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Abstract: Retinoids represent a class of chemical compounds derived from or structurally and functionally related to vitamin A. Retinoids play crucial roles in regulating a range of crucial biological processes spanning embryonic development to adult life. These include regulation of cell proliferation, differentiation, and cell death. Due to their promising characteristics, retinoids emerged as potent anti-cancer agents, and their effects were validated in vitro and in vivo preclinical models of several solid and hematological malignancies. However, their clinical translation remained limited due to poor water solubility, photosensitivity, short half-life, and toxicity. The development of retinoid delivery formulations was extensively studied to overcome these limitations. This review will summarize some preclinical and commercial synthetic retinoids in cancer and discuss their different delivery systems.

Insects are gaining interest as a sustainable and highly nutritious source of proteins and lipids for food and feed production sectors. Insect bio-refinery includes lipid extraction by pressing, dewatering, microbiological decontamination, and protein fractionation. The present study is experimenting the use of instant controlled pressure-drop (DIC), an emerging technology, for treating yellow mealworms and evaluating its combined effects on insect bio-refinery steps. A preliminary study allowed identifying the optimal hydraulic pressing conditions for Tenebrio molitor larvae. Then, establishing an experimental design with DIC operative parameters of the saturated dry steam absolute pressure and treatment time ranging between (0.15 and 0.45 MPa) and (15 and 35 s), respectively, allowed identifying the DIC impact as a pretreatment on different larvae properties. It was possible to identify the optimal pressing parameters at 6 MPa, 60 °C, 2 cm of thickness, and 0.15 mm/s as initial piston speed. Moreover, DIC performed at 0.15 MPa for 25 seconds stood as an efficient killing method. Thanks to the changes in the membrane’s structure it provokes, DIC treatment modified larvae properties, ensured a partial expulsion of the matter (up to 0.47 g/g dry basis (db)), and resulted in larval expansion (up to 67%) which resulted in a decrease in the apparent density. As for the chemical properties, the larvae and larvae juice colours were found to become lighter as we increased the treatment conditions, which might be caused by the inactivation of oxidative enzymes. Moreover, severe DIC operative parameters decreased the pressing yields from 68 to 55%, possibly caused by protein aggregation and denaturation phenomena that prevent molecules from coming out by pressing. However, the water activity and moisture, lipid, and protein contents remained unaffected.

With the advances in Natural Language Processing (NLP), the industry has been moving towards human-directed artificial intelligence (AI) solutions. Recently, chatbots and automated news generation have captured a lot of attention. The goal is to automatically generate readable text from tabular data or web data commonly represented in Resource Description Framework (RDF) format. The problem can then be formulated as Data-to-text (D2T) generation from structured non-linguistic data into human-readable natural language. Despite the significant work done for the English language, no efforts are being directed towards low-resource languages like the Arabic language. This work promotes the development of the first RDF data-to-text (D2T) generation system for the Arabic language while trying to address the low-resource limitation. We develop several models for the Arabic D2T task using transfer learning from large language models (LLM) such as AraBERT, AraGPT2, and mT5. These models include a baseline Bi-LSTM Sequence-to-Sequence (Seq2Seq) model, as well as encoder-decoder transformers like BERT2BERT, BERT2GPT, and T5. We then provide a detailed comparative study highlighting the strengths and limitations of these methods setting the stage for further advancement in the field. We also introduce a new Arabic dataset (AraWebNLG) that can be used for new model development in the field. To ensure a comprehensive evaluation, general-purpose automated metrics (BLEU and Perplexity scores) are used as well as task-specific human evaluation metrics related to the accuracy of the content selection and fluency of the generated text. The results highlight the importance of pre-training on a large corpus of Arabic data and show that transfer learning from AraBERT gives the best performance. Text-to-text pre-training using mT5 achieves second best performance results even with multilingual weights.

Learning response generation models constitute the main component of building open-domain dialogue systems. However, training open-domain response generation models requires large amounts of labeled data and pre-trained language generation models that are often nonexistent for low-resource languages. In this article, we propose a framework for training open-domain response generation models in low-resource settings. We consider Dialectal Arabic (DA) as a working example. The framework starts by warm-starting a transformer-based encoder-decoder with pre-trained language model parameters. Next, the resultant encoder-decoder model is adapted to DA by employing self-supervised pre-training on large-scale unlabeled data in the desired dialect. Finally, the model is fine-tuned on a very small labeled dataset for open-domain response generation. The results show significant performance improvements on three spoken Arabic dialects after adopting the framework’s three stages, highlighted by higher BLEU and lower Perplexity scores compared with multiple baseline models. Specifically, our models are capable of generating fluent responses in multiple dialects with an average human-evaluated fluency score above 4. Our data is made publicly available.

