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The purpose of this research is to assess how energy poverty affects an individual's social wellbeing and financial constraints. The present research examines the effects of energy deprivation on a family's well-being, educational attainment, and economic advancement using survey data from PSLM (Pakistan Social and Living Standard Measurement). The investigation's empirical findings imply that a household's needs for energy are directly correlated with the fuel type they use and how little or expensively they rely on renewable energy. The consequent implications of energy dependence on family prosperity are significant. Energy-poor households have been shown to be more prone to experience respiratory illnesses, pay more for health care, drop out of school, and have less employment opportunities.

Objectives Higher physical activity (PA) levels are associated with better quality of life in people with head and neck cancer (HNC). Despite this positive association, most individuals with these cancer types have a sedentary or low-activity lifestyle. Limited knowledge exists regarding the factors that influence PA in this group. Therefore, we reviewed and mapped the available literature on factors that may influence PA in people with HNC.Design We conducted a scoping review based on the framework of Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline extension for scoping reviews.Data sources CINHAL, the Cochrane Library, EMBASE, PsycINFO, MEDLINE and Scopus were searched from inception to July 2023.Eligibility criteria We included qualitative and quantitative studies that stated factors such as barriers, facilitators, beliefs, perceptions and views influencing PA in individuals with HNC. Furthermore, views and recommendations of healthcare professionals involved in the care of people affected by HNC and researchers in this domain were eligible for data extraction.Data extraction and synthesis Data were extracted and synthesised by one reviewer according to the predefined items including characteristics, barriers, facilitators, beliefs, perceptions and views of people being affected and views and recommendations of experts. Quantitative data were charted descriptively, and qualitative data were analysed and summarised using a basic content analysis approach.Results Of the 1351 publications, we included 19 in our review. Publications mainly focused on barriers to PA, with some studies reporting facilitators and collecting data on patients’ and healthcare professionals’ views on PA. Most research teams made recommendations for promoting PA in people with HNC.Characteristics associated with activity levels included age, cancer type and stage, morbidity level and attitude towards being active. Prevalent barriers consisted of health-related factors, including fatigue, pain and nutritional issues, alongside personal and environmental impediments such as time constraints, lack of interest or motivation. Facilitating factors for PA included perceived or experienced mental and health-related benefits. Consensus among patients, healthcare professionals and researchers highlighted the necessity for enhanced information and education, emphasising individualised approaches to promote PA throughout the cancer continuum.Conclusions Numerous factors affect PA in individuals with HNC. Future research should concentrate on screening and addressing risk factors for sedentary behaviour and activity barriers and on optimal design and delivery of interventions to incorporate PA promotion into the care pathway.

Summary: Dendritic cell (DC) progenitors adapt their transcriptional program during development, generating different subsets. How chromatin modifications modulate these processes is unclear. Here, we investigate the impact of histone deacetylation on DCs by genetically deleting histone deacetylase 1 (HDAC1) or HDAC2 in hematopoietic progenitors and CD11c-expressing cells. While HDAC2 is not critical for DC development, HDAC1 deletion impairs pro-pDC and mature pDC generation and affects ESAM+cDC2 differentiation from tDCs and pre-cDC2s, whereas cDC1s are unchanged. HDAC1 knockdown in human hematopoietic cells also impairs cDC2 development, highlighting its crucial role across species. Multi-omics analyses reveal that HDAC1 controls expression, chromatin accessibility, and histone acetylation of the transcription factors IRF4, IRF8, and SPIB required for efficient development of cDC2 subsets. Without HDAC1, DCs switch immunologically, enhancing tumor surveillance through increased cDC1 maturation and interleukin-12 production, driving T helper 1-mediated immunity and CD8+ T cell recruitment. Our study reveals the importance of histone acetylation in DC development and anti-tumor immunity, suggesting DC-targeted therapeutic strategies for immuno-oncology.

BackgroundExtracellular particles (EPs), particularly extracellular vesicles, play a crucial role in regulating various pathological mechanisms, including immune dysregulations post-trauma. Their distinctive expression of cell-specific markers and regulatory cargo such as cytokines or micro-ribonucleic acid suggests their potential as early biomarkers for organ-specific damage and for identifying patients at risk for complications and mortality. Given the critical need for reliable and easily assessable makers to identify at-risk patients and guide therapeutic decisions, we evaluated the early diagnostic value of circulating EPs regarding outcomes in severely injured multiple-trauma patients.MethodsPlasma samples were collected from 133 severely injured trauma patients (Injury Severity Score (ISS) ≥16) immediately upon arrival at the emergency department (ED). Patients were categorized into survivors and non-survivors. Injury characteristics and outcomes related to sepsis, pneumonia, or early (

Ocean warming reduces O2 solubility and increases organismal O2 demand, endangering marine life. Coastal ecosystems, however, experience O2 supersaturation during peak daytime temperatures due to metabolic cycles. Recent discoveries show that this environmental supersaturation can reduce the vulnerability of tropical species to warming by satisfying their oxygen requirements. To test whether this also occurs within the cnidarian holobiont, we elevated internal O2 in Cassiopea andromeda at nighttime (i.e. holobiont respiration prevails on Symbiodniaceae O2 production) relying on bell pulsation for ventilation, then experimentally subjected them to thermal stress (+1°C day-1). Though ecologically unrealistic, this approach verified our hypothesis and eliminated confounding factors. Holobionts were exposed to either constant levels of 100% air saturation (100AS) or nighttime supersaturation (NSS; where 100% air saturation transitioned to O2 supersaturation at nighttime). At sublethal temperatures, supersaturation mitigated reductions in holobiont size of ~ 10.37% (-33.418% ± 0.345 under 100AS vs -23.039% ± 0.687 under NSS). Supersaturation alleviated chlorophyll-a loss by 42.73% until 34°C, when counteraction of this process could not be sustained due to excessive thermal stress. Supersaturation also enriched potentially beneficial bacterial taxa of the microbiome and selected a more consistent bacterial community. Although modest, the detected effects show that a O2 surplus increased the resistance of the holobionts to thermal stress.

Meat-free foodstuffs that emulate key properties of meat, meat alternatives, are portrayed as instruments to contribute to a dietary transition towards more protein from non-animal sources, a protein transition. Although they promise the large audience of meat-eating consumers easy sustainability gains, truly sustainable diets require changes beyond the replacement of animal by other proteins, a full-fledged protein transition. Meat-alternative companies are in a central position to support and to shape the form of the protein transition. So far, however, it is not entirely clear for “how much transition” enterprises actually aim, what activities they engage in to get there, and what limits their efforts. Our research contributes to elucidating these questions. Drawing from the concept of organizational purpose and from sustainability marketing scholarship, we investigate the transitional purpose of companies in the German market for plant-based meat alternatives. Through a series of semi-structured interviews and by studying the websites of key firms, we find that enterprises indeed largely aim for a protein transition, which replaces meat by meat-like substitutes. Also, there seems to be little company activity to facilitate dietary changes at the level of consumers or society. Nonetheless, our work indicates that wider changes are possible - e.g., even firms’ standard marketing activity could stimulate changes. In doing so, it lines out a path for future research that could help to better assess the potential role of meat-alternative businesses for a full-fledged protein transition.

