea and vomiting) occurrence. By the day of discharge, 98% in cohorts B and C had bowel movements or stoma output, compared to 66% in cohort A (p < 0.001). Solid food intake on POD1 was higher in cohorts B and C (p = 0.025), while opioid use was lower (p = 0.003 and p < 0.001). Cohort C showed 90% recovery on discharge. Conclusion: This study demonstrates improved early mobility, reduced need for opioids, a higher rate of patients with solid food intake on POD1, and earlier bowel movement as well as excellent recovery following the colorectal ERAS® implementation. [ABSTRACT FROM AUTHOR]

An overview is made of the national protected areas in the Eastern Rhodopes floristic region in terms of their number, areas and categories, purposes of designation, as well as vascular plant species, subject to conservation. In addition, the correlation of the categories of national protected areas in Bulgaria with those of the IUCN is derived. In the floristic region, 58 protected areas are declared, as follows: 1 Strict reserve, 2 Managed reserves, 27 Natural monuments and 28 Protected sites. A database of inspections of the Protected areas and monitoring of vascular plants in them, stored in the Regional Inspectorate of Environment and Waters - Haskovo for the last 20 years has been processed. Based on this, the trends are highlighted and conclusions and recommendations are derived, regarding the sufficiency of the protected areas network, and the adequacy of the regimes introduced by the designation orders for the protection of plant species of conservation concern. [ABSTRACT FROM AUTHOR]

Paeonia tenuifolia is a rare steppe species that is protected in Romania. Anthropogenic influences have led to a decline in the size and number of P. tenuifolia populations. There is currently insufficient data on this species' phytocoenology and habitat preferences. Therefore, this study aimed to identify the habitat preferences of P. tenuifolia in Romania. 65 relevés from the Banat, Transylvania, and Dobrogea regions were analyzed to achieve this. The size of the plots varied from 25 m2 to 200 m2. Agglomerative Hierarchical Clustering (AHC) was used to classify the vegetation, in the GINKGO program. The relationship between floristic composition and environmental variables was assessed using Detrended Correspondence Analysis (DCA) and Canonical Correspondence Analysis (CCA), in CANOCO. The environmental variables were represented by climatic variables (mean annual temperature, annual precipitation), topographic variables (elevation) and edaphic variables (pH, P, and K). The study results showed that AHC allowed the identification of 11 clusters. P. tenuifolia occurs most frequently in the associations Agropyro pontici-Thymetum zygioidis and Festuco rupicolae-Brachypodietum pinnati. CCA results imply strong relationships between floristic composition and annual precipitation (BIO12). Among the three analyzed regions, P. tenuifolia was confirmed only in the Dobrogea and Transylvania regions. Knowledge of the floristic composition and its correlation with environmental variables in the analyzed areas should guide future conservation strategies and management efforts. [ABSTRACT FROM AUTHOR]

Iris brandzae is one of the most threatened plant species in Romania. The current distribution of this species is very fragmented, and the population size has been reduced in the last 30 years. Information on the habitat preferences of the species has not been summarized yet. In this context, this study aimed to identify the habitat preferences of the species I. brandzae in Romania. The study was carried out in the NE (Moldova) and SE (Muntenia) regions of Romania. For the vegetation analysis, a total of 46 relevés were used. To classify the vegetation, we applied the hierarchical agglomerative clustering method, using the ß-flexible algorithm with ß = -0.25 and the Bray-Curtis dissimilarity. The data were represented as mean percentage values, according to the the Braun-Blanquet scale. Relationships between floristic composition and environmental variables were analyzed with Detrended Correspondence Analysis (DCA) and Canonical Correspondence Analysis (CCA). The vegetation analysis showed that I. brandzae grows in xerophilous, mesophilous and halophilous grasslands and ash-alpine alluvial forests. The species occurs in the communities of the Stipion lessingianae alliance, of the Festucetalia valesiacae order, mainly. The results of the CCA analysis indicate that the variation of the floristic composition of I. brandzae is influenced by the annual mean temperature (BIO1). [ABSTRACT FROM AUTHOR]

The present study investigated the 1H Nuclear Magnetic Resonance (NMR) spectra of hydrogen-rich water (HRW) produced using the EVObooster device. The analyzed HRW has pH = 7.1 ± 0.11, oxidation–reduction potential (ORP) of (−450 ± 11) mV, and a dissolved hydrogen concentration of 1.2 ppm. The control sample was tap water filtered by patented technology. A 600 NMR spectrometer was used to measure NMR spectra. Isotropic 1H nuclear magnetic shielding constants of the most stable clusters (H2O)n with n from 3 to 28 have been calculated by employing the gauge-including-atomic-orbital (GIAO) method at the MPW1PW91/6-311+G(2d,p) density function level of theory (DFT). The HRW chemical shift is downfield (higher chemical shifts) due to increased hydrogen bonding. More extensive formations were formed in HRW than in control filtered tap water. The exchange of protons between water molecules is rapid in HRW, and the 1H NMR spectra are in fast exchange mode. Therefore, we averaged the calculated chemical shifts of the investigated water clusters. As the size of the clusters increases, the number of hydrogen bonds increases, which leads to an increase in the chemical shift. The dependence is an exponential saturation that occurs at about N = 10. The modeled clusters in HRW are structurally stabilized, suggesting well-ordered hydrogen bonds. In the article, different processes are described for the transport of water molecules and clusters. These processes are with aquaporins, fusion pores, gap-junction channels, and WAT FOUR model. The exponential trend of saturation shows the dynamics of water molecules in clusters. In our research, the chemical shift of 4.257 ppm indicates stable water clusters of 4–5 water molecules. The pentagonal rings in dodecahedron cage H3O+(H2O)20 allow for an optimal arrangement of hydrogen bonds that minimizes the potential energy. [ABSTRACT FROM AUTHOR]

Introduction: Hospital readmission has a negative impact on older people and the healthcare system. Current hospital readmission research predominantly reports on clinical outcomes based on cross‐sectional data. Research exploring patients' experiences and priorities is limited. This study aimed to explore older people's experiences of hospital readmission in order to develop an understanding of what matters most to them. Methods: Semi‐structured qualitative interviews were conducted to generate data that were analysed using principles of interpretative phenomenological analysis. Results: Ten participants over 65 years old, who had experienced unplanned hospital readmission within a period of 30 days, were recruited from a large single tertiary referral centre. Four themes emerged: 'All about me without me', 'Fragmented and ad hoc post‐discharge support', 'My readmission experience and what led me back' and 'Segregated health and social services that are detached from people's needs'. Conclusion: The study findings suggest that patients should be more involved in decisions about their care, and health professionals should endeavour to better understand the contexts, resources and access to formal and informal support of patients. Effective communication and stronger continuum of care could be a key to patients' recovery and avoidance of hospital readmission. This research highlights the importance of shared decision‐making and patient‐centred care to improve quality of care, maintain independence and preserve older adult's right to feel valued. [ABSTRACT FROM AUTHOR]

Machine-learned computational chemistry has led to a paradoxical situation in which molecular properties can be accurately predicted, but they are difficult to interpret. Explainable AI (XAI) tools can be used to analyze complex models, but they are highly dependent on the AI technique and the origin of the reference data. Alternatively, interpretable real-space tools can be employed directly, but they are often expensive to compute. To address this dilemma between explainability and accuracy, we developed SchNet4AIM, a SchNet-based architecture capable of dealing with local one-body (atomic) and two-body (interatomic) descriptors. The performance of SchNet4AIM is tested by predicting a wide collection of real-space quantities ranging from atomic charges and delocalization indices to pairwise interaction energies. The accuracy and speed of SchNet4AIM breaks the bottleneck that has prevented the use of real-space chemical descriptors in complex systems. We show that the group delocalization indices, arising from our physically rigorous atomistic predictions, provide reliable indicators of supramolecular binding events, thus contributing to the development of Explainable Chemical Artificial Intelligence (XCAI) models. Chemical AI often behaves as a black box, providing accurate, but opaque, predictions. Here, the authors show that the synergy of cutting-edge ANNs with the rigor of Quantum Chemical Topology can result in Explainable Chemical AI (XCAI). [ABSTRACT FROM AUTHOR]

Pressure on healthcare systems to address growing population needs is forcing services to adapt, which includes supporting acute patients in the community. One emerging service in the United Kingdom that offers this level of treatment is "Hospital at Home" (HaH). Self‐management support is an area of particular importance in this context considering that acute treatment is provided in a community setting with limited input and monitoring by healthcare professionals. There is currently limited understanding about the range of formal and informal support and resources needed and accessed by patients in such circumstances, and whether and how HaH professionals engage with the everyday contexts and the network members of patients. Semistructured interviews were conducted with nurses (n = 9) from a single Hospital at Home site to further understand their experiences of providing acute treatments in the context of patients' homes; and how self‐management and social network support roles are perceived. Thematic analysis was used and four themes were identified: The value of prioritising illness work at home within a discourse of person-centered care; the work involved in the "naturally" therapeutic environment of the home; partners as key members of the informal care team; limited awareness and engagement with (in)formal networks. Findings demonstrate tensions between discourses where nurses idealise the value of the home and a holistic service provision, while in practice prioritising illness (over relational, emotional, and practical) work and delivering a service that is routinised, and time‐ and cost‐efficient. Nurses recognise the positive role of network members for illness management in the context of people's everyday life, but awareness and engagement are limited to partners and the formal services that HaH staffs are familiar with. Developing a better understanding of the role of social networks (SNs) in supporting people with acute needs at home can help improve patient experiences and care and HaH services, especially for people who are vulnerable, with complex needs, living alone, and with limited access to resources. [ABSTRACT FROM AUTHOR]

Coronary artery disease (CAD) presents a significant risk for patients with systemic vasculitides, a group of disorders characterized by the inflammation of blood vessels. In this review, we focus on the pathophysiological mechanisms, complications, and management strategies for CAD in systemic vasculitides. We highlight how the inflammatory processes inherent in vasculitis contribute to accelerated atherosclerosis and myocardial ischemia. Key strategies in managing CAD in this patient population include using medicine treatments to mitigate vascular inflammation while balancing the risk of promoting cardiovascular events and lifestyle modifications. Understanding the nuanced relationship between systemic vasculitides and CAD is crucial for improving patient outcomes and guiding therapeutic approaches. [ABSTRACT FROM AUTHOR]

The present study deals with the investigation of the beech forests of Pernik Province. It aims to test a methodological approach for determination of the condition of beech forests. The area of research is located in the western parts of Bulgaria. Forests represent an essential natural resource that impacts the quality of the environment and the population living in its vicinity. The processes of mapping and monitoring of tree habitats has a long tradition in dendrology. Landsat 8 data has been used for the calculation of the Normalized Difference Vegetation (NDVI) for the study area. Four months (May, June, July and November) have been studied with the available satellite data. The tested methodological approach shows promise when it comes to June and July, yet data regarding May and November is controversial. [ABSTRACT FROM AUTHOR]

