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The production of municipal solid waste (MSW) has led to an unprecedented level of environmental pollution, worsening the global challenges posed by climate change. Researchers and policymakers have recently made significant strides in the field of sustainable and renewable energy sources, which are viable from technological, environmental, and economic perspectives. Consequently, the waste-to-energy programs enhance nations’ socioeconomic status while positively impacting the environment. To predict the higher heating value (HHV) of MSW fuel based on carbon, hydrogen, oxygen, nitrogen, and sulfur content, the current study introduces a Gradient Boosting Regression Tree (GBRT) model optimized with the Slime Mold Algorithm (SMA). This model was evaluated using an additional 50 data points after being trained with 202 MSW biomass data points. The performance of the model was assessed using three metrics: root mean square error (RMSE), mean absolute error (MAE), and the coefficient of determination (R2). The results indicated that our model outperformed previously developed models in terms of accuracy and reliability. Additionally, a graphical user interface (GUI) was developed to facilitate the practical application of the model, allowing users to easily input data and receive predictions on the enthalpy of the combustion of MSW fuel.

Southeast Asian Games or SEA Games is a Southeast Asian sporting event held every 2 years, where the participants are 11 member countries of the Association of Southeast Asian Nation (ASEAN). Cambodia was chosen as the host for the 2023 SEA Games. The implementation of the SEA Games in Cambodia experienced many controversies ranging from the inverted Indonesian flag to leaking lodging rooms for athletes. Social media Twitter became one of the places for netizens to express their opinions about the implementation of the SEA Games in Cambodia. This study aims to determine the level of tendency of positive, negative and neutral opinions through the sentiment analysis process. The sentiment analysis process is carried out using the Naive Bayes method, through five main stages, namely Data Selection, Preprocessing, Transformation, Data Mining, and Evaluation. The data used comes from Twitter users who use the hashtag "SEA Games Cambodia" then obtained data as many as 1595 tweets. The results of this study describe the results of Naive Bayes implementation and performance testing using confusion matrix obtained accuracy 66%, precision 70%, recall 66%, and f1-score 61%. and also obtained the results of the tendency of public opinion sentiment on Twitter with positive results as much as 49%, then negative results as much as 40% and neutral results as much as 11%.

Abstract We surveyed the performance of ponatinib, as salvage therapy, in a real-world setting of chronic phase chronic myeloid leukemia (CML-CP). Among 55 consecutive patients (median age 49 years) with relapsed/refractory CML-CP, 35 (64%) had failed ≥3 tyrosine kinase inhibitors (TKIs), 35 (64%) were pre-treated with nilotinib, and 14 (28%) harbored ABL1T315I. At start of ponatinib (median dose 30 mg/day), 40 patients were already in complete hematologic (CHR), 4 in complete cytogenetic (CCyR), 3 in major molecular (MMR) remission, while 8 had not achieved CHR (NR). Ponatinib improved the depth of response in 13 (33%), 3 (75%), 2 (66%), and 4 (50%) patients with CHR, CCyR, MMR, and NR, respectively (p = 0.02). At a median follow-up of 42 months, 13 (23%) deaths, 5 (9%) blast transformations, and 25 (45%) allogeneic transplants were recorded. Five/10-year post-ponatinib survival was 77%/58% with no significant difference when patients were stratified by allogeneic transplant (p = 0.94), ponatinib-induced deeper response (p = 0.28), or a post-ponatinib ≥CCyR vs CHR remission state (p = 0.25). ABL1T315I was detrimental to survival (p = 0.04) but did not appear to affect response. Prior exposure to nilotinib was associated with higher risk of arterial occlusive events (AOEs; 11% vs 0%; age-adjusted p = 0.04). Ponatinib starting/maintenance dose (45 vs 15 mg/day) did not influence either treatment response or AOEs. Our observations support the use of a lower starting/maintenance dose for ponatinib in relapsed/refractory CML-CP but a survival advantage for deeper responses was not apparent and treatment might not overcome the detrimental impact of ABL1T315I on survival. The association between prior exposure to nilotinib and a higher risk of post-ponatinib AOEs requires further validation.

Conclusions: Eosinophils are tumor-infiltrating cells in breast cancer, both intratumoral and stromal. The presence of tissue eosinophilic infiltration can predict HER2/NEU negativity in breast cancer.

The current data on various aspects of Brown syndrome are limited and sporadic. This review provides a coherent and comprehensive review of basic features, etiology, classification, differential diagnosis, and different management strategies of patients with Brown syndrome. In this topical review, PubMed, Scopus, and Google Scholar search engines were searched for papers, published between 1950 and January 2023 based on the keywords of this article. The related articles were collected, summarized, categorized, assessed, concluded, and presented. Brown syndrome is identified by restricted passive and active elevation of the eye in adduction. The condition is divided into congenital and acquired causes. The clinical features result from a restricted motion of the superior oblique tendon sheath through the trochlea while trying to look up in adduction. The newest explanation of the underlying pathophysiology has been explained as the presence of a fibrotic strand in the superior oblique muscle tendon with variable insertion sites which creates various elevation deficits seen in Brown syndrome. The most common clinical features include the presence of an abnormal head posture, V-pattern strabismus, and hypotropia in the primary position. Management of Brown syndrome includes watchful observation, surgical, and non-surgical procedures. Some cases might resolve spontaneously without any intervention; however, some acquired cases might require systemic and/or intra-trochlear steroid administration to treat the underlying causes. Surgical procedures such as superior oblique tenectomy and using a silicon tendon expander are indicated in the presence of hypotropia and significant abnormal head posture in the primary position.

Background: Over the last decade, artificial intelligence in medicine has been growing. Since endometrial cancer can be treated with early diagnosis, finding a non-invasive method for screening patients, especially high-risk ones, could have a particular value. Regarding the importance of this issue, we aimed to investigate the risk factors related to endometrial cancer and find a tool to predict it using machine learning. Methods: In this cross-sectional study, 972 patients with abnormal uterine bleeding from January 2016 to January 2021 were studied, and the essential characteristics of each patient, along with the findings of curettage pathology, were analyzed using statistical methods and machine learning algorithms, including artificial neural networks, classification and regression trees, support vector machine, and logistic regression. Results: Out of 972 patients with a mean age of 45.77 ± 10.70 years, 920 patients had benign pathology, and 52 patients had endometrial cancer. In terms of endometrial cancer prediction, the logistic regression model had the best performance (sensitivity of 100% and 98%, specificity of 98.83% and 98.7%, for trained and test data sets respectively,) followed by the classification and regression trees model. Conclusion: Based on the results, artificial intelligence-based algorithms can be applied as a non-invasive screening method for predicting endometrial cancer.

The problem that will be studied in this research is the types of bullying experienced by street children in the city of Padang. Street children are children who are forced to take to the streets due to several factors. The situation of street children is sometimes exacerbated by violence. Violence that occurs in the child's environment can be referred to as bullying. Bullying does not only occur in educational environments, but can also occur on the streets. This type of qualitative research with the case study method. Sources of data from street children as research subjects and research informants. Data collection methods used are interviews and observation. The data analysis technique refers to Miles and Huberman's interactive analysis model. To test the validity of the data used triangulation techniques with sources. The results showed that the type of bullying experienced by street children was direct bullying in the form of being beaten, pushed, tripped over, stoned, teased, humiliated, grabbed, compassed, pulled by his clothes, cursed at and slapped. For this type of indirect bullying in the form of being ostracized from social groups, spreading gossip, being insulted via the internet and being threatened via the internet.

This research aims to analysis the effectiveness of the allocation of Aceh’s special autonomy fund for development in the sectors of poverty alleviation, education, and health during the period of 2017 to 2022. The method used in this study is qualitative descriptive with the data collection techniques are interviews and documentation. Moreover, this research focus on the existence of Aceh as an asymmetric decentralization. The theory that used to strengthen the argument is public management theory and used the concept of effectiveness. The result showed that during the period of Irwandi Yusuf-Nova Iriansyah, the allocation of Aceh’s special autonomy fund has not been effective for development in Aceh, especially in the sector of poverty, improving the quality of education and health. It is because of the management of the special autonomy fund’s allocation is not optimal implemented since the planning to the controlling. It has the impact to the allocation of Aceh’s special autonomy fund which is not well-targeted to achieve the goals and to improve the society’s welfare.

