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The study explores the moderating role of peer conformity on the relationship between self-concept, economic literacy, and e-money adoption with the consumptive behavior of university students, specifically those receiving the KIP Kuliah scholarship in Indonesia. Data were collected through an online survey of 328 students and analyzed using Moderated Regression Analysis (MRA). The results indicated that the relationship between self-concept and consumptive behavior, as well as e-money adoption and consumptive behavior, was significantly strengthened by peer conformity. However, the effect of economic literacy on consumptive behavior was not moderated by peer conformity. These findings suggest that while self-concept and e-money adoption are influenced by peer conformity, economic literacy operates independently of peer conformity. The importance of fostering economic literacy and a critical self-concept among students to mitigate the effects of peer pressure on consumption was highlighted in this research. The findings reveal that peer conformity strengthens the effect of self-concept and e-money adoption on consumptive behavior, but does not moderate the impact of economic literacy. The research highlights the need for fostering economic literacy and critical self-concept to reduce the influence of peer conformity on student consumption decisions. Further research should expand the scope beyond KIP Kuliah students to include a broader student population.

Abstract Expansion of the glutamine tract (poly-Q) in the protein huntingtin (HTT) causes the neurodegenerative disorder Huntington’s disease (HD). Emerging evidence suggests that mutant HTT (mHTT) disrupts brain development. To gain mechanistic insights into the neurodevelopmental impact of human mHTT, we engineered male induced pluripotent stem cells to introduce a biallelic or monoallelic mutant 70Q expansion or to remove the poly-Q tract of HTT. The introduction of a 70Q mutation caused aberrant development of cerebral organoids with loss of neural progenitor organization. The early neurodevelopmental signature of mHTT highlighted the dysregulation of the protein coiled-coil-helix-coiled-coil-helix domain containing 2 (CHCHD2), a transcription factor involved in mitochondrial integrated stress response. CHCHD2 repression was associated with abnormal mitochondrial morpho-dynamics that was reverted upon overexpression of CHCHD2. Removing the poly-Q tract from HTT normalized CHCHD2 levels and corrected key mitochondrial defects. Hence, mHTT-mediated disruption of human neurodevelopment is paralleled by aberrant neurometabolic programming mediated by dysregulation of CHCHD2, which could then serve as an early interventional target for HD.

Abstract Aims Cancer therapy-related cardiac dysfunction (CTRCD) is a dreaded complication of anthracycline therapy. CTRCD most frequently appears in patients with cardiovascular risk factors (CVR) or known cardiovascular disease. However, limited data exist on incidence and course of anthracycline-induced CTRCD in patients without preexisting risk factors. We therefore aimed to longitudinally investigate a cohort of young women on anthracycline treatment due to breast cancer without cardiovascular risk factors or known cardiovascular disease (NCT03940625). Methods and results We enrolled 59 women with primary breast cancer and scheduled anthracycline-based therapy, but without CVR or preexisting cardiovascular disease. We conducted a longitudinal assessment before, immediately and 12 months after cancer therapy with general laboratory, electrocardiograms, echocardiography and cardiovascular magnetic resonance (CMR), including myocardial relaxometry with T1, T2 and extracellular volume mapping. Every single patient experienced a drop in CMR-measured left ventricular ejection fraction (LVEF) of 6 ± 3% immediately after cancer therapy. According to the novel definition 32 patients (54.2%) developed CTRCD after 12 months defined by reduction in LVEF, global longitudinal strain (GLS) and/or biomarkers elevation, two of them were symptomatic. Global myocardial T2 relaxation times as well as myocardial mass increased coincidently with a decline in wall-thickening. While T2 values and myocardial mass normalized after 12 months, LVEF and GLS remained impaired. Conclusion In every single patient anthracyclines induce a decline of myocardial contractility, even among patients without pre-existing risk factors for CTRCD. Our data suggest to thoroughly evaluate whether this may lead to an increased risk of future cardiovascular events. Graphical Abstract Reduced myocardial contractility in low-risk patients receiving anthracycline-based cancer therapy. This study included 59 otherwise healthy women with primary breast cancer undergoing anthracycline-based chemotherapy. CMR was performed at baseline, directly and 12 months after cancer therapy. A decline in left ventricular function was observed in every single patient accompanied by transient edema. More than 50% were diagnosed with cancer therapy related cardiovascular dysfunction. LVEF: left ventricular function, CTRCD: cancer therapy related cardiovascular dysfunction, GLS = Global longitudinal strain, hs-TnT = high sensitive Troponin T, NT-pro BNP = NT-pro brain natriuretic peptide

Abstract Background Despite the fundamental progress in hematopoietic stem cell transplant, this treatment is also associated with complications. Graft-versus-host disease is a possible complication of HSCT. Bronchiolitis obliterans syndrome (BOS) is the pulmonary form of this syndrome. Due to the high morbidity and mortality rate of BOS, various studies have been conducted in the field of drug therapy for this syndrome, although no standard treatment has yet been proposed. According to the hypotheses about the similarities between BOS and chronic obstructive pulmonary disease, the idea of using tiotropium bromide as a bronchodilator has been proposed. Method/design A randomized, double-blind, placebo-controlled, and crossover clinical trial is being conducted to evaluate the efficacy of tiotropium in patients with BOS. A total of 20 patients with BOS were randomly assigned (1:1) to receive a once-daily inhaled capsule of either tiotropium bromide (KP-Tiova Rotacaps 18 mcg, Cipla, India) or placebo for 1 month. Patients will receive tiotropium bromide or placebo Revolizer added to usual standard care. Measurements will include spirometry and a 6-min walking test. Ethics/dissemination This study was approved by the Research Ethics Committees of Imam Khomeini Hospital Complex, Tehran University of Medical Science. Recruitment started in September 2022, with 20 patients randomized. The treatment follow-up of participants with tiotropium is currently ongoing and is due to finish in April 2024. The authors will disseminate the findings in peer-reviewed publications, conferences, and seminar presentations. Trial registration Iranian Registry of Clinical Trial (IRCT) IRCT20200415047080N3. Registered on 2022–07-12, 1401/04/21.

