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The efficiency of water distribution at primary, secondary, and tertiary levels in the Indus Basin Irrigation System (IBIS) has historically suffered due to poor design, suboptimal operation, and water scarcity. To address these issues, the system has been designed with ungated irrigation outlets to ensure equitable water allocation at secondary and tertiary levels. This research evaluates the hydraulic performance of three irrigation outlets: adjustable proportional module (APM), adjustable orifice semi-module (AOSM), and open flume (OF) using a physical model study. A distributary channel model with these outlets was constructed at the Centre of Excellence in Water Resources Engineering, where discharge coefficients (Cd) were calibrated and measured under various hydraulic and geometric conditions, including free and submerged flow conditions, and with adjustments to flow depths and outlet settings. The results showed variability in Cd values under free flow and submerged flow conditions with APM and AOSM ranging from 6.07 to 8.20 and 0.56 to 0.74, respectively, and OF between 2.46 and 4.31. Additionally, the behavior of outlet tampering on Cd values was also assessed under three scenarios: tampering with the half wing wall (1st), tampering with the full wing wall (2nd), and lowering the bed level downstream of the outlet (3rd). The increase in Cd values for APM and AOSM was + 10.84% and + 14.49% under 1st scenario, + 17.12% and + 22.36% under 2nd scenario, and + 24.25% and + 26.30% under 3rd scenario, respectively. The results reveal that even minor tampering with outlet structures can lead to significant deviations in performance, highlighting the importance of maintaining stringent control over outlet configurations to ensure equitable and efficient water distribution. There is a critical need for rigorous, site-specific calibration of irrigation outlets to optimize their performance under local conditions and redesigning outlet structures to minimize the impacts of tampering, thereby enhancing the overall sustainability of water use in large-scale irrigation systems. The findings from this study provide essential insights for irrigation engineers and policymakers tasked with upgrading and maintaining irrigation infrastructure. By adopting a more customized approach to outlet design and management, it is possible to significantly improve water use efficiency and achieve more sustainable irrigation practices., Competing Interests: Declarations. Ethics approval: Not applicable. This study did not involve any human or animal subjects, and thus, no ethical approval was required. Consent to participate: Not applicable. Consent for publication: All authors consent to the publication of this manuscript. Competing interests: The authors declare no competing interests. Disclaimer: “All authors have read, understood, and have complied as applicable with the statement on ‘Ethical responsibilities of Authors’ as found in the Instructions for Authors.” The content of this article is solely the responsibility of the authors., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objectives: Evaluation of the validity of the Quadruple-D score in the prediction of success in pediatric stone disease., Materials and Methods: Of the 292 children treated with SWL between 2007 and 2023, a total of 158 children who had adequate follow-up data and evaluated with non-contrast computed tomography before SWL, were included in the study. Parameters were calculated for each of the stone volume (SV), skin-to-stone distance (SSD), stone density (SD) and stone location (SL) variables. Receiver operator characteristic analysis was used to set cut-off values. Quadruple-D scores were calculated, and success rates were determined for each score. Stone-free status was determined as complete clearance after three months of final SWL., Results: The median age of the study group was 8 (range 1 to 16). One hundred and one of the 158 (64%) children had stone-free status. Mean SV, SSD and SD values were significantly higher in SWL failed group than stone-free group after detecting cutoff values of 150 mm 3 , 6.7 cm, and 540 HU, respectively. Stone-free rates were detected as 19.6%, 24.7%, 37.2%, 76.2%, and 90.2% with the Quadruple-D scores of 0, 1, 2, 3 and 4 points., Conclusions: Quadruple-D scoring system can further improve Triple-D scoring system by adding stone position parameter to clarify SFR with a simple and easy calculation. We believe that the Quadruple-D score will have better clinical significance than the Triple-D scoring system in predicting the success of SWL in children., Competing Interests: Declarations Competing interests The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

In this study, the impact of mobile phone radiation on blood-brain barrier (BBB) permeability was investigated. A total of 21 New Zealand rabbits were used for the experiments, divided into three groups, each consisting of 7 rabbits. One group served as the control, while the other two were exposed to electromagnetic radiation at frequencies of 1800 MHz with a distance of 14.5 cm and 2100 MHz with a distance of 17 cm, maintaining a constant power intensity of 15 dBm, for a duration equivalent to the current average daily conversation time of 38 min. The exposure was conducted under non-thermal conditions, with RF radiation levels approximately ten times lower than normal values. Evans blue (EB) dye was used as a marker to assess BBB permeability. EB binds to plasma proteins, and its presence in brain tissue indicates a disruption in BBB integrity, allowing for a quantitative evaluation of radiation-induced permeability changes. Left and right brain tissue samples were analyzed using trichloroacetic acid (TCA) and phosphate-buffered solution (PBS) solutions to measure EB amounts at 620 nm via spectrophotometry. After the experiments, BBB tissue samples were collected from the right and left brains of all rabbits in the three groups and subjected to a series of medical procedures. Samples from Group 1 were compared with those from Group 2 and Group 3 using statistical methods to determine if there were any significant differences. As a result, it was found that there was no statistically significant difference in the BBB of rabbits exposed to 1800 MHz radiation, whereas there was a statistically significant difference at a 95% confidence level in the BBB of rabbits exposed to 2100 MHz radiation. A decrease in EB values was observed upon the arithmetic examination of the BBB., Competing Interests: Declarations Ethical approval We obtained ethical approval for this study from the Animal Experiment Local Ethics Committee at Van Yüzüncü Yıl University (VAN YÜHADYEK) by approval no:2021/01–08. The study was conducted in accordance with the ethical guidelines and standards for the use of animals in scientific research. Conflict of interest The authors declare no competing interests., (© 2024. International Federation for Medical and Biological Engineering.)

Objective: To develop the Still's Disease Activity Score (SDAS)., Methods: We used data from the prospective adult-onset Still's disease cohort study and evaluated the disease activity. An expert group selected the most frequent, reproducible, and objective variables significantly modified in statistical analysis when comparing patients in the active group and in the remission group. These criteria were weighted to design the Still's Disease Activity Score (SDAS). The Delphi method was used to appreciate the level of disease activity. Total SDAS was calculated for each patient and compared to final consensus experts., Results: At the diagnosis, all patients had an active disease (n = 80), while 48 patients were in remission at 6 months. The SDAS criteria were weighted as follows: fever ≥ 38.5 °C (1 point), rash (1 point), joint involvement (arthralgia: 1 point, swollen joints count "SJC": 1-3 SJC: 2 points, ≥ 4 SJC: 3 points), physician global assessment VAS ≥ 5/10 or a raise in physician VAS ≥ 2/10 (3 points), patient VAS ≥ 5 or a raise in patient VAS ≥ 2/10 (1 point), and CRP (> 10 mg/l: 1 point, ≥ 100 mg/l: 2 points). At 6 months, the consensus was achieved for 76 (95%) patients with 40 in remission (0-1 point), 8 in low disease activity (2-3 points), 16 in moderate disease activity (4-7 points), and 12 in severe disease activity (≥ 8 points)., Conclusion: The Still's Disease Activity Score is a valid and sensitive assessment of the disease activity and the therapeutic response in Still's disease, despite its heterogeneous manifestations and patterns with systemic and articular forms. Key Points • The Still's Disease Activity Score (SDAS) is a good simple tool to assess the activity of the disease in a stable state for a week. • The SDAS is developed specifically for Still's disease without the need for an application or a calculator to calculate SDAS in routine clinical practice. • SDAS is a composite score classifying the disease activity in remission, low disease activity, moderate disease activity, and severe disease activity despite its heterogeneous patterns (systemic and articular forms). • The SDAS is a valid, reliable, and sensitive score and can be useful to guide the therapeutic strategy in clinical practice and in research., (© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Purpose: An abdominal aortic aneurysm (AAA) is a dilation of the aorta over its normal diameter (> 3 cm). The minimally invasive treatment adopted uses a stent graft to be deployed into the aneurysm by a catheter to flow blood through it. However, this approach demands frequent monitoring using imaging modalities that involve radiation and contrast agents. Moreover, the multiple follow-ups are expensive, time-consuming, and resource-demanding for healthcare systems. This study proposes a novel wireless implantable medical sensor (WIMS) to measure the aneurysm growth after the endovascular repair., Methods: The proposed sensor is composed of a Z-shaped inductor, similar to a stent ring. The proposed design of the sensor is explored by investigating the inductance, resistance, and quality factor of different possible geometries related to a Z-shaped configuration, such as the height and number of struts. The study is conducted through a combination of numerical simulations and experimental tests, with the assessment being carried out at a frequency of 13.56 MHz., Results: The results show that a higher number of struts result in higher values of inductance and resistance. On the other hand, the increase in the number of struts decreases the quality factor of the Z-shaped inductor due to the presence of high resistance from the inductor. Moreover, it is observed that the influence of the number of struts present in the Z-shaped inductor tends to decrease for larger radii., Conclusions: The numerical and experimental evaluation concludes the ability of the proposed sensor to measure the size of the aneurysm., (© 2024. The Author(s) under exclusive licence to Biomedical Engineering Society.)

