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Schimmelpenning syndrome, or epidermal nevus syndrome, is a rare, neurocutaneous disorder characterized by skin abnormalities, such as epidermal nevi, and involvement of the central nervous system, including intracranial tumors. There are only a few reported cases of intracranial tumors associated with Schimmelpenning syndrome. In most cases, a single nucleotide mutation in the RAS family proto-oncogenes, like HRAS or KRAS genes, can result in the genetic mosaicism that is responsible for the clinical manifestations of this syndrome. The authors present a case report of a woman with Schimmelpenning syndrome who sought medical help with complaints of progressive headache and dizziness. The radiological and histopathological findings indicated an astrocytoma, IDH-mutant (WHO grade 3). The molecular analysis revealed pathogenic changes in the oncogenic HRAS gene with a prevalence of 31%. The patient underwent surgical treatment and had no neurological sequelae. By presenting such a clinical case, attention is paid to the interrelationship between genetic syndromes and intracranial tumors.

Society needs long-term sustainability and healthy building projects, and indoor air quality assurance engineering systems play a pivotal role in the energy performance of buildings. Therefore, when designing heating, ventilation, and air conditioning systems, it is crucial to make the most technically sound decisions in terms of energy consumption and assess their impact on the building’s energy performance. This article delves into the design of ventilation and air conditioning systems, presenting a method for evaluating their performance. The foundation of project development is an agreement on the design criteria, which are developed based on a preliminary analysis of the building concept. This agreement ensures cohesive collaboration among all stakeholders: the client, the architect, the system designer, the contractor, and ultimately the personnel responsible for commissioning, operating, and maintaining the systems post-construction. We suggest conducting a comprehensive analysis of the processes occurring within the space without initially linking them to room air exchange. From this analysis, we derive the angular coefficient for the direction of the air condition change on both a psychrometric chart and a Mollier diagram. The process line on the psychrometric chart provides insights into how the performance factor of the air distribution system will influence the desired supply air parameters. We can then evaluate how significantly the gap between the supply air and the exhaust air parameters expands if the room’s air exchange volume is reduced for budgetary reasons. The article showcases this design methodology using a simplified case study.

Background and Objectives: In recent years, electronic scooters (e-scooters) have gained popularity, whether for private use or as a publicly available transportation method. With the introduction of these vehicles, reports of e-scooter-related accidents have surged, sparking public debate and concern. The aim of this study was to analyze the epidemiological data, characteristics, and severity of traumatic brain injury (TBI) related to e-scooter accidents. Materials and Methods: This retrospective case series evaluated patients who were admitted to the three largest neurosurgery clinics in Riga, Latvia, from the time period of April to October in two separate years—2022 and 2023—after e-scooter-related accidents. The data were collected on patient demographics, the time of the accident, alcohol consumption, helmet use, the type of TBI, other related injuries, and the treatment and assessment at discharge. Results: A total of 28 patients were admitted with TBI related to e-scooter use, with a median age of 30 years (Q1–Q3, 20.25–37.25), four individuals under the age of 18, and the majority (64%) being male. In 23 cases, the injury mechanism was falling, in 5 cases, collision. None were wearing a helmet at the time of the injury. Alcohol intoxication was evident in over half of the patients (51.5%), with severe intoxication (>1.2 g/L) in 75% of cases among them. Neurological symptoms upon admission were noted in 50% of cases. All patients had intracranial trauma: 50% had brain contusions, 43% traumatic subdural hematoma, and almost 30% epidural hematoma. Craniofacial fractures were evident in 71% of cases, and there were fractures in other parts of body in three patients. Six patients required emergency neurosurgical intervention. Neurological complications were noted in two patients; one patient died. Conclusions: e-scooter-related accidents result in a significant number of brain and other associated injuries, with notable frequency linked to alcohol influence and a lack of helmet use. Prevention campaigns to raise the awareness of potential risks and the implementation of more strict regulations should be conducted.

Schimmelpenning syndrome, or epidermal nevus syndrome, is a rare, neurocutaneous disorder characterized by skin abnormalities, such as epidermal nevi, and involvement of the central nervous system, including intracranial tumors. There are only a few reported cases of intracranial tumors associated with Schimmelpenning syndrome. In most cases, a single nucleotide mutation in the RAS family proto-oncogenes, like HRAS or KRAS genes, can result in the genetic mosaicism that is responsible for the clinical manifestations of this syndrome. The authors present a case report of a woman with Schimmelpenning syndrome who sought medical help with complaints of progressive headache and dizziness. The radiological and histopathological findings indicated an astrocytoma, IDH-mutant (WHO grade 3). The molecular analysis revealed pathogenic changes in the oncogenic HRAS gene with a prevalence of 31%. The patient underwent surgical treatment and had no neurological sequelae. By presenting such a clinical case, attention is paid to the interrelationship between genetic syndromes and intracranial tumors. [ABSTRACT FROM AUTHOR]

