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The purpose of teeth whitening is the removal of intrinsic or extrinsic discoloration via mechanical or chemical techniques that restore the teeth to their natural shade or lighten it, depending on the chosen method. Both the abrasive particles used in mechanical procedures and the oxidant agents applied in chemical bleaching are effective if they are used according to the stain aetiology, however, the risks associated with these products (e.g. potential tooth wear, sensitivity, damage of the enamel or dentin organic matrix) are not negligible. As a response to these issues, current research in the tooth whitening field is directed towards the development of safer whitening products such as dentifrices with lower abrasive index, natural bleaching agents, or laser-assisted whitening procedures that require shorter exposure time for optimal results. This review aims to provide a description of the currently available teeth whitening techniques and their limitations, as well as the novel alternatives that promise similar or superior results with less potential side effects. For a better understanding of the subject, the structure of the tooth, the causes of teeth discoloration as well as the mechanisms of action and chemistry behind the abrasive agents and peroxide-based whitening processes were also discussed.

Labour costs are a fundamental component of production expenses, significantly impacting both the quantity and quality of output. This study explores the determinants of labour costs within EU member states that have implemented minimum wage policies over the past two decades. The research technique includes a comprehensive panel analysis of EU member states to identify significant variables influencing labour costs, as well as cluster analysis to discover underlying patterns across the nations under examination. Our findings reveal that higher minimum wage levels, higher employment rates, increased labour productivity, and greater trade openness are positively correlated with higher labour costs. Specifically, increases in these variables lead to higher wages and a broader tax base, while greater trade openness results in elevated labour costs due to expanded market opportunities. Conversely, gross fixed capital formation negatively affects labour costs, as investments in production assets tend to reduce labour requirements or hours worked. The cluster analysis led to the identification of three distinct groups. The first cluster consists of well-developed economies with modest labour cost increases and average minimum wages. The second cluster includes countries with substantial labour cost increases, low minimum wages, and significant productivity gains. The third cluster features nations with high minimum wages and high employment rates. This paper contributes to the field by highlighting the complex interplay between labour costs and economic factors, offering insights for decision-makers to tailor macroeconomic and company-level strategies to specific local conditions. The findings emphasise the importance of balancing wage policies with sustainable economic development to enhance competitiveness while ensuring fair labour conditions.

Carbonaceous aerosols (CA), composed of black carbon (BC) and organic matter (OM), significantly impact the climate. Light absorption properties of CA, particularly of BC and brown carbon (BrC), are crucial due to their contribution to global and regional warming. We present the absorption properties of BC (bAbs,BC) and BrC (bAbs,BrC) inferred using Aethalometer data from 44 European sites covering different environments (traffic (TR), urban (UB), suburban (SUB), regional background (RB) and mountain (M)). Absorption coefficients showed a clear relationship with station setting decreasing as follows: TR > UB > SUB > RB > M, with exceptions. The contribution of bAbs,BrC to total absorption (bAbs), i.e. %AbsBrC, was lower at traffic sites (11–20 %), exceeding 30 % at some SUB and RB sites. Low AAE values were observed at TR sites, due to the dominance of internal combustion emissions, and at some remote RB/M sites, likely due to the lack of proximity to BrC sources, insufficient secondary processes generating BrC or the effect of photobleaching during transport. Higher bAbs and AAE were observed in Central/Eastern Europe compared to Western/Northern Europe, due to higher coal and biomass burning emissions in the east. Seasonal analysis showed increased bAbs, bAbs,BC, bAbs,BrC in winter, with stronger %AbsBrC, leading to higher AAE. Diel cycles of bAbs,BC peaked during morning and evening rush hours, whereas bAbs,BrC, %AbsBrC, AAE, and AAEBrC peaked at night when emissions from household activities accumulated. Decade-long trends analyses demonstrated a decrease in bAbs, due to reduction of BC emissions, while bAbs,BrC and AAE increased, suggesting a shift in CA composition, with a relative increase in BrC over BC. This study provides a unique dataset to assess the BrC effects on climate and confirms that BrC can contribute significantly to UV–VIS radiation presenting highly variable absorption properties in Europe.