Introduction: Lebanon is facing challenges affecting the whole health sector, including access to medications. Lebanon has only proposed very few short-term national pharmaceutical strategic solutions. Previous reform attempts targeting the pharmaceutical sector, could not protect it from the crises and their detrimental consequences on patient and population health. Purpose: This document unveils the critical elements that should be addressed in the planned National Pharmaceutical Sector Strategy (NPS) being developed by the Order of Pharmacists of Lebanon (OPL) in consultation with the concerned stakeholders. Method: Strategic goals were proposed for adoption and implementation by the competent authorities based on consultations, situational assessments, and gap analyses. The objectives and an implementation plan were developed based on the available resources and policy dialogue, respectively. Conclusion: The National Pharmaceutical Strategy would help the Lebanese authorities/policy-makers, aided by competent healthcare professionals, develop and implement a time-bound roadmap to attain a nation with access to quality and safe medications for the whole population. Implementing this strategy would require the commitment of decision-makers, the accountability of involved parties, innovation in finding solutions, close collaboration between stakeholders, and lengthy efforts to attain the stated vision.

Background Occipitocervical fusion (OCF) is a procedure performed for multiple upper cervical pathologies. A common postprocedural complication of OCF is dysphagia, which has been linked to the narrowing of the pharyngeal space due to fixation in a hyper-flexed angle. Postoperative dysphagia is linked to reduced quality of life, prolonged hospital stay, aspiration pneumonia, and increased mortality. This has led to investigations of the association between sagittal radiographic angles and dysphagia following OCF. Methods A systematic review of the literature was performed to explore the current evidence regarding cervical sagittal radiographic measurements and dysphagia following OCF. A search strategy was carried out using the PubMed, Embase, and Web of Science databases from their dates of inception until August 2022. Only original English-language studies were considered. Moreover, studies had to include the correlation between dysphagia and at least one radiographic measurement in the sagittal plane. Results The search and subsequent selection process yielded eight studies that were included in the final review, totaling 329 patients in whom dysphagia had been assessed and graded. The dysphagia score by Bazaz et al. (Spine 27, 22:2453–2458, 2002) was used most often. The pooled incidence of dysphagia, in the early postoperative period, was estimated at 26.4%. At long-term follow-up (range: 17–72 months), about one-third of patients experienced resolution of symptoms, which resulted in a long-term post-OCF dysphagia incidence of 16.5%. Across the studies included, six different radiographic parameters were used to derive several measures which were repeatedly and significantly associated with the occurrence of dysphagia. Conclusions The high incidence of postoperative dysphagia following OCF warrants close monitoring of patients, especially in the short-term postoperative period. These patients may be assessed through standardized tools where the one by Bazaz et al. was the most commonly used. Moreover, there are several radiographic measurements that can be used to predict the occurrence of dysphagia. These findings may serve as a basis for strategies to prevent the occurrence of dysphagia after OCF.

Introduction: Overgrowth syndromes are a heterogeneous group of genetic disorders characterized by excessive growth, often accompanied by additional clinical features, such as facial dysmorphism, hormonal imbalances, cognitive impairment, and increased risk for neoplasia. Moreno-Nishimura-Schmidt (M-N-S) overgrowth syndrome is a very rare overgrowth syndrome characterized by severe pre- and postnatal overgrowth, dysmorphic facial features, kyphoscoliosis, large hands and feet, inguinal hernia, and distinctive skeletal features. The clinical and radiological features of the disorder have been well delineated, yet its molecular pathogenesis remains unclear. Case Presentation: We report on a Lebanese boy with M-N-S syndrome, whose clinical manifestations were compared with those of previously reported 5 affected individuals. Whole-exome sequencing combined with comparative genome hybridization analysis failed to delineate the molecular basis of the phenotype. However, epigenetic studies revealed a different methylation status of several CpG sites between him and healthy controls, with methyltransferase activity showing the most significant enrichment. Conclusion: An additional case of M-N-S syndrome recapitulated the clinical and radiological manifestations described in the previous reports. The data in the epigenetic studies implicated that abnormal methylations might play an essential role in development of the disease phenotype. However, additional studies in a clinically homogeneous cohort of patients are crucial to confirm this hypothesis.

This single-center study aimed to retrospectively evaluate the survival outcomes of patients with FIGO stage I clear cell and serous uterine carcinoma according to the type of adjuvant treatment received. The data were collected between 2003 and 2020 and only patients with stage I clear cell or serous uterine carcinoma treated with primary surgery were included. These were classified into three groups: No treatment or brachytherapy only (G1), radiotherapy +/− brachytherapy (G2), chemotherapy +/− radiotherapy +/− brachytherapy (G3). In total, we included 52 patients: 18 patients in G1, 16 in G2, and 18 in G3. Patients in the G3 group presented with poorer prognostic factors: 83.3% had serous histology, 27.8% LVSI, and 27.8% were FIGO stage IB. Patients treated with adjuvant radiotherapy showed an improved 5-year overall survival (OS) (p = 0.02) and a trend towards an enhanced 5-year progression-free survival (PFS) (p = 0.056). In contrast, OS (p = 0.97) and PFS (p = 0.84) in the chemotherapy group with poorer prognostic factors, were similar with increased toxicity (83.3%). Radiotherapy is associated with improved 5-year OS and tends to improve 5-year PFS in women with stage I clear cell and serous uterine carcinoma. Additional chemotherapy should be cautiously considered in serous carcinoma cases presenting poor histological prognostic factors.

