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The aim of the current study was to conduct a 12-year follow-up on the authors´ previously evaluated group of irradiated patients who underwent postmastectomy breast reconstruction with deep inferior epigastric perforator (DIEP) and latissimus dorsi (LD)-flaps with implant.The follow-up involved 67% of the patients from the original cohort (17 DIEP and 13 LD). Patient-reported outcome measures (PROMS) were measured using the BREAST-Q, SF-36, a satisfaction form, and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaires. Aesthetics were evaluated by a board of independent plastic surgeons.The average follow-up time was 12.6 years (DIEP) and 11.8 years (LD). Contralateral symmetry procedures were performed on 15 DIEP and 9 LD patients. Both groups underwent an average of 2.5 reconstructive procedures. The BREAST-Q and satisfaction questionnaires showed no group difference. SF-36 showed no group difference but had significantly higher values in both groups compared to the general population with regard to the physical role limitations (p=0.034 and p=0.004, respectively). The DASH scores showed minimal shoulder function impact in the LD group.Aesthetic evaluations revealed a discrepancy between the opinions of the patients and surgeons, with patients valuing the size (p=0.015) and overall aesthetic (p=0.012) of the reconstructed breast higher in the DIEP group. The weighted kappa analysis showed poor agreement between patients and surgeons. Over time, the patients´ preferences shifted from LD to DIEP flaps, possibly due to the more natural aging process associated with autologous reconstruction. This underscores the importance of long term follow-up studies.

Objectives: Motivation is the most influential factor in the drive and performance of adolescents with cerebral palsy (CP). As identification and analysis of volition in Iranian adolescents with CP seem to be essential, designing appropriate tools for assessing their motivation is crucial. To achieve this goal, we developed an adolescent motivation inventory-CP (AMI-CP) and evaluated its psychometric properties. Methods: In the first phase, item generation was conducted. Next, in the second phase, face and content validities of the items were assessed. Moreover, construct validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). A total of 304 adolescents with CP participated in the EFA, while 210 adolescents with CP participated in the CFA. Afterward, convergent and discriminant validities of the inventory were measured. Moreover, reliability was evaluated by calculating Cronbach α, McDonald’s omega, average inter-item correlation, composite, and test re-test reliability. Lastly, the standard error of measurement (SEM) and the minimum detectable change (MDC) were applied. Results: Five factors with 22 items were extracted by EFA, accounting for 50.42% of the variance. The results of model fit indexes confirmed the goodness-of-fit of the final model with 20 items. In addition, the AMI-CP had a Cronbach α value of 0.75 and an intra-class correlation coefficient of 0.94. Moreover, the SEM and MDC of the inventory were 2.63 and 7.31, respectively. Discussion: The AMI-CP is a helpful measure of motivation in adolescents with CP. This inventory can enhance the assessment of the CP adolescents’ motivation by evaluating values, interests, personal causation, and physical and social environments.

The dimensions and arrangement of columns have a significant impact on the seismic behavior of a structure. The objective of this paper is to ascertain the appropriate dimensions and configuration of columns for a building utilizing a frame system and framed tube system. Various column sizes and configurations were utilized to model four different types of buildings. The pushover analysis method was employed to determine the deformation capacity. The results obtained from the pushover analysis, indicate that the drift ratio for each building model remains below the prescribed 2% drift limit. The fourth building model, known as the framed tube system, exhibits the lowest drift ratio among the models, measuring at 0.81%. Upon reviewing the budget plan, it is evident that the second model building exhibits the lowest cost, displaying a notable disparity of 20.98% in comparison to the fourth model building, which boasts the highest cost. After considering both structural performance and budgeted cost, it is determined that the framed tube structural system is the optimal configuration.

Abstract From the start of life on Earth, several immune defense mechanisms have evolved to guarantee cellular integrity, homeostasis, and host survival. All these sophisticated balances as shaped by and towards the environmental needs have occurred over hundreds of millions of years. Human spaceflight involves various health hazards, such as higher levels of radiation, altered gravity, isolation and confinement, living in tight quarters, and stress associated with being away from home. A growing body of evidence points towards immunological changes in astronauts, including heightened pro-inflammatory responses, reactivation of latent viruses, and cell-mediated alterations, reflecting a dysbalanced state in astronauts. Simultaneously, enhanced pathogenicity, virulence, and drug resistance properties of microorganisms tip the scale out of favor for prolonged stay in space. As we have learned from the past, we see potential for the human immune system, forged and maintained throughout evolutionary history, to adapt to the space exposome. It is unlikely that this will happen in the short time frames set for current space exploration missions. Instead, major risks to astronaut health need to be addressed first, before humans can safely evolve into the space environment.

Abstract Triticale is a man-made crop produced by crossing wheat (Triticum aestivum) and rye (Secal cereal) with the aim of increasing the adaptability and potential production of its parental line (wheat) under environmental stresses and harsh conditions. Accordingly, the objectives of this study are as follow, a: compare different stability measurement methods regarding their suitability, b: identify most stable genotypes for cultivar release, and c: provide a freely available package in R programming language (named ‘Stbidx’) capable of exploiting all stability methods for similar studies. Accordingly, 30 triticale genotypes were evaluated for their stability and adaptability to changing environments during four consecutive years from 2016 to 2020 in different locations in Iran (one year in Zarghan, two years in Ghorveh, one year in Sanandaj) and under two different irrigation regimes (normal irrigation and water deficit stress conditions). All 30 triticale genotypes were cultivated in a randomized complete block design (RCBD) with three replications in each environment (12 environments: 6 trials in 2 conditions). Grain yield of triticale genotypes was measured and it applied to calculate all known stability indices (univariate methods) along with the meta-analysis models were evaluated in this study. Additionally, two novel techniques (Stability ID: SID and AMMI PC Value: APCV) were introduced and successfully tested for screening stable genotypes. These methods were introduced to improve and resolve the limitation of the previous stability methods. Meanwhile, heatmap analysis, as a proper data-mining technique, has been successfully applied for the first time to find stable genotypes in different environments in this study. The results clearly indicated a higher suitability of our introduced methods over previous multi-trials screening methods. Based on our methods and considering all environments, triticale genotypes ELTTCL21 (SID = 8.00; APCV = 28.12), ELTTCL25‌ (SID = 8.14; APCV = 30.02), ELTTCL30 (SID = 8.43; APCV = 17.00), ET-90-8 (SID = 14.00; APCV = 42.05), and Sanabad (SID = 10.57; APCV = 12.44) were among stable genotypes and they can be nominated as new cultivars. Additionally, for stress condition genotypes ELTTCL30 (stress: 380.6 g/m2) and ELTTCL18 (stress: 360.79 g/m2) and for normal condition genotypes ET-90-4 (normal: 849.4 g/m2) and ELTTCL20 (normal:845 g/m2) were respectively the most proper genotypes with the highest production to be considered for each condition separately.

Abstract Background Clinical data warehouses provide harmonized access to healthcare data for medical researchers. Informatics for Integrating Biology and the Bedside (i2b2) is a well-established open-source solution with the major benefit that data representations can be tailored to support specific use cases. These data representations can be defined and improved via an iterative approach together with domain experts and the medical researchers using the platform. To facilitate these discussions, it is important to understand how users interact with the system. Objective The objective of this work was to develop metrics for describing user interactions with clinical data warehouses in general and i2b2 in particular. Moreover, we aimed to develop a dashboard featuring interactive visualizations that inform data engineers and data stewards about potential improvements. Methods We first identified metrics for different data usage dimensions and extracted the relevant metadata about previous user queries from the i2b2 database schema for further analysis. We then implemented associated visualizations in Python and integrated the results into an interactive dashboard using Dash. Results The identified categories of metrics include frequency of use, session duration, and use of functionality and features. We created a dashboard that extends our local i2b2 data warehouse platform, focusing on the latter category, further broken down into the number of queries, frequently queried concepts, and query complexity. The implementation is available as open-source software. Conclusion A range of metrics can be derived from metadata logged in the i2b2 database schema to provide data engineers and data stewards with a comprehensive understanding of how users interact with the platform. This can help to identify the strengths and limitations of specific instances of the platform for specific use cases and aid their iterative improvement.