The research aims to provide a comprehensive review of the syntaxonomy, ecology and distribution of the Potamogeton communities in Bulgaria. A dataset of 171 relevés, collected across the country according to the Braun-Blanquet approach was analysed. Hierarchical clustering was performed with the PC-ORD software package using the Bray-Curtis dissimilarity and the flexible beta clustering algorithm for classification analyses. The diagnostic species were determined by calculating the Phi-coefficient and only the statistically significant values were considered. The syntaxonomical diversity is represented by 1 class, 1 order, 2 alliances and 10 associations (Potamogetonetum pusilli*, Potamogetonetum berchtoldii*, Potamogetonetum crispi, Potamogetonetum lucentis, Potamogetonetum natantis, Potamogetonetum nodosi, Potamogetonetum pectinati, Potamogetonetum perfoliati*, Potamogetonetum trichoidis*, Scirpo fluitantis-Potametum polygonifolii*). The most wide-spread associations are Potamogetonetum nodosi and Potamogetonetum natantis. Five associations are recorded for the first time for the territory of the country. [ABSTRACT FROM AUTHOR]

The floristic region of Eastern Rhodopes (ER) is situated in Rilo-Rhodopean range, Southeast Bulgaria. In the ER are designated 58 national protected areas (PAs), 19 of them with 31 plant species of conservation significance, as an object of protection. PAs are one of the most important tools for the conservation of biological diversity. It is expected that the introduced protection regimes in each of them lead to the maintenance or improvement of the state of the populations of the target species. For eight species, this is the only floristic region, in which they are found in Bulgaria. Based on the above the present study aims to review the state of the vascular plant species populations of high conservation concern. The habitats and populations of most of the studied species have not deteriorated since the declaration of the respective protected areas. The main threats are related to habitat deterioration due to changes in ecological conditions (warming, drying), or anthropogenic activities (waste dumping, rock mass mining, reduction/absence of grazing, etc.). Conclusions and recommendations are made on the status and conservation of the presented plant species. In general, it can be concluded that the protected areas in the Eastern Rhodopes guarantee the protection of plant species of high conservation concern. However, a periodic assessment of the state of their populations and adaptation of the conservation regimes is necessary. [ABSTRACT FROM AUTHOR]

This research aimed to contribute the knowledge on the syntaxonomy and ecology of class Sisymbrietea Gutte et Hilbig 1975 on the territory of Bulgaria. During the period 2018-2023, 297 phytocoenological relevés with a plot size of 10-16 m2 following the Braun-Blanquet approach were collected. All relevés were contributed to the Balkan Vegetation Database (EU-00-013) and nomenclature of species was standardized according to the Euro+Med PlantBase. The hierarchical clustering was performed using the PC-ORD software package using Bray-Curtis dissimilarity and flexible beta clustering algorithm. The diagnostic species were determined by calculating the Phi-coefficient and only the statistically significant values, evaluated by Fisher's exact test (P < 0.05), were considered. As a result of investigation were found four new ruderal associations (Descurainietum sophiae, Hordeo murini-Brometum sterilis, Linario-Brometum tectorum and Aegilopsietum cylindricae) for Bulgarian vegetation. Descurainietum sophiae association is typical for areas with nitrophilization, while the other three associations occur within agrocoenoses, other anthropogenic territories or in altered grasslands. [ABSTRACT FROM AUTHOR]

There are several ways to convert a closure or interior operation to a different operation that has particular desirable properties. In this paper, we axiomatize three ways to do so, drawing on disparate examples from the literature, including tight closure, basically full closure, and various versions of integral closure. In doing so, we explore several such desirable properties, including hereditary , residual , and cofunctorial , and see how they interact with other properties such as the finitistic property. [ABSTRACT FROM AUTHOR]

Introduction: Diabetic foot disease is an advanced complication of diabetes mellitus, which is associated with severe invalidization and high mortality rate among affected people. Many factors are involved in its pathogenesis but not all of them are fully elucidated. Objectives: Adipose tissue and its hormones – adipokines, are related to diabetic complications and metabolic disorders. Until now, there are limited data on their role in diabetic foot. The aim of this cross-sectional study is to determine the levels of the adipokine omentin-1 in people with and without diabetic foot disease and to look for its potential involvement in this complication. Methods: Eighty patients with type 2 diabetes and mean age of 60.8±10.5 years were included in this study. They were divided into two groups: with (n=36) and without (n=44) diabetic foot disease. Standard antrometric, clinical and laboratory tests were made. Body composition was analyzed by bioelectrical impedance based device. Serum omentin-1 was measured using ELISA method. Results: Levels of omentin-1 were significantly higher among people with diabetic foot disease (700.2±345.1 ng/ml), compared to the other group (560.2±176.7 ng/ml). This difference remained significant even after adjusting for potential confounders. In a regression model omentin-1 proved its predictive value for development of diabetic foot. Conclusion: Adipokines, and particularly omentin-1, might be included in the pathogenesis of diabetic foot disease. [ABSTRACT FROM AUTHOR]

The potential for using artificial intelligence (AI) systems in education (including foreign language teaching and learning) poses new demands on 21st century pre-service teachers who need to be prepared to integrate it successfully in their classrooms. The current paper, therefore, aimed to examine the attitude and readiness of 52 Bulgarian pre-service foreign language teachers on using AI in English language instruction. Based on the data obtained, it was established that the pre-service teachers demonstrated a general positive disposition towards using AI tools in their foreign language lessons and declared their readiness to implement AI technologies in the foreign language classroom but lacked the skills and competencies needed to do so. The results also showed that teacher training institutions and policy makers on national level have to define the AI knowledge, competencies and skills of prospective teachers so that they could actively engage with AI ethically and meaningfully in their profession. [ABSTRACT FROM AUTHOR]

In a rapidly changing world, the adaptation of educators to new challenges becomes critical. Our research within the framework of the research and technical program (grant No. BR21882260, funded by the Science Committee of the Ministry of Science and Higher Education of the Republic of Kazakhstan) found that 9,890 (16.1%) of 61,426 teachers consider innovation, creativity, and critical thinking skills to be unimportant or not very important for mentoring. This rejection of an innovation requires a deep understanding of its causes and consequences. These objections may be due to fear of an uncertain future, misunderstanding of the benefits of artificial intelligence (AI), or fear of job loss. The current paper presents the conditions and mechanisms for teachers to adapt to changes in an increasingly complex world using AI. [ABSTRACT FROM AUTHOR]

The article discusses the importance of psychological interventions in treating bipolar disorder (BD) alongside medication. It highlights various evidence-based psychological interventions such as psychoeducation, cognitive behavioral therapy (CBT), and family-focused therapy (FFT) that have shown positive outcomes in managing BD. The paper emphasizes the need for personalized treatment plans based on individual needs and stages of the disorder, as well as the challenges of accessing evidence-based psychological interventions globally due to factors like awareness, availability, and affordability. The authors recommend large-scale efforts to develop and implement psychological interventions for BD, optimize treatments based on treatment moderators, and work towards equitable access to these interventions worldwide. [Extracted from the article]

Coronary bifurcation lesions account for a significant proportion of all percutaneous coronary interventions (PCIs). Interventional treatment of coronary bifurcations is related to significant technical challenges, high complication rates, and worse angiographic and long-term clinical outcomes. This review covers the specific features and structure of coronary bifurcation and explores the main challenges in the interventional treatment of these lesions. This review evaluates various methodologies designed to address these lesions, considering factors such as plaque distribution and bifurcation geometry. It also emphasizes the limitations associated with current techniques. A novel combined optimization approach applied in the interventional treatment of coronary bifurcation may offer superior procedural and long-term outcomes. This combined technique could potentially address the drawbacks of each method, providing a more effective solution for optimizing stent placement in bifurcation lesions. Refining and evaluating these combined techniques is essential for improving clinical outcomes in patients with bifurcation lesions. [ABSTRACT FROM AUTHOR]

Background and Objectives: Patients with atrial fibrillation and coronary artery disease represent a group with a greater risk of mortality. To evaluate patients with atrial fibrillation (AF) and a significant coronary bifurcation lesion and compare the clinical outcomes between the patients on anticoagulant treatment with Vitamin K antagonist (VKA) and those on direct anticoagulant (DOAC). Materials and Methods: This is a prospective study of patients with AF and stable coronary artery disease, who had evidence of a significant coronary bifurcation lesion. A log-rank test was used to assess the difference in mortality between patients taking VKA and those on DOAC. The primary endpoint was the incidence of all-cause and cardiovascular death at mid-term. Results: A total of 226 patients with AF and a significant bifurcation lesion were included. The mean age was 70.9 ± 9.2, and 70% were males. Of the patients, 123 (54.7%) were on VKA treatment, and 103 (45.3%) were taking DOAC. For a median follow-up time of 55 (39–96) months, overall mortality was 40%, whereas CV mortality was 31%. Both all-cause (28.2% versus 50.4%, p = 0.020) and CV death (12.7% versus 24.9%, p = 0.032) were significantly lower in patients taking DOAC versus those on VKA. In patients treated with PCI, CV mortality was significantly lower in patients taking DOAC (21.4% versus 40.5%, p = 0.032). VKA therapy was an independent predictor of cardiovascular death (HR 1.88; 95% CI 1.11–3.18; p = 0.01), together with chronic kidney disease (HR 1.81; 95% CI 1.13–2.92; p = 0.01). Conclusions: Treatment with DOAC in patients with atrial fibrillation and coronary bifurcation lesion was associated with significantly lower mortality independently of the treatment approach. VKA was an independent predictor of CV mortality. [ABSTRACT FROM AUTHOR]

This study presents an analysis of the influence of weather conditions on the performance of a multicrystalline silicon photovoltaic module, which operates under constant resistive load and is situated near a limestone quarry. The quarry is a significant source of dust, and hence the focus of the study is on the weather factors influencing the presence of soiling on the module's surface. The analysis encompasses a three-week period, during which the global horizontal irradiance and wind speed were recorded at 10-min intervals by an on-site weather station. The current, voltage, and back temperature of the module were also measured. Supplementary weather data were obtained from the Copernicus Atmosphere Monitoring Service and the NASA POWER databases. The primary objective is to assess whether any influence of the observed weather conditions on the presence of soiling can be inferred from the recorded data. The contribution is in part intended to test how different techniques can be used to extract useful information on the weather-related effects from somewhat limited data, assembled from various sources, while dealing with the underlying uncertainties. The analysis indicates a persistent deterioration of the module's performance because of soiling and its subsequent improvement due to a favourable weather event. [ABSTRACT FROM AUTHOR]

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Methanol is a promising feedstock for the bio-based economy as it can be derived from organic waste streams or produced electrochemically from CO2. Acetate production from CO2 in microbial electrosynthesis (MES) has been widely studied, while more valuable compounds such as butyrate are currently attracting attention. In this study, methanol was used as a co-substrate with CO2 to enhance butyrate production in MES. Feeding with CO2 and methanol resulted in the highest butyrate production rates and titres of 0.36 ± 0.01 g L−1 d−1 and 8.6 ± 0.2 g L−1, respectively, outperforming reactors with only CO2 feeding (0.20 ± 0.03 g L−1 d−1 and 5.2 ± 0.1 g L−1, respectively). Methanol acted as electron donor and as carbon source, both of which contributed ca. 50% of the carbon in the products. Eubacterium was the dominant genus with 52.6 ± 2.5% relative abundance. Thus, we demonstrate attractive route for the use of the C1 substrates, CO2 and methanol, to produce mainly butyrate. Key points: • Butyrate was the main product from methanol and CO2in MES • Methanol acted as both carbon and electron source in MES • Eubacterium dominating microbial culture was enriched in MES [ABSTRACT FROM AUTHOR]