Abstract Background Adenoid cystic carcinoma (ACC) in Bartholin’s gland is an uncommon malignant tumor. These tumors have a vague clinical feature, so they are diagnosed late and discovered at a high-level stage. Our case presented Three Recurrences and Three times Misdiagnosis of Adenoid Cystic Carcinoma (ACC). Case presentation We report a case of adenoid cystic carcinoma arising in Bartholin's gland of a 64-year-old female patient that appeared after three previous vulvar tumors were excised. The patient underwent bilateral radiotherapy which was performed on the perineum. Conclusion ACC of the vulvar sweat glands is prone to misdiagnosis and delay in both diagnosis and treatment. As seen in our case, it was misdiagnosed three times as Chondroid Syringoma. Further studies need to be conducted to better understand the tumor prognosis, and its optimal treatment options.

Potent hypoglycemic and antioxidant effects were recently reported for the apple-derived phenolic compound phloretamide (PLTM). The renoprotective effects of this compound are yet to be shown. This study aimed to examine the potential of PLTM to prevent diabetic nephropathy in streptozotocin-induced diabetic rats and to examine the possible mechanisms of protection. Non-diabetic and STZ-diabetic male rats were treated orally by gavage with either the vehicle or with PTLM (200 mg/kg; twice/week) for 12 weeks. PTLM significantly increased urine volume and prevented glomerular and tubular damage and vacuolization in STZ-diabetic rats. It also increased creatinine excretion and reduced urinary albumin levels and the renal levels of kidney injury molecule-1 (KIM-1), 8-hydroxy-2′-deoxyguanosine (8-OHdG), neutrophil gelatinase-associated lipocalin (NGAL), and nephrin in the diabetic rats. PTLM also prevented an increase in the nuclear levels of NF-κβ, as well as the total levels of tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), caspase-3, and Bax in the kidneys of diabetic rats. These effects were associated with reduced serum levels of triglycerides, cholesterol, and low-density lipoprotein cholesterol. In both the control and diabetic rats, PTLM significantly reduced fasting plasma glucose and enhanced the renal mRNA and cytoplasmic levels of Nrf2, as well as the levels of Bcl2, superoxide dismutase (SOD), and glutathione (GSH). However, PTLM failed to alter the cytoplasmic levels of keap1 in diabetic rats. In conclusion, PTLM prevents renal damage and dysfunction in STZ-diabetic rats through its hypoglycemic and hypolipidemic activities, as well as through its antioxidant potential, which is mediated by activating the Nrf2/antioxidant axis.

Objective: To evaluate the relevance of thrombocytopenia to other disease states in patients reporting at a haematology laboratory. Method: The cross-sectional, retrospective study was conducted at the Dow Diagnostic Research and Reference Laboratory of the Dr Ishrat ul Ebad Khan Institute of Blood Diseases, Down University of Health Sciences, Karachi, and comprised data from the blood bank and haematology laboratory related to patients who visited during October 2021to August 2022. Data was analysed using SPSS 26. Results: Of the 1,249 patient with mean age 38.5±19.7 years (range: 0-89 years), 79(6.3%) were aged 40. Most of the patients were males 793(63.5%), and 604(48.4%) had Grade 1 thrombocytopenia. Among the females, Grade 1 thrombocytopenia was found in 246(53.9%) and Grade 2 in 140(30.7%) patients compared to 358(45.1%) and 222(28%) in males, respectively (p0.05). Conclusion: Thrombocytopenia was found to be strongly associated with gender. Key Words: Thrombocytopenia, Bleeding, Dengue, Malaria.

This study examined the effects rheological properties of different composition kaolin and kaolin geo-filler in polypropylene composites. Polypropylene composites with varying composition of kaolin geo-filler 0 wt%, 2 wt%, 4 wt%, 6 wt%, 8 wt%, and 10 wt% was prepared and compared with polypropylene composite with raw kaolin. Kaolin is an aluminosilicate based mineral filler was used to prepare geopolymer paste by combining with alkaline activator solution. The polypropylene composite was compounded using a twin-screw extruder and the melt flow index was determined by a constant weight pressure of 2.16 kg at 230°C in 10 min. Knowing the melt flow index is necessary to predict and control the process, the study has demonstrated that the composition of kaolin filler and kaolin geo-filler affects the melt flow, melt density and surface morphology at varies composition. Composites with kaolin geo-filler have demonstrated high melt flow index process and having better distribution and flow.

