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Objective Assess agreement of hypernasality and audible nasal emission (ANE) ratings between audio-recordings and a clinic setting.Design/Setting Cross-sectional study using retrospective clinical recordings.Participants/Intervention Audio-recording ratings by two trained speech language pathologists.Main Outcome Measures Percent agreement and intra- and inter-rater reliability of perceptual ratings.Results Intra-rater reliability (AC2) of 167 audio-recorded speech samples for the primary and secondary raters, respectively, was 0.82 and 0.79 for hypernasality; for ANE, it was 0.57 and 0.75. Inter-rater reliability was 0.77 for hypernasality and 0.63 for ANE. When comparing ratings made from audio-recording versus the original clinical ratings, intra-rater reliability was 0.85 and 0.61 (primary and secondary rater, respectively) for hypernasality and 0.21 and 0.34 for ANE.Conclusions Ratings for hypernasality made from audio recordings were consistent with clinical evaluation, while ratings of ANE were not. ANE ratings made from audio recordings may not be a valid measure of velopharyngeal insufficiency speech characteristics.

Previous studies have reported alterations in cortical thickness in autism. However, few have included enough autistic females to determine if there are sex specific differences in cortical structure in autism. This longitudinal study aimed to investigate autistic sex differences in cortical thickness and trajectory of cortical thinning across childhood. Participants included 290 autistic (88 females) and 139 nonautistic (60 females) individuals assessed at up to 4 timepoints spanning ~2–13 years of age (918 total MRI timepoints). Estimates of cortical thickness in early and late childhood as well as the trajectory of cortical thinning were modeled using spatiotemporal linear mixed effects models of age-by-sex-by-diagnosis. Additionally, the spatial correspondence between cortical maps of sex-by-diagnosis differences and neurotypical sex differences were evaluated. Relative to their nonautistic peers, autistic females had more extensive cortical differences than autistic males. These differences involved multiple functional networks, and were mainly characterized by thicker cortex at ~3 years of age and faster cortical thinning in autistic females. Cortical regions in which autistic alterations were different between the sexes significantly overlapped with regions that differed by sex in neurotypical development. Autistic females and males demonstrated some shared differences in cortical thickness and rate of cortical thinning across childhood relative to their nonautistic peers, however these areas were relatively small compared to the widespread differences observed across the sexes. These results support evidence of sex-specific neurobiology in autism and suggest that processes that regulate sex differentiation in the neurotypical brain contribute to sex differences in the etiology of autism.

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The brown marmorated stink bug (Halyomorpha halys) poses a significant threat to hazelnut crops by affecting kernel development and causing quality defects, reducing the market value. While previous studies have identified bitter-tasting compounds in affected kernels, the impact of stink bug feeding on the hazelnut metabolome, particularly concerning aroma precursors, remains underexplored. This study aims to map the nonvolatile metabolome and volatilome of hazelnut samples obtained by caging H. halyson different cultivars in two locations to identify markers for diagnosing stink bug damage. Using a multiomic approach involving headspace solid-phase microextraction (HS-SPME), comprehensive two-dimensional gas chromatography-time-of-flight mass spectrometry (GC × GC-TOF MS), and liquid chromatography-high-resolution mass spectrometry (LC-HRMS), both raw and roasted hazelnuts are analyzed, with artificial intelligence (AI) and machine learning tools employed to explore data correlations. The study finds that the hazelnut metabolome and volatilome exhibit high chemical complexity with significant classes of compounds such as aldehydes, ketones, alcohols, and terpenes identified in both raw and roasted hazelnuts. Multivariate analysis indicates that the orchard location significantly impacts the metabolome, followed by damage type, with cultivar differences being less pronounced. Partial least-squares discriminant analysis (PLS-DA) models achieve high predictive accuracy for orchard location (99%) and damage type (≈80%), with the roasted volatilome showing the highest predictive accuracy. Correlation matrices reveal significant relationships between raw hazelnut metabolites and aroma compounds in roasted samples, suggesting potential markers for stink bug damage that could guide the quality assessment and mitigation strategies. Data fusion techniques further enhance classification performance, particularly in predicting damage type, underscoring the potential of integrating multiple data sets for comprehensive quality assessment.