The study is focused on the study of forest habitats of Svoge Municipality, situated in the western part of the country. The total area of Svoge Municipality is 868 km². 134 relevés were collected during the period of 2015-2019, following the Braun-Blanquet approach and 445 field points were verified, as well. As a result, nine forest habitat types, included in Directive 92/43/EEC, were identified, representing a habitat diverse municipality. They are covering 135.89 km² or 15.7% of the total municipality’s area. The habitat type of the Asperulo-Fagetum beech forests (9130) covers the largest area (57.86 km²), followed by the habitat type of the MedioEuropean limestone beech forests of the Cephalanthero-Fagion (9150) (31.03 km²). The dominance by beech forest is typical for the Western Balkan Range where these types of forests expanded due to climatic and anthropogenic factors, which led to the reduction of the belts, dominated by the common hornbeam, the spruce and the fir. Major threats include forest degradation and loss, because of logging activities, pests, presence of invasive species, quarries and illegal household disposing. Measures, including afforestation with local species and forest regeneration, are needed. [ABSTRACT FROM AUTHOR]

Class Mulgedio-Aconitetea comprises plant communities that develop primarily in the upper montane to subalpine vegetation belts. It is vegetation where tall herb species (forbs, ferns, grasses) occur dominantly; in the Balkans, it was studied only marginally. In this article, based on floristic composition we assess two questions: (1) what is the diversity of the class Mulgedio-Aconitetea in Bulgaria and (2) what environmental factors are responsible for the vegetation assemblages in the area? We analyzed 387 plots. We created an expert system that classifies this vegetation and tested environmental variables for their influence on these vegetation types. In total, 15 associations and one uncategorized community were classified using the Braun-Blanquet approach. The length of the growing season (number of growing degree days > 0 °C) and climate moisture have a significant effect on the vegetation. Disturbance severity, disturbance frequency and reaction have influence over the species scores. Moreover, all variables significantly differed between the vegetation types. [ABSTRACT FROM AUTHOR]

Background: The rising number of dementia diagnoses and imminent adoption of disease-modifying treatments necessitate innovative approaches to identify individuals at risk, monitor disease course and intervene non-pharmacologically earlier in the disease course. Digital assessments of dementia risk and cognitive function have the potential to outperform traditional in-person assessments in terms of their affordability, accuracy and longitudinal tracking abilities. However, their accessibility and reliability in older adults is unclear. Aims: To evaluate the usability and reliability of a smartphone assessment of lifestyle and cognitive factors relevant to dementia risk in a group of UK-based older adults. Method: Cognitively healthy adults (n = 756) recruited through the Dementias Platform UK Great Minds volunteer register completed three assessments of cognitive function and dementia risk over a 3-month period and provided usability feedback on the Five Lives smartphone application (app). We evaluated cognitive test scores for age, gender and higher education effects, normality distributions, test–retest reliability and their relationship with participants' lifestyle dementia risk factors. Results: Participants found the app 'easy to use', 'quick to complete' and 'enjoyable'. The cognitive tests showed normal or near-to-normal distributions, variable test–retest reliabilities and age-related effects. Only tests of verbal ability showed gender and education effects. The cognitive tests did not correlate with lifestyle dementia risk scores. Conclusions: The Five Lives assessment demonstrates high usability and reliability among older adults. These findings highlight the potential of digital assessments in dementia research and clinical practice, enabling improved accessibility and better monitoring of cognitive health on a larger scale than traditional in-person assessments. [ABSTRACT FROM AUTHOR]

The paper concerns the dynamics and stability of double-walled carbon nanotubes conveying fluid. The equations of motion adopted in the current study to describe the dynamics of such nano-pipes stem from the classical Bernoulli–Euler beam theory. Several additional terms are included in the basic equations in order to take into account the influence of the conveyed fluid, the impact of the surrounding medium and the effect of the van der Waals interaction between the inner and outer single-walled carbon nanotubes constituting a double-walled one. In the present work, the flow-induced vibrations of the considered nano-pipes are studied for different values of the length of the pipe, its inner radius, the characteristics of the ambient medium and the velocity of the fluid flow, which is assumed to be constant. The critical fluid flow velocities are obtained at which such a cantilevered double-walled carbon nanotube embedded in an elastic medium loses stability. [ABSTRACT FROM AUTHOR]

Aim: To evaluate temporal changes in metastatic colorectal cancer (mCRC), incidence, and use of chemotherapy treatment by age group using real-world data (RWD) from the USA. Methods: A retrospective, observational study describing temporal trends in mCRC incidence and FOLFOXIRI treatment by age group using a nationwide database of commercially and Medicare Advantage-insured patients from 2010 to 2019. Results: Incidence of mCRC increased by 22.1 and 14.9% in the 18–49 and 50–64 years cohorts, respectively, and decreased by 21.6% in the ≥65 years cohort. Overall, younger patients were more likely to receive FOLFOXIRI treatment versus older patients. Conclusion: The shifting age distribution of mCRC should be considered when recommending screening and treatment. Further research is needed to inform age-specific treatment guidelines. Plain language summary What is this article about? This article reports the results of a study that used a US database of commercially and Medicare Advantage-insured adults to evaluate how the number of adults with metastatic colorectal cancer (mCRC) in three age groups (18–49 years, 50–64 years and 65 years and over) changed from 2010 to 2019. The study also looked at the use of an aggressive chemotherapy treatment, known as 5-fluorouracil, oxaliplatin, leucovorin calcium and irinotecan (FOLFOXIRI), by age group. What were the results? Overall, 23,970 adults with mCRC were included in the study. From 2010 to 2019, the number of adults with mCRC increased by 22.1% among those aged 18–49 years, increased by 14.9% among those aged 50–64 years, and decreased by 21.6% among those aged 65 years and over. There were some differences between age groups; a higher percentage of younger patients (18–49 years) were Hispanic or Asian, and from the South compared with the older age groups. In comparison, those aged 65 years and over were more likely to be from the West and Northeast of the USA. The study also found that a higher proportion of those aged 18–49 years received FOLFOXIRI (8.4%) compared with adults aged 50–64 years (4.4%) and 65 years and over (1.9%). What do the results of the study mean? Healthcare providers should be aware that early-onset mCRC is becoming more common and consider this when recommending screening and treatment. Summary points A rise in early-onset metastatic colorectal cancer (mCRC) has been observed in high-income countries, in contrast with the steady decline in late-onset mCRC due to improved screening. Contemporary data are required to better understand temporal changes in mCRC incidence by age group in the USA. This retrospective, observational cohort study used a database of commercially and Medicare Advantage-insured patients enrolled between 2010 and 2019 to describe temporal trends in mCRC incidence, patient characteristics, and treatment regimens by age group. Among patients aged 18–49 years, the standardized incidence rate (IR) for mCRC increased by 22.1% in 2010 to 2019, with an annual percentage change (APC) of 2.8%; in the 50–64 years cohort, the standardized IR increased by 14.9%, with an APC of 2.3%; in the ≥65 years cohort, the standardized IR decreased by 21.6%, with an APC of −2.1%. Patient characteristics varied between age groups, with a higher proportion of patients with early-onset mCRC being Hispanic or Asian, from the Southern USA and having commercial rather than Medicare Advantage insurance compared with patients with late-onset mCRC. Exploratory analyses suggested that a higher proportion of patients with early-onset mCRC received more aggressive multiagent chemotherapy compared with patients with late-onset mCRC. These findings add to the accumulating evidence of a rise in the incidence of early-onset mCRC and increasing use of aggressive chemotherapy regimens in these patients without a confirmed corresponding survival benefit. The shifting age distribution and patient characteristics in mCRC should be considered when developing appropriate treatment guidelines. [ABSTRACT FROM AUTHOR]