Carbon black - materials rich in carbon nanostructures - have been successfully applied as modifiers of electrochemical transducers, rivalling other carbon nanomaterials for cost and ease-of-use. Despite the remarkable promise of this nanomaterial, no study has yet comparatively characterised a wide range of different grades of carbon black for their utility in electrochemical sensors. Here, we explore several commonly-studied carbon black grades (N220, N234, N326, N330, N339, N375, N550, N660 and Lamp Black-101), alongside relatively newer grades (Printex®-200, Printex® G, Printex® XE-2B, and Printex® Zeta) for their application in electrochemical sensors. The effects of coating glassy carbon electrodes with carbon black on electrode performance were studied by cyclic voltammetry using three redox probes: ferri-/ferrocyanide (anionic probe molecules), ferrocenemethanol (neutral) and hexaammineruthenium (cationic). Raman Spectroscopy characterisation of the different grades associated a lower degree of graphitisation with superior electrode modifiers. Generally, modification increased the anodic peak current for ferri-/ferrocyanide probes; and lowered anodic potential for ferri-/ferrocyanide and hexaammineruthenium probes. Increases in peak current and potential observed at ferrocenemethanol are consistent with the increased tendency for this probe to adsorb to the surface of modified electrodes. N330 and Printex® XE-2B displayed the best electrocatalytic properties in terms of enhanced peak currents and lowered anodic overpotentials for the redox probes. CB grades were used to modify screen-printed carbon electrodes and the obtained sensors examined for anodic detection of reduced nicotinamide adenine dinucleotide (NADH) cofactor by cyclic voltammetry. Printex® XE-2B significantly improved the detection of NADH and was further used for chronoamperometric detection of NADH at low overpotentials. Grades N220, N375, N550 and P-G showed their suitability as enzyme scaffolds for sensor fabrication, as determined by their preservation of the activity of a NAD-dependent aldehyde dehydrogenase.

Aristophanes2 (446–386 BC), Thucydides (460–c. 400 BC),3 and Erasmus of Rotterdam (1466–1536)4 were concerned with the importance of maintaining peace among peoples and wrote about this concept. The latter author even speaks about the ‘Arts of Peace’ in his third book dedicated to the education of a prince. But recent literature, especially that within the field of Byzantine and European Medieval culture, does not containsubstantial works dedicated to the notion of peace. My main research question is why this is the case since this notion connects many others and should be central to academic research. Within the paper I elaborate on several types of peace agreements: those confirming a ‘complete’ victory of one of the opponent parties involved in a war, those reached mainly by exchange of territories, those having the exchange of prisoners as central, and those referring to the payment of tribute for various purposes.

Poverty is a challenge for all countries and its eradication is a common goal in the European Union. Our paper analyses the statistical and theoretical relationship between social inequalities and the at-risk-of-poverty rate. For a holistic understanding of the poverty phenomenon in the EU, other variables such as economic growth, social protection expenditure, and the old-age dependency ratio were also included in the analysis. The methodology is based on panel data models. A regression model was built with data for the period 2011-2022, for the 27 EU countries. The econometric model of the at-risk-of-poverty rate highlighted a series of factors, among which the Gini coefficient is one of the most influential. Other important factors were research and development expenditure, social protection expenditure, GDP per capita, the unemployment rate, and the old-age dependency ratio. The cluster analysis grouped the EU countries into three clusters. Understanding the phenomenon of poverty is a prerequisite for alleviating it, generating social solidarity, and rebuilding a fairer society. Our research contributes to the evaluation of the interaction between inequalities and poverty in Romania and the EU.

A new non-sparking metallic material, Cu-Ti, with applications in potentially explosive environments is proposed as an alternative to CuBe, to reduce the processing and toxic effects of Be. Using high-purity Cu and Ti materials, a Cu (~3–4 wt%) Ti alloy with good chemical and structural homogeneity was fabricated in an induction furnace under an Ar atmosphere. The hot-rolled material was tested in an explosive gas mixture (10% H2 or 6.5% CH4) under extremely severe wear tests for 15,000 cycles, and no hot sparks were produced to ignite the medium. The material was investigated as hot-rolled plates (600 s at 950 °C and 10% reduction). The microstructures and surface of the wear test samples were investigated by light optical microscopy (LOM) and scanning electron microscopy (SEM). The chemical compositions were determined by energy dispersive spectrometry (EDS). The corrosion behavior was studied using electrochemical techniques: open-circuit, linear, and cyclic potentiometry in saline electrolyte solutions. The mechanical properties, such as microhardness and friction coefficient, were determined using UMT equipment. The results showed that the alloy is suitable for applications requiring non-ignition properties, with good hot rolling deformability and chemical composition homogeneity. Regarding the corrosion analysis and mechanical properties of the experimental CuTi alloy, minor differences were observed between the cast- and hot-rolled material.