Abstract The activation of the Ca2+-channel Orai1 via the physiological activator stromal interaction molecule 1 (STIM1) requires structural rearrangements within the entire channel complex involving a series of gating checkpoints. Focusing on the gating mechanism operating along the peripheral transmembrane domain (TM) 3/TM4-interface, we report here that some charged substitutions close to the center of TM3 or TM4 lead to constitutively active Orai1 variants triggering nuclear factor of activated T-cell (NFAT) translocation into the nucleus. Molecular dynamics simulations unveil that this gain-of-function correlates with enhanced hydration at peripheral TM-interfaces, leading to increased local structural flexibility of the channel periphery and global conformational changes permitting pore opening. Our findings indicate that efficient dehydration of the peripheral TM-interfaces driven by the hydrophobic effect is critical for maintaining the closed state of Orai1. We conclude that a charge close to the center of TM3 or TM4 facilitates concomitant hydration and widening of peripheral TM interfaces to trigger constitutive Orai1 pore opening to a level comparable to or exceeding that of native activated Orai1.

Abstract Background The risk of breast cancer patients for long-term side effects of therapy such as neurotoxicity and cardiotoxicity as well as late effects regarding comorbidities varies from individual to individual. Personalised follow-up care concepts that are tailored to individual needs and the risk of recurrences, side effects and late effects are lacking in routine care in Germany. Methods We describe the methodology of BETTER-CARE, a parallel-arm cluster-randomised controlled trial conducted at 15 intervention and 15 control centres, aiming to recruit 1140 patients, and the results of the pilot phase. The needs- and risk-adapted complex intervention, based on existing development frameworks, includes a multidisciplinary network and digital platforms for symptom and need documentation and just-in-time adaptive interventions. The control group comprises usual care according to clinical guidelines. The primary outcome is health-related quality of life (EORTC QLQ-C30 global health), and secondary outcomes include treatment adherence. Results The 2-month pilot phase comprising 16 patients in one intervention and one control pilot centre demonstrated the feasibility of the BETTER-CARE approach. Discussion BETTER-CARE is a feasible intervention and study concept, investigating individualised needs- and risk-adapted breast cancer follow-up care in Germany. If successful, the approach could be implemented in German routine care. Trial registration German Clinical Trial Register DRKS00028840. Registered on April 2022.

Abstract Weight-inducing psychotropic treatments are risk factors for age-related diseases such as cardiovascular disorders, which are associated with both inflammation and telomere length shortening. With a longitudinal design, the present study evaluates telomere length trajectories after 1 year of weight-inducing psychotropic medication, accounting for weight changes and the inflammatory biomarker high-sensitivity C-Reactive Protein (CRP). Among 200 patients, an overall median telomere shortening of -41.2 bp was observed (p = 0.014), which is comparable with the general population’s yearly telomere attrition. Linear regression showed on average -93.1 and -58.9 bp of further telomere shortening per five units of BMI for BMI values < or ≥30 kg/m2, respectively (p = 0.003 and p = 0.009, respectively). Importantly, the overall telomere shortening was predicted to be increased four-fold among patients with low baseline weight (i.e., 50 kg) and with clinically relevant weight gain (≥ 7%) after 1 year of treatment (interaction term between relevant weight gain and baseline weight: +6.3 bp, p = 0.016). Patients with relevant weight gain showed greater CRP levels (+ 49%; p = 0.016), and a telomere shortening of -36.2 bp (p = 0.010) was estimated whenever CRP level doubled. Mendelian randomization using UKBiobank data showed a causal effect of BMI on telomere shortening, notably stronger among patients receiving weight-inducing psychotropic treatments (n = 9798) than among psychiatric patients without such drugs (n = 16228) and non-psychiatric controls (n = 252932) (beta: -0.37, -0.12, -0.06, respectively; p = 0.004, p

Abstract Nigeria is witnessing a mass emigration of its active labor force to more advanced economies, just like other developing countries. Approximately half of licensed medical doctors in Nigeria have emigrated, contributing to a widening doctors-to-patients ratio. In response to this concerning trend, in 2023, a legislator introduced a bill to restrain doctors from leaving Nigeria upon completing their studies by withholding their full license for five years. The public, including health professionals, criticized the bill. This study investigates the public discourse on the bill by extracting and analyzing responses published in newspaper articles, blogs, tweets, and LinkedIn posts. The analysis revealed that, while a few politicians supported the bill, the general populace opposed it due to perceived inconsistencies, a lack of focus on the core causes of migration, allegations of political elite’s hypocrisy, concerns about human rights violations and unemployment. By conducting this research, this article sheds light on the complexities of public opinion surrounding the proposed legislation, providing valuable insights into the multifaceted challenges associated with addressing the medical brain drain in Nigeria. The article contributes to the ongoing debate on the migratory trends of highly skilled workers from developing countries to advanced economies.

Abstract We present an exploration of the effect of electron-phonon coupling and broken inversion symmetry on the electronic and thermal properties of the semimetal LaRhGe3. Our transport measurements reveal evidence for electron-hole compensation at low temperatures, resulting in a large magnetoresistance of 3000% at 1.8 K and 14 T. The carrier concentration is on the order of 1021/cm3 with high carrier mobilities of 2000 cm2/Vs. When coupled to our theoretical demonstration of symmetry-protected almost movable Weyl nodal lines, we conclude that LaRhGe3 supports a Weyl semimetallic state. We discover superconductivity in this compound with a T c of 0.39(1) K and B c(0) of 2.2(1) mT, with evidence from specific heat and transverse-field muon spin relaxation. We find an exponential dependence in the normal state electrical resistivity below ~50 K, while Seebeck coefficient and thermal conductivity measurements each reveal a prominent peak at low temperatures, indicative of strong electron-phonon interactions. To this end, we examine the temperature-dependent Raman spectra of LaRhGe3 and find that the lifetime of the lowest energy A 1 phonon is dominated by phonon-electron scattering instead of anharmonic decay. We conclude that LaRhGe3 has strong electron-phonon coupling in the normal state, while the superconductivity emerges from weak electron-phonon coupling. These results open up the investigation of electron-phonon interactions in the normal state of superconducting non-centrosymmetric Weyl semimetals.

Background and objective: Collagen biosynthesis is intricately involved in the development and progression of solid tumors. Renin-angiotensin system inhibitors (RASi) impede TGF-β-mediated collagen synthesis in tumors by hindering activation of the angiotensin receptor. Our aim was to investigate a potential association between RASi use and the aggressiveness of prostate cancer (PCa). Methods: We conducted a retrospective multicenter analysis for a cohort of 1250 patients with PCa who underwent radical prostatectomy (RP) between 1990 and 2023 in four European high-volume centers. The study cohort comprised 625 RASi-treated patients and 625 age-matched RASi-naïve patients. Data for various parameters were collected, including age at RP, body mass index (BMI), prostate volume, prostate-specific antigen (PSA), percentage of free PSA, Gleason score (GS) at biopsy and RP, TNM stage, and the rate of biochemical recurrence (BCR). Clinical parameters for patients with and without RASi treatment were documented. Differences between the groups were compared using a Mann-Whitney U test and χ2 tests. Survival analyses were performed using the Kaplan-Meier method. Key findings and limitations: As expected, the RASi group had higher BMI levels than the RASi-naïve group (p

Abstract The vibration and acoustic noise of a permanent‐magnet synchronous motor are analysed and evaluated. Acoustic noise sound levels, their prominent frequencies, and the noisiest motor speed range are predicted. According to many resources, the radial vibration of the stator system due to the magnetic attraction between rotor permanent magnets and stator iron teeth is the main reason for the acoustic noise propagation of the PMSMs. The dominant orders of the spatial circumferential harmonics of the radial magnetic forces (RMFs) have been investigated and compared. The complete and complicated mechanical components, materials, and harmonics of the magnetic forces of the motor and their interaction are simplified and equalised to a vibration model, which consists of the interaction between the stator system and the dominant harmonic orders of the RMFs. Based on this approach, the simplest and most adequate semi‐analytical‐FEM model for noise prediction in PMSMs is proposed. This model, in addition to simplification, clarifies the role of the main mechanical and electromagnetic origins of noise generation. The acoustic noise prediction, using the proposed method has been compared with the experimental results. There is a proper agreement between the analytical, the FEM, and measurement results.

