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We present the model we developed to reconstruct the CUORE radioactive background based on the analysis of an experimental exposure of 1038.4 kg yr. The data reconstruction relies on a simultaneous Bayesian fit applied to energy spectra over a broad energy range. The high granularity of the CUORE detector, together with the large exposure and extended stable operations, allow for an in-depth exploration of both spatial and time dependence of backgrounds. We achieve high sensitivity to both bulk and surface activities of the materials of the setup, detecting levels as low as 10 nBq kg-1 and 0.1 nBq cm-2, respectively. We compare the contamination levels we extract from the background model with prior radio-assay data, which informs future background risk mitigation strategies. The results of this background model play a crucial role in constructing the background budget for the CUPID experiment as it will exploit the same CUORE infrastructure.

Abstract Four distinct neural models were used to evaluate the efficiency of a V-trough solar water heater (VTSWH) equipped with square-cut twisted tape (SCTT) and V-cut twisted tape (VCTT) at two different twist ratios, 3 and 5. The objective of this study was the use of ANFIS (Adaptive Neuro-Fuzzy Inference System), G.L.R. (Generalised linear regression), R.T. (Regression tree), and SVM (Support Vector Machine). A total of 162 data sets were acquired for these models through a variety of trials. Outdoor experiments were done using a twist ratio of Y = 3 and Y = 5, using both SCTT and VCTT. The models included eight distinct variables: ambient temperature, water mass flow rate, water intake temperature, water exit temperature, absorber plate temperature, tube temperature, solar intensity, and twist ratio. The dependent variables in this study are the Nusselt number (Nu), friction factor (FF), and efficiency (η). 130 datasets were chosen for training purposes, while 32 were used for testing. Using the ANFIS, G.L.R., R.T., and SVM techniques, the correlation coefficient (R2) values for Nusselt number were 0.9990, 0.9961, 0.9562, and 0.9280 for friction factor 0.9966, 0.9683, 0.9810, and 0.9560, and for efficiency 0.9997, 0.9976, 0.9845, and 0.9614, respectively. Comparing all models shows that ANFIS is the most effective of the four strategies studied. The ANFIS model outperformed the other models regarding Nu, FF, and η, with RMSE values of 0.0805, 0.0.0004, and 0.4534. According to the above data, the VTSWH thermal performance predicted using the ANFIS approach has the highest accuracy.

Introduction: Singapore has implemented an evidence-based smoking cessation framework to support smokers in quitting. Our study investigated the prevalence and correlates of (1) quit attempts (QA) and quit intentions (QI) among current smokers, and (2) smoking cessation (SC) among ever-smokers in Singapore. Method: Data was collected from a nationwide survey conducted between 2020 and 2022. QA was defined as attempting to stop smoking at least once in the past 12 months, while QI was defined as planning to quit smoking in the next 30 days or the next 6 months. SC referred to individuals who quit smoking over 6 months ago. Sociodemographic factors, doctor’s advice to quit and perceived harm from smoking were assessed using logistic regression among current smokers (n=1024) and ever-smokers (n=1457). Results: Among current smokers, 31.3% and 41.2% reported QI and QA, respectively. Smokers with secondary or pre-tertiary education were less likely to report QI compared to those with a degree or higher. Doctor’s advice to quit was associated with a higher likelihood of QA. Among ever-smokers, 25.3% reported SC, and this was more likely when they perceived smoking one or more packs of cigarettes daily as posing a moderate or high health risk. Conclusion: Educational campaigns should focus on simplifying messages for individuals with lower literacy levels. Smoking cessation training can be integrated into medical education, and graphic health warnings on cigarette packs can help effectively communicate the dangers of smoking.

Introduction: Informed Consent (IC) is a decision-making process wherein patients are provided with all necessary information regarding treatment to make an uncoerced, educated choice. There are gaps in the implementation of the IC process that need to be identified and addressed. Aim: To estimate the proportion of patients/surrogates who read, understood, and signed the IC form before undergoing surgical procedures; to identify the different healthcare team members involved in explaining the IC form; to evaluate the extent to which different components of the IC form were explained to patients/surrogates; and to determine the influence of the IC form on surgical decision-making, and the overall satisfaction with the IC process. Materials and Methods: This cross-sectional study was conducted at a tertiary care hospital in the Dakshina Kannada District of Southern India from April 2020 to March 2021. It included 100 adult patients admitted to the postsurgical wards of general surgery, orthopaedics, obstetrics and gynaecology, otorhinolaryngology, and ophthalmology. Ethical clearance was obtained from the Institutional Ethics Committee. The parameters studied included socio-demographic variables, administration of the IC form, details on the person explaining the IC form along with its content, and the influence of the IC form on decision-making, as well as overall satisfaction with the IC process. Data were collected using a predesigned questionnaire and analysed using descriptive statistics in Statistical Package for the Social Sciences (SPSS) version 27.0. Categorical variables were presented as frequencies and proportions, whereas continuous variables were presented as means and standard deviations. Results: All participants received the IC form; however, only 21% read, understood, and signed it. The explanation of the IC form was given to 59% of the patients, with only 15% of these explanations provided by the treating surgeon. The components of the IC form, such as the surgical procedure and its benefits, were explained to the majority of the patients; however, the risks of the surgical procedure and alternative options were explained to only 53% and 7% of patients, respectively. The IC form had a minor influence on surgical decision-making for 61% of patients, and 43% expressed satisfaction with the IC process. Conclusion: The study revealed that the implementation of IC was inadequate. Surgeons should provide and explain the IC form well in advance, allowing time for patients to read, understand, and clarify their doubts. Hospital Ethics Committees need to enforce strict adherence to IC guidelines to ensure informed decision-making.

