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In 2015, Alex Gino published their first novel George and received numerous awards such as the Lambda Literary Award and the American Library Association’s Stonewall Award. Despite its success, Gino’s novel has been subject to controversy as it has been challenged and banned for being “age inappropriate.” When George was on the top challenged list from the years 2016-2020, some of the cited reasons for challenging the work were because: it does not reflect “the values of our community,” because schools and libraries should not “put books in a child’s hand that require discussion,” and the novel conflicted with “traditional family structure” (American Library Association). A common thread that lies between each instance of book banning, or challenging, is the involvement of mothers and their need to protect the community of vulnerable children. While none of these phrases specifically mention the roles that parents play in the challenging of this book, it is indexed by key words such as community, child, and family. With right-wing reactions to mask requirements during the COVID-19 pandemic, racial issues following the Black Lives Matter protests, the hyper fixation on assumptions regarding Critical Race Theory, and an increase in anti-queer legislation on both a state and federal level it is not a coincidence that the censorship of books have risen alongside these moments of panic. I want to shift the conversation away from the government to a place that has been seen as much more private – the home. To look within the home, I will examine Gino’s novel that predates the existence of Moms for Liberty as a place of potential overlap between liberal and the conservative mother. A place of commonality is the reliance on a single answer on how to parent a transgender child. I will explore what role secrets play in the anxiety surrounding a trans child, and how secrecy is a privilege that a child does not have within the home. By looking at both the secrets Gino’s protago

There has been renewed interest in the use of 3,4-methylenedioxy-methamphetamine (MDMA) and serotonergic psychedelics in the treatment of multiple psychiatric disorders. Many of these compounds are known to produce prosocial effects, but how these effects relate to therapeutic efficacy and the extent to which prosocial effects are unique to a particular drug class is unknown. In this article, we present a narrative overview and compare evidence for the prosocial effects of MDMA and serotonergic psychedelics to elucidate shared mechanisms that may underlie the therapeutic process. We discuss 4 categories of prosocial effects: altered self-image, responses to social reward, responses to negative social input, and social neuroplasticity. While both categories of drugs alter self-perception, MDMA may do so in a way that is less related to the experience of mystical-type states than serotonergic psychedelics. In the case of social reward, evidence supports the ability of MDMA to enhance responses and suggests that serotonergic psychedelics may also do so, but more research is needed in this area. Both drug classes consistently dampen reactivity to negative social stimuli. Finally, preclinical evidence supports the ability of both drug classes to induce social neuroplasticity, promoting adaptive rewiring of neural circuits, which may be helpful in trauma processing. While both MDMA and serotonergic psychedelics produce prosocial effects, they differ in the mechanisms through which they do this. These differences affect the types of psychosocial interventions that may work best with each compound.

Food and/or housing instability (FHI) has been minimally examined in post-9/11 US veterans. A randomly selected nationally representative sample of men and women veterans (n = 38,633) from the post-9/11 US veteran population were mailed invitation letters to complete a survey on health and well-being. Principal component analysis and multivariable logistic regression were used to identify FHIs key constructs and correlates for 15,166 men and women respondents (9524 men, 5642 women). One-third of veterans reported FHI; it was significantly more likely among women than men (crude odds ratio = 1.31, 95% CI:1.21-1.41) and most prevalent post-service (64.2%). Mental Health/Stress/Trauma, Physical Health, and Substance Use were FHIs major constructs. In both sexes, significant adjusted associations (p < 0.01) were found between FHI and homelessness, depression, adverse childhood experiences, low social support, being enlisted, being non-deployed, living with seriously ill/disabled person(s), and living in dangerous neighborhoods. In men only, posttraumatic stress disorder (adjusted odds ratio (AOR) = 1.37, 95% CI:1.14-1.64), cholesterol level (elevated versus normal, AOR = 0.79, 95% CI:0.67-0.92), hypertension (AOR = 1.25, 95% CI:1.07-1.47), and illegal/street drug use (AOR = 1.28, 95% CI:1.10-1.49) were significant (p < 0.01). In women only, morbid obesity (AOR = 1.90, 95%CI:1.05-3.42) and diabetes (AOR = 1.53, 95% CI:1.06-2.20) were significant (p < 0.05). Interventions are needed that jointly target adverse food and housing, especially for post-9/11 veteran women and enlisted personnel.

Bakgrund: Diabetes mellitus typ 2 (DMT2) är ett globalt växande kronisk sjukdom. Cirka 500 000 personer i Sverige lider av diabetes, varav 90 procent har diabetes typ 2. Förekomsten av DMT2 ökar bland personer som har immigrerat till Sverige, vilket bedöms orsakas av en kombination av genetiska faktorer, livsstilsfaktorer och socioekonomiska omständigheter. För att effektivt hantera sjukdomen är det avgörande med noggrann egenvård, som inkluderar regelbunden självkontroll av blodsockernivåer, anpassad kost och fysisk aktivitet. Syfte: Syftet var att beskriva erfarenheter av egenvård hos immigrerade patienter som har diabetes typ 2. Metod: Kvalitativ litteraturöversikt baserad på 13 utvalda vetenskapliga artiklar som publicerades mellan 2003–2023. Litteratur söktes i databaserna CINAHL och Medline. Artiklarna analyserades enligt Fribergs femstegsmodell. Resultat: En rad olika faktorer påverkade patienternas upplevelse av egenvård. Bristande kommunikation och språkfärdigheter samt otillräcklig kunskap om diabetes utgjorde stora utmaningar för patienterna när det gällde att förstå sin sjukdom. Patienterna hade olika uppfattningar om varför de drabbats av sjukdomen, ofta kopplade till kulturella och religiösa orsaker. Dessutom beskrivs frustration över vårdgivarnas bemötande och svårigheter för patienterna att bibehålla livsstilsförändringar. Slutsats: Patienternas uppfattning av DMT2 och egenvård spelar en avgörande roll. Det finns ett behov av ökad kunskap om kost, motion och medicinering för att möjliggöra kontinuerlig egenvård och förbättra hälsa. Socialt stöd underlättar acceptans av förändringar i livsstilen och främjar därmed egenvården., Background: Diabetes mellitus type 2 (DMT2) is a globally growing chronic disease. Approximately 500 000 people in Sweden suffer from diabetes, of which 90 percent have DMT2. The prevalence of DMT2 is increasing among individuals who have immigrated to Sweden, which is assessed to be caused by a combination of genetic factors, lifestyle choices and social economic circumstances. To effectively manage DMT2, self-care is crucial, including regular monitoring of blood sugar levels, a tailored diet and physical activity. Aim: Describe self-care experiences among immigrant patients with diabetes type 2. Method: Qualitative literature review based on 13 selected articles published between 2003 and 2023. Literature was searched in the CINAHL and Medline databases. The articles were analysed using Friberg’s five-step model. Results: Several factors influenced a patient’s experience in managing their self-care. Lack of communication and language skills and insufficient knowledge about diabetes posed significant challenges for patients in understanding their illness. Patients held diverse perceptions regarding the causes for their diabetes, often linked to cultural and religious reasons. Furthermore, there was frustration regarding the healthcare providers’ attitudes and difficulties for patients in maintaining lifestyle changes. Conclusions: The patients’ perception of DMT2 and self-care plays a crucial role. There’s a need for increased knowledge about diet, exercise, and medication to enable continuous self-care and improve health. Social support facilitates the acceptance of lifestyle changes, thereby promoting self-care.

Additive Manufacturing (AM) or 3D printing technologies use fused layers of the material to build the cross-sectional geometry of the product. As variable processing parameters have an impact on product quality, it is crucial to ascertain the relationships of AM process parameters, productivity, sustainability, and structure performance. This research investigates the effect of the fused deposition modeling (FDM) process parameters on the response variables, including mechanical attributes, energy consumption, material consumption, and manufacturing time of the 3D printed product. Experiments are conducted for the FDM variable parameters of the infill pattern, infill density, layer height, printing speed, printing temperature, and wall thickness. Design of the experiment approach is used to determine the best combination of the chosen parameters. A L18 orthogonal design method is employed to collect the testing data. Taguchi and analysis of variance methods are applied in the data analysis of variable FDM parameter settings. The research finds different effects on the response variables. The optimization of response characteristics is performed using the multi-objective optimization desirability technique. The best combinations of process parameters are obtained for the chosen response variables.

The purpose of this thesis is to highlight the experiences of social workers regarding the ongoing impact of digitalization on the administration of economic assistance within social services. The literature presented discusses how digitalization influences social workers and clients in the current workplace. Additionally, the study analyzes factors that have proven particularly demanding for social workers in relation to digitization. The discourse regarding whether or not increased digitalization within social service is beneficial or detrimental is further explored by applying theories such as Lean and New Public Management (NPM), along with the theoretical concept of transparency. The effects of digitalization on economic assistance introduce characteristics and conditions that align well with these two theoretical perspectives. The implementation of NPM and Lean has notably influenced working methods in the public sector, leading to the establishment of new standards and approaches in the field. Through the application of these theories, the thesis aims to formulate an opinion on whether digitalization constitutes a positive transformation in the nuanced tasks of social workers or if it represents a new challenge and increased workload. The thesis seeks to analyze and comprehend the role of digitization as either a facilitating factor for the work of social workers or as a new aspect that adds to the workload within the organization.

Bakgrund: Diabetes mellitus typ 2 (DMT2) är ett globalt växande kronisk sjukdom. Cirka 500 000 personer i Sverige lider av diabetes, varav 90 procent har diabetes typ 2. Förekomsten av DMT2 ökar bland personer som har immigrerat till Sverige, vilket bedöms orsakas av en kombination av genetiska faktorer, livsstilsfaktorer och socioekonomiska omständigheter. För att effektivt hantera sjukdomen är det avgörande med noggrann egenvård, som inkluderar regelbunden självkontroll av blodsockernivåer, anpassad kost och fysisk aktivitet. Syfte: Syftet var att beskriva erfarenheter av egenvård hos immigrerade patienter som har diabetes typ 2. Metod: Kvalitativ litteraturöversikt baserad på 13 utvalda vetenskapliga artiklar som publicerades mellan 2003–2023. Litteratur söktes i databaserna CINAHL och Medline. Artiklarna analyserades enligt Fribergs femstegsmodell. Resultat: En rad olika faktorer påverkade patienternas upplevelse av egenvård. Bristande kommunikation och språkfärdigheter samt otillräcklig kunskap om diabetes utgjorde stora utmaningar för patienterna när det gällde att förstå sin sjukdom. Patienterna hade olika uppfattningar om varför de drabbats av sjukdomen, ofta kopplade till kulturella och religiösa orsaker. Dessutom beskrivs frustration över vårdgivarnas bemötande och svårigheter för patienterna att bibehålla livsstilsförändringar. Slutsats: Patienternas uppfattning av DMT2 och egenvård spelar en avgörande roll. Det finns ett behov av ökad kunskap om kost, motion och medicinering för att möjliggöra kontinuerlig egenvård och förbättra hälsa. Socialt stöd underlättar acceptans av förändringar i livsstilen och främjar därmed egenvården., Background: Diabetes mellitus type 2 (DMT2) is a globally growing chronic disease. Approximately 500 000 people in Sweden suffer from diabetes, of which 90 percent have DMT2. The prevalence of DMT2 is increasing among individuals who have immigrated to Sweden, which is assessed to be caused by a combination of genetic factors, lifestyle choices and social economic circumstances. To effectively manage DMT2, self-care is crucial, including regular monitoring of blood sugar levels, a tailored diet and physical activity. Aim: Describe self-care experiences among immigrant patients with diabetes type 2. Method: Qualitative literature review based on 13 selected articles published between 2003 and 2023. Literature was searched in the CINAHL and Medline databases. The articles were analysed using Friberg’s five-step model. Results: Several factors influenced a patient’s experience in managing their self-care. Lack of communication and language skills and insufficient knowledge about diabetes posed significant challenges for patients in understanding their illness. Patients held diverse perceptions regarding the causes for their diabetes, often linked to cultural and religious reasons. Furthermore, there was frustration regarding the healthcare providers’ attitudes and difficulties for patients in maintaining lifestyle changes. Conclusions: The patients’ perception of DMT2 and self-care plays a crucial role. There’s a need for increased knowledge about diet, exercise, and medication to enable continuous self-care and improve health. Social support facilitates the acceptance of lifestyle changes, thereby promoting self-care.

Walkability has recently been a major topic and an essential attribute in the sustainability approach to urban design and planning. Studying urban dimensions and qualities in a specific context is essential to developing walkability criteria, as each environment has its conditions and spatial scale that will affect walkability scenarios differently. This paper studies the main criteria contributing to successful walkable environments in high-density communities. The methodology consists of developing detailed walkability criteria by studying urban qualities related to three dimensions: morphological/visual, functional, and social. Each urban quality is analyzed by stating its definition, assessment method and studying its condition in high-density communities. The assessment methods are based on quantitative and qualitative indicators depending on the nature of the criteria, which include imageability, transparency, scale of enclosure, complexity, connectivity, land use mix, legibility, as well as pedestrian comfort and safety. Providing tools to upgrade walkability in a city like Alexandria in Egypt is another objective of this study. Walkability criteria are tested on a typical city center street where buildings of every age and condition are mingled, and which is similar to many other Alexandria streets, thus, the results and recommendations can contribute to enhancing the walkability of everyday streets in the city. Received: 21 January 2024Accepted: 23 May 2024Published: 30 June 2024

The circumstances of commute travel behavior in a large part of developing countries, particularly in the Middle East and North Africa as well as the preferences of the main populations and the recent migrants are unclear. Thus, this study attempts to investigate the behaviors and preferences of commuters in Cairo and Alexandria, Egypt focusing on the Egyptian and non-Egyptian demographic groups. Two research questions were answered in this paper: (1) Are there significant differences between the commuting characteristics of Egyptians and non-Egyptians? (2) What are the subjective public transport use correlates of commute trip generation among Egyptians and non-Egyptians? Mann-Whitney U test and Ordinary Least Square models were applied to answer these questions based on the primary, disaggregate data of 1,810 face-to-face interviews (1,193 in Cairo and 617 in Alexandria) conducted from Nov. 2022 to May 2023. The results show a significant difference between the commuting variables of Egyptians and non-Egyptians in the sample, including their commute trip generation, commute trip time on weekdays, ideal commute trip time per day, satisfaction with commuting, willingness to spend time in commuting, and commuting expenses per month. When controlling for age, household size, and car ownership, four variables related to public transportation use significantly define the commute trip generation of both Egyptian and non-Egyptian groups. These variables include evaluation of the quality of buses and minibuses, perceived security when using public transportation, perceived security when uniformed guards or security forces are near the PT station/stop, and perceived security when the stations/stops are well-lit. These results can be used for better urban and mobility policymaking in the countries of the Middle East and North Africa. Received: 30 November 2024 Accepted: 12 March 2024 Published: 22 May 2024

Risk measurement from standard operating procedures implemented by an institution determines the level of maturity of a service system at that institution. The government's determination of the Tri Dharma of Higher Education consists of education and teaching, research, and community service. These activities must be implemented in the academic information system of every university in Indonesia. Appropriate and fast academic services depend on information technology and adequate and trained human resources (HR). Factors that influence information system security determine the stability of application services. The ISO/IEC 27001:2005 standard is an international benchmark for measuring the level of maturity and security risks of an application. Risk assessment in standard operating procedures in organizations can use the ISO/IEC 27001 standard. This research aims to determine the current level of Academic Information System (AIS) service by measuring maturity and security risks. Three clauses measure the maturity level of information security controls with the ISO 27001 System Security Engineering-Capability Maturity Model (SSE-CMM). These research respondents are educational work units at the Science and Technology Faculty in UIN Syarif Hidayatullah Jakarta. This research method uses quantitative research methods. This research results show the maturity level of information security in the academic information system based on three clauses as the embodiment of the stability of the academic administration activities services at the Science and Technology Faculty. The measurement results reveal that the average score of information security controls on AIS is 3.51, which means good or average standard processing has been carried out following procedures.

The rapid increase in mobile device usage worldwide presents a significant challenge for brands aiming to attract and retain customers. Building customer trust in a brand is essential for achieving this goal. However, the wide variety of mobile devices and intense competition compel manufacturers to incorporate more features into a single device, often resulting in complexity and reduced interactivity, which adversely affects the device's usability. Moreover, mobile devices have profoundly transformed customers' lifestyles, complicating the task of marketers to measure buying behavior trends accurately. Consequently, a deep understanding of customers is necessary for effective segmentation. This research aims to fill this gap by providing a roadmap for academics and practitioners to build brand trust in mobile devices, thereby enhancing the user experience by improving usability and brand trust. This quantitative, cross-sectional, and explanatory study utilized an adapted scale to collect data from a population of mobile device users. A sample size of 534 respondents was gathered through online sources and self-administered questionnaires. The study hypothesized that simplicity, interactivity, and brand trust impact usability, which in turn leads to increased brand trust. Additionally, the study examined the direct impact of simplicity and usability on brand trust. It also sought to explore the mediating effect of usability between its antecedents (simplicity and interactivity) and the consequent brand trust. All hypotheses were accepted, except for the direct impact of simplicity on brand trust. Unlike most existing marketing studies that focus primarily on the direct relationship between brand trust and loyalty, this study introduced a novel model. This model elucidates the relationships between simplicity, interactivity, and usability, demonstrating how these factors collectively influence brand trust.

Consumers and brands are crucial concepts and compelling research areas in brand management. A decade ago, researchers have noted that the brand equity’s concept is less explored in the education sector. Education system is too vital industries that are playing a major role in the society and growth of nation, thus highlighting its importance. Corporate industries prioritize customer satisfaction and loyalty, and some studies suggest that students should be considered customers. Consequently, universities need to enhance their understanding of brand equity-related concepts such as brand strength, brand image, and service quality. Providing high levels of service quality and cultivating a strong brand image leads to loyal customers. This study examines the mediating effect of student satisfaction on the relationships between brand strength, brand image, service quality, and loyalty. Using convenience sampling, we distributed 600 questionnaires to respondents from public sector universities in Pakistan. Service quality is identified as a multidimensional construct comprising interactional quality, outcome quality, and physical environment quality. These types are positively and significantly related to student loyalty. The study reveals that brand image and service quality show full mediation, while brand strength shows partial mediation. The results indicate that universities with a better understanding of their students, and those that share their plans and information effectively have more satisfied students. The findings regarding brand image suggest that universities should have a clear and definite vision to satisfy their students. Additionally, satisfied students feel honored to study at these institutions. Regarding service quality, the study suggests that universities with courteous, sympathetic, reassuring, and job-oriented administrative staff have more satisfied students. The perceived quality of the environment indicates that poor physical layouts, inadeq

With the present investigation it will be possible to verify that, one of the main characteristics when studying the regional integration at world-wide level is the difficulty to establish a concept and nature of the studied variable when finding diverse theories, identifying the clearest theories in order to create an own concept and verify its nature. In this text I will analyze, from the point of view of the International Relations, the main characteristics and the importance of the economic integration systems, later I will explore if the convergence to a single system of economic integration in Latin America is possible., Con la presente investigación se podrá constatar que, una de las características principales al estudiar la integración regional a nivel mundial es la dificultad para establecer un concepto y naturaleza de la variable estudiada al encontrar diversas teorías, identificando las teorías más claras con el fin de crear un concepto propio y comprobar su naturaleza. En este texto analizaré, desde el punto de vista de las Relaciones Internacionales las características principales y la importancia de los sistemas de integración económicos, posteriormente exploraré si es posible la convergencia a un único sistema de integración económica el Latinoamérica.