This study examines the complex volatilome of maize silage, both with and without commercial heterolactic strain inoculation, conserved for 100 days, using quantitative volatilomics. Chemical classes linked to microbial metabolism were analyzed across a concentration range from 10 μg g–1to 1 ng g–1. A reference method using comprehensive two-dimensional gas chromatography (GC × GC) and time-of-flight mass spectrometry (TOF MS) with loop-type thermal modulation (TM) was translated to a differential-flow modulation (FM) platform with parallel MS and flame ionization detector (FID) detection. With translation, the original method’s analyte elution order and resolution are preserved. The new method allowed for accurate quantification using multiple headspace solid-phase microextraction (MHS-SPME) and FID-predicted relative response factors (RRFs). Both methods showed comparable discriminatory power with FM GC × GC-MS/FID achieving satisfactory quantification accuracy without external calibration. Analysis of 98 volatiles provided insights into silage fermentation, supporting marker discovery and correlations with silage quality and stability.

Although phthalate exposure has been linked with multiple adverse pregnancy outcomes, their underlying biological mechanisms are not fully understood. We examined associations between biomarkers of phthalate exposures and metabolic alterations using untargeted metabolomics in 99 pregnant women and 86 newborns [mean (SD) gestational age = 39.5 (1.5) weeks] in the PROTECT cohort. Maternal urinary phthalate metabolites were quantified using isotope dilution high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS), while metabolic profiles in maternal and cord blood plasma were characterized via reversed-phase LC-MS. Multivariable linear regression was used in metabolome-wide association studies (MWAS) to identify individual metabolic features associated with elevated phthalate levels, while clustering and correlation network analyses were used to discern the interconnectedness of biologically relevant features. In the MWAS adjusted for maternal age and prepregnancy BMI, we observed significant associations between specific phthalates, namely, di(2-ethylhexyl) phthalate (DEHP) and mono(3-carboxypropyl) phthalate (MCPP), and 34 maternal plasma metabolic features. These associations predominantly included upregulation of fatty acids, amino acids, purines, or their derivatives and downregulation of ceramides and sphingomyelins. In contrast, fewer significant associations were observed with metabolic features in cord blood. Correlation network analysis highlighted the overlap of features associated with phthalates and those identified as differentiating markers for preterm birth in a previous study. Overall, our findings underscore the complex impact of phthalate exposures on maternal and fetal metabolism, highlighting metabolomics as a tool for understanding associated biological processes. Future research should focus on expanding the sample size, exploring the effects of phthalate mixtures, and validating identified metabolic features in larger, more diverse populations.

Nonlinear delay differential equations (NDDEs) are essential in mathematical epidemiology, computational mathematics, sciences, etc. In this research paper, we have presented a delayed mathematical model of the Ebola virus to analyze its transmission dynamics in the human population. The delayed Ebola model is based on the four human compartments susceptible, exposed, infected, and recovered (SEIR). A time-delayed technique is used to slow down the dynamics of the host population. Two significant stages are analyzed in the said model: Ebola-free equilibrium (EFE) and Ebola-existing equilibrium (EEE). Also, the reproduction number of a model with the sensitivity of parameters is studied. Furthermore, the local asymptotical stability (LAS) and global asymptotical stability (GAS) around the two stages are studied rigorously using the Jacobian matrix Routh–Hurwitz criterion strategies for stability and Lyapunov function stability. The delay effect has been observed in the model in inverse relation of susceptible and infected humans (it means the increase of delay tactics that the susceptibility of humans increases and the infectivity of humans decreases eventually approaches zero which means that Ebola has been controlled into the population). For the numerical results, the Euler method is designed for the system of delay differential equations (DDEs) to verify the results with an analytical model analysis.