Jin G Choi,1,2 Pathik Amin,3 Alaina Tarantino,4 Mary Qiu3 1Pritzker School of Medicine, University of Chicago, Chicago, IL, USA; 2Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA; 3Department of Ophthalmology and Visual Science, University of Chicago, Chicago, IL, USA; 4Ambulatory Pharmacy Services, University of Chicago, Chicago, IL, USACorrespondence: Mary Qiu, Department of Ophthalmology and Visual Science, University of Chicago, Chicago, IL, USA, Tel +1 (773) 702-3937, Email mary.qiu@gmail.comPurpose: A major barrier to glaucoma medication adherence is the patient’s out-of-pocket costs. At the University of Chicago Medical Center (UCMC), the institutional pharmacy piloted a program to query out-of-pocket costs for each patient’s medication list based on their insurance coverage. This study aims to describe the impact of this collaboration between the glaucoma service and the outpatient pharmacy service.Methods: This study is a single institution, retrospective chart review of glaucoma patients with a formulary inquiry placed by a single glaucoma specialist between 4/1/2020 and 2/28/2022. Main outcome measures included medications before and after formulary inquiries, additional steps required to access the medications (ie, formulary exceptions, prior authorizations, tier exceptions), and out-of-pocket costs.Results: A total of 343 formulary inquiries, representing 568 individual medication inquiries, were conducted. Out of the 568 medication inquiries, only 78 could be filled for an affordable price without any additional steps. For 45 inquiries, additional steps were required for the medication to become covered at an affordable price. The remaining 445 inquires required additional steps with subsequent denial or prohibitive out-of-pocket costs.Conclusion: The UCMC workflow provided transparent out-of-pocket costs for patients to access glaucoma medications. This workflow may be cost-effective as it minimizes the burden on the overall system by reducing the number of patients who are unable to fill a prescription at the pharmacy due to issues with coverage or affordability. This model of physician-pharmacy collaboration can guide other institutions to implement similar workflows which directly mitigate costs and improve quality of care.Keywords: medication, access, cost

Abstract In this research, a novel magnetic zirconium-based metal-organic framework (Fe3O4@SiO2@MIP-202, MMOF), was fabricated, fully characterized, and applied for the batch-mode solid phase extraction of trace amounts of Pd2+ ions from water and wastewater samples before its spectrophotometric detection. Pd2+ ions were desorbed from MMOF by nitric acid and were complexed by treating with KI solution to have a maximum absorbance at 410 nm. The synthesized MMOF composite showed a very large surface area (65 m2.g− 1), good magnetization (1.7 emu.g− 1) and a large pore volume (0.059 cm3.g− 1) with adsorption capacity of 194.5 mg of Pd2+ ions/g of the adsorbent. This nanosorbent boasts chemo-mechanical stability, high adsorption capacity due to its vast active sites, and facile recovery facilitated by its magnetic properties. Parameters affecting the extraction efficiency of the method were optimized as pH of the sample 7.4, volume of the sample 25 mL, 15 mg adsorbent, 1 mL of 0.1 M HNO3 eluent, with 10 and 15 min as the extraction and desorption times, respectively. The calibration curve was found to be linear across the 10.0–1500.0 µg.L− 1 range with a limit of detection of 1.05 µg.L− 1. The obtained extraction efficiency and enrichment were 98% and 245, respectively. The total analysis time was less than 30 min. This MMOF has never been used for the extraction of Pd2+ ions before.

Widespread and indiscriminate use of pesticides has become one of the most important environmental and public health problems around the world. This study was conducted with the aim of applying the theory of planned behavior model to investigate the knowledge, attitude, and behavior of tomato growers in the face of pesticides in agricultural lands located in Kurdistan province, western Iran. We included 300 tomato growers in this study and they filled up a standard TPB questionnaire containing questions about basic information, knowledge, attitude and behavior about pesticides and their actions for disposing of the residual spray solution, washing place of pesticide sprayer, and the disposal of water from washing the equipment. Most of the respondents, 86.7 %, had not participated in promotional classes on how to dispose of the residual solution. Approximately 46.15, 38.46, and 15.39 % of pesticides contained moderately toxic, slightly toxic and practically non-toxic compounds, respectively. More than two-thirds (89 %) of the tomato growers stated that they leave the water from washing the equipment in the field. In addition, among the three variables of TPB, attitudes had the highest score (3.38), which indicated the positive to relatively neutral attitude of farmers towards the safe use of pesticides. These findings can be useful for planners and environmental organizations to make effective interventions to reduce environmental pollution caused by pesticides. Since the incorrect use of pesticides is one of the important environmental and health factors, education and awareness programs can help farmers to consider the correct use of pesticides and environmental protection more.

The substantial amount of food waste generated in Sragen Regency due to inadequate food loss and waste (FLW) management has a detrimental impact on the environment. This study aims to analyze the efforts to optimize FLW management, examine the relationships between variables, and assess stakeholder synergy in accelerating FLW management to support the implementation of a circular economy in the Sragen Regency. This research employs a mixed-methods approach, with data analysis conducted using MICMAC and MACTOR methodologies. The MICMAC analysis results indicate that stakeholder relationships, waste prevention, location factors, cultural factors, and community scale are the core variables for accelerating improvements in FLW management. In contrast, the MACTOR analysis identifies the Environmental Agency (DLH), Kecik Waste Bank, and Si Repi Waste Bank as the primary stakeholders in these efforts. Additionally, the MACTOR analysis highlights changes in community behavior and the utilization of FLW in the circular economy as primary objectives agreed upon by all stakeholders. The findings from the MICMAC and MACTOR analyses provide a basis and reference for determining the model and grand design of an FLW management acceleration strategy to support the implementation of a circular economy in the Sragen Regency.

Abstract Red blood cells (RBC) are the major carriers of sphingosine-1-phosphate (S1P) in blood. Here we show that variations in RBC S1P content achieved by altering S1P synthesis and transport by genetic and pharmacological means regulate glucose uptake and metabolic flux. This is due to S1P-mediated activation of the catalytic protein phosphatase 2 (PP2A) subunit leading to reduction of cell-surface glucose transporters (GLUTs). The mechanism dynamically responds to metabolic cues from the environment by increasing S1P synthesis, enhancing PP2A activity, reducing GLUT phosphorylation and localization, and diminishing glucose uptake in RBC from diabetic mice and humans. Functionally, it protects RBC against lipid peroxidation in hyperglycemia and diabetes by activating the pentose phosphate pathway. Proof of concept is provided by the resistance of mice lacking the S1P exporter MFSD2B to diabetes-induced HbA1c elevation and thiobarbituric acid reactive substances (TBARS) generation in diabetic RBC. This mechanism responds to pharmacological S1P analogues such as fingolimod and may be functional in other insulin-independent tissues making it a promising therapeutic target.

Background/Objectives: Acute myocardial infarction (AMI), characterized by irreversible heart muscle damage and impaired cardiac function caused by myocardial ischemia, is a leading cause of global mortality. The damage associated with reperfusion, particularly mitochondrial dysfunction and reactive oxygen species (ROS) formation, has emerged as a crucial factor in the pathogenesis of cardiac diseases, leading to the recognition of mitochondrial proteins as potential markers for myocardial damage. This study aimed to identify differentially expressed proteins based on the type of cardiac injury, in particular those with and without reperfusion. Methods: Male C57Bl/6J mice were either left untreated, sham-operated, received non-reperfused AMI, or reperfused AMI. Twenty-four hours after the procedures, left ventricular (LV) function and morphological changes including infarct size were determined using echocardiography and triphenyl tetrazolium chloride (TTC) staining, respectively. In addition, plasma was isolated and subjected to untargeted mass spectrometry and, further on, the ELISA-based validation of candidate proteins. Results: We identified mitochondrial creatine kinase 2 (Ckmt2) as a differentially regulated protein in plasma of mice with reperfused but not non-reperfused AMI. Elevated levels of Ckmt2 were significantly associated with infarct size and impaired LV function following reperfused AMI, suggesting a specific involvement in reperfusion damage. Conclusions: Our study highlights the potential of plasma Ckmt2 as a biomarker for assessing reperfusion injury and its impact on cardiac function and morphology in the acute phase of MI.