Walkability has recently been a major topic and an essential attribute in the sustainability approach to urban design and planning. Studying urban dimensions and qualities in a specific context is essential to developing walkability criteria, as each environment has its conditions and spatial scale that will affect walkability scenarios differently. This paper studies the main criteria contributing to successful walkable environments in high-density communities. The methodology consists of developing detailed walkability criteria by studying urban qualities related to three dimensions: morphological/visual, functional, and social. Each urban quality is analyzed by stating its definition, assessment method and studying its condition in high-density communities. The assessment methods are based on quantitative and qualitative indicators depending on the nature of the criteria, which include imageability, transparency, scale of enclosure, complexity, connectivity, land use mix, legibility, as well as pedestrian comfort and safety. Providing tools to upgrade walkability in a city like Alexandria in Egypt is another objective of this study. Walkability criteria are tested on a typical city center street where buildings of every age and condition are mingled, and which is similar to many other Alexandria streets, thus, the results and recommendations can contribute to enhancing the walkability of everyday streets in the city. Received: 21 January 2024Accepted: 23 May 2024Published: 30 June 2024

The circumstances of commute travel behavior in a large part of developing countries, particularly in the Middle East and North Africa as well as the preferences of the main populations and the recent migrants are unclear. Thus, this study attempts to investigate the behaviors and preferences of commuters in Cairo and Alexandria, Egypt focusing on the Egyptian and non-Egyptian demographic groups. Two research questions were answered in this paper: (1) Are there significant differences between the commuting characteristics of Egyptians and non-Egyptians? (2) What are the subjective public transport use correlates of commute trip generation among Egyptians and non-Egyptians? Mann-Whitney U test and Ordinary Least Square models were applied to answer these questions based on the primary, disaggregate data of 1,810 face-to-face interviews (1,193 in Cairo and 617 in Alexandria) conducted from Nov. 2022 to May 2023. The results show a significant difference between the commuting variables of Egyptians and non-Egyptians in the sample, including their commute trip generation, commute trip time on weekdays, ideal commute trip time per day, satisfaction with commuting, willingness to spend time in commuting, and commuting expenses per month. When controlling for age, household size, and car ownership, four variables related to public transportation use significantly define the commute trip generation of both Egyptian and non-Egyptian groups. These variables include evaluation of the quality of buses and minibuses, perceived security when using public transportation, perceived security when uniformed guards or security forces are near the PT station/stop, and perceived security when the stations/stops are well-lit. These results can be used for better urban and mobility policymaking in the countries of the Middle East and North Africa. Received: 30 November 2024 Accepted: 12 March 2024 Published: 22 May 2024

Objective: The paper reviews and systematizes the metrics proposed in the literature for measuring the different elements of entrepreneurial ecosystems and covers the challenges of measuring ecosystems at the regional level and the Brazilian case. Method: A literature review of the metrics proposed for Entrepreneurship Ecosystems and descriptive statistics to systematize the indicators found in the review. Results: There is still no uniformity in the proposal of metrics. Most of them have a national approach and are related to the dimensions of Public policy & Regulation, Culture, and Human capital. The effort to apply theory to the Brazilian case is still incipient, and it is necessary to create adequate metrics for the national context. Theoretical/methodological contributions: The article enriches the discourse on measuring entrepreneurial ecosystems by shedding light on a variety of methodologies, identifying gaps, highlighting the necessity for subnational indicators, and exploring their implications within the Brazilian context. Relevance/Originality: While the concept of EE and its measuring methods hold significant potential for orienting public policies, they remain underexplored in the Brazilian academic community. This article aims to bridge this gap and underscore the promising nature of this research area., Objetivo: O artigo realiza uma revisão e uma sistematização das métricas propostas na literatura para a mensuração dos diferentes elementos dos ecossistemas de empreendedorismo e discussão acerca dos desafios para a mensuração de ecossistemas em nível regional e no caso brasileiro. Método: Revisão bibliográfica acerca das métricas propostas para Ecossistemas de Empreendedorismo e estatística descritiva para sistematizar os indicadores encontrados na literatura. Resultados: Ainda não há uniformidade na proposição de métricas. A maioria delas possui abordagem nacional e estão relacionadas com as dimensões políticas públicas e regulação, cultural e recursos. O esforço de aplicar a teoria sobre o caso brasileiro ainda é incipiente e é necessário construir métricas adequadas à realidade nacional. Contribuições teóricas/metodológicas: O artigo contribui com o debate acerca da mensuração de ecossistemas de empreendedorismo ao mostrar a diversidade de metodologias e indicadores propostos, as lacunas existentes, a necessidade de se pensar indicadores para o nível subnacional e as implicações para o caso brasileiro. Relevância/Originalidade: Apesar de seu potencial como ferramenta para políticas públicas, o conceito de EE e suas formas de mensuração ainda é pouco explorado pela comunidade acadêmica brasileira. O artigo pretende preencher essa lacuna e demonstrar que essa linha de pesquisa acadêmica é promissora., Meta: El artículo revisa y sistematiza las métricas propuestas en la literatura para medición de los diferentes elementos de ecosistemas de emprendimiento y discutir los desafíos para medir ecosistemas en el nível regional y en el caso brasileño. Método: Revisión bibliográfica de las métricas propuestas para los ecosistemas de emprendimiento y estadísticas descriptivas para sistematizar los indicadores que se encontró en la literatura. Resultados: Aún no hay uniformidad en las métricas propuestas. La mayoría tiene enfoque nacional y están relacionadas a las dimensiones de políticas públicas y regulación, cultura y recursos. El esfuerzo para aplicar la teoría al caso brasileño aún es incipiente, y es necesario crear métricas métricas adecuadas a la realidad nacional. Contribuciones teóricas/metodológicas: El artículo contribuye a la discusión sobre la medición de los ecosistemas de emprendimiento al mostrar la diversidad de metodologías y indicadores propuestos, las lacunas existentes y la necesidad de pensar sobre los indicadores al nível subnacional, y las implicaciones para el caso brasileño. Relevancia/Originalidad: A pesar de su potencial como una herramienta para las políticas públicas, el concepto de EE y sus métodos de medición aún son subexplorados por la comunidad académica brasileña. El artículo intenta llenar este vacío y demostrar que tal línea de investigación académica es promisoria.

Dysregulation of the central amygdala is thought to underlie aberrant choice in alcohol use disorder, but the role of central amygdala neural activity during reward choice and consumption is unclear. We recorded central amygdala neurons in male rats as they consumed alcohol or sucrose. We observed activity changes at the time of reward approach, as well as lick-entrained activity during ongoing consumption of both rewards. In choice scenarios where rats could drink sucrose, alcohol, or quinine-adulterated alcohol with or without central amygdala optogenetic stimulation, rats drank more of stimulation-paired options when the two bottles contained identical options. Given a choice among different options, central amygdala stimulation usually enhanced consumption of stimulation-paired rewards. However, optogenetic stimulation during consumption of the less-preferred option, alcohol, was unable to enhance alcohol intake while sucrose was available. These findings indicate that the central amygdala contributes to refining motivated pursuit toward the preferred available option.

INTRODUCTION: Information on whether race and ethnicity are associated with a greater risk of recurrent hyperkalemia is limited. The aim of this study was to examine the association between race or ethnicity and recurrent hyperkalemia in a population of US veterans. METHODS: This retrospective study used the US Veterans Affairs database to identify adults (aged ≥18 years) with at least one serum potassium measurement during the study period who ever experienced hyperkalemia (serum potassium > 5.0 mmol/L). The proportion of patients with hyperkalemia recurrence (≥1 subsequent event) within one year was determined for different race and ethnicity groups. The association between patient race and ethnicity and the risk of hyperkalemia recurrence within one year after the index hyperkalemia event was analyzed using competing risk regression. RESULTS: Among a total of 1,493,539 veterans with incident hyperkalemia (median age (interquartile range): 61.0 years (54.0, 71.0)), recurrence within one year occurred in 19.1% of Black, 16.0% of Native Hawaiian/other Pacific Islander, 15.1% of White, 14.9% of American Indian/Alaska Native, and 13.1% of Asian patient groups. Recurrent hyperkalemia occurred in 18.1% of Hispanic and 15.6% of non-Hispanic patient groups. In a fully-adjusted regression model, recurrent hyperkalemia risk was significantly higher in Black versus White patient groups (subhazard ratio (sHR), 1.17; 95% confidence interval (CI), 1.16-1.19; p< 0.0001) and in Hispanic versus non-Hispanic patient groups (sHR, 1.30; 95% CI, 1.28-1.33; p< 0.0001). DISCUSSION/CONCLUSION: Among US veterans with incident hyperkalemia, the risk of recurrent hyperkalemia was higher in Black and Hispanic patient groups. This information may be useful for health system screenings to risk stratify patient groups and both guide the frequency of serum potassium monitoring and better understand the root causes of group differences.