Machine-learned computational chemistry has led to a paradoxical situation in which molecular properties can be accurately predicted, but they are difficult to interpret. Explainable AI (XAI) tools can be used to analyze complex models, but they are highly dependent on the AI technique and the origin of the reference data. Alternatively, interpretable real-space tools can be employed directly, but they are often expensive to compute. To address this dilemma between explainability and accuracy, we developed SchNet4AIM, a SchNet-based architecture capable of dealing with local one-body (atomic) and two-body (interatomic) descriptors. The performance of SchNet4AIM is tested by predicting a wide collection of real-space quantities ranging from atomic charges and delocalization indices to pairwise interaction energies. The accuracy and speed of SchNet4AIM breaks the bottleneck that has prevented the use of real-space chemical descriptors in complex systems. We show that the group delocalization indices, arising from our physically rigorous atomistic predictions, provide reliable indicators of supramolecular binding events, thus contributing to the development of Explainable Chemical Artificial Intelligence (XCAI) models. Chemical AI often behaves as a black box, providing accurate, but opaque, predictions. Here, the authors show that the synergy of cutting-edge ANNs with the rigor of Quantum Chemical Topology can result in Explainable Chemical AI (XCAI). [ABSTRACT FROM AUTHOR]

This multicenter, randomized study aimed to compare the sirolimus-eluting BiOSS LIM C dedicated coronary bifurcation stent with second-generation -limus drug-eluting stents (rDESs) in the treatment of non-left main (non-LM) coronary bifurcation. The deployment of a single stent in the main vessel–main branch across a side branch was the default strategy in all patients. The primary endpoint was the rate of major cardiovascular events (cardiac death, myocardial infarction, and target lesion revascularization) at 48 months. We enrolled 230 patients, allocating 116 patients to the BiOSS LIM C group and 114 patients to the rDES group. Most procedures were elective (BiOSS vs. rDES: 48.3% vs. 59.6%, p = 0.09) and performed in bifurcations within the left anterior descending/diagonal branch (BiOSS vs. rDES: 51.7% vs. 61.4%, p = 0.15). At 48 months, there were no statistically significant differences between the BiOSS and rDES groups in terms of major adverse cardiovascular events (MACE), cardiac death, myocardial infarction (MI), or target lesion revascularization (TLR) as follows: MACEs—18.1% vs. 14.9%, HR 1.36, 95% CI 0.62–2.22, and p = 0.33; cardiac death—4.3% vs. 3.5%, HR 1.23, 95% CI 0.33–4.56, and p = 0.75; MI—2.6% vs. 3.5%, HR 0.73, 95% CI 0.17–3.23, and p = 0.68; and TLR—11.2% vs. 7.9%, HR 1.66, 95% CI 0.75–3.71, and p = 0.21. The implantation success rate of the BiOSS LIM C stent was very high, and the cumulative MACE rates were promising. The POLBOS 3 trial sets an important benchmark for treating non-LM coronary bifurcations (ClinicalTrials.gov NCT03548272). [ABSTRACT FROM AUTHOR]

The design and synthesis of analogs of natural products can be a valuable source of medicinal preparations for the pharmaceutical industry. In the present study, the structural elucidation of eleven derivatives of 2,4-dihalogeno substituted synthetic analogues of the natural compound carvacrol was carried out by means of NMR experiments, and of another thirteen by DFT calculations. By selective NOE experiments and the irradiation of CH signals of the isopropyl group, individual conformers were assigned as syn and anti. By comparing GIAO/B3LYP/6-311++G(d,p)-calculated and experimentally measured vicinal 3JCH spin-spin constants, this assignment was confirmed. An unusual relationship is reported for proton-carbon vicinal couplings: 3JCH (180°) < 3JCH (0°). The conformational mobility of carvacrols was studied by 2D EXSY spectra. The application of homonuclear decoupling technique (HOBS) to these spectra simplifies the spectra, improves resolution without reducing the sensitivity, and allows a systematic examination of the rotational barrier of all compounds via their CH signals of the isopropyl group in a wider temperature interval. The rate constants of the isopropyl rotation between syn and anti conformers were determined and the corresponding energy barriers (14–17 kcal/mol) were calculated. DFT calculations of the energy barriers in carvacrol derivatives allowed the determination of the steric origin of the restricted isopropyl rotation. The barrier height depends on the size of the 2- and 4-position substituents, and is independent of the derivatization of the OH group. [ABSTRACT FROM AUTHOR]