Nowadays national and international directives have focused on improving energy efficiency in the building sector. According to them, energy consumption and emissions of buildings must be reduced. This can be achieved by balancing energy demand in buildings. In this context, this paper proposes a buildings’ energy demand balancing method using the building energy consumption simulation program IDA ICE and real measurements. A 3D model of the building was developed, energy consumption and indoor climate of the building was monitored throughout the year, the behaviour of the occupants (a survey was conducted) was analysed, dynamic change of the weather was studied and all data were integrated into IDA ICE simulation. In order to increase the energy efficiency of buildings, the possibilities of optimization of heat production equipment and heating devices, as well as inspecting and optimization of ventilation and cooling equipment were considered. By adjusting the parameters of the heating system of the researched object, the energy consumption of the auto centre decreased to 39.3 kWh/m2 per year. One of the most popular methods of balancing energy demand in recent years – the creation of smart grids – is also considered.

Small and medium-sized enterprises (SMEs) represent in Europe up to 99% of all businesses and provide two-thirds of the total employment in private sector. However, business literature as well as training programs often tend to use large companies and corporations as best practice examples for setting up management practices. This research review existing literature on governance and management system development in context of small and medium enterprises and compare findings with three small-medium-sized companies from different European countries. Companies analyzed demonstrate different ways of setting up management system and processes to achieve positive financial and market results. This leads to conclusion that it is essential to achieve fit of management system elements to business circumstances, rather implementing selected good practices. For small and medium enterprises, this is even more important, as they are characterized by limited resources and competences. This paper enlighten challenges SMEs are facing and some possible solutions that will contribute to improving their management and sustainability.

Background and Objectives: We aimed to determine the link between brain volumetry results and functional disability calculated using the Expanded Disability Status Scale (EDSS) among multiple sclerosis (MS) patients in relation to the provided treatment (disease-modifying therapies (DMTs)) during a 5-year follow-up period. Materials and Methods: A retrospective cohort study was performed enrolling 66 consecutive patients with a confirmed diagnosis of MS, predominantly females (62% (n = 41)). Relapsing–remitting (RR) MS was noted in 92% (n = 61) of patients, with the rest being patients with secondary progressive (SP) MS. The mean age was 43.3 years (SD 8.3 years). All patients were evaluated clinically using the EDSS and “FreeSurfer© 7.2.0” radiologically during a 5-year follow-up. Results: A significant increase in patient functional disability was noted, calculated using the EDSS during a 5-year follow-up. The baseline EDSS ranged between 1 and 6 with a median of 1.5 (IQR 1.5–2.0), and after 5 years, the EDSS was between 1 and 7, with a median EDSS of 3.0 (IQR 2.4–3.6). Compared with RRMS patients, SPMS patients demonstrated a significant increase in EDSS score during a 5-year period, with a median EDSS of 2.5 in RRMS patients (IQR 2.0–3.3) and 7.0 (IQR 5.0–7.0) among SPMS patients. Significantly lower brain volumetry results in different brain areas were found, including cortical, total grey and white matter, p < 0.05. Statistically significant differences were observed between baseline volumetry results of the hippocampus and the middle anterior part of the corpus callosum and their volumetry results after 5 years, p < 0.001. In this study population, the thalamus did not demonstrate significant changes in volumetry results during follow-up, p > 0.05. The provided treatment (DMTs) did not demonstrate a significant impact on the brain MRI volumetry results during a 5-year follow-up, p > 0.05. Conclusions: Brain MRI volumetry seriously impacts the early detection of brain atrophic changes. In this study, significant relationship between brain magnetic resonance volumetry results and disability progression among MS patients with no important impact of the provided treatment was described. Brain MRI volumetry may aid in the identification of early disease progression among MS patients, as well as enrich the clinical evaluation of MS patients in clinical patient care.

ABSTRACT: A large proportion of small and medium-sized enterprises are managed by their owners and founders. The goal of this research was to describe the diversity of management practices in owner-managed SMEs. Understanding this diversity will raise awareness of the challenges SMEs are facing and suggest possible solutions that will help improve their management and sustainability. In this study, 205 owner-managed SMEs with more than nine people employed were analyzed using a company self-assessment based on a tailor-made governance model. Data were analyzed using statistical analysis software in combination with a visual analysis. To group similar companies, the cluster analysis technique was used. The results showed a high diversity in how companies were managed and their performances. This research indicated that statistical analysis itself is not sufficient for exploring this diversity, and other approaches, such as visual analysis, must be used as well.