BACKGROUND & AIMS: Metabolic syndrome (MS) is a growing epidemic and a risk factor for the development of hepatocellular carcinoma (HCC). This study investigated the long-term outcomes of liver resection (LR) for HCC in patients with MS. Rates, timing, patterns, and treatment of recurrences were investigated, and cancer-specific survivals were assessed. METHODS: Between 2001 and 2021, data from 24 clinical centers were collected. Overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival were analyzed as well as recurrence patterns and treatment. The analysis was conducted using a competing-risk framework. The trajectory of the risk of recurrence over time was applied to a competing risk analysis. For post-recurrence survival, death resulting from tumor progression was the primary endpoint, whereas deaths with recurrence relating to other causes were considered as competing events. RESULTS: In total, 813 patients were included in the study. Median OS was 81.4 months (range 28.1-157.0 months), and recurrence occurred in 48.3% of patients, with a median RFS of 39.8 months (range 15.7-174.7 months). Cause-specific hazard of recurrence showed a first peak 6 months (0.027), and a second peak 24 months (0.021) after surgery. The later the recurrence, the higher the chance of receiving curative intent approaches (p = 0.001). Size >5 cm, multiple tumors, microvascular invasion, and cirrhosis were independent predictors of recurrence showing a cause-specific hazard over time. RFS was associated with death for recurrence (hazard ratio: 0.985, 95% CI: 0.977-0.995; p = 0.002). CONCLUSIONS: Patients with MS undergoing LR for HCC have good long-term survival. Recurrence occurs in 48% of patients with a double-peak incidence and time-specific hazards depending on tumor-related factors and underlying disease. The timing of recurrence significantly impacts survival. Surveillance after resection should be adjusted over time depending on

Clonal cytopenia of undetermined significance (CCUS) represents a distinct disease entity characterized by myeloid-related somatic mutations with a variant allele fraction of ≥2% in individuals with unexplained cytopenia(s) but without a myeloid neoplasm (MN). Notably, CCUS carries a risk of progressing to MN, particularly in cases featuring high-risk mutations. Understanding CCUS requires dedicated studies to elucidate its risk factors and natural history. Our analysis of 357 CCUS patients investigated the interplay between clonality, cytopenia, and prognosis. Multivariate analysis identified 3 key adverse prognostic factors: the presence of splicing mutation(s) (score = 2 points), platelet count <100×109/L (score = 2.5), and ≥2 mutations (score = 3). Variable scores were based on the coefficients from the Cox proportional hazards model. This led to the development of the Clonal Cytopenia Risk Score (CCRS), which stratified patients into low- (score <2.5 points), intermediate- (score 2.5-<5), and high-risk (score ≥5) groups. The CCRS effectively predicted 2-year cumulative incidence of MN for low- (6.4%), intermediate- (14.1%), and high- (37.2%) risk groups, respectively, by Gray's test (P <.0001). We further validated the CCRS by applying it to an independent CCUS cohort of 104 patients, demonstrating a c-index of 0.64 (P =.005) in stratifying the cumulative incidence of MN. Our study underscores the importance of integrating clinical and molecular data to assess the risk of CCUS progression, making the CCRS a valuable tool that is practical and easily calculable. These findings are clinically relevant, shaping the management strategies for CCUS and informing future clinical trial designs.

Nur Rahayuningsih,1,2 Rano K Sinuraya,1,3,4 Yasmin Fatinah,1 Ajeng Diantini,1,4 Auliya A Suwantika1,4,5 1Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia; 2Faculty of Pharmacy, Universitas Bakti Tunas Husada, Tasikmalaya, Indonesia; 3Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; 4Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, Indonesia; 5Center for Health Technology Assessment, Universitas Padjadjaran, Sumedang, IndonesiaCorrespondence: Rano K Sinuraya, Email r.k.sinuraya@unpad.ac.id; r.k.sinuraya@rug.nlBackground: To date, the primary global concern has revolved around addressing the COVID-19 pandemic. However, there is a growing awareness of the pandemic’s secondary impacts on critical aspects of healthcare, such as childhood immunization programs.Objective: This study aims to assess the impact of the COVID-19 pandemic on childhood immunization programs in Indonesia, with a specific focus on performance disparities between rural and urban areas. It considers factors like access, utilization, and program workload.Methods: Data were collected from primary health cares (PHCs) in two regions in West Java Province, Indonesia, representing rural and urban areas. A descriptive analysis was conducted to compare vaccination coverage, drop-out rates, and the ratio of vaccinators per dose from 2019 to 2021 in 40 and 22 PHCs for rural and urban areas, respectively. A general linear model was employed to evaluate the differences in these parameters over the three consecutive years.Results: The results indicate fluctuations in vaccine coverage over the three years, with the most significant impact observed in 2020, particularly in rural areas. Statistical analysis revealed a significant difference in routine immunization coverage, drop-out rates, and vaccinator ratios b

A presente pesquisa, aborda as complicações pós-operatórias que sucedem de procedimentos como exodontias de terceiros molares, enfatizando inflamações e infecções, como a alveolite seca/úmida e osteomielite. É verificado as etapas de reparação alveolar, destacando a importância do coágulo sanguíneo e os efeitos adversos da sua má formação, até sua perda. O presente estudo abrange fatores de risco, diagnósticos, sintomas e prevenção dessas complicações, salientando que as infecções podem se manifestar até 30 dias após a cirurgia. Mesmo que incomuns, tais infecções são observadas como o principal motivo de retardo na cicatrização pós-cirúrgica. A classificação da cirurgia de remoção de terceiros molares como contaminação é debatida em relação a incidência de infecções, destacando a importância dos cuidados e da técnica operatória em comparação com a administração profilática de antibióticos. Orientações específicas são demonstradas para pacientes com sistema imunológico comprometido. O conteúdo desenvolve estratégias de prevenção, incluindo descontaminação, uso de materiais estéreis, terapia medicamentosa, limpeza e desbridamento de feridas cirúrgicas com intuito de tratar e prevenir tais infecções. Destacando-se que o uso de antibióticos não é justificado pela ausência de cuidados de biossegurança e enfatiza a essencialidade da manutenção da cadeia asséptica para o êxito do tratamento. Esta pesquisa objetiva a contribuir para um entendimento mais aprofundado das complicações pós-operatórias em exodontias de terceiros molares, proporcionando uma abordagem preventiva e eficaz no âmbito da cirurgia odontológica., This study addresses the postoperative complications that follow procedures such as third molar extractions, emphasizing inflammation and infections such as wet-dry alveolitis and osteomyelitis. The stages of alveolar repair are examined, highlighting the importance of the blood clot and its adverse effects, from its malformation to its loss. The study covers risk factors, diagnosis, symptoms and prevention of these complications, emphasizing that infections can manifest up to 30 days after surgery. Although uncommon, these infections are seen as the main reason for delayed healing after surgery. The classification of third molar removal surgery as contamination is debated in relation to the incidence of infections, highlighting the importance of care and operative technique compared to the prophylactic administration of antibiotics. Specific guidelines are demonstrated for patients with compromised immune systems. The content develops prevention strategies, including decontamination, use of sterile materials, drug therapy, cleaning and debridement of surgical wounds in order to treat and prevent such infections. It stresses that the use of antibiotics is not justified by the absence of biosafety precautions and emphasizes the essentiality of maintaining the aseptic chain for successful treatment. This research aims to contribute to a more in-depth understanding of post-operative complications in third molar extractions, providing a preventative and effective approach to dental surgery., Esta investigación aborda las complicaciones postoperatorias que surgen de procedimientos como extracciones de terceros molares, enfatizando la inflamación y las infecciones, como la alveolitis seca/húmeda y la osteomielitis. Se verifican las etapas de la reparación alveolar, resaltando la importancia del coágulo sanguíneo y los efectos adversos de su malformación, hasta su pérdida. El presente estudio abarca factores de riesgo, diagnóstico, síntomas y prevención de estas complicaciones, destacando que las infecciones pueden manifestarse hasta 30 días después de la cirugía. Aunque son poco comunes, estas infecciones se observan como la razón principal del retraso en la curación posquirúrgica. La clasificación de la cirugía de extracción de terceros molares como contaminación es objeto de debate en relación con la incidencia de infecciones, destacando la importancia del cuidado y la técnica operatoria frente a la administración profiláctica de antibióticos. Se demuestran pautas específicas para pacientes con sistemas inmunológicos comprometidos. El contenido desarrolla estrategias de prevención, incluyendo descontaminación, uso de materiales estériles, farmacoterapia, limpieza y desbridamiento de heridas quirúrgicas con el objetivo de tratar y prevenir dichas infecciones. Cabe señalar que el uso de antibióticos no se justifica por la ausencia de precauciones de bioseguridad y enfatiza la esencialidad del mantenimiento de la cadena aséptica para el éxito del tratamiento. Esta investigación tiene como objetivo contribuir a un conocimiento más profundo de las complicaciones postoperatorias en las extracciones de terceros molares, brindando un abordaje preventivo y eficaz dentro del ámbito de la cirugía odontológica.

A presente pesquisa, aborda as complicações pós-operatórias que sucedem de procedimentos como exodontias de terceiros molares, enfatizando inflamações e infecções, como a alveolite seca/úmida e osteomielite. É verificado as etapas de reparação alveolar, destacando a importância do coágulo sanguíneo e os efeitos adversos da sua má formação, até sua perda. O presente estudo abrange fatores de risco, diagnósticos, sintomas e prevenção dessas complicações, salientando que as infecções podem se manifestar até 30 dias após a cirurgia. Mesmo que incomuns, tais infecções são observadas como o principal motivo de retardo na cicatrização pós-cirúrgica. A classificação da cirurgia de remoção de terceiros molares como contaminação é debatida em relação a incidência de infecções, destacando a importância dos cuidados e da técnica operatória em comparação com a administração profilática de antibióticos. Orientações específicas são demonstradas para pacientes com sistema imunológico comprometido. O conteúdo desenvolve estratégias de prevenção, incluindo descontaminação, uso de materiais estéreis, terapia medicamentosa, limpeza e desbridamento de feridas cirúrgicas com intuito de tratar e prevenir tais infecções. Destacando-se que o uso de antibióticos não é justificado pela ausência de cuidados de biossegurança e enfatiza a essencialidade da manutenção da cadeia asséptica para o êxito do tratamento. Esta pesquisa objetiva a contribuir para um entendimento mais aprofundado das complicações pós-operatórias em exodontias de terceiros molares, proporcionando uma abordagem preventiva e eficaz no âmbito da cirurgia odontológica., This study addresses the postoperative complications that follow procedures such as third molar extractions, emphasizing inflammation and infections such as wet-dry alveolitis and osteomyelitis. The stages of alveolar repair are examined, highlighting the importance of the blood clot and its adverse effects, from its malformation to its loss. The study covers risk factors, diagnosis, symptoms and prevention of these complications, emphasizing that infections can manifest up to 30 days after surgery. Although uncommon, these infections are seen as the main reason for delayed healing after surgery. The classification of third molar removal surgery as contamination is debated in relation to the incidence of infections, highlighting the importance of care and operative technique compared to the prophylactic administration of antibiotics. Specific guidelines are demonstrated for patients with compromised immune systems. The content develops prevention strategies, including decontamination, use of sterile materials, drug therapy, cleaning and debridement of surgical wounds in order to treat and prevent such infections. It stresses that the use of antibiotics is not justified by the absence of biosafety precautions and emphasizes the essentiality of maintaining the aseptic chain for successful treatment. This research aims to contribute to a more in-depth understanding of post-operative complications in third molar extractions, providing a preventative and effective approach to dental surgery., Esta investigación aborda las complicaciones postoperatorias que surgen de procedimientos como extracciones de terceros molares, enfatizando la inflamación y las infecciones, como la alveolitis seca/húmeda y la osteomielitis. Se verifican las etapas de la reparación alveolar, resaltando la importancia del coágulo sanguíneo y los efectos adversos de su malformación, hasta su pérdida. El presente estudio abarca factores de riesgo, diagnóstico, síntomas y prevención de estas complicaciones, destacando que las infecciones pueden manifestarse hasta 30 días después de la cirugía. Aunque son poco comunes, estas infecciones se observan como la razón principal del retraso en la curación posquirúrgica. La clasificación de la cirugía de extracción de terceros molares como contaminación es objeto de debate en relación con la incidencia de infecciones, destacando la importancia del cuidado y la técnica operatoria frente a la administración profiláctica de antibióticos. Se demuestran pautas específicas para pacientes con sistemas inmunológicos comprometidos. El contenido desarrolla estrategias de prevención, incluyendo descontaminación, uso de materiales estériles, farmacoterapia, limpieza y desbridamiento de heridas quirúrgicas con el objetivo de tratar y prevenir dichas infecciones. Cabe señalar que el uso de antibióticos no se justifica por la ausencia de precauciones de bioseguridad y enfatiza la esencialidad del mantenimiento de la cadena aséptica para el éxito del tratamiento. Esta investigación tiene como objetivo contribuir a un conocimiento más profundo de las complicaciones postoperatorias en las extracciones de terceros molares, brindando un abordaje preventivo y eficaz dentro del ámbito de la cirugía odontológica.

This study evaluates the effect of the population’s age structure on CO2 emissions based on the panel data of 82 developing nations between 1990 and 2019. We use 20–34, 35–49, 50–64, and 65 and above as four population age groups. The findings from the dynamic common correlated effect (DCCE) estimator show a positive association between the ratios of the population aged 20–34, 35–49, and 50–64 years with CO2 emissions. The results also exhibit the heterogeneous impacts of the population’s age structure on the CO2 emissions for lower-income and higher-income countries. For instance, people aged 20–34 and 35–49 years in lower-income countries are responsible for an increase in CO2 emissions, and the population over age 65 and age 50–64 years are associated with an increase in the CO2 emissions in higher-income countries. The additional findings indicate that urbanisation, energy consumption, and economic growth are other factors that adversely affect the environment. Based on this evidence, to mitigate the aggregate CO2 emissions, the governments of these nations must pay close attention to the population’s age distribution.

This empirical study investigates the impact of deforestation on energy security in sub-Saharan Africa. To achieve this, we explored the intricate dynamics between deforestation, key energy security indicators, and socio-economic factors in sub-Saharan Africa. We employed a comprehensive dataset and analysed it with system GMM methodology and difference GMM and pooled OLS as robustness checks. The study validates the model’s suitability and confirms a significant negative relationship between deforestation rates and energy security. A central finding is the consistently negative impact of deforestation on energy security across various models. Diminishing forest cover is shown to jeopardise a nation’s ability to meet energy demands, underscoring the urgent need for policies promoting forest conservation and sustainable management. The study also identifies positive associations between energy security and total primary energy supply, per capita energy consumption, carbon dioxide emissions, and renewable energy. Higher energy supply and consumption and increased reliance on renewables contribute to enhanced energy security. However, unchecked population growth is highlighted as a potential impediment. Policy implications advocate for comprehensive interventions, emphasising conservation strategies, renewable energy adoption, and population management. It also calls for foreign trade policies that emphasise timber certification and sustainability agreements to protect forest resources alongside regional security measures and collaborative guidelines for sustainable forest management. The findings provide a nuanced understanding for policymakers, offering a roadmap to navigate challenges and opportunities in pursuing sustainable and secure energy systems in sub-Saharan Africa.

This empirical study investigates the impact of deforestation on energy security in sub-Saharan Africa. To achieve this, we explored the intricate dynamics between deforestation, key energy security indicators, and socio-economic factors in sub-Saharan Africa. We employed a comprehensive dataset and analysed it with system GMM methodology and difference GMM and pooled OLS as robustness checks. The study validates the model’s suitability and confirms a significant negative relationship between deforestation rates and energy security. A central finding is the consistently negative impact of deforestation on energy security across various models. Diminishing forest cover is shown to jeopardise a nation’s ability to meet energy demands, underscoring the urgent need for policies promoting forest conservation and sustainable management. The study also identifies positive associations between energy security and total primary energy supply, per capita energy consumption, carbon dioxide emissions, and renewable energy. Higher energy supply and consumption and increased reliance on renewables contribute to enhanced energy security. However, unchecked population growth is highlighted as a potential impediment. Policy implications advocate for comprehensive interventions, emphasising conservation strategies, renewable energy adoption, and population management. It also calls for foreign trade policies that emphasise timber certification and sustainability agreements to protect forest resources alongside regional security measures and collaborative guidelines for sustainable forest management. The findings provide a nuanced understanding for policymakers, offering a roadmap to navigate challenges and opportunities in pursuing sustainable and secure energy systems in sub-Saharan Africa.

Women’s Empowerment in Agriculture Index, Innovation Policy and Scaling (IPS), Gender Equality research initiative Gender Equality (HER+) is a One CGIAR Research Initiative seeking to address the following four dimensions of gender inequality in agrifood systems: o Women’s lack of agency or limited ability to define and act on goals, make decisions that matter to them, and participate in the economy and in public life; o Women’s lack of access to and control over resources; o Social norms that discriminate based on gender; and o Policies and governance that fail to include and benefit women. HER+ uses impactful gender research to address the four dimensions of gender inequality by applying gender-transformative approaches to address harmful norms. It does this by bundling innovations for women’s empowerment, leveraging social protection to increase women’s access to and control over resources, and promoting inclusive governance and policies for increased resilience. HER+ will generate learning and evidence on levers and entry points to disrupt the foundations of inequality in agrifood systems (AFS).

Women’s Empowerment in Agriculture Index, Innovation Policy and Scaling (IPS), Gender Equality research initiative Gender Equality (HER+) is a One CGIAR Research Initiative seeking to address the following four dimensions of gender inequality in agrifood systems: o Women’s lack of agency or limited ability to define and act on goals, make decisions that matter to them, and participate in the economy and in public life; o Women’s lack of access to and control over resources; o Social norms that discriminate based on gender; and o Policies and governance that fail to include and benefit women. HER+ uses impactful gender research to address the four dimensions of gender inequality by applying gender-transformative approaches to address harmful norms. It does this by bundling innovations for women’s empowerment, leveraging social protection to increase women’s access to and control over resources, and promoting inclusive governance and policies for increased resilience. HER+ will generate learning and evidence on levers and entry points to disrupt the foundations of inequality in agrifood systems (AFS).

Background and purpose: Pediatric pelvic fractures are uncommon, representing 0.2-3% of total pediatric fractures. The long-term patient-reported outcome in the pediatric population has not been evaluated yet. The purpose of the study was to describe the epidemiology of pelvic and acetabular fractures in pediatric patients including long-term patient-reported outcomes. Patients and methods: The Swedish Fracture Register (SFR) was used to identify all patients aged 6-17 years at injury with a pelvic fracture between 2015 and 2021. All patients were invited to answer Patient-Reported measurement instruments in 2021. Results: The study cohort consisted of 223 patients with a median age at fracture of 15 years and with 62 % boys. 201 sustained a pelvic and 22 acetabular fractures. Falls were the leading cause of fracture, followed by transport accidents. Most fractures (both pelvis and acetabulum) were type A (73 %), and 21 fractures (9 %) could not be classified according to AO. 85 % of fractures were treated non-surgically. All Type C fractures were treated surgically. Seven PROMIS (R) profile domains were completed by 31 % of the sample at a mean follow-up time of 3.5 years after pelvic/acetabular fracture. Most patients had "no concern" or "mild concern" but those who had surgery had an inferior t-score in most domains. Conclusion: Most fractures occurred in older individuals, with falls during sports activities being the most common cause. This raises important questions about prevention strategies. The PROMIS-Pain-Interference scale indicated that the younger the age at fracture, the more pain was reported at follow-up.