Background: There is a lack of summarized reports of the relationship between dietary acid load (DAL) and bone health in post-menopausal women. Therefore, we aimed to design a systematic review and summarize eligible studies evaluating this association.Methods: The present study was a systematic review. From the literature search on PubMed, Google Scholar, Scopus, and Medline until March 2020, six studies comprising 2 crosssectionals, 2 cohorts, and 2 randomized control trials were selected and included in this study.Results: Four studies revealed a significant correlation between DAL and osteoporosis in post-menopausal women. In two reviewed studies, a significant association was seen between DAL and BMD, but in this association was not obtained in n another study. In addition, out of two randomized clinical studies (RCTs), one showed positive changes in bone markers when PRAL was decreased; however, no change was obtained in another RCT.Conclusion: The present study showed that post-menopausal women, especially those with a fracture history, may have a greater susceptibility to osteoporosis because of the detrimental effect of dietary acidity. In addition, DAL rather than protein might be the main risk factor for bone loss in this population. It should be noted that insufficient calcium intake may exacerbate bone loss following a high protein–high acid ash diet in these women.

Abstract The statistical properties of the detection events constituting the interference fringes at the output of an interferometer are well-known. Nevertheless, there is still no unified view of what is happening to a quantum system inside an interferometer. Strong measurements of path operators destroy the interference effect. In weak measurements, an observable is weakly coupled to a pointer system and the resulting weak values quantify the observable by minimally disturbing the system. Previous which-way experiments with weak measurements could extract either the real or imaginary part of a single weak value with each ensemble. Here, we present the simultaneous full complex quantification of two path weak values with a single ensemble in a Mach–Zehnder neutron interferometer. Magnetic fields, oscillating with different frequencies, change the energy state in each interferometer path. The time-dependent phase between the energy states distinctly marks each path. The resulting beating intensity modulation at the interferometer output gives both path weak values. For the present experiment, the weak values’ absolute value and phase directly describe the observed amplitude and phase of the intensity modulation.

Abstract Shock is a life-threatening condition. This study evaluated if sublingual microcirculatory perfusion on admission is associated with 30-day mortality in older intensive care unit (ICU) shock patients. This trial prospectively recruited ICU patients (≥ 80 years old) with arterial lactate above 2 mmol/L, requiring vasopressors despite adequate fluid resuscitation, regardless of shock cause. All patients received sequential sublingual measurements on ICU admission (± 4 h) and 24 (± 4) hours later. The primary endpoint was 30-day mortality. From September 4th, 2022, to May 30th, 2023, 271 patients were screened, and 44 included. Patients were categorized based on the median percentage of perfused small vessels (sPPV) into those with impaired and sustained microcirculation. 71% of videos were of good or acceptable quality without safety issues. Patients with impaired microcirculation had significantly shorter ICU and hospital stays (p = 0.015 and p = 0.019) and higher 30-day mortality (90.0% vs. 62.5%, p = 0.036). Cox regression confirmed the independent association of impaired microcirculation with 30-day mortality (adjusted hazard ratio 3.245 (95% CI 1.178 to 8.943, p = 0.023). Measuring sublingual microcirculation in critically ill older patients with shock on ICU admission is safe, feasible, and provides independent prognostic information about outcomes. Trial registration NCT04169204.

Abstract Nowadays, the use of hybrid systems has become very common all over the world. In this study, the aim is to minimize the use of grid energy to provide heating and cooling energy with the help of a hybrid heat pump equipped with a flat solar collector, phase change material (PCM), and photovoltaic (PV) panels. To achieve the best results, a numerical dynamic model consisting of different solar PV panels in three models, batteries, inverters, and hybrid heat pump along with collector and PCM has been modeled by solving Engineering Equation Solver (EES) and TRNSYS software. According to the proposed scenarios, multi‐objective optimization has been done to simultaneously improve the study answers in several sections by multi‐objective particle swarm optimization algorithm with MATLAB software. Also, economic and environmental optimization is also presented separately for comparing and reviewing solutions. The results of multi‐objective optimization show that the amount of lifecycle cost (LCC) when using polycrystalline panel is 21.26% lower than monocrystalline panel and 38.71% higher than thin film panel. As a result, according to the specific conditions and attitude, you can choose the desired system. Also, in the economic optimization, it was found that the best system is related to the polycrystalline panel, the volume of PCM used in the system is equal to 1 m 3, the number of panels used is 18, and the minimum amount of LCC is $3929.08.

Abstract Decision to explore new options with uncertain outcomes or exploit familiar options with known outcomes is a fundamental challenge that the brain faces in almost all real-life decisions. Previous studies have shown that humans use two main explorative strategies to negotiate this explore-exploit tradeoff. Exploring for the sake of information is called directed exploration, and exploration driven by behavioral variability is known as random exploration. While previous neuroimaging studies have shown different neural correlates for these explorative strategies, including right frontopolar cortex (FPC), right dorsolateral prefrontal cortex (DLPFC), and dorsal anterior cingulate cortex (dACC), there is still a lack of causal evidence for most of these brain regions. Here, we focused on the right DLPFC, which was previously supported to be involved in exploration. Using the continuous theta burst stimulation (cTBS) and Horizon task on twenty-five healthy right-handed adult participants, we showed that inhibiting rDLPFC did not change directed exploration but selectively reduced random exploration, by increasing reward sensitivity over the average reward of each option. This suggests a causal role for rDLPFC in random exploration, and further supports dissociable neural implementations for these two explorative strategies.

Abstract The (re-)construction of past and future personal experiences, termed mental time travel (MTT), is highly adaptive and contributes to self-related beliefs and attitudes. Mounting evidence suggests that self-efficacy (SE), the belief that one can overcome obstacles on their own account, is functionally related to MTT. In the present study, we used novel methods for the analysis of MTT narratives based on natural language processing (NLP) to investigate the relation between SE and MTT. We demonstrated that self-efficacious participants remembered and imagined experiences which were semantically less similar and contained a wider variety of contents. Additionally, increased SE was related to a positive reappraisal of personal episodes and reports of a more active role within mental scenarios. In conclusion, NLP appears to be a valuable method to quantify changes to the (re-)construction of personal experience that might support cognitive and emotional functioning.

Abstract Background Diabetes is a global health problem, and its incidence and complications increase with the duration of the disease and over time. This increase in complications in older patients can lead to disability and a lower quality of life. This study aimed to investigate the rate of diabetes control and complications in older adults. Method This was a cross-section of an ongoing cohort of patients with type 2 diabetes mellitus (T2DM) aged 65 years and older. The clinical and laboratory characteristics of older adult patients with T2DM in good and intermediate health conditions were collected between 2010 and 2022. Results A total of 2,770 older adult patients with T2DM were enrolled, including 1,530(55.3%) female and 1,240 (44.7%) male participants. Metabolic syndrome, hypertension, and coronary artery disease were the most common comorbidities, affecting 1,889 (71.4%), 1,495 (54.4%), and 786 (29.2%) patients, respectively. Albuminuria was present in 626 (22.6%) patients, while retinopathy was detected in 408 (14.7%) patients, including 6% with proliferative retinopathy. Most patients were treated with oral antidiabetic agents (88.9%), with metformin being the most prescribed medication (85.6%). Statins were prescribed to 71.8% of the patients. The most prescribed antihypertensive medications were angiotensin receptor blockers and angiotensin-converting enzyme inhibitors, prescribed to 54% and 15% of patients, respectively. The hemoglobin A1c (HbA1c) goal (HbA1c