Background/Objectives: Hashimoto’s thyroiditis (HT) is an autoimmune disorder characterized by chronic inflammation of the thyroid gland. Recent evidence indicates that the inflammation may extend beyond the thyroid. The study aims to explore the potential of complete blood count (CBC)-derived indices as markers of systemic inflammation in HT. Materials and Methods: This cross-sectional retrospective study from 1 January 2015, to 31 December 2023 included 147 pediatric HT patients and 144 apparently healthy controls. Thyroid profiles, antibodies, CBC, and protein electrophoresis data were collected from patient records. CBC-derived indices were calculated and compared between the HT and control groups, as well as among HT subgroups. Results: The median age of HT patients was 13.6 years (range: 11.2–15.5 years), with 66% being girls. The control group had a similar age and gender distribution, with a median age of 13.7 years (range: 11–15.8 years) and 70.8% girls. Of the HT patients, 50% had subclinical HT, 15% were euthyroid, and 34% had overt thyroid dysfunction. HT patients showed significantly higher neutrophil and lymphocyte counts, as well as all evaluated CBC-derived indices than controls (p < 0.001)). These differences were not significant among HT subgroups. Logistic regression indicated a strong association between an elevated neutrophil-to-lymphocyte ratio (NLR) and HT diagnosis (p < 0.001), while ROC analysis confirmed NLR as the most accurate CBC-derived marker for distinguishing HT from controls. Conclusions: Elevated NLR levels in pediatric HT patients provide additional evidence that inflammation may extend beyond the thyroid gland. These results support the potential of NLR as a reliable and accessible biomarker for evaluating inflammation in Hashimoto’s thyroiditis.

In recent years, EU member states have faced two significant crises: the COVID-19 pandemic and high inflation, exacerbated by geopolitical instability. These events have led to a decline in household purchasing power. Our study aims to quantify the impact of these crises on household income dynamics in Romania, using data from the EU Survey on Income and Living Conditions and the EUROMOD tax-benefit microsimulation model. We analyze income changes across demographic segments from 2019 to 2021 (COVID-19 period) and 2021 to 2023 (inflation crisis), focusing on household characteristics such as the presence and number of children, the gender of the household head, and the presence of elderly members. Our findings reveal that while disposable income increased from 2019 to 2021, the poorest 10% experienced the smallest gains. In 2022–2023, inflation eroded these increases, and the lower half of the income distribution struggled with reduced earnings and pensions. Despite this, the Gini coefficient for disposable income decreased from 2019 to 2023, indicating a reduced inequality. Our study highlighted that targeted public policy interventions are essential to support vulnerable households and mitigate the effects of economic shocks.

Background and Objectives: The role of surgery in pancreatic metastases of renal cell carcinoma (PM_RCC) is highly controversial, particularly in the context of modern systemic therapies and the conflicting results of studies published so far. This study aims to explore a single surgical center experience (including mainly pancreatic resections) regarding the indications, the type of pancreatectomies, and early and long-term outcomes for PM_RCC. Materials and Methods: The data of all patients with surgery for PM_RCC (from 1 January 2002 to 31 December 2023) were retrospectively assessed, and potential predictors of survival were explored. Results: 20 patients underwent surgery for PM_RCC (pancreatectomies—95%). Metachronous PM_RCC was 90%, with a median interval between the initial nephrectomy and PM_RCC occurrence of 104 months. For elective pancreatectomies, the overall and severe morbidity and mortality rates were 24%, 12%, and 0%, respectively; 32% of patients underwent non-standardized pancreatic resections. The median survival of patients with negative resection margins was 128 months after pancreatectomies, with an 82% 5-year survival rate. Left kidney RCC and the body/tail PM_RCC were favorable prognostic factors for the overall survival after pancreatectomies for PM_RCC. Body/tail, asymptomatic PM_RCC, and an interval after initial nephrectomy > 2 were favorable prognostic factors for the overall survival after initial nephrectomy for RCC. Conclusions: Pancreatectomies for PM_RCC can achieve long-term survival whenever complete resection is feasible, with acceptable complication rates. Patients with left kidney RCC, body/tail, and asymptomatic PM_RCC and an interval of more than 2 years after nephrectomy exhibit the best survival rates.

It is documented that maternal diseases or treatments influence a newborn’s clinical status at birth. If a prenatal medical history is not available, or if signs or symptoms of a mother’s disease are revealed for the first time during pregnancy or postpartum, their effects on the newborn may be misattributed. Objective: The objective of this study is to emphasize the paramount importance of prenatal care, for both mothers and newborns, as a lack of maternal signs and symptoms during pregnancy does not exclude a potential severe neonatal condition. Materials and methods: We present a series of three cases of pregnant women who gave birth to very sick preterm newborns that required admission to the Neonatal Intensive Care Unit (NICU). The mothers were asymptomatic during pregnancy and unaware of their subclinical disease. The newborns’ complications, considered initially as consequences of prematurity or infection, subsequently revealed transient autoimmune disease in two of the cases (myasthenia gravis and hyperthyroidism) and a severe form of thrombophilia in the third case. Results: The newborns’ diagnosis preceded maternal diagnosis and contributed to the identification of the maternal pathology; adequate treatment was prescribed, with favorable short- and long-term outcomes. Conclusions: Prenatal exams and investigations throughout pregnancy are a good opportunity to detect subclinical diseases or predispositions. As newborns usually develop non-specific signs, one should have experience and pay attention to differentiating among etiologies. Our paper takes a reversed approach to the usual medical diagnosis pathway: from infant to mother instead of from mother to infant, proving that inter-specialty collaboration can work bi-directionally.