Objective: Glioma is one of the most malignant brain tumors, accounting for about half of the gliomas that occur in central nervous system (CNS), originates from the glial tissue of the brain. The aim of the present study was to determine the expression levels of 3 lncRNAs (AGAP2-AS1, LINC01446 and HOTAIRM1) in patients with high grade glioma in comparison with low grade glioma. Methods: Case group consisted of 70 high grade glioma patients control group consisted of 70 patients affected with low grade glioma. RNA extraction was performed using a RNA extraction kit. Result: Our results showed that the expression of AGAP2-AS1 and LINC01446 genes significantly increased with increasing tumor grade (with fold-change ratio of 2.1 and 3.8 respectively). Also the expression of HOTAIRM1 gene increased with increasing tumor grade but this increase was not statistically significant (P value=0.6). Conclusion: We concluded that AGAP2-AS1 and LINC01446 are promising lncRNA markers in prognosis of glioma.

BackgroundUnderstanding complex cardiac anatomy is essential for percutaneous left atrial appendage (LAA) closure. Conventional multi-slice computed tomography (MSCT) and transesophageal echocardiography (TEE) are now supported by advanced 3D printing and virtual reality (VR) techniques for three-dimensional visualization of volumetric data sets. This study aimed to investigate their added value for LAA closure procedures.MethodsTen patients scheduled for interventional LAA closure were evaluated with MSCT and TEE. Patient-specific 3D printings and VR models were fabricated based on MSCT data. Ten cardiologists then comparatively assessed LAA anatomy and its procedure relevant surrounding structures with all four imaging modalities and rated their procedural utility on a 5-point Likert scale questionnaire (from 1 = strongly agree to 5 = strongly disagree).ResultsDevice sizing was rated highest in MSCT (MSCT: 1.9 ± 0.8; TEE: 2.6 ± 0.9; 3D printing: 2.5 ± 1.0; VR: 2.5 ± 1.1; p

Economic progress is often seen as a means to enhance living standards, yet it often comes with an unintended consequence: a decline in environmental well-being. This research seeks to validate the Environmental Kuznets Curve (EKC) theory within the top 10 most populous nations and scrutinize the impact of urbanization, economic advancement, energy usage, and forest coverage on CO2 emissions. Utilizing data sourced from the World Development Indicator spanning from 2000 to 2019, this study employed a robust analytical approach known as the generalized method of moments (GMM) dynamic panel data, validated through Sargan and Arellano-Bond tests. The findings affirmed that economic growth, energy consumption, and forest area exerted significant influence on carbon dioxide emissions, aligning with the EKC hypothesis. However, contrary to expectation, urbanization didn't display a discernible impact on emissions, likely due to well-integrated transportation systems and higher educational standards prevalent in urban settings. This underscores the necessity for a sustainable economic growth strategy, advocating for industries with minimal pollution and eco-friendly products conducive to easy recycling. Furthermore, initiatives aimed at expanding forested areas should consider innovative techniques like vertical garden-based reforestation.

Ambon bananas (Musa acuminata cavendish) are nutritious and economically valuable fruits. Bananas, being a climacteric fruit, have the potential to undergo deterioration subsequent to the harvesting process. The utilization of an edible coating on bananas has demonstrated potential in delaying spoilage, whereas the substantial use of peppermint oil has been observed in the preservation of fruit freshness. This research investigated how a carrageenan-based coating and peppermint essential oil enhance banana shelf life. This research compares uncoated bananas, carrageenan-coated bananas, and carrageenan-peppermint-coated bananas. Weight loss, total soluble solids (TSS), pH, colour, and water activity were tested. In this study, it was observed that the application of a carrageenan edible coating resulted in a reduction in weight loss and TSS as compared to bananas that were not coated. Duncan's test shows statistically significant discrepancy in weight loss among bananas that have undergone different treatments, thereby influencing the overall weight loss outcome. There are variations in pH levels and aw values. Meanwhile, pH and water activity of coated and uncoated bananas were relatively the same and stable during storage, so the carrageenan edible coating treatment and the addition of peppermint essential oil had no effect. The findings indicate that edible coatings made from carrageenan have the ability to inhibit the ripening process of bananas. Nevertheless, the efficacy of this inhibition decreases when peppermint essential oil is given as a supplementary constituent.

Point of Sale (POS) system in the business field, especially in the field of sales in retail stores is needed. This is because POS can replace business processes from conventional to systemized using electronic devices, namely computers. Toko Kafindra currently has not implemented a computerized business process. Therefore, this research implements a POS that can help Toko Kafindra in facilitating the management of business processes so that the retail store business can grow rapidly. This research uses a prototype model to facilitate the identification of user needs for the system to be built. The results showed that the Kafindra Store POS not only made it easier for the owner to know the outgoing goods but also could make it easier for the owner to know the incoming goods using the system of purchasing goods to suppliers. In addition, based on the results of the blackbox test on the system, the test results are valid and the system functions properly

Abstract Aims We aimed to conduct a clinical process cost analysis to evaluate all upcoming costs of mitral valve transcatheter edge-to-edge repair (M-TEER) treatment using the MitraClip and the PASCAL repair system. Methods First, we prospectively enrolled 107 M-TEER patients treated with either the PASCAL or MitraClip system and compared all upcoming costs during the M-TEER procedure and the associated in-hospital stay. Second, we retrospectively analysed 716 M-TEER procedures with regard to the occurrence of complications and their associated costs. All materials used in the catheterization laboratory for the procedures were evaluated. The cost analysis considered various expenses, such as general in-hospital costs, device costs, catheter laboratory and material costs. Results In the prospective study, 51 patients were treated using the PASCAL system, and 56 were treated using the MitraClip system. The two groups had comparable baseline characteristics and comorbidities. The total in-hospital costs were 25 414 (Interquartile range (IQR) 24 631, 27 697) € in the PASCAL group and 25 633 (IQR 24 752, 28 256) € in the MitraClip group (p = 0.515). The major cost driver was initial material expenditure, mostly triggered by device costs, which were similar to the PASCAL and MitraClip systems. Overall intensive care unit and general ward costs did not differ between the PASCAL and MitraClip groups. In the retrospective analysis, M-TEER-related complications were rare but were associated with higher costs, mainly due to prolonged hospitalisation. Conclusion The major cost driver of M-TEER was the material expenditure, which was mostly triggered by high device costs. The costs of treating patients were similar for the PASCAL and MitraClip systems. M-TEER-related complications are associated with higher costs, mainly due to prolonged hospitalisation. This analysis provides valuable insights into reducing expenses by modifying the process of M-TEER.