This paper explores the fundamental tenets of Plato's philosophy of education, particularly his views on a practice of great educational potential: communal musical participation. According to Plato, music can attune the individual and the community to cosmic harmony and this, in turn, is the only way to form and maintain a community. The paper explores how the concepts of ethos and nomos are utilized to explain music's role in community cohesion. It argues that Plato's understanding of the power of immediate and pre-reflective participation in music can provide valuable insight for contemporary philosophy of music education. The concept of nomos, in particular, allows music educators to take this frame of thought to better understand the role of music in creating communities. [ABSTRACT FROM AUTHOR]

Aims: Developing a hierarchical classification system for classes, orders and alliances of the diverse dry grasslands of the Central and Eastern Balkan Peninsula and translating this into an electronic expert system (ES) for the automatic assignment of plots. Location: Serbia, Kosovo, North Macedonia, Bulgaria and northern Greece. Methods: We extracted 5734 plots from the Balkan Dry Grassland Database corresponding to eight classes of dry grasslands reported from the region, using the EuroVegChecklist ES. This data set and later the plots within each derived subunit were subjected to a new numerical approach: starting with an initial partitioning (expert‐interpreted TWINSPAN classification), diagnostic species were determined based on their phi‐values for the target vegetation type and the differences in phi‐values to the next similar types. These diagnostic species were fed into an ES to create a new partitioning, a procedure which was iterated until diagnostic species and species of the ES converged. Then the same approach was applied within each of the derived units to define the units of the next‐lower level. Results: The iterative cluster optimisation (ICO) converged in all cases. The resulting hierarchical expert system (HES) classified 95% of all plots to alliances. We distinguished four classes with eight orders and 12 alliances: (1) Tuberarietea guttatae (Romuleion); (2) Stipo‐Brachypodietea distachyi (Clinopodio alpini‐Thymion striati); (3) Festuco‐Brometea with Brachypodietalia pinnati (Chrysopogono‐Danthonion calycinae and Cirsio‐Brachypodion pinnati), Festucetalia valesiacae (Festucion valesiacae), an unnamed order of rocky steppes (with Pimpinello‐Thymion zygioidis) and Koelerietalia splendentis (Centaureo‐Bromion fibrosi, Saturejion montanae and Diantho haematocalycis‐Festucion hirtovaginatae); (four) Koelerio‐Corynephoretea with Sedo acris‐Festucetalia (Festucion vaginatae) and Trifolio arvensis‐Festucetalia ovinae (Armerio rumelicae‐Potentillion and Minuartio montanae‐Poion molinerii all. nov.). Conclusions: We created a unified hierarchical classification with an electronic ES using diagnostic species defined by phi‐values. Our new approach (ICO‐HES: iterative cluster optimisation for hierarchical expert systems) allows dividing large data sets into meaningful units at several hierarchical levels, and thus has high potential for complex classifications. Importantly, it overcomes the divide between ES species and diagnostic species and re‐unites them into one concept. [ABSTRACT FROM AUTHOR]

This study explores plant communities dominated by the invasive species Fallopia x bohemica (Bohemian Knotweed) in Bulgaria. Using field data from 91 locations, an analysis identified the association Reynoutrietum japonicae within the alliance Aegopodion podagrariae. That association is recorded for the first time in Bulgaria. The vegetation is characteristically dominated by the Bohemian Knotweed species, which forms dense stands with low species richness. It mainly occurs in disturbed areas, such as riverbanks, roadsides and abandoned spots. This study contributes to understanding the distribution and composition of plant communities dominated by that invasive species. The negative impact of Bohemian Knotweed on the native flora and vegetation is also highlighted, with an emphasis on the need in control measures. [ABSTRACT FROM AUTHOR]

Claytonia sibirica has native distribution in the Komandorskie Islands and Western North America. As an introduced plant, it is found in some countries in Europe and New Zealand. It has been reported for Bulgaria in 1951. Recent observations in the Rila Mts and other available data on the distribution, habitats and population of the species are presented in this work. Locally, it is very abundant, with high population density and heterogeneous age structure. Claytonia sibirica is a naturalized alien species in Bulgaria, most likely deliberately introduced. Considering the long period of time since the species has been getting established in the country and its current distribution, it can be concluded that this non-native plant is spreading at a low rate by means of short-and mid-distance dispersion. [ABSTRACT FROM AUTHOR]

The contents of 49 trace elements in sub-bituminous Pernik coals and their waste products from preparation and combustion processes were investigated. The studied coals have trace element contents higher than the respective Clarke values for brown coals and some of them may pose environmental concerns. The elements Li, Rb, Cs, Ba, Sc, Y, La, Ce, Nd, Sm, Eu, Er, Ga, Zr, Sn, V, Nb, Ta, W, F, Cu, Zn, In, Pb, Cr, Co, Ni, and Th in the feed coals have concentrations that exceed twice the Clarke values. Most element contents in bottom ash are enriched compared with those in feed coal. Some of the volatile elements are equal or significantly depleted including Sn, Mo, Sb, F, Bi, Cd, Ge, and Pb. Fly ash has higher contents of Ga, Zr, Hf, Sn, V, Nb, Mo, and F in comparison with bottom ash. Most elements have a significant positive correlation with ash yield, indicating their inorganic association. The mixed wastes (coal slurry, bottom ash, and fly ash) in the disposal pond are slightly depleted of most of the elements studied with the exclusion of Cl, Ba, and Br. The Pernik coals and their waste products are unpromising for the extraction of REY due to their low element contents. [ABSTRACT FROM AUTHOR]