Abstract Background Synaptic degeneration, axonal injury, and white matter disintegration are among the pathological events in Alzheimer’s disease (AD), for which growth-associated protein 43 (GAP-43) and diffusion tensor imaging (DTI) could be an indicator. In this study, the cerebrospinal fluid (CSF) GAP-43 clinical trajectories and their association with progression and AD hallmarks with white matter microstructural changes were evaluated. Methods A total number of 133 participants were enrolled in GAP-43 and DTI values were compared between groups, both cross-sectionally and longitudinally with two and four-year follow-ups. Subsequently, the correlation between GAP-43 levels in the CSF and DTI values was investigated using Spearman’s correlation. Results The CSF level of GAP-43 is negatively correlated with the mean diffusivity measures in Fornix (Cres)/Stria terminals in early and late MCI (rs=-0.478 p = 0.021 and rs=-0.425 p = 0.038). Additionally, the CSF level of GAP-43 is negatively correlated with fractional anisotropy in the cingulum in late MCI (rs=-0.437 p = 0.033). Moreover, the axial diffusivity in superior corona radiate (rs=-0.562 p = 0.005 and rs=-0.484 p = 0.036) and radial diffusivity in superior fronto-occipital fasciculus was negatively correlated with GAP-43 level in the early and mid-MCI participants (rs=-0.520 p = 0.011 and rs=-0.498 p = 0.030). Conclusions Presynaptic marker GAP-43 in combination with DTI can be used as a novel biomarker to identify microstructural synaptic degeneration in the early MCI. In addition, it can be used as a biomarker for tracking the progression of AD and monitoring treatment efficacy.

Abstract Prior studies have shown strong genetic effects on cortical thickness (CT), structural covariance, and neurodevelopmental trajectories in childhood and adolescence. However, the importance of genetic factors on the induction of spatiotemporal variation during neurodevelopment remains poorly understood. Here, we explore the genetics of maturational coupling by examining 308 MRI-derived regional CT measures in a longitudinal sample of 677 twins and family members. We find dynamic inter-regional genetic covariation in youth, with the emergence of regional subnetworks in late childhood and early adolescence. Three critical neurodevelopmental epochs in genetically-mediated maturational coupling were identified, with dramatic network strengthening near eleven years of age. These changes are associated with statistically-significant (empirical p-value

ABSTRACT: The objective of this study was to describe the prevalence of antimicrobial resistance of Escherichia coli, Klebsiella oxytoca, Klebsiellapneumoniae, and Serratiamarcescens from quarter milk samples submitted to the udder health laboratory of the Bavarian Animal Health Services (TGD) in Southern Germany between 2014 and 2022. All samples were tested with the California Mastitis Test and analyzed with a standard microbroth dilution to determine the MIC. The antimicrobials tested were amoxicillin/clavulanate, cefazoline, kanamycin/cefalexin, cefoperazone, cefquinome, and marbofloxacin. Breakpoints were chosen in accordance with the Clinical and Laboratory Standards Institute (CLSI). Over the study period, E. coli, K. oxytoca, and K. pneumoniae showed only few resistances to all antimicrobials tested. For those pathogens MIC 50 and MIC 90 were below breakpoint for all antimicrobials except cefoperazone over the 9 years. A decrease in MIC could be seen for E. coli and K. oxytoca for all of the antimicrobials. While the MIC for K. pneumoniae stayed more stagnant, the prevalence of resistance still decreased overall. Serratiamarcescens isolates were proven intrinsically resistant to amoxicillin/clavulanate and cefazolin, and while in vitro resistances were low for all other antimicrobials tested, S. marcescens tended toward higher MIC for most of the antimicrobials over the years. Over time, there was also an overall increase in the number of isolates for all 4 pathogens per year. Starting 2018 there was a steep increase in the number of isolates particularly from clinical cases. This jump in numbers coincided with a change of the regulation for veterinary drug prescriptions in Germany in 2018 that required, among other things, antimicrobial resistance testing before a change of antibiotics in the course of treatment and the use of critically important antimicrobials. Overall, although the pathogens increased in numbers, the prevalence of their antimicrobial resistance remained low.

Abstract Background Do different genetic disorders impart different psychiatric risk profiles? This question has major implications for biological and translational aspects of psychiatry, but has been difficult to tackle given limited access to shared batteries of fine-grained clinical data across genetic disorders. Methods Using a new suite of generalizable analytic approaches, we examine gold-standard diagnostic ratings, scores on 66 dimensional measures of psychopathology, and measures of cognition and functioning in two different sex chromosome aneuploidies (SCAs)—Klinefelter (XXY/KS) and XYY syndrome (n = 102 and 64 vs. n = 74 and 60 matched XY controls, total n = 300). We focus on SCAs for their high collective prevalence, informativeness regarding differential X- vs. Y-chromosome effects, and potential relevance for normative sex differences. Results We show that XXY/KS elevates rates for most psychiatric diagnoses as previously reported for XYY, but disproportionately so for anxiety disorders. Fine-mapping across all 66 traits provides a detailed profile of psychopathology in XXY/KS which is strongly correlated with that of XYY (r = .75 across traits) and robust to ascertainment biases, but reveals: (i) a greater penetrance of XYY than KS/XXY for most traits except mood/anxiety problems, and (ii) a disproportionate impact of XYY vs. XXY/KS on social problems. XXY/KS and XYY showed a similar coupling of psychopathology with adaptive function and caregiver strain, but not IQ. Conclusions This work provides new tools for deep-phenotypic comparisons of genetic disorders in psychiatry and uses these to detail unique and shared effects of the X- and Y-chromosome on human behavior.

Abstract Background Influenza is the most common vaccine-preventable infection among travelers, affecting approximately one percent of those travelling to subtropical and tropical destinations. Methods We analysed demographic, travel-related and clinical information from travelers diagnosed with influenza at our travel clinic between January 2015 and March 2020 and influenza-negative controls. Results We included 68 travelers diagnosed with influenza and 207 controls. In total, 22.1% of influenza patients (n = 15) were older than 60 years and/or had comorbidities for which annual influenza vaccination is recommended, but only one had received an influenza vaccine. Patients with respiratory and musculoskeletal symptoms who presented during the German influenza season had the highest risk proportion of positive tests (54%, n = 25/46). Overall, three (4.4%) influenza patients were hospitalised, two (2.9%) received antiviral treatment, and eight (11.8%) received antibiotic therapy. Conclusions Influenza occurs throughout the year in international travelers and can cause significant morbidity. Travelers with febrile illness should be tested for influenza, especially if they have respiratory or musculoskeletal symptoms, present during the local influenza season, or have travelled to South-East Asia. Influenza vaccination coverage among international travelers needs to be improved among high-risk individuals.

Abstract Introduction Appendicitis is a common cause of acute abdomen. Rarely, it may form adhesions to nearby structures, complicating surgeries, especially when involving vascular structures such as the internal iliac artery, potentially causing severe intraoperative hemorrhage. Case presentation A 65-year-old Middle Eastern male presented with abdominal pain and anorexia for 5 days. Examination and imaging confirmed acute appendicitis with complications. Additionally, a large pelvic mass was noted. During surgery, severe bleeding was encountered due to an adhesion between the appendix and the right internal iliac artery, managed by ligating the artery. The patient recovered well and was discharged in stable condition. Histopathology confirmed the diagnosis. Conclusion This case highlights a rare vascular complication of appendectomy due to abnormal adhesions between the appendix and the internal iliac artery, associated with a large pelvic mass. This study emphasizes the need for thorough preoperative evaluation and careful surgical planning in patients with unusual anatomical variations or specific underlying conditions such as neurofibromatosis. Early recognition and strategic management of vascular adhesions are essential to optimize patient outcomes in appendectomies complicated by such rare scenarios.