Objectives: As the hormonal status of women does influence both mammographic breast density and atherosclerosis, the aim of the study was to evaluate the association between breast density on mammography and carotid intima-media thickness (CIMT).Methods: Two-hundred premenopausal women with mammographic breast density of one (n=100) or four (n=100) were selected for this cross-sectional study. CIMT was measured according to the guidelines of Mannheim Consensus. The correlation between mammographic breast density and CIMT was assessed.Results: Mean age was 45.9±3.4 years and 45.8±3.2 years in the groups with mammographic density of 1 and 4, respectively, which showed no significant difference. CIMT correlated with age with a Pearson Correlation Coefficient of 0.470 (p

Seaweed contains high dietary fiber and low fat, which is beneficial for health. The content of omega-3 and its antioxidants supports public awareness of a healthy lifestyle. This review paper aims to investigate the research progress of seaweed as food in Indonesia. The research progress in this study focus on seaweed addition to food and its effect on the chemical and organoleptic characteristics. Seaweed research as food has been developed. As one of the seaweed producers, Indonesia needs to increase seaweed use to increase seaweed value and provide sustainable, nutritious food. Food that can combine with seaweed is dodol, jelly candy, fish sticks, pempek, tempeh, and fish balls. The addition of seaweed to food increases protein, water, iodine, and fiber. Seaweed fiber content can decrease cholesterol levels and help regulate blood glucose levels which can prevent cardiovascular disease. Aroma and flavor are sensory properties strongly affected by seaweed in food. The seaweed addition has to consider the sensory properties that determine consumer acceptance. The suitable composition of seaweed addition to food can improve nutrition and consumer acceptance

In this research, the effect of anodization time on the length of the titanium oxide nanotube arrays (TNAs) and photovoltaic parameters of back-side illuminated dye-sensitized solar cells (DSSCs) were investigated. The TNAs were characterized using X-ray diffraction (X-ray) or (XRD), and scanning electron microscopy (SEM). Anodic TNAs having tube lengths from 7.9 to 20.17 μm were produced in ethylene glycol containing ammonium fluoride-NH4F by increasing the anodizing time from 20 min to 6 h. Based on I–V curves, the power conversion efficiency (PCE) of back-side illuminated dye sensitized solar cells (DSSCs) increased for TNAs grown for up to 120 min, but decreased afterward. Using electrochemical impedance spectroscopy (EIS), we understand that the resistance of the TNAs decreased from 94.82 Ω cm−2 for TNAs anodized for 20 min down to 50.43 Ω cm−2 for those TNAs anodized for 120 min, however, it increases for TNAs anodized for longer periods of time. Furthermore, the short circuit current density (Jsc) increased from 3.14 to 5.67 mA cm−2 during 2 h anodic oxidation for TNAs, and leading to enhanced efficiency of about 200 % (from 1.19 % to 2.45 %). We interpret this behaviour with the top surface morphology evolution of TNAs as a function of anodization time which is associated with the formation of top surface nanograss and bundling the tubes for specific durations.

Background and aims: Wound healing is one of the most important issues in medical science. Synthetic drugs have long been introduced and used to speed up the healing process of wounds, but most of them have many side effects. The present study was performed to evaluate the healing efficiency of watercress seed mucilage (Lepidium sativum L.) on wounds. Methods: In this study, the animals were randomly divided into five groups. The treatment groups were (1), (2), (3), sham (4), and control (5). The treatment groups were treated with 20%, 10%, and 5% watercress seed mucilage in the Eucerin base, respectively, and the sham was treated with Eucerin, while the control received no treatment. Then, 5 pairs of full-thickness wounds with a diameter of 7 mm were created on both sides of the rabbit’s spine. Macroscopic and wound area studies were performed on days 4, 7, and 14 after surgery. Results: According to the analysis of variance, there was a significant difference between groups 1, 2, 3, sham, and control (P=0.001), but no significant difference was observed between group 3, sham group, and control group (P=0.993). Based on these findings, at the end of the treatment period, group 1 had the highest healing rate and the lowest wound area (1.12±0.77) compared to group 2 (4.42±0.30) and 3 (7.05±0.35), as well as the sham (8.34±1.10) and control (8.50±1.90) groups. Thus, the treatment method of this group has been more effective in wound healing than that of the other treatment groups. Conclusion: It seems that watercress seed mucilage can treat wounds due to its important compounds such as flavonoids, phenols, and vitamins A and C.

Abstract Background ST-segment elevation myocardial infarction (STEMI) still causes significant mortality and morbidity despite best-practice revascularization and adjunct medical strategies. Within the STEMI population, there is a spectrum of higher and lower risk patients with respect to major adverse cardiovascular and cerebral events (MACCE) or re-hospitalization due to heart failure. Myocardial and systemic metabolic disorders modulate patient risk in STEMI. Systematic cardiocirculatory and metabolic phenotyping to assess the bidirectional interaction of cardiac and systemic metabolism in myocardial ischemia is lacking. Methods Systemic organ communication in STEMI (SYSTEMI) is an all-comer open-end prospective study in STEMI patients > 18 years of age to assess the interaction of cardiac and systemic metabolism in STEMI by systematically collecting data on a regional and systemic level. Primary endpoint will be myocardial function, left ventricular remodelling, myocardial texture and coronary patency at 6 month after STEMI. Secondary endpoint will be all-cause death, MACCE, and re-hospitalisation due to heart failure or revascularisation assessed 12 month after STEMI. The objective of SYSTEMI is to identify metabolic systemic and myocardial master switches that determine primary and secondary endpoints. In SYSTEMI 150–200 patients are expected to be recruited per year. Patient data will be collected at the index event, within 24 h, 5 days as well as 6 and 12 months after STEMI. Data acquisition will be performed in multilayer approaches. Myocardial function will be assessed by using serial cardiac imaging with cineventriculography, echocardiography and cardiovascular magnetic resonance. Myocardial metabolism will be analysed by multi-nuclei magnetic resonance spectroscopy. Systemic metabolism will be approached by serial liquid biopsies and analysed with respect to glucose and lipid metabolism as well as oxygen transport. In summary, SYSTEMI enables a comprehensive data analysis on the levels of organ structure and function alongside hemodynamic, genomic and transcriptomic information to assess cardiac and systemic metabolism. Discussion SYSTEMI aims to identify novel metabolic patterns and master-switches in the interaction of cardiac and systemic metabolism to improve diagnostic and therapeutic algorithms in myocardial ischemia for patient-risk assessment and tailored therapy. Trial registration Trial Registration Number: NCT03539133