The aim of this study was to evaluate the color stability and the surface roughness of a bulk-fill composite flow (SDR® Plus) by comparison to an ORMOCER-based composite (Ceram.x® Universal SphereTEC?) in order to confirm the validity of using SDR® Plus i

To explore reoperation rates for different radical nephrectomy (RN) approaches that are experiencing a shift from open radical nephrectomy (ORN) toward minimally invasive surgery (MIS), we aimed to compare reoperation rates along with their culprit etiologies between the different types of surgical approaches for RN.The national surgical quality improvement program dataset was used to select patients who underwent RN between the years 2012-2019. A 1:1 propensity score matched analysis was used. Reoperation rates and causes were then compared between open and MIS approach.The propensity matched cohort included 15,294 patients. Reoperation rates due to large bowel injury (0.01 vs. 0.14%), vascular injury (0.07 vs. 0.22%), and other abdominal (0.5 vs. 0.77%) were more common in ORN as compared to MIS (MIS vs. ORN, respectively, p 0.034). Reoperation due to hernia (0.14 vs. 0.03%) was more common in MIS as compared to ORN (p = 0.027). No difference was seen for small bowel injury and incision/wound debridement. General reoperation (1.61 vs. 2.22%) and mortality (0.57 vs. 1.47%) were also more common in ORN as compared to MIS (p 0.008).Reoperation due to large bowel injury, vascular injury, and other abdominal was more likely to occur in ORN. Whereas reoperation due to hernia was more likely to occur in MIS. Surgical approach was an independent risk factor for immediate and early reoperation rates in RN patients. These results could be used to counsel patients pre-operatively on possible surgical approaches and complications.

Adjuvant chemotherapy for stage III colon cancer is underutilized in the United States. The aim of this study was to assess the use of adjuvant chemotherapy in younger and medically fit patients and analyze the socioeconomic factors associated with its utilization.Using the National Cancer Database from 2004 to 2015, we selected stage III colon cancer patients between age 18 to 65, Charlson-Deyo Comorbidity Index (CDCI) of 0 or 1, and those that survived at least 12 months after surgery. We then compared patients that underwent surgery only with those that received adjuvant chemotherapy. Multivariable logistic regression analysis was performed to identify variables associated with adjuvant chemotherapy use in the population. Overall survival was estimated by Kaplan-Meier curves.Of the 48,336 patients that met inclusion criteria, 43,315 (90%) received adjuvant chemotherapy. The utilization of adjuvant chemotherapy increased from 87% in 2004 to 91% in 2015. On multivariable regression analysis, the use of adjuvant chemotherapy was lower among males, Non-Hispanic Blacks and Hispanics, low-grade cancer, left-sided tumors, CDCI 1, those who travel ≥ 50 miles, yearly income$40,227, and uninsured patients. The most common reason for the omission of adjuvant chemotherapy was the patient or caregiver's choice (40% between 2013 and 2015). The 5-year and 10-year overall survival rates were 76.7% and 63.8% respectively, in those who received adjuvant chemotherapy as compared to 65.1% and 49.3% in those who underwent surgery only (P.001).In young and medically fit stage III colon cancer patients, most patients received guideline-compliant care in the United States. However, socioeconomic disparities adversely impacted the use of adjuvant chemotherapy. The patient or caregiver's decision was the most common reason for non-adherence to adjuvant chemotherapy and lead to poor survival outcomes. Emphasis should be placed on developing patient-centered strategies to improve adherence to chemotherapy in all patients.

Stereotypes among health professionals can jeopardize the delivery of collaborative healthcare and the achievement of positive patient outcomes. However, interprofessional education (IPE) can promote early clarification of roles, and understanding and mutual respect among trainees from different health disciplines. We studied the effects of IPE activities on the views and attitudes of pharmacy students toward nurse- and physician-trainees.Pharmacy students completed a structured written reflection exercise immediately following two separate IPE activities with nursing and medical students, both oriented around diabetes care. We conducted an inductive content analysis of these texts to identify key themes according to the domains of the contact hypothesis theoretical framework: organizational authority, common goals, intergroup cooperation, equal group status and intergroup status. Pharmacy students were also asked how these IPE activities have influenced their views regarding their future pharmacy practice.Pharmacy students felt that their groups had cooperated to solve the common patient care goals in each IPE activity, and noted no distinction between the nursing and medical students. However, through either explicit or implicit negotiation of overlapping roles, many pharmacy students ultimately assumed deferential positions relative to medical students. Overall, pharmacy students' attitudes and views regarding the abilities and roles of nursing and medical students in patient care were favorably altered through the IPE activities. Notably, nurses' drug knowledge and diagnostic abilities of nurses and physicians' familiarity with the primary literature and prescribing regimens was previously under-rated but became recognized after IPE activities.Pharmacy students' stereotypical views towards nursing and medical students were positively shifted when IPE activity conditions were optimized for intergroup contact.يمكن للقوالب النمطية للمهنيين الصحيين أن تؤثر سلبا على تقديم الرعاية الصحية التعاونية والنتائج الإيجابية للمرضى. ومع ذلك، يمكن أن يكون التعليم البيني مفيدا في تعزيز التوضيح المبكر لأدوار العاملين الصحيين والتفاهم والاحترام المتبادل بين المتدربين من مختلف التخصصات الصحية. درسنا تأثير أنشطة التعليم البيني على آراء ومواقف طلاب الصيدلة تجاه الممرضين والأطباء المتدربين.أكمل طلاب الصيدلة تمرينا منظما تأمليا بعد نشاطين منفصلين للتعليم البيني مع طلاب التمريض وطلاب الطب، وكلا النشاطين حول رعاية مرضى السكري. لقد أجرينا تحليلا استقرائيا للمحتوى لخواطر التأملات لتحديد الموضوعات الرئيسية وفقا لمجالات الإطار النظري لفرضية الاتصال: السلطة التنظيمية، والأهداف المشتركة، والتعاون بين المجموعات، وحالة المجموعة المتساوية، والحالة بين المجموعات. سُئل طلاب الصيدلة أيضا عن كيفية تأثير أنشطة التعليم البيني على تصورهم لممارسة الصيدلة مستقبلا.شعر طلاب الصيدلة أن مجموعاتهم قد تعاونت لحل أهداف رعاية المرضى المشتركة في كل أنشطة التعليم البيني دون تمييز ملحوظ بين طلاب التمريض أو الطب. ومع ذلك، عن طريق التفاوض الصريح أو الضمني حول الأدوار المتداخلة، اتخذ الكثيرون في النهاية مواقف تفضيلية بالنسبة لطلاب الطب. بشكل عام، تم تغيير مواقف طلاب الصيدلة ووجهات نظرهم تجاه قدرات وأدوار طلاب التمريض والطب في رعاية المرضى بشكل إيجابي من خلال أنشطة التعليم البيني. على وجه الخصوص، اكتشف طلاب الصيدلة المعرفة الدوائية والقدرات التشخيصية للممرضات، وكذلك الإلمام بالأدبيات الأولية وأنظمة وصف الأدوية من قبل الأطباء.تم تغيير وجهات النظر النمطية لطلاب الصيدلة تجاه طلاب التمريض والطب بشكل إيجابي عندما تم تحسين ظروف نشاط التعليم البيني للتواصل بين المجموعات. على نطاق أوسع، يعد البحث المستمر ضروريا لفهم الآثار طويلة المدى للتعرض المبكر لمجموعات الأقران من المهنيين الصحيين على الصور النمطية التي قد تظهر في الرعاية القائمة على الفريق في المستقبل.

Purpose: The aim of this retrospective study is to compare the results of MRI-TRUS fusion targeted and systematic prostate biopsy (TSPB) versus conventional systematic prostate biopsy (SPB), in biopsy naïve patients with available MRI results at time of biopsy. Between January 1, 2018, and May 31, 2022, patients with Materials And Methods: clinical suspicion of prostate cancer based on abnormal PSA level and/or abnormal Digital Rectal Exam (DRE) who were scheduled for prostate biopsy, were included. All patients had undergone multiparametric (mp) MRI before biopsy, and the results of this scan were known to the urologist performing the biopsy. Patients were classied according to whether they had undergone MRI-TRUS fusion targeted + systematic biopsies (TSPB, group 1) or standard TRUS systematic biopsies (SPB, group 2). We compared cancer detection rate (CDR), clinically signicant cancer (ISUP≥2) detection rate, rate of upgrading or downgrading in radical prostatectomy treatment group and prostate biopsy complications. Results: There was no statistically signicant difference in global CDR between group 1 (TSPB) and group 2 (SPB), CDR 59.7% (43/72) and 54.8% (102/186), (p< 0.48), respectively. Prostate cancer prevalence was 56.2% (145/258). There was 3 times higher risk of PCa detection in patients with MRI-visible lesions comparable to those with no MRI-visible lesions, CDR 66% (110/166 patients), and 38% (35/92 patients), OR 3.2 CI [1.9-5.4], (p

This work describes a computational method for reconstructing clusters of social relationships among early modern printers and publishers, the most determinant agents for the process of transformation of scientific knowledge. The method is applied to a dataset retrieved from the Sphaera corpus, a collection of 359 editions of textbooks used at European universities and produced between the years 1472 and 1650. The method makes use of standard bibliographic data and fingerprints; social relationships are defined as “awareness relationships”. The historical background is constituted of the production and economic practices of early modern printers and publishers in the academic book market. The work concludes with empirically validating historical case studies, their historical interpretation, and suggestions for further improvements by utilizing machine learning technologies.