Héctor M Ramos-Zaldívar,1 Iva Polakovicova2,3 ,† Edison Salas-Huenuleo,4 Claudia P Yefi,5 David Silva-Ancahuail,2,6 Pedro Jara-Guajardo,2,6 Juan Esteban Oyarzún,7,8 Álvaro Neira-Troncoso,3,9 Patricia V Burgos,9 Viviana A Cavieres,9 Eloísa Arias-Muñoz,9 Carlos Martínez,10 Ana L Riveros,2,6 Alejandro H Corvalán,2,3 Marcelo J Kogan,2,6 Marcelo E Andia7,8 1Doctoral Program in Medical Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; 2Advanced Center for Chronic Diseases (ACCDiS), Santiago, Chile; 3Department of Hematology and Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; 4Advanced Integrated Technologies SpA, (AINTECH), Santiago, Chile; 5Escuela de Medicina Veterinaria, Facultad de Ciencias de la Naturaleza, Universidad San Sebastián, Santiago, Chile; 6Departamento de Química Farmacológica y Toxicológica, Facultad de Ciencias Químicas y Farmacéuticas, Laboratorio de Nanobiotecnología, Universidad de Chile, Santiago, Chile; 7Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile; 8Biomedical Imaging Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; 9Centro de Biología Celular y Biomedicina (CEBICEM), Facultad de Medicina y Ciencia, Universidad San Sebastián, Santiago, Chile; 10Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile†Iva Polakovicova passed away on October 12, 2020Correspondence: Héctor M Ramos-Zaldívar, Email hmramos@uc.clIntroduction: The meningeal lymphatic vessels have been described as a pathway that transports cerebrospinal fluid and interstitial fluid in a unidirectional manner towards the deep cervical lymph nodes. However, these vessels exhibit anatomical and molecular characteristics typical of initial lymphatic vessels, with the absence of surrounding smooth muscle and few or absent valves. Given its structure, this network could theoretically allow for bidirectional motion. Nevertheless, it has not been assessed as a potential route for nanoparticles to travel from peripheral tissues to the brain.Methods: We employed superparamagnetic iron oxide nanoparticles (SPIONs), exosomes loaded with SPIONs, gold nanorods, and Chinese ink nanoparticles. SPIONs were prepared via chemical coprecipitation, while exosomes were isolated from the B16F10 melanoma cell line through the Exo-Spin column protocol and loaded with SPIONs through electroporation. Gold nanorods were functionalized with polyethylene glycol. We utilized C57BL/6 mice for post-mortem and in vivo procedures. To evaluate the retrograde directional flow, we injected each nanoparticle solution in the deep cervical lymph node. The head and neck were fixed for magnetic resonance imaging and histological analysis.Results: Here we show that extracellular vesicles derived from the B16F10 melanoma cell line, along with superparamagnetic iron oxide nanoparticles, gold nanorods, and Chinese ink nanoparticles can reach the meningeal lymphatic vessels and the brain of C57BL/6 mice after administration within the deep cervical lymph nodes post-mortem and in vivo, exclusively through lymphatic structures.Discussion: The functional anatomy of dural lymphatics has been found to be conserved between mice and humans, suggesting that our findings may have significant implications for advancing targeted drug delivery systems using nanoparticles. Understanding the retrograde transport of nanoparticles through the meningeal lymphatic network could lead to novel therapeutic approaches in nanomedicine, offering new insights into fluid dynamics in both physiological and neuropathological contexts. Further research into this pathway may unlock new strategies for treating neurological diseases or enhancing drug delivery to the brain.Keywords: extracellular vesicles, SPIONs, gold nanorods, Chinese ink, meningeal lymphatic vessels, nanomedicine

Introduction: In neonatal intensive care units, neonatal thrombocytopenia is one of the common hematological abnormality seen. Neonatal autoimmune thrombocytopenia should be considered in any neonate who is born to a known case of immune thrombocytopenia purpura (ITP) mother, with early onset thrombocytopenia without any signs of sepsis. Neonatal ITP is a condition of autoantibody mediated platelet destruction. Case details: Two neonates with thrombocytopenia, born to mothers with ITP are described in this report. Lowest platelet count noted was 7000 cells/cmm in one of the neonate. Both neonates received intra venous immunoglobulin (IVIG) while one neonate had persistent and severe thrombocytopenia requiring multiple random donor platelet (RDP) transfusions followed by oral steroid as well. Conclusion: Neonatal thrombocytopenia associated with maternal ITP need close monitoring, early sampling and diagnosis to prevent any possible complications and warrant early initiation of treatment.

Thrombosis of cerebral venous sinuses is a rare condition but can be associated with serious clinical consequences. Pathogenesis of thrombosis of cerebral venous sinus is still not clear. As there is diverse etiology but presentation is subtle, it often leads to delay in the diagnosis. We are reporting the case of a term male neonate born by LSCS (indication obstructed labour with meconium stained amniotic fluid) with diagnosis of severe birth asphyxia, Hypoxic Ischemic Encephalopathy- stage II, probable sepsis, shock and Germinal Matrix Haemorrhage. The magnetic resonance imaging (MRI) of brain and magnetic resonance (MR) venogram done at 2 weeks of age showed superior saggital sinus thrombosis. Baby received anticoagulation therapy and extensive workup was done. Early neuroimaging in all the babies who has neonatal seizures will improve the identification and will warrant early treatment.

The Search for Extraterrestrial Intelligence aims to find evidence of technosignatures, which can point toward the possible existence of technologically advanced extraterrestrial life. Radio signals similar to those engineered on Earth may be transmitted by other civilizations, motivating technosignature searches across the entire radio spectrum. In this endeavor, the low-frequency radio band has remained largely unexplored; with prior radio searches primarily above 1 GHz. In this survey at 110-190 MHz, observations of 1,631,198 targets from TESS and Gaia are reported. Observations took place simultaneously with two international stations (noninterferometric) of the Low Frequency Array in Ireland and Sweden. We can reject the presence of any Doppler drifting narrowband transmissions in the barycentric frame of reference, with equivalent isotropic radiated power of 1017 W, for 0.4 million (or 1.3 million) stellar systems at 110 (or 190) MHz. This work demonstrates the effectiveness of using multisite simultaneous observations for rejecting anthropogenic signals in the search for technosignatures.