This article shares findings from the first phase of program evaluation of Antle, a holistic language resource for teaching, learning and assessment. The program evaluation was guided by understandings that appreciate the interconnections of literacies and identities and is situated within a decolonizing framework that recognizes the transformation of Indigenous knowledges as essential. A quantitative and qualitative analysis was conducted. Analysis revealed the educators valued Antle but did not use the resource consistently. Recommendations include providing information to teachers about connections between literacies theories, curriculum outcomes, and program activities, and additional support for implementation. This article serves as an invitation to researchers and educators across Canada to rethink literacy assessment practices.

Tree nut consumption has been widely associated with various health benefits, with walnuts, in particular, being linked with improved cardiovascular and neurological health. These benefits have been attributed to walnuts’ vast array of phenolic antioxidants and abundant polyunsaturated fatty acids. However, recent studies have revealed unexpected clinical outcomes related to walnut consumption, which cannot be explained simply with the aforementioned molecular hallmarks. With the goal of discovering potential molecular sources of these unexplained clinical outcomes, an exploratory untargeted metabolomics analysis of the isolated walnut pellicle was conducted. This analysis revealed a myriad of unusual lipids, including oxylipins and endocannabinoids. These lipid classes, which are likely present in the pellicle to enhance the seeds’ defenses due to their antimicrobial properties, also have known potent bioactivities as mammalian signaling molecules and homeostatic regulators. Given the potential value of this tissue for human health, with respect to its “bioactive” lipid fraction, we sought to quantify the amounts of these compounds in pellicle-enriched waste by-products of mechanized walnut processing in California. An impressive repertoire of these compounds was revealed in these matrices, and in notably significant concentrations. This discovery establishes these low-value agriculture wastes promising candidates for valorization and translation into high-value, health-promoting products; as these molecules represent a potential explanation for the unexpected clinical outcomes of walnut consumption. This “hidden quality” of the walnut pellicle may encourage further consumption of walnuts, and walnut industries may benefit from a revaluation of abundant pellicle-enriched waste streams, leading to increased sustainability and profitability through waste upcycling.

ABSTRACT Daptomycin is a membrane-targeting last-resort antimicrobial therapeutic for the treatment of infections caused by methicillin- and/or vancomycin-resistant Staphylococcus aureus. In the rare event of failed daptomycin therapy, the source of resistance is often attributable to mutations directly within the membrane phospholipid biosynthetic pathway of S. aureus or in the regulatory systems that control cell envelope response and membrane homeostasis. Here we describe the structural changes to the cell envelope in a daptomycin-resistant isolate of S. aureus strain N315 that has acquired mutations in the genes most commonly reported associated with daptomycin resistance: mprF, yycG, and pgsA. In addition to the decreased phosphatidylglycerol (PG) levels that are the hallmark of daptomycin resistance, the mutant with high-level daptomycin resistance had increased branched-chain fatty acids (BCFAs) in its membrane lipids, increased membrane fluidity, and increased cell wall thickness. However, the successful utilization of isotope-labeled straight-chain fatty acids (SCFAs) in lipid synthesis suggested that the aberrant BCFA:SCFA ratio arose from upstream alteration in fatty acid synthesis rather than a structural preference in PgsA. Transcriptomics studies revealed that expression of pyruvate dehydrogenase (pdhB) was suppressed in the daptomycin-resistant isolate, which is known to increase BCFA levels. While complementation with an additional copy of pdhB had no effect, complementation of the pgsA mutation resulted in increased PG formation, reduction in cell wall thickness, restoration of normal BCFA levels, and increased daptomycin susceptibility. Collectively, these results demonstrate that pgsA contributes to daptomycin resistance through its influence on membrane fluidity and cell wall thickness, in addition to phosphatidylglycerol levels.IMPORTANCEThe cationic lipopeptide antimicrobial daptomycin has become an essential tool for combating infections with Staphylococcus aureus that display reduced susceptibility to β-lactams or vancomycin. Since daptomycin's activity is based on interaction with the negatively charged membrane of S. aureus, routes to daptomycin-resistance occur through mutations in the lipid biosynthetic pathway surrounding phosphatidylglycerols and the regulatory systems that control cell envelope homeostasis. Therefore, there are many avenues to achieve daptomycin resistance and several different, and sometimes contradictory, phenotypes of daptomycin-resistant S. aureus, including both increased and decreased cell wall thickness and membrane fluidity. This study is significant because it demonstrates the unexpected influence of a lipid biosynthesis gene, pgsA, on membrane fluidity and cell wall thickness in S. aureus with high-level daptomycin resistance.

The paper presents aspects connected with the application of the principles of the experiential learning theory in engineering education, in teaching graphical subjects. The experiential learning theory presents the process of learning as being cyclical, with four stages - experience, reflection, abstract conceptualization and experimentation, each stage being related to a certain learning style. The paper intends to outline aspects on ways that would help students to develop appropriate learning styles and also, would help to improve student learning, by gaining experience continuously and transforming it into knowledge. The applications presented are focused on applying the experiential learning theory in engineering education, in teaching technical drawing.

The paper presents applications developed for teaching descriptive geometry. The aim of the applications presented is the understanding of the basic elements of the descriptive geometry – the relative positions of a straight line and a plane and they are focused on the intersection of a straight line and a plane. These applications are ment to help the development and improvement of the space sight ability of the students such as to enable the understanding of the basic elements of the descriptive geometry – the straight line and the plane and their relative positions in space.

BackgroundKidney transplantation is the therapy of choice for end-stage kidney disease, and a fast-growing transplant procedure worldwide. Diverse clinical practices for recipients and donors' selection and management between transplant centers hinder the creation and dissemination of an anesthesia-surgical checklist.MethodsComponents of the anesthesia-surgical checklist were selected after a review of the English literature using PubMed search for donor, recipient and graft protocols and outcomes of existing practices in the field of kidney transplantation. Key elements of the most relevant articles were combined with our own center's experience and formulated into the proposed checklist. The checklist is intended to be used perioperatively, once patient receives an offer.ResultsThe perioperative checklist centers primarily on the following donor and recipient's factors: (i) Review of the pretransplant candidate workup; (ii) Assessment of donor/graft status; (iii) Hypothermic machine perfusion parameters; (iv) Operating room management; (v) Sign out. The proposed kidney transplant checklist was designed to ensure consistency and completeness of diverse tasks and facilitates team communication and coordination.ConclusionWe present a novel standardized combined anesthesia-surgical checklist framework for kidney transplant aimed at increasing perioperative safety and streamline the perioperative care of recipients. Future validation studies will determine its clinical feasibility and post-implementation efficacy.