Newborn screening (NBS) is a state-level initiative that detects life-threatening genetic disorders for which early treatment can substantially improve health outcomes. Cystic fibrosis (CF) is among the most prevalent disorders in NBS. CF can be caused by a large number of mutation variants to the CFTR gene. Most states use a multitest CF screening process that includes a genetic test (DNA). However, due to cost concerns, DNA is used only on a small subset of newborns (based on a low-cost biomarker test with low classification accuracy), and only for a small subset of CF-causing variants. To overcome the cost barriers of expanded genetic testing, we explore a novel approach, of multipanel pooled DNA testing. This approach leads not only to a novel optimization problem (variant selection for screening, variant partition into multipanels, and pool size determination for each panel), but also to novel CF NBS processes. We establish key structural properties of optimal multipanel pooled DNA designs; develop a methodology that generates a family of optimal designs at different costs; and characterize the conditions under which a 1-panel versus a multipanel design is optimal. This methodology can assist decision-makers to design a screening process, considering the cost versus accuracy trade-off. Our case study, based on published CF NBS data from the state of New York, indicates that the multipanel and pooling aspects of genetic testing work synergistically, and the proposed NBS processes have the potential to substantially improve both the efficiency and accuracy of current practices. This paper was accepted by Stefan Scholtes, healthcare management. Funding: This work was supported by National Science Foundation [Grant 1761842]. Any opinion, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation. Supplemental Material: The data files and e-companion are available at https://doi.org/10.1287/mnsc.2021.4289 .

The last international guidelines on the evaluation and management of primary hyperparathyroidism (PHPT) were published in 2014. Research since that time has led to new insights into epidemiology, pathophysiology, diagnosis, measurements, genetics, outcomes, presentations, new imaging modalities, target and other organ systems, pregnancy, evaluation, and management. Advances in all these areas are demonstrated by the reference list in which the majority of listings were published after the last set of guidelines. It was thus, timely to convene an international group of over 50 experts to review these advances in our knowledge. Four Task Forces considered: 1. Epidemiology, Pathophysiology, and Genetics; 2. Classical and Nonclassical Features; 3. Surgical Aspects; and 4. Management. For Task Force 4 on the Management of PHPT, Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology addressed surgical management of asymptomatic PHPT and non-surgical medical management of PHPT. The findings of this systematic review that applied GRADE methods to randomized trials are published as part of this series. Task Force 4 also reviewed a much larger body of new knowledge from observations studies that did not specifically fit the criteria of GRADE methodology. The full reports of these 4 Task Forces immediately follow this summary statement. Distilling the essence of all deliberations of all Task Force reports and Methodological reviews, we offer, in this summary statement, evidence-based recommendations and guidelines for the evaluation and management of PHPT. Different from the conclusions of the last workshop, these deliberations have led to revisions of renal guidelines and more evidence for the other recommendations. The accompanying papers present an in-depth discussion of topics summarized in this report. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

This issue features a diverse selection of research articles covering a wide range of topics, including supply chain distribution, economic evaluation of costs, challenges faced by informal traders, the effects of macroprudential regulation, sustainability reporting, well-being in the funeral parlor industry, application of green accounting, self esteem, and job satisfaction among academic staff, science under occupation, oil exchange rates and organizational performance, the efficiency of zakat institutions, corporate social responsibility (CSR) adoption, talent management challenges, business risks, the impact of trust, and the impact of resilience.

Lateral dog ear after mastectomy in overweight or large breasted patients is a source for patient discomfort and is aesthetically unpleasing. Although many different techniques have been proposed, none of them have emerged as standard. In 2012, the authors published their mastectomy technique based on an inverted L-scar incision and closure with a lateral skin flap advanced supero-medially onto the chest wall. Authors sought to report their experience with this technique in patients with wide or large breasts operated with mastectomy without immediate breast reconstruction. As a refinement to their initial technique, they added lipoaspiration to the lateral chest wall.A retrospective study identified 43 patients operated on using the L incision and lipoaspiration from January 2015 to January 2021. Patient and tumor characteristics, operative details, post-operative results, and complications were recorded. Patients were followed-up and assessed for arm motion restriction, lymphedema, and recurrence.The mean age was 68 years; the mean BMI was 29 kg/m 2. The mean follow-up was 32 months. The mean weight of the mastectomy specimen was 1009 g and the mean aspirated volume in the lateral chest wall was 450 mL. One patient had a hematoma, four patients had seroma, and one patient developed a minor wound dehiscence. No skin necrosis or arm movement restriction was observed. Two patients developed mild lymphedema. Three patients underwent delayed breast reconstruction.The proposed technique is a safe and effective method to avoid lateral dog deformity after mastectomy, achieving both functional and cosmetic outcomes.

Patients with solid organ transplant have weaker immune system and can develop opportunistic infections. Prophylactic antimicrobials can help lower that risk but do not prevent it completely. High index of suspicion increases the chance of diagnosing rare opportunistic infections in immunocompromised patients and helps early and effective treatment. We present a unique case of a patient who developed pneumonia from Nocardia early after kidney transplant despite being on trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis. He was diagnosed and treated early which helped improving his outcome. We discuss incidence, risk factors, and treatment of nocardiosis post kidney transplant.