Coronary artery calcification (CAC), a measure of subclinical atherosclerosis, predicts future symptomatic coronary artery disease (CAD). Identifying genetic risk factors for CAC may point to new therapeutic avenues for prevention. Currently, there are only four known risk loci for CAC identified from genome-wide association studies (GWAS) in the general population. Here we conducted the largest multi-ancestry GWAS meta-analysis of CAC to date, which comprised 26,909 individuals of European ancestry and 8,867 individuals of African ancestry. We identified 11 independent risk loci, of which eight were new for CAC and five had not been reported for CAD. These new CAC loci are related to bone mineralization, phosphate catabolism and hormone metabolic pathways. Several new loci harbor candidate causal genes supported by multiple lines of functional evidence and are regulators of smooth muscle cell-mediated calcification ex vivo and in vitro. Together, these findings help refine the genetic architecture of CAC and extend our understanding of the biological and potential druggable pathways underlying CAC.

Purpose: To compare the visual outcomes and efficacy of opposite clear corneal incision (OCCI) and toric intraocular lens (IOL) implantation in correcting preexisting astigmatism (PEA) in patients undergoing phacoemulsification. Methods: This prospective interventional comparative study was conducted between June 2022 and January 2023 in patients having cataract with PEA undergoing phacoemulsification. Patients were divided into two groups – group A underwent phacoemulsification with OCCI and group B underwent phacoemulsification with toric IOL implantation. Uncorrected distance visual acuity (UDVA), manifest refractive cylinder, and corneal astigmatism using corneal tomography were measured preoperatively and at 6 weeks postoperatively. The eyes were categorized into three groups with PEA ranging from 1 to 1.5 D, 1.6 to 2 D, and 2.1 to 3 D. Depending upon the white-to-white corneal diameter, the eyes were also categorized into four groups with corneal diameter ranging from 10.5 to 10.9 mm, 11 to 11.4 mm, 11.5 to 11.9 mm, and 12 to 12.4 mm. Results: Sixty eyes of 60 patients were studied. At postoperative 6 weeks, 83.3% (25 eyes) in the OCCI group and 96.7% (29 eyes) in the toric IOL group achieved UDVA of 6/9 or better. No statistically significant difference was noted between the groups (P = 0.37). The reduction in mean corneal astigmatism was 0.63 ± 0.37 D in the OCCI group and 0.15 ± 0.12 D in the toric IOL group (P < 0.001). The residual mean refractive cylinder was 0.60 ± 0.38 D in the OCCI group and 0.05 ± 0.15 D in the toric IOL group at 6 weeks (P = 0.007). Conclusion: Both OCCI and toric IOL are effective in correcting PEA. However, in a resource-limited setting, OCCI is a better alternative surgical option for correcting astigmatism of 1–1.5 D during phacoemulsification without requiring additional skills or instruments.

Introduction: Depression among medical students is an overlooked public health issue in India. Addressing this problem is crucial to prevent its negative impact on educational performance and career development through early detection and appropriate interventions. This study aimed to assess the prevalence of depression and its associated factors among medical students. Materials and methods: 305 medical students selected randomly were assessed for depression using the Beck Depression Inventory. The relationships between depression and various factors, including academic year, social influences such as addictive habits, family issues, a history of depression, and living away from home were assessed. Results: 137 (44.91%) students were found to have some degree of depression according to Becks Inventory Scale. Majority (81.02%) of them were found to have mild to moderate depression while the prevalence of severe and very severe depression was 6.10% and 2.25% respectively. The difference between the grade of depression and year of studying was found to be statistically significant. Factors such as being coerced into the MBBS program instead of choosing it, academic performance during the course, and a history of previous depression had a significant impact on the likelihood of developing depression. Conclusion: Depression is notably common among medical students in this region. Our results highlight the need for widespread screening and psychiatric counseling for this vulnerable group.

Background: Complex renal calculi, characterized by their size, location, and composition, pose a significant challenge to urologists due to the potential for complications and the difficulty in achieving complete stone clearance. Conventional percutaneous nephrolithotomy (PCNL) and endoscopic combined intrarenal surgery (ECIRS) are two established techniques for managing these complex renal calculi. Aims and Objectives: The aims and objectives are to compare the effectiveness, safety, and outcomes of PCNL versus ECIRS in managing complex renal calculi in a cohort of 60 cases treated at GMKMCH-Salem. Materials and Methods: A retrospective analysis was conducted on 60 patients with complex renal calculi who underwent either conventional PCNL or ECIRS during a specified period at GMKMCH-Salem. Patient demographics, stone characteristics, procedural details, intraoperative and post-operative parameters, and complications were analyzed and compared between the two treatment groups. Results: The study found that both PCNL and ECIRS techniques were effective in treating complex renal calculi. However, significant differences were observed between the two groups in terms of outcomes. The ECIRS technique exhibited superior outcomes with higher stone clearance rates (P

Background: The treatment of lower calyceal calculi with a size

Summary: A cross-sectional survey, using standard e iieiniological methods, was carried out in Yenagoa Local Government Area of Rivers State with the aim of quantifying risk factors for neonatal tetanus (NNT). Twenty-eight of 1,867 children from the 1464 households that were surveyed, sat isfied the WHO criteria for the diagnosis of NNT; there was thus an incidence of 15 cases of NNT per 1000 live births. Non-attendance for antenatal care and delivery outside health-care establishments had overriding effects on other risk factors. The other important risk factor was the formal educational level of the mothers. It is suggested that improvement in the educational level of mothers, promotion of health-seeking behaviours and healthy practices among parents and health work ers are specific ways of reducing the prevalence of NNT.