IntroductionAutism spectrum disorder (ASD) is characterised by difficulty with social communication and restricted, repetitive patterns of behaviour. This study aimed to improve understanding of the ASD patient experience with the treatment (bumetanide) regarding the changes in core symptoms and to assess changes considered as meaningful. To achieve this, qualitative interviews were conducted with caregivers of patients in two phase 3 clinical trials (NCT03715153; NCT03715166) of a novel ASD treatment.MethodsCaregivers were invited to participate in one interview after completion of the pivotal phase 3 study; for those of them who continued treatment after study completion, a second interview was held 3 months after trial completion. The interviews were conducted by qualitative researchers and followed a semi-structured interview guide. The interviews focused on patients’ ASD symptoms and their impact on their daily life before enrolment, and on any symptom changes patients experienced during the trial.ResultsOut of the 13 eligible patients’ caregivers, 11 were interviewed up to two times at clinical sites in the UK, Spain, and Italy. The caregivers reported impairments in a wide range of skills: deficits in communication and social interaction; restricted, repetitive patterns of behaviour, interests, or activities; and cognitive, emotional, and motor impairments. Compared to before the trial initiation, caregivers also reported improvements in the following domains: communication, interaction with others, cognition, aggression, emotions, repetitive movements, eating, and sleeping.ConclusionThe exit interviews provided a rich source of qualitative data, allowing a deeper understanding of caregivers’ and patients’ experience of the disease and allowing us to understand what constitutes a meaningful change. These data also helped identify important experiences that may inform the patient-reported outcome measurement strategy for future trials in ASD.

Introdução: Readiness for Interprofessional Learning Scale (RIPLS) é uma escala psicométrica de autorrelato que se propõe a avaliar a disponibilidade de estudantes e profissionais de saúde para o aprendizado compartilhado e colaborativo entre profissões de diferentes áreas. Desde que foi proposta originalmente na Inglaterra, em 1999, a RIPLS tem sido utilizada em diferentes países, incluindo o Brasil, num processo contínuo de aprimoramento e de demonstração de evidências de validade e confiabilidade para uso e interpretação dos resultados obtidos com sua utilização. Objetivo: Avaliar evidências de validade e confiabilidade para a RIPLS-40 em uma amostra de estudantes de cursos de graduação em saúde de uma universidade pública localizada no interior do estado da Bahia. Metodologia: Participaram 205 estudantes de cinco cursos da área da saúde (Psicologia, Nutrição, Enfermagem, Medicina e Bacharelado Interdisciplinar em Saúde), com modelos de formação distintos: formação linear e em ciclos. Os dados foram coletados em sala de aula. Foram realizadas análises fatoriais/modelagens exploratórias de equações estruturais (ESEM) para avaliar a dimensionalidade do instrumento, bem como análises de confiabilidade e de comparação de grupos ao nível de p ≤ 0,05. Resultados: Os resultados das análises psicométricas indicaram ajuste satisfatório do modelo fatorial de três fatores: “Trabalho em equipe e colaboração” (CC = 0,89); “Identidade profissional” (C = 0,67); “Atenção centrada no paciente” (CC = 0,92). A RIPLS-40 foi capaz de diferenciar grupos e identificar atividades acadêmicas potentes para a promoção da interprofissionalidade. Conclusão: Foram demonstradas evidências de validade e de confiabilidade da RIPLS-40, sobretudo para os fatores “Trabalho em equipe e colaboração” e “Atenção centrada no paciente”. Estudos complementares são recomendados para o uso da escala RIPLS-40, em particular para o fator “Identidade profissional”, que vem apresentando fragilidade na validação nos contextos brasileiros, bem como em outros países.

Descrição do editorial: O editorial do primeiro número de 2024 da Saberes Plurais propôs-se, em um primeiro momento, a compartilhar com seus autores e leitores informações sobre o processo de avaliação da Saberes Plurais pelo Comitê de Avaliação e Seleção de Periódicos LILACS Brasil e o relatório recebido. Relata modificações imediatas realizadas pela equipe editorial e o planejamento coletivo de ações a serem implementadas ao longo de um período de tempo. Em um segundo momento, contextualiza a situação de emergência climático-ambiental vivenciada pelas chuvas no Rio Grande do Sul e, de modo especial, em Porto Alegre, e o impacto na vida das pessoas, das cidades e no fluxo de trabalho do periódico. Ao final, apresenta o convite à leitura dos textos publicados neste número – 20 artigos, uma resenha e um boletim informativo –, e à escrita sobre o vivenciado/experenciado, com análises sobre os efeitos no cotidiano de vida, educação e trabalho.

BackgroundThere is increasing interest in using patient-generated health data (PGHD) to improve patient-centered care during pregnancy. However, little research has examined the perspectives of patients and providers as they report, collect, and use PGHD to inform obstetric care. ObjectiveThis study aims to explore the perspectives of patients and providers about the use of PGHD during pregnancy, including the benefits and challenges of reporting, collecting, and using these data, as well as considerations for expanding the use of PGHD to improve obstetric care. MethodsWe conducted one-on-one interviews with 30 pregnant or postpartum patients and 14 health care providers from 2 obstetrics clinics associated with an academic medical center. Semistructured interview guides included questions for patients about their experience and preferences for sharing PGHD and questions for providers about current processes for collecting PGHD, opportunities to improve or expand the collection of PGHD, and challenges faced when collecting and using this information. Interviews were conducted by phone or videoconference and were audio recorded, transcribed verbatim, and deidentified. Interview transcripts were analyzed deductively and inductively to characterize and explore themes in the data. ResultsPatients and providers described how PGHD, including physiologic measurements and experience of symptoms, were currently collected during and between in-person clinic visits for obstetric care. Both patients and providers reported positive perceptions about the collection and use of PGHD during pregnancy. Reported benefits of collecting PGHD included the potential to use data to directly inform patient care (eg, identify issues and adjust medication) and to encourage ongoing patient involvement in their care (eg, increase patient attention to their health). Patients and providers had suggestions for expanding the collection and use of PGHD during pregnancy, and providers also shared considerations about strategies that could be used to expand PGHD collection and use. These strategies included considering the roles of both patients and providers in reporting and interpreting PGHD. Providers also noted the need to consider the unintended consequences of using PGHD that should be anticipated and addressed. ConclusionsAcknowledging the challenges, suggestions, and considerations voiced by patients and providers can inform the development and implementation of strategies to effectively collect and use PGHD to support patient-centered care during pregnancy.

Carpal Tunnel Syndrome (CTS) has traditionally been viewed as a specialized medical condition. However, its escalating prevalence among professionals across a multitude of industries has sparked substantial interest in recent years. This review aims to delve into CTS as an occupational disease, focusing on its epidemiological patterns, risk factors, symptoms, and management options, particularly emphasizing its relevance in professional environments. The complex interaction of anatomical, biomechanical, and pathophysiological factors that contribute to the development of CTS in different work settings underlines the critical role of ergonomic measures, prompt clinical identification, and tailored treatment plans in reducing its effects. Nevertheless, the challenges presented by existing research, including diverse methodologies and definitions, highlight the need for more unified protocols to thoroughly understand and tackle this issue. There’s a pressing demand for more in-depth research into the epidemiology of CTS, its injury mechanisms, and the potential role of targeted medicine. Moreover, recognizing CTS’s wider ramifications beyond personal health is essential. The economic burden associated with CTS-related healthcare costs, productivity losses, and compensation claims can significantly impact both businesses and the broader society. Therefore, initiatives aimed at preventing CTS through workplace interventions, education, and early intervention programs not only benefit the affected individuals but also contribute to the overall well-being of the workforce and economic productivity. By fostering a collaborative approach among healthcare professionals, employers, policymakers, and other stakeholders, we can strive towards creating safer and healthier work environments while effectively managing the challenges posed by CTS in occupational settings.