Abstract Background This large-scale analysis pools individual data about the Clinical Frailty Scale (CFS) to predict outcome in the intensive care unit (ICU). Methods A systematic search identified all clinical trials that used the CFS in the ICU (PubMed searched until 24th June 2020). All patients who were electively admitted were excluded. The primary outcome was ICU mortality. Regression models were estimated on the complete data set, and for missing data, multiple imputations were utilised. Cox models were adjusted for age, sex, and illness acuity score (SOFA, SAPS II or APACHE II). Results 12 studies from 30 countries with anonymised individualised patient data were included (n = 23,989 patients). In the univariate analysis for all patients, being frail (CFS ≥ 5) was associated with an increased risk of ICU mortality, but not after adjustment. In older patients (≥ 65 years) there was an independent association with ICU mortality both in the complete case analysis (HR 1.34 (95% CI 1.25–1.44), p

Abstract Antiplatelet medication is standard of care in acute myocardial infarction (AMI). However, it may have obscured beneficial properties of the activated platelet secretome. We identify platelets as major source of a sphingosine-1-phosphate (S1P) burst during AMI, and find its magnitude to favorably associate with cardiovascular mortality and infarct size in STEMI patients over 12 months. Experimentally, administration of supernatant from activated platelets reduces infarct size in murine AMI, which is blunted in platelets deficient for S1P export (Mfsd2b) or production (Sphk1) and in mice deficient for cardiomyocyte S1P receptor 1 (S1P1). Our study reveals an exploitable therapeutic window in antiplatelet therapy in AMI as the GPIIb/IIIa antagonist tirofiban preserves S1P release and cardioprotection, whereas the P2Y12 antagonist cangrelor does not. Here, we report that platelet-mediated intrinsic cardioprotection is an exciting therapeutic paradigm reaching beyond AMI, the benefits of which may need to be considered in all antiplatelet therapies.

Acute myocardial infarction (AMI) is one of the leading causes of death worldwide. Cell apoptosis in the myocardium plays an important role in ischemia and reperfusion (I/R) injury, leading to cardiac damage and dysfunction. Platelets are major players in hemostasis and play a crucial role in vessel occlusion, inflammation, and cardiac remodeling after I/R. Here, we studied the impact of platelets on cell apoptosis in the myocardium using a close-chest mouse model of AMI. We found caspase-3-positive resident cardiac cells, while leukocytes were negative for caspase-3. Using two different mouse models of thrombocytopenia, we detected a significant reduction in caspase-3 positive cells in the infarct border zone after I/R injury. Further, we identified platelet FasL to induce cell apoptosis via the extrinsic pathway of Fas receptor activation of target cells. Mechanistically, hypoxia triggers platelet adhesion to FasR, suggesting that platelet-induced apoptosis is elevated after I/R. Platelet-specific FasL knock-out mice showed reduced Bax and Bcl2 expression, suggesting that platelets modulate the intrinsic and extrinsic pathways of apoptosis, leading to reduced infarct size after myocardial I/R injury. Thus, a new mechanism for how platelets contribute to tissue homeostasis after AMI was identified that should be validated in patients soon.

Myasthenia gravis (MG) is a prototypical autoimmune disease of the neuromuscular junction (NMJ). The study of the underlying pathophysiology has provided novel insights into the interplay of autoantibodies and complement-mediated tissue damage. Experimental autoimmune myasthenia gravis (EAMG) emerged as a valuable animal model, designed to gain further insight and to test novel therapeutic approaches for MG. However, the availability of native acetylcholine receptor (AChR) protein is limited favouring the use of recombinant proteins. To provide a simplified platform for the study of MG, we established a model of EAMG using a recombinant protein containing the immunogenic sequence of AChR in mice. This model recapitulates key features of EAMG, including fatigable muscle weakness, the presence of anti-AChR-antibodies, and engagement of the NMJ by complement and a reduced NMJ density. Further characterization of this model demonstrated a prominent B cell immunopathology supported by T follicular helper cells. Taken together, the herein-presented EAMG model may be a valuable tool for the study of MG pathophysiology and the pre-clinical testing of therapeutic applications.

The study examines the relationship between corruption, innovation, and renewable energy consumption in Indonesia using the Marshalian Demand Function (MDF) framework. The research analyzes data from 1984 to 2020 and applies several statistical tests to validate the model's accuracy. The Autoregressive Distributed Lag (ARDL) approach is applied to evaluate the long and short-term effects of several variables on renewable energy consumption. The study finds that economic growth, number of patents, and FDI positively impact renewable energy consumption in the long term, while urbanization has a negative impact. Trade openness has no long-term impact on renewable energy consumption. In the short term, FDI, corruption, and the number of patents were found to have a significant negative association with renewable energy consumption, while GDP had a significant positive correlation. Diagnostic tests validate the model's suitability and ensure that it lacks heteroscedasticity and serial correlation. The study emphasizes the importance of encouraging renewable energy consumption and addressing the problems of urbanization and corruption in Indonesia to achieve a more sustainable and energy-efficient future.

Abstract Aims Therapeutic options targeting post‐ischaemic cardiac remodelling are sparse. The bioactive sphingolipid sphingosine‐1‐phosphate (S1P) reduces ischaemia/reperfusion injury. However, its impact on post‐ischaemic remodelling independently of its infarct size (IS)‐reducing effect is yet unknown and was addressed in this study. Methods and results Acute myocardial infarction (AMI) in mice was induced by permanent ligation of the left anterior descending artery (LAD). C57Bl6 were treated with the S1P lyase inhibitor 4‐deoxypyridoxine (DOP) starting 7 days prior to AMI to increase endogenous S1P concentrations. Cardiac function and myocardial healing were assessed by cardiovascular magnetic resonance imaging (cMRI), murine echocardiography, histomorphology, and gene expression analysis. DOP effects were investigated in cardiomyocyte‐specific S1P receptor 1 deficient (S1PR1 Cardio Cre+) and Cre− control mice and S1P concentrations measured by LC‐MS/MS. IS and cardiac function did not differ between control and DOP‐treated groups on day one after LAD‐ligation despite fourfold increase in plasma S1P. In contrast, cardiac function was clearly improved and myocardial scar size reduced, respectively, on Day 21 in DOP‐treated mice. The latter also exhibited smaller cardiomyocyte size and reduced embryonic gene expression. The benefit of DOP treatment was abolished in S1PR1 Cardio Cre+. Conclusions S1P improves cardiac function and myocardial healing post AMI independently of initial infarct size and accomplishes this via the cardiomyocyte S1PR1. Hence, in addition to its beneficial effects on I/R injury, S1PR1 may be a promising target in post‐infarction myocardial remodelling as adjunctive therapy to revascularization as well as in patients not eligible for standard interventional procedures.