Background: The ultra-processed food (UPF) contributed 20-85% of total daily calories. The consumption of UPF can be triggered by food security status. Many studies revealed that UPF consumption has a direct negative impact on health, mainly in overweight and obesity. Objectives: To review published studies assessing food security, UPF consumption, and overweight or obesity and find the possible links between those three factors. Methods: A literature review of scientific articles about food security, UPF consumption, and overweight or obesity, selected systematically according to the PRISMA Diagram. All articles were gathered through medical search engines, including PubMed, ScienceDirect, and Scopus, from December 2021 to February 2022. The bias risk of each selected paper was assessed using the checklist from The Joanna Briggs Institute (JBI) Critical Appraisal. Peer review and group discussions were performed to assess the quality of all articles gathered as objectively as possible using the STROBE Checklist. A narrative synthesis approach was opted to unify all findings across included studies systematically. Results: Nineteen (19) scientific published papers were filtered. The association between food security status and UPF consumption showed inconsistent findings. However, UPF consumption revealed a consistent association with overweight/obesity, where the higher the UPF intake, the greater odds of being overweight/obese. The relationship between food security status and overweight or obesity tended to have a similar pattern. In high-income countries, the association was negative (the more food insecure, the higher overweight or obesity), while in low- and middle-income countries showed the opposite. The pathway could be: (1) food-insecure adults have higher UPF intake, hence gaining body weight, or (2) food-secure adults have higher UPF intake, hence gaining body weight. Conclusions: UPF consumption is indicated as a potential mediator for food security status and nutritional status (overweight/obesity) through two pathways involving socio-demographic factors, psychological factors, social protections, and food choice motives.

This research investigates ‘The Impact of Covid-19 Pandemic on Small Retail Stores in India’. Its primary focus was to find out the various obstacles faced, strategies implemented and measures adopted by small retail stores during the Covid-19 pandemic and if there were any variations among the various retail stores in South Goa. Data was obtained from 69 small retail stores of South Goa namely medical, general, clothing and electronic stores. A One-way ANOVA test was used to analyze the data responses. Results indicated there were no much variations among the retail stores with respect to the obstacles faced, strategies implemented and measures adopted during Covid-19 pandemic. Due to the pandemic a large number of small retail stores faced many constraints. This paper elucidates how small retail stores can strategize and implement various ways to meet the needs of the customers in case of any such future emergencies.

This study came to examine the impact of Digital transformation on sustainable performance. The research population consisted of employees of Industrial companies listed in Amman stock exchange that is 23 companies. Because of the difficulty of collecting data using a complete census, a random sample of 530 employees was determined. 397 responses were used for the purposes of the statistical analysis of this research. In order to find the impact of digital transformation on sustainable performance, the structural equation modeling (SEM) technique was used. Research results show that digital transformation dimensions had a positive impact on sustainable performance. Big data had the greatest impact. Accordingly, the researchers recommend Industrial companies invest more in manufacturing modern technologies, represented by Digital transformation technologies that give companies the ability to provide high-quality performance and prepare an infrastructure to operate these technologies.

Abstract Idiopathic and acquired pedophilia are two different disorders with two different etiologies. However, the differential diagnosis is still very difficult, as the behavioral indicators used to discriminate the two forms of pedophilia are underexplored, and clinicians are still devoid of clear guidelines describing the clinical and neuroscientific investigations suggested to help them with this difficult task. Furthermore, the consequences of misdiagnosis are not known, and a consensus regarding the legal consequences for the two kinds of offenders is still lacking. The present study used the Delphi method to reach a global consensus on the following six topics: behavioral indicators/red flags helpful for differential diagnosis; neurological conditions potentially leading to acquired pedophilia; neuroscientific investigations important for a correct understanding of the case; consequences of misdiagnosis; legal consequences; and issues and future perspectives. An international and multidisciplinary board of scientists and clinicians took part in the consensus statements as Delphi members. The Delphi panel comprised 52 raters with interdisciplinary competencies, including neurologists, psychiatrists, neuropsychologists, forensic psychologists, expert in ethics, etc. The final recommendations consisted of 63 statements covering the six different topics. The current study is the first expert consensus on a delicate topic such as pedophilia. Important exploitable consensual recommendations that can ultimately be of immediate use by clinicians to help with differential diagnosis and plan and guide therapeutic interventions are described, as well as future perspectives for researchers.