A pesar de que en los últimos años se ha avanzado en el control de los factores de riesgo vascular, los datos de vida real muestran cómo solo un porcentaje bajo de los pacientes consiguen alcanzar unas concentraciones de colesterol ligado a lipoproteínas de baja densidad definidos. Recientemente, han surgido nuevas dianas terapéuticas en el campo de los fármacos hipolipemiantes que pueden ayudar a la consecución de los objetivos terapéuticos recomendados por las guías de práctica clínica y, por consiguiente, reducir la incidencia de eventos vasculares adversos. No obstante, existen ciertas incertidumbres en la práctica clínica acerca del momento oportuno de su prescripción y en qué pacientes utilizarlas, en comparación con las terapias «clásicas» como las estatinas o la ezetimiba. Debido a este complejo escenario se propone este documento de consenso, certificado por las sociedades científicas que más frecuentemente se enfrentan al paciente con enfermedad aterosclerótica (SEC/SEA/SEEN/SEMFYC/SEMERGEN/SEMG/SEN/SEACV/S.E.N.), y cuyo objetivo es ayudar de una forma práctica y con la evidencia científica actual a la utilización de las nuevas terapias hipolipemiantes en diferentes escenarios clínicos.

The Medtronic MiniMed™ 780G (MM780G) system uses an algorithm that includes autocorrection bolus (AB) delivery. This study evaluates the impact of omitted meal boluses and the system settings, glucose target and active insulin time (AIT), on the AB.

This study investigates the impact of lean and green supply chain practices on business process performance and sustainable supply chain performance. The research utilises the resource-based view (RBV) theory to construct a conceptual model wherein lean and green supply chain practices are employed to augment business processes and sustainable performance. Concurrently, dynamic capabilities theory is applied to signify an organisation’s capacity to adapt and evolve in response to internal and external pressures from customers and competitors. The conceptual model is validated using structural equation modelling with a sample of 170 supply chain practitioners from the apparel and textile supply chain in Jordan. Results indicate that lean practices exhibit no direct impact, whereas green practices significantly influence business process performance and indirectly affect sustainable supply chain performance. Business process performance does not mediate the relationship for lean practices, but it does so for green practices. Moreover, the environmental orientation of both competitors and customers negatively moderates the impact of green practices on business processes and sustainable supply chain performance. These findings contribute to existing literature and underscore the crucial role of green supply chain practices in enhancing sustainable supply chain performance in the apparel and textile industry.

Background:The evidence for the health benefits of physical activity is growing; however, the prevalence of unhealthy lifestyles continues to contribute to the increase in chronic non-communicable diseases. We know that occupational-time physical activity does not provide the same benefits as leisure-time physical activity, which has been shown to reduce mortality and pain. We also know that multiple factors influence pain; however, there are no studies that specifically analyze the impact of type of working time and occupational-time physical activity on the impairment of daily activities due to pain. We aimed to study the influence of both personal and occupational factors on the impairment of daily activities due to pain, assessing whether leisure-time physical activity acts as a protective factor. Methods: A cross-sectional, population-based design was used based on the 2017 National Health Survey in Spain (ENSE). Sociodemographic, leisure-time physical activity, and work-related variables were collected. The outcome variable was the impairment of daily activities due to pain. Ordinal logistic regression was applied, and the analysis was complemented with simple correspondence analysis. Results: A total of 1,441 workers between 18 and 65 years of age were studied. Significant differences were found between sexes for all variables except age and leisure-time physical activity. Logistic regression revealed significant associations between sex, primary and secondary education levels, no leisure-time physical activity, and overweight with impairment of daily activities due to pain. Simple correspondence analysis showed that the categories doing leisure-time physical activity several times a week as well as several times a month are closer to the categories of little or no pain. Conclusion: Female gender, low educational level, overweight, and lack of leisure-time physical activity were associated with increases in impairment of daily activities due to pain. Occupational-time physical activity and work shift were not related to impairment of daily activities due to pain. Implications for Occupational Health Practice: Occupational Health Nursing interventions through education and counseling on the importance of leisure-time physical activity promotion programs potentially can reduce the impairment of daily activities due to pain in working populations.