Background and purpose - It is controversial as to which patients affected by Legg-Calv & eacute;-Perthes disease (LCPD) benefit from containment surgery. This populationbased study based on data from a national quality registry aims to assess the incidence of LCPD and to explore which factors affect the decision for surgical intervention. Methods - This observational study involved 309 patients with unilateral LCPD reported between 2015 and 2023 to the Swedish Pediatric Orthopedic Quality Register (SPOQ). Descriptive statistics and logistic regression models were used for analysis. Results - In 2019, the assessed incidence of LCPD in the Swedish population of 2-12 -year -olds was 4.2 per 10 5 . 238 (77%) were boys with a mean age of 6 years. At diagnosis, 55 (30%) were overweight or obese, rising to 17 patients (39%) and 16 patients (40%) at 2 -year follow-up for surgically and non -surgically treated groups, respectively. At diagnosis, affected hips had reduced abduction compared with healthy hips, and their abduction remained restricted at the 2 -year follow-up. Surgically treated patients had inferior abduction compared with non -surgically treated ones at diagnosis. The adjusted risk for containment surgery increased with age and in the presence of a positive Trendelenburg sign but decreased with greater hip abduction. Conclusion - We found a lower national yearly incidence (4.2 per 10 5 ) than previously reported in Swedish studies. A higher proportion of overweight or obese patients compared with the general Swedish population of 4-9 -yearolds was identified. Increasing age, positive Trendelenburg sign, and limited hip abduction at diagnosis correlated with increased surgical intervention likelihood.

The dietary protein, tryptophan, carbohydrate, and oil content of fish feed has many vital roles in the growth performances, stress management, and digestive physiology of fish. However, in this context, the functions of gut melatonin, which depends on the availability of food, timing of food supply, frequency of feeds/day, quality of food, and growth stages of carp, still need to be clarified. The present study aimed to investigate the impact of different experimental diets on growth performances, melatonin, oxidative stress and its essential antioxidants in the gut, and vital digestive enzymes of juvenile carp, Catla catla (mean body weight ~50g). The fish were fed any one of the seven diets viz. (i) a standard diet (SD/control) (with 34.99% protein, 14.56% carbohydrate, 9.84% oil, and 0.36% L-tryptophan) (ii) two protein (PRD1 with 41.02%, and PRD2 with 50.55% protein), (iii) two L-tryptophan (TrpRD1 with 0.96%, and TrpRD2 with 1.36% tryptophan), (iv) one carbohydrate (CRD with 24.62% carbohydrate), and (v) one oil (ORD with 14.68% oil) - rich diets for 30 days. Results indicated that the growth performance was better in PRDs, TrpRDs, and CRD compared to SD but not in ORD-fed carp. Further, PRDs and TrpRDs stimulated gut melatonin and suppressed oxidative stress by enhancing all the studied antioxidant levels. Upregulated digestive enzyme activities were also recorded after the PRDs and TrpRDs supply. However, CRD and ORD-fed groups exhibit less/no impact on most studied parameters, except digestive physiology. Nonetheless, the current study reports for the first time that PRDs and TrpRDs can modulate gut melatonin, oxidative stress, different antioxidants, and digestive efficacy.

Penelitian ini bertujuan menentukan jumlah telur yang digunakan untuk menghasilkan tambusu baik ditinjau dari kualitas fisik dan mutu hedonik. Penelitian ini menggunakan Rancangan Acak Lengkap (RAL) dengan 5 perlakuan dan 4 ulangan. Perlakuan pada penelitian ini adalah A = 1 butir telur, B = 2 butir telur, C = 3 butir telur, D = 4 butir telur dan E = 5 butir telur. Peubah yang diamati yaitu kualitas fisik (kadar air, perubahan diameter dan warna) dan mutu hedonik (warna, rasa, tekstur dan aroma). Dari data penelitian didapatkan bahwa penggunaan jumlah telur yang semakin besar berpengaruh terhadap kadar air dan warna lightness (L*). Hasil dari penelitian dapat disimpulkan bahwa penggunaan jumlah telur perlakuan 2 butir telur (B) menunjukkan hasil yang terbaik dengan kadar air 72,45%, perubahan diameter 15,82 cm, Lightness 75,43, aroma 4,18 (netral), tekstur 3,56 (agak padat) dan rasa 2,80 (terasa tahu).

The dietary protein, tryptophan, carbohydrate, and oil content of fish feed has many vital roles in the growth performances, stress management, and digestive physiology of fish. However, in this context, the functions of gut melatonin, which depends on the availability of food, timing of food supply, frequency of feeds/day, quality of food, and growth stages of carp, still need to be clarified. The present study aimed to investigate the impact of different experimental diets on growth performances, melatonin, oxidative stress and its essential antioxidants in the gut, and vital digestive enzymes of juvenile carp, Catla catla (mean body weight ~50g). The fish were fed any one of the seven diets viz. (i) a standard diet (SD/control) (with 34.99% protein, 14.56% carbohydrate, 9.84% oil, and 0.36% L-tryptophan) (ii) two protein (PRD1 with 41.02%, and PRD2 with 50.55% protein), (iii) two L-tryptophan (TrpRD1 with 0.96%, and TrpRD2 with 1.36% tryptophan), (iv) one carbohydrate (CRD with 24.62% carbohydrate), and (v) one oil (ORD with 14.68% oil) - rich diets for 30 days. Results indicated that the growth performance was better in PRDs, TrpRDs, and CRD compared to SD but not in ORD-fed carp. Further, PRDs and TrpRDs stimulated gut melatonin and suppressed oxidative stress by enhancing all the studied antioxidant levels. Upregulated digestive enzyme activities were also recorded after the PRDs and TrpRDs supply. However, CRD and ORD-fed groups exhibit less/no impact on most studied parameters, except digestive physiology. Nonetheless, the current study reports for the first time that PRDs and TrpRDs can modulate gut melatonin, oxidative stress, different antioxidants, and digestive efficacy.

Bakgrund. Handboll är en intermittent idrott som är fylld med kontaktmoment i hög hastighet. Det dynamiska spelet ställer stora krav på fysisk kapacitet. Tidigareanalyser av matchbilden har identifierat positionsspecifika fysiska krav. Man kan dock inte bortse från handbollens komplexitet, där sportens framgångsfaktorer i matcherna kan skilja sig mellan matcher och lag. Däremot finns argument för att en välutvecklad fysisk kapacitet kan vara bidragande till taktisk och teknisk effektivitet och det genererar bra förutsättningar för lyckade prestationer. Syfte. Studiens syfte var att undersöka kapacitetprofilen på svenska handbollsspelare med hänsyn till skillnader mellan kön och spelarpositioner. Metod. Lag från Handbollsligan dam/herr samt Allsvenskan dam/herr tillfrågades och slutligen inkluderades 49 kvinnor och 49 män i studien. Analys av genomförda testbatterier gjordes. Variabler som inkluderades var tester som återfanns i SOK:s kravprofil för handbollsspelare. Resultat. Tydliga mönster och tendenser till skillnader fanns mellan kvinnliga och manliga handbollsspelare i Sverige. Men tenderar att vara båda längre, tyngre, starkare, mer explosiva och snabbare än kvinnor. Det fanns inte lika tydliga mönster mellan positionerna för respektive kön. Kantspelare tenderar att uppvisa lägst kroppsmått, oberoende kön. Linjespelare tenderade att uppvisa högst medelvärde i vikt, oberoende kön. Det fanns inte lika tydliga mönster för prestationsvariablerna.Kantspelare tenderade att prestera bäst i vertikala hopp och sprint, oberoende kön, med små skillnader till niometerspelare men större skillnad gentemot linjespelare. Minst mönster sågs i variabeln chins och Beeptest. Slutsatser. Jämförelser till SOK:s kravprofil samt tidigare forskning avslöjade resultaten att svenskahandbollsspelare var svaga i VO2max men uppvisade däremot lite bättre värden i styrka- och powerbaserade test som knäböj, frivändning, SJ, CMJ, CMJ(a). Praktisk information. Mer forskning behövs för att kunna, Background: Handball is an intermittent sport filled with high-speed contact moments. The dynamic nature of the game requires a well-developed physical capacity. Previous analyses of match play have identified position-specific physical requirements. However, one cannot ignore the complexity of handball, where the sport's success factors in matches can differ between games and teams. Nevertheless, there are arguments that well-developed physical capacity can contribute to tactical and technical efficiency, providing good conditions for successful performances. Purpose: The purpose of the study was to investigate the capacity profile of Swedish handball players regarding to differences between genders and player positions. Method: Teams from the Handbollsligan and the Allsvenskan, both men and women, were approached. 49 women and 49 men were included in the study. An analysis of the conducted test batteries was performed. The variables included were tests found in the Swedish Olympic Committee's physical requirement profile for handball players. Results: Clear patterns and tendencies to differences were found between female and male handball players in Sweden. Men tend to be taller, heavier, stronger, more explosive, and faster than women. There were no equally clear patterns between the positions for each gender. Wing players tended to exhibit the lowest body measurements, regardless of gender. Line players tended to have the highest average weight, regardless of gender. There were no equally clear patterns for the performance variables. Wing players tended to perform best in vertical jumps and sprints, regardless of gender, with small differences compared to backcourt players but larger differences compared to line players. The least patterns were seen in the variables for pull-ups and the Beep test. Conclusions: Comparisons with the SOK's physical requirement profile and previous research revealed that Swedish handball players were weak in VO2max but exhibited sli

