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Abstract The oil derived from the spiny-tailed lizards (STLs) is illegally sold as an alternative medicinal aphrodisiac that is claimed to cure male sexual dysfunction in addition to other bodily ailments. The high demand generated from this illegal trade is rapidly depleting the species from its natural habitat. The goal of this research is to uncover the process of cyber-enabled illegal trade in STLs. To achieve this goal, this research uses data from a total of 127 videos and 4608 comments associated with these videos and the crime script analysis technique to outline and detail the steps taken to poach, prepare, and sell oil derived from spiny-tailed lizards (STL) and other protected wild animals on YouTube. The results indicate that sellers, operating primarily from Pakistan, employ a variety of techniques to attract buyers, such as preparing the oil by dissecting alive STL while being captured in the video to show the authenticity of the product. In addition to YouTube, sellers use other social media platforms, including WhatsApp, Facebook, Instagram, and Twitter/X, to communicate with potential buyers and to advertise their products. These products are shipped around the world using international courier services, such as DHL and TCS, with primary markets in South Asia and the Middle East. The sellers accept money transactions from Western Union, MoneyGram, and PayPal. They also seem to operate without any major restrictions from local authorities or host social media platforms. Based on these findings, this research proposed various recommendations for policy and practice.

Objectives: The FilmArray gastrointestinal panel (FAGIP) is widely used to detect infectious diarrhoea due to its outstanding sensitivity compared to conventional methods, but there is geographic variation, such as in the distribution of pathogens, among populations. Methods: This was a retrospective study that analysed patients with acute diarrhoea who underwent FAGIP tests from all age groups during 2022. We compared positive rates of FAGIP between paediatric (n = 245) and adult patients (n = 242) of different origins. The targeted therapy rate and antimicrobial agent use rate were also analysed. Results: Among the 487 stool samples evaluated, the overall, community-origin (CO), and nosocomial (NC) positivity rates of paediatric patients were significantly higher than those of adults (73.9 % vs. 43.0 %, p = 0.000; 76.2 % vs. 51.7 %, p = 0.000; 50.0 % vs. 19.7 %, p = 0.000). Salmonella was the most frequently detected pathogen (35.9 %) in children, while the predominant pathogen in adult patients was toxin A/B-genic Clostridioides difficile (13.2 %). There was a significantly lower antimicrobial agent use rate after FAGIP results were available (79.1 % vs. 64.5 %, p = 0.000) and a higher rate of targeted therapy towards C. difficile infection in adults than in children (84.4 % vs. 69.0 %, p = 0.011). Conclusion: Paediatric diarrhoea patients showed higher positivity rates than adult patients. Application of FAGIP for acute diarrhoea might lower unnecessary antimicrobial use.

Abstract Background Early-stage colorectal cancer had excellent outcomes after curative resection, typically. However, a perplexing survival paradox between stage II and stage III was noted. This paradox could be influenced by the administration of routine postoperative adjuvant chemotherapy and the presence of high-risk factors in stage II CRC. The objective of the study was to investigate the influence of high-risk factors on patients with stage II CRC and assess the efficacy of oral tegafur/uracil (UFT) plus leucovorin as adjuvant chemotherapy for stage II CRC patients. Methods A retrospective study was conducted using propensity score matching at a single medical institution. A total of 1544 patients with stage II colorectal cancer who underwent radical surgery between January 2004 and January 2009 were included. The intervention used was tegafur/uracil plus leucovorin as adjuvant chemotherapy. The main outcome measures were disease-free survival and overall survival. Results After propensity score matching, 261 patients were included in three groups: no-treatment, half-year treatment, and one-year treatment. The clinical characteristics of each group tended to be more consistent. The Cox proportional hazard models showed that tegafur/uracil treatment or not was a significant independent factor for oncological outcome. Kaplan–Meier analysis also showed significantly better disease-free survival and overall survival. Further investigation revealed that tegafur/uracil duration was an independent factor for oncological outcome. While the survival curve did not reach statistical significance, the one-year UFT treatment group demonstrated the best treatment trend. Conclusions This study suggests that tegafur/uracil plus leucovorin is a feasible adjuvant chemotherapy regimen for patients with stage II colorectal cancer after curative surgical treatment. Prolonged tegafur/uracil plus leucovorin treatment for 12 months showed a trend towards better outcomes in patients with stage II colorectal cancer.