The training of hospital pharmacists in the coming years must adapt and respond to constant current and future social and technological challenges, without neglecting the basic areas of the profession. It is necessary to acquire knowledge in what is known as digital comprehensive health: artificial intelligence, technology and automation, digital skills, and new forms of communication with patients, such as telemedicine and telepharmacy that are already a reality in many hospitals.

La formación de los farmacéuticos especialistas de hospital en los próximos años debe adaptarse y dar respuesta a constantes retos sociales y tecnológicos actuales y futuros, sin descuidar las áreas básicas de la profesión. Es necesario adquirir conocimientos en lo que se conoce como salud integral digital: inteligencia artificial, tecnología y automatización, competencias digitales y nuevas formas de comunicación con los pacientes, como la telemedicina y la telefarmacia, que ya son una realidad en muchos hospitales.

Background: To describe demographic and clinicopathological aspects of a South-American cohort of incipient oral squamous cell carcinoma patients. Material and Methods: A cross-sectional, observational study was performed to assess demographic and clinicopathological characteristics of incipient oral squamous cell carcinoma patients from 6 South-American institutions Results: One hundred and seven patients within the histopathological spectrum of incipient oral squamous cell carcinoma (in-situ and microinvasive) were included. Fifty-eight (54.2%) patients were men with a mean age of 60.69 years. Forty-nine (45.8%) and thirty-nine (36.5%) patients had history of tobacco and alcohol use, respectively. Clinically, most of the lesions were plaques (82.2%), ≥ 2 cm in extension (72%), affecting the lateral border of the tongue (55.1%), and soft palate (12.1%) with a mixed (white and red) appearance. Eighty-two (76.7%) lesions were predominantly white and 25 (23.3%) predominantly red. Conclusions: To the best of our knowledge, this is the largest cohort of incipient oral squamous cell carcinoma patients, which raises awareness of clinicians’ inspection acuteness by demonstrating the most frequent clinical aspects of this disease, potentially improving oral cancer secondary prevention strategies. [ABSTRACT FROM AUTHOR]

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Background: The increased contamination of illicit drugs with fentanyl in the United States drug market has contributed to escalating mortality from drug overdose. Leisure and hospitality service industry workers are encountering opioid-triggered overdoses in their workplaces, such as restaurants and bars. Consequently, this increases the need for overdose education and naloxone distribution (OEND) training, which has been limited. We aimed to describe the experiences among service industry workers encountering an overdose in their workplace.Methods: We conducted in-depth qualitative interviews with service industry workers in Little Five Points (L5P), Atlanta, between October 2019 and April 2020 and triangulated methods with participant observations and fieldwork. Purposive criterion sampling methods were applied to recruit from different establishments in the L5P commercial district, which comprised restaurants, bars, retail shops, and theaters. After an initial seed sample was identified by engaging key stakeholders during fieldwork (business owners, managers, and the business association), a snowball sample followed for a final sample of N= 15. To contextualize the local population of harm reduction workers, people who use drugs and/or obtain safer drug consumption supplies in L5P (sterile syringes, safer using kits, naloxone), and service industry workers and their customers in L5P, the first author volunteered with an Atlanta syringe services program from October 2019 to April 2020. The first author conducted participant observations during the syringe exchange program and field notes were taken during observation (44 hours). This engagement ensured a rich, thick description. We used a pragmatic approach to thematic data analysis for this study. Data were analyzed iteratively and inductively from interviews and observations. Two independent researchers reviewed transcripts to identify passages in the data related to the question of interest. The passages were contextualized within the full data set independently to understand the relationships in developing a theory of what was commonly occurring across participants’ experiences, and these relationships led to emerging salient themes regarding encountering an opioid overdose at work.Results: One salient theme related to overdose response emerged with the service industry workers included fear of negative consequences of overdose response, specifically, fear of disease transmission from artifacts of drug use and overdose response, including the spread of blood-borne disease, violence, and exposure to unintentional overdose. When discussing drug use, participants’ beliefs about the potential for personal danger from drug use artifacts (syringes and discarded drugs) and violence were identified as barriers to opioid overdose responses.Conclusions/Implications for Occupational Health Practice: Our findings provide valuable insights for tailoring OEND training for service industry workers to confront fears associated with opioid overdose response in their places of work to decrease mortality from the opioid epidemic. Harm reduction approaches need to be sensitive to the places in which overdose occurs and who the overdose responder is likely to be, which requires appropriately tailoring OEND training for service industry workers.