Equations in Sections 2.3 and 2.4 of the article by Afonine et al. [Acta Cryst. (2013). D69, 625-634] are corrected.

CUPID is a next-generation bolometric experiment aiming at searching for neutrinoless double-beta decay with ∼250 kg of isotopic mass of 100Mo. It will operate at ∼10 mK in a cryostat currently hosting a similar-scale bolometric array for the CUORE experiment at the Gran Sasso National Laboratory (Italy). CUPID will be based on large-volume scintillating bolometers consisting of 100Mo-enriched Li2MoO4 crystals, facing thin Ge-wafer-based bolometric light detectors. In the CUPID design, the detector structure is novel and needs to be validated. In particular, the CUORE cryostat presents a high level of mechanical vibrations due to the use of pulse tubes and the effect of vibrations on the detector performance must be investigated. In this paper we report the first test of the CUPID-design bolometric light detectors with NTD-Ge sensors in a dilution refrigerator equipped with a pulse tube in an above-ground lab. Light detectors are characterized in terms of sensitivity, energy resolution, pulse time constants, and noise power spectrum. Despite the challenging noisy environment due to pulse-tube-induced vibrations, we demonstrate that all the four tested light detectors comply with the CUPID goal in terms of intrinsic energy resolution of 100 eV RMS baseline noise. Indeed, we have measured 70-90 eV RMS for the four devices, which show an excellent reproducibility. We have also obtained high energy resolutions at the 356 keV line from a 133Ba source, as good as Ge semiconductor γ detectors in this energy range.

An array of twelve 0.28 kg lithium molybdate (LMO) low-temperature bolometers equipped with 16 bolometric Ge light detectors, aiming at optimization of detector structure for CROSS and CUPID double-beta decay experiments, was constructed and tested in a low-background pulse-tube-based cryostat at the Canfranc underground laboratory in Spain. Performance of the scintillating bolometers was studied depending on the size of phonon NTD-Ge sensors glued to both LMO and Ge absorbers, shape of the Ge light detectors (circular vs. square, from two suppliers), in different light collection conditions (with and without reflector, with aluminum coated LMO crystal surface). The scintillating bolometer array was operated over 8 months in the low-background conditions that allowed to probe a very low, μBq/kg, level of the LMO crystals radioactive contamination by 228Th and 226Ra.

CUPID is a next-generation tonne-scale bolometric neutrinoless double beta decay experiment that will probe the Majorana nature of neutrinos and discover lepton number violation in case of observation of this singular process. CUPID will be built on experience, expertise and lessons learned in CUORE and will be installed in the current CUORE infra-structure in the Gran Sasso underground laboratory. The CUPID detector technology, successfully tested in the CUPID-Mo experiment, is based on scintillating bolometers of Li2MoO4 enriched in the isotope of interest 100Mo. In order to achieve its ambitious science goals, the CUPID collaboration aims to reduce the backgrounds in the region of interest by a factor 100 with respect to CUORE. This performance will be achieved by introducing the high efficient α/β discrimination demonstrated by the CUPID-0 and CUPID-Mo experiments, and using a high transition energy double beta decay nucleus such as 100Mo to minimize the impact of the gamma background. CUPID will consist of about 1500 hybrid heat-light detectors for a total isotope mass of 250 kg. The CUPID scientific reach is supported by a detailed and safe background model based on CUORE, CUPID-Mo and CUPID-0 results. The required performances have already been demonstrated and will be presented.

Objetivos: Cromossomos em anel (RC) são moléculas circulares de DNA geradas após um dano com consequente reparo, sendo raramente descritos em Neoplasias mieloides (NM). O intuito deste trabalho foi avaliar o significado prognóstico dos RC em NM e verificar sua correlação com alterações no gene TP53. Material e métodos: Estudo retrospectivo envolvendo amostras de medula óssea de pacientes com NM (≥ 18 anos), entre elas: Síndrome Mielodisplásica (SMD), Leucemia Mieloide Aguda (LMA), Neoplasia Mieloproliferativa (NMP) e Leucemia Aguda Bifenotípica (LAB), que possuíam cariótipo com RC, entre 2017-2022 em laboratório de citogenética de rotina. Complexidade cariotípica foi definida como a presença de 3 ou mais anormalidades citogenéticas, sendo muito complexo 5 ou mais anormalidades. Foi analisada a alteração cariotípica do cromossomo 17p. Deleção e mutação no gene TP53 foram analisadas por técnica de FISH (sonda TP53 - MetaSystems) e NGS, respectivamente. TP53 multi-hit foi definido por VAF > 40% ou duas mutações com VAF > 10% ou presença de deleção e mutação VAF > 10%. Análises estatísticas foram realizadas com uso dos softwares IBM-SPSS/Microsoft-Excel de acordo com dados coletados em REDCap. A sobrevida global foi calculada a partir da data do exame citogenético até o último seguimento ou óbito, com utilização da curva de Kaplan Meier e comparações realizadas por teste de log-rank ou regressão de Cox bivariada. Estudo aprovado pelo comitê de ética institucional, com submissão de Termo de Consentimento Livre e Esclarecido. Resultados: Entre os 12.935 cariótipos, somente 38 (0,29%) dos cariótipos oncohematológicos apresentaram RC, sendo analisados 21 indivíduos que preenchiam critérios de inclusão. Mediana de idade de 69 anos (53-89), 14 (67%) homens, LMA e SMD em 9 (43%) casos cada. Mediana de anormalidades cariotípicas de 9 (1-28). Complexidade cariotípica (3 ou +), alteração 17p, deleção TP53, mutação TP53 e TP53 multi-hit esteve presente em (81%; 17/21), (38,1%; 8/21), (19%; 4/21), (78%; 14/18) e (61%; 11/18) dos casos, respectivamente. RC identificáveis derivativos dos cromossomos 6 e 7 foram os mais encontrados. A mediana de sobrevida global foi de 3,2 meses. Mutações multi-hit em TP53 (HR 10,63; IC95% 2,25-50,31; p = 0,001) e o número de anormalidades ao cariótipo (HR 1,06; IC95% 1,00-1,11; p = 0,043) se associaram significativamente a maiores taxas de mortalidade, sendo que pacientes com KT muito complexo (66,7%) apresentaram risco de óbito 5,53 vezes maior (IC95% 1,12-27,28) em relação a cariótipos não complexos. Discussão: A incidência de RC foi baixa em NM, se associou a alta taxa de cariótipo complexo e mutações em TP53, fatores associados a prognóstico bastante reservado. Conclusão: Nosso estudo contribui com a hipótese de que os cromossomos em anel são uma alteração secundária no desenvolvimento das neoplasias mieloides, surgindo devido à instabilidade genética gerada pelo cariótipo complexo e não estando envolvidos de forma causal com a patologia.

Introdução: As duas principais isoformas da tirosina quinase BCR-ABL oncogênica p210 e p190, são expressas na translocação do Cromossomo Filadélfia (Ph), produto resultante de uma translocação recíproca entre os cromossomos 9 e 22 (t9;22) que dá origem a um gene de fusão BCR-ABL1. Enquanto p210 é um marcador diagnóstico prevalente em Leucemia Mieloide Crônica, o p190 está mais frequentemente associado às Leucemias Linfoblásticas Agudas. O mRNA de fusão e1a2 e e1a3 codificam p190. Objetivo: O objetivo deste estudo foi avaliar a prevalência da fusão BCR-ABL p190 e a frequência das variantes e1a2 e e1a3 em amostras de um laboratório de grande porte no Brasil. Material e métodos: Avaliamos a prevalência da fusão BCR-ABL1 p190 e a frequência das variantes de transcrição em amostras laboratoriais coletadas de diversas regiões do Brasil no período de 01/2023 a 12/2023, totalizando 338 amostras. As amostras foram submetidas a RT-PCR qualitativo multiplex para detecção do transcrito p190. Os dados foram analisados respeitando a Lei n°13.709/2018, garantindo a confidencialidade dos dados dos pacientes. Resultados e discussão: Em um total de 338 amostras processadas no ano de 2023 para pesquisa diagnóstica do transcrito BCR-ABL1, apenas 1% (2 amostras) foram detectadas para o mRNA de fusão e1a2. Dos resultados detectados, 100% das amostras pertenciam ao sexo masculino (n = 2), destas amostras, uma era de adulto com 51 anos e a outra de criança com 7 anos de idade. Em ambos os casos, os pacientes estavam em pesquisa diagnóstica para LLA. Em um estudo de Azevedo e colaboradores (2014) também encontraram uma maior prevalência no sexo masculino com uma idade média de 33 anos em pacientes com LLA. Conclusão: O estudo teve uma maior frequência de casos de LLA com mRNA de fusão e1a2 no sexo masculino. A identificação do transcrito de fusão em pacientes com leucemia é importante para um melhor entendimento do prognóstico e da resposta à terapia.

Introdução: O gene BCR-ABL é atualmente visto como marca registrada da Leucemia Mieloide Crônica (LMC), responsável por 15% das leucemias adultas. Pode também ser encontrado em casos de Leucemia Linfoide Aguda (LLA). Esses casos são definidos pela presença do Cromossomo Filadélfia (Ph), produto resultante de uma translocação recíproca entre os cromossomos 9 e 22 (t9;22) que dá origem a um gene de fusão BCR-ABL1. Os mRNAs de fusão b2a2, b3a2, b2a3 e b3a3 codificam a proteína de fusão p210 e e1a2 e e1a3 codificam p190. Objetivo: O objetivo deste estudo foi avaliar a prevalência da fusão BCR-ABL e das variantes de transcrição em amostras de um laboratório de grande porte no Brasil. Material e métodos: Avaliamos a prevalência da fusão BCR-ABL1 p210 e a frequência das variantes de transcrição em amostras laboratoriais coletadas de diversas regiões do Brasil no período de 01/2023 a 12/2023, totalizando 412 amostras. As amostras foram submetidas a RT-PCR qualitativo multiplex para detecção e diferenciação entre os transcritos p210 (b2a2, b3a2, b3a3 e b2a3). Os dados foram analisados respeitando a Lei n° 13.709/2018, garantindo a confidencialidade dos dados dos pacientes. Resultados e discussão: Em um total de 412 amostras processadas no ano de 2023 para pesquisa diagnóstica do transcrito p210, apenas 17% (72 amostras) foram detectadas. Entre seus mRNAs de fusão, 28 amostras foram detectadas para b2a2 (7%), 35 para b3a2 (8%) e 9 para b2a2/b3a2 (2%). Dos resultados positivos 56% das amostras pertenciam ao sexo masculino (n = 40) e 75% (n = 54) eram amostras de pacientes adultos. O diagnóstico da LMC ocorre com maior frequência na fase adulta. Foi observada uma maior prevalência do transcrito b3a2 do que b2a2 nas amostras analisadas, assim como em diversos estudos publicados previamente (Ayatollahi H et al. 2018; Iqbal Z et al. 2011). Conclusão: Este estudo mostrou uma maior frequência de transcritos b3a2 do que b2a2 em amostras coletadas de diversas regiões do Brasil. A detecção e diferenciação do transcrito de fusão em pacientes com leucemia é importante para o auxílio no prognóstico e na escolha da terapia alvo que consequentemente refletem na resposta do paciente, além da necessidade convencional de monitorar a resposta ao tratamento.