Learning loss pertains to the decline or regression in knowledge and abilities, as well as setbacks in academic advancement. This phenomenon typically arises from prolonged interruptions or gaps in the pupil's educational journey. Learning loss can be observed in diverse manifestations due to many factors. One example that can be illustrated is the disruption of formal education due to the COVID-19 pandemic that struck the world in 2019. As a result, this phenomenon has impacted students' academics, whether at the school level or higher education institutions, especially primary school students, thus causing learning poverty. This scoping review aims to identify the degree of reading literacy among primary school students and to investigate the factors that contribute to the learning losses of primary school students from the reading aspect. Four databases, including Scopus, Education Resources Information Center (ERIC), Bielefeld Academic Search Engine (BASE), and Directory of Open Access Journals (DOAJ), were used in this research, which found 40 articles for eligibility. Only 20 articles are eligible for analysis and reference after the exclusion and inclusion process for data collection. The findings show that learning losses have impacted the education sector, leading to poverty, especially among primary school children.

The roll forming process plays a critical role in producing various sections used in industries. Also, the quality of these products is strongly affected by the thickness of the strip, the distance between stands, the section web, the flower pattern, and the plastic anisotropy. Therefore, the influences of practical factors on the bowing defect of the symmetrical U-section are experimentally and mathematically characterized in the present research. The investigated material is DC03 (1.0347) steel. Different prediction models such as linear and non-linear model based on the general full-factorial design of experiment are used to predict the effect of following factors on the bowing defect. Accuracy of the analytical model was verified by comparing the output results with the practical data. Results show that the strip thickness of investigated material, the flower pattern, and the section web have the most significant effect on the bowing defect. Also, the anisotropic properties of the investigated material and the inter distance have the minor impact on the bowing defect, but the effect of material with considering the anisotropic properties on increasing the accuracy of process simulation results is very impressive and increases the accuracy of simulation results from 84% to 91%. Finally, the predicted bowing defect using the modified two-factor model was in 91% agreement with the experimental results.

AbstractFlowering transition is important in plant growth and development, and the SUPPRESSOR OF OVEREXPRESSION OF CO 1 (SOC1) gene belongs to the MADS-box gene family, which is an integrator involved in the regulation of flower formation in plants. Current studies have shown that the structural domain of SOC1 is relatively conserved in a variety of plants. To further investigate the function of the SOC1 homologous gene in pak choi, the full-length coding sequence of pak choi BrcSOC1 was cloned, and the structure, subcellular localization and spatiotemporal expression pattern of BrcSOC1 were analyzed in this study. The tissue-specific expression results showed that BrcSOC1 was expressed in roots, leaves, bolts, flowers and pods. The expression results at different developmental stages showed that BrcSOC1 was expressed at the highest level at floral bud differentiation stage 5. When BrcSOC1 was overexpressed in Arabidopsis thaliana, the flowering time in all transgenic plants was significantly earlier than in the wild type, and the expression analysis indicated that BrcSOC1 positively regulated the expression of the downstream genes AGAMOUS-LIKE 24 (AGL24) and LEAFY (LFY). These results provide an important reference for further research on the mechanism of BrcSOC1 in the flowering pathway of pak choi.

Oil mining that is managed by the public can increase local income but on the other side inflict environmental damage. The aim of this research is to analyze the link between the environmental, economic, and social factors and to test whether there is a trade-off between economic and environment factor for traditional oil mining in Wonocolo Village, Kedewan Sub-district, Bojonegoro Regency. The respondents are 84 traditional oil miners in Wonocolo Village. The method of collecting data is by using questionnaire. The analysis tool for analyzing the data is using Factor Analysis by Principal Component Analysis method. The variables consist of Income, Education, Age, Distance from home to mine, and Willingness to Pay (WTP). The result shows that income and education are related positively to WTP which means the higher the income and education, the bigger the WTP. Age and distance from the mine are related negatively to WTP which means the older and the farther the house from the mine, the smaller the WTP. The higher the income, the bigger the WTP shows that there is no trade-off between economic and environment factors for traditional oil mining. Policy implications is that trade-off does not happen between economy and environment quality which means mining activity in Wonocolo is still doable to increase GDRP without degrading the quality of environment. However, this activity needs evaluation especially on how rapidly crude oil reserves depleted and to prepare about green technology that can substitute non-renewable natural resources such as crude oil.

Abstract The formation and progress of cerebral aneurysm is highly associated with hemodynamic factors and blood flow feature. In this study, comprehensive efforts are done to investigate the blood hemodynamic effects on the creation and growth of the Internal Carotid Artery. The computational fluid dynamic method is used for the visualization of the bloodstream inside the aneurysm. Transitional, non-Newtonian and incompressible conditions are considered for solving the Navier–Stokes equation to achieve the high-risk region on the aneurysm wall. OSI and WSS of the aneurysm wall are compared within different blood flow stages. The effects of blood viscosity and coiling treatment on these factors are presented in this work. Our study shows that in male patients (HCT = 0.45), changing the porosity of coiling from 0.89 with 0.79 would decreases maximum OSI up to 75% (in maximum acceleration). However, this effect is limited to about 45% for female patients (HCT = 0.35).

Man-made changes in the structure of new materials and compositions with the aim of meeting today's needs may cause long-term damage to which current civil liability cannot respond well. Finding the cause of damage in the long-lasting damages with their effects in the long run is a specialized issue that is beyond the capability of most individuals. Thus, first, the attribution of the causal relationship is complex and sometimes impossible. Second, the extent of the damage is such that even the richest people cannot compensate for it in some cases. Third, if there is financial capability, compensation will not be possible in most cases. Considering these items, there is a need for prevention in civil liability. In this regard, it is necessary to introduce a new literature in civil liability so that in case of such damages, preventive measures can be taken to reduce the damage. The data collection measure in this study was analytical-descriptive. Moreover, the preventive liability and the feasibility of choosing preventive and deterrent measures in civil liability have been investigated through valid jurisprudential and legal sources, laws and conventions at the national and international levels. Being inspired by jurisprudential capacities and based on various rules such as warning rule and obligation to prevention of possible damage, customary acceptance of prevention in international law and precautionary misconduct can discuss about revolution in civil liability which has surfed beyond the limited boundaries of the traditional civil liability and prevented damage in the future.

Ammonia utilisation in internal combustion engines has attracted wide interest due to the current trend toward decarbonisation, as ammonia is a zero-carbon fuel with different combustion properties to hydrocarbons. The laminar burning velocity (LBV) is a fundamental property of fuels with a significant effect on the combustion processes and accurate calculations and measurements of the LBV over a wide range of fuel blends, pressures and flow conditions is a time-consuming, complicated procedure. The main goal of the current study is to predict the LBV of NH3/H2/air mixtures using a hybrid machine learning (ML) approach based on a training dataset consisting of both the experimental LBV values and additional data obtained from numerical simulations with a detailed kinetic model. Initial ML model training data is collected from existing experimental LBV in the literature for NH3/H2/air mixtures. Then, synthetic data is generated using one-dimensional (1D) simulations to reduce data inhomogeneity and increase accuracy of the ML model. In total, 24 different ML algorithms are tested to find the best model both for the experimental and the hybrid dataset. The results suggest that both Gaussian Process Regression (GPR) and Neural Networks (NNs) can be utilised to predict LBV of NH3/H2/air mixtures with reasonable accuracy. The hybrid ML model achieved a coefficient of determination of R2 = 0.998. Finally, hybrid ML model hyperparameters are optimised to achieve a coefficient of determination of R2 = 0.999. It was also found that ML can speed up LBV computation from 9500 to 27000 times compared to 1D simulations with a reduced mechanism.