Abstract This article investigated the charge and discharge management structure of electric vehicles (EVs) in intelligent parking lots (IPLs). It seems that with the expansion of renewable energy sources (RESs) as clean energy and investigation of the effects of EVs on the operation and planning of future distribution networks around the way EVs exchange energy with each other and the upstream network operator, RESs such as solar and wind sources, along with hydrogen storage are essential. Therefore, a new stochastic multi‐scenario approach for charge/discharge management of EVs parked in IPL was proposed, in which a newly developed model for the IPL with a hydrogen storage system (HSS) consisting of a fuel cell, an electrolyzer, and a hydrogen storage tank was presented. In the proposed model, the constraints of upstream network and power balance constraints, with the operating constraints related to the IPL, including EVs, renewable energy sources, and the hydrogen storage system, were formulated as the most important objectives of the optimization problem. The optimization algorithm, Competitive Swarm Optimizer (CSO), was formulated for implementation, and its results were compared with those of the PSO and GWO algorithms. The CSO must handle a variety of practical, large‐scale optimization problems. Based on the obtained results, the excess energy purchased from the upstream network or renewable sources was used as hydrogen storage for consumption during peak hours. As expected, the technical constraints and financial goals of the system were met, and the proposed system was evaluated on a 33‐bus network. As the expected benefits will be the most beneficial with the presence of renewable sources, the final profit will be reduced by taking into account uncertainty for charge/discharge management in EVs such as the uncertainty of electric load, market price, wind turbine, and photovoltaic cell sources. Nonetheless, the profit obtained from renewable resources is preferable to losses resulting from the uncertainty of the system, and according to expectation, the performance of the system for managing the optimal charging and discharging of EVs in the IPL will be acceptable with the maximum profit for the grid.

Air pollution has significant detrimental impacts on the environmental compartments and human health. The present study investigates the interactions between selected air pollutants, including CO, O3, NO2, SO2, PM10, and PM2.5, in Tehran megacity, the capital of Iran, using statistical modeling and simulating approaches. Data on selected air pollutants have been extracted from 16 sensors across Tehran during 2013–2022. Using the development of three machine learning models, including XGBoost (XGB), LightGBM (LGBM) and Random Forest (RF), significant relationships between the air pollutants were observed. The comparison of the models demonstrated that the RF model has the highest level of optimality in forecasting the concentrations of CO, O3, NO2, and SO2 (R2CO = 0.63, R2O3 = 0.6, R2NO2 = 0.54, R2SO2 = 0.55). The LGBM model provided higher optimality for NO2 and PM2.5 (R2NO2 = 0.56, R2PM2.5 = 0.88), while the XGB model exhibited higher accuracy for the PM10 (R2PM10 = 0.88). Regarding the results obtained from the statistical models, it can be inferred that the RF model has superior performance in the forecasting of gaseous pollutants. Moreover, the XGB and LGBM models exhibited comparable performance and therefore may be regarded as appropriate options for PM prediction. The findings from the simulations indicated that a rise in an individual pollutant likely leads to an increase in other pollutants. Consequently, implementing air quality management strategies for a specific pollutant meaningfully, directly influences other pollutants, highlighting the significance of considering the chemical aspect of air pollutants interaction and enforcing air pollution management rules.

Digital Twin (DT) technology is a pivotal innovation within the built environment industry, facilitating digital transformation through advanced data integration and analytics. DTs have demonstrated significant benefits in building design, construction, and asset management, including optimising lifecycle energy use, enhancing operational efficiency, enabling predictive maintenance, and improving user adaptability. By integrating real-time data from IoT sensors with advanced analytics, DTs provide dynamic and actionable insights for better decision-making and resource management. Despite these promising benefits, several challenges impede the widespread adoption of DT technology, such as technological integration, data consistency, organisational adaptation, and cybersecurity concerns. Addressing these challenges requires interdisciplinary collaboration, standardisation of data formats, and the development of universal design and development platforms for DTs. This paper provides a comprehensive review of DT definitions, applications, capabilities, and challenges within the Architecture, Engineering, and Construction (AEC) industries. This paper provides important insights for researchers and professionals, helping them gain a more comprehensive and detailed view of DT. The findings also demonstrate the significant impact that DTs can have on this sector, contributing to advancing DT implementations and promoting sustainable and efficient building management practices. Ultimately, DT technology is set to revolutionise the AEC industries by enabling autonomous, data-driven decision-making and optimising building operations for enhanced productivity and performance.

Background: Systemic juvenile idiopathic arthritis (sJIA) is marked with arthritis and several features of systemic inflammation, including fever, rashes, hepatosplenomegaly, lymphadenopathy, and serositis. Interleukin-1 receptor blockers have been used as one of the most effective biologics for the treatment of resistant types of disease. The main purpose of this study was to evaluate the safety and efficacy of PerkinRA in comparison with Kineret in patients with sJIA. Methods: This was a double-blind, randomized clinical trial conducted on 72 patients with sJIA. The patients were enrolled based on the 2018 International League of Associations for Rheumatology criteria and were treated at the outpatient clinic of Mofid Children’s Hospital, Pediatric Medical Center, and four other centers between February 2020 and March 2021. Patients were randomly assigned in a 1:1 ratio to one of two treatment groups: one group received PerkinRA (manufactured by Persis Gene, n = 36), while the other group received Kineret (manufactured by SOBI, n = 36). The primary outcome measure was the proportion of patients achieving an American College of Rheumatology (ACR) 30, ACR 50, and ACR 70 response. Secondary outcomes included changes in vital signs, incidence of adverse events, clinical laboratory assessments, and findings from physical examinations. These parameters were evaluated at 1, 2, 4, 8, 12, 16, 20, and 24 weeks after the first injection, and the two treatment groups were compared. Results: A total of 35 patients in the PerkinRA group and 32 patients in the Kineret group were included in the final analysis. The results showed no clinically significant differences between the two treatment groups. Patients in both the PerkinRA and Kineret groups achieved similar proportions of ACR 30, ACR 50, and ACR 70 responses over the 6-month evaluation period. Conclusion: Based on the findings of this study, the two investigational medications, PerkinRA and Kineret, demonstrated comparable efficacy in the treatment of sJIA. The two treatment groups showed no significant differences in the primary and secondary outcomes assessed. Therefore, it can be concluded that PerkinRA and Kineret are noninferior to each other for the management of sJIA.

Abstract Background Academic dishonesty as a fundamental challenge in adherence of ethical principles in providing care to patients has caused concern to the scientific community of nurses. In addition, positive professional identity and high moral competence are important for nurses to perform multiple care roles in high quality care of patients. The purpose of the present study is of investigating academic dishonesty and its relationship with moral competence and professional identity of master’s and PhD nursing students. Methods This descriptive-analytical study was conducted by census method on 65 master’s and PhD nursing students in Shiraz University of Medical Sciences, Iran in 2023. Data collection tools included 4 questionnaires (Demographic information, Academic Dishonesty Scale (DAS), Nurses’ moral competence and Professional Identity Scale for Nursing Students (PISNS)). Data collection was done within 2 months. Descriptive and inferential analyzes including independent t-test, Pearson correlation coefficient and linear regression were used to analyze the data. The collected data were analyzed by SPSS.V.22 software. P-value less than 0.05 was considered significant. Results The average age of 65 participants was 31.5 ± 5.61 years. The majority of the participants in this study were women 48 (73.8%). There is a significant and negative correlation between academic dishonesty and moral competence (r=-0.260, P-value = 0.036). There is no significant correlation between academic dishonesty and professional identity (r = 0.154, P-value = 0.22). Also, a significant positive correlation was found between moral competence and professional identity (r = 0.294, P-value = 0.018). Conclusion Therefore, considering that the fact that students have a great impact on patient care, Researchers suggest that educational institutions should prevent the increase of academic dishonesty among students by establishing new rules and regulations.

Abstract Visual working memory depends on both material-specific brain areas in the ventral visual stream (VVS) that support the maintenance of stimulus representations and on regions in the prefrontal cortex (PFC) that control these representations. How executive control prioritizes working memory contents and whether this affects their representational formats remains an open question, however. Here, we analyzed intracranial EEG (iEEG) recordings in epilepsy patients with electrodes in VVS and PFC who performed a multi-item working memory task involving a retro-cue. We employed Representational Similarity Analysis (RSA) with various Deep Neural Network (DNN) architectures to investigate the representational format of prioritized VWM content. While recurrent DNN representations matched PFC representations in the beta band (15–29 Hz) following the retro-cue, they corresponded to VVS representations in a lower frequency range (3–14 Hz) towards the end of the maintenance period. Our findings highlight the distinct coding schemes and representational formats of prioritized content in VVS and PFC.

Abstract Background Metabolic dysfunction-associated steatotic liver disease (MASLD) patients are at an elevated risk of developing severe coronavirus disease 2019 (COVID-19). The objective of this study was to assess antibody responses and safety profiles six months after the third dose of the inactivated acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in MASLD patients. Methods This study included MASLD patients and healthy volunteers without a history of SARS-CoV-2 infection. Blood samples were collected six months after receiving the third dose of the inactivated vaccine to measure the levels of neutralizing antibodies (NAbs) and anti-spike IgG antibodies against SARS-CoV-2. Results A total of 335 participants (214 MASLD patients and 121 healthy volunteers) were enrolled. The seroprevalence of NAb was 61.7% (132 of 214) in MASLD patients and 74.4% (90 of 121) in healthy volunteers, which was a significant difference (p = 0.018). Statistically significant differences in IgG seroprevalence were also observed between MASLD patients and healthy volunteers (p = 0.004). Multivariate analysis demonstrated that the severity of MASLD (OR, 2.97; 95% CI, 1.32–6.68; p = 0.009) and age (OR, 1.03; 95% CI, 1.01–1.06; p = 0.004) were independent risk factors for NAb negativity in MASLD patients. Moderate/severe MASLD patients had a lower NAb seroprevalence than mild MASLD patients (45.0% vs. 65.5%, p = 0.016). Conclusion Lower antibody responses were observed in MASLD patients six months after their third dose of the inactivated vaccine than in healthy volunteers, providing further assistance in monitoring patients who are more vulnerable to hypo-responsiveness to SARS-CoV-2 vaccines.

Objective: Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), have been associated with sleep disturbances as extra-intestinal manifestations. We aimed to evaluate sleep quality in a group of Middle Eastern IBD patients while assessing the links between disease characteristics, sleep disturbances, and related comorbidities. Materials and Methods: Outpatient IBD cases who attended our hospital clinic from 2019 to 2021 were recruited in this prospective study. The patients filled in verified translations of the insomnia severity index, Epworth sleepiness scale, Pittsburgh sleep quality index, Berlin questionnaire for obstructive sleep apnea (OSA), and restless legs syndrome (RLS) questionnaire by means of online or phone surveys. The chi-squared test and Student’s t-test were used for binary and continuous variables, respectively. The Mann-Whitney U test was used for non-normally distributed data. Results: The sleep quality of 82 IBD patients (13 CD and 69 UC) was assessed. Low sleep quality was observed in 52 cases (63.4%), and UC patients with pancolitis were significantly more likely to have sleep disturbances compared to patients with partial colitis (p=0.015). Moreover, patients with elevated C-reactive protein (CRP) displayed significantly higher frequencies of OSA and RLS (p=0.038 and p=0.040, respectively). Conclusion: Sleep impairment was identified in more than half of our IBD patient pool. Therefore, we suggest screening for sleep disturbances (particularly in UC patients with pancolitis) and related comorbidities, such as OSA and RLS (especially in patients with elevated CRP levels), in IBD patients to enhance their quality of sleep.

Abstract Although reduced experimental pain habituation is proposed as a proxy of diminished endogenous pain modulatory capacity in chronic pain, prior studies show contradictory findings. Even across healthy participants, pain habituation varies substantially, which may relate to another measure of endogenous pain modulation, i.e., conditioned pain modulation (CPM). Hence, this study investigated the relationship between pain habituation and CPM. Pain habituation was assessed in 45 healthy participants between two blocks of 15–20 contact-heat stimuli applied to the hand. Habituation of subjective pain ratings and objective neurophysiological readouts (contact-heat evoked potential (CHEP) and palmar sympathetic skin response (SSR)) was investigated. CPM was assessed by comparing heat pain thresholds before and after hand immersion in a noxious cold (9 °C) and lukewarm water bath (32 °C, to control for repeated measures effects). Pain habituation showed a large variability, with subjective but not objective pain habituation correlating with cold-induced CPM effects (r = 0.50; p = 0.025). This correlation was not observed for ‘true’ CPM effects (corrected for repeated measures effects) nor for CPM effects induced by a lukewarm water bath. These findings suggest that the observed variability in subjective pain habituation may be influenced by both descending endogenous pain modulation and peripheral adaptation processes associated with repeated measures. Objective pain habituation readouts, i.e., CHEPs and SSRs, capture different, complementary aspects of endogenous pain modulation.

Abstract Background Comprehensive characterization of the metabolome in cerebrospinal fluid (CSF) and serum by Nuclear Magnetic Resonance (NMR) spectroscopy may identify biomarkers and contribute to the understanding of the pathophysiology of neurological diseases. Methods Metabolites were determined by NMR spectroscopy in stored CSF/serum samples of 20 patients with Parkinson’s disease, 25 patients with other neuro-degenerative diseases, 22 patients with cerebral ischemia, 48 patients with multiple sclerosis, and 58 control patients with normal CSF findings. The data set was analysed using descriptive and multivariate statistics, as well as machine learning models. Results CSF glucose and lactic acid measured by NMR spectroscopy and routine clinical chemistry showed a strong correlation between both methods (glucose, R2 = 0.87, n = 173; lactic acid, R2 = 0.74, n = 173). NMR spectroscopy detected a total of 99 metabolites; 51 in both, CSF and serum, 16 in CSF only, and 32 in serum only. CSF concentrations of some metabolites increased with age and/or decreasing blood–brain-barrier function. Metabolite detection rates were overall similar among the different disease groups. However, in two-group comparisons, absolute metabolite levels in CSF and serum discriminated between multiple sclerosis and neurodegenerative diseases (area under the curve (AUC) = 0.96), multiple sclerosis and Parkinson’s disease (AUC = 0.89), and Parkinson’s disease and control patients (AUC = 0.91), as demonstrated by random forest statistical models. Orthogonal partial least square discriminant analysis using absolute metabolite levels in CSF and serum furthermore permitted separation of Parkinson’s disease and neurodegenerative diseases. CSF propionic acid levels were about fourfold lower in Parkinson’s disease as compared to neurodegenerative diseases. Conclusions These findings outline the landscape of the CSF and serum metabolome in different categories of neurological diseases and identify age and blood–brain-barrier function as relevant co-factors for CSF levels of certain metabolites. Metabolome profiles as determined by NMR spectroscopy may potentially aid in differentiating groups of patients with different neurological diseases, including clinically meaningful differentiations, such as Parkinson’s disease from other neurodegenerative diseases.

Abstract This study was designed to investigate the effect of vitamin D and/or synbiotics on the response to treatment, cytokines profile and hormonal biomarkers in breast cancer patients undergoing neoadjuvant therapy. A total of 76 patients were recruited and completed the course of the intervention between 2019 and 2021 in Kerman, Iran. breast cancer patients were randomly enrolled in this study. Patients divided into four groups to receive one of the following regimens: placebo, vitamin D, synbiotics and a combination of vitamin D and synbiotics. clinicopathologic parameters, inflammatory and anti-inflammatory biomarkers and hormonal levels were measured at the baseline and four months after intervention. The study results found no clear link between the interventions and achieving pathological complete response (pCR), and a similar trend was observed in Ki-67 index examination. After neoadjuvant therapy, TNF-α concentrations decreased, with vitamin D supplementation moderating this decline. Vitamin D supplemented groups showed a significant increase in serum IL-6 levels. While IL-10 levels decreased in the placebo group, all intervention groups were protected from this decline. Moreover, there was a notable increase in the anti-inflammatory index, particularly in the group receiving both vitamin D and synbiotic supplementation, suggesting potential synergistic anti-inflammatory effects from their combined administration. The outcomes suggest a potential anti-inflammatory function of this combination. Consequently, more extensive studies with prolonged follow-up periods and substantial sample sizes are warranted to thoroughly evaluate their potential benefits for breast cancer patients.

Abstract Large biobanks have dramatically advanced our understanding of genetic influences on human brain anatomy. However, most studies have combined rather than compared male and female participants. Here we screen for sex differences in the common genetic architecture of over 1000 neuroanatomical phenotypes in the UK Biobank and establish a general concordance between male and female participants in heritability estimates, genetic correlations, and variant-level effects. Notable exceptions include higher mean heritability in the female group for regional volume and surface area phenotypes; between-sex genetic correlations that are significantly below 1 in the insula and parietal cortex; and a common variant with stronger effect in male participants mapping to RBFOX1 - a gene linked to multiple neuropsychiatric disorders more common in men. This work suggests that common variant influences on human brain anatomy are largely consistent between males and females, with a few exceptions that will guide future research in growing datasets.

Abstract Borna disease virus 1 (BoDV-1) is the causative agent of Borna disease, a fatal neurologic disorder of domestic mammals and humans, resulting from spill-over infection from its natural reservoir host, the bicolored white-toothed shrew (Crocidura leucodon). The known BoDV-1-endemic area is remarkably restricted to parts of Germany, Austria, Switzerland and Liechtenstein. To gain comprehensive data on its occurrence, we analysed diagnostic material from suspected BoDV-1-induced encephalitis cases based on clinical and/or histopathological diagnosis. BoDV-1 infection was confirmed by RT-qPCR in 207 domestic mammals, 28 humans and seven wild shrews. Thereby, this study markedly raises the number of published laboratory-confirmed human BoDV-1 infections and provides a first comprehensive summary. Generation of 136 new BoDV-1 genome sequences from animals and humans facilitated an in-depth phylogeographic analysis, allowing for the definition of risk areas for zoonotic BoDV-1 transmission and facilitating the assessment of geographical infection sources. Consistent with the low mobility of its reservoir host, BoDV-1 sequences showed a remarkable geographic association, with individual phylogenetic clades occupying distinct areas. The closest genetic relatives of most human-derived BoDV-1 sequences were located at distances of less than 40 km, indicating that spill-over transmission from the natural reservoir usually occurs in the patient´s home region.

Background: The global population has been under threat of ongoing COVID-19 pandemics. Diet was shown to significantly impact the severity of the disease. The primary focus of this research is to explore the potential correlation between consuming nuts and the severity of COVID-19 symptoms.Methods: Totally, 684 individuals who recovered from COVID-19 were enrolled; while 168-item frequency questionnaire (FFQ), International Physical Activity Questionnaire (IPAQ), were used to assess dietary intakes of participants. The severity of COVID-19 was assessed based on the COVID-19 Treatment Guidelines (CTG). Satisfaction with Life Scale (SWLS) questionnaire was utilized to determine the level of life satisfaction. Outcomes including severity of COVID-19 symptoms, hospitalization, hypoxia, lung infection, need to respiratory support, duration of disease, recovery after hospitalization, serum levels of C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) and saturation of peripheral oxygen (SpO2) level were evaluated.Results: Among those recovered from COVID-19, there was an association between increased intake of nuts and reduction in CRP level (p=0.007), increase in life satisfaction score (p

Background: The impact of Nigella sativa on various health markers have been studied before. The present systematic review and meta-analysis reveals the effect of N. sativa on lipid profile, fasting blood sugar (FBS) and blood pressure.Methods: Relevant studies published up to April 21, 2024 were searched through the PubMed, SCOPUS and google scholar databases to collect all randomized clinical trials that evaluated the effect of N. sativa on FBS, total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with different conditions. We conducted our study according to the 2020 PRISMA guidelines. Only English language publications were included. Pooled meta-analysis was measured by a random-effect model and were reported as the weighted mean difference (WMD) and 95% confidnce interval (95%CI). Results: Fifteen articles were included in this systematic review and meta-analysis. Our pooled meta-analysis indicated a significant reduction in TG, TC, LDL, SBP, DBP and FBS after administration of N. sativa. Also, a significant increase in HDL was noticed after administration of N. sativa.Conclusion: This meta-analysis demonstrated the decreased effect of N. sativa on FBS, HDL, LDL, TG, TC, SBP and DBP. Further large random clinical trials are required to shed light on this issue.

Community Question Answering (CQA) sites, now navigating through millions of daily user visits, hinge significantly on the quality of user-generated questions to bolster user satisfaction and, consequently, website traffic – crucial for platform sustainability. While the quality of questions ostensibly sets the stage for insightful answers, thereby attracting substantial traffic, existing research has predominantly sidelined the significance of questions, favoring a focus on traditional factors, such as answer quality, to elucidate traffic determinants. In this study we quantified the interrelation between question quality and traffic by extracting 15 relevant question-quality features and corresponding traffic (i.e. pageview) data from a leading Chinese CQA platform. Utilizing Grey Relational Analysis, we assessed these attributes’ relative influence on pageviews and created a ranking list of features of questions. Based on the rankings, our findings spotlight the paramount influence of a question's digital popularity and attributes tied to the questioner – central pillars of social features – surpassing the impact of textual elements. This study further delineates the underlying reasons for such patterns based on traffic sourced from diverse channels. Our revelations offer pivotal insights for optimizing CQA platform engagement and furnish avenues for prospective research.

Abstract Background Angina pectoris can occur in up to 40% of patients following percutaneous coronary intervention (PCI). There is limited data assessing whether the type of stent implanted during revascularization can predict post-PCI angina symptoms. Methods In this study, data regarding revascularization characteristics including the stent type in patients admitted for PCI was collected. Prospective data including occurrence of angina and the presenting class, new onset ST-segment elevation myocardial infarction (STEMI), and other clinical outcomes were collected at 1, 3, and 6-month follow-up intervals. Univariable and multivariable logistic regression models were used to assess the potential predictors of angina symptoms at 6-month follow-up. Results A total of 787 patients (64.5% males) undergoing PCI with three stent types (Orsiro, Promus, and Xience) were included in the study. The occurrence of post PCI angina pectoris and new STEMI was similar among the stent types (p > 0.05). A linear association was found between the development of new STEMI (p = 0.018) and stroke (p = 0.003) and the worsening of angina class. The stent type was not a predictor of angina during the follow-up period. Other variables including dyslipidemia (odds ratio (OR) (95% CI), 1.51 (1.08; 2.10)), prior coronary artery disease (CAD) (OR (95% CI), 1.63 (1.02; 2.61)), and previous hospitalization (OR (95% CI), 2.10 (1.22; 3.63)) were independent predictors of angina. Conclusions Although the type of stent may not have an association with the post-PCI angina, other predictors such as dyslipidemia and previous CAD and hospitalization may predict recurrence of cardiac angina. The class of angina severity may have a linear association with new-onset STEMI and stroke.

Abstract Hodgkin lymphoma (HL) is a rare malignancy affecting the lymphatic system. Our study examined the incidence rates of adult HL based on sex, race/ethnicity, age, and histological subgroups in the United States (US) from 2000 to 2020. Data for this study were extracted from the Surveillance, Epidemiology, and End Results 22 database. HL patients were identified utilizing the International Classification of Diseases for Oncology version 3 and categorized as classical HL, lymphocyte-rich/mixed cell/lymphocyte depleted, nodular sclerosis, classical HL, not otherwise specified, and nodular lymphocyte-predominant HL. The study reported average annual percent change (AAPC). All estimates were presented as counts and age-standardized incidence rates (ASIRs) per 100,000 individuals. Between 2000 and 2019, a total of 70,924 cases of HL were reported in the US. Classical HL was the predominant subtype (94.27%), and most incident cases were among non-Hispanic Whites (66.92%) and those aged 20–29 years (24.86%). The ASIR per 100,000 population was 3.83 for men and 2.92 for women. Both sexes showed declines in the AAPCs between 2000 and 2019 (− 0.64% [− 0.99, − 0.28] and − 0.40% [− 0.77, − 0.03] for men and women, respectively). There was a significant decrease in ASIRs after COVID-19 among both sexes (percent change: − 7.49% [− 11.58, − 3.40]). Throughout all age groups, men had a higher incidence rate compared to women, except for those aged 20–29 years. Although the overall HL incidence rate was lowered in the study period from 2000 to 2019, a dramatic decrease in ASIRs of HL patients following COVID-19 pandemic was observed.

Abstract When studying the working memory (WM), the ‘slot model’ and the ‘resource model’ are two main theories used to describe how information retention occurs. The slot model shows that WM capacity consists of a certain number of predefined slots available for information storage. This theory explains that there is a binary condition during information recall in which information is either wholly maintained within a slot or forgotten. The resource model has a resolution-based approach, suggesting a continuous resource able to be distributed among a number of items in WM capacity. Recently hybrid models have been introduced, suggesting that WM may not strictly conform to only one model. Accordingly, to understand the relationship between two of the most widely used paradigms in WM evaluation, we implemented a correlational assessment in two different psychophysics tasks, an analog recall paradigm with sequential bar presentation and a delayed match-to-sample (DMS) task with checkerboard stimuli. Our study revealed significant correlations between WM performance in the DMS task and recall error, precision, and sources of errors in the sequential paradigm. Overall, the findings emphasize the importance of considering both tasks in understanding WM processes, as they shed light on the debate between the slot and resource models by revealing overlapping elements in both theories and the tasks used to evaluate WM capacity.

ABSTRACT Vertical axis wind turbine (VAWT) has a rotating axis perpendicular to the wind direction. This type of wind turbine that is suitable for urban environments has low wind direction dependency and noise. In this research, a novel surrogated approach for optimizing a VAWT is proposed, used, tested, and verified, which is not reported in literature. The proposed method consisted of 3D computational fluid dynamics (CFD) analysis of wind flow through the wind turbine with FLUENT software by solving the unsteady turbulent equations. However, 3D CFD analysis was time and cost consuming to obtain the output result (power coefficient) from input values (airfoil chord length, pitch angle, and tip speed ratio as turbine design variables). Thus, artificial neural network (ANN) was applied to obtain weight functions to correlate FLUENT software inputs and outputs after learning process. Finally, genetic algorithm was used for maximizing the turbine power coefficient considering three defined design variables. The optimum value of power coefficient was improved to 0.244, and the optimum values of design variables for blade chord length, blade pitch angle, and blade tip speed ratio were 0.218, −0.453, and 1.24, respectively. This novel surrogated method reduced the computational time and cost of VAWT optimizing considerably.

Introduction: For those with ST-segment myocardial infarction (STEMI), therapeutic delays are the leading cause of mortality. Contacting a health-care provider takes longer than the emergent prehospital system, the patient referral process, the emergency room, and within the hospital. In our nation’s various cities, we aimed to compare these variables. Methods: In the Iranian cities of Sanandaj and Tehran, the Rajaie Cardiovascular Medical and Research Center (RHC) and Tohid Hospital, respectively, undertook this multicenter, multiprefectural, cross-sectional study between 2016 and 2020. Baseline characteristics were gathered from medical records, including age, sex, and employment. In two centers, the first medical contact-to-door (FTD) and door-to-balloon (DTB) times as well as electrocardiographic abnormalities, adjunctive therapy, causal lesions, and FTD and DTB times were evaluated. Results: The study population consisted of 600 STEMI patients, 300 from each institutions. Most of the participants were male, approximately a third of the patients arrived at the hospital using emergency medical service, the most frequent culprit artery in both hospitals was the left anterior descending artery, the average FTD was 333 min in Tehran and 151 min in Sanandaj, with the statistical significance difference (P < 0.001), DTB was significantly lower at RHC than at Tohid Hospital (54.8 min vs. 88.3 min; P < 0.001), the maximum FTD was observed among patients older than 70-year-old (284.72 min). Conclusion: Preparing sufficient facilities for primary percutaneous coronary intervention units, increasing the number of specialists and ensuring their permanent presence in hospitals, and providing health-care personnel with improved training may play significant roles in minimizing DTB.

Background and purpose: Diabetic nephropathy leads to end-stage renal disease. The present study aimed to evaluate the prophylactic effect of pioglitazone-loaded mesoporous silica and alumina scaffold on renal function and the underlying mechanisms in streptozotocin-induced diabetic rats. Experimental approach: The mesoporous nanoparticles were synthesized by chemical methods from tetraethylorthosilicate and aluminum isopropoxide and characterized by Fourier transform infrared spectroscopy, X-ray diffraction, and scanning electron microscopy. The soaking method was applied to load pioglitazone into the mesoporous silica and alumina. Subsequently, the most capable formulation was evaluated for lipid profile, blood glucose, renal function biomarkers, malondialdehyde, and kidney histopathological changes in diabetic rats. Findings/Results: Pioglitazone loaded in the mesoporous included a superior release of about 80%. No interaction was observed in Fourier transform infrared spectroscopy and X-ray diffraction was shown crystalline. Scanning electron microscopy showed the size of the nanometer in the range of 100 - 300 nm. Mesoporous silica containing the drug significantly decreased urinary parameters, triglycerides, low-density lipoprotein, blood urea nitrogen, blood glucose, malondialdehyde, and creatinine. In addition, it showed increased high-density lipoprotein, significantly. The renal histopathological changes indicated improvement compared with the untreated diabetic group. Conclusion and implications: It was concluded that the mesoporous was potent to serve as a promising drug carrier and a platform aimed at the delivery of poorly water-soluble drugs for improving oral bioavailability. Furthermore, it has the potential to provide a beneficial effect on the changes in diabetic parameters.

Abstract There are two main families of G protein-coupled receptors that detect odours in humans, the odorant receptors (ORs) and the trace amine-associated receptors (TAARs). Their amino acid sequences are distinct, with the TAARs being most similar to the aminergic receptors such as those activated by adrenaline, serotonin, dopamine and histamine. To elucidate the structural determinants of ligand recognition by TAARs, we have determined the cryo-EM structure of a murine receptor, mTAAR7f, coupled to the heterotrimeric G protein Gs and bound to the odorant N,N-dimethylcyclohexylamine (DMCHA) to an overall resolution of 2.9 Å. DMCHA is bound in a hydrophobic orthosteric binding site primarily through van der Waals interactions and a strong charge-charge interaction between the tertiary amine of the ligand and an aspartic acid residue. This site is distinct and non-overlapping with the binding site for the odorant propionate in the odorant receptor OR51E2. The structure, in combination with mutagenesis data and molecular dynamics simulations suggests that the activation of the receptor follows a similar pathway to that of the β-adrenoceptors, with the significant difference that DMCHA interacts directly with one of the main activation microswitch residues, Trp6.48.

Abstract Background The distinction between normal and high blood pressure remains a debated topic, with varying guidelines on when to start medication. Contemporary guidelines advocate for the initiation of antihypertensive therapy in individuals who present with high-normal blood pressure, particularly those exhibiting elevated 10-year atherosclerotic cardiovascular disease (ASCVD) risk scores. Despite these recommendations, there is a notable lack of direct evidence supporting the efficacy of treating high-normal blood pressure to prevent major adverse cardiovascular events (MACE). Methods The PRINT-TAHA9 trial, a unicentric, randomized, open-label, controlled, parallel clinical study, seeks to explore the effects of intensive blood pressure control on MACE in participants with high-normal blood pressure. We will enroll 1620 adults aged 18 years and above with a systolic blood pressure range of 130–140 mmHg, diastolic blood pressure under 90 mmHg, and atherosclerotic cardiovascular disease (ASCVD) risk score exceeding 7.5%. The study will be executed in five distinct phases, with each phase enrolling between 300 and 400 participants. Participants will be randomly assigned to either the treatment group receiving antihypertensive medication (amlodipine/valsartan) and a low-salt/low-fat diet or to the control group receiving a similar diet. Follow-up visits are scheduled every 6 months over a 3-year period to monitor blood pressure, evaluate medication adherence, document any adverse events, and adjust the intervention as necessary. Cox proportional hazards regression analysis will be employed to examine the disparities between the two arms. Discussion Despite guidelines promoting early treatment of elevated blood pressure, the debate continues due to insufficient evidence that such interventions significantly reduce the occurrence of MACE. This trial seeks to address this critical evidence gap. Trial registration The PRINT-TAHA9 trial was registered in October 2019 with the Iranian Registry of Clinical Trials (IRCT.ir) under the registration number IRCT20191002044961N1. https://irct.behdasht.gov.ir/trial/43092 .