IntroductionIt is unknown how intestinal B cell populations and B cell receptor (BCR) repertoires are established and maintained over time in humans. Following intestinal transplantation (ITx), surveillance ileal mucosal biopsies provide a unique opportunity to map the dynamic establishment of recipient gut lymphocyte populations in immunosuppressed conditions.MethodsUsing polychromatic flow cytometry that includes HLA allele group-specific antibodies distinguishing donor from recipient cells along with high throughput BCR sequencing, we tracked the establishment of recipient B cell populations and BCR repertoire in the allograft mucosa of ITx recipients.ResultsWe confirm the early presence of naïve donor B cells in the circulation (donor age range: 1-14 years, median: 3 years) and, for the first time, document the establishment of recipient B cell populations, including B resident memory cells, in the intestinal allograft mucosa (recipient age range at the time of transplant: 1-44 years, median: 3 years). Recipient B cell repopulation of the allograft was most rapid in infant (

An approach to the elementary spectral theory for quaternionic linear operators was presented by the author in a recent paper, quoted and discussed in the Introduction, where, unlike in works by other authors, the construction of the analytic functional calculus used a Riesz-Dunford-Gelfand type kernel, and the spectra were defined in the complex plane. In fact, the present author regards the quaternionic linear operators as a special class of real linear operators, a point of view leading to a simpler and a more natural approach to them. The author's main results in this framework are summarized in the following, and other pertinent comments and remarks are also included in this text. In addition, a quaternionic joint spectrum for pairs of operators is discussed, and an analytic functional calculus which uses a Martinelli type kernel in two variables is recalled.

Our article aims to present an in-depth analysis of the correlation between health status and poverty in European countries. Our research is grounded on two types of data: a survey of the perceptions of the European citizens related to their own physical and mental health conducted in 2017 in European Union countries and the United Kingdom on a sample of 28,000 respondents and macroeconomic data retrieved from Eurostat Database, showing the incidence of poverty and working poor in Europe during the 2017-2019 time span. Multiple logistic regression has revealed that self-rated health status is influenced by the sociodemographic characteristics of the respondents, whereas TwoStep Cluster analysis and Mann-Whitney U test proved that health is an important driver of the differences between countries in terms of poverty and working poor. The originality of our research stems from both the integrated approach, the analysis being made at individual, group, and country levels, and by the results that bring new evidence about population health status as a determinant of quality of life and national competitiveness.

The present article aims to bring to the attention of the public the compensations granted to people injured as a result of traffic accidents. In the lives of each of us, tragic events remind everyone of the importance of abiding by the traffic rules and paying more attention to the road both as drivers and as pedestrians. Car drivers are urged to be cautious, adapt speed to road conditions and avoid reckless behaviour in traffic. Also, pedestrians must know and respect the traffic rules. Practically, these are simple measures that make the difference between life and death, between a happy life and one in which traumas affect the state of well-being, of normality, in similar emergency situations.

Metal-ceramics dental prosthetic restorations are clinically recommended for their advantages related to good esthetic features along with strength and long-term clinical use. Given the importance of the quality of the metalceramic (M-C) bond, the metal substructure analysis has a major importance to the quality of the manufactured dental prosthesis. In the present study was analyzed the behavior of experimentally developed novel titanium alloys (TiZr, TiZrNbTa) comparatively with other frequently used titanium alloys (e.g., Ti Cp, Ti6Al4V) designated for the technology of mixed prosthetic restorations. All samples were been plated, simultaneously in the same conditions, with the same titanium specific compatible ceramic plating material (Ti22 Noritake). The examination of the surface of both components was performed by scanning electron microscopy SEM) analysis and EDS analysis, which showed differences in the characteristics of the oxide layer formed, depending on the composition of the metal substructure. The evaluation of the alloy-ceramic adhesion was performed by mechanical tests, which attest to the fact that the adhesion and the quality of the bond between metal and ceramic depend on the thickness of the oxide films formed. The results showed the superiority of titanium novel titanium alloys (TiZr, TiZrNbTa), having highest hardness values, highest values of shear strength, a continuous thin oxide films, and consequently, a better metal-ceramic adhesion. Comparatively, less ductile titanium alloys (TiZrNbTa/Ti3) are generating lower adhesion forces with values above 30MPa in some samples justifying less predictable clinical results.

Duchenne muscular dystrophy (DMD) affects cardiac and skeletal muscles but represents a condition that causes numerous secondary pathologies. Although there is no curative treatment available, multidisciplinary approaches, centered on the needs of the patient, improve the quality and duration of life. Therapies such as physiotherapy, occupational therapy, physical activities, and respiratory physiotherapy, but also the management of cardiac, osteo-muscular, and neuro-psychiatric manifestations, are continuously developing, (as new data becomes available) and are the key to DMD management today. These multidisciplinary approaches can lead to good long-term outcomes by helping patients with muscular dystrophy reduce muscle damage, early detect and treat heart failure, and manage cognitive impairment as best they can.