Background: the assessment of P16 expression and Ki-67 proliferative index is now proposed as an adjunct test for the diagnosis of high-risk precursor lesions for cervical cancer. The aim of the present study was to elucidate the quality expression of P16 and quantification Ki-67 index in different types of cervical intraepithelial neoplasia and also to determine the cutoff for Ki67 index to predict the severity of CIN lesions. Methods: This cross-sectional study was conducted on patients with colposcopic indication. Selected samples with different CIN grades were examined for P16 and Ki-67 index by immunohistochemical (IHC) methods. Results: All LSIL (CIN I) cases were negative for P16, while in 58.7% of HSIL cases (CIN 2/3), P16 was positive. The mean Ki67 index in the present study was 3.13 ± 2.65 in the upper two/third of the squamous epithelium in the LSIL group and 19.04 ±36.40 in the HSIL group, which was statistically significant. Also, the mean Ki67 index in full thickness squamous epithelium in HSIL group was significantly higher than LSIL. The sensitivity of P16 and Ki67 index in our study was 58.73%, 66.67% and the specificity was 100% and 100%, respectively. Conclusion: Assessment of P16 expression and Ki67 index can be used to distinguish low grade (CIN1) intraepithelial lesion from high grade (CIN2/3) intraepithelial or precancerous lesions.

The primary goal of this research is to examine the influence of the Internet of Things on Pharmaceutical Inventory Management in Jordan. The employees of the pharmaceutical companies in Jordan represent the population of the study. Accordingly, the study instrument was distributed to an appropriate sample of 620 employees of pharmaceutical companies in Jordan; the questionnaires used in the analysis were 432. Structural equation modeling (SEM) was used to test the study hypotheses. The study results indicated that all dimensions of the Internet of Things had an influence on inventory management. The greatest influence was for cloud computing. Based to the study findings, pharmaceutical companies in Jordan should provide high-quality Internet coverage in their offices and stores, as well as to invest in Internet of things technologies that allow the company to remotely monitor and control the physical components of the stores, attract employees with knowledge of modern Internet technologies, and provide the necessary training and development for their employees.

It is very important to communicate with the mute and deaf people, and listen to what they need. The gesture sign is one of the first methods of communication between the mutes and deaf on one hand, and other people on the other hand. This way has rules and basics that should be respected and be familiar with, at the same time; most people cannot translate sign language. For this reason, this research proposes a model to translate sign language by preprocessing sign images in order to get an accurate classification. In this paper, background subtraction and edge detection are used together to present images with high edge details for the gesture sign, which is the region of interest, this work is done using OpenCV in python3. The results show that using background subtraction and edge detection algorithms produced better quality images for the translation model with testing accuracy is 85.71%. [ABSTRACT FROM AUTHOR]

Abstract Much of the knowledge and information needed for enabling high-quality clinical research is stored in free-text format. Natural language processing (NLP) has been used to extract information from these sources at scale for several decades. This paper aims to present a comprehensive review of clinical NLP for the past 15 years in the UK to identify the community, depict its evolution, analyse methodologies and applications, and identify the main barriers. We collect a dataset of clinical NLP projects (n = 94; £ = 41.97 m) funded by UK funders or the European Union’s funding programmes. Additionally, we extract details on 9 funders, 137 organisations, 139 persons and 431 research papers. Networks are created from timestamped data interlinking all entities, and network analysis is subsequently applied to generate insights. 431 publications are identified as part of a literature review, of which 107 are eligible for final analysis. Results show, not surprisingly, clinical NLP in the UK has increased substantially in the last 15 years: the total budget in the period of 2019–2022 was 80 times that of 2007–2010. However, the effort is required to deepen areas such as disease (sub-)phenotyping and broaden application domains. There is also a need to improve links between academia and industry and enable deployments in real-world settings for the realisation of clinical NLP’s great potential in care delivery. The major barriers include research and development access to hospital data, lack of capable computational resources in the right places, the scarcity of labelled data and barriers to sharing of pretrained models.