We present a novel photon-acid diffusion method to integrate polymer microlenses (MLs) on a four-channel, high-speed photo-receiver consisting of normal-incidence germanium (Ge) p-i-n photodiodes (PDs) fabricated on a 200 mm Si substrate. For a 29 µm diameter PD capped with a 54 µm diameter ML, its dark current, responsivity, 3 dB bandwidth (BW), and effective aperture size at −3 V bias and 850 nm wavelength are measured to be 138 nA, 0.6 A/W, 21.4 GHz, and 54 µm, respectively. The enlarged aperture size significantly decouples the tradeoff between aperture size and BW and enhances the optical fiber misalignment tolerance from ±5 µm to ±15 µm to ease the module packaging precision. The sensitivity of the photo-receiver is measured to be −9.2 dBm at 25.78 Gb/s with a bit error rate of 10−12 using non-return-to-zero (NRZ) transmission. Reliability tests are performed, and the results show that the fabricated Ge PDs integrated with polymer MLs pass the GR-468 reliability assurance standard. The demonstrated photo-receiver, a first of its kind to the best of our knowledge, features decent performance, high yield, high throughput, low cost, and compatibility with complementary metal-oxide-semiconductor (CMOS) fabrication processes, and may be further applied to 400 Gb/s pulse-amplitude modulation four-level (PAM4) communication.

Google Trends (GT) data could potentially supplement traditional crime measurement strategies, allowing criminologists to better understand crime statistics on a macro level. This study assesses the validity of GT crime estimates. The findings indicate that GT data are reliable for estimating MVT, larceny, and rape. Additionally, we illustrate how to use GT to identify places with high rates of unreported offenses. The results of this study demonstrate the feasibility of leveraging open-source big data such as GT to supplement traditional sources of crime data, particularly for categories of crime with substantial underreporting rates. Results suggest the GT rape measure may be a more accurate estimate of the true incidence of rape than the measure drawn from the Uniform Crime Report (UCR). The limitations associated with the use of GT to generate estimates of crime are also discussed.

The healthcare industry has made significant progress in the diagnosis of heart conditions due to the use of intelligent detection systems such as electrocardiograms, cardiac ultrasounds, and abnormal sound diagnostics that use artificial intelligence (AI) technology, such as convolutional neural networks (CNNs). Over the past few decades, methods for automated segmentation and classification of heart sounds have been widely studied. In many cases, both experimental and clinical data require electrocardiography (ECG)-labeled phonocardiograms (PCGs) or several feature extraction techniques from the mel-scale frequency cepstral coefficient (MFCC) spectrum of heart sounds to achieve better identification results with AI methods. Without good feature extraction techniques, the CNN may face challenges in classifying the MFCC spectrum of heart sounds. To overcome these limitations, we propose a capsule neural network (CapsNet), which can utilize iterative dynamic routing methods to obtain good combinations for layers in the translational equivariance of MFCC spectrum features, thereby improving the prediction accuracy of heart murmur classification. The 2016 PhysioNet heart sound database was used for training and validating the prediction performance of CapsNet and other CNNs. Then, we collected our own dataset of clinical auscultation scenarios for fine-tuning hyperparameters and testing results. CapsNet demonstrated its feasibility by achieving validation accuracies of 90.29% and 91.67% on the test dataset.

An efficient optical coupler to transfer the signal between an optical fiber and a silicon waveguide is essential for realizing the applications of silicon photonic integrated circuits such as optical communication and optical sensing. In this paper, we numerically demonstrate a two-dimensional grating coupler based on a silicon-on-insulator platform to obtain completely vertical and polarization-independent couplings, which potentially ease the difficulty of packaging and measurement of photonic integrated circuits. To mitigate the coupling loss induced by the second-order diffraction, two corner mirrors are respectively placed at the two orthogonal ends of the two-dimensional grating coupler to create appropriate interference conditions. Partial single-etch is assumed to form an asymmetric grating to obtain high directionalities without a bottom mirror. The two-dimensional grating coupler is optimized and verified with finite-difference time-domain simulations, achieving a high coupling efficiency of −1.53 dB and a low polarization-dependent loss of 0.015 dB when coupling to a standard single-mode fiber at approximately 1310 nm wavelength.

In recent years, combining different types of therapy has emerged as an advanced strategy for cancer treatment. In these combination therapies, oral delivery of anticancer drugs is more convenient and compliant. This study developed an irinotecan/rapamycin-loaded oral lecithin-based self-nanoemulsifying nanoemulsion preconcentrate (LBSNENPir/ra) and evaluated its synergistic combination effects on pancreatic cancer. LBSNENP loaded with irinotecan and rapamycin at a ratio of 1:1 (LBSNENPir10/ra10) had a better drug release profile and smaller particle size (LBSNENPir10/ra10 exhibited a strong synergistic effect (combination index [CI] < 1.0) in cell viability and combination effect studies. In the tumor inhibition study, the antitumor activity of LBSNENPir10/ra10/sily20 against MIA PaCa-2 (a human pancreatic cancer cell line) was significantly increased compared with the other groups. When administered with rapamycin and silymarin, the area under the curve and the maximum concentration of irinotecan significantly improved compared with the control. We successfully developed an irinotecan/rapamycin-loaded oral self-nanoemulsifying nanoemulsion system to achieve treatment efficacy for pancreatic cancer.

Objective: This study aimed to investigate the contribution of high body mass index (BMI) to growth velocity among school-aged children who remained in the same BMI categories for a 6-year period.Methods: This retrospective cohort study included children who enrolled in the school year 2009 and remained in the same BMI categories during their 1st, 4th, and 7th grades (6–7, 9–10, 12–13 years of age). Annual linear growth velocity and weight gain were calculated and compared between sexes, BMI groups, and different times. Risk analysis and repeated measures analysis of variance were performed to identify the impact of BMI on growth velocity.Results: Of the 1,637 subjects, 53.0% were male, and 2.5% and 10.9% belonged to BMI groups of overweight and obese, respectively. In students between 6 and 13 years of age, obesity was associated with higher annual weight gain and height gain. Risk analysis showed that obese subjects had higher linear growth velocity than normal BMI groups of both sexes between 6 and 9 years of age. Unexpectedly, overweight and obese girls between 9 and 13 years of age had less linear growth velocity than underweight girls at the same interval. Repeated measures analysis of variance in both sexes showed a significant statistical association between BMI and different times of growth. However, the effect was less in girls between 9 and 13 years of age.Conclusion: Puberty may dominate over BMI as the main contributor to high growth velocity in girls with underweight BMI emerging into pubertal age.

BackgroundSevere leptospirosis can have a case-fatality rate of over 50%, even with intensive care unit (ICU) support. Multiple strategies-including protective ventilation and early renal replacement therapy (RRT)-have been recommended to improve outcomes. However, management guidelines vary widely around the world and there is no consensus on the optimal approach.Methodology/principal findingsAll cases of leptospirosis admitted to the ICU of Cairns Hospital in tropical Australia between 1998 and 2018 were retrospectively reviewed. The patients' demographics, presentation, management and clinical course were examined. The 55 patients' median (interquartile range (IQR)) age was 47 (32-62) years and their median (IQR) APACHE III score was 67 (48-105). All 55 received appropriate antibiotic therapy, 45 (82%) within the first 6 hours. Acute kidney injury was present in 48/55 (87%), 18/55 (33%) required RRT, although this was usually not administered until traditional criteria for initiation were met. Moderate to severe acute respiratory distress syndrome developed in 37/55 (67%), 32/55 (58%) had pulmonary haemorrhage, and mechanical ventilation was required in 27/55 (49%). Vasopressor support was necessary in 34/55 (62%). Corticosteroids were prescribed in 20/55 (36%). The median (IQR) fluid balance in the initial three days of ICU care was +1493 (175-3567) ml. Only 2/55 (4%) died, both were elderly men with multiple comorbidities.ConclusionIn patients with severe leptospirosis in tropical Australia, prompt ICU support that includes early antibiotics, protective ventilation strategies, conservative fluid resuscitation, traditional thresholds for RRT initiation and corticosteroid therapy is associated with a very low case-fatality rate. Prospective studies are required to establish the relative contributions of each of these interventions to optimal patient outcomes.

Organophosphorus based flame retardants (OPFRs) extensively used as alternatives to banned polybrominated diphenyl ethers and hexabromocyclododecane have been garnering interest due to the possibility that these compounds may have less significant impact on human and environmental health. Long pretreatment time, larger consumption of organic solvents, matrix interferents, and cross-contamination were found in previous studies while assessing OPFRs in indoor environments. We developed and optimized the extraction methods and simultaneous analysis of 11 OPFRs in indoor air, dust and skin wipe samples using the GC-MS approach. The proposed methods were validated using a standard addition approach, dust SRM 2585 and the real samples. Our procedures enabled the analyst to effectively limit coextracted interferences and simultaneous analytical methods of 11 target OPFRs for three matrices were achieved. The validation was performed according to standard guidelines (relative errors were identified by the analytes: −19% to 18% for indoor air, −11% to 14% for house dust, −15% to 16% for skin wipe). Good practices for quality assurance and quality control were well stated. The current high-Eco-scored methods could be categorized as “an excellent green analysis”. All analytes for the target OPFRs were detected in the real samples of indoor air, house dust and skin wipe collected from ten Taiwanese homes. Tris(2-butoxyethyl) phosphate, tris(1,3-dichloro-2-propyl)phosphate and tris(chloroisopropyl) phosphate were the most abundant OPFRs. Rapid, green and cost-effective GC-MS methods were developed and validated for the analysis of eleven OPFRs in indoor air, house dust and skin wipes.

In this study, we developed a novel cerium/ascorbic acid/iodine active species to design a redox flow battery (RFB), in which the cerium nitrate hexahydrate [Ce(NO3)3·6H2O] was used as a positive Ce3+/Ce4+ ion pair, and the potassium iodate (KIO3) containing ascorbic acid was used as a negative I2/I− ion pair. In order to improve the electrochemical activity and to avoid cross-contamination of the redox pair ions, the electroless plating and sol–gel method were applied to modify the carbon paper electrode and the Nafion 117 membrane. The electrocatalytic and electrochemical properties of the composite electrode using methanesulfonic acid as a supporting electrolyte were assessed using the cyclic voltammetry (CV) test. The results showed that the Ce (III)/Ce (IV) active species presented a symmetric oxidation/reduction current ratio (1.09) on the C–TiO2–PdO composite electrode. Adding a constant amount of ascorbic acid to the iodine solution led to a good reversible oxidation/reduction reaction. Therefore, a novel Ce/ascorbic acid/I RFB was developed with C–TiO2–PdO composite electrodes and modified Nafion 117–SiO2–SO3H membrane using the staggered-type flow channel, of which the energy efficiency (EE%) can reach about 72%. The Ce/ascorbic acid/I active species can greatly reduce the electrolyte cost compared to the all-vanadium redox flow battery system, and it therefore has greater development potential.

BACKGROUND:The case-fatality rate of severe leptospirosis can exceed 50%. While prompt supportive care can improve survival, predicting those at risk of developing severe disease is challenging, particularly in settings with limited diagnostic support. METHODOLOGY/PRINCIPAL FINDINGS:We retrospectively identified all adults with laboratory-confirmed leptospirosis in Far North Queensland, Australia, between January 1998 and May 2016. Clinical, laboratory and radiological findings at presentation were correlated with the patients' subsequent clinical course. Medical records were available in 402 patients; 50 (12%) had severe disease. The presence of oliguria (urine output ≤500 mL/24 hours, odds ratio (OR): 16.4, 95% confidence interval (CI): 6.9-38.8, p

(1) Background: Diabetic nephropathy (DN) is common complication of diabetes. Current therapy for DN does not include promotion of podocyte protection. Therefore, we investigated the therapeutic effect of melatonin (Mel) combined extracorporeal shock wave (SW) therapy on a DN rat model. (2) Methods: The DN rats were treated with Mel (5 mg/kg) twice a week for 6 weeks and SW treatment once a week (0.13 mJ/mm2) for 6 weeks. We assessed urine microalbumin, albumin to creatinine ratio (ACR), glomerular hypertrophy, glomerular fibrosis, podocyte markers (Wilm’s tumor protein-1, synaptopodin and nephrin), cell proliferation, cell survival, cell apoptosis, renal inflammation and renal oxidative stress. (3) Results: The Mel combined SW therapy regimen significantly reduced urine microalbumin excretion (3.3 ± 0.5 mg/dL, p < 0.001), ACR (65.2 ± 8.3 mg/g, p < 0.001), glomerular hypertrophy (3.1 ± 0.1 × 106 μm3, p < 0.01) and glomerular fibrosis (0.9 ± 0.4 relative mRNA fold, p < 0.05). Moreover, the Mel combined SW therapy regimen significantly increased podocyte number (44.1 ± 5.0% area of synaptopodin, p < 0.001) in the Mel combined SW group. This is likely primarily because Mel combined with SW therapy significantly reduced renal inflammation (753 ± 46 pg/mg, p < 0.01), renal oxidative stress (0.6 ± 0.04 relative density, p < 0.05), and apoptosis (0.3 ± 0.03 relative density, p < 0.001), and also significantly increased cell proliferation (2.0 ± 0.2% area proliferating cell nuclear antigen (PCNA), p < 0.01), cell survival, and nephrin level (4.2 ± 0.4 ng/mL, p < 0.001). (4) Conclusions: Mel combined SW therapy enhances podocyte protection and ameliorates kidney function in a DN rat model. Mel combined SW therapy may serve as a novel noninvasive and effective treatment of DN.

Extracellular matrix (ECM) hydrogel can create a favorable regenerative microenvironment and act as a promising dressing for accelerating the healing of diabetic wound. In this study, a simple and effective decellularization technique was developed and optimized to obtain acellular extracellular matrix (aECM) from porcine skin. It was found that decellularization at 30% formic acid for 72 h effectively decellularized porcine skin while retaining >75% collagen and ~37% GAG in the aECM with no presence of nuclei of cellular remnants. aECM hydrogel was fabricated by digesting aECM with pepsin in various acidic solutions (0.1 N HCl, glycolic acid (GA) and 2-pyrrolidone-5-carboxylic acid (PCA)) and then treated with a pH-controlled neutralization and temperature-controlled gelation procedure. Based on physical characterizations, including SDS-PAGE, rheological analysis and SEM analysis, aECMHCl hydrogels fabricated at 25 mg/mL in 0.1 N HCl were selