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While major advances have been made over the past years in comparing citizenship laws globally, most measures remain restricted to the law-on-the-books. Knowledge about the implementation of these laws remains limited. This poses the question to what extent these measures correspond with the law as experienced by targeted populations. In order to overcome the implementation gap when comparing and measuring citizenship law globally, this paper addresses the question of how to gain a coherent understanding of implementation. Developing a comprehensive typology, the paper distinguishes three crucial elements of implementation: (1) the entry into force of legal provisions (capturing the applicable state of citizenship law), (2) the interpretation of law (the specific interpretation of legal provisions used by the authorities responsible for their execution), and (3) the application of law (executing legal provisions in practice by the authorities). Subsequently, the paper illustrates how this typology can be applied to the analysis of citizenship law implementation by a case study of dual citizenship acceptance, focusing on the renunciation requirement for naturalisation and dual citizenship treaties. The paper concludes by outlining directions for a comparative research agenda that better corresponds with the lived experience of citizenship laws. [ABSTRACT FROM AUTHOR]

There are limited comparative studies on modeling fluid transport in fractured porous media. Hence, this paper systematically compares the steady-state creeping flow Stokes–Brinkman and Darcy–Darcy models for computational efficiency and accuracy. Sensitivity analyses were also conducted on the effect of fracture orientations, fracture sizes, mesh resolution, and fractures with Local Grid Refinement (LGR) under the FEniCS computational framework. Both models were validated numerically, and the accuracy of their solution is compared using the R-squared metric and L2 norm estimates. Key results showed that both models have similar pressure and velocity field solutions for a given fracture orientation. The computational time required for solving the Stokes–Brinkman models for a single fracture case was unusually lower than that of the Darcy–Darcy model when the pressure and velocity terms in the Darcy–Darcy model were solved simultaneously using two equations, contrary to where only one equation solves for the pressure and the velocity is obtained by projecting the gradient of pressure onto a vector space. The Stokes–Brinkman model is more sensitive to mesh resolution, and as a result, the Darcy–Darcy model tends to be more accurate than the Stokes–Brinkman model at low resolutions. Local Grid Refinement (LGR) can improve the Stokes–Brinkman model's accuracy at low mesh resolution. Furthermore, both models showed similar results when compared for complex fracture systems such as multiple fracture cases: interconnecting and isolated fractured porous media systems under low-velocity and steady-state creeping flow conditions. The FEniCS code in this paper is shared for future researchers to reproduce results or extend the research work. [ABSTRACT FROM AUTHOR]

Extensive research on the multi-bridge extension of cascaded rectifier stages is deemed important to meet the requirements of high-voltage and high-power applications. Two control structures for capacitor voltage balancing in cascaded rectifier stages are analyzed in this paper. On this basis, the balance strategy for the multi-bridge extension of single-phase cascaded rectifiers is explored. The balance method of ultra-fast balance modulation trajectories is introduced into single-phase multi-bridge cascaded rectification, and the optimal control strategy is selected through simulation verification and comparative analysis. During the actual experiments, some disturbance factors were introduced into the system, causing an instantaneous unbalanced state. However, through the control strategy proposed in this paper, the system can quickly regain balance. Through simulation validation and analysis of the experimental results, the reliability and innovation of this control strategy have been demonstrated. [ABSTRACT FROM AUTHOR]

Background: One of the potential dimensions on which exclusion and injustice may occur in energy transitions is age. Age-based patterns of exclusion—ageism—has recently been conceptualized in the context of decarbonization as energy ageism. This paper offers a comparative empirical analysis of the senior citizens' outlook towards an imminent energy transition as well as the impact of energy poverty in two European countries: Norway and Poland. Results: Drawing on interviews and focus groups with Polish and Norwegian seniors, we present the differences and similarities between the two countries, and the determinants of energy ageism, as well as the concept's overall applicability and empirical usefulness. We find that socioeconomic conditions outweigh ageism, that is, the resilience of senior citizens in dealing with energy poverty during a transition is conditioned by their material standing and welfare state robustness rather than age based. An important factor is household heating technology, combined with economic vulnerability can push some individuals into energy poverty, while others using alternative sources of heat can navigate through energy crises unscathed. Conclusions: We note the importance of mainstreaming social inclusion considerations in energy policy and of targeted digital competence building which can enhance senior citizen integration in the energy transition. Lower levels of digital competences among senior citizens certainly play a role and need to be addressed with education programs to increase participation. In both countries, household heating is a major issue and heating sources are strong predictors of energy poverty and regulatory measures and subsidies should be designed at national, regional, and municipal level to assist vulnerable groups in this area. [ABSTRACT FROM AUTHOR]

This paper analyzed the role of national economic factors, in addition to some key city-level variables, in the variation of the urban green space (UGS) in Mashhad City (Iran) during three decades (1998–2018). The correlation result revealed the effects of the increasing trend of land price, population rate, and construction of built-up areas in the decreasing trend of UGS in the study area (R from − 0.95 to -0.99 at p-value > 95%). Also, the country-level economic factors, i.e., GDP per capita, oil price, export total value, and FDI, represented the overall increasing trend from 1988 to 2018, correlating with the decrease of green space areas (R from − 0.76 to -0.92 at p-value > 75%). Some statistical analyses, such as the run-test, the skewness and kurtosis tests, the Kolmogorov-Smirnov test, and the ANOVA test were done to confirm the normality of the data distribution and reliability of the results. Ultimately, clustering the research variables based on the significance and confidence levels of the estimated correlation results revealed that the change in the oil price and national export values in the petroleum-dependent economy of Iran can be assumed as the lead key economic factors to fluctuate all city-level variables, particularly the UGS variations. [ABSTRACT FROM AUTHOR]

In this paper, a wideband polarization conversion metasurface is designed. Additionally, coding and chessboard metasurfaces are specifically tailored for radar cross-section reduction (RCS). Initially, a compact unit cell demonstrating exceptional polarization conversion performance is introduced, achieving a polarization conversion ratio (PCR) exceeding 90 % across frequencies ranging from 7.9 to 22.7 GHz. The PCR remains effective even when oblique incidence angles of up to 30 ∘ are utilized across this frequency band. Roger RT5880, with a thickness of 0.254 mm, serves as the substrate. An airgap is introduced between the substrate and the ground plane to enhance the polarization conversion bandwidth. This unit cell serves as the fundamental building block for subsequent metasurface configurations. To assess the scalability and effectiveness, a 36 × 36 unit array is assembled, confirming efficient polarization conversion capabilities extending to larger structures. Moreover, a 1-bit coding unit "0" and "1" are formed by the Pancharatnam-Berry phase based on the same-sized meta-atom with 90 ∘ orientations. The robustness and practicality of the design are demonstrated by creating 12 × 12 lattices and evaluating their RCS reduction potential under two distinct scenarios: a chessboard pattern and a coding-based scheme. Notably, its results indicate substantial RCS reduction across a broad frequency spectrum (7.9 to 22.7 GHz) for both configurations. This study demonstrates the wide-ranging applicability of metasurface design, making it a valuable contribution to the fields of microwave engineering, polarization control, and radar stealth technology. Owing to its simplicity, bandwidth, and versatility, this approach offers innovative solutions for diverse real-world applications. [ABSTRACT FROM AUTHOR]

Handwriting-based technologies have progressed significantly over the years. Scientists have worked beyond just recognizing pieces of plain text from paper. With archaeological advancements, discovery of ancient documents has not been as scarce as it was in the past. However, such documents are discovered in perfect condition once in a blue-moon. They are often subjected to degradation due to the perils of time and understanding them requires skilled manpower which is not easy to find. Here, an automated system is proposed for this task. The proposed system uses a new CNN-based framework to analyze the macro and micro features of an image to recognize the text. Experiments are performed with over 250K historical images of numerals from a publicly available dataset and a highest accuracy of 99.68% is obtained. The data is further subjected to different type of noises and distortions. A novel technique is used to introduce synthesized degradation in the documents. The system performs steadily in all these experimental scenarios. Comparative analysis indicates that our results are higher than the reported works and other standard techniques. [ABSTRACT FROM AUTHOR]

Background: Established health-related quality of life scores do not consider both subjective and objective indices of health. We propose the subjective and objective quality of life score (SOQOL) for the comprehensive assessment of health-related quality of life and aim to provide normative population data. The SOQOL is compatible with smartphone applications, allowing widespread use on a global scale. Methods: Normative SOQOL population data was sourced from pre-existing datasets on the EQ-5D-5L, daily step count, and walking speed. Normative values were calculated using weighted grand means. We trialled the SOQOL in a group of five patients presenting to a spinal neurosurgery clinic. Results: SOQOL scores decreased with age, and women had lower scores in every age group. In our case series, the spine patients with the biggest SOQOL deficit compared to age- and sex-matched population averages were found to be surgical while the rest were non-surgical. Conclusions: The SOQOL shows promise as a simple and effective scoring tool that is compatible with smartphones, potentially useful for screening in primary and specialized care settings, and for assessment following healthcare interventions. This study, however, is preliminary, and the findings are primarily suggestive. They underline the necessity for future, more comprehensive studies to validate and expand upon these initial observations. The conclusion of both this abstract and the full paper will clearly state these limitations and the preliminary nature of the study. [ABSTRACT FROM AUTHOR]

This study examines Einstein's field equations in the context of general relativity, comparing five distinct methodologies: (a) vanishing complexity, (b) embedding class one or the Karmarkar condition, (c) conformally flat spacetime, (d) conformal killing symmetry, and (e) the Karmarkar scalar condition. The first four methods reveal a significant connection between two metric potentials, while the fifth method provides a coordinate-independent condition expressed in terms of structural scalars. The paper provides a comprehensive comparative analysis of a new exact solution derived by assuming a common metric function and solving the remaining metric functions through corresponding bridge equations to evaluate their effectiveness and validity. Critical parameters such as thermodynamic factors, causality conditions, stability, and mass function analysis are investigated. [ABSTRACT FROM AUTHOR]

Pairwise comparisons have been a long-standing technique for comparing alternatives/criteria and their role has been pivotal in the development of modern decision-making methods such as the Analytic Hierarchy/Network Process (AHP/ANP), the Best-Worst method (BWM), PROMETHEE and many others. Pairwise comparisons can be performed within several frameworks such as multiplicative, additive and fuzzy representations of preferences, which are particular instances of a more general framework based on Abelian linearly ordered groups. Though multiplicative, additive and fuzzy representations of preferences are widely used in practice, it is unknown whether decision makers are equally precise in the three aforementioned representations when they measure objective data. Therefore, the aim of this paper is to design, carry out and analyse an experiment with over 200 respondents (undergraduate university students) from two countries, Czechia and Italy, to compare precision of the respondents in all three representations. In the experiment, respondents pairwise compared (by approximation) the areas of four geometric figures and then, the imprecision of their assessments was measured by computing the distance with the exact pairwise comparisons. We grouped the respondents in such a way that each participant was allowed to deal with a unique type of representation. The outcomes of the experiment indicate that the multiplicative approach is the most precise. [ABSTRACT FROM AUTHOR]

In the realm of multiprocessor systems, the evaluation of interconnection network reliability holds utmost significance, both in terms of design and maintenance. The intricate nature of these systems calls for a systematic assessment of reliability metrics, among which, two metrics emerge as vital: connectivity and diagnosability. The R g -conditional connectivity is the minimum number of processors whose deletion will disconnect the multiprocessor system and every processor has at least g fault-free neighbors. The R g -conditional diagnosability is a novel generalized conditional diagnosability, which is the maximum number of faulty processors that can be identified under the condition that every processor has no less than g fault-free neighbors. In this paper, we first investigate the R g -conditional connectivity of generalized exchanged X-cubes G E X (s , t) and present the lower (upper) bounds of the R g -conditional diagnosability of G E X (s , t) under the PMC model. Applying our results, the R g -conditional connectivity and the lower (upper) bounds of R g -conditional diagnosability of generalized exchanged hypercubes, generalized exchanged crossed cubes, and locally generalized exchanged twisted cubes under the PMC model are determined. Our comparative analysis highlights the superiority of R g -conditional diagnosability, showcasing its effectiveness in guiding reliability studies across a diverse set of networks. [ABSTRACT FROM AUTHOR]

This Special Section explores the interplay between Indigenous peoples, industry, and the state in five proposed and active mining projects in Canada and Sweden. The overall aim is to identify factors shaping the quality of Indigenous community-industry-state interactions in mining and mine development. An ambition underlying the research is to develop knowledge to help manage mining related land-use conflicts in Sweden by drawing on Canadian comparisons and experience. This paper synthesizes the comparative research that has been conducted across jurisdictions in three Canadian provinces and Sweden. It focuses on the interplay between the properties of the governance system, the quality of interaction and governance outcomes. We combine institutional and interactive governance theory and use the concept of governability to assess how and why specific outcomes, such as mutually beneficial interaction, collaboration, or opposition, occurred. The analysis suggests there are measures that can be taken by the Swedish Government to improve the governability of mining related issues, by developing alternative, and more effective, avenues to recognize, and protect, Sámi rights and culture, to broaden the scope and increase the legitimacy and transparency of the EIAs, to raise the quality of interaction and consultation, and to develop tools to actively stimulate and support collaboration and partnerships on equal terms. Generally, we argue that Indigenous community responses to mining must be understood within a larger framework of Indigenous self-determination, in particular the communities' own assessments of their opportunities to achieve their long-term objectives using alternative governing modes and types of interactions. [ABSTRACT FROM AUTHOR]

This study addresses the challenge of deformation and failure on loess slopes, predominantly triggered by rainfall, by evaluating the efficacy of various slope protective measures. Recognizing the escalating preference for ecological protection techniques, this paper focuses on identifying optimal strategies that align with local rainfall patterns. A comprehensive analysis of loess slopes under diverse rainfall conditions was conducted, encompassing scenarios with prime soil, stabilized soil, and no protection. Utilizing the finite element software ABAQUS, a sophisticated rainfall infiltration slope model was developed and validated against experimental data. The investigation reveals that under low rainfall intensities, the choice of protective material—whether stabilized or prime soil—exerts limited influence on slope pore pressure. In contrast, at higher rainfall intensities, the impact of these protective materials on slope stability becomes significantly more pronounced. [ABSTRACT FROM AUTHOR]

This work compares the electroanalytical performance of two electroanalytical systems based on (1) the glassy carbon electrode (GCE), and (2) the electrified liquid–liquid interface (eLLI), for the detection of fluoroquinolone antibiotic–danofloxacin (DANO). Our aim was to define the optimal conditions to detect the chosen analyte with two employed systems, extract a number of electroanalytical parameters, study the mechanism of the charge transfer reactions (oxidation at GCE and ion transfer across the eLLI), and to provide physicochemical constants for DANO. Detection of the chosen analyte was also performed in the spiked milk samples. To the best of our knowledge, this is the first work that directly compares the electroanalytical parameters obtained with solid electrode (in this case GCE) and eLLI. We have found that for DANO the latter provides better electroanalytical parameters (lower LOD and LOQ) as well as good selectivity when the milk was analyzed. [ABSTRACT FROM AUTHOR]

Glycosylated derivatives of natural product polyphenols display a spectrum of biological activities, rendering them critical for both nutritional and pharmacological applications. Their enzymatic synthesis by glycosyltransferases is frequently constrained by the limited repertoire of characterized enzyme-catalyzed transformations. Here, we explore the glycosylation capabilities and substrate preferences of newly identified plant uridine diphosphate (UDP)-dependent glycosyltransferases (UGTs) within the UGT72 and UGT84 families, with particular focus on natural polyphenol glycosylation from UDP-glucose. Four UGTs are classified according to their phylogenetic relationships and reaction products, identifying them as biocatalysts for either glucoside (UGT72 enzymes) or glucose ester (UGT84 members) formation from selected phenylpropanoid compounds. Detailed kinetic evaluations expose the unique attributes of these enzymes, including their specific activities and regio-selectivities towards diverse polyphenolic substrates, with product characterizations validating the capacity of UGT84 family members to perform di-O-glycosylation on flavones. Sequence analysis coupled with structural predictions through AlphaFold reveal an unexpected absence of a conserved threonine residue across all four enzymes, a trait previously linked to pentosyltransferases. This comparative analysis broadens the understood substrate specificity range for UGT72 and UGT84 enzymes, enhancing our understanding of their utility in the production of natural phenolic glycosides. The findings from this in-depth characterization provide valuable insights into the functional versatility of UGT-mediated reactions. Uridine diphosphate-dependent glycosyltransferases (UGTs) play a vital role in the biocatalytic glycosylation of phenolic compounds, however, UGT-catalyzed transformations remain not well-characterized. Here, the authors investigate new members of UGT72 and UGT84 families, revealing their specific reactivity and regio-selectivity on selected polyphenolic substrates. [ABSTRACT FROM AUTHOR]

Background: The word-in-noise discrimination test evaluates the phonological aspect of speech based on the detection of the vowels. While word-in-noise perception (WINP) test is one of the speech perception exams and evaluates the ability to understand the meaning of words by discovering the consonants. Until now, all word-in-noise tests have assessed speech discrimination performance, and for the first time, the normal values of the WINP test for adults have been determined. Since the normal values of WINP scores in children have not been reported, our research aimed to determine the normal values of the WINP test in children aged 5 to 13 years. In this cross-sectional study, 120 Persian speaking Iranain children with normal hearing thresholds were evaluated from the beginning to the end of spring 2023. We divided them into 4 age groups (A = 5–7 < years, B = 7–9 < years, C = 9–11 < years, D = 11–13 < years). The evaluations included general audiology tests and WINP tests using homtonic-monosyllabic words (HMWs) at a signal-to-noise ratio of 5 dB. Results: Significant difference was observed between the mean scores of the WINP test in age group A (54%) compared to age group B (66%), (Pv = 0.04). Also, the differences between the mean scores of age group A compared to age groups C (70%) and D (69%) were significant (Pv = 0.01, Pv = 0.03). Conclusions: This article presented the norm values of WINP test scores for Persian speaking Iranian children aged 5 to 13 years. The norm values of WINP test scores in the age group of 5–7 years were lower than in the age groups of 7–13 years. The biggest change in the performance of speech perception in noise was observed in the age range of 7–9 years. [ABSTRACT FROM AUTHOR]

Veronica anagallis-aquatica L. and Veronica undulata Wall. are widely used ethnomedicinal plants in China. The two species have different clinical efficacies, while their extremely similar morphology and unclear interspecific relationship make it difficult to accurately identify them, leading to increased instances of mixed usage. This article reports on the complete chloroplast genomes sequence of these two species and their related Veronica species to conduct a comparative genomics analysis and phylogenetic construction. The results showed that the chloroplast (cp) genomes of Veronica exhibited typical circular quadripartite structures, with total lengths of 149,386 to 152,319 base pairs (bp), and GC content of 37.9 to 38.1%, and the number of genes was between 129–134. The total number of simple sequence repeats (SSRs) in V. anagallis-aquatica and V. undulata is 37 and 36, while V. arvensis had the highest total number of 56, predominantly characterized by A/T single bases. The vast majority of long repeat sequence types are forward repeats and palindromic repeats. Selective Ka/Ks values showed that three genes were under positive selection. Sequence differences often occur in the non-coding regions of the large single-copy region (LSC) and small single-copy region (SSC), with the lowest sequence variation in the inverted repeat regions (IR). Seven highly variable regions (trnT-GGU-psbD, rps8-rpl16, trnQ-UUG, trnN-GUU-ndhF, petL, ycf3, and ycf1) were detected, which may be potential molecular markers for identifying V. anagallis-aquatica and V. undulata. The phylogenetic tree indicates that there is a close genetic relationship between the genera Veronica and Neopicrorhiza, and V. anagallis-aquatica and V. undulata are sister groups. The molecular clock analysis results indicate that the divergence time of Veronica may occur at ∼ 9.09 Ma, and the divergence time of these two species occurs at ∼ 0.48 Ma. It is speculated that climate change may be the cause of Veronica species diversity and promote the radiation of the genus. The chloroplast genome data of nine Veronica specie provides important insights into the characteristics and evolution of the chloroplast genome of this genus, as well as the phylogenetic relationships of the genus Veronica. [ABSTRACT FROM AUTHOR]

This study addresses the vital role of engine dampers in reducing vibrations and enhancing ride comfort in quad bikes. Utilizing ANSYS modal analysis and CATIA V5 design, the research aims to optimize damper design by assessing natural frequencies and potential resonance in the cage structure and engine. Through extensive analysis, the study evaluates vibrations transmitted from the engine to the chassis, crucial for understanding and improving overall vehicle performance. Neoprene rubber emerges as the optimal material for vibration dampers, offering superior density, elasticity, stiffness, and damping coefficient. Comparative analysis reveals that Design 3 of the dampers significantly outperforms Design 2 and Design 1, showcasing a remarkable 62% reduction in vibration. However, the study underscores the influence of various factors, such as application specificity and vibration characteristics, on damper effectiveness. Thus, while Design 3 may excel under certain conditions, careful consideration of diverse a variable is essential for optimal damper selection and performance across different engine types and operational contexts. [ABSTRACT FROM AUTHOR]

Background: The clinical value of the trajectory of temporal changes in acute kidney injury (AKI) biomarkers has not been well established among intensive care unit (ICU) patients. Methods: This is a single-center, prospective observational study, performed at a mixed ICU in a teaching medical institute in Tokyo, Japan. Adult ICU patients with an arterial line and urethral catheter were enrolled from September 2014 to March 2015. Patients who stayed in the ICU for less than 48 h and patients with known end-stage renal disease were excluded from the study. Blood and urine samples were collected for measurement of AKI biomarkers at 0, 12, 24, and 48 h after ICU admission. The primary outcome was major adverse kidney events (MAKE) at discharge, defined as a composite of death, dialysis dependency, and persistent loss of kidney function (≥ 25% decline in eGFR). Results: The study included 156 patients. Serum creatinine-based estimated glomerular filtration rate (eGFR), plasma neutrophil gelatinase-associated lipocalin (NGAL), and urinary liver-type fatty acid-binding protein (uL-FABP) were serially measured and each variable was classified into three groups based on group-based trajectory modeling analysis. While the trajectory curves moved parallel to each other (i.e., "low," "middle," and "high") for eGFR and plasma NGAL, the uL-FABP curves showed distinct trajectory patterns and moved in different directions ("low and constant," "high and exponential decrease," and "high and exponential increase"). These trajectory patterns were significantly associated with MAKE. MAKE occurred in 16 (18%), 16 (40%), and 9 (100%) patients in the "low and constant," "high and exponential decrease," and "high and exponential increase" groups, respectively, based on uL-FABP levels (p-value < 0.001). The initial value and the 12-h change in uL-FABP were both significantly associated with MAKE, even after adjusting for eGFR [Odds ratio (95% confidence interval): 1.45 (1.17–1.83) and 1.43 (1.12–1.88) for increase of initial value and 12-h change of log-transformed uL-FABP by 1 point, respectively]. Conclusions: Trajectory pattern of serially measured urinary L-FABP was significantly associated with MAKE in ICU patients. [ABSTRACT FROM AUTHOR]

Advances in neural machine translation utilizing pretrained language models (PLMs) have shown promise in improving the translation quality between diverse languages. However, translation from English to languages with complex morphology, such as Arabic, remains challenging. This study investigated the prevailing error patterns of state-of-the-art PLMs when translating from English to Arabic across different text domains. Through empirical analysis using automatic metrics (chrF, BERTScore, COMET) and manual evaluation with the Multidimensional Quality Metrics (MQM) framework, we compared Google Translate and five PLMs (Helsinki, Marefa, Facebook, GPT-3.5-turbo, and GPT-4). Key findings provide valuable insights into current PLM limitations in handling aspects of Arabic grammar and vocabulary while also informing future improvements for advancing English–Arabic machine translation capabilities and accessibility. [ABSTRACT FROM AUTHOR]

Background: The wingless signaling pathway of bone development is inhibited by sclerostin, which may contribute to the etiology of ankylosing spondylitis. Aim: The study aimed to evaluate serum sclerostin levels in ankylosing spondylitis patients and investigate how it correlated with radiographic damage using the Spondylo-arthritis Research Consortium of Canada index (SPARCC), disease activity, and functional impairment. Results: This cross-sectional case–control study revealed a significantly lower mean serum sclerostin (11.28 ng/ml) in AS patients compared with controls (101.25 ng/ml). Serum sclerostin levels showed a significant negative correlation with each of Bath Ankylosing Spondylitis Metrology Index (BASMI) (p = 0.043), sacroiliac joints SPARCC, spine SPARCC, and overall SPARCC scores (p = 0.012, p = 0.036, and p = 0.007). The detection of AS, serum sclerostin levels ≤ 20 ng/ml showed 100% sensitivity and specificity. Conclusion: Serum sclerostin had good discriminating power between ankylosing spondylitis cases and healthy control individuals and was correlated with subclinical activity status on magnetic resonance imaging. [ABSTRACT FROM AUTHOR]

6–11-year-old children provide a critical window for physical activity (PA) interventions. The Virtual Fitness Buddy ecosystem is a precision health PA intervention for children integrating mixed reality technology to connect people and devices. A cluster randomized, controlled trial was conducted across 19 afterschool sites over two 6-month cohorts to test its efficacy in increasing PA and decreasing sedentary behavior. In the treatment group, a custom virtual dog via a mixed reality kiosk helped children set PA goals while sharing progress with parents to receive feedback and support. Children in the control group set PA goals using a computer without support from the virtual dog or parents. 303 children had 8+ hours of PA data on at least one day of each of the 3 intervention time intervals. Conversion of sedentary time was primarily to light-intensity PA and was strongest for children with low baseline moderate-to-vigorous PA than children above 45 min of baseline moderate-to-vigorous PA. Findings suggest that the VFB ecosystem can promote sustainable PA in children and may be rapidly diffused for widespread public health impact. [ABSTRACT FROM AUTHOR]

Background: COVID-19-associated pulmonary fibrosis remains frequent. This study aimed to investigate pulmonary redox balance in COVID-19 ARDS patients and possible relationship with pulmonary fibrosis and long-term lung abnormalities. Methods: Baseline data, chest CT fibrosis scores, N-terminal peptide of alveolar collagen III (NT-PCP-III), transforming growth factor (TGF)-β1, superoxide dismutase (SOD), reduced glutathione (GSH), oxidized glutathione (GSSG) and malondialdehyde (MDA) in bronchoalveolar lavage fluid (BALF) were first collected and compared between SARS-CoV-2 RNA positive patients with moderate to severe ARDS (n = 65, COVID-19 ARDS) and SARS-CoV-2 RNA negative non-ARDS patients requiring mechanical ventilation (n = 63, non-ARDS). Then, correlations between fibroproliferative (NT-PCP-III and TGF-β1) and redox markers were analyzed within COVID-19 ARDS group, and comparisons between survivor and non-survivor subgroups were performed. Finally, follow-up of COVID-19 ARDS survivors was performed to analyze the relationship between pulmonary abnormalities, fibroproliferative and redox markers 3 months after discharge. Results: Compared with non-ARDS group, COVID-19 ARDS group had significantly elevated chest CT fibrosis scores (p < 0.001) and NT-PCP-III (p < 0.001), TGF-β1 (p < 0.001), GSSG (p < 0.001), and MDA (p < 0.001) concentrations on admission, while decreased SOD (p < 0.001) and GSH (p < 0.001) levels were observed in BALF. Both NT-PCP-III and TGF-β1 in BALF from COVID-19 ARDS group were directly correlated with GSSG (p < 0.001) and MDA (p < 0.001) and were inversely correlated with SOD (p < 0.001) and GSH (p < 0.001). Within COVID-19 ARDS group, non-survivors (n = 28) showed significant pulmonary fibroproliferation (p < 0.001) with more severe redox imbalance (p < 0.001) than survivors (n = 37). Furthermore, according to data from COVID-19 ARDS survivor follow-up (n = 37), radiographic residual pulmonary fibrosis and lung function impairment improved 3 months after discharge compared with discharge (p < 0.001) and were associated with early pulmonary fibroproliferation and redox imbalance (p < 0.01). Conclusions: Pulmonary redox imbalance occurring early in COVID-19 ARDS patients drives fibroproliferative response and increases the risk of death. Long-term lung abnormalities post-COVID-19 are associated with early pulmonary fibroproliferation and redox imbalance. Highlights: Altering pulmonary redox balance drives an early pulmonary fibroproliferative response in COVID-19 ARDS. Pulmonary redox imbalance and fibroproliferation increase the risk of death in COVID-19 ARDS. Approximately 60% of moderate to severe COVID-19 ARDS survivors suffer residual pulmonary fibrosis and lung function impairment 3 months after hospital discharge. Pulmonary redox imbalance and fibroproliferation affect the resolution of residual pulmonary fibrosis and recovery from lung function impairment post-COVID-19. [ABSTRACT FROM AUTHOR]

Through technological innovations, patient cohorts can be examined from multiple views with high-dimensional, multiscale biomedical data to classify clinical phenotypes and predict outcomes. Here, we aim to present our approach for analyzing multimodal data using unsupervised and supervised sparse linear methods in a COVID-19 patient cohort. This prospective cohort study of 149 adult patients was conducted in a tertiary care academic center. First, we used sparse canonical correlation analysis (CCA) to identify and quantify relationships across different data modalities, including viral genome sequencing, imaging, clinical data, and laboratory results. Then, we used cooperative learning to predict the clinical outcome of COVID-19 patients: Intensive care unit admission. We show that serum biomarkers representing severe disease and acute phase response correlate with original and wavelet radiomics features in the LLL frequency channel (cor(Xu1, Zv1) = 0.596, p value < 0.001). Among radiomics features, histogram-based first-order features reporting the skewness, kurtosis, and uniformity have the lowest negative, whereas entropy-related features have the highest positive coefficients. Moreover, unsupervised analysis of clinical data and laboratory results gives insights into distinct clinical phenotypes. Leveraging the availability of global viral genome databases, we demonstrate that the Word2Vec natural language processing model can be used for viral genome encoding. It not only separates major SARS-CoV-2 variants but also allows the preservation of phylogenetic relationships among them. Our quadruple model using Word2Vec encoding achieves better prediction results in the supervised task. The model yields area under the curve (AUC) and accuracy values of 0.87 and 0.77, respectively. Our study illustrates that sparse CCA analysis and cooperative learning are powerful techniques for handling high-dimensional, multimodal data to investigate multivariate associations in unsupervised and supervised tasks. [ABSTRACT FROM AUTHOR]

Myelodysplastic syndrome is primarily characterized by dysplasia in the bone marrow (BM), presenting a challenge in consistent morphology interpretation. Accurate diagnosis through traditional slide-based analysis is difficult, necessitating a standardized objective technique. Over the past two decades, imaging flow cytometry (IFC) has proven effective in combining image-based morphometric analyses with high-parameter phenotyping. We have previously demonstrated the effectiveness of combining IFC with a feature-based machine learning algorithm to accurately identify and quantify rare binucleated erythroblasts (BNEs) in dyserythropoietic BM cells. However, a feature-based workflow poses challenges requiring software-specific expertise. Here we employ a Convolutional Neural Network (CNN) algorithm for BNE identification and differentiation from doublets and cells with irregular nuclear morphology in IFC data. We demonstrate that this simplified AI workflow, coupled with a powerful CNN algorithm, achieves comparable BNE quantification accuracy to manual and feature-based analysis with substantial time savings, eliminating workflow complexity. This streamlined approach holds significant clinical value, enhancing IFC accessibility for routine diagnostic purposes. [ABSTRACT FROM AUTHOR]

Background: Bisphenol A (BPA) is currently one of the most widely used synthetic chemicals in the production of a wide range of plastics. Due to its diverse endocrine disrupting potential alternative bisphenols, also referred to as analogues, have been developed. Although the toxicity of BPA is well studied, the (eco)toxicological effects of the bisphenol analogues are largely unknown. The similar molecular structure of the analogues suggests comparable toxicological effects. This study aims to extend the (eco)toxicological knowledge on the bisphenol analogues by evaluating eleven bisphenol analogues compared to the reference substance BPA in in vitro bioassays. The examined endpoints are endocrine potential on three nuclear receptors in recombinant yeast cells of Saccharomyces cerevisiae, baseline toxicity (also referred to as non-specific toxicity, describing the minimal toxicity of a chemical) in the luminescent bacterium Aliivibrio fischeri, and mutagenicity in two strains of Salmonella typhimurium. Results: Bisphenol A showed estrogenic and anti-androgenic activity at EC50 concentrations of 0.516 mg/L (2.26 × 10–6 M) and 1.06 mg/L (4.63 × 10–6 M), respectively. The assays confirmed notable estrogenic and anti-androgenic activity for the vast majority of analogues in comparable, and often higher, efficacies to BPA. Some analogues showed anti-estrogenic instead of estrogenic activity in a range from 0.789 mg/L (1.45 × 10–6 M; TBBPA) to 2.69 mg/L (2.46 × 10–6 M; BADGE). The baseline toxicity of the analogues revealed a similar tendency of comparable to more prominent effects compared to BPA, ranging from 5.81 mg/L (1.73 × 10–5 M; BPAF) to 39.1 mg/L (1.56 × 10–4 M; BPS). There was no evidence of mutagenicity found. Conclusion: The examined bisphenol analogues prove to be equally, if not more, problematic in endocrine activities than the reference bisphenol A. Based on these results, the tested bisphenols cannot be regarded as safer alternatives and reinforce the notion of bisphenol analogues being considered as regrettable substitutions. [ABSTRACT FROM AUTHOR]

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In the context of high-dimensional credit card fraud data, researchers and practitioners commonly utilize feature selection techniques to enhance the performance of fraud detection models. This study presents a comparison in model performance using the most important features selected by SHAP (SHapley Additive exPlanations) values and the model's built-in feature importance list. Both methods rank features and choose the most significant ones for model assessment. To evaluate the effectiveness of these feature selection techniques, classification models are built using five classifiers: XGBoost, Decision Tree, CatBoost, Extremely Randomized Trees, and Random Forest. The Area under the Precision-Recall Curve (AUPRC) serves as the evaluation metric. All experiments are executed on the Kaggle Credit Card Fraud Detection Dataset. The experimental outcomes and statistical tests indicate that feature selection methods based on importance values outperform those based on SHAP values across classifiers and various feature subset sizes. For models trained on larger datasets, it is recommended to use the model's built-in feature importance list as the primary feature selection method over SHAP. This suggestion is based on the rationale that computing SHAP feature importance is a distinct activity, while models naturally provide built-in feature importance as part of the training process, requiring no additional effort. Consequently, opting for the model's built-in feature importance list can offer a more efficient and practical approach for larger datasets and more intricate models. [ABSTRACT FROM AUTHOR]

Background: Headache is a prevalent and debilitating symptom following traumatic brain injury (TBI). Large-scale, prospective cohort studies are needed to establish long-term headache prevalence and associated factors after TBI. This study aimed to assess the frequency and severity of headache after TBI and determine whether sociodemographic factors, injury severity characteristics, and pre- and post-injury comorbidities predicted changes in headache frequency and severity during the first 12 months after injury. Methods: A large patient sample from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) prospective observational cohort study was used. Patients were stratified based on their clinical care pathway: admitted to an emergency room (ER), a ward (ADM) or an intensive care unit (ICU) in the acute phase. Headache was assessed using a single item from the Rivermead Post-Concussion Symptoms Questionnaire measured at baseline, 3, 6 and 12 months after injury. Mixed-effect logistic regression analyses were applied to investigate changes in headache frequency and associated predictors. Results: A total of 2,291 patients responded to the headache item at baseline. At study enrolment, 59.3% of patients reported acute headache, with similar frequencies across all strata. Female patients and those aged up to 40 years reported a higher frequency of headache at baseline compared to males and older adults. The frequency of severe headache was highest in patients admitted to the ICU. The frequency of headache in the ER stratum decreased substantially from baseline to 3 months and remained from 3 to 6 months. Similar trajectory trends were observed in the ICU and ADM strata across 12 months. Younger age, more severe TBI, fatigue, neck pain and vision problems were among the predictors of more severe headache over time. More than 25% of patients experienced headache at 12 months after injury. Conclusions: Headache is a common symptom after TBI, especially in female and younger patients. It typically decreases in the first 3 months before stabilising. However, more than a quarter of patients still experienced headache at 12 months after injury. Translational research is needed to advance the clinical decision-making process and improve targeted medical treatment for headache. Trial registration: ClinicalTrials.gov NCT02210221. [ABSTRACT FROM AUTHOR]

Objective: We aim to evaluate the efficacy of CT-guided percutaneous radiofrequency ablation (RFA) and surgical treatment in osteoid osteoma (OO) treated at the Medical University of Graz. Materials and methods: In a single-institution study, we analysed data from January 2005 to January 2021 of patients with histological/radiological diagnosis of OO. CT and MRI scans were reviewed for typical findings. Means (with SD) and medians (with IQR) were reported for normally and non-normally distributed variables. Differences between groups were assessed using chi-squared tests and t-tests. Results: One hundred nineteen patients (mean age: 21.6 ± 10.9 years; 63.9% males) with confirmed OO were retrospectively evaluated. 73 and 43 patients underwent RFA and surgery, respectively. In three cases, RFA combined with surgery was performed. Pre-intervention, 103 patients (88.8%) had undergone CT, and 101 had an MRI (87.1%). The nidus was confirmed in 82.5% of cases with CTs (85/103) and 63.4% with MRIs (64/101). The majority of nidi were located cortically (n = 96; 82.8%), most frequently in the femur (38 patients, 33.3%) with a median size of 8.0 mm (IQR: 5.0–12.0 mm). Median symptom duration before treatment was 6.0 (IQR: 4.0–13.0) months. The complication rate was 12.1% (14/116; 15.1% RFA vs. 7.0% surgery; p = 0.196). In total, 11.2% of patients had persistent symptoms after one week with clinical success rates of RFA and surgery, 86.3% and 90.7% (p = 0.647), respectively. Conclusion: Compared to surgical treatment, CT-guided percutaneous RFA is a safe, minimally invasive, reliable, and efficient treatment option for OO. Critical relevance statement: This article critically assesses the diagnosis and treatment of osteoid osteoma, emphasising accurate imaging, and detailing a non-invasive option for effective management. Key points: • This study analyses 116 cases of OO at one institution, focusing on symptom persistence, recurrence in short-term follow-up, and complications in two study groups. • Surgery showed higher, though not statistically significant, success despite comparable symptom persistence; CT displayed typical OO features more than MRI, regardless of the intramedullary, cortical and subperiosteal location as well as the site of the affected bone. • CT-guided RFA is an effective therapeutic alternative for OO compared to surgical intervention. In case of atypical OO appearance, RFA is not the first-line treatment. [ABSTRACT FROM AUTHOR]

Introduction: The efficiency of The International Classification of Headache Disorders (ICHD-3) in reflecting patients' disability has recently been questioned. This prompts consideration that clinical features beyond pain may more accurately indicate the extent of underlying brain impairment than the mere frequency of headache days. Important cognitive dysfunctions and psychological impairment have been reported in burdensome cases of migraine, and the presence of these alterations has been associated with biological changes in the nervous system. This study aimed to compare migraine-related disability within a specific patient group, classified using ICHD-3 criteria or classified based on findings from a neuropsychological evaluation using machine learning. Additionally, a complementary voxel-based morphometry (VBM) comparison was conducted to explore potential neuroanatomical differences between the resulting groups. Patients and methods: The study included episodic and chronic migraine patients seeking consultation at a specialized headache department. A neuropsychological evaluation protocol, encompassing validated standardized tests for cognition, anxiety, depression, perceived stress, and headache-related impact (HIT-6) and disability (MIDAS), was administered. Results from this evaluation were input into an automated K-means clustering algorithm, with a predefined K=2 for comparative purposes. A supplementary Voxel-based Morphometry (VBM) evaluation was conducted to investigate neuroanatomical contrasts between the two distinct grouping configurations. Results: The study involved 111 participants, with 49 having chronic migraine and 62 having episodic migraine. Seventy-four patients were assigned to cluster one, and 37 patients were assigned to cluster two. Cluster two exhibited significantly higher levels of depression, anxiety, and perceived stress, and performed worse in alternating and focalized attention tests. Differences in HIT-6 and MIDAS scores between episodic and chronic migraine patients did not reach statistical significance (HIT-6: 64.39 (±7,31) vs 62.92 (±11,61); p= 0. 42 / MIDAS: 73.63 (±68,61) vs 84.33 (±63,62); p=0.40). In contrast, patients in cluster two exhibited significantly higher HIT-6 (62.32 (±10,11) vs 66.57 (±7,21); p=0.03) and MIDAS (68.69 (±62,58) vs 97.68 (±70,31); p=0.03) scores than patients in cluster one. Furthermore, significant differences in grey matter volume between the two clusters were noted, particularly involving the precuneus, while differences between chronic and episodic migraine patients did not withstand correction for multiple comparisons. Conclusions: The classification of migraine patients based on neuropsychological characteristics demonstrates a more effective separation of groups in terms of disability compared to categorizing them based on the chronic or episodic diagnosis of ICHD-3. These findings could reveal biological changes that might explain differences in treatment responses among apparently similar patients. [ABSTRACT FROM AUTHOR]

Background: Lateral ankle sprain (LAS) is the most common sports injury, leading to a high rate of recurrence and the development of chronic ankle instability. One possible explanation is the lack of objective, evidence-based criteria to inform return to sport decisions following LAS. The aim of this study was therefore to assess the efficacy of a new functional score to distinguish patients at risk of recurrent LAS within two years after the initial injury. Methods: The Ankle-GO score was used in 64 active patients two months after LAS. This composite score includes 2 self-reported questionnaires and 4 functional tests, for a maximum score of 25 points. The rate of reinjury was prospectively recorded 2 years after inclusion. Potential predictive variables for reinjury were tested using the Chi-square and independent t-tests. The area under the receiver operating characteristics curve (AUC) with the optimal cut-off score was determined to assess the predictive value of the Ankle-GO score for the risk of reinjury. Multivariate logistic regression was then used to determine the influence of risk factors of reinjury. Results: Fifty-four (85%) patients were included (23 men and 31 women, 34.7 ± 13 years old) including 18 (33.3%) with a reinjury. The two-month Ankle-GO score was lower in patients with a recurrent LAS (5.4 ± 2.8 points vs. 9.1 ± 4.5, p = 0.002) and predicted the risk of reinjury (AUC = 0.75). Patients with < 8 points were found to have a significantly higher risk of reinjury (OR = 8.6; 95%CI: 2-37.2, p = 0.001). Women also tend to have a higher risk of recurrence (OR = 3.8; 95%CI: 0.9–15.5, p = 0.065). Conclusion: The Ankle-GO score is a new objective criterion for RTS after LAS. Patients with a low score at two months have a 9-fold greater risk of recurrence within two years. Key points: • The two-year risk of ankle sprain recurrence is nine times higher in patients with a low Ankle-GO score. • Women tend to have a fourfold higher risk of re-injury within two years, despite an initial Ankle-GO score comparable to men. • This innovative score could significantly influence the clinical management of LAS by providing an objective assessment of the readiness to RTS after LAS. [ABSTRACT FROM AUTHOR]

Seborrheic keratosis (SK) is a common skin disease in the elderly. However, in cases where SK presenting as multiple skin-colored or clustered lesions can be easily misdiagnosed as verruca plana (VP), especially in the young population. This retrospective study investigated the prevalence of SK and VP in the lesions that appear clinically similar to VP according to age. We examined the pathology slides of the skin tissue and photographs of patients who were clinically suspected to have VP. A total of 503 patients were included in the study, out of which 174 patients were finally diagnosed with SK (34.6%) and 132 with VP (26.2%). The mean ages of the SK- and VP-diagnosed group were 39.3 and 35.4 years, respectively. SK had a higher prevalence among individuals older than 30 years, and relative frequency of SK should not be ignored in patients with a grouped distribution in their 20 s and 30 s. Therefore, our study suggests that multiple verrucous skin-colored to brownish plaques are also commonly diagnosed as SK in young people as well as VP, and the prevalence of SK and VP may not always depend solely on chronological aging, and the prevalence of SK among young people may be higher than commonly believed stereotypes suggest. [ABSTRACT FROM AUTHOR]

Wearable inertial measurement units (IMUs) are being used to quantify gait characteristics that are associated with increased fall risk, but the current limitation is the lack of contextual information that would clarify IMU data. Use of wearable video-based cameras would provide a comprehensive understanding of an individual's habitual fall risk, adding context to clarify abnormal IMU data. Generally, there is taboo when suggesting the use of wearable cameras to capture real-world video, clinical and patient apprehension due to ethical and privacy concerns. This perspective proposes that routine use of wearable cameras could be realized within digital medicine through AI-based computer vision models to obfuscate/blur/shade sensitive information while preserving helpful contextual information for a comprehensive patient assessment. Specifically, no person sees the raw video data to understand context, rather AI interprets the raw video data first to blur sensitive objects and uphold privacy. That may be more routinely achieved than one imagines as contemporary resources exist. Here, to showcase/display the potential an exemplar model is suggested via off-the-shelf methods to detect and blur sensitive objects (e.g., people) with an accuracy of 88%. Here, the benefit of the proposed approach includes a more comprehensive understanding of an individual's free-living fall risk (from free-living IMU-based gait) without compromising privacy. More generally, the video and AI approach could be used beyond fall risk to better inform habitual experiences and challenges across a range of clinical cohorts. Medicine is becoming more receptive to wearables as a helpful toolbox, camera-based devices should be plausible instruments. [ABSTRACT FROM AUTHOR]

Background: B12 deficiency, which can be seen in type 2 DM patients using metformin, can cause peripheral nerve damage that can easily be confused with peripheral neuropathy, a complication of diabetes. Therefore, early diagnosis is important in patients. Objective: In our study, we aimed to investigate benefit of Active B12 measurement in diagnosing B12 deficiency, as it might be a better alternative in follow-up of B12 levels in type 2 DM patients using metformin. Methods: Patients were divided into three groups according to their Total B12 levels: Deficient, Borderline and Sufficient. Homocysteine and Active B12 (holotranscobalamin) levels were studied with Chemiluminescent Microparticle Immunoassay (CMIA) for quantitative determination. Duration of use, daily metformin dose, and other parameters were collected from records and interviews. Results: A statistically significant positive correlation was found between Total B12 and Active B12 (r = 0.624, p = 0.000). A statistically significant negative correlation was found between metformin dose and Active B12 and Total B12 levels (r = -0.309, r = -0.212, respectively; p < 0.05). While effects of metformin dose and duration of use groups were not found statistically significant in binary logistic regression analysis for Total B12 groups, the OR value for Active B12 was found to be 5.575 (95% CI 1.456–21.343, p = 0.012). Conclusions: It is important to closely follow up Type2 DM patients with high daily metformin dose in terms of B12 deficiency. Active B12 is a significant predictor of B12 deficiency compared to other parameters. [ABSTRACT FROM AUTHOR]

Extensive research has shown the potential value of digital health solutions and highlighted the importance of clinicians' adoption. As general practitioners (GPs) are patients' first point of contact, understanding influencing factors to their digital health adoption is especially important to derive personalized practical recommendations. Using a mixed-methods approach, this study broadly identifies adoption barriers and potential improvement strategies in general practices, including the impact of GPs' inherent characteristics – especially their personality – on digital health adoption. Results of our online survey with 216 GPs reveal moderate overall barriers on a 5-point Likert-type scale, with required workflow adjustments (M = 4.13, SD = 0.93), inadequate reimbursement (M = 4.02, SD = 1.02), and high training effort (M = 3.87, SD = 1.01) as substantial barriers. Improvement strategies are considered important overall, with respondents especially wishing for improved interoperability (M = 4.38, SD = 0.81), continued technical support (M = 4.33, SD = 0.91), and improved usability (M = 4.20, SD = 0.88). In our regression model, practice-related characteristics, the expected future digital health usage, GPs' digital affinity, several personality traits, and digital maturity are significant predictors of the perceived strength of barriers. For the perceived importance of improvement strategies, only demographics and usage-related variables are significant predictors. This study provides strong evidence for the impact of GPs' inherent characteristics on barriers and improvement strategies. Our findings highlight the need for comprehensive approaches integrating personal and emotional elements to make digitization in practices more engaging, tangible, and applicable. [ABSTRACT FROM AUTHOR]

The integration of microgrids into the existing power system framework enhances the reliability and efficiency of the utility grid. This manuscript presents an innovative mathematical paradigm designed for the optimization of both the structural and operational aspects of a grid-connected microgrid, leveraging the principles of Demand-Side Management (DSM). The focus of this work lies in a comprehensive exploration of the implications brought about by the Renewable Generation-Based Dynamic Pricing Demand Response (RGDP-DR) mechanism, particularly in terms of its influence on the optimal microgrid configuration, considering perspectives from end-users and the utility entity. This inquiry is rooted in a holistic assessment that encompasses technical and economic performance benchmarks. The RGDP-induced DR framework adeptly addresses the needs of the consumer base, showcasing notable efficiency and economic feasibility. To address the intricate nonlinear optimization challenge at hand, we employ an evolutionary algorithm named the "Dandelion Algorithm" (DA). A rigorous comparative study is conducted to evaluate the efficacy of four optimization techniques, affirming the supremacy of the proposed DA. Within this discourse, the complexity of microgrid sizing is cast as a dual-objective optimization task. The twin objectives involve minimizing the aggregate annual outlay and reducing emissions. The results of this endeavor unequivocally endorse the superiority of the DA over its counterparts. The DA demonstrates exceptional proficiency in orchestrating the most cost-effective microgrid and consumer invoice, surpassing the performance of alternative optimization methodologies. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) and essential tremor (ET) are prevalent movement disorders that mainly affect elderly people, presenting diagnostic challenges due to shared clinical features. While both disorders exhibit distinct speech patterns—hypokinetic dysarthria in PD and hyperkinetic dysarthria in ET—the efficacy of speech assessment for differentiation remains unexplored. Developing technology for automatic discrimination could enable early diagnosis and continuous monitoring. However, the lack of data for investigating speech behavior in these patients has inhibited the development of a framework for diagnostic support. In addition, phonetic variability across languages poses practical challenges in establishing a universal speech assessment system. Therefore, it is necessary to develop models robust to the phonetic variability present in different languages worldwide. We propose a method based on Gaussian mixture models to assess domain adaptation from models trained in German and Spanish to classify PD and ET patients in Czech. We modeled three different speech dimensions: articulation, phonation, and prosody and evaluated the models' performance in both bi-class and tri-class classification scenarios (with the addition of healthy controls). Our results show that a fusion of the three speech dimensions achieved optimal results in binary classification, with accuracies up to 81.4 and 86.2% for monologue and /pa-ta-ka/ tasks, respectively. In tri-class scenarios, incorporating healthy speech signals resulted in accuracies of 63.3 and 71.6% for monologue and /pa-ta-ka/ tasks, respectively. Our findings suggest that automated speech analysis, combined with machine learning is robust, accurate, and can be adapted to different languages to distinguish between PD and ET patients. [ABSTRACT FROM AUTHOR]

Digital measures of health status captured during daily life could greatly augment current in-clinic assessments for rheumatoid arthritis (RA), to enable better assessment of disease progression and impact. This work presents results from weaRAble-PRO, a 14-day observational study, which aimed to investigate how digital health technologies (DHT), such as smartphones and wearables, could augment patient reported outcomes (PRO) to determine RA status and severity in a study of 30 moderate-to-severe RA patients, compared to 30 matched healthy controls (HC). Sensor-based measures of health status, mobility, dexterity, fatigue, and other RA specific symptoms were extracted from daily iPhone guided tests (GT), as well as actigraphy and heart rate sensor data, which was passively recorded from patients' Apple smartwatch continuously over the study duration. We subsequently developed a machine learning (ML) framework to distinguish RA status and to estimate RA severity. It was found that daily wearable sensor-outcomes robustly distinguished RA from HC participants (F1, 0.807). Furthermore, by day 7 of the study (half-way), a sufficient volume of data had been collected to reliably capture the characteristics of RA participants. In addition, we observed that the detection of RA severity levels could be improved by augmenting standard patient reported outcomes with sensor-based features (F1, 0.833) in comparison to using PRO assessments alone (F1, 0.759), and that the combination of modalities could reliability measure continuous RA severity, as determined by the clinician-assessed RAPID-3 score at baseline (r2, 0.692; RMSE, 1.33). The ability to measure the impact of the disease during daily life—through objective and remote digital outcomes—paves the way forward to enable the development of more patient-centric and personalised measurements for use in RA clinical trials. [ABSTRACT FROM AUTHOR]

The recently proposed method for on-site radiation dosimetry by a combination of radiochromic film and portable colorimeter was tested for six combinations of two popular Gafchromic films (EBT3 and EBT-XD) and three commercially available portable colorimeters (nix pro2, nix spectro2 and Spectro1 Pro; abbreviated to "NixP", "NixS" and "SpoP", respectively). EBT3 and EBT-XD were irradiated with X-rays (160 kV, 6.3 mA) up to 40 Gy and 80 Gy, respectively, and the radiation-induced color levels of RGB and CMYK components were measured with the three colorimeters. Angle dependence was examined by reading at 15° intervals. As a result, it was judged that all combinations would work effectively under certain irradiation conditions. NixP and NixS were applicable to a wider dose range for both films, while SpoP fit a lower dose range. On the other hand, SpoP showed an advantageous feature of no angular dependence in reading films, while NixP and NixS showed significant angle-dependent changes. These differences are considered to be attributable to the different geometries of LED light emission, which came from all directions (360°) in SpoP, 4 directions in NixP, and 8 directions in NixS. These findings are expected to expand the applicability of the novel method to various occasions of on-site dosimetry. [ABSTRACT FROM AUTHOR]

Background: Presbyopia is an age-related condition that causes a decreased ability to focus on nearby objects. Multifocal contact lenses are commonly used to address this issue. However, there seems to be a notable dissatisfaction among multifocal contact lens wearers. The absence of a reliable instrument to measure the patient's perspective, despite the widespread use of this method, highlights the need for further research in this area. Objective: The objective of this study is to develop an item-bank integrating all domains necessary to assess the patient's perspective on multifocal contact lens performance, offering a comprehensive measure. The item-bank will ensure a high level of content validity, be self-administered, and will initially be available in Spanish. The aim of this tool is to serve as a valuable resource for research and optometric clinics, facilitating the follow-up of patients with presbyopia who wear multifocal contact lenses or those who are newly starting to use them. Methodology: The MCL-PRO item bank, followed a systematic and step-wise inductive approach to gather information, following the recommendations outlined in the COSMIN guidelines and similar studies. The process involved the following steps: (1) Literature review and relevant existing items identification (2) Social media review, (3) Semi-structured focus groups, (4) performing qualitative analysis, (5) refining and revising the items, and (6) generating the content of the item bank. Results: A total of 575 items were included in the item-bank hosted under 8 different domains that were found to be important for presbyopic population: visual symptoms (213), activity limitation (111), ocular symptoms (135), convenience (36), emotional well-being (33), general symptoms (16), cognitive issues (21) and economic issues (10). Conclusion: The item-bank created has followed standardised methodology for its development and encloses all the aspects for MCL performance evaluation from patients perspective. [ABSTRACT FROM AUTHOR]

As China and the United States strive to be the primary global leader in AI, their visions are coming into conflict. This is frequently painted as a fundamental clash of civilisations, with evidence based primarily around each country's current political system and present geopolitical tensions. However, such a narrow view claims to extrapolate into the future from an analysis of a momentary situation, ignoring a wealth of historical factors that influence each country's prevailing philosophy of technology and thus their overarching AI strategies. In this article, we build a philosophy-of-technology-grounded framework to analyse what differences in Chinese and American AI policies exist and, on a fundamental level, why they exist. We support this with Natural Language Processing methods to provide an evidentiary basis for our analysis of policy differences. By looking at documents from three different American presidential administrations––Barack Obama, Donald Trump, and Joe Biden––as well as both national and local policy documents (many available only in Chinese) from China, we provide a thorough comparative analysis of policy differences. This article fills a gap in US–China AI policy comparison and constructs a framework for understanding the origin and trajectory of policy differences. By investigating what factors are informing each country's philosophy of technology and thus their overall approach to AI policy, we argue that while significant obstacles to cooperation remain, there is room for dialogue and mutual growth. [ABSTRACT FROM AUTHOR]

Snow and glaciers are very sensitive to changing climate. Glaciers in the central Karakoram, western Himalaya and eastern Hindukush mountain ranges are not responding to global warming in the same manner as their counterparts around the world. Glaciers in this region are behaving differently. Some are retreating, while others are stable or surging. It is important to monitor these changes to protect downstream communities from the negative consequences. This study is conducted to monitor the state of the selected glaciers of Hunza River Basin, such as Batura, Passu, Ghulkin, Gulmit, Baulter, Barpu, Samaiyar Bar, Muchuhar, and Shishper glaciers were analysed using Digital Elevation Model and satellite images for 1972, 1979, 1990, 1998, 2008 and 2018. A semi-automatic approach was adopted to delineate the glacier boundary supplemented by manual editing. These glaciers show different fluctuations over the last fifty years. The Batura glacier showed surge in the 1970s and then retreated followed by quiescence. There is no prominent change in Ghulkin, Barpu, and Samaiyar Bar glaciers while almost 40 m per year retreat was observed in Passu and Gulmit glaciers but Muchuhar retreated at a faster rate. The surge of Shishper results in the formation of glacier-dammed lake which has so far triggered four Glacial Lake Outburst Floods (GLOFs). Overall, area of nine glaciers decreased from 596.54 ± 31.02 km2 in 1972 to 568.52 ± 8.51 km2 in 2018, which accounts for 4.8% decrease in area. This decrease will affect landscape development, regional hydrology and people living downstream. [ABSTRACT FROM AUTHOR]

Background: The benefit–risk balance and optimal timing of surgery for severe infective endocarditis (IE) with ischemic or hemorrhagic strokes is unknown. The study aim was to compare the neurological outcome between patients receiving surgery or not. Methods: In a prospective register-based multicenter ICU study, patients were included if they met the following criteria: (i) left-sided IE with an indication for heart surgery; (ii) with cerebral complications documented by cerebral imaging before cardiac surgery; (iii) with Sequential Organ Failure Assessment score ≥ 3. Exclusion criteria were isolated right-sided IE, in-hospital acquired IE and patients with cerebral complications only after cardiac surgery. In the primary analysis, the prognostic value of surgery in term of disability at 6 month was assessed by using a propensity score-adjusted logistic regression. Results: 192 patients were included including ischemic stroke (74.5%) and hemorrhagic lesion (15.6%): 67 (35%) had medical treatment and 125 (65%) cardiac surgery. In the propensity score-adjusted logistic regression, a favorable 6-month neurological outcome was associated with surgery (odds ratio 13.8 (95% CI 6.2–33.7). The 1-year mortality was strongly reduced with surgery in the fixed-effect propensity-adjusted Cox model (hazard ratio 0.18; 95% CI 0.11–0.27; p < 0.001). These effects remained whether the patients received delayed surgery (n = 62/125) or not and whether they were deeply comatose (Glasgow Coma Scale ≤ 10) or not. Conclusions: In critically ill IE patients with an indication for surgery and previous cerebral events, a better propensity-adjusted neurological outcome was associated with surgery compared with medical treatment. [ABSTRACT FROM AUTHOR]

Purpose: The prevalence of hyperdynamic left ventricular (LV) systolic function in septic patients and its impact on mortality remain controversial. In this systematic review and meta-analysis, we investigated the prevalence and association of hyperdynamic LV systolic function with mortality in patients with sepsis. Methods: We searched MEDLINE, Cochrane Central Register of Controlled Trials, and Embase. Primary outcomes were the prevalence of hyperdynamic LV systolic function in adult septic patients and the associated short-term mortality as compared to normal LV systolic function. Hyperdynamic LV systolic function was defined using LV ejection fraction (LVEF) of 70% as cutoff. Secondary outcomes were heart rate, LV end-diastolic diameter (LVEDD), and E/e' ratio. Results: Four studies were included, and the pooled prevalence of hyperdynamic LV systolic function was 18.2% ([95% confidence interval (CI) 12.5, 25.8]; I2 = 7.0%, P < 0.0001). Hyperdynamic LV systolic function was associated with higher mortality: odds ratio of 2.37 [95%CI 1.47, 3.80]; I2 = 79%, P < 0.01. No difference was found in E/e' (P = 0.43) between normal and hyperdynamic LV systolic function, while higher values of heart rate (mean difference: 6.14 beats/min [95%CI 3.59, 8.69]; I2 = 51%, P < 0.0001) and LVEDD (mean difference: − 0.21 cm [95%CI − 0.33, − 0.09]; I2 = 73%, P < 0.001) were detected in patients with hyperdynamic LV systolic function. Conclusion: The prevalence of hyperdynamic LV systolic function is not negligible in septic patients. Such a finding is associated with significantly higher short-term mortality as compared to normal LV systolic function. [ABSTRACT FROM AUTHOR]

Increased sequencing depth can improve the detection rate of noninvasive prenatal testing (NIPT) for chromosome aneuploidies and copy number variations (CNVs). However, due to the technical limitations of NIPT, false-positives and false-negatives are inevitable. False-positives for aneuploidy and CNVs have been widely reported, but few missed cases have been reported. In this study, we report 3 patients missed by NIPT, which were still missed after increasing the sequencing depth. To verify the detection efficiency of the platform, the results of NIPT in 32,796 patients treated in Yulin Women and Children Health Care Hospital from 2020 to 2022 were retrospectively analyzed. Data on false-negative cases found by postnatal follow-up or amniocentesis were collected, and the sequencing data, pregnancy examination data, and postnatal follow-up results of these missed patients were summarized. Five patients missed by NIPT were found, and they were missed again by retesting or increasing the sequencing depth. Except for hypospadias found in 1 patient, ultrasonography of the other 4 patients showed no obvious abnormalities during the whole pregnancy. Our results suggest that pregnant women should be fully informed of the benefits and limitations of NIPT before undergoing the examination to avoid unnecessary medical disputes. [ABSTRACT FROM AUTHOR]

Several epidemiological models use the Caputo fractional-order differential operator without establishing its significance. This study verifies a Caputo operator-based fractional-order epidemiological model of the SAIVR type. COVID-19 kills. Infection weakens the immune system. The fractional Caputo operator describes COVID-19 immunization. Fundamental system characteristics are determined using fractional calculus. Our analysis included the fractional system's Hyers–Ulam–Rassias stability and stable states. The uniqueness and existence of fractional Caputo system solutions are explored. The least-squares approach determines system parameters. The Caputo fractional-order α value is optimized to 6.757 e − 01 , indicating that the system best fits real-life medical data for infection. Caputo and classical systems were compared for absolute mean errors. The Box-Whisker chart case summaries show the Caputo operator superiority. When α → 1 , the memory traces and hereditary traits are also observed. Finally, the Caputo fractional framework simulates COVID-19 using strong numerical methods. [ABSTRACT FROM AUTHOR]

Background: Patellofemoral pain (PFP) is among the most common injuries in runners. While multiple risk factors for patellofemoral pain have been investigated, the interactions of variables contributing to this condition have not been explored. This study aimed to classify runners with patellofemoral pain using a combination of factors including biomechanical, anthropometric, and demographic factors through a Classification and Regression Tree analysis. Results: Thirty-eight runners with PFP and 38 healthy controls (CON) were selected with mean (standard deviation) age 33 (16) years old and body mass index 22.3 (2.6) kg/m2. Each ran at self-selected speed, but no between-group difference was identified (PFP = 2.54 (0.2) m/s x CON = 2.55 (0.1) m/s, P =.660). Runners with patellofemoral pain had different patterns of interactions involving braking ground reaction force impulse, contact time, vertical average loading rate, and age. The classification and regression tree model classified 84.2% of runners with patellofemoral pain, and 78.9% of healthy controls. The prevalence ratios ranged from 0.06 (95% confidence interval: 0.02–0.23) to 9.86 (95% confidence interval: 1.16–83.34). The strongest model identified runners with patellofemoral pain as having higher braking ground reaction force impulse, lower contact times, higher vertical average loading rate, and older age. The receiver operating characteristic curve demonstrated high accuracy at 0.83 (95% confidence interval: 0.74–0.93; standard error: 0.04; P <.001). Conclusions: The classification and regression tree model identified an influence of multiple factors associated with patellofemoral pain in runners. Future studies may clarify whether addressing modifiable biomechanical factors may address this form of injury. Key Points: This study highlights interactions between multiple biomechanical factors associated with patellofemoral pain. Interactions between braking ground reaction force impulse, contact time, vertical average loading rate, and age correctly identified runners with patellofemoral pain and controls. Step rate, sex, and body mass index were not predictors of patellofemoral pain in runners when a classification and regression tree analysis was used [ABSTRACT FROM AUTHOR]

Along with the adoption of hybrid teaching and learning modes, the integration of ICT into language instruction in higher education during the COVID-19 pandemic has afforded teachers and students increased opportunities to engage with technology. This quantitative study uses a self-report questionnaire to examine language learners' attitudes and behavior tied to the role of ICT in learning before and after the COVID-19 pandemic. Firstly, the study confirms the questionnaire's validity for assessing ICT attitudes and behavior in the Hungarian educational context. Additionally, the measurement invariance and differential item functioning of the assessment tool pre- and post-COVID-19 show that attitudes and the frequency of ICT use remain consistent at both the construct and item levels. Overall, the results demonstrate significant variations between the two student groups in attitudes and behavior tied to the use of ICT tools in language learning. The findings show that the post-COVID-19 group exhibits higher attitudes, and an increased frequency of technology use is observed compared to the pre-COVID-19 period. Furthermore, the study indicates that attitudes before COVID-19 do not strongly influence habitual technology use for language learning, while the opposite is true for the post-COVID-19 period. [ABSTRACT FROM AUTHOR]

Scientific estimation and dynamic monitoring of CO2 emission trends are an important basis for formulating regional differentiated carbon reduction strategies. Using the integrated nighttime light data, this study estimated CO2 emissions in the Yellow River Basin (YRB) and Yangtze River Basin (YZRB) and discussed the similarities and differences of the spatial distribution of CO2 emissions for the two river basins. The results showed that: (1) The CO2 emissions in the two basins continued to rise, but the growth rate decreased from 2000 to 2018, showing an overall convergence trend, but have not yet reached carbon peak. (2) The high emission and high agglomeration areas were located in Shandong Province in the downstream of the YRB, Shanxi, Shaanxi and Inner Mongolia in the midstream and upstream, and the Yangtze River Delta (YRD). (3) Compared with the YRB, the growth rate of CO2 emissions in the YZRB is slower, and the growth rate declines greatly. In the YRB, it had higher CO2 emissions amount, wider area of high carbon emissions and more obvious spatial agglomeration than that in the YZRB. (4) According to CO2 emissions and economic development level, 220 cities of the two river basins were classified three types: low CO2–low development, high CO2–low development and high CO2–high development. [ABSTRACT FROM AUTHOR]