The objective of our study was to evaluate the changes in cardiovascular parameters in patients with hypertension who completed a 3-month physical exercise program. 229 sub-jects with high normal values of blood pressure and stage 1 hypertension (group 1) and 120 patients with stage 2 hypertension (group 2) followed a 3-month physical exercise program. The following parameters were measured: systolic blood pressure, diastolic blood pressure, pulse pressure, heart rate, pulse wave velocity. For group 1 there were sta-tistically significant differences for all the tested parameters after the 3-month program (decreased systolic blood pressure, heart rate, pulse pressure and pulse wave velocity, p< 0.0001; lower diastolic blood pressure, p=0.018)). In group 2 all the tested parameters had decreased values after the 3-month rehabilitation program. However, only for the pulse wave velocity there was recorded a statistically significant reduction after the exercise program (p< 0.001). There were significant direct correlations between total cholesterol and pulse wave velocity for group 1 at both initial (p=0.024) and final assessments (p=0.03), and for group 2 patients at the 3-month assessment (p=0.001). A medium-term physical exercise program improved the cardiovascular parameters (blood pressure, arte-rial stiffness) in hypertensive patients.

Issues such as plagiarism, copyright infringement, unethical uses of computer programs and multimedia resources, as well as the unreasonable use of resources for educational purposes are becoming ever more complicated with the exponential development of generative artificial intelligence (gAI) tools. Do gAI tools violate academic integrity? Will they encourage scientific fraud? How could gAI be used to personalize and differentiate language learning acquisition? Will educators stop assigning reflective essays? Do we need AI literacy? The main purpose of this paper is to explore some of these questions, with an emphasis on teaching English as a second language in higher education.

Abstract Frequent complications arising from low anterior resections include urinary and fecal incontinence, as well as sexual disorders, which are commonly associated with damage to the pelvic autonomic nerves during surgery. To assist the surgeon in preserving pelvic autonomic nerves, a novel approach for intraoperative pelvic neuromonitoring was investigated that is based on impedance measurements of the innervated organs. The objective of this work was to develop an algorithm called AMINA to classify the bioimpedance signals, with the goal of facilitating signal interpretation for the surgeon. Thirty patients included in a clinical investigation underwent nerve-preserving robotic rectal surgery using intraoperative pelvic neuromonitoring. Contraction of the urinary bladder and/or rectum, triggered by direct stimulation of the innervating nerves, resulted in a change in tissue impedance signal, allowing the nerves to be identified and preserved. Impedance signal characteristics in the time domain and the time–frequency domain were calculated and classified to develop the AMINA. Stimulation-induced positive impedance changes were statistically significantly different from negative stimulation responses by the percent amplitude of impedance change Amax in the time domain. Positive impedance changes and artifacts were distinguished by classifying wavelet scales resulting from peak detection in the continuous wavelet transform scalogram, which allowed implementation of a decision tree underlying the AMINA. The sensitivity of the software-based signal evaluation by the AMINA was 96.3%, whereas its specificity was 91.2%. This approach streamlines and automates the interpretation of impedance signals during intraoperative pelvic neuromonitoring.

Abstract Background Generating rigorous evidence to inform care for rare diseases requires reliable, sustainable, and longitudinal measurement of priority outcomes. Having developed a core outcome set for pediatric medium-chain acyl-CoA dehydrogenase (MCAD) deficiency, we aimed to assess the feasibility of prospective measurement of these core outcomes during routine metabolic clinic visits. Methods We used existing cohort data abstracted from charts of 124 children diagnosed with MCAD deficiency who participated in a Canadian study which collected data from birth to a maximum of 11 years of age to investigate the frequency of clinic visits and quality of metabolic chart data for selected outcomes. We recorded all opportunities to collect outcomes from the medical chart as a function of visit rate to the metabolic clinic, by treatment centre and by child age. We applied a data quality framework to evaluate data based on completeness, conformance, and plausibility for four core MCAD outcomes: emergency department use, fasting time, metabolic decompensation, and death. Results The frequency of metabolic clinic visits decreased with increasing age, from a rate of 2.8 visits per child per year (95% confidence interval, 2.3–3.3) among infants 2 to 6 months, to 1.0 visit per child per year (95% confidence interval, 0.9–1.2) among those ≥ 5 years of age. Rates of emergency department visits followed anticipated trends by child age. Supplemental findings suggested that some emergency visits occur outside of the metabolic care treatment centre but are not captured. Recommended fasting times were updated relatively infrequently in patients’ metabolic charts. Episodes of metabolic decompensation were identifiable but required an operational definition based on acute manifestations most commonly recorded in the metabolic chart. Deaths occurred rarely in these patients and quality of mortality data was not evaluated. Conclusions Opportunities to record core outcomes at the metabolic clinic occur at least annually for children with MCAD deficiency. Methods to comprehensively capture emergency care received at outside institutions are needed. To reduce substantial heterogeneous recording of core outcome across treatment centres, improved documentation standards are required for recording of recommended fasting times and a consensus definition for metabolic decompensations needs to be developed and implemented.

Abstract Fetal akinesia deformation sequence (FADS) represents the severest form of congenital myasthenic syndrome (CMS), a diverse group of inherited disorders characterised by impaired neuromuscular transmission. Most CMS originate from defects in the muscle nicotinic acetylcholine receptor, but the underlying molecular pathogenesis is only poorly understood. Here we show that RNAi-mediated silencing of FADS-related proteins rapsyn and NUP88 in foetal fibroblasts alters organisation of the actin cytoskeleton. We show that fibroblasts from two independent FADS individuals have enhanced and shorter actin stress fibre bundles, alongside with an increased number and size of focal adhesions, with an otherwise normal overall connectivity and integrity of the actin-myosin cytoskeleton network. By proximity ligation assays and bimolecular fluorescence complementation, we show that rapsyn and NUP88 localise nearby adhesion plaques and that they interact with the focal adhesion protein paxillin. Based on these findings we propose that a respective deficiency in rapsyn and NUP88 in FADS alters the regulation of actin dynamics at focal adhesions, and thereby may also plausibly dictate myofibril contraction in skeletal muscle of FADS individuals.

Abstract Segmental instillation of lipopolysaccharide (LPS) by bronchoscopy safely induces transient airway inflammation in human lungs. This model enables investigation of pulmonary inflammatory mechanisms as well as pharmacodynamic analysis of investigational drugs. The aim of this work was to describe the transcriptomic profile of human segmental LPS challenge with contextualization to major respiratory diseases. Pre-challenge bronchoalveolar lavage (BAL) fluid and biopsies were sampled from 28 smoking, healthy participants, followed by segmental instillation of LPS and saline as control. Twenty-four hours post instillation, BAL and biopsies were collected from challenged lung segments. Total RNA of cells from BAL and biopsy samples were sequenced and analysed for differentially expressed genes (DEGs). After challenge with LPS compared with saline, 6316 DEGs were upregulated and 241 were downregulated in BAL, but only one DEG was downregulated in biopsy samples. Upregulated DEGs in BAL were related to molecular functions such as “Inflammatory response” or “chemokine receptor activity”, and upregulated pro-inflammatory pathways such as “Wnt-"/“Ras-"/“JAK-STAT” “-signaling pathway”. Furthermore, the segmental LPS challenge model resembled aspects of the five most prevalent respiratory diseases chronic obstructive pulmonary disease (COPD), asthma, pneumonia, tuberculosis and lung cancer and featured similarities with acute exacerbations in COPD (AECOPD) and community-acquired pneumonia. Overall, our study provides extensive information about the transcriptomic profile from BAL cells and mucosal biopsies following LPS challenge in healthy smokers. It expands the knowledge about the LPS challenge model providing potential overlap with respiratory diseases in general and infection-triggered respiratory insults such as AECOPD in particular.

The aerobic endurance capacity of PJKR progdi students must be above the average of the aerobic endurance capacity of other students. Observing this phenomenon, this study aims to determine the capacity of aerobic endurance (VO₂Max) using the Bleep Test in first semester students of the PJKR study programme. The method in this study is quantitative non-experimental with a quantitative descriptive approach. The population used in this study were first semester students of the PJKR study programme, the number of samples was 70 people. The research was carried out at the PJKR study programme. Data analysis using statistical analysis includes preparation, tabulation and data application. Based on the results of research and discussion, it is concluded that the level of physical fitness of Physical Education study programme students is categorised as very less (95.51%) and 4.28% of students are categorised as less. It can be said that more than 95% of physical education study programme students have a very poor level of physical fitness. Students need to manage their diet, rest and exercise activities regularly. The study programme is recommended to monitor and improve physical fitness for students through training and evaluation programmes.

La producción de sedimentos por erosión hídrica es un tema de gran interés debido a que su desconocimiento puede representar graves peligros para las comunidades e infraestructuras cercanas. En los últimos años se han desarrollado varios métodos para cuantificar los sedimentos, pero su complejidad, precisión y exactitud varía dependiendo del enfoque empleado. Sin embargo, muchos de estos modelos requieren de la utilización de extensas series temporales de precipitaciones, pero, en Ecuador, las estaciones meteorológicas presentan una preocupante carencia de datos y su distribución espacial no es homogénea, lo que genera una incorrecta estimación de las lluvias en el territorio analizado. Para resolver este problema, es posible utilizar metodologías que empleen información ráster satelital. El objetivo de la presente investigación fue estimar los volúmenes de sedimentos en las cuencas hidrográficas de la provincia de Manabí, mediante la implementación del modelo RUSLE, a través de un procedimiento empírico que requiere de la utilización de la densidad aparente del suelo en sus tres texturas principales (arena, arcilla y limo). La metodología consideró la delimitación de las cuencas analizadas, la evaluación de datos ráster satelitales para determinar los seis parámetros del modelo RUSLE entre el año 2001 y 2020 y la estimación de la densidad aparente mediante un método innovador. La delimitación de las cuencas fue obtenida de fuentes regionales; la información satelital fue obtenida desde fuentes web oficiales; los valores típicos de la densidad aparente fueron obtenidos de fuentes a escala mundial; y la validación de los datos de densidad aparente se realizó mediante un muestreo en sitio. Los resultados permitieron identificar tasas de erosión del suelo que varían entre 0,10 ton ha-1 y 3252,22 ton ha-1, lo que generó una estimación de sedimentos entre 0,06 m3 año-1 y 692,43 m3 año-1 a nivel de píxel. La densidad aparente promedio fue de 1,49 ton m-3, lo que demuestra un elevado contenido de arena en las cuencas manabitas. La validación de datos reveló una excelente compatibilidad entre la metodología propuesta y el análisis convencional en sitio, que se ve reflejada en una diferencia promedio inferior al 3%. La información obtenida permitirá a las entidades gubernamentales competentes, establecer programas de mitigación para hacer frente a la pérdida del suelo por erosión hídrica y al control de la producción de sedimentos.

Proxy servers are widely used in many contexts since they can enhance performance, security, and access control for production networks. The Constrained Application Protocol (CoAP), the de facto standard of Internet of Things (IoT) communications, specifies mechanisms and semantics to applications based on RESTful approach similar to HTTP. The CoAP standard defines an additional operation mode for proxying request, which is supported by several programming languages and platforms. However, there is no current implementation of a CoAP proxy for embedded systems, namely for devices supporting the Contiki-NG operating system. This paper discusses the design, implementation, and evaluation of a forward CoAP Proxy server for 6LoWPAN embedded systems with cache capabilities. We perform simulation and experimental evaluations with topologies involving up to three hops from the proxy to study performance in terms of response times and the number of exchanged packets. In simulation environments results show a 48.03%, 85.39%, and 134.21% in response time reduction at one, two, and three hops away. In experimental environments, results show that the use of our embedded CoAP Proxy server reduces response times in 7.46%, 30.67%, and 37.43% when requests are targeted to servers at one, two, and three hops away from the proxy respectively. In both scenarios, a reduction in the number of exchanged packets of 71.42%, 125%, and 166.66% for requests at each hop is achieved.

The purpose of this research is to examines how is the competition and pricing for audit services in the audit service market in Indonesia from the perspective of the auditors. This study uses a questionnaire with auditor respondents at manager level to audit partners. The data analysis technique used in this research is descriptive statistical analysis. By using a total of 414 respondents from audit firms Big 4 and non-Big 4, this research found that most of the respondents considered the audit service market competition in Indonesia to be high and agree that competition for audit services creates pressure that creates relatively low audit fee in Indonesia. The results of this study confirm and strengthen previous studies which using secondary data that the level of concentration of the audit services market is related to the level of competition for audit services and create pressure to reduce audit fee. The implication of this research is that further research needs to be carried out using more objective secondary data to examine the impact of the level of competition of audit services on audit fees and audit quality as well as evaluating whether regulations are needed to determine minimum audit fees.

The current paper introduces Miha, an affordable yet highly performant humanoid platform for research and development. The motivation behind the platform is to significantly lower the costs compared to similar offerings, democratizing access to humanoid robotics research and helping in the standardization of common control functions. The platform offers 22 degrees of freedom smart actuators, pressure sensors, inertial measurement units, stereo cameras, multiple microphones, speakers, and a convenient 2.4-inch liquid crystal display for the on-device user interface. It includes a unique dual hot-swap battery design that allows continuous operation in the field with best-in-class 3-hours autonomy on one charge. The presented version uses a Raspberry Pi Compute Module 4 as the main controller and uses ROS Noetic. We demonstrate several control functions, including walking. The vast majority of hardware and software components are either off-the-shelf or provided as open-source.

Panax Ginseng (GSG) may be a useful agent for treating depression and anxiety. The aim of the research was to evaluate two administrations of a product containing GSG (P-GSG) in intense acute physical stress. Healthy men were voluntarily enrolled into 4 groups: control (C) no treatment; who received placebo (P); who received P-GSG for one week (GSG1); who received P-GSG for 3 weeks (GSG3). All participants were subjected to the same type of stress: an acute and short-term intense physical effort on a cycle ergometer. The administered products were: placebo and P-GSG. The scans were: anxiety (A) and heart rate (HR). Parameters were significantly increased at C and P, for A and HR compared to GSG1 and GSG3. The greatest impact of P-GSG was on A. GSG1 compared to GSG3 had a greater impact on A and HR. In conclusion, through this study we found that Panax Ginseng, especially if taken for a longer period of time, reduces heart rate and anxiety in short-term acute intense exercise stress.

AbstractRecent years have seen the development of a variety of mammalian library approaches for display and secretion mode. Advantages include library approaches for engineering, preservation of precious immune repertoires and their repeated interrogation, as well as screening in final therapeutic format and host. Mammalian display approaches for antibody optimization exploit these advantages, necessitating the generation of large libraries but in turn enabling early screening for both manufacturability and target specificity. For suitable libraries, high antibody integration rates and resulting monoclonality need to be balanced – we present a solution for sufficient transmutability and acceptable monoclonality by applying an optimized ratio of coding to non-coding lentivirus. The recent advent of microfluidic-assisted hit discovery represents a perfect match to mammalian libraries in secretion mode, as the lower throughput fits well with the facile generation of libraries comprising a few million functional clones. In the presented work, Chinese Hamster Ovary cells were engineered to both express the target of interest and secrete antibodies in relevant formats, and specific clones were strongly enriched by high throughput screening for autocrine cellular binding. The powerful combination of mammalian secretion libraries and microfluidics-assisted hit discovery could reduce attrition rates and increase the probability to identify the best possible therapeutic antibody hits faster.

Introduction: The Basic Emergency Care (BEC) course is an open-access training designed for frontline providers in low resource settings which focuses on recognizing and managing emergent conditions. This study describes the implementation of the BEC course for nurses at Bugando Medical Center (BMC) in Mwanza, Tanzania in March 2020 as part of an educational initiative to improve nurses’ knowledge and confidence in providing emergency care. Methods: This is a 2-week educational intervention with pre-post measurements. 12 nurses (cohort 1) received BEC training from in-country facilitators over the course of 4 days. A training-of-trainers (ToT) course followed immediately and the 5 newly trained facilitators then taught the BEC course to 12 additional nurses (cohort 2). Pre- and post-BEC knowledge was assessed with a standardized 25-question multiple choice (MCQ) exam; confidence levels were evaluated using a 4-point Likert scale survey; and qualitative feedback obtained was examined by thematic analysis. Results: 24 participants completed the BEC course, 5 of which completed a ToT to become BEC facilitators. For the combined group, knowledge assessment scores improved significantly from 63.8% to 85.2% with a mean difference of 21.5% (t(24)= 9.3, p

Se analizó la percepción del riesgo frente a fenómenos geológicos en la zona costera del municipio Moa. Se emplearon métodos empíricos y matemáticos para evaluar el conocimiento de los pobladores de esta región y la gestión de la información proveniente de fuentes reconocidas. Los métodos empíricos consistieron en la aplicación de encuestas a los habitantes del territorio con el propósito de indagar sobre su percepción del riesgo, mientras que los métodos matemáticos se utilizaron para realizar un análisis porcentual que permitió cuantificar e interpretar los resultados obtenidos de manera tanto cuantitativa como cualitativa. Los hallazgos revelaron que la población encuestada presenta niveles reducidos de percepción de riesgo. Estos resultados son relevantes para el diseño de estrategias de gestión de desastres por parte de las autoridades competentes.

Abstract Purpose To determine if pelvic/ovarian and omental lesions of ovarian cancer can be reliably segmented on computed tomography (CT) using fully automated deep learning-based methods. Methods A deep learning model for the two most common disease sites of high-grade serous ovarian cancer lesions (pelvis/ovaries and omentum) was developed and compared against the well-established “no-new-Net” framework and unrevised trainee radiologist segmentations. A total of 451 CT scans collected from four different institutions were used for training (n = 276), evaluation (n = 104) and testing (n = 71) of the methods. The performance was evaluated using the Dice similarity coefficient (DSC) and compared using a Wilcoxon test. Results Our model outperformed no-new-Net for the pelvic/ovarian lesions in cross-validation, on the evaluation and test set by a significant margin (p values being 4 × 10–7, 3 × 10–4, 4 × 10–2, respectively), and for the omental lesions on the evaluation set (p = 1 × 10–3). Our model did not perform significantly differently in segmenting pelvic/ovarian lesions (p = 0.371) compared to a trainee radiologist. On an independent test set, the model achieved a DSC performance of 71 ± 20 (mean ± standard deviation) for pelvic/ovarian and 61 ± 24 for omental lesions. Conclusion Automated ovarian cancer segmentation on CT scans using deep neural networks is feasible and achieves performance close to a trainee-level radiologist for pelvic/ovarian lesions. Relevance statement Automated segmentation of ovarian cancer may be used by clinicians for CT-based volumetric assessments and researchers for building complex analysis pipelines. Key points • The first automated approach for pelvic/ovarian and omental ovarian cancer lesion segmentation on CT images has been presented. • Automated segmentation of ovarian cancer lesions can be comparable with manual segmentation of trainee radiologists. • Careful hyperparameter tuning can provide models significantly outperforming strong state-of-the-art baselines. Graphical Abstract

Abstract Background Pregnancy after liver transplantation poses a significant challenge to both the patient and the transplant team. Case presentation We present the case of a 19-year-old European patient who underwent liver transplantation 5 years previously owing to autoimmune hepatitis. Poor compliance with immunosuppressive therapy and missed follow-up visits during the patient’s first pregnancy likely contributed to her liver function deterioration, hospitalization, and failed pregnancy. Owing to the patient’s complex medical history, combined immunosuppressive treatment, and risks to the fetus, her second pregnancy was high risk. However, close outpatient monitoring and adherence to treatment led to a successful, uneventful, full-term pregnancy and healthy delivery. Conclusion Liver transplant recipients who desire to become pregnant require careful planning and management to ensure optimal outcomes for both the mother and the fetus. A personalized strategy is necessary to balance the potential benefits of childbirth with the risks involved in pregnancy after liver transplantation.

Abstract Autophagy-related protein 18 (Atg18) participates in the elongation of early autophagosomal structures in concert with Atg2 and Atg9 complexes. How Atg18 contributes to the structural coordination of Atg2 and Atg9 at the isolation membrane remains to be understood. Here, we determined the cryo-EM structures of Atg18 organized in helical tubes, Atg18 oligomers in solution as well as on lipid membrane scaffolds. The helical assembly is composed of Atg18 tetramers forming a lozenge cylindrical lattice with remarkable structural similarity to the COPII outer coat. When reconstituted with lipid membranes, using subtomogram averaging we determined tilted Atg18 dimer structures bridging two juxtaposed lipid membranes spaced apart by 80 Å. Moreover, lipid reconstitution experiments further delineate the contributions of Atg18’s FRRG motif and the amphipathic helical extension in membrane interaction. The observed structural plasticity of Atg18’s oligomeric organization and membrane binding properties provide a molecular framework for the positioning of downstream components of the autophagy machinery.

Aims. The aim of this retrospective study was to try to find correlations between different diagnoses established by clinical examination, anorectal manometry and MRI-defecography and, the association with psychiatric disorders. Methods. 44 patients (median age 53.81 years) presenting with intestinal motility disorders and who underwent clinical, biological and psychiatric examination, dynamic defecographic-MRI (resting, squeezing, straining, defecation and evacuation phases), anorectal manometry, colonoscopy. MRI was performed using the 1,5 T. Results. MRI-defecography revealed the following changes: anismus (16), rectocele (12), pelvic floor dysfunction (6), peritoneocele (2), cervical-cystic-ptosis (1), rectal prolapse (6), and in 1 case the examination was normal. Hypertonic anal sphincter (16) and lack of defecation reflex (12) at anorectal manometry correlated with anismus in all patients at MRI-defecography. Lack of inhibitor anal reflex (6) was associated with rectocele (4), cervix-cysto-ptosis (1) and peritoneocele (2). Anxiety (11), depression (6) and anxiety-depressive disorders (10) were found in 27/44, somatization disorders in 9/44 and no psychiatric changes in 8/44 cases. Conclusion. As multiparous women are at risk for outlet obstruction constipation, MRI-defecography is suggested in this category. There is good correlation between diagnosis using anorectal manometry and MRI-defecography in patients with terminal constipation and anismus. Lower defecation dysfunction is often associated with psychiatric disorders.