The paper addresses the problem of transliteration of scanned copies of old Romanian books written in the Cyrillic script into the Latin script. The motivation of this endeavor and attendees of such a technology are enumerated. Then, a number of peculiarities of these documents, which create difficulties for automatic processing, are exemplified. The proposed technology is presented in the form of a pipeline of modules, each applying AI or symbolic methods. Then, the component parts are discussed individually, and solutions are presented. The research is presented as work in progress, which leaves space for further enhancements. The data supporting training and evaluation of the modules is rooted in the former DeLORo project.

Superior mesenteric artery aneurysms are a rare pathology, and rupture due to a pancreatic cyst in the context of alcohol-induced pancreatitis is an even rarer condition. The first line of treatment is usually an endovascular approach. We present the case of a 51-year-old male with alcohol-induced pancreatitis, diagnosed with a superior mesenteric artery aneurysm with active bleeding in close contact with a large pancreatic cyst. A covered stent was used to treat this condition. The patient developed hemorrhagic shock 12 h after the procedure and an urgent laparotomy was performed. A second rupture of the arterial wall at the distal end of the stent was observed and in order to obtain distal perfusion, first, an infrarenal aorta to superior mesenteric artery bypass distal to the rupture was performed in order to exclude the aneurysm. Secondly, a bypass originating from the distal end of the first bypass to the distal end of the superior mesenteric artery was performed. The patient had an uneventful recovery and was discharged after 10 days. We reviewed the literature regarding the incidence and the therapeutic management of superior mesenteric artery aneurysm complicated by pancreatic cyst. An advanced search on PubMed from 2004 to 2024 returned 194 results and after applying the inclusion–exclusion criteria, 11 publications were selected. Although the endovascular approach is usually the first line of treatment with obvious advantages for the patient, a patient-tailored approach should be made in such cases and surgery could be the first option, when considering that the mechanism of aneurysm rupture is due to erosion of the arterial wall by the pancreatic enzymes. Surgery has the advantage of cyst drainage and aneurysm exclusion and in our case proved lifesaving.

An ectopic thyroid (ET) involves numerous scenarios of detection and outcomes, while its current management is not standardised. A mediastinal ET (MET) represents a low index of suspicion. In this paper, we introduce a 47-year-old female who was accidentally identified with an MET, and a modern surgical approach was provided. An anterior mediastinal mass of 3.2 cm was found at CT upon a prior COVID-19 infection. Previous to the infection, she experienced non-specific complaints for a few months (intermittent night sweats, facial erythema, chest pressure, and dyspnoea). Also, CT identified a thymus-like mass and a left adrenal incidentaloma of 3 cm. The endocrine panel was normal, and the subject declined further investigations. She was re-admitted 12 months later: the MET had increased +1 cm (+45% volume) and was confirmed at a 99mTc pertechnetate scintigraphy. Noting the symptoms, mediastinal anatomy, and size change, the MET was removed via a minimally invasive trans-cervical approach (eutopic gland preservation) with the help of a Cooper thymectomy retractor (which also allowed for a synchronous thymus mass resection). No post-operatory complications were registered, the thyroid function remained normal, and the mentioned symptoms were remitted. A histological exam confirmed a benign MET and thymus hyperplasia, respectively. To conclude, this case pinpoints important aspects, such as the clinical picture became clear only upon thoracic surgery due to the complete remission of the complaints that initially seemed widely non-specific. The incidental MET finding was associated with a second (adrenal) incidentaloma, a scenario that might not be so rare, following multiple imaging scans amid the COVID-19 era (no common pathogenic traits have been identified so far). The co-presence of a thymus mass represented one more argument for surgery. Minimally invasive cervicotomy associated with eutopic gland conservation and the use of a Cooper thymectomy retractor highlight modern aspects in video-assisted thoracic surgery, which provided an excellent outcome, involving one of the lowest mediastinal thyroids to be removed by this specific procedure. Awareness of such unusual entities helps inform individualised, multidisciplinary decisions for optimum prognoses.

Background: medical teams continue to face challenges with infections following hip replacement surgery, whether they occur shortly after the procedure or months or years later. Certain medical conditions like diabetes, rheumatoid arthritis, and obesity are risk factors that make patients more susceptible to infections. Traditional intervention methods such as DAIR, one-step, or two-step procedures are being enhanced and refined to ensure quicker and more effective treatment. Some cases present particularly difficult challenges, featuring persistent fistulas and unpredictable responses to treatment. Methods: in our article, we share two unique cases, detailing their histories, progressions, and treatment decisions. We explore the use of antibiotic-impregnated calcium biocomposite as a local adjuvant therapy and the application of negative pressure therapy to expedite healing. The system of NWPT has seen widespread uptake and is now implemented routinely for open wounds, such as open fractures, fasciotomies, ulcers, and infected wounds. Results: our findings demonstrate that surgical debridement and calcium sulfate bead insertion successfully treat bone and joint infections without causing any side effects or complications. As a particularity, in the first case, we encountered the exteriorization of Stimulan pearls after surgery, without other complications related to the biocomposite. Conclusions: we have found that NPWT is a beneficial tool in managing complex wounds in both acute and chronic stages, after the infection is cured, reducing the need for frequent dressing changes, shortening hospital stays, and enhancing patient comfort.

Histoplasma capsulatum (H. capsulatum) is considered to be one of the most extensively spread dysmorphic fungi worldwide. Histoplasmosis primarily impacts patients with weakened immune systems and can result in a diverse range of clinical manifestations. In immunocompetent patients, the disease may manifest as a self-limiting or asymptomatic infection; however, in immunocompromised individuals, it can occur as a debilitating, disseminated disease. Diagnosing histoplasmosis may be challenging. A medical professional that specializes in treating endemic fungal illnesses is better able to assist with an accurate and timely diagnosis since they have a deeper grasp of these illnesses. Consequently, the process of diagnosing histoplasmosis might be difficult for less experienced physicians. The case presented is an example of the myriad faces that histoplasmosis can take on, mimicking other common infectious or malignant conditions, leading to extensive work-up and invasive procedures in establishing the diagnosis of this otherwise benign condition. We hereby report the case of disseminated histoplasmosis in a young immunocompetent female patient.

Biosolids from stabilized sludge present a high fertilization potential, due to their rich content of nutrients and organic matter. The intrinsic and subtle properties of such fertilizers may greatly influence the fertilization efficiency. In this sense, the utility, advantages and limitations of advanced characterization methods, for the investigation of structural and dynamic properties at the microscopic scale of slightly different formulations of fertilizers were assessed. For that, three formulas of organo-mineral fertilizers based on biosolids (V1, V2 and V3), having at least 2% N, 2% P2O5, and 2% K2O, were characterized by advanced methods, such as 1H NMR relaxometry, 1H MAS and 13C CP-MAS NMR spectroscopy, 1H double-quantum NMR and FT-IR spectroscopy. Advanced structural characterization was performed using SEM, EDX and X-ray diffraction. Four dynamical components were identified in the NMR T2 distribution showing that the rigid component has a percentage larger than 90%, which explains the broad band of NMR spectra confirmed by the distributions of many components in residual dipolar coupling as were revealed by 1H DQ-NMR measurements. SEM and EDX measurements helped the identification of components from crystalline-like X-ray diffraction patterns. To evaluate the release properties of organo-mineral fertilizers, dynamic measurements of classical electric conductivity and pH were performed by placing 0.25 g of the formulas (V1, V2 and V3) in 200 mL of distilled water. The content of N and P were quantified using specific reactants, combined with VIS-nearIR spectroscopy. Two release mechanisms were observed and characterized. It was found that V3 presents the smallest release velocity but releases the largest number of fertilizers.

As the EU strives to achieve its climate goals, it is becoming increasingly crucial to understand the complex relationships between economic activity, energy consumption, and carbon emissions. In this context, our paper aims to investigate the correlation between carbon emissions, energy consumption, and economic development. To fulfill our aim, we have used Eurostat and OECD data for the EU-27 member states for a period of 13 years (2010–2022), using a linear regression as the main analysis method. Our results have shown that there is a strong correlation between demand-based and production-based CO2 emissions as well as between production-based CO2 emissions and final energy consumption, while at the same time, our findings have shown that there is no direct correlation between energy consumption and economic development, aligning our study with the neutrality hypothesis of the energy growth nexus. This paper expands the ongoing discussion on sustainable development and climate change mitigation by conducting a thorough analysis of the EU-27 countries over a span of thirteen years. The results emphasize the need for integrated strategies that address both production and consumption emissions, emphasize the vital role of energy efficiency, and raise questions about the effectiveness of increasing energy consumption to enhance economic productivity or CO2 efficiency.