Groundwater depletion and water scarcity are pressing issues in water-limited regions worldwide, including Pakistan, where it ranks as the third-largest user of groundwater. Lahore, Pakistan, grapples with severe groundwater depletion due to factors like population growth and increased agricultural land use. This study aims to address the lack of comprehensive groundwater availability data in Lahore's semi-arid region by employing GIS techniques and remote sensing data. Various parameters, including Land Use and Land Cover (LULC), Rainfall, Drainage Density (DD), Water Depth, Soil Type, Slope, Population Density, Road Density, Normalized Difference Vegetation Index (NDVI), Normalized Difference Built-Up Index (NDBI), Moisture Stress Index (MSI), Water Vegetation Water Index (WVWI), and Land Surface Temperature (LST), are considered. Thematic layers of these parameters are assigned different weights based on previous literature, reclassified, and superimposed in weighted overlay tool to develop a groundwater potential zones index map for Lahore. The groundwater recharge potential zones are categorized into five classes: Extremely Bad, Bad, Mediocre, Good, and Extremely Good. The groundwater potential zone index (GWPZI) map of Lahore reveals that the majority falls within the Bad to Mediocre recharge potential zones, covering 33% and 28% of the total land area in Lahore, respectively. Additionally, 14% of the total area falls under the category of Extremely Bad recharge potential zones, while Good to Extremely Good areas cover 19% and 6%, respectively. By providing policymakers and water supply authorities with valuable insights, this study underscores the significance of GIS techniques in groundwater management. Implementing the findings can aid in addressing Lahore's groundwater challenges and formulating sustainable water management strategies for the city's future., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

This meta-analysis consolidates various related studies to identify patterns in the impact of feeding algae on performance aspects, including milk fat, milk protein, and carcass yield in several ruminant species, such as cattle, sheep, and goats. The data were collected from 67 articles that examined factors such as the type of algae (macro- and microalgae), algal species, and animal breed. Barki sheep, Moghani sheep, and Zaraibi goats demonstrated an increased average daily gain (P < 0.05) when fed with both macro- and microalgae. Conversely, sheep such as Canadian Arcott and Ile-de-France showed adverse effects on the feed conversion ratio (FCR) (P < 0.05). Elevated FCR values were observed across castrated and young animals (P < 0.05). Algae extract notably increased the hot carcass weight (P < 0.001), particularly among Moghani sheep (P < 0.001). Raw algae significantly reduced the milk fat content (P < 0.001), particularly in cattle and sheep (P < 0.001). A decrease in milk fat was particularly noticeable in lactating females of Assaf sheep, Damascus goats, and Holstein cows (P < 0.001). Overall, algae inclusion tended to decrease the milk protein content (P < 0.05), leading to reduced milk production (P < 0.001) with cumulative algae feeding in Assaf sheep. However, conjugated linoleic acid (CLA; C18:2 c9,t11-CLA and C18:2 c12,t10-CLA) and docosahexaenoic acid (DHA; C22:6n-3) mostly increased in meat and milk from Holstein cow, Assaf sheep, Dorset sheep, and Ile-de-France sheep (P < 0.01). This meta-analysis highlights the necessity for additional research aimed at optimizing the sustainable use of algae in feed for ruminants, despite the demonstrated improvements in performance and the levels of CLA and DHA found in meat and milk., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Livestock production significantly contributes to greenhouse gas (GHG) emissions particularly methane (CH 4 ) emissions thereby influencing climate change. To address this issue further, it is crucial to establish strategies that simultaneously increase ruminant productivity while minimizing GHG emissions, particularly from cattle, sheep, and goats. Recent advancements have revealed the potential for modulating the rumen microbial ecosystem through genetic selection to reduce methane (CH 4 ) production, and by microbial genome editing including CRISPR/Cas9, TALENs (Transcription Activator-Like Effector Nucleases), ZFNs (Zinc Finger Nucleases), RNA interference (RNAi), Pime editing, Base editing and double-stranded break-free (DSB-free). These technologies enable precise genetic modifications, offering opportunities to enhance traits that reduce environmental impact and optimize metabolic pathways. Additionally, various nutrition-related measures have shown promise in mitigating methane emissions to varying extents. This review aims to present a future-oriented viewpoint on reducing methane emissions from ruminants by leveraging CRISPR/Cas9 technology to engineer the microbial consortia within the rumen. The ultimate objective is to develop sustainable livestock production methods that effectively decrease methane emissions, while maintaining animal health and productivity., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Purpose: This non-interventional study investigates variations in the type and frequency of late complications linked to novel zygomatic implant designs, installed adhering to the Zygoma Anatomy-Guided Approach (ZAGA) concept, over an extended follow-up period of at least 3 years., Methods: Consecutive patients presenting indications for treatment with ZIs were treated according to ZAGA recommendations. Implants were immediately loaded. The ORIS success criteria for prosthetic offset, stability, sinus changes and soft-tissue status were used to evaluate the outcome., Results: Twenty patients were treated. Ten patients received two ZIs and regular implants; one received three ZIs plus regular implants, and nine received four ZIs. Fifty-nine ZIs were placed: thirty-six (61%) Straumann ZAGA-Flat implants and twenty-three (39%) Straumann ZAGA-Round implants. Four patients (20%) presented earlier sinus floor discontinuities. Fifteen patients (75%) had prior sinus opacities. Nineteen patients were followed for between 38 and 53 months (mean 46.5 months). One patient dropped out after 20 months. When comparing pre-surgical CBCT with post-surgical CBCT, 84.7% of the sites presented identical or less sinus opacity; nine locations (15%) showed decreased, and another nine increased (15%) post-surgical sinus opacity. Fifty-three ZIs (89.8%) maintained stable soft tissue. Six ZIs had recessions with no signs of infection. ZIs and prosthesis survival rate was 100%., Conclusions: The study highlights the effectiveness of ZAGA-based zygomatic implant rehabilitations using Round and Flat designs. Despite patient number constraints, minimal changes in the frequency of late complications from the 1-year follow-up were observed. 100% implant and prosthesis survival rate over a mean follow-up of 46.5 months is reported., (© 2024. The Author(s).)

The aim of current experiment was to determine the effect of replacement of alfalfa hay with ribwort plantain (Plantago lanceolata) hay in ruminant diets on the fermentation parameters such as gas production, methane (CH 4 ) production, true digestible dry matter (TDDM), true digestibility (TD), partitioning factor, microbial protein, and efficiency of microbial protein using in vitro gas production technique. The alfalfa hay was replaced with P. lanceolata hay in a diets isocaloric (2650 kcal/kg DM) and nitrogenic (17% CP kg DM) at the ratio of 0, 5, 10 and 15%. Partial substitution of alfalfa hay with P. lanceolata hay had no significant effect on gas and methane (ml/incubated substrate or %) production whereas the partial substitution had a significant effect on TDDM, TD, gas (ml/digested DM), CH 4 (ml ml/digested DM) and microbial MP of diets. The replacement of alfalfa hay with ribwort plantain hay shifted the fermentation pattern from gas and methane production to microbial protein production. Therefore alfalfa hay can be replaced with ribwort plantain hay with high digestibility and anti-methanogenic potential in ruminant diets up to 15% to decrease methane production and improve microbial protein production. However further in vivo experiments are required to determine the effect of replacement on feed intake and animal production., (© 2024. The Author(s).)

Although FRAX is used for fracture risk evaluation, this tool does not include balance and fall risk. The association between the predictors of falls and high FRAX scores we found in this study suggests that risk indicators for falls may add substantial value to FRAX by improving fracture risk prediction., Purpose: This observational, descriptive, and cross-sectional study aimed to assess the fall risk predictors and explore their association with FRAX in Turkish patients with postmenopausal osteoporosis., Methods: Two hundred and nine (209) women with postmenopausal osteoporosis referred to the Fracture Liaison Service (FLS) at Istanbul University-Cerrahpaşa were enrolled in the FRACT study (The Fracture Study of Turkey). Clinical risk factors were assessed using the FRAX tool. Tandem stance, Tandem walking, Timed up and go (TUG), and Chair stand tests were performed to assess balance and fall risk., Results: Among patients with a mean age of 67.6 (± 9.7) years, 66 patients (31.6%) had osteoporosis without fractures and 143 patients (68.4%) had fragility fractures. The proportion of patients with poor performance of fall prediction tests was significantly higher in patients with a fragility fracture than those with osteoporosis alone. There was an inverse relationship between dynamic balance tests and the reported number of prior falls in the past year. FRAX score was higher in patients with impaired Tandem stance, Tandem walking, and TUG tests (p = 0.008, p = 0.035, p = 0.001, respectively)., Conclusion: Assessment of fall risk predictors should be one of the major pillars in the physical evaluation of osteoporotic patients in the FLS setting. FRAX is a useful tool to determine the fracture risk of patients with both static and dynamic balance impairments. Combining balance assessment with FRAX may be an important step to optimize osteoporosis risk assessment., (© 2024. The Author(s).)