In Malaysia, our knowledge of freshwater ecosystem and its aquatic inhabitants, particularly freshwater fish, remains inadequate, even in protected regions. It is essential to understand the composition of freshwater fish, their distribution along river gradients, and their interactions between environmental variables to develop and strategize effective conservation and management plans. Consequently, an investigation into freshwater fish assemblages in three rivers draining off from the western part of Endau-Rompin Landscape was conducted in 12 established substations. Sampling sessions were conducted from September to December 2021 in the Labis district of Johor, using multiple sampling methods along 200 meters for each substation. The environmental variables were measured using water quality parameters. A total of 66 species were collected. The family Cyprinidae presented the highest species diversity (17 species), constituting 52% of total capture. Crossocheilus obscurus was the most dominant species, and the highest species richness was recorded in the Segamat River (45 species), followed by Juaseh (36 species) and Labis River (34 species). It was discerned that the composition of fish varied between the substations. The knowledge presented here is the first documentation on the freshwater fish from these rivers. It would serve as a baseline information for key authorities and stakeholders to conserve the biodiversity inhabiting freshwater ecosystems in Malaysia.

Abstract Background Due to pre-existing difficulties, refugees are especially susceptible to the negative effects of the pandemic; nonetheless, the pandemic’s effect on this group is still unclear. The purpose of this study was to determine the effects of the COVID-19 pandemic on the mental health of Palestine refugees in Gaza by identifying the role of social determinants. During the pandemic, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) enacted a number of policies and measures. The purpose of this research was to assess their efficacy and acceptability. Methods This qualitative study took place between August and November 2020. Twenty-nine key-informant interviews were conducted remotely with UNRWA Headquarters, field and clinical staff in Gaza and with community members, aged ≥18 years and residing in Rafah and Jabalia camps. We sought informed consent verbally or via email. Data was coded based on the framework for social determinants of mental health. Results Interview results indicated that the relationship might be unidirectional, with COVID-19 causing the degradation of living conditions and vice versa, with living conditions exacerbating the COVID-19 situation by facilitating virus transmission. In other instances, the association between mental health determinants and COVID-19 might be bidirectional. In terms of experiencing violence and anxieties, women, children, and daily-paid employees were significantly more disadvantaged than other groups in the community. UNRWA modified its service delivery techniques in order to continue providing essential services. In general, UNRWA’s strategies throughout the pandemic were deemed beneficial, but insufficient to meet the needs of Gazans. Conclusion The pandemic highlights the need to go beyond disease treatment and prevention to address social determinants to improve refugees’ health and reduce their susceptibility to future shocks. UNRWA has rapidly implemented telemedicine and mental telehealth services, making it imperative to assess the efficacy of these novel approaches to provide care at a distance. A long-term option may be to employ a hybrid strategy, which combines online and in-person therapy.

Introduction: Cervical cancer is the fourth common cancer in women and human papillomavirus is the most common risk factor of it. The present study was performed aimed to determine the relationship between Vitamin D and human papillomavirus in women referring to the hospitals of Shahid Beheshti University of Medical Sciences.Methods: This comparative study was conducted on 140 women referring to the hospitals of Shahid Beheshti University of Medical Sciences of Tehran in 2020. The case group were women with HPV infection and the control group in the same centers were the women with no HPV infection based on liquid based pap smear. Data was collected by interview and completing the questionnaire of Pap smear and measuring serum level of vitamin D. Data were analyzed by SPSS software (version 26) and Mann-Whitney test, independent t, chi-square, Fisher's exact and logistic regression. P

Abstract Background COVID-19 poses a global health challenge with more than 325 million cumulative cases and above 5 million cumulative deaths reported till January 17, 2022, by the World Health Organization. Several potential treatments to treat COVID-19 are under clinical trials including antivirals, steroids, immunomodulators, non-specific IVIG, monoclonal antibodies, and passive immunization through convalescent plasma. The need to produce anti-COVID-19 IVIG therapy must be continued, alongside the current treatment modalities, considering the virus is still mutating into variants of concern. In this context, as the present study will exploit pooled diversified convalescent plasma collected from recovered COVID-19 patients, the proposed hyperimmune Anti-COVID-19 intravenous immunoglobulin (C-IVIG) therapy would be able to counter new infectious COVID-19 variants by neutralizing the virus particles. After the successful outcome of the phase I/II clinical trial of C-IVIG, the current study aims to further evaluate the safety and efficacy of single low dose C-IVIG in severe COVID-19 patients for its phase II/III clinical trial. Methods This is a phase II/III, adaptive, multi-center, single-blinded, randomized controlled superiority trial of SARS-CoV-2 specific polyclonal IVIG (C-IVIG). Patients fulfilling the eligibility criteria will be block-randomized using a sealed envelope system to receive either 0.15 g/Kg C-IVIG with standard of care (SOC) or standard of care alone in 2:1 ratio. The patients will be followed-up for 28 days to assess the primary and secondary outcomes. Discussion This is a phase II/III clinical trial evaluating safety and efficacy of hyperimmune anti-COVID-19 intravenous immunoglobulin (C-IVIG) in severe COVID-19 patients. This study will provide clinical evidence to use C-IVIG as one of the first-line therapeutic options for severe COVID-19 patients. Trial registration Registered at clinicaltrial.gov with NCT number NCT04891172 on May 18, 2021.

Highly granular pixel detectors allow for increasingly precise measurements of charged particle tracks. Next-generation detectors require that pixel sizes will be further reduced, leading to unprecedented data rates exceeding those foreseen at the High- Luminosity Large Hadron Collider. Signal processing that handles data incoming at a rate of $\mathcal{O}$ (40 MHz) and intelligently reduces the data within the pixelated region of the detector at rate will enhance physics performance at high luminosity and enable physics analyses that are not currently possible. Using the shape of charge clusters deposited in an array of small pixels, the physical properties of the traversing particle can be extracted with locally customized neural networks. In this first demonstration, we present a neural network that can be embedded into the on-sensor readout and filter out hits from low momentum tracks, reducing the detector’s data volume by 57.1%–75.7%. The network is designed and simulated as a custom readout integrated circuit with 28 nm CMOS technology and is expected to operate at less than 300 $\mu W$ with an area of less than 0.2 mm ^2 . The temporal development of charge clusters is investigated to demonstrate possible future performance gains, and there is also a discussion of future algorithmic and technological improvements that could enhance efficiency, data reduction, and power per area.

Exoplanets with short orbit periods reside very close to their host stars. They transition very rapidly between different sectors of the circumstellar space environment along their orbit, leading to large variations of the magnetic field in the vicinity of the planet on short timescales. This rapid change of the magnetic flux through the conducting and resistive layer of the planetary upper atmosphere may drive currents that dissipate in the form of Joule heating (JH). Here, we estimate the amount of JH dissipation in the upper atmosphere of Trappist-1e, and two hypothetical planets orbiting the Sun in close-in orbits. We find that the rapid orbital motion could drive a significant amount of atmospheric heating and could significantly affect the planetary atmosphere escape rate. Thus, the process should be accounted for when studying the long-term evolution of exoplanetary atmospheres.

Polypropylene (PP) is known as a polymer without antistatic properties that is susceptible to the use of high temperatures. Therefore, to improve the thermal and antistatic properties of PP, it is necessary to modify PP to antistatic bio-nanocomposites with mono-diacylglycerols (M-DAG) as an antistatic agent and cellulose nanocrystals (CNC) as a reinforcement. This research aimed to characterize the electrical resistivity and thermal properties of PP-based antistatic bio-nanocomposites reinforced with M-DAG and CNC at different concentrations of CNC (0%–5%), and 2% of M- DAG, compared to pure PP. The results showed that the addition of 2% CNC (AS-BNC-2) gave the melting temperature of 125.0 °C, which was higher than pure PP of 118.3 °C. The thermal stability of the antistatic bio-nano composites with 3% CNC (AS-BNC-3) was 457.10 °C, which was higher than pure PP of 441.56 °C. The electrical resistivity of the antistatic bio-nano composites from all treatments was still in the range of the antistatic category of 10 ^10 –10 ^12 Ω/sq. The melting temperature and thermal stability of bio-nano composites were higher than those of pure PP and they have antistatic properties. This indicates the potential application of these materials in the electronics devices and packaging industries.

Background: Lynch syndrome (LS) is one of the commonest genetic cancer syndromes, with an incidence rate of 1 per 250–1000 population. The aim of this study was to evaluate the frequency and characteristics of MMR deficiency in endometrial cancer in Iranian women. Methods: One hundred endometrial carcinoma cases who referred to the gynecological oncology clinic of Imam Hossein Medical Center located in Tehran, Iran, from 2018 to 2020 were included in the study. Immunohistochemistry (IHC) evaluation was performed mainly on the hysterectomy specimens of all endometrial cancer (EC) patients to assess MMR proteins (MLH1, MSH2, MSH6, and PMS2) expression. Results: A total of 23 out of 100 (23%) cases were identified through IHC screening to be MMR-deficient. The most common types were loss of MLH1/PMS2 (17.4%) and solitary MSH2 (17.4%) expressions followed by PMS2/MSH2 loss (13%). MMR deficiency (dMMR) histopathology was significantly overrepresented in patients with family history of cancer or Lynch syndrome (LS) associated cancers (p-values of 0.016 and 0.005, respectively). The rate of myometrial invasion and lower uterine segment involvement were also significantly higher in dMMR EC patients compared to MMR-intact EC (p-value of 0.021 and 0.018, respectively). Conclusion: MMR deficiency, observed in 23% of endometrial cancer cases, was associated with higher rates of poor prognostic factors including myometrial invasion and lower uterine segment involvement. The presence of positive family history of cancer and family history of LS-associated cancer increased the probability of MMR-deficiency in endometrioid endometrial cancer to 47% and 70%, respectively