Dysfunctionality in socialisation is undoubtedly the most crucial characteristic of autism. For a long time, social functioning and its improvement have been considered among the most important interventions in the literature. Individuals with autism are responsive to therapist-mediated and/or peer-mediated interventions that increase their social engagement. The present study examines the impact of outdoor integrated activities, such as music therapy, equine-assisted therapy, and art therapy, in autistic individuals (n=14). The analysis was carried out on the application of a questionnaire assessing three social skill domains: Joint Attention (JA), Imitation (IMI), and Turn-Taking (T-T) mediated by the therapists and by peers. The development and acquisition of these social behaviours were examined in a structured outdoor context (ASO). Data were collected by two independent observers by White's Scale questionnaire. The results revealed that the proposed interventions facilitated and led to an increase in social-behavioural experience.

The hazel dormouse, Muscardinus avellanarius is a vulnerable and protected species that is challenging to study due to its specific way of life. Limited data on its distribution and population parameters are available for Romania. We collected data regarding species’ biology and ecology in the hilly areas of central-western Romania, within deciduous forests dominated by oak or beech species. We regularly monitored 80 wooden nestboxes, which served as shelter and breeding sites for the species, to assess the seasonal and sex-related variations in nest box usage. The highest occupancy levels were observed during the autumn, with a smaller peak in the spring. Males occupied more nest boxes than females, although the difference was not statistically significant. They also travelled greater distances. Most nest boxes were occupied by a single individual at a time. Recapture rates did not differ significantly between males and females, and most individuals were recaptured only once. Hazel dormice showed a high level of site fidelity, often returning to the same nestbox or one nearby. Interestingly, 14% of the females bred twice a year, which is a lower percentage compared to findings from other studies. Nest box occupancy rates in this region were also lower than those reported in other areas. However, it is important to note that these variations may be attributed to differences in methodology. The occupancy rate declined with the increased presence of the larger species, the fat dormouse Glis glis, which outcompeted the hazel dormouse.

Aim of the study The main objective of this paper is to perform an updated literature review of future endodontics trends based on the available up-to-date scientific literature to identify and describe the new techniques, new materials and their benefits or their limitations. Material and methods Electronic databases (PubMed, Wiley Online Library, Google Scholar and Web of Science) were used to perform a literature search from 2018 to 2023 using MESH terms: Endodontics, Artificial Intelligence, Lasers. After discarding duplicates, out of 1283 results, a total of 18 articles were eligible and point out how endodontic protocol may change with the onset of new technologies and procedures. Results Nanoparticle, laser, regenerative treatment, guided endodontics and artificial intelligence are the main areas that shown promising results in endodontic treatment. New materials with biological capacities will improve the long-term results. Overall, endodontic treatment tends to became more precise and the complications can be reduced. Conclusions Endodontics will see many exciting developments over the coming years, some incremental, others paradigm shifting.

Moebius Syndrome represents a congenital malformation that affects the facial and oculomotor cranial nerves. The growing severity of the clinical manifestations of the disease with age and the fact that its cause is not yet known prompted us to do this study. The materials used consisted of histologic material from two abortion products and of three pediatric patients suffering of this disease. Methods used comprised of usual stains for connective tissue and MRI scans. The results show reticular organization and incomplete insertions as specific histological markers, which cannot be noticed radiologically. Current studies paint a new picture of the architectonics of the superficial musculoaponeurotic system with specific regional particularities. The histologic study of SMAS needs to be corelated with clinical data obtained from patients and continued with larger, statistically significant cohorts.

Studying the literature I found few studies on the applications in dentistry of essential geranium oil. Lack of research on the species of Pelargonium roseum, generators of essential geranium oil, forces us to develop our own culture to obtain essential oil for the elaboration of products for dental use previously tested on different bacterial cultures. Based on the antibacterial, antifungal, antiviral, anti-inflammatory, antitumor, analgesic properties, and sedative-hypnotics we aim to obtain nanocapsules based on volatile geranium oil with application in oral pathology both periodontal and tumor. Following the cultivation in the period 2020-2023 and taking into account the good yield in obtaining the essential oil in the soil and climatic conditions of our country we consider that we can develop a culture that supports the subsequent production of essential oil for the production of nanocapsules.

The act of modeling and forecasting stock market volatility has become essential to risk management practice; it has become one of the most prevalent subjects in financial econometrics and has been mainly and continuously used in the valuation of financial assets and the Value at Risk, as well as the pricing of options and derivatives. The purpose of this paper is to contrast the FIGARCH model in the prospect of establishing the best algorithm to forecast PSI 20 index (PSI stands for Portuguese Stock Index). This study analyzed PSI 20 index to identify the behavior of the Portugal stock market in terms of volatility and then evaluated the forecasting ability of GARCH family models using Portugal PSI 20 index sample data for the long period from May 2010 - August 2023 (which is more than 13 years in daily data). There are 3396 daily observations. The results indicated that the PSI 20 index’s volatility is asymmetric. The present empirical investigation also seeks to illustrate the potential for investment returns as well as the associated risk. Our findings may have implications for risk management in Portugal, as well as a deeper understanding of the PSI-20 Portugal stock market volatility dynamics, given the scarcity of prior such studies.

Asian countries are facing environmental degradation issue which is the result of non-renewable energy usage for growth however this issue cannot be unnoticed. This study is an effort to highlight the causes for an emerging issue of environmental degradation in selected Asian economies. The research findings demonstrate that urban population, energy consumption and economic growth increases carbon emission CO2 (i.e., environmental degradation) in Asian countries. It is suggested that strategy formulation in Asian economies should implement and indorse renewable energy sources in order to meet up the high energy demand and to reduce CO2 emissions for certain sustainable economic development in Asian countries.

Abstract The inflammatory burden as measured by high-sensitivity C-reactive Protein (hsCRP) is recognized as a cardiovascular risk factor, which can however be affected by lifestyle-related risk factors (LRF). Up-to-date the interplay between hsCRP, LRF and presence and extent of atherosclerotic disease is still largely unknown, which we therefore sought to investigate in a contemporary population-based cohort. We included participants from the cross-sectional population-based Hamburg City Health Study. Affected vascular beds were defined as coronary, peripheral, and cerebrovascular arteries. LRF considered were lack of physical activity, overweight, active smoking and poor adherence to a Mediterranean diet. We computed multivariable analyses with hsCRP as the dependent variable and LRF as covariates according to the number of vascular beds affected. In the 6765 individuals available for analysis, we found a stepwise increase of hsCRP concentration both according to the number of LRF present as well as the number of vascular beds affected. Adjusted regression analyses showed an independent association between increasing numbers of LRF with hsCRP levels across the extent of atherosclerosis. We demonstrate increasing hsCRP concentrations according to both the number of LRF as well as the extent of atherosclerosis, emphasizing the necessity of lifestyle-related risk factor optimization.