Prenatal per- and poly-fluoroalkyl substances (PFAS) exposure may influence gestational outcomes through bioactive lipids─metabolic and inflammation pathway indicators. We estimated associations between prenatal PFAS exposure and bioactive lipids, measuring 12 serum PFAS and 50 plasma bioactive lipids in 414 pregnant women (median 17.4 weeks’ gestation) from three Environmental influences on Child Health Outcomes Program cohorts. Pairwise association estimates across cohorts were obtained through linear mixed models and meta-analysis, adjusting the former for false discovery rates. Associations between the PFAS mixture and bioactive lipids were estimated using quantile g-computation. Pairwise analyses revealed bioactive lipid levels associated with PFDeA, PFNA, PFOA, and PFUdA (p< 0.05) across three enzymatic pathways (cyclooxygenase, cytochrome p450, lipoxygenase) in at least one combined cohort analysis, and PFOA and PFUdA (q< 0.2) in one linear mixed model. The strongest signature revealed doubling in PFOA corresponding with PGD2 (cyclooxygenase pathway; +24.3%, 95% CI: 7.3–43.9%) in the combined cohort. Mixture analysis revealed nine positive associations across all pathways with the PFAS mixture, the strongest signature indicating a quartile increase in the PFAS mixture associated with PGD2 (+34%, 95% CI: 8–66%), primarily driven by PFOS. Bioactive lipids emerged as prenatal PFAS exposure biomarkers, deepening insights into PFAS’ influence on pregnancy outcomes.

Despite many organizations recognizing the need for more comprehensive resilience planning for transportation infrastructure, the United States still lacks a standardized planning framework to guide these decisions and prioritize improvements. Therefore, this paper develops and demonstrates the application of a flexible resilience framework that supports transportation resilience decision-making across multiple operational and infrastructure systems. This Performance-based Resilience Evaluation Procedure (PREP) framework calculates comparable resilience scores and can be implemented for any type of transportation infrastructure to assist transportation agencies and community stakeholders in making informed decisions in relation to project prioritization, risk mitigation, asset management, and design for more reliable infrastructure. The PREP framework, comprised of 12 steps organized in five phases, calculates resilience as a weighted probability of hazard events and the impacts of such hazards on measures of performance. Having such a framework is crucial because it allows stakeholders to develop the data-driven knowledge necessary to deliver informed management and planning of the entire transportation infrastructure system against disruptive events.

PHERGain was designed to assess the feasibility, safety, and efficacy of a chemotherapy-free treatment based on a dual human epidermal growth factor receptor 2 (HER2) blockade with trastuzumab and pertuzumab in patients with HER2-positive early breast cancer (EBC). It used an 18fluorine-fluorodeoxyglucose-PET-based, pathological complete response (pCR)-adapted strategy.

The sustainable production of vanillin from the oxidative depolymerization of lignin was evaluated. Vanillin was produced from Kraft lignin using heterogeneous catalysts based on activated carbons prepared by chemical activation of sodium lignosulfonate with H3PO4. The novel redox catalytic system, obtained by HNO3treatment, allows the heterogenization of nitrobenzene structures on the activated carbon, reaching vanillin yield 30% higher than that obtained without a heterogeneous catalyst (about 3.1 wt %). A copper catalyst (5 wt %) was also prepared for comparison purposes. The highest vanillin yield was obtained at 200 °C and 10 bar for the nitrobenzene-like catalyst, reaching full extraction from the selected technical lignin. The catalyst was successfully reused without any regeneration treatment, evidencing no signs of deactivation. The possibility of transferring oxygen from oxidized P groups to reduced N groups in a redox cycle seems to be responsible for this sustained catalytic activity. To promote zero waste production, the obtained residual lignin was also used to prepare an activated carbon with outstanding properties, ABET∼ 1000 m2/g.