Purpose: The aim of this article is to evaluate to the masticatory function performance and Oral Health-related Quality of Life (OHRQoL) in implant-retained overdenture compared with different implant number placements in the edentulous mandible., Methods: From 2013 to 2015, each patients received 3 implants (iSy-Implant, Camlog, Wimsheim, Germany) in intraforaminal mandible (34, 41/31, 44). After operation, inserted implants were gradually loaded and incorporated into an overdenture with a self-aligning attachment system (Locator abutments) in 3 + 3 + 3 months. Five checked points were performed chewing cycle test with multicolored chewing gum and OHIP-G14 questionnaire and a sum score questionnaire as following: pre-operation, one implant load (41/31), two implants loaded (33,43), three implants loaded and 1-year follow up., Result: A total of 10 patients with 30 implants were placed, the survival rate of the implants was 100% within 1-year follow-up. Regarding the masticatory function analysis, for the higher number of chewing cycles, the higher mixing rate was observed. After 1 year, the inter-mixing rate without significant changes was found compared to the time after three implants were loaded with attachment system. The mean value of OHIP-G14 was 30.4 preoperatively, 21.1 after loading the first locator, 10.7 after loading two locator abutments, and 3.2 after loading all three locator abutments. After 1 year, OHIP-G14 was 2.6 without significantly changed. The mean of the sum score was 15.5 preoperatively, 27.8 after activation of the first locator, 39.4 after activation of two locators, 46.2 after activation of all three locators, and 47.3 after 1 year. An increase of 0.7 sum score units per time point was observed. No significance was detectable, analogous to OHIP-G14, compared to the time of activation of all three locator setups (p-value = 0.22)., Conclusions: A significant improvement in masticatory function performance and OHRQoL was evaluated with the increasing number of implants with locator attachment in edentulous mandible. With the investigation of the OHIP-G14 and sum score, the results of patient report outcome might be associated with the increase in the number of implants., (© 2024. The Author(s).)

In this study, we present TURead, an eye movement dataset of silent and oral sentence reading in Turkish, an agglutinative language with a shallow orthography understudied in reading research. TURead provides empirical data to investigate the relationship between morphology and oculomotor control. We employ a target-word approach in which target words are manipulated by word length and by the addition of two commonly used suffixes in Turkish. The dataset contains well-established eye movement variables; prelexical characteristics such as vowel harmony and bigram-trigram frequencies and word features, such as word length, predictability, frequency, eye voice span measures, Cloze test scores of the root word and suffix predictabilities, as well as the scores obtained from two working memory tests. Our findings on fixation parameters and word characteristics are in line with the patterns reported in the relevant literature., (© 2023. The Author(s).)

This study was planned to detect the adverse pathological consequences of aflatoxin B1 in White Leghorn (WLH) layer breeder males. Eight-week-old male layer cockerels were separated into six experimental categories: A group was kept as negative control, offered with normal feed only; group B was fed with 400 ppb amount of aflatoxin, while groups F and D fed with normal feed and supplemented with vitamin E 100 ppm and 1% Moringa oleifera, respectively, whereas groups E and C were fed with 400 ppb aflatoxin containing feed and ameliorated with vitamin E 100 ppm and 1% Moringa oleifera, respectively. This study was continued for 2 months and immunologic disorders and reproductive parameters were observed during the trial. To find out immunological status lymphoproliferative response to phytohemagglutinin-P (PHA-P), antibody titers against sheep red blood cells (SRBCs) and carbon clear assay were performed by collecting samples from five birds from each group. The whole data was measured by ANOVA test, and group means were compared by DMR test by using M-Stat C software. Regarding the reproductive status, spermatogenesis, blood testosterone level, testes weight, testes histology, sperm motility, and morphology were negatively affected by aflatoxins, but these deviations positively ameliorated by vitamin E and Moringa. Vitamin E and Moringa found advantageous in boosting the immune status of affected bird. All the immunological parameters including antibody titers against sheed red blood cells, lymphoproliferative response to avian tuberculin and phagocytic potential of macrophages were suppressed by AFB1 however in control, Moringa and vitamin E groups these immunological responses were significantly higher., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Pesticide application has become a mandatory requirement of the modern agricultural system, resulting in the objectionable levels of pesticide residues in the treated food commodities and posing health threats to the consumers. This study aimed at optimization and validation of an analytical method which can be reliably applied for routine monitoring of the selected eighteen widely reported pesticides in tomato and eggplant. The principle of quick, easy, cheap, effective, rugged, and safe, i.e., QuEChERS, involving the acetate-buffered extraction followed by cleanup using the primary secondary amines (PSA) was employed. The analytical method was validated at three spiking levels (0.05, 0.01, 0.005 mg/kg) using gas chromatograph-micro electron capture detector (GC-µECD). Gas chromatograph-mass spectrometric detector (GC-MSD) was also used for confirmation and quantification using selective ion monitoring (SIM) mode. The method was applied on fresh samples of tomato (n = 33) and eggplant (n = 27) collected from local markets of Khyber Pakhtunkhwa, Pakistan, in the crop season 2020-2021. Twenty-five (76%) tomato samples and fifteen (56%) eggplant samples were found positive for one or more pesticides. Though the chronic and acute health risk assessments indicate that both of these vegetables are unlikely to pose any unacceptable health threat to their consumers, yet the risks from regular intake of pesticides-contaminated food commodities should be regularly addressed for possible protection of the public health and assurance of safe and consistent agro-trade, alike., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Gut microbes are important and may play important role in spreading cancers specially the gastrointestinal malignancies preferably colorectal cancers. Gut microbes and diet can influence the tissues in gastrointestinal tract increasing the risk of cancer spread. Insufficient nutrient intake and imbalance diet can disturb the microbiome of gastrointestinal tract causing metabolism of xenobiotics which is beneficial as well as detrimental. Dietary imbalance may also weaken the immune system which is another reason for spreading and development of cancers. The triage of gut microbiome, host immune system, and dietary patterns may help the initiation of mechanism of carcinogenesis. In addition to its role in carcinogenesis and tumor development, there is still growing evidence as to how intestinal microflora influences the efficacy and toxicity of chemotherapy and immunotherapy by the gut microbiome. It can therefore be used as a biomarker to predict treatment response or poor response and can also be modified to improve cancer treatment., (© 2024. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Pediatric populations represent a major fraction of rare diseases and compound the intrinsic challenges of pediatric drug development and drug development for rare diseases. The intertwined complexities of pediatric and rare disease populations impose unique challenges to clinical pharmacologists and require integration of novel clinical pharmacology and quantitative tools to overcome multiple hurdles during the discovery and development of new therapies. Drug development strategies for pediatric rare diseases continue to evolve to meet the inherent challenges and produce new medicines. Advances in quantitative clinical pharmacology research have been a key component in advancing pediatric rare disease research to accelerate drug development and inform regulatory decisions. This article will discuss the evolution of the regulatory landscape in pediatric rare diseases, the challenges encountered during the design of rare disease drug development programs and will highlight the use of innovative tools and potential solutions for future development programs., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Global sustainable development demands boosting renewable energy and optimizing industrial structures. This study employs a panel vector autoregressive (PVAR) model to examine the dynamic relationship between energy structure, industrial structure, environmental quality, and urbanization in the BRICS countries from 1990 to 2021. Energy structure, industrial structure, environmental quality, and urbanization cointegrate empirically. Energy mix optimization and industrial structure upgrades can improve environmental quality. Energy enhancements also supported urbanization. Accelerating industrial change could adversely impact urbanization. The impulse response results demonstrate that expanding renewable energy and tertiary industries such as financial and service boost environmental quality and urbanization. The variance decomposition investigation reveals significant "path dependence" in reducing carbon emissions and increasing urbanization. Finally, based on the findings, policy insights for enhancing environmental quality and fostering urbanization are laid out and disputed, with long-term implications for environmental managers and urban planners., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Besides human leukocyte antigen (HLA-DRB1) locus, more than 100 loci across the genome have been identified and linked with the onset, expression and/or progression of rheumatoid arthritis (RA). However, there are still grey areas in our understanding of the key genetic contributors of the disease, particularly in familial cases., Methods: In the present study, we have performed the whole exome sequencing (WES) of RA patients from two consanguineous families of Pakistan in a quest to identify novel, high-impact, RA-susceptibility genetic variants., Results: Through stepwise filtering, around 17,000 variants (common in the affected members) were recognized, out of which 2651 were predicted to be deleterious. Of these, 196 had direct relevance to RA. When selected for homozygous recessive mode of inheritance, two novel pathogenic variants (c.1324T>C, p.Cys 442 →Arg 442 ; c.2036T>C, p.Ile 679 →Thr 679 ) in the TLR1 gene displayed the role of compound heterozygosity in modulating the phenotypic expression and penetrance of RA. The structural and functional consequences of the TLR1 missense single nucleotide mutations (Cys 442 →Arg 442 ; Ile 679 →Thr 679 ) were evaluated through molecular dynamic simulation (MDS) studies. Analysis showed domain's rigidification, conferring stability to mutant TLR1-TIR/TIRAP-TIR complex with concomitant increase in molecular interactions with pro-inflammatory cytokines, compared to the wild-type conformation. Gene co-expression network analysis highlighted interlinked partnering genes along with interleukin-6 production of TLR1 (corrected p-value 2.98e-4) and acetylcholine receptor activity of CHRNG (corrected p-value 6.12e-2) as highly enriched associated functions., Conclusion: The results, validated through case-control study subjects, suggested that the variants identified through WES and confirmed through Sanger sequencing and MDS are the novel disease variants and are likely to confer RA-susceptibility, independently and/or in a family-specific context. Key Points • Exploration of population based/ethno-specific big data is imperative to identify novel causal variants of RA. • Two new deleterious missense mutations in mutational hotspot exon 4 of TLR1 gene have been identified in Pakistani RA patients. • MD simulation data provides evidence for domain's rigidification, conferring stability to mutant TLR1-TIR/TIRAP-TIR complex, with concomitant increase in production of pro-inflammatory cytokines, thus adding to the onset/erosive outcome of RA., (© 2023. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Reducing carbon emissions is a critical approach for attaining global environmental sustainability and combating climate change. To investigate how energy, population, industry, and economic structure affect environmental quality. This study collects panel data for 90 Belt and Road (B&R) nations from 1995 to 2021. For the first time, the nonlinear dynamic impacts of renewable energy, newborn birth rate, industrialization, and economic growth on carbon emissions are investigated using a threshold panel model and a panel vector autoregression (PVAR) model. According to the study's findings: (1) models 1-4 demonstrate that all structural factors have substantial threshold impacts on carbon emissions, demonstrating a nonlinear connection. (2) Carbon emissions are negatively impacted by energy structure (renewable energy) and population structure (newborn birth rate). Industrial structure (industrialization) and economic structure (economic growth), on the other hand, have a beneficial influence on carbon emissions. However, when the structural variables grow in size, their threshold effects all increase this contribution. (3) In three groups of nations with varying wealth levels, differences in the influence intensity of structural factors on carbon emissions, particularly renewable energy and economic growth, were detected. The impact of renewable energy on carbon emissions is: middle-income (MI) countries > high-income countries (HI) > low-income countries (LI). The impact of economic growth on carbon emissions is MI countries > LI countries > HI countries. Based on the findings, relevant policy recommendations are provided to the policy makers of the "B&R" countries from the perspectives of structural factors and heterogeneity. It provides certain references for the realization of global environmentally sustainable development strategies and the coordinated development of economic, social and environmental systems., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Deep neural networks (DNNs) have recently showed remarkable performance in various computer vision tasks, including classification and segmentation of medical images. Deep ensembles (an aggregated prediction of multiple DNNs) were shown to improve a DNN's performance in various classification tasks. Here we explore how deep ensembles perform in the image segmentation task, in particular, organ segmentations in CT (Computed Tomography) images. Ensembles of V-Nets were trained to segment multiple organs using several in-house and publicly available clinical studies. The ensembles segmentations were tested on images from a different set of studies, and the effects of ensemble size as well as other ensemble parameters were explored for various organs. Compared to single models, Deep Ensembles significantly improved the average segmentation accuracy, especially for those organs where the accuracy was lower. More importantly, Deep Ensembles strongly reduced occasional "catastrophic" segmentation failures characteristic of single models and variability of the segmentation accuracy from image to image. To quantify this we defined the "high risk images": images for which at least one model produced an outlier metric (performed in the lower 5% percentile). These images comprised about 12% of the test images across all organs. Ensembles performed without outliers for 68%-100% of the "high risk images" depending on the performance metric used., (© 2023. The Author(s).)