Introdução: A classificação de neoplasias mieloproliferativas surgem de células-tronco hematopoiéticas com sinalização de tirosina quinase alterada somaticamente. Sua classificação se baseia em características hematológicas, histopatológicas e moleculares. Das classificações moleculares, a pesquisa da translocação BCR–ABL1 e JAK2V617F são as principais utilizadas, embora sua presença seja considerada exclusiva, alguns artigos relatam casos com BCR–ABL1 e JAK2V617F concomitantes. Objetivo: O objetivo deste estudo foi identificar a presença concomitante da translocação BCR–ABL1 p190 e JAK2V617F em amostras de um laboratório de grande porte no Brasil. Material e métodos: Foram analisadas 2462 amostras laboratoriais de sangue total e medula óssea coletadas de diversas regiões do Brasil no período de 01/2023 a 12/2023. As amostras foram submetidas a RT-PCR qualitativo multiplex para detecção e diferenciação entre os transcritos p210 (b2a2, b3a2, b3a3 e b2a3) e p190 (e1a2 e e1a3). Além disso, para pesquisa da mutação JAK2V617F, as amostras foram processadas pela técnica de PCR em tempo real. Os dados foram analisados respeitando a Lei n° 13.709/2018, garantindo a confidencialidade dos dados dos pacientes. Resultados e discussão: Em um total de 2462 amostras processadas no ano de 2023 para pesquisa diagnóstica da mutação JAK2V617F, 26% (n = 639) foram detectadas. Não houve diferença significativa entre sua prevalência no sexo masculino e feminino e a maior frequência das amostras com a mutação JAK2V617F foram em idosos (n = 352) e adultos (n = 252). Destas amostras, uma paciente do sexo feminino com 65 anos de idade obteve resultado detectados para JAK2V617F e BCR–ABL1 p190 identificados simultaneamente no diagnóstico inicial. A mutação JAK2V617F está presente em grande parte dos casos de Policitemia Vera, trombocitemia essencial e mielofibrose. Fortuitamente não se encontra em quadros de leucemia mieloide crônica, mas alguns autores já reportaram a coexistência com a oncoproteína p210BCR−ABL como o estudo de Gaocci e colaboradores (2010) que reportou pela primeira vez na literatura a coexistência de JAK2V617F e p190BCR−ABL em um quadro de LMC. Conclusão: Embora incomum, é importante estar ciente da combinação genética potencialmente desordenada (BCR-ABL e JAK2V617F), que reflete diretamente no perfil de resistência à terapia ou progressão da doença. Com a detecção concomitante de JAK2V617F e BCR-ABL1 comumente é indicada terapia combinada para redução da linhagem eritróide e redução da carga leucêmica. O aconselhável para diagnóstico de neoplasias mieloproliferativas é que seja realizado a triagem da mutação JAK2V617F juntamente com testes de detecção da translocação BCR-ABL1, devido a possível presença de eventos leucemogênicos.

Electroencephalography (EEG) is a non-intrusive and powerful tool for understanding the complex nature of the brain. Epileptic seizures, a neurological disorder, are characterized by excessively synchronized neuronal activity within the brain. This abnormal synchronization disrupts the normal functioning of neural networks, leading to seizures. This work proposes to use the Gaussian-based Stockwell Transform (GST) to segment EEG signals into various frequency bands such as delta, theta, alpha, beta, and gamma band for analysis. The feature extraction process on these sub-band signals generates a feature set, encompassing the fluctuation index, relative amplitude, holoentropy, logarithmic band power, and the newly introduced Hermite polynomial-based delta amplitude modulation spectrogram. To differentiate between epileptic and non-epileptic events in EEG signals, the previous features have been applied to the Random Forest Classifier (RFC) algorithm. The effectiveness of our proposed method is validated using a benchmark EEG dataset, with GST and RFC demonstrating accurate results in distinguishing seizure activity. Experimental results show an optimal classification accuracy of 96.4 %, a sensitivity of 97 %, and a specificity of 96.4 %.

Global DC fast-charging infrastructure is being rapidly developed to accommodate the ever-increasing demand from the electric vehicle market. A major complication in the electric power system's process is the proliferation of ultra-fast charging (UFC) stations, which are known for their enormous power consumption and unpredictable, intermittent performance. By implementing grid-supportive features and ensuring an improved power consumption profile for the grid, installing regional energy storage can solve these challenges. This study presents a control approach for managing the grid-side AC/DC converters of rapid charging stations focused on future-oriented regulation. The paper primarily concentrates on various Vienna rectifier topologies. The technology, characteristics, benefits, and operational aspects of Vienna rectifier topologies are vital to improving the performance, efficiency, and grid integration of electric vehicle charging systems. Fast charging, grid stability, energy economy, and the smooth integration of electric vehicles into the electrical grid are all made possible by Vienna rectifiers. When used in battery energy storage systems (BESS) for electric vehicle charging infrastructure, Vienna rectifiers allow for effective discharge and charging of the batteries. The configurations and assessments of these converters are examined, assessed, and compared based on power output parameters, element count, power factor, THD, and efficiency. The Vienna rectifier has been identified as the best suitable DC fast-charging converter architecture for power levels exceeding 15 kW due to its exceptional efficiency, limited output voltage ripples, high power density, reduced current ripples, and reliable performance. Research on ways to improve electric vehicle charging infrastructure can be spurred by a better grasp of the Vienna rectifier's technological complexities and performance benefits, leading to greener and more efficient transportation options. As a result, the system's power density will eventually rise and elemental stress will decrease.

Employing carbon-neutral (NH3) and low carbon footprint (biodiesel) fuels in Reactivity Controlled Compression Ignition (RCCI) engine mode is one possible method for minimizing carbon emissions in diesel engines. In this study, a Compression Ignition (CI) engine was customized to run in RCCI mode, employing High Reactive Fuel (HRF) as biodiesel and Low Reactive Fuel (LRF) as ammonia (NH3). Based on our earlier findings, the proportion of ammonia in premixing is fixed at 40 %. In the first phase, the primary injection timing of the algal biodiesel varied between 12 and 21°CA bTDC at a preset pre-injection timing of 46°CA bTDC. In the next phase, the pre-injection time varied between 46 and 54°CA bTDC, with the optimal main injection time being 18°CA. The result suggested that the optimal main and pre-injection at 18 and 58°CA bTDC increased the Cylinder Pressure (CP) by 30.1 %, and peak HRR and combustion phase angle were advanced. Brake Thermal Efficiency exhibited an 11 % enhancement, with Brake Specific Energy Consumption decreasing by 24.1 %. Nitrogen Oxide levels saw an increase of around 39.5 %. In contrast, reductions of 19.2 %, 23.5 %, 39.7 %, and 21.7 % were observed in Hydrocarbons, Carbon Monoxide, smoke emissions, and Exhaust Gas Temperature, respectively, compared to the single injection under full load conditions.

Appendiceal mucinous neoplasms, particularly Low-grade Appendiceal Mucinous Neoplasms (LAMN), are rare but important diagnostic entities as they are potential causes of a surgical abdomen. The clinical manifestations of this lesion are obscure and ill-defined, and these lesions are commonly misdiagnosed as acute appendicitis, adnexal masses, or retroperitoneal tumours. This lesion can rupture and seed mucin and neoplastic epithelium into the peritoneum, leading to Pseudomyxoma Peritonei (PMP), a serious complication with a high morbidity and mortality rate. Therefore, timely identification and treatment of LAMN are crucial for reducing the risk of PMP and improving prognosis and outcomes. Ultrasonography (USG) and Computed Tomography (CT) scans are useful methods for diagnosis; however, the diagnosis is often incidental or found intraoperatively during resection for suspected acute appendicitis. Clinical awareness of the misleading presentations of LAMN should be present in cases of a surgical acute abdomen to prevent performing a dissimilar treatment intervention. Considering the rarity of this lesion and its varied presentation, it is important to study and document this type of neoplasia in the literature. Hereby, authors report a rare case of LAMN in a 33-year-old male patient with a primary diagnosis of acute appendicitis. This case highlights the importance of having a high index of clinical suspicion of appendiceal malignancy and mucocele rupture in patients planned for appendectomy. This also emphasises the fact that all excised appendicectomy tissues should be sent for histopathological examination as they can harbor pathological changes like LAMN.

Introduction: The primary aims of the current nationwide study were to establish the lifetime and 12-month prevalence of consumption of illicit drugs and its correlates in the general population of Singapore. Method: A representative sample of 6509 Singapore residents (Singapore citizens and permanent residents) aged between 15 and 65 years were randomly selected for participation. Questionnaires were administered to assess the consumption of illicit drugs and collect information on correlates. All analyses were weighted to produce prevalence estimates for the consumption of drugs and other measured outcomes. Rao-Scott chi-square test and logistic regression analyses were performed to determine the association of sociodemographic and clinical characteristics with lifetime consumption of illicit drugs. Results: The study was completed with a response rate of 73.2%. The lifetime prevalence of consuming illegal drugs was 2.3% (95% confidence interval [CI] 1.9–2.8) (n=180). Compared to individuals aged 15–34, those aged 50–65 (odds ratio [OR] 0.3, 95% CI 0.2–0.7) had lower odds of lifetime drug consumption. Current smokers (OR 4.7, 95% CI 2.7–8.3) and ex-smokers (OR 5.9, 95% CI 3.2–11.1) had significantly higher odds of lifetime drug consumption than non-smokers. Individuals with hazardous alcohol use (OR 3.3, 95% CI 1.7–6.5) had higher odds of lifetime drug consumption than those without hazardous alcohol use. Conclusion: This is the first nationwide study to examine the prevalence of illicit drug consumption in the general population of Singapore. The results highlight the need to increase awareness of drug consumption in Singapore, especially among parents, teachers, healthcare workers and others who work with young people.

Diverse COVID-19 severity levels and a spectrum of clinical manifestations underscore the need to comprehend the underlying genetic mechanisms. Such knowledge is essential for improving disease management and therapeutic approaches. This study aims to explore and uncover pivotal genes and pathways linked to distinct COVID-19 conditions, providing insights into potential therapeutic avenues. Gene expression data from COVID-19 patients across different conditions were analyzed using differential gene expression analysis. Significant genes were subjected to pathway analysis and protein–protein interaction network analysis. Gene ontology was used to identify the functions of these genes. The genes ADAMTS2, PCSK9, and OLAH were upregulated across all disease conditions including SARS-CoV-2 bacterial coinfection, potentially serving as therapeutic targets. The proteins, including RPL and CEACAM, could serve as a potential therapeutic target. The deregulated genes were majorly involved in inflammation, lipid metabolism, and immune regulation. The study's findings reveal significant gene expression differences among COVID-19 disease conditions. These insights guide future research toward targeted therapies and an improved understanding of disease progression and long-term consequences.

Introduction: This systematic review is aimed at (1) evaluating the association between media portrayals of suicides and subsequent copycat suicides or attempts among the general public in Asia, (2) understanding the factors associated with copycat suicides and (3) determining the positive impacts of the media reporting of suicides (e.g. increased help-seeking, coping). Method: A systematic review and narrative synthesis of English and Chinese articles from 8 electronic databases (i.e. PsycINFO, MEDLINE, Embase, CINAHL, Web of Science, Ariti, China National Knowledge Infrastructure and OpenGrey) from January 2000 to May 2023 was conducted. Observational studies were included, and the data were analysed through narrative synthesis. The protocol was registered with PROSPERO (CRD42021281535). Results: Among the 32 studies included (n=29 for evidence synthesis) in the review, there is good-quality evidence to show that copycat suicides and suicide attempts increase after media reports of a suicide, regardless of country, celebrity status, study design, type of media, mode of suicide or follow-up period. Females, younger age groups and those sharing similar characteristics as the deceased in publicised suicides (age, gender) were more susceptible to negative impact. Reporting of the mode of death of the deceased increased suicides by the same method among the public. Conclusion: Media portrayals of suicide appear to have a negative impact on copycat suicides at the population level in Asia. Thus, in addition to tighter media control, healthcare systems, professional medical bodies and community outreach services should work collaboratively to promote early help-seeking in those with psychological distress.