Background and Objectives: Carotid revascularization is one of the most effective treatment options in patients with severe carotid artery stenosis causing hypoperfusion in basal ganglia. Atypical manifestations include hyperkinetic movements, noted as extremely rare. We report a case about a patient with 2-months-long complaints of Uncontrollable movements in his right side of the body subsided after carotid revascularization. Case presentation: A 71-year-old male was admitted to Pauls Stradins Clinical University Hospital with the main complaints of 2-months-long uncontrollable movements in his right hand and his right leg. When performing coordination tasks, slight inaccuracy was noted with the right-side extremities. Hyperkinetic movements—choreoathetosis in the right side of the patient’s face, arm, and leg—were seen. Computed tomography angiography revealed subocclusion in the proximal segment of the left internal carotid artery and 30% stenosis in the proximal segment of the right internal carotid artery. The patient was consulted by a vascular surgeon. Eversion endarterectomy of the left internal carotid artery was performed. The early postoperative period occurred without complications. The patient was discharged from the hospital 2 days after the surgery in good overall health condition. Two months later, choreoathetotic movements in his right side of the body had markedly decreased. No focal neurologic deficits were noted. Conclusions: Revascularization may be effective by eliminating emboli and stenosis, leading to hypoperfusion in watershed territories. A case of a 71-year-old male patient with the main complaints of 2-months-long uncontrollable movements in his right side of the body subsiding after carotid revascularization was demonstrated. It is vital to recognize atypical manifestations of hypoperfusion, associated with stenosis in internal carotid arteries, to early make a diagnosis, to perform an appropriate treatment, and to reduce the risk of cerebral infarction in the future, resulting in a longer high-quality life for the patient.

This study presents a novel approach to produce phosphorescent coatings on metal surfaces.Strontium aluminates are the most popular modern phosphorescent materials exhibiting long afterglow at room temperature and a broad spectral distribution of luminescence in the visible range. However, despite a large amount of research done, methods for synthesis of such materials remain relatively energy inefficient and environmentally unfriendly.A long-afterglow luminescent coating containing SrAl2O4:Eu2+, Dy3+ is prepared by the plasma electrolytic oxidation on the surface of commercial aluminum alloy Al6082. During the electrical discharges in this process, the strontium aluminate is formed in a similar way to the solid-state reaction method. X-ray powder diffraction analysis confirms that the monoclinic SrAl2O4 phase is present in the coating.Optical properties of the obtained coating were analyzed with luminescence methods classically used for studies of luminophores. The performance of the coating was compared with commercially available strontium aluminate powder.The proposed method of coating synthesis may be of value for the development of energy-efficient and long-lasting automotive and public safety infrastructure. Keywords: Phosphorescent coating, Strontium aluminate, Long afterglow, Persistent luminophore, Electrolytic oxidation

Prejudice against LGBTQ people during their schooling years can be detrimental due to its long-term consequences. This includes the development of beliefs that the world is unsafe, which can perpetuate mental health struggles later in life. Fostering a school environment where LGBTQ people can express their identity can contribute to greater well-being. This qualitative study drew on interviews with 13 school graduates to examine the environmental factors within Australian schools that influenced LGBTQ students’ expression of their identity. Drawing on Altman’s conceptualization of oppression and liberation, this study found students typically experienced liberation in the form of acceptance and validation within their micro-environment at school. This micro-environment was composed of those close to the student, such as friends, allies, teachers, and other LGBTQ students who provided acceptance and validation, which enabled the student to express their identity regardless of oppression within the broader school environment. Oppression on the other hand originated from the invisibility of LGBTQ identities; the limited representation in curriculum and access to LGBTQ-specific resources and supports; concerns around gendered, gender-neutral, and safe spaces; and limited support from teachers. Based on the findings, implications are drawn to enhance both the micro and macro environment for LGBTQ school students. [ABSTRACT FROM AUTHOR]

The focus of this research paper is to develop a verified simulation model for a cooling panel with integrated phase-change materials (PCMs)—a stainless steel panel filled with PCM and integrated hydronic piping circuit. This solution is targeted for passive cooling of residential buildings in Baltic Sea region that experience overheating for most of the year due to highly insulated building envelopes and extensive glazing—a phenomena for nearly zero energy buildings (NZEBs). This approach aims to maintain comfortable indoor temperature all year round by passive means—free-cooling, adiabatic (evaporative) cooling or limited mechanical cooling. The simulations are performed with IDA ICE 4.8 and the measurements for simulation model verification are collected from a test chamber. The results show that reasonable agreement can be reached for simulated and experimentally measured data.

Background and objectives. Fatigue is one of the most common symptoms of multiple sclerosis (MS). The aim of this study was to determine the presence of fatigue in MS patients in Latvia and its relation to life style factors, neurological disability and depression. Material and methods. This cross-sectional study included 117 participants (44 patients with MS and 73 healthy control group). Applied research instruments were: Expanded Disability Status Scale (EDSS), Patient Health Questionnaire (PHQ-9), Fatigue Severity Scale (FSS), and the general questionnaire for the collection of socio-demographic, life style habits and clinical data constructed for the purposes of this study. Results. Mean FSS score was 3.9±1.9 in MS group. 26 (59.1%) patients had FSS score of 3.8 or more and were classified as a fatigue group (MSF) while 18 (40.9%) patients had FSS of 3.7 or less and were classified as a non-fatigue (MSNF) group. There was statistically significant difference between MSF and MSNF groups considering PHQ-9 score (p=0.019), FSS score (p