Latar Belakang: Buah kersen mengandung serat pangan dan antioksidan, namun belum banyak dimanfaatkan sebagai pangan fungsional. Sari buah berpotensi sebagai bahan dasar minuman sinbiotik. Prebiotik dapat membantu ketahanan bakteri. Maltodekstrin atau gum arab membantu menguragi kelengketan dan menjaga kandungan buah kersen saat proses pengeringan dengan spray dryer. Tujuan: Menganalisis karakteristik fisik, kimia, total bakteri asam laktat (BAL) pada formula minuman sinbiotik sari buah kersen instan dengan penambahan enkapsulator dan prebiotik, serta menentukan formula terbaik. Metode Penelitian eksperimental ini menggunakan rancangan acak lengkap faktorial, dengan variabel bebas jenis enkapsulator (maltodekstrin, gum arab) danjenis prebiotik (FOS, inulin). Terdapat empat formula dengan kombinasi masing-masing jenis enkapsulator dan prebiotik. Analisis karakteristik fisik mencakup Aw, pH, sifat rehidrasi (wettability, dispersibility, solubility); karakteristik kimia mencakup proksimat, total gula, serat pangan total, aktivitas antioksidan; serta total BAL. Uji beda antar formula menggunakan ANOVA two way dan uji lanjut Duncan. Hasil: Sari buah kersen dapat digunakan sebagai bahan dasar minuman sinbiotik instan. Formula dengan enkapsulator gum arab memiliki kadar abu dan serat pangan total signifikan lebih tinggi, serta kadar karbohidrat dan dispersibility signifikan lebih rendah dibandingkan formula dengan enkapsulator maltodekstrin (p value < 0,05). Formula kombinasi gum arab dan FOS memiliki nilai wettability tertinggi, sedangkan formula kombinasi maltodekstrin dan FOS memiliki nilai total BAL tertinggi (p value < 0,05). Kesimpulan: Produk mengandung serat pangan, antioksidan, serta probiotik. Formula dengan enkapsulator gum arab dan prebiotik FOS merupakan formula terbaik karena kandungan serat yang lebih tinggi, kandungan karbohidrat yang lebih rendah, serta aktivitas antioksidan yang sama, dan total BAL yang tidak jauh berbeda dengan formula lainnya.

This paper reports a case of tuberculous dactylitis and multiple scrofuloderma spreading through the lymph nodes. Scrofuloderma, also known as tuberculosis colliquativa cutis, is a form of cutaneous tuberculosis (TB) that occurs most often in children and young adults and involves the skin over the infection focus (i.e., lymph nodes, bones, or joints). Scrofuloderma can affect the lower limbs and upper arms by spreading osteomyelitis TB on the humerus, wrist, and elbow. This study reports the case of a 19-year-old man who initially developed painful and swollen skin, followed by the appearance of numerous recurring lumps on the left arm and hand and the right foot, as well as the folding right hamstring, over 3 years. The patient had no clinical improvement with antibiotics and excision. Radiography of the left hand showed tuberculous dactylitis. A biopsy of the left arm was performed, and Ziehl-Neelsen staining showed acid-fast bacilli. Mycobacterium tuberculosis was confirmed by a real-time polymerase chain reaction. Anti-TB drug treatment was initiated with rifampicin, isoniazid, pyrazinamide, and ethambutol, and debridement was performed on the left hand, which resulted in significant improvement of the lesion. Atypical clinical manifestations and unawareness of M. tuberculosis as an underlying disease delayed the diagnosis and treatment of this patient with tuberculous dactylitis and multiple scrofuloderma.