Due to the complex and variable anatomy of the left atrial appendage, percutaneous left atrial appendage closure (LAAC) can be challenging. In this study, we investigated the impact of fusion imaging (FI) on the LAAC learning curve of two interventionalists. The first interventionalist (IC 1) was initially trained without FI and continued his training with FI. The second interventionalist (IC 2) performed all procedures with FI. We compared the first 36 procedures without FI of IC 1 (group 1) with his next 36 interventions with FI (group 2). Furthermore, group 1 was compared to 36 procedures of IC 2 who directly started his training with FI (group 3). Group 1 demonstrated that the learning curve without FI has a flat course with weak correlations for fluoroscopy time, contrast volume, and procedure time, but not for dose area product. Group 2 with FI showed improvement with a steep course and strong correlations for all four parameters. In group 3, we also saw a steep progression with strong correlations. Furthermore, the mean measurements of the parameters in the groups with FI decreased significantly as an indicator of procedural efficacy. We demonstrated that FI may improve the learning curve of experienced and non-experienced ICs.

Abstract Aims Implantation of left ventricular assist devices (LVADs) as a bridge to transplant or as destination therapy is increasing. The selection of suitable patients and outcome assessment belong to the key challenges. Mortality has traditionally been a focus of research in this field, but literature on quality of life is very limited. This study aimed to identify perioperative factors influencing patients' life as measured by days alive and out of hospital (DAOH) in the first year after LVAD implantation. Methods and results This retrospective single‐centre cohort study screened 227 patients who underwent LVAD implantation at the University Hospital Duesseldorf, Germany, between 2010 and 2020. First, the influence of 10 prespecified variables on DAOH was investigated by univariate analysis. Second, multivariate quantile regression was conducted including all factors with significant influence on DAOH in the univariate model. Additionally, the impact of all variables on 1 year mortality was investigated using Kaplan–Meier curves to oppose DAOH and mortality. In total, 221 patients were included into analysis. As pre‐operative factors, chronic kidney disease (CKD), pre‐operative mechanical circulatory support (pMCS), and Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) stadium

Abstract Thromboembolism is frequent in infective endocarditis (IE). However, the optimal antithrombotic regimen in IE is unknown. Staphylococcus aureus (SA) is the leading cause of IE. First studies emphasize increased platelet reactivity by SA. In this pilot study, we hypothesized that platelet reactivity is increased in patients with SA− IE, which could be abrogated by antiplatelet medication. We conducted a prospective, observatory, single-center cohort study in 114 patients with IE, with four cohorts: (1) SA coagulase positive IE without aspirin (ASA) medication, (2) coagulase negative IE without ASA, (3) SA coagulase positive IE with ASA, (4) coagulase negative IE with ASA. Platelet function was measured by Multiplate electrode aggregometry, blood clotting by ROTEM thromboelastometry. Bleeding events were assessed according to TIMI classification. In ASA-naïve patients, aggregation with ADP was increased with coag. pos. IE (coagulase negative: 39.47 ± 4.13 AUC vs. coagulase positive: 59.46 ± 8.19 AUC, p = 0.0219). This was abrogated with ASA medication (coagulase negative: 42.4 ± 4.67 AUC vs. coagulase positive: 45.11 ± 6.063 AUC p = 0.7824). Aspirin did not increase bleeding in SA positive patients. However, in SA negative patients with aspirin, red blood cell transfusions were enhanced. SA coagulase positive IE is associated with increased platelet reactivity. This could be abrogated by aspirin without increased bleeding risk. The results of this pilot study suggest that ASA might be beneficial in SA coagulase positive IE. This needs to be confirmed in clinical trials.

Abstract Background The number of patients treated with extracorporeal membrane oxygenation (ECMO) devices is increasing. Anticoagulation therapy is crucial to prevent thrombosis during ECMO therapy. Predominantly, heparin has been used as primary anticoagulant but direct thrombin inhibitors (DTI) have been established as alternatives. The aim of this systematic review and meta-analysis was to evaluate clinical outcomes in patients treated with heparin compared to different DTI during ECMO. Methods A systematic search was conducted. Full scientific articles were sought for inclusion if heparin anticoagulation was compared to DTI (argatroban/bivalirudin) in ECMO patients. Risk of bias was assessed by Newcastle Ottawa scale. Primary endpoint was in-hospital mortality. Bleeding events, thrombotic events, hours of ECMO support, days of hospital stay, percentage of time within therapeutic range and time to therapeutic range were extracted from full texts as secondary endpoints. Results were presented as Forrest-plots. GRADE was used for confidence assessment in outcomes. Results Systematic search identified 4.385 records, thereof 18 retrospective studies for a total of 1942 patients, complied with the predefined eligibility criteria:15 studies investigated bivalirudin and 3 studies investigated argatroban versus heparin. Risk of bias was high for most studies. In-hospital mortality, major bleeding events and pump-related thrombosis were less frequent in DTI group as compared to heparin [mortality—OR 0.69, 95% CI 0.54–0.86; major bleeding—OR 0.48, 95% CI 0.29–0.81; pump thrombosis—OR 0.55, 95% CI 0.40–0.76]. Additionally, percentage of time within therapeutic range was higher for DTI [SMD 0.54, 95% CI 0.14–0.94]. GRADE approach revealed a very low level of certainty for each outcome. Conclusion In this meta-analysis, DTI and especially bivalirudin showed beneficial effects on clinical outcomes in ECMO patients as compared to heparin. However, due to the lack of randomized trials, certainty of evidence is low. Trial Registration This systematic review and meta-analysis was prospectively registered at PROSPERO data base (reference number CRD42021237252 ). Graphical Abstract

Background and aims: Skin ulcers are caused by various reasons such as physical, chemical, and biological damages. Wound healing has long been considered one of the most important issues in surgery. Extensive research has been employed in this field and various chemical, herbal, homeopathic, and physical methods such as laser therapy have been used for treatment. Nowadays, wound healing is one of the most important aims of medical science. Furthermore, people prefer to use natural drugs because of fewer side effects. Therefore, the present study was designed considering these issues. Methods: For this study, 6 albino rabbits with an average weight of 3 kg were purchased. After preparing the rabbits, two pairs of full-thickness wounds were created in a completely round shape with a diameter of almost 6.30 mm on both sides of the spine in two anterior and posterior parts at a distance of 3 cm from the midline of the body. The animals were divided into 2 groups of 3 rabbits, including 1 experimental group and 1 control group. The wounds of the experimental group were treated with fig fruit extract while the wounds of the control group received no treatment. The wounds were macroscopically examined at 4, 7, 12, 16, and 20 days after surgery. Results: The results of t-test showed a significant difference (P