Trippelnegativ bröstcancer är en aggressiv typ av bröstcancer som kännetecknas av att östrogenreceptor, progesteronreceptor och human epidermal tillväxtfaktorreceptor är negativa. Den vanligaste subtypen som står för 65-75% av bröstcancerfallen är hormonreceptorpositiv/ human epidermal tillväxtfaktorreceptor-2 negativ. Det forskas för närvarande mycket om potentiella terapier som skulle kunna förbättra prognosen hos framförallt mTNBC Trophoblast cell surface antigen 2 är ett cellyteglykoprotein som är aktivt i flera signalvägar och leder till tumörutveckling och metastaser. Ett överuttryck av proteinet har associerats till dessa bröstcancertyper och. därför anses den vara ett attraktivt terapeutiskt mål hos patienter med de här typerna av bröstcancer. Sacituzumab govitecan tillhör antikroppsläkemedelskonjugat och är en humaniserad monoklonak antikropp som riktar sig mot Tophoblast cell surface antigen 2. Syftet med arbetet var att undersöka om sacituzumab govitecan har gett klinisk effekt på metastatisk trippelnegativ bröstcancer samt hormonpositiv/ human epidermal tillväxtfaktorreceptr-2 negativ metastatisk bröstcancer på kliniska studier. Deta genom att granska utfallsmåtten, progression free survival, overall survival, duration of response och observed response rate. Det här arbetet är en systematisk litteraturöversikt och metoden för att besvara syftet var att granska vetenskapliga artiklar från databsen Pubmed med relevanta inklusions- och exklusionskriterier. Resultatet innehöll sju artiklar. Studiedesignen för dessa studier var uppbyggda på samma sätt. Vissa av studierna är randomiserade studier där patienterna tilldelats antingen sacituzumab govitecan eller ett kemoterapi läkemedel. En signifikant förbättring av utfallsmåttet mättes med 95% konfidensintervall enligt RECIST version 1.1. Slutsatsen var att sacituzumab govitecan har visat klinisk effekt för metastatisk trippelnegativ bröstcancer och hormonreceptorpositiv/ human epidermal tillväxtfaktornreceptor

Latar Belakang: PERNEFRI melaporkan 130.931 pasien gagal ginjal kronis (GGK) di Indonesia aktif menjalani hemodialisis (HD) pada tahun 2020. Semakin lama HD yang dijalani, semakin banyak kehilangan zat gizi, ketidakseimbangan asam-basa, dan inflamasi kronis yang dialami pasien sehingga membutuhkan peningkatan asupan protein. Penelitian ini dilakukan untuk mengetahui hubungan lama menjalani HD dan asupan protein dengan massa otot pasien GGK di RSUD Prof. Dr. Margono Soekarjo. Metodologi: Penelitian cross sectional dilakukan pada 70 pasien HD Instalasi Dialisis RSUD Prof. Dr. Margono Soekarjo. Lama menjalani HD dan karakteristik responden diperoleh berdasarkan wawancara dan rekam medis, asupan protein menggunakan Semi-Quantitative Food Frequency Questionnaire, dan massa otot menggunakan Bioelectrical Impedance Analysis. Data dianalisis menggunakan uji korelasi Pearson dan Spearman. Hasil Penelitian: Mayoritas responden adalah perempuan (54,3%), berusia 44 – 55 tahun (47,1%), berstatus gizi normal (54,3%), lama menjalani HD 31±22,84 bulan, asupan protein 34,5 (17,4–68,8) g, dan massa otot 29,6± 6,80%. Uji korelasi Pearson menunjukkan tidak ada hubungan antara lama menjalani HD dengan massa otot (p=0,782). Uji korelasi Spearman menunjukkan tidak ada hubungan asupan protein dengan massa otot (p=0,151). Kesimpulan: Tidak ada hubungan antara lama menjalani hemodialisis dan asupan protein dengan massa otot pasien GGK di RSUD Prof. Dr. Margono Soekarjo Purwokerto.

Kultur sel hewan merupakan suatu proses dimana sel-sel dari jaringan hewan ditempatkan dan ditumbuhkan dalam lingkungan yang sesuai di luar tubuhnya. Kultur sel memerlukan serum sebagai suplemen, serum yang sering digunakan adalah Fetal Bovine Serum (FBS). Namun, penggunaan FBS memiliki keterbatasan, termasuk biaya tinggi dan dampak negatif terhadap kesejahteraan hewan. Human Platelet Lysate (HPL) yang dihasilkan melalui proses freezing-thawing dari Platelet Concentrate (PC) berkualitas baik dapat dijadikan sebagai alternatif pengganti FBS. HPL menyediakan faktor pertumbuhan dan memiliki keunggulan efektivitas biaya serta produksi yang besar dan terstandarisasi. Meskipun HPL telah terbukti efektif sebagai suplemen dalam kultur sel, penggunaannya dalam cryopreservation belum banyak diteliti. Atas dasar hal ini, maka diperlukan uji berbagai konsentrasi HPL dalam medium cryopreservation pada kultur sel-sel hati mencit (Mus musculus). Penelitian ini bertujuan untuk mengetahui konsentrasi Human Platelet Lysate (HPL) dalam kombinasi cryoprotectant yang optimum untuk mendukung viabilitas dan densitas pada kultur sel primer hati mencit (Mus musculus) serta mengetahui konsentrasi Human Platelet Lysate (HPL) yang optimum untuk mendukung viabilitas, densitas, dan morfologi pada kultur sel post-thawing hati mencit (Mus musculus). Metode penelitian yang digunakan adalah metode eksperimental dalam dua tahapan eksperimental berkelanjutan yaitu dengan Rancangan Acak Lengkap (RAL) yang terdiri dari 5 perlakuan dan 5 ulangan pada proses cryopreservation dan 5 perlakuan dan 3 ulangan pada kultur post-thawing. Penelitian dilaksanakan pada bulan Januari - Maret 2024 di Laboratorium Struktur dan Perkembangan Hewan Universitas Jenderal Soedirman dan Laboratorium Riset Fakultas Kedokteran Universitas Jenderal Soedirman. Data densitas dan viabilitas sel primer hati mencit diuji normalitasnya menggunakan Kolmogrov-Smirnov dan homogenitasnya menggunakan Levene test. Selanjutnya data yang terd

Kultur sel hewan merupakan suatu proses dimana sel-sel dari jaringan hewan ditempatkan dan ditumbuhkan dalam lingkungan yang sesuai di luar tubuhnya. Kultur sel memerlukan serum sebagai suplemen, serum yang sering digunakan adalah Fetal Bovine Serum (FBS). Namun, penggunaan FBS memiliki keterbatasan, termasuk biaya tinggi dan dampak negatif terhadap kesejahteraan hewan. Human Platelet Lysate (HPL) yang dihasilkan melalui proses freezing-thawing dari Platelet Concentrate (PC) berkualitas baik dapat dijadikan sebagai alternatif pengganti FBS. HPL menyediakan faktor pertumbuhan dan memiliki keunggulan efektivitas biaya serta produksi yang besar dan terstandarisasi. Meskipun HPL telah terbukti efektif sebagai suplemen dalam kultur sel, penggunaannya dalam cryopreservation belum banyak diteliti. Atas dasar hal ini, maka diperlukan uji berbagai konsentrasi HPL dalam medium cryopreservation pada kultur sel-sel hati mencit (Mus musculus). Penelitian ini bertujuan untuk mengetahui konsentrasi Human Platelet Lysate (HPL) dalam kombinasi cryoprotectant yang optimum untuk mendukung viabilitas dan densitas pada kultur sel primer hati mencit (Mus musculus) serta mengetahui konsentrasi Human Platelet Lysate (HPL) yang optimum untuk mendukung viabilitas, densitas, dan morfologi pada kultur sel post-thawing hati mencit (Mus musculus). Metode penelitian yang digunakan adalah metode eksperimental dalam dua tahapan eksperimental berkelanjutan yaitu dengan Rancangan Acak Lengkap (RAL) yang terdiri dari 5 perlakuan dan 5 ulangan pada proses cryopreservation dan 5 perlakuan dan 3 ulangan pada kultur post-thawing. Penelitian dilaksanakan pada bulan Januari - Maret 2024 di Laboratorium Struktur dan Perkembangan Hewan Universitas Jenderal Soedirman dan Laboratorium Riset Fakultas Kedokteran Universitas Jenderal Soedirman. Data densitas dan viabilitas sel primer hati mencit diuji normalitasnya menggunakan Kolmogrov-Smirnov dan homogenitasnya menggunakan Levene test. Selanjutnya data yang terd