Background and Objectives:Spinal cord infarction (SCInf) is a rare condition where consensus regarding diagnostic criteria is lacking and mis- or delayed diagnosis can be detrimental. The aim of this study was to describe baseline findings and predictors of long-term functional outcome in a population-based cohort of patients with SCInf.Methods:All adult patients (≥18 years) treated at the Spinal Cord Injury Unit of the study center, between 2006–2019, and discharged with a G95 diagnosis(“other and unspecified disease of the spinal cord”) were screened for inclusion. The diagnostic criteria proposed by Zalewski et al. were retrospectively applied to evaluate the certainty of the SCInf diagnosis.Results:270 patients were screened and 57 were included in the study, of whom 30 had a spontaneous and 27 had a periprocedural SCInf. The median American Spinal Cord Injury Association Impairment Scale (AIS) on admission was C, which at median follow-up of 2.1 years had improved to D (p=0.002). Compared to periprocedural cases, spontaneous SCInf showed significantly better admission-AIS (median AIS D vs. B, pDiscussion:SCInf is a rare neurological emergency lacking specific management guidelines. While the presumptive diagnosis is based on the typical presentation and clinical findings, T2-weighted and diffusion-weighted MRI were the most useful diagnostic tools in establishing a definitive diagnosis. Our data shows that spontaneous SCInf mostly affected a single spinal cord segment while periprocedural cases were more extensive, had poorer AIS on admission, poorer ambulatory function, and longer hospital stays. Regardless of the etiology, significant neurological improvements were seen at long-term follow-up, highlighting the importance of active rehabilitation.

Biomass estimation is important in many applications, such as carbon sequestration and precision agriculture. Developing a reliable method for biomass estimation from satellite, airborne and near-surface remote sensing sensors is an ongoing task due to the large uncertainty in current methods, which are often related to sensor limitations. Indeed, signals from optical sensors and synthetic aperture radar at high and medium frequencies suffer from saturation issues at high biomass levels. The Cosmic-Ray Neutron Sensor (CRNS) is a new non-invasive near-surface sensor used primarily to estimate soil water content (SWC), but it has also shown potential for retrieving other hydrological and environmental parameters such as biomass water equivalent and snow depth. The CRNS detects and counts the number of neutrons controlled by hydrogen atoms in the soil, air just above the ground, and vegetation. Biomass attenuates the intensity of cosmic ray neutrons, hence the ability to estimate biomass from a CRNS. Recent studies have used CRNS measurements to estimate biomass changes in crop areas and forest stands, while the use of CRNSs in orchards is limited. The objective of this study is to explore the potential of two CRNSs to estimate the biomass variation in irrigated cherry and olive tree orchards. The olive tree orchard is located in an arid region in northern Saudi Arabia (plantation density of 1667 trees/hectare) with an average tree height of 3 m and canopy diameter of 2 m. The cherry field is located in southern France (plantation density of 260 trees/hectare) with an average tree height of 3.5 m and canopy diameter of 5.5 m. Several soil moisture probes recording soil water content (SWC) at 15-min intervals at both sites were installed at different depths within the CRNS footprint. SWC measurements were used to assess the variations in the sensitivity of CRNS to soil moisture with increasing biomass. Tree parameters (height, canopy width, canopy length, leaf area index, and diameter at breast height) were measured in situ to estimate biomass using allometric equations. In addition, repetitive Light Detection and Ranging (LiDAR) scanning was performed over the cherry field to detect canopy volume changes over time. The results showed that the CRNS is sensitive to SWC variation, and this sensitivity is controlled by biomass evolution, indicating that CNRS measurements can also be used to estimate biomass. The sensitivity of CRNS neutron counts to SWC in the early season (before blooming) was twice as high as that during the mid- and late growing seasons (maximum leaf cover). The Cornish Pasdy model­, which models the measured neutron counts as a function of SWC and biomass contribution, was calibrated and then inverted to estimate the biomass in the cherry and olive tree orchards.

Monitoring the water-uptake rate (WUR) in olive orchards is a key parameter for improving irrigation efficiency and represents an indicator of tree health and yield. Commercial olive orchards extend over large areas and therefore, the use of in-situ sensors to monitor tree WUR, such as the installation of sap flow meters, which are costly and time-consuming to install, are not feasible. The aim of this study is to investigate the potential of C-band Synthetic Aperture Radar (SAR) data acquired by Sentinel-1 with 6-days revisit time to estimate the WUR in very high-density olive orchards in the hot and arid desert climate of Saudi Arabia. A random forest regression (RFR) model was used to calibrate the SAR-derived metrics against WUR measurements recorded by sap flow meters in six plots in 2019, 2020, and 2021. Later, SAR-derived metrics and the coincident WUR measurements were used for RFR optimization and validation. A SAR-derived metric to predict the WUR in a plot at a given Sentinel-1 acquisition date was the difference between the SAR backscattering at that image date and the average SAR backscattering in the second-half of January, when WUR was negligible (around 0.1 L.h-1). The optimized RFR approach provided an accurate estimate of WUR (R2 = 0.86, RMSE = 0.13 [L.h-1]). The optimized RFR was used to operationally map the WUR at the plot level between 2019 and 2021 with a revisit time of 6 days. Results showed that the average WUR over the mapped area co-varied with the average daily air temperature (R2 = 0.82) and inversely co-varied with the average daily air humidity (R2 = 0.58), both recorded by a weather station installed at the study site. These observations support the operational mapping results as they are consistent with the principle of soil-plant-atmosphere interactions, where the WUR generally increases with air temperature and decreases with air humidity. Future work should focus on the assimilation of SAR-derived WUR into water-use models to evaluate the added value of SAR-derived WUR for water resource management in olive orchards.