In this research, the impact of land use and land cover (LULC) on debris flow was evaluated in the Gilgit to Khunjerab region. Two events have been done: (i) LULC stimulations for 2026 and 2030 using the MOLUSCE plugin and (ii) debris flow susceptibility mapping using linear aggression model. The evaluation of LULC on debris flow susceptibility is based on two scenarios: (i) existing (2010, 2014, 2018, 2022) LULC scenarios and (ii) stimulated (2026, 2030) LULC scenarios. The linear aggression model has 16 contributing factors to developing the debris flow susceptibility mapping. The main contributing components in debris flow susceptibility mapping are slope and LCCS. According to the linear aggressiveness model, debris flow susceptibility grows as the LULC changes, and the high susceptibility zones' share increases. For the current years 2010, 2014, 2018, and 2022, as well as the stimulated years 2026 and 2030, the model had high success rates (> 90.0%) and prediction rates (> 85.0%). The findings backed up prior research and suggested that the impact of LULC will grow in the future., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The Drug Burden Index (DBI) is a validated tool for assessing the dose-dependent cumulative exposure to sedative and anticholinergic medications. However, the increased risk of delirium superimposed dementia (DSD) with high DBI levels has not yet been investigated., Aim: This study aimed to examine the potential association between DBI scores and delirium in community-dwelling older adults with dementia., Method: A total of 1105 participants with cognitive impairment underwent a comprehensive geriatric assessment. Experienced geriatricians made the final diagnosis of delirium based on DSM-IV-TR and DSM-V. We calculated the DBI as the sum of all sedatives and anticholinergics taken continuously for at least four weeks before admission. Polypharmacy was defined as regular use of five or more medications. We classified the participants as having no exposure (DBI = 0), low exposure (0 < DBI < 1), and high exposure (DBI ≥ 1)., Results: Of the 721 patients with dementia, the mean age was 78.3 ± 6.7 years, and the majority were female (64.4%). In the whole sample, low and high exposures to anticholinergic and sedative medications at admission were 34.1% (n = 246) and 38.1% (n = 275), respectively. Patients in the high-exposure group had higher physical impairment (p = 0.01), higher polypharmacy (p = 0.01), and higher DBI scores (p = 0.01). In the multivariate Cox regression analysis, high exposure to anticholinergic and sedative medications increased the risk of delirium 4.09-fold compared to the no exposure group (HR = 4.09, CI: 1.63-10.27, p = 0.01)., Conclusion: High exposure to drugs with sedative and anticholinergic properties was common in community-dwelling older adults. A high DBI was associated with DSD, highlighting the need for an optimal prescription in this vulnerable population., Trial Registration: The trial was retrospectively registered at ClinicalTrials.gov. Identifier: NCT04973709 Registered on 22 July 2021., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