ABSTRACTGlobally, COVID-19 had an immense impact on mental health systems, but research on how community mental health (CMH) systems and services contributed to the pandemic mental health response is limited. We conducted a systematic review and meta-ethnography to understand the roles of CMH services, determinants of the quality of CMH care, and dynamics within CMH systems during COVID-19. We searched and screened across five databases and appraised study quality using the CASP tool, which yielded 27 qualitative studies. Our meta-ethnographic process used Noblit and Hare’s approach for synthesizing findings and applying interpretive analysis to original research. This identified several key themes. Firstly, CMH systems played the valuable pandemic role of safety nets and networks for the broader mental health ecosystem, while CMH service providers offered a continuous relationship of trust to service users amidst pandemic disruptions. Secondly, we found that the determinants of quality CMH care during COVID-19 included resourcing and capacity, connections across service providers, customized care options, ease of access, and human connection. Finally, we observed that power dynamics across the CMH landscape disproportionately excluded marginalized groups from mainstream CMH systems and services. Our findings suggest that while the pandemic role of CMH was clear, effectiveness was driven by the efforts of individual service providers to meet demand and service users’ needs. To reprise its pandemic role in the future, a concerted effort is needed to make CMH systems a valuable part of countries’ disaster mental health response and to invest in quality care, particularly for marginalized groups.

Systems of correlated particles appear in many fields of modern science and represent some of the most intractable computational problems in nature. The computational challenge in these systems arises when interactions become comparable to other energy scales, which makes the state of each particle depend on all other particles1. The lack of general solutions for the three-body problem and acceptable theory for strongly correlated electrons shows that our understanding of correlated systems fades when the particle number or the interaction strength increases. One of the hallmarks of interacting systems is the formation of multiparticle bound states2-9. Here we develop a high-fidelity parameterizable fSim gate and implement the periodic quantum circuit of the spin-½ XXZ model in a ring of 24 superconducting qubits. We study the propagation of these excitations and observe their bound nature for up to five photons. We devise a phase-sensitive method for constructing the few-body spectrum of the bound states and extract their pseudo-charge by introducing a synthetic flux. By introducing interactions between the ring and additional qubits, we observe an unexpected resilience of the bound states to integrability breaking. This finding goes against the idea that bound states in non-integrable systems are unstable when their energies overlap with the continuum spectrum. Our work provides experimental evidence for bound states of interacting photons and discovers their stability beyond the integrability limit.

Introduction People with diabetes are at risk of developing chronic kidney disease. However, limited data are available to quantify their risk of kidney function decline in South Asia. This study evaluates the rate and predictors of kidney function decline among people with type 2 diabetes in South Asia.Research design and methods We analyzed data from the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) Trial to quantify the rate of decline in estimated glomerular filtration rate (eGFR) in people with type 2 diabetes (n=1146) over 2.5 years of follow-up. The CARRS Trial evaluated a multicomponent intervention of decision-supported electronic health records and non-physician care coordinator to improve diabetes management at 10 diabetes clinics in India and Pakistan. We used linear mixed models to estimate eGFR slope among all participants and tested the association of eGFR slope with demographic, disease-related, and self-care parameters, accounting for randomization and site.Results The mean age of participants was 54.2 years, with a median duration of diabetes of 7.0 years (IQR: 3.0 - 12.0) and median CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) eGFR of 83.6 (IQR: 67.7 to 97.9) mL/min/1.73 m2. The overall mean eGFR slope was −1.33/mL/min/1.73 m2/year. There were no differences in the eGFR slope by treatment assignment to intervention versus usual care. In the adjusted regression model, pre-existing diabetic retinopathy (slope difference: −2.11; 95% CI: −3.45 to –0.77), previous cardiovascular disease (−1.93; 95% CI: −3.45 to –0.40), and statins use (−0.87; 95% CI: −1.65 to –0.10) were associated with faster eGFR decline.Conclusions People with diabetes receiving care at urban diabetes clinics in South Asia experienced annual eGFR decline at two times higher rate than that reported from other contemporary international diabetes cohorts. Risk factors for faster decline were similar to those previously established, and thus care delivery models must put an additional emphasis on kidney protective therapies among subgroups with microvascular and macrovascular diabetes complications.Trial registration number NCT01212328.

ABSTRACT Managing fertile eggs and minimizing seasonal impacts is crucial in poultry farming. This study evaluated the effects of the storage time of fertile eggs, broiler breeder strain, and age on hatchability and first-week broiler performance. Twelve treatments were carried out in a factorial arrangement with two broiler breeder strains (Cobb MV and Ross 308AP), two breeder age intervals (between 30-40 weeks and between 50-60 weeks), and three egg storage times (4, 7 and 9 days). The Ross 308AP strain showed the highest hatchability (91.74%) at 30-40 weeks, while Cobb MV had the greatest weight gain (162.75g) from days 1 to 7 at 50-60 weeks. Longer egg storage affected weight gain at 7 days for Cobb MV. Nine-day storage reduced chick weight (45.46g) from breeders aged 50-60 weeks. Lower first-stage embryonic mortality was observed in Ross 308 AP (3.83%) in breeders aged 30-40 weeks (4.13%), and in eggs stored for 4 days (4.01%). The Ross 308AP had the greatest percentage of infertile eggs (10.25%), and breeders aged 50-60 weeks showed greater percentages of infertility (10.14%). The Cobb MV had lower second-stage embryonic mortality but higher percentages of discarded chicks. Hatchability and first-week broiler performance depend on storage time, breeder age and strain.