Integrating remote sensing technology into crop growth models is a viable approach for water resources management and agricultural sustainability assurance since it allows crop water requirements and yield within agricultural fields to be estimated. Saudi Arabia has severely limited renewable water resources and non-renewable groundwater reserves that are rapidly depleting. Unlike rain-fed agriculture, the majority of agricultural water demand in Saudi Arabia is pumped from deep aquifers (up to 1000 m) to irrigate center pivots. This situation entails continuous monitoring of agricultural water use to enhance agricultural water productivity (i.e., producing more crops per drop) and preserve the equilibrium among the water, food, and energy sectors. The main purpose of this study is to calibrate the AquaCrop-OSPy model (an open-source Python implementation of the FAO crop-water productivity model, known as AquaCrop) using field data and Sentinel-2 (S2) images for operational mapping of crop yield, water demand, and water productivity. Another objective is to spatiotemporally estimate the energy requirements and associated CO2 emissions related to groundwater pumping for irrigation. The study area is located in the north of Saudi Arabia. It is a commercial farm with an area of 30,000 hectares comprising more than 200 agricultural fields with center-pivot irrigation systems. The crops cultivated on the farm are wheat and tomato. Field data were collected over three consecutive growing seasons (2019-2020, 2020-2021, and 2021-2022) and include information on wells, pumps, irrigation technique, field management practices, soil parameters, crop parameters, daily meteorological data, actual crop yield, and water use. The AquaCrop-OSPy model was first calibrated and validated using the collected field data as well as S2 images over the three seasons. Subsequently, the fractional vegetation cover (FVC) derived from S2 images was assimilated into the AquaCrop-OSPy model by direct insertion in place of AquaCrop-OSPy's simulated canopy cover (CC). Later, the energy requirements and CO2 emissions associated with irrigation groundwater pumping were estimated using crop water demand information calculated with the calibrated AquaCrop-OSPy model along with pumps and wells data. Coupling the S2-derived FVC and the AquaCrop-OSPy model improved AquaCrop-OSPy predictions of crop water demand, yield, and water productivity as S2 images provide spatialized FVC information every 6-days. This integration further permitted a robust quantification of the energy requirements and CO2 emissions associated with groundwater pumping for irrigation. These results, when applied to larger scales and multiple crops, can help develop a comprehensive understanding of the water-energy-agriculture nexus and indicate potential improvements in AquaCrop-OSPy estimates that could be achieved once remote sensing data are integrated.

Mangroves are essential ecosystems composed of salt-tolerant plants that grow in tropical and subtropical intertidal zones, acting as a vital link between aquatic and terrestrial ecosystems. Interest in mangrove preservation and restoration has been increasing in recent years due to their important role in climate regulation by capturing and preserving carbon. Despite their importance, these ecosystems are under huge pressure due to human activities. It is estimated that these environments have lost up to half of the area occupied under pristine conditions. Leaf area index (LAI) is a well-known biophysical parameter related to plant health, as it provides information on the water, energy, and CO2 exchange between plants and the atmosphere. Unmanned aerial vehicles (UAVs) have emerged in recent years as a viable solution for ecosystem monitoring, as they allow for rapid and frequent data acquisition of a wide range of wavelengths. In this work, we evaluated the potential of multispectral images acquired by a UAV to estimate the LAI of a mangrove (Avicennia marina) forest located in the coastal area of the Red Sea in the Kingdom of Saudi Arabia. Multicollinearity assessment was performed to select significant variables suited for estimating LAI, including five multispectral bands, a canopy height model, and eight vegetation indices. Multicollinearity assessment was performed with three approaches: the Least Absolute Shrinkage and Selection Operator (LASSO), Random Forest (RF) for variable selection, and Hierarchical Cluster Analysis (HCA). The capability of significant variables to estimate LAI was assessed using the Generalized Linear Model (GLM), RF and Support Vector Machine (SVM). Results showed high estimation accuracy of LAI (R² = 0.91 for GLM, R² = 0.89 for RF and R² = 0.90 for SVM). However, further analysis showed that it is possible to estimate LAI of the mangrove forest with reasonable accuracy (R² = 0.87 for GLM, R² = 0.78 for RF and R² = 0.87 for SVM) using only two variables, the canopy height model and the GreenNDVI. The same variables were used to estimate LAI at another mangrove site and similar results were obtained (R² = 0.74 for GLM, R² = 0.73 for RF and R² = 0.68 for SVM).