Changing old habits and adopting new behaviors can be challenging and requires perseverance and motivation. For this reason, the study aimed to determine oral health behaviors among young adults. MATERIALS AND METHODS: The study group consisted of 129 students from “Grigore T. Popa” University in Iași, during the period of February 2023 to March 2023. The questionnaire method was used, specifically the Health-Promoting Lifestyle Profile II – HPLP II and the Generalized Self-Efficacy Scale. RESULTS: The students showed a moderate tendency to change in almost all areas assessed by the HPLP II questionnaire. For the “interpersonal relationships” domain, the average score of 2.74 indicated a strong desire for change. The GSE score α is 28.47, indicating a moderate to high confidence in dealing with challenging situations. CONCLUSIONS: The message of promoting health-promoting behavior is perceived positively, thus reducing behavioral barriers and promoting the prompt adoption of correct behavior.

The educational environment has a significant impact on students’ satisfaction with the learning process. Material and methods: The study was conducted on a sample of 105 students. The Dundee Ready Education Environment Measure (DREEM) indicator was used to assess the educational environment. Results: Overall, students have positive perceptions of education. The average overall score of the DREEM indicator was 122.74/200, indicating that the university’s academic environment is more positive than negative. Conclusions: Students have positively evaluated the educational environment.

Serviciile ecosistemice culturale oferă o serie de beneficii pentru bunăstarea umană, dar dintr-o perspectivă identitară. Aceste beneficii includ experiențe estetice, cunoștințe și abilități, spiritualitate, implicarea în conservarea naturii, ceea ce înseamnă că, indirect, serviciile culturale asigură conservarea tuturor formelor de viață. Conceptul de servicii culturale ale ecosistemelor a devenit din ce în ce mai important în ultimii ani, deoarece ajută la înțelegerea valorii socio-culturale a pădurilor și la echilibrarea intereselor părților interesate în gestionarea pădurilor. În România, serviciile ecosistemice sunt recunoscute prin funcțiile de protecție și de producție atribuite pădurilor. Din fericire, sistemul forestier românesc integrează numeroase servicii ecosistemice în procesul de elaborare a managementului forestier, prima corelație între categoriile funcționale specifice fiecărui tip de arboret și măsurile silvice propuse. Mai mult decât atât, instrumentele de politică forestieră mixtă pentru serviciile ecosistemice forestiere fac referire la documentele necesare privind armonizarea planificării silvice cu planul de management al ariilor naturale protejate și cu cele complementare oferite de sistemul de certificare FSC. Serviciile ecosistemice culturale se confruntă cu mai multe provocări, una dintre acestea fiind lipsa unor concepte coerente care împiedică evaluarea și integrarea serviciilor ecosistemice forestiere în proiectarea arhitecturii peisajului. Rezultatele analizei arată că pădurile cu rol cultural identificate prin procesul de certificare se referă, în general, la pădurile din apropierea clădirilor culturale și/sau de patrimoniu (cum ar fi bisericile și mănăstirile) sau la pădurile care oferă valori estetice și/sau recreative importante. În mod evident, certificarea managementului forestier contribuie, printr-o abordare metodologică simplă, la identificarea pădurilor cu rol cultural, în special în situațiile în care planurile de management forestier nu le acordă prioritate din cauza limitărilor impuse de criteriile de zonare funcțională. Mai mult de 40% din pădurile culturale analizate au un rol recreativ și ecoturistic, urmate de cele cu valoare spirituală sau religioasă, cu 18% din suprafața totală a pădurilor culturale analizate. Deși prin acest studiu au fost identificate șapte tipuri de servicii ecosistemice culturale, componenta de diversitate culturală este imposibil de diferențiat la nivel național, deoarece diversitatea culturală implică existența populațiilor indigene. În schimb, studiul poate fi extins la o scară mai mare pentru a identifica mai multe păduri cu valoare inspirațională sau estetică, ambele valorificate la nivel de peisaj.

Asigurarea unei gestionări durabile a pădurilor este principiul fundamental al managementului forestier și e adresată la nivel legislativ în România, silvicultorii fiind provocați să răspundă și să se adapteze cerințelor și condițiilor unei societăți moderne, societate aflată într-o continuă evoluție. Astfel, competențele oferite de învățământul superior silvic trebuie în permanentă adaptate pentru a ține pasul cu evoluția societății. Prezentul studiu are drept scop analiza percepțiilor studenților anului I din cadrul Facultății de Silvicultură din Suceava asupra gestionării pădurilor din România. Pentru realizarea studiului s-a folosit metoda anchetei pe bază de chestionar. Studiul a fost realizat pe un eșantion de 252 de studenți (197 băieți și 55 fete) în perioada 2015-2020. 75% dintre respondenți consideră că pădurile României nu sunt gestionate corespunzător, că aceste păduri sunt tăiate abuziv și ilegal (84%) și mult mai mult decât în ​​alte țări europene (75%). În ceea ce privește tăierile de pădure în următorii 10 ani, 56% sunt de părere că acestea ar trebui oprite total în timp ce 23% consideră că mai degrabă nu. Părerile studenților anului I asupra imaginii gestionării pădurilor private sunt împărțite în mod egal. Astfel 34% consideră că imaginea s-a deteriorat, 33% consideră că imaginea s-a îmbunătățit și 33% că a rămas la fel. În cazul gestionării pădurilor de stat procentul celor care cred că situația s-a deteriorat este identic cu al celor care cred că situația a rămas la fel (38%). Doar 24% consideră că situația s-a îmbunătățit. Studiul oferă informații esențiale atât pentru direcțiile de comunicare cu publicul larg și de îmbunătățire a educației forestiere la nivel pre-universitar pentru de-mitizarea unor teme percepute distorsionat față de realitățile datelor statistice existente, dar și asupra direcțiilor de îmbunătățire a curriculei universitare necesar a fi adaptate pentru a adresa cu fundamente științifice preocupările studenților privind problematicile de gestionare a pădurilor naționale.

Folliculosebaceous cystic hamartoma (FSCH) is a rare and benign form of cutaneous hamartomas. These skin lesions often lead to clinical and histopathological misdiagnosis due to their similarities to cutaneous lesions with overproduction of clustered sebaceous glands. Clinically, the lesions often present as solitary, skin-colored, pedunculated warts to cauliflower-like, exophytic papules and nodules, usually with a diameter ranging 0.5–1.5 cm that rarely exceed 2 cm in size. Only a small number of giant variants are reported in the literature with a diameter in the range of 5–23 cm. The vast majority of the lesions appear in the central face and show a striking predilection for the nose, ears, and scalp, but also emerge on the nipples, extremities, and genitals. Histologically, the epithelial components of folliculosebaceous cystic hamartoma comprise dilated infundibular cystic proliferation with surrounding mesenchymal components, which commonly include fibroplasia and vascular and adipose tissue proliferation. These histological characteristics were coined by Kimura and colleagues (1991). To the best of our knowledge, our case represents the biggest variant of giant folliculosebaceous cystic hamartoma.