Iordan Iordanov passed away unexpectedly on October 3, 2021. His loss is deeply felt by the academic community and friends around the world. The current work provides an overview of his academic career and achievements and surveys his research in mathematics, economics and finance. [ABSTRACT FROM AUTHOR]

Purpose: Two major developments have taken place in the agri-food industry in recent decades. First, valorization of the plant by-products can contribute significantly for ensuring sustainability, especially applying green technologies for recovery of bio- and/or techno-functional compounds. Second, substitution of synthetic food additives, particularly colorants, by their natural counterparts is of utmost importance to meet consumer demands. The aim of this study was to evaluate a new process for green extraction of polyphenols from Crocus sativus tepals, the primary by-product of saffron spice production. Methods: A new strategy for recovery of polyphenols from saffron tepals was studied. An extraction process combining two subcritical water extractions steps with enzymatic treatment incorporated between them was established on a pilot scale. Liquid chromatography–mass spectrometry was used for polyphenols profile characterisation. The co-pigmentation efficiency of the polyphenol extract and its effect on thermal stability of strawberry anthocyanins were evaluated in model solutions. Results: An approximately fourfold increase in the polyphenolic yield was achieved with the new combined extraction method. 16 flavonoids, mainly flavonols, were detected in the saffron tepal extract. To the best of our knowledge, the presence of the flavone apigenin has not been described before in Crocus sativus. The addition of saffron tepal polyphenols, acting as co-pigments, significantly reduced the thermal degradation of strawberry anthocyanins. Conclusion: The obtained results demonstrate an innovative approach for the valorisation of saffron tepals through potential application of the by-product polyphenols in fruit processing. [ABSTRACT FROM AUTHOR]

One of the challenges for large-scale biomass gasification is inevitable ash-related problems such as ash deposition, corrosion, fouling, acid gas emission, and others, mainly caused by the volatile ash-forming elements in biomass. Water washing is an efficient, low-cost, and manageable way to alleviate these ash-related problems by reducing the concentrations of ash-forming elements in biomass. The leaching characteristics of ash-forming elements such as K, Na, Ca, Mg, Al, Fe, S, Cl, and P of corn straw (CS) were studied by inductively coupled plasma mass spectrometry (ICP-MS), ion chromatography (IC), and ultraviolet–visible spectroscopy (UV–Vis) during water washing at different time and temperatures. It was found that the water washing process removes almost all of K, Cl, and P with a removal efficiency higher than 90% within the first 10 min; large proportions of S, Na, and Mg with a removal efficiency of more than 70% within 120 min; and small amounts of Ca, Al, and Fe with a removal efficiency less than 63% within 120 min even at 50 ºC. The kinetic analysis indicated that the leaching of ash-forming elements was a two-step process consisting of an initial fast step and a second slow step. The leaching of ash-forming elements might be controlled by the first-order kinetic model, namely, homogeneous model and shrinking core model. Still, the second-order reaction model presents high regression coefficients, which is better suitable to fit the leaching kinetics of ash-forming elements from CS than the first-order kinetic leaching model. The reaction rate for the second-order reaction is faster than the first-order reaction during the water leaching of CS. The water washing could reduce the slagging tendency in the gasifier and diminish the emission of acid gases during corn straw gasification. [ABSTRACT FROM AUTHOR]

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This document, titled "Soil Fungi in Sustainable Agriculture," discusses the importance of soil fungi in promoting sustainable and productive agriculture. The document emphasizes the role of plant-beneficial microorganisms, including fungi, in improving soil fertility, enhancing plant growth, and mitigating various stress factors. It highlights the significance of arbuscular mycorrhizal fungi (AMF) in plant nutrition and health, particularly in challenging environmental conditions. The document also explores the potential of fungi in phosphorus solubilization, bioremediation of pesticides, and enhancing crop yields. Overall, the document suggests that fungi play a vital role in sustainable agriculture by improving plant nutrition, reducing the need for chemical inputs, and enhancing soil health. [Extracted from the article]

There is certain discordance between the functional (hemodynamic) and imaging methods for assessing the characteristics of the atherosclerotic plaques. It would be of practical value to find if there was a correlation between neurotrophins -- brain-derived growth factor (BDNF), neuronal growth factor (NGF) and carotid plaque morphology. Aim: To make a first attempt to combine biochemical and morphological markers to better assess the risk of carotid plaques. Material and Methods: Thirteen consecutive patients (Eastern European -- Caucasian race, 9 males and 4 females; mean age 73.08±7.65 years) with angiographically proven significant carotid atherosclerotic stenoses, referred for carotid stenting were evaluated. Plaque morphology was evaluated with intravascular ultrasound (IVUS) and virtual histology (VH). Serum concentrations of BDNF and NGF were tested and their results compared with a control group of 17 individuals without documented clinically significant atherosclerotic disease, carotid pathology, or cardiovascular risk factors. Results: The patients with significant carotid stenoses had lower mean BDNF values than the reference group (Eastern European, Caucasian race). There was a negative correlation between luminal diameter and BDNF (p=0.049; r=-0.605), and positive correlation between: total Ca2+ area (mm2) and BDNF (r=0.681, p=0.021), proximal Ca2+area and BDNF (p=0.007, r=0.784), fibro-fatty area and total calcium area and NGF (p=0.001). The results of carotid IVUS and VH measurements and serum BDNF and NGF concentrations in patients with carotid stenoses compared to patients without carotid artery disease are discussed. Both groups were free of acute vascular incident in other vascular territories. Conclusion: Preliminary results from a small case series study with intravascular ultrasound and serum levels of BDNF and NGF established a potentially meaningful clinical association between carotid atherosclerosis and neurotrophins, necessitating future expansion of the studies. [ABSTRACT FROM AUTHOR]