IntroductionThe aim of this study was to develop a model of selection criteria for university presidents in selected universities around the world.MethodThe research was applied in terms of purpose and qualitative in terms of approach. The statistical population of the study included documents, regulations, instructions, books, and available articles about selection of university presidents in sixteen countries from different continents. The statistical sample was the same as the community. Content - validity method and peer – group method were used to evaluate the validity of the research and the reliability, respectively. Data were analyzed using Qualitative content analysis method. After encoding the resulting data, concepts, core categories (dimensions or structures), and components (core competencies) were identified.ResultsThe results showed that among the 144 codes extracted, interactive selection criteria (12), communication management (9), management experience (8), academic management experience (7), scientific competence (7), innovation (6), Financial management (6), partnership (5) and organizational commitment (5) are the most important and have played a significant role in the selection of university presidents at the level of the studied universities in the world. Using the results, a comprehensive model was developed for the selection of university presidents, which resulted in the classification of three main categories of individual, organizational and managerial characteristics. Individual class includes personality and scientific characteristics; The organizational class included general organizational characteristics, the selection process and nationalism, and the managerial class included managerial skills, participation, experience, and expertise.DiscussionGiven that the data obtained from a research was a Qualitative based, the results can provide significant criteria when selecting university presidents in the recruitment and selection processes. According to the obtained results, it is suggested that a comprehensive model for the selection of university deans worldwide be developed by leading organizations in this field so that universities can follow this comprehensive model to select the desired president of their university.

Abstract Development of efficient virus aerosol monitoring and removal devices requires aerosolization of the test virus using atomizers. The number concentration and size measurements of aerosolized virus particles are required to evaluate the performance of the devices. Although diffusion dryers can remove water droplets generated using atomizers, they often fail to remove them entirely from the air stream. Consequently, particle measurement devices, such as scanning mobility particle sizer (SMPS), can falsely identify the remaining nanosized water droplets as virus aerosol particles. This in turn affects the accuracy of the evaluation of devices for sampling or removing virus aerosol particles. In this study, a plaque-forming assay combined with SMPS measurement was used to evaluate sufficient drying conditions. We proposed an empirical equation to determine the total number concentration of aerosolized particles measured using the SMPS as a function of the carrier air flow rate and residence time of the particles in the diffusion dryers. The difference in the total number concentration of particles under sufficient and insufficient diffusion drying conditions was presented as a percentage of error.

Abstract Aims Primary graft dysfunction (PGD) is a feared complication after heart transplantation (HTX). HTX patients frequently receive veno‐arterial extracorporeal membrane oxygenation (VA‐ECMO) until graft recovery. Long‐term mortality of patients weaned from VA‐ECMO after HTX is comparable with non‐ECMO patients. However, impact on quality of life is unknown. This study investigated days alive and out of hospital (DAOH) as patient‐centred outcome in HTX patients at 1 year after surgery. Methods and results This retrospective single‐centre cohort study included patients who underwent HTX at the University Hospital Düsseldorf, Germany, from 2010 to 2020. Main exposure was VA‐ECMO due to PGD. VA‐ECMO and non‐VA‐ECMO patients were compared regarding the primary endpoint DAOH at 1 year after HTX. Subgroup analysis for patients weaned from VA‐ECMO was performed. In total, 144 patients were included into analysis; 1 year mortality was significantly lower in non‐ECMO patients [non‐ECMO 14.3% (14/98) vs. VA‐ECMO 34.8% (16/46), adjusted hazard ratio: 0.32, 95% confidence interval: 0.15–0.74; P = 0.002]. Mortality did not differ significantly between patients weaned from VA‐ECMO and non‐ECMO patients [non‐ECMO 14.3% (14/98) vs. VA‐ECMO (weaned) 18.9% (7/37), adjusted hazard ratio: 0.72, 95% confidence interval: 0.27–1.90; P = 0.48]. DAOH were significantly higher in non‐ECMO patients compared with VA‐ECMO patients and patients weaned from VA‐ECMO [non‐ECMO vs. VA‐ECMO: median 310 (inter‐quartile range 277–327) days vs. 243 (0–288) days; P

Background: Removal of heavy metals by bioadsorbents is one of the effective and inexpensive methods for water and wastewater treatment. The aim of this study was to investigate the ability of tea pulp in order to remove Cu2+ and Pb2+ metals in two states of adsorption (single element and two elements) from aqueous solutions. Methods: Experiments were performed on synthetic and real samples at ambient temperature. The effect of solution pH, adsorbent dose, contact time, and initial concentration on single and competitive removal of copper metals and lead was studied. Adsorption kinetics and adsorption isotherms were analyzed by pseudo-second-order kinetic equations, Elovich model and intraparticle diffusion, Freundlich and Langmuir equations, respectively. Results: The maximum adsorption capacity for copper and lead was observed at pH = 5-8 and pH = 4-8, respectively. Maximum adsorption capacity for copper and lead by tea pulp in single-element solution (single) was 37.17 and 48.54 mg/g and in two-element solution (competitive), was 28.41 and 43.47 mg/g, respectively. The adsorption reaction of heavy metals by tea pulp followed the Longmuir isotherm and pseudo-second-order kinetic models. Conclusion: Tea pulp as an inexpensive bioadsorbent is able to remove about one-third of the copper, and approximately, half of lead from aqueous solutions, so its use in the treatment of aqueous solutions will be beneficial.

To investigate the effect of different planting densities on yield and yield components of quinoa (Titicaca cultivar), a factorial experiment based on complete randomized block design was studied at the Research Farm of the Agricultural and Natural Resources Research and Training Center of Kerman province in 2018-2019. Two inter-row space (30 and 50 cm) considered as the first factor and four intra-row space including 5, 10, 15 and 20 cm as the second factor. Increasing the intra-row and inter-row spacing resulted in significant reduction in CGR. Thus, the lowest value of this index, at both intra-row spacing attributed to 20 cm the inter-row spacing. The lowest grain yield (225.76 g.m-2) was related to the treatment of 50 cm inter-row and 20 cm intra-row spacings, Reduction intra-row spacing up to 10 cm resulted in a significant increase in seed yield. However, at in the inter-row spacing of 30 cm, there was no significant difference between the intra-row spacings in seed yield. The highest seed yield value was obtained from the intra- row spacing of 20 cm, with an average of 386.36 g.m-2. In general, the inter-row spacing of 30 cm and intra-row spacing of 15 and 20 cm resulted in highest seed yield and 1000 seed weight of quinoa in this research.