As per statistical estimations, we have only around 100 years of uranium life in terrestrial ores. In contrast, seawater has viable uranium resources that can secure the future of energy. However, to achieve this, environmental challenges need to be overcome, such as low uranium concentration (3.3 ppb), fouling of adsorbents, uranium speciation, oceanic temperature, and competition between elements for the active site of adsorbent (such as vanadium which has a significant influence on uranium adsorption). Furthermore, the deployability of adsorbent under seawater conditions is a gigantic challenge; hence, leaching-resistant stable adsorbents with good reusability and high elution rates are extremely needed. Powdered (nanostructured) adsorbents available today have limitations in fulfilling these requirements. An increase in the grafting density of functional ligands keeping in view economic sustainability is also a major obstacle but a necessity for high uranium uptake. To cope with these challenges, researchers reported hundreds of adsorbents of different kinds, but amidoxime-based polymeric adsorbents have shown some remarkable advantages and are considered the benchmark in uranium extraction history; they have a high affinity for uranium because of electron donors in their structure, and their amphoteric nature is responsible for effective uranium chelation under a wide range of pH. In this review, we have mainly focused on recent developments in uranium extraction from seawater through amidoxime-based adsorbents, their comparative analysis, and problematic factors that are needed to be considered for future research., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: Narrow-diameter implants facilitate single-tooth restoration when interdental or inter-implant spaces and bone volume are inadequate for using standard diameter implants. This study reports the short-term data on the clinical safety and performance of a bone-level-tapered two-piece implant with a 2.9 mm diameter in the clinical practice setting. This study was retrospectively registered on March 1st, 2016 (NCT02699866)., Methods: Implants were placed in partially healed extraction sockets of the central and lateral incisors in the mandible and lateral incisors in the maxilla for single-tooth replacement. The primary outcome was to assess implant survival at 12 months after placement. Secondary outcomes included implant success, pink esthetic score, marginal bone-level changes, and safety., Results: Twenty four males and 17 females with a mean age of 44.5 (± 18.3 standard deviation) received the implant. Three out of 41 implants were lost yielding a survival rate of 92.7% (95%-CI: 79.0%; 97.6%) at 1 year. One patient reported an ongoing foreign body sensation, pain, and/or dysesthesia at month 12. The average pink esthetic score at 6 months was 11.2 (95%-CI: 10.5; 11.9). The bone level was stable with a mean bone-level change of-0.3 mm (± 0.42 mm standard deviation) at 1 year after implantation. No serious adverse events or adverse device events were reported., Conclusions: The use of a 2.9 mm diameter bone-level-tapered implant is a safe and reliable treatment option for narrow tooth gaps at the indicated locations. Overall performance and good survival rates support their use in cases, where wider implants are unsuitable., (© 2023. Deutsche Gesellschaft für Implantologie im Zahn‐, Mund‐ und Kieferbereich e.V., Japanese Society of Oral Implantology.)

Objectives: The aim of the ITI Consensus Workshop on zygomatic implants was to provide Consensus Statements and Clinical Recommendations for the use of zygomatic implants., Materials and Methods: Three systematic reviews and one narrative review were written to address focused questions on (1) the indications for the use of zygomatic implants; (2) the survival rates and complications associated with surgery in zygomatic implant placement; (3) long-term survival rates of zygomatic implants and (4) the biomechanical principles involved when zygoma implants are placed under functional loads. Based on the reviews, three working groups then developed Consensus Statements and Clinical Recommendations. These were discussed in a plenary and finalized in Delphi rounds., Results: A total of 21 Consensus Statements were developed from the systematic reviews. Additionally, the group developed 17 Clinical Recommendations based on the Consensus Statements and the combined expertise of the participants., Conclusions: Zygomatic implants are mainly indicated in cases with maxillary bone atrophy or deficiency. Long-term mean zygomatic implant survival was 96.2% [95% CI 93.8; 97.7] over a mean follow-up of 75.4 months (6.3 years) with a follow-up range of 36-141.6 months (3-11.8 years). Immediate loading showed a statistically significant increase in survival over delayed loading. Sinusitis presented with a total prevalence of 14.2% [95% CI 8.8; 22.0] over a mean 65.4 months follow-up, representing the most common complication which may lead to zygomatic implant loss. The international experts suggested clinical recommendations regarding planning, surgery, restoration, outcomes, and the patient's perspective., (© 2023. Deutsche Gesellschaft für Implantologie im Zahn‐, Mund‐ und Kieferbereich e.V., Japanese Society of Oral Implantology.)

The aims of the this study are to select the best cultivation type for plant growth regulator (PGR) production, to optimize PGR production with statistical experimental design, and to calculate bioprocess parameters and yield factors during PGR production by P. eryngii in flask and reactor scales. Submerged fermentation was the best cultivation type with 4438.67 ± 37.14, 436.95 ± 27.31, and 54.32 ± 3.21 mg/L of GA 3 , ABA, and IAA production values, respectively. The Plackett-Burman and Box-Behnken designs were used to determine effective culture parameters and interactive effects of the selected culture parameters on PGR production by Pleurotus eryngii under submerged fermentation. The statistical model is valid for predicting PGR production by P. eryngii . After these studies, maximum PGR production (7926.17 ± 334.09, 634.92 ± 12.15, and 55.41 ± 4.38 mg/L for GA 3 , ABA, and IAA, respectively) was reached on the 18th day of fermentation under optimized conditions. The optimum formula was 50 g/L fructose, 3 g/L NaNO 3 , and 1.5 g/L KH 2 PO 4 , 1 mg/L thiamine, incubation temperature 25 °C, initial medium pH 7.0, and an agitation speed of 150 rpm. The kinetics of PGR production was investigated in batch cultivation under 3-L stirred tank reactor conditions. Concentrations of GA 3 , ABA, and IAA of 10,545.00 ± 527.25, 872.32 ± 21.81, and 60.48 ± 3.48 mg/L were obtained at the reactor scale which were 4.1, 3.4, and 2.3 times higher than the initial screening values. The specific growth rate ( µ ), the volumetric ( r p ) and specific ( Q p ) PGR production rates, 486.11 mg/L/day and 107.43 mg/g biomass/day for GA 3 , confirmed the successful transfer of optimized conditions to the reactor scale. In the presented study, PGR production of P. eryngii is reported for the first time., Competing Interests: Conflict of interestOn behalf of all the authors, the corresponding author states that there is no conflict of interest., (© King Abdulaziz City for Science and Technology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: As required in every dynamic stabilization system, the implantation of the BDYN TM device implies a perfect positioning of the screws and rods to benefit from its biomechanical properties. To achieve this goal, intra-operative imaging seems mandatory., Method: Through a case report of a patient with symptomatic grade I lumbar degenerative spondylolisthesis, we present the surgical tips for the implantation of BDYN TM dynamic stabilization system under the assistance of spinal navigation Surgivisio® 2D/3D., Conclusion: The pedicular screw convergence, their placement in the pedicles, and the proper alignment of the BDYN TM system placed in neutral position are important steps of the surgery. Intra-operative spinal navigation helps achieving precise and safe positioning of the dynamic stabilization BDYN TM device taking optimal advantages of its biomechanical characteristics., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Background: Takotsubo cardiomyopathy (TC) is a transient cardiac syndrome that manifests with symptoms resembling acute myocardial infarction (MI). It is characterized by temporary wall-motion abnormalities predominantly affecting the apical and mid-portions of the left ventricle, despite the absence of significant obstructive coronary disease. TC poses diagnostic challenges due to its resemblance to ST-segment elevation myocardial infarction. Our study aimed to determine the prevalence of TC and identify the factors associated with its occurrence in patients presenting with acute MI in Palestine., Results: A retrospective analysis was conducted on a cohort of patients diagnosed with TC at Al-Makassed hospital. Women accounted for 90.7% of TC cases (95% CI 88.2-93.2%). The mean age of affected individuals ranged from 62 to 76 years. The most common presenting symptoms were chest pain (83.4%, 95% CI 80.0-86.7%) and dyspnea (20.4%, 95% CI 16.3-24.5%), often following an emotionally or physically stressful event. Electrocardiography (ECG) on admission indicated ST-segment elevations in 71.1% of cases (95% CI 67.2-75.1%), accompanied by mild elevations of Troponins in 85.0% of cases (95% CI 80.8-89.1%). Despite the initial severity, left ventricular ejection fraction (LVEF) improved from 20-49.9 to 59-76% within a mean time of 7-37 days. The in-hospital mortality rate was 1.7% (95% CI 0.5-2.8%), with complete recovery observed in 95.9% of cases (95% CI 93.8-98.1%) and rare recurrence. The underlying etiology is believed to involve exaggerated sympathetic stimulation., Conclusions: TC should be considered as a significant differential diagnosis in acute coronary syndrome (ACS) cases, particularly among postmenopausal women with a preceding stressful event. Our study provides insights into the prevalence and characteristics of TC in the Palestinian population. While stress has been recognized as a potential trigger for TC, further research is needed to explore if there are specific associations between occupation and other unique stressors in the Palestinian context and the prevalence of TC. The study's results can raise awareness among healthcare professionals in Palestine about the prevalence and characteristics of TC in their patient population., (© 2023. Egyptian Society of Cardiology.)