Hiperkolesterolemia mulai dijumpai pada usia muda dan bermanifestasi pada penyakit jantung iskemik hingga berujung kematian. Senam aerobik dan pembatasan minuman manis diketahui dapat menurunkan kadar kolesterol total. Penelitian bertujuan untuk mengetahui efektivitas senam aerobik dan pembatasan minuman manis dalam menurunkan kadar kolesterol total. Penelitian ini menggunakan metode true experimental randomized control pre-test post-test group design. Sejumlah 42 mahasiswi usia 19-23 tahun, memiliki kadar kolestetol total >190 mg/dL, tidak sedang menjalankan diet khusus dan tidak mengonsumsi obat penurun kolesterol dibagi menjadi tiga kelompok yakni kelompok senam aerobik, pembatasan minuman manis, dan kontrol. Pemeriksaan kolesterol menggunakan metode hand prick sebelum dan sesudah intervensi. Intervensi diberikan selama 4 minggu berupa senam aerobik 8 kali pada kelompok senam, pembatasan minuman manis maksimal 236 mL/hari pada kelompok pembatasan minuman manis, dan kelompok kontrol tidak diberi intervensi. Analisis statistik uji paired t-test dan ANOVA one way menggunakan SPSS versi 26.0 dengan taraf kepercayaan 95%. Sebanyak 71,4% responden tinggal di kost dan 90,5% memiliki kualitas tidur yang buruk. Kadar kolesterol total pada kelompok senam aerobik mengalami penurunan sebesar 32,71±34,76 mg/dL dan kelompok pembatasan minuman manis 16,21±17,54 mg/dL. Terdapat pengaruh intervensi senam aerobik terhadap kadar kolesterol total (p=0,004). Terdapat pengaruh intervensi pembatasan minuman manis terhadap kadar kolesterol total (p=0,004). Terdapat perbedaan rata-rata perubahan kadar kolesterol total ketiga kelompok dengan penurunan terbesar pada kelompok senam aerobik (p= 0,012). Intervensi senam aerobik dan pembatasan minuman manis dapat menurunkan kadar kolesterol total. Intervensi yang paling efektif menurunkan kadar kolesterol total adalah senam aerobik. Kata Kunci : Hiperkolesterolemia, Senam Aerobik, Minuman Manis, Kolesterol Total.

Background: While physical activity (PA) is important during youth, it is unclear if children and adolescents with developmental dysplasia of the hip (DDH), Legg-Calv & eacute;-Perthes disease (LCPD), or slipped capital femoral epiphysis (SCFE) are expected or encouraged to return to PA once they have healed. This study examines the orthopaedic surgeons' role in advising pediatric hip patients on the PA they should engage in, assessing their practice, opinions, and consensus when making recommendations. Methods: Orthopaedic surgeons were invited from member lists of 4 hip study groups. The survey included demographics, opinions regarding PA, and 10 case scenarios that queried respondents on the duration and intensity of PA as well as the restrictions on activity type that they would recommend for DDH, LCPD, or SCFE patients. Consensus was evaluated on a scale ranging from 0 to 1, with a value of 0 indicating no agreement among respondents and a value of 1 indicating complete agreement. Results: A total of 51 orthopaedic surgeons responded. While 94% agreed that it is important for school-aged hip patients to return to PA after they have healed, 53% believed that PA may compromise the hip and contribute to the development of osteoarthritis. Average standardized consensus was 0.92 for suggesting the patient engage in some amount of PA, 0.44 for suggesting the recommended daily minimum of 60 minutes of moderate-to-vigorous physical activity (MVPA), and 0.33 for suggesting restrictions on activity type. The most frequently selected restrictions included avoiding impact activities (93%, 235/254) and contact activities (58%, 147/254), followed by weight-bearing activities (24%, 62/254). Respondents were not aware of existing PA guidelines, although 57% expressed interest in following guidelines and 39% were uncertain. Conclusions: While there is consensus among orthopaedic surgeons that children with chronic hip conditions should engage in PA, there is considerable va

Background and purpose: It is controversial as to which patients affected by Legg–Calvé–Perthes disease (LCPD) benefit from containment surgery. This population-based study based on data from a national quality registry aims to assess the incidence of LCPD and to explore which factors affect the decision for surgical intervention. Methods: This observational study involved 309 patients with unilateral LCPD reported between 2015 and 2023 to the Swedish Pediatric Orthopedic Quality Register (SPOQ). Descriptive statistics and logistic regression models were used for analysis. Results: In 2019, the assessed incidence of LCPD in the Swedish population of 2–12-year-olds was 4.2 per 105. 238 (77%) were boys with a mean age of 6 years. At diagnosis, 55 (30%) were overweight or obese, rising to 17 patients (39%) and 16 patients (40%) at 2-year follow-up for surgically and non-surgically treated groups, respectively. At diagnosis, affected hips had reduced abduction compared with healthy hips, and their abduction remained restricted at the 2-year follow-up. Surgically treated patients had inferior abduction compared with non-surgically treated ones at diagnosis. The adjusted risk for containment surgery increased with age and in the presence of a positive Trendelenburg sign but decreased with greater hip abduction. Conclusion: We found a lower national yearly incidence (4.2 per 105) than previously reported in Swedish studies. A higher proportion of overweight or obese patients compared with the general Swedish population of 4–9-year-olds was identified. Increasing age, positive Trendelenburg sign, and limited hip abduction at diagnosis correlated with increased surgical intervention likelihood.

Kultur sel hewan merupakan suatu proses dimana sel-sel dari jaringan hewan ditempatkan dan ditumbuhkan dalam lingkungan yang sesuai di luar tubuhnya. Kultur sel memerlukan serum sebagai suplemen, serum yang sering digunakan adalah Fetal Bovine Serum (FBS). Namun, penggunaan FBS memiliki keterbatasan, termasuk biaya tinggi dan dampak negatif terhadap kesejahteraan hewan. Human Platelet Lysate (HPL) yang dihasilkan melalui proses freezing-thawing dari Platelet Concentrate (PC) berkualitas baik dapat dijadikan sebagai alternatif pengganti FBS. HPL menyediakan faktor pertumbuhan dan memiliki keunggulan efektivitas biaya serta produksi yang besar dan terstandarisasi. Meskipun HPL telah terbukti efektif sebagai suplemen dalam kultur sel, penggunaannya dalam cryopreservation belum banyak diteliti. Atas dasar hal ini, maka diperlukan uji berbagai konsentrasi HPL dalam medium cryopreservation pada kultur sel-sel hati mencit (Mus musculus). Penelitian ini bertujuan untuk mengetahui konsentrasi Human Platelet Lysate (HPL) dalam kombinasi cryoprotectant yang optimum untuk mendukung viabilitas dan densitas pada kultur sel primer hati mencit (Mus musculus) serta mengetahui konsentrasi Human Platelet Lysate (HPL) yang optimum untuk mendukung viabilitas, densitas, dan morfologi pada kultur sel post-thawing hati mencit (Mus musculus). Metode penelitian yang digunakan adalah metode eksperimental dalam dua tahapan eksperimental berkelanjutan yaitu dengan Rancangan Acak Lengkap (RAL) yang terdiri dari 5 perlakuan dan 5 ulangan pada proses cryopreservation dan 5 perlakuan dan 3 ulangan pada kultur post-thawing. Penelitian dilaksanakan pada bulan Januari - Maret 2024 di Laboratorium Struktur dan Perkembangan Hewan Universitas Jenderal Soedirman dan Laboratorium Riset Fakultas Kedokteran Universitas Jenderal Soedirman. Data densitas dan viabilitas sel primer hati mencit diuji normalitasnya menggunakan Kolmogrov-Smirnov dan homogenitasnya menggunakan Levene test. Selanjutnya data yang terd

Background and purpose: Pediatric pelvic fractures are uncommon, representing 0.2-3% of total pediatric fractures. The long-term patient-reported outcome in the pediatric population has not been evaluated yet. The purpose of the study was to describe the epidemiology of pelvic and acetabular fractures in pediatric patients including long-term patient-reported outcomes. Patients and methods: The Swedish Fracture Register (SFR) was used to identify all patients aged 6-17 years at injury with a pelvic fracture between 2015 and 2021. All patients were invited to answer Patient-Reported measurement instruments in 2021. Results: The study cohort consisted of 223 patients with a median age at fracture of 15 years and with 62 % boys. 201 sustained a pelvic and 22 acetabular fractures. Falls were the leading cause of fracture, followed by transport accidents. Most fractures (both pelvis and acetabulum) were type A (73 %), and 21 fractures (9 %) could not be classified according to AO. 85 % of fractures were treated non-surgically. All Type C fractures were treated surgically. Seven PROMIS (R) profile domains were completed by 31 % of the sample at a mean follow-up time of 3.5 years after pelvic/acetabular fracture. Most patients had "no concern" or "mild concern" but those who had surgery had an inferior t-score in most domains. Conclusion: Most fractures occurred in older individuals, with falls during sports activities being the most common cause. This raises important questions about prevention strategies. The PROMIS-Pain-Interference scale indicated that the younger the age at fracture, the more pain was reported at follow-up.

In-depth multiomic phenotyping provides molecular insights into complex physiological processes and their pathologies. Here, we report on integrating 18 diverse deep molecular phenotyping (omics-) technologies applied to urine, blood, and saliva samples from 391 participants of the multiethnic diabetes Qatar Metabolomics Study of Diabetes (QMDiab). Using 6,304 quantitative molecular traits with 1,221,345 genetic variants, methylation at 470,837 DNA CpG sites, and gene expression of 57,000 transcripts, we determine (1) within-platform partial correlations, (2) between-platform mutual best correlations, and (3) genome-, epigenome-, transcriptome-, and phenome-wide associations. Combined into a molecular network of > 34,000 statistically significant trait-trait links in biofluids, our study portrays "The Molecular Human". We describe the variances explained by each omics in the phenotypes (age, sex, BMI, and diabetes state), platform complementarity, and the inherent correlation structures of multiomics data. Further, we construct multi-molecular network of diabetes subtypes. Finally, we generated an open-access web interface to "The Molecular Human" (http://comics.metabolomix.com), providing interactive data exploration and hypotheses generation possibilities., QC 20240906