Although a few registry-based studies have shown associations between receiving kidney allografts from Black donors and shorter allograft survival, detailed, large, single-center studies accounting for common confounding factors are lacking. Furthermore, pathologic alterations underlying this potential disparity have not been systematically studied. We performed a retrospective clinical-pathological study of kidney transplant recipients who received kidney allografts from either Black (n = 407) or White (n = 1,494) donors at Columbia University Irving Medical Center from 2005 to 2018, with median follow-up of 4.5 years post-transplantation. Black donor race was independently associated with allograft failure (adjusted HR = 1.34, p = 0.02) and recipients of kidney allografts from Black donors had a higher incidence of collapsing glomerulopathy [7.4% vs. 1.9%, OR = 4.17, p < 0.001]. When causes of allograft failure were examined, only allograft failure following development of collapsing glomerulopathy was more frequent in recipients of allografts from Black donors [15% vs. 5%, OR = 3.16, p = 0.004]. Notably, when patients who developed collapsing glomerulopathy were excluded from analysis, receiving kidney allografts from Black donors was not independently associated with allograft failure (adjusted HR = 1.24, p = 0.10). These findings revealed that, compared with recipients of kidney allografts from White donors, recipients of kidneys from Black donors have modestly shorter allograft survival and a higher probability of developing collapsing glomerulopathy, which negatively impacts allograft outcome. Identification of collapsing glomerulopathy risk factors may help decrease this complication and improve allograft survival, which optimally may reduce racial disparities post-transplantation.

Background:. In response to the growing popularity of noninvasive facial cosmetic procedures, this study assessed the rate and predictors of satisfaction with such procedures in Saudi Arabia, filling a research gap and emphasizing the role of patient satisfaction in optimizing care and understanding the economic implications for healthcare. Methods:. This cross-sectional study was conducted from May to June 2023 using an online self-administered questionnaire distributed across all regions of Saudi Arabia. Eligible participants were Saudi adults aged 18 years and older who had undergone noninvasive facial cosmetic procedures. Patients who underwent surgical/invasive cosmetic procedures, nonfacial interventions, or interventions performed by doctors other than plastic surgeons or dermatologists were excluded. Results:. Most participants reported satisfaction with their procedures. Significant predictors of satisfaction included sex, income, and residential area. Women, higher-income individuals, and residents of certain areas were more likely to report satisfaction. Participants also expressed a high level of satisfaction with the friendly and polite treatment they received from their doctors but showed dissatisfaction with the difficulty they faced in securing immediate postprocedure appointments. Conclusions:. This study provides valuable insights into the rate and predictors of satisfaction after noninvasive facial cosmetic procedures in Saudi Arabia. These findings underscore the importance of considering sociodemographic factors in patient satisfaction and suggest areas for improvement in patient care, particularly in facilitating immediate postprocedure appointments. Future research should continue to explore these and other potential predictors to further improve patient outcomes in the field of noninvasive facial cosmetic procedures.

(1) Background: Intraoral scanners undergo rapid advancements in hardware and software, prompting frequent updates by manufacturers. (2) Aim: This study aimed to quantitatively assess the precision of full dental arch digital impressions obtained from four different intraoral scanners: Trios 5—3SHAPE, Copenhagen, Denmark, CEREC Primescan— Dentsply Sirona, New York, NY, USA, Planmeca Emerald S—Planmeca Oy, Helsinki, Finland, and Medit i700—Medit Corp, Seoul, Republic of Korea. (3) Methods: A maxillary virtual dental model (digital master model) was created in accordance with ISO standard 20896-1. Subsequently, a 3D-printed model was obtained from the master model’s STL file and scanned 15 times consecutively with each scanner. STL files were aligned with the master model’s STL using Medit Link—Medit Design software v.3.1.0. The accuracy was evaluated by measuring deviations in micrometers between each scanner’s scans and the master model. (4) Results: The study revealed variations in accuracy ranging from 23 to 32 µm across scans of the same dental arch, irrespective of the scanner used and scanning strategy employed. The anterior regions exhibited higher precision (Mean Absolute Deviation of 112 µm) compared to the posterior regions (Mean Absolute Deviation of 127 µm). Trios 5 demonstrated the smallest deviation (average 112 µm), indicating superior accuracy among the scanners tested. Emerald S and Medit i700 exhibited balanced performance (average 117 µm and 114 µm, respectively), while Primescan consistently displayed high deviation (average 127 µm). (5) Conclusions: Based on clinically accepted thresholds for accuracy in intraoral scanning, which are typically 200 µm for full arch scans, Trios 5 surpasses these benchmarks with its average deviation falling within the 200 µm range. Emerald S and Medit i700 also meet these standards, while Primescan, although showing high overall deviation, approaches the upper limit of clinical acceptability. Considering the limitations of an in vitro investigation, the findings demonstrate that each intraoral scanner under evaluation is capable of reliably and consistently capturing a full arch scan for dentate patients.

In contemporary dentistry, several 3D printing techniques, including a stereolithography apparatus (SLA), digital light processing (DLP), liquid crystal display (LCD), and PolyJet 3D inkjet printing technology (PolyJet), are employed for model production. Despite their widespread use, there remains a paucity of the literature regarding the trueness and precision of these devices in dental applications. Existing studies comparing the accuracy of dental models manufactured by different printing technologies yield disparate conclusions regarding dental prosthesis manufacturing. This study aimed to test two null hypotheses: first, that the trueness of various new-generation 3D printers is equivalent, and second, that the trueness of printing by these printers is sufficient for achieving high-precision mastercasts in dental prosthodontics manufacturing. The research focuses on evaluating the trueness of five contemporary dental 3D printers: Anycubic Mono X 6Ks (Hongkong Anycubic Technology Co., Hongkong, China), Asiga Max (Asiga, Sydney, Australia), Creo C5 (Planmeca Oy, Helsinki, Finland), Form 3B (Formlabs, Boston, MA, USA), and J5 Dentajet (Stratasys Ltd., Eden Prairie, MN, USA). The methodology employed involved the creation of a digital test object using Blender software, adhering meticulously to the dimensions outlined in ISO standard 20896-1. These dimensions were chosen to be both relevant for this study and representative of clinical scenarios. Subsequently, the test object was printed and precise measurements were conducted utilizing a metrology-type Nikon XTH225 ST Reflection target in conjunction with VGStudio MAX analysis software. The results of our investigation revealed clinically negligible deviations in ball dimensions across all printers, with the maximum observed deviations ranging between 1.17% and 2.03% (notably observed in the Creo C5 printer). Transversal distortion exhibited variance based on the linear accuracy of each printer, with Stratasys21 and Formlabs 3B demonstrating superior accuracy among the evaluated printers. Distortions in the analyzed dimensions (specifically, anterior b–c, posterior a–d, and oblique a–c) were found to be uniform. In conclusion, while the first null hypothesis was rejected, indicating variations in trueness among the 3D printers assessed, our findings affirm the suitability of all five analyzed 3D printers for clinical applications. Consequently, these printers can be utilized for the fabrication of high-precision mastercasts in dental prosthodontics manufacturing.

The study carried out aims to determine the way in which the heat transfer occurs from the front part of the orifice of the extrusion nozzle of the thermoplastic material to the component elements of such an assembly. The paper considers the study in the introductory part of the current situation in the specialized literature. The second part is affected by the analysis of their geometric and dimensional structure and the way of their realization and their interconnection. Further, in the analysis, the way in which the discretization of the process of calculating the temperature values ​​is carried out in the simulation program was considered, and last but not least, the way of its evolution. Based on the graphic simulation for the extrusion temperatures considering poly lactic acid (PLA) and respectively acrylonitrile butadiene styrene (ABS) it was possible to highlight that the area where the extruded material in the part of the structure modification has an increasing temperature trend towards the upper part of cooling it.

Today‘s military environment requires many states to find ways to develop capabilities to fight a high-intensity conventional war, to protect and to fight with scattered forces under the conditions of an effective adversary threat to include air attacks and modern missile technology. Simultaneously, modern disruptive technology could deny command structures the ability to maintain constant communication with their forces on the ground. Such situations in which subordinates are unable to communicate easily with their superiors might create the risk of losing the fight initiative or the chance to seize opportunities while awaiting new orders. These factors emphasize the importance of creating military units that can fight autonomously, with limited guidance from higher levels of command, by properly exercising Mission Command (MC) principles. The main goal of this paper is to analyze the role of education as an enabler to an easier adoption of Mission Command philosophy, to formulate recommendations regarding the establishment of a proper organizational culture that favors MC and to highlight the complexity of implementing MC in practice.

In this paper, we propose FlexTDOA, an indoor localization method using ultra-wideband (UWB) radios, and we demonstrate its performance in a functional system. Our method uses time-difference of arrival (TDOA) localization so that the user device remains passive and is able to compute its location simply by listening to the communication between the fixed anchors, ensuring the scalability of the system. The anchors communicate using a custom and flexible time-division multiple-access (TDMA) scheme in which time is divided in slots. In each time slot, one anchor interrogates one or more anchors which respond in the same slot. The anchors do not need to have their clocks synchronized. We implemented FlexTDOA on in-house designed hardware using a commercial UWB module. We evaluate the localization accuracy of FlexTDOA with different system parameters such as the number of responses, the order of responses, and the number of anchors. We simulate and evaluate the effect of the physical speed of the tag on the choice of optimum system parameters. We also compare FlexTDOA against the classic TDOA approach and range-based localization in a deployment of ten anchors and one tag, both with and without obstructions. Results show that FlexTDOA achieves the highest localization accuracy in most of the scenarios, with up to 38% reduction in the localization error compared to the classic approach.

This paper presents real-time monitoring of processes that listen on IBM queues which transfer messages, alerting the smart home ownership in case of exceptions. To help that monitoring, the IBM CheckMK tool notifies the residents by email or SMS with a specific message showing the problem that occurred when a certain flow in the home has changes due to unknown causes. The actual announcement to the owner of the house can be made through various platforms that verify in real time the e-mail address or phone number and notify the residents with an alarm in case of a major problem at the level of IoT-based processes and components. It is shown that through this implementation the situations in which the messages do not reach the recipient person in the smart home environment can be avoided, thus causing even financial damage.