Dissolved organic matter (DOM) in wastewater interacts with heavy metal particles in aquatic environments, which changes their dynamics and bioavailability. For quantifying the DOM, an excitation-emission matrix (EEM) paired alongside parallel factor analysis (PARAFAC) is typically employed. However, a drawback of PARAFAC has been revealed in recent studies, i.e., the rise of overlapping spectra or wavelength shifts in fluorescent components. Here, traditional EEM-PARAFAC and, for the first time, two-dimensional Savitzky-Golay second-order differential-PARAFAC (2D-SG-2nd-df-PARAFAC) were used to study the DOM-heavy metal binding. The samples from four treatment units of a wastewater treatment plant, i.e., influent, anaerobic, aerobic, and effluent, underwent the process of fluorescence titration with Cu 2+ . Four components were separated with dominant peaks in regions I, II, and III (proteins and fulvic acid-like) through PARAFAC and 2D-SG-2nd-df-PARAFAC. A single peak was observed in region V (humic acid-like) by PARAFAC. In addition, Cu 2+ -DOM complexation indicated clear differences in DOM compositions. The binding strength increased between Cu 2+ and fulvic acid-like components in contrast to protein-like components from influent to the effluent, and increasing fluorescence intensity with the addition of Cu 2+ in the effluent indicated changes in their structural composition. Moreover, when comparing both methods, the 2D-SG-2nd-df-PARAFAC provided the components without peak shifts and better fitting for Cu 2+ -DOM complexation model, demonstrating it to be a more reliable technique compared to only traditional PARAFAC for DOM characterization and quantifying metal-DOM in wastewater., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Homogeneous low-attenuation renal masses that are too small to characterize (tstc) are considered clinically insignificant; however, based primarily on expert opinion., Objective: To determine the prevalence of malignant or possibly malignant masses among homogeneous low-attenuation renal masses that are tstc., Materials and Methods: This retrospective cross-sectional study evaluated 75 patients with 104 tstc who underwent renal CT and MRI between Jan 2016 and Jul 2022. Low-attenuation renal masses measuring < 1 cm in size were identified and, independently evaluated by two blinded radiologists measuring attenuation (Hounsfield Units, HU) at non-contrast enhanced CT (NECT) and nephrographic phase contrast-enhanced (CE)-CT when possible. Reference standard for benign cyst was MRI and for other renal masses was pathology or MRI showing enhancement., Results: Average tstc size was 6 ± 2 (range 2-10) mm. Considering only incidental tstc (CT performed for another reason), 100% (98/98, 95%CI 96-100%) tstc were benign. Overall, considering both incidental and tstc referred for further characterization, there were 94% (98/104; 95% Confidence Intervals [CIs] 88-98%) benign cysts and 6% (6/104; 95%CI 2-12%) other masses (1 Bosniak 2F cystic mass, 2 probable renal cell carcinoma (RCC), three metastases). Pseudoenhancement, attenuation change > 10 HU or > 20 HU, was present in 29% (15/59) and 12% (7/59) benign cysts. All six other masses enhanced by > 20 HU. CECT threshold of ≤ 30 HU correctly classified 62% of benign cysts (61/98). All six other masses measured > 30 HU at CECT., Conclusion: The prevalence of malignant or possibly malignant renal masses among homogeneous low-attenuation too small to characterize masses among incidental tstc masses is near zero. Attenuation measurements misclassify a substantial proportion of these cysts, likely due to their small size., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This study explores the relationship between economic growth, tourism, and the environment in South Asian economies. It finds that factors such as GDP, human capital, globalization, and financial risk are interconnected and have long-term associations in these countries. The study employs various methodologies and tests to analyze the data. The author employs novel panel methodologies such as the method of moment of quantile regression analysis, slope heterogeneity, cross-section dependence test, and Westerlund cointegration. Additionally, a causality test along with the latest unit-root test is used. The results reveal important findings. As GDP expands, its impact on international tourism diminishes at higher quantiles, suggesting a decreasing effect. However, GDP still contributes positively to tourism across all quantiles. Human capital has a stronger effect on attracting tourists at lower quantiles, while globalization has varying impacts depending on the level of globalization in a country. Financial risk has a greater negative impact on tourism in larger economies compared to smaller ones. The study also examines the relationship between CO 2 emissions and the variables under investigation. It finds that the effect of GDP on emissions decreases at higher quantiles, indicating a smaller contribution. Human capital has a larger effect on reducing emissions at lower quantiles, while the impact of globalization is more significant at higher quantiles. Moreover, an increase in financial risk leads to a decrease in emissions, particularly at lower quantiles. Based on these findings, the study suggests policy recommendations for South Asian economies. These include promoting sustainable tourism practices, investing in human capital development, encouraging responsible globalization, mitigating financial risks, and aligning tourism strategies with sustainable development goals., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction and Hypothesis: Data from a large US population-based, cross-sectional, epidemiological study (the EpiNP Study) were used to assess the symptoms and bother experienced by women with nocturnal polyuria (NP)., Methods: Consenting participants recruited from an online panel completed the baseline EpiNP survey online (Lower Urinary Tract Symptoms Tool and urological comorbidities). All reporting ≥2 voids/night and a random sample of 100 respondents, each reporting 0 or 1 void/night were asked to complete a 3-day web-based bladder diary recording time, volume, and urgency rating of each void. NP was calculated by the proportion of urine production that occurred during nocturnal hours using a Nocturnal Polyuria Index (NPI33) threshold of >0.33 or nocturnal urine production of >90 ml/h (NUP90). The frequency of participants reporting LUTS and bother was determined by age and NP: idiopathic NP, NP associated with overactive bladder (NPOAB), NP associated with comorbidities (NPCom), and no NP (did not meet NP criteria)., Results: A total of 5,290 women completed the baseline survey. Mean age (range) was 54.9 (30-95) years; 1,841 (34.8%) reported ≥2 nocturnal voids. The prevalence of LUTS increased across the lifespan; however, bother associated with each LUTS decreased with increasing age. The percentage of women rating bother by nocturia episodes ≥2 "> somewhat" ranged from 40.3% to 68.3%, with bother ratings highest in the NPOAB and No NP groups., Conclusions: NP is prevalent in women with considerable bother and is often associated with other urinary symptoms. Multifactorial causes and potential treatments of NP should be considered, particularly at a later age., (© 2023. The International Urogynecological Association.)

The management of ship-generated oily waste is subject to international regulations due to its high environmental impact and significant valorisation potential. The advancement of research leads port authorities to think of emerging technologies to add value to existing systems. In light of this, the objective of this paper is to devise and simulate a collection system based on Internet of Things technology. It is primarily an intelligent simulator with capabilities of sensors' imitation, relaying data, evaluating vehicle routing algorithms and calculation of performance indicators. Using a numerical experience adapted from the regional context in Morocco, the metrics about collected quantities, transportation distances and tank storage levels tend to prefer the intelligent scenario over the status quo. The total distance travelled has decreased by 45.25%, and the average quantity collected per round has risen by 24.22%. On average, every cubic meter stored in a port saves 16.4 km of monthly travelled distances. These results warrant additional study to evaluate the impact of a national coverage extent. Nevertheless, additional tests on investment requirements in terms of network implementation and storage resources are essential to prove the acquisition of this solution is viable in the long range., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Purpose: The purpose of this document is to clarify the biomechanical principles involved when zygoma implants are placed under functional loads., Methods: Two independent reviewers conducted electronic search of the literature from January 2000 to February 2023 describing the biomechanical principles involved using the zygoma implant for maxillary reconstruction. Articles describing the stresses within the zygoma implant, the maxillary bone and the zygoma bone under functional loads were included., Results: The lack of maxillary boney support at the implant platform resulted in significant higher stress measured within the zygoma implant as well as the zygoma bone., Conclusion: The maxilla is the primary support when zygoma implants are placed under functional loads. Quad-cortical stabilization of the zygoma implants and their cross-arch stabilization are recommended to reduce the degree of stress whenever possible., (© 2023. The Author(s).)

Background: Intraoperative molecular imaging (IMI)-guided resections have been shown to improve oncologic outcomes for patients undergoing surgery for solid malignancies. The technology utilizes fluorescent tracers targeting cancer cells without the use of any ionizing radiation. However, currently available targeted IMI tracers are effective only for tumors with a highly specific receptor expression profile, and there is an unmet need for IMI tracers to label a broader range of tumor types. Here, we describe the development and testing of a novel tracer (CR)-S0456) targeted to the sodium multivitamin transporter (SMVT)., Methods: Preclinical models of fibrosarcoma (HT-1080), lung (A549), breast (4T1), and renal cancers (HEK-293 T) in vitro and in vivo were used for assessment of (CR)-S0456 specific tumor labeling via sodium-mediated SMVT uptake in dipotassium phosphate or choline chloride-containing media buffer. Additionally, pharmacologic inhibition of multiple intracellular coenzyme-R obligate signaling pathways, including holocarboxylase synthetase (sulconazole nitrate), PI3K/AKT/mTOR (omipalisib), and calmodulin-dependent phosphatase (calmidazolium), were investigated to assess (CR)-S0456 uptake kinetics. Human fibrosarcoma-bearing xenografts in athymic nude mice were used for tumor and metabolic-specific labeling. Novel NIR needle confocal laser endomicroscopic (nCLE) intratumoral sampling was performed to demonstrate single-cell specific labeling by CR-S0456., Results: CR-S0456 localization in vitro correlated with highly proliferative cell lines (MTT) and doubling time (p < 0.05) with the highest microscopic fluorescence detected in aggressive human fibrosarcomas (HT-1080). Coenzyme-R-specific localization was demonstrated to be SMVT-specific after competitive inhibition of internal localization with excess administration of pantothenic acid. Inhibiting the activity of SMVT by affecting sodium ion hemostasis prevented the complete uptake of CR-S0456. In vivo validation demonstrated (CR)-S0456 localization to xenograft models with accurate identification of primary tumors as well as margin assessment down to 1 mm 3 tumor volume. Systemic treatment of xenograft-bearing mice with a dual PI3K/mTOR inhibitor suppressed intratumoral cell signaling and (CR)-S0456 uptake via a reduction in SMVT expression. Novel analysis of in vivo intratumoral cytologic fluorescence using near-infrared confocal laser endomicroscopy demonstrated the absence of coenzyme-R-mediated NIR fluorescence but not fibroblast activation protein (FAP)-conjugated fluorochrome, indicating specific intracellular inhibition of coenzyme-R obligate pathways., Conclusion: These findings suggest that a SMVT-targeted NIR contrast agent can be a suitable tracer for imaging a wide range of malignancies as well as evaluating metabolic response to systemic therapies, similar to PET imaging with immune checkpoint inhibitors., (© 2022. The Author(s), under exclusive licence to World Molecular Imaging Society.)

Purpose: To assess the outcome [zygomatic implant (ZI) survival] and complications of the original surgical technique (OST) and an Anatomy-Guided approach (AGA) in the placement of ZI in patients with severely atrophic maxillae., Methods: Two independent reviewers conducted an electronic literature search from January 2000 to August 2022. The inclusion criteria were articles reporting at least five patients with severely atrophic edentulous maxilla undergoing placement OST and/or AGA, with a minimum of 6 months of follow-up. Number of patients, defect characteristics, number of ZI, implant details, surgical technique, survival rate, loading protocol, prosthetic rehabilitation, complications, and follow-up period were compared., Results: Twenty-four studies comprised 2194 ZI in 918 patients with 41 failures. The ZI survival rate was 90.3-100% in OST and 90.4-100% in AGA. Probability of complications with ZI with OST was as follows: sinusitis, 9.53%; soft tissue infection, 7.50%; paresthesia, 10.78%; oroantral fistulas, 4.58%; and direct surgical complication, 6.91%. With AGA, the presenting complications were as follows: sinusitis, 4.39%; soft tissue infection, 4.35%; paresthesia, 0.55%; oroantral fistulas, 1.71%; and direct surgical complication, 1.60%. The prevalence of immediate loading protocol was 22.3% in OST and 89.6% in the AGA. Due to the heterogeneity of studies, statistical comparison was only possible after the descriptive analysis., Conclusions: Based on the current systematic review, placing ZI in severely atrophic edentulous maxillae rehabilitation with the OST and AGA is associated with a high implant survival rate and surgical complications within a minimum of 6 months follow-up. Complications, including sinusitis and soft tissue infection around the implant, are the most common. The utilization of immediate loading protocol is more observed in AGA than in OST., (© 2023. The Author(s).)

Background: Robot-assisted distal pancreatectomy (RDP) is increasingly used as an alternative to laparoscopic distal pancreatectomy (LDP) in patients with resectable pancreatic cancer but comparative multicenter studies confirming the safety and efficacy of RDP are lacking., Methods: An international, multicenter, retrospective, cohort study, including consecutive patients undergoing RDP and LDP for resectable pancreatic cancer in 33 experienced centers from 11 countries (2010-2019). The primary outcome was R0-resection. Secondary outcomes included lymph node yield, major complications, conversion rate, and overall survival., Results: In total, 542 patients after minimally invasive distal pancreatectomy were included: 103 RDP (19%) and 439 LDP (81%). The R0-resection rate was comparable (75.7% RDP vs. 69.3% LDP, p = 0.404). RDP was associated with longer operative time (290 vs. 240 min, p < 0.001), more vascular resections (7.6% vs. 2.7%, p = 0.030), lower conversion rate (4.9% vs. 17.3%, p = 0.001), more major complications (26.2% vs. 16.3%, p = 0.019), improved lymph node yield (18 vs. 16, p = 0.021), and longer hospital stay (10 vs. 8 days, p = 0.001). The 90-day mortality (1.9% vs. 0.7%, p = 0.268) and overall survival (median 28 vs. 31 months, p = 0.599) did not differ significantly between RDP and LDP, respectively., Conclusions: In selected patients with resectable pancreatic cancer, RDP and LDP provide a comparable R0-resection rate and overall survival in experienced centers. Although the lymph node yield and conversion rate appeared favorable after RDP, LDP was associated with shorter operating time, less major complications, and shorter hospital stay. The specific benefits associated with each approach should be confirmed by multicenter, randomized trials., (© 2023. The Author(s).)

The energy sector is a crucial pillar of the economic development of every nation. In developing countries, renewable energy deployment is scarce; consequently, the government and private sectors are exploring efficient energy resources. This research aims to scrutinize the linkages among value orientation, utilitarian benefits, collectivism, the reason for adoption, attitude toward renewable energy (RE), and adoption intention in the renewable energy context. The study analyzes survey data from 359 Pakistani consumers using solar panels for households. An approach called structural equation modeling is applied to evaluate hypotheses. Empirical findings suggest that value orientation positively and significantly influences the reason for the adoption of RE and attitude toward RE. Similarly, the utilitarian benefit positively and substantially affects attitude toward RE. Moreover, collectivism and reason for adoption are substantially and favorably related to attitude toward RE. The study's findings also show that customer intentions to use renewable energy are favorably and substantially influenced by RE attitudes. The research has contributed to the enhancement of future avenues for scholars and professionals are provided by the literature on renewable practice., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Numerous Chinese manufacturing organizations are grappling with the challenge of absorbing and using green information acquisition across the supply chain to achieve excellent firm performance. Utilizing the organizational learning theory's indirect stream of research, we address this research gap by developing a moderated-mediation framework to investigate the impact of green information acquisition and institutional pressure on a firm's performance. Hypotheses are evaluated by taking a sample of 567 manufacturing enterprises in China. Structural equation modeling (SEM) has been applied to analyze and investigate the proposed hypotheses. Empirical results indicate that absorptive capacity significantly mediates the relationship between green information acquisition and firm performance. In a similar vein, institutional pressure significantly moderates the relationship between green information acquisition and firm performance. Study findings have essential managerial recommendations for Chinese manufacturing enterprises, proposing that they considerably enhance their absorptive capacity and continuously monitor institutional pressure to reap the advantages of green information acquisition on firm performance., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