Context The risk of fragility fractures is increased in both type 1 and type 2 diabetes. Numerous biochemical markers reflecting bone and/or glucose metabolism have been evaluated in this context. Objective This review summarizes current data on biochemical markers in relation to bone fragility and fracture risk in diabetes. Methods A group of experts from the International Osteoporosis Foundation and European Calcified Tissue Society reviewed the literature focusing on biochemical markers, diabetes, diabetes treatments, and bone in adults. Results Although bone resorption and bone formation markers are low and poorly predictive of fracture risk in diabetes, osteoporosis drugs seem to change bone turnover markers (BTMs) in diabetics similarly to nondiabetics, with similar reductions in fracture risk. Several other biochemical markers related to bone and glucose metabolism have been correlated with bone mineral density and/or fracture risk in diabetes, including osteocyte-related markers such as sclerostin, glycated hemoglobin A1c (HbA1c) and advanced glycation end products, inflammatory markers, and adipokines, as well as insulin-like growth factor-1 and calciotropic hormones. Conclusion Several biochemical markers and hormonal levels related to bone and/or glucose metabolism have been associated with skeletal parameters in diabetes. Currently, only HbA1c levels seem to provide a reliable estimate of fracture risk, while BTMs could be used to monitor the effects of antiosteoporosis therapy.

The environment and the exposure individuals carry throughout their lifetime can gar- ner diverse effects on their health. This paper discusses the application of association analysis, to determine relationships between carcinogenesis and the human exposome. Human exposome data from the World Health Organization was analyzed to determine associations between human exposure and breast cancer. The discovered associations outline specific factors that may be associated with the prevention or causation of breast cancer. We discovered an association between biomarkers in specific biospecimens and breast cancer. Xanthophylls, measured in two different biospecimens, were determined to be associated with American breast cancer patients. The associations discovered may be of use in future cancer studies. This research is particularly interesting because of xanthophylls’ relationship to retinol, inhibiting oncogenesis. Providing support and data for such associations will encourage more research on the exposome’s effect on breast cancer and other conditions.

Dialogue generation is the automatic generation of a text response, given a user’s input. Dialogue generation for low-resource languages has been a challenging tasks for researchers. However, the advancements in deep learning models have made developing conversational agents that perform the tasks of dialogue generation not only possible, but also effective and helpful in many applications spanning a variety of domains. Nevertheless, work on conversational bots for low-resource languages such as the Arabic language is still limited due to various challenges including the language structure, vocabulary, and the scarcity of its data resources. Meta-learning has been introduced before in the natural language processing (NLP) realm and showed significant improvements in many tasks; however, it has rarely been used in natural language generation (NLG) tasks and never in Arabic NLG. In this work, we propose a meta-learning approach for Arabic dialogue generation for fast adaptation on low resource domains, namely Arabic. We start by using existing pre-trained models; we then meta-learn the initial parameters on high resource dataset before fine-tuning the parameters on the target tasks. We prove that the proposed model that employs meta-learning techniques improves generalization and enables fast adaptation of the transformer model on low-resource NLG tasks. We report gains in the BLEU-4 and improvements in Semantic textual Similarity (STS) metrics when compared to the existing state-of-the-art approach. We also do a further study on the effectiveness of the meta-learning algorithms on the response generation of the models.

Background Social distancing restrictions to manage the COVID-19 pandemic were put in place from March 2020 in the United Kingdom (UK), with those classed as “highly clinically vulnerable” advised to shield entirely and remain at home. However, personal risk perception has been shown to comprise of various elements beyond those outlined in the national pandemic guidance. It is unclear whether those deemed COVID-19 vulnerable identified as high-risk to COVID-19 and thus complied with the relevant advice. The aim of this research is to explore the perception of risk in catching and spreading COVID-19, amongst individuals from individual households, and vulnerable groups in a region of the UK. Methods Two individual, semi-structured interviews were conducted, four-weeks apart, with adults living in households in the Liverpool City Region. At the follow-up interview, participants were given the option of using photo-elicitation to guide the discussion. Reflexive thematic analysis was employed to conceptualise themes. The qualitative analysis was underpinned with symbolic interactionism. Results Twenty-seven participants (13:14 males:females, and 20 with a vulnerable risk factor to COVID-19) completed a baseline interview, and 15 of these completed a follow-up interview four-weeks later. Following thematic analysis, two overarching themes were conceptualised, with subthemes discussed: theme 1) Confusion and trust in the risk prevention guidance; and theme 2) Navigating risk: compliance and non-compliance with public health guidance. Conclusion Participants developed their own understanding of COVID-19 risk perception through personal experience and comparison with others around them, irrespective of vulnerability status. COVID-19 guidance was not complied with as intended by the government, and at times even rejected due to lack of trust. The format in which future pandemic guidance is conveyed must be carefully considered, and take into account individuals’ experiences that may lead to non-compliance. The findings from our study can inform future public health policy and interventions for COVID-19 and future pandemics.

Key resource table with RRID

Supplementary table S3