We aimed to compare the effectiveness of panoramic radiography (PR) and cone beam computed tomography (CBCT) in radiographic diagnosis of maxillary sinus (MS) diseases. MS diseases (mucosal thickening, mucus retention cyst, polyp sinusitis, mucocele and tumoral formations) was carried out on both PR and CBCT images belonging to 625 patients. Analyzes were performed separately for right and left maxillary sinus, and total of 1250 PR and CBCT images. While a diagnosis of disease was made in 42.96% of a total of 1250 MS according to CBCT. According to PR, diagnosis was made in 58.72%. The 537 diagnoses where lesion presence was determined on CBCT in our study were compared over PR, and it was observed that, there was the right diagnosis (true positive) in 106 (19.73%) of these including respectively mucus retention cyst (n = 88), polyp (n = 16), 1 sinusitis and 1 tumor, and there was an incorrect diagnosis (false positive) in 221 (41.15%). In 42.92% of the MS that were identified as healthy based on CBCT, the correct diagnosis was also made on PR (true negative). The use of CBCT instead of PR in the diagnosis of pathological or inflammatory diseases contributes to a more accurate radiographic differential diagnosis., Competing Interests: Conflict of interestAll authors declare that they have no conflict of interest., (© Association of Otolaryngologists of India 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background and Aims: There are limited data about the benign biliary strictures (BBS) which can develop during the clinical course of acute biliary pancreatitis (ABP) due to compression of the common bile duct (CBD) by edematous and inflamed pancreatic tissue. We aimed to determine the incidence of BBS due to ABP and its clinical course after endoscopic management., Methods: The study was retrospectively conducted among patients with ABP who were admitted to a single tertiary reference center during 3 years. BBS-ABP was defined as distal narrowing of the CBD with proximal dilatation and delayed drainage of the contrast into the duodenum. Endoscopic treatment was performed by inserting a single 7F or 10F plastic stent which was exchanged every 3 months until stricture resolution. Patients were followed for 1 year after stricture resolution., Results: Seven hundred and twenty-one patients had ABP during the study period. Among them, 257 (35.6%) patients underwent ERCP and 26 patients (3.6%) had CBD stricture due to ABP. A 7 Fr plastic stent was inserted in 18 patients and 10 Fr in 8 patients. The stricture was completely resolved at 3 months in 66.7%, at 6 months 23.8% and at 9 months (9.5%) of the patients. There was no procedure-related complications other than asymptomatic stent migration in 4 (19%) patients. None of the patients had recurrent biliary stricture during the 1 year stent-free follow-up period., Conclusion: BBS-ABP is a frequently seen clinical entity. In most patients, the stricture improves within 3 months and temporary endoscopic stenting prevents the patients from the consequences of the obstruction during this period., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Due to China's massive usage of fossil fuels, climate change concerns have become serious challenges to the country's sustainable development. Despite the fact that China has effectively employed solar technology to address these problems, there is a paucity of research examining consumers' intention to adopt solar energy in the rural region of China. This study intends to fill this gap in the literature by studying consumers' buying intentions for solar energy in rural China for household purposes. Additionally, the study added to the theory of planned behavior by adding three new variables, namely, environmental knowledge, environmental concern, and beliefs about the benefits of solar energy. Primary data were collected from 847 respondents in Hebei Province using a comprehensive questionnaire survey. Structural equation modeling was employed to examine the data. Empirical results revealed that attitude, environmental knowledge, subjective norm, perceived behavioral control, and beliefs about the benefits of solar energy positively influence buying intention of solar energy. On the contrary, environmental concern had no significant effect on buying intention for solar energy. Study outcomes emphasize the critical significance of changing societal norms, boosting consumer awareness, redesigning regulatory mechanisms, and stressing the benefits provided by solar power through coherent and persistent efforts while simultaneously enhancing environmental sustainability practices., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The energy needs of Pakistan have increased many folds in recent years due to improved lifestyle, ever-increasing population, and economic development. Though the government and private sectors are considering efficient energy resources to overcome energy scarcity in the country, studies focusing on assessing consumers' sustainable consumption behavior in the form of energy-saving home appliances are limited in the country. This study aims to address this research gap and also contribute by augmenting the theoretical mechanism of the theory of planned behavior by including three unique dimensions (eco-label knowledge, attitude toward environment, and customer green trust) to comprehensively analyze sustainable consumption behavior in the Pakistani context. An analysis is performed on survey data of 631 consumers in the four largest cities of Pakistan: Karachi, Lahore, Faisalabad, and Islamabad. For the purpose of evaluating formulated hypotheses, the structural equation modeling approach is employed. Empirical findings suggest that eco-label knowledge positively and significantly influences attitude toward environment and consumer green trust. Similarly, attitude toward environment and consumer green trust has a positive and significant influence on purchase intention. Moreover, a significant positive relationship exists between consumer green trust and purchase intention. The research outcomes further disclose that purchase intention positively and significantly influence paying attention to environmental labels. These findings contribute to the literature on sustainable consumption behavior and provide academics and practitioners with future directions to transform social norms, raise consumers' awareness, and redesign policy frameworks through integrative and consistent efforts., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Flood disasters resulting from excessive water in stream beds inflict extensive damage. Floods are caused by the expansion of cities, the erosion of riverbeds, inadequate infrastructure, and increasing precipitation due to climate change. Floods cause great damage to agricultural areas and settlements. Regions that may be affected by floods should be identified, and precautions should be taken in these areas to prevent these damages. Flood susceptibility maps are produced for this reason. The purpose of this study was to construct a flood susceptibility map so that susceptible locations in Mersin may be identified. Firstly, 429 flood events were identified for the flood inventory map. Twelve conditioning factors, namely elevation, slope, distance to river, distance to drainage, drainage density, soil permeability, precipitation, land cover/land use, stream power index (SPI), topographic wetness index (TWI), aspect, and curvature were used to create flood susceptibility maps, applying logistic regression and best-worst methods. The flood inventory data were used to prepare susceptibility maps and test their consistency. The receiver operating characteristic (ROC) curve was used for consistency analysis. In logistic regression, 86% of floods were located within 20% of the study area that was categorized as high and very high susceptibility. According to the value of the area under the ROC curve (AUC), logistic regression had a 0.901 value. Land use, soil permeability, and elevation were the most important factors in the logistic regression method. In the best-worst method, 85% of floods were located within the 14% of the study area categorized as high and very high susceptibility. According to the AUC value, the best-worst method had a 0.898 value. Elevation, distance to river, and precipitation factors had the highest coefficient value in the best-worst method. Based on the AUC values, the flood susceptibility maps had a high prediction capacity., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: In November 2021, variant B.1.1.529 of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified by the World Health Organization (WHO) and designated Omicron. Omicron is characterized by a high number of mutations, thirty-two in total, making it more transmissible than the original virus. More than half of those mutations were found in the receptor-binding domain (RBD) that directly interacts with human angiotensin-converting enzyme 2 (ACE2). This study aimed to discover potent drugs against Omicron, which were previously repurposed for coronavirus disease 2019 (COVID-19). All repurposed anti-COVID-19 drugs were compiled from previous studies and tested against the RBD of SARS-CoV-2 Omicron., Methods: As a preliminary step, a molecular docking study was performed to investigate the potency of seventy-one compounds from four classes of inhibitors. The molecular characteristics of the best-performing five compounds were predicted by estimating the drug-likeness and drug score. Molecular dynamics simulations (MD) over 100 ns were performed to inspect the relative stability of the best compound within the Omicron receptor-binding site., Results: The current findings point out the crucial roles of Q493R, G496S, Q498R, N501Y, and Y505H in the RBD region of SARS-CoV-2 Omicron. Raltegravir, hesperidin, pyronaridine, and difloxacin achieved the highest drug scores compared with the other compounds in the four classes, with values of 81%, 57%, 18%, and 71%, respectively. The calculated results showed that raltegravir and hesperidin had high binding affinities and stabilities to Omicron with ΔG binding of - 75.7304 ± 0.98324 and - 42.693536 ± 0.979056 kJ/mol, respectively. Further clinical studies should be performed for the two best compounds from this study., (© 2023. The Author(s).)

Purpose: This retrospective cohort study evaluates the regeneration of severe peri-implantitis deficiencies treated with the laser-assisted peri-implant defect regeneration (LAPIDER) approach within a 3-year follow-up., Methods: Twenty-four implants with severe peri-implantitis in 18 patients were treated according to the LAPIDER technique. In contrast to classic techniques for reconstructive peri-implantitis surgery with a marginal incision, a buccal split-flap preparation avoiding papillae separation was used. After a coronal flap elevation and a laser-assisted peri-implant defect cleaning, connective tissue and autogenous bone grafting was performed. Primary outcomes were the changes of the marginal bone levels (MBL) and the buccal bone thickness. Secondary outcomes included implant survival, peri-implant probing depths (PPD), bleeding on probing (BOP), recession, width of keratinized mucosa (KMW), thickness of keratinized mucosa (KMT), soft tissue esthetics (PES), and implant success., Results: MBL improved interproximal by 3.10 ± 2.02 mm (p < 0.001), buccal by 3.49 ± 2.89 mm (p < 0.001), and lingual by 1.46 ± 1.98 mm (p = 0.003); buccal bone thickness by 0.55 ± 0.60 mm (p = 0.005), and 1.01 ± 1.25 mm (p = 0.001) at 1 and 3 mm below reference level. Two implants were removed; 22 implants were still in function at a mean follow-up of 36 months. PPD changed from 5.05 ± 1.39 to 3.08 ± 0.71 mm (p < 0.001); recession was reduced from 2.07 ± 1.70 to 0.91 ± 1.13 mm (p = 0.001); KMW increased from 2.91 ± 1.81 to 4.18 ± 1.67 mm (p = 0.006); KMT improved from 1.73 ± 0.50 to 2.44 ± 0.43 mm (p < 0.001); PES changed from 7.7 ± 2.8 to 10.7 ± 1.9 (p < 0.001). 45.8% to 54.2% of the implants met the criteria of implant success., Conclusions: The favorable results document the proof of principle for the regeneration of severe peri-implant hard and soft tissue deficiencies by the LAPIDER treatment approach., (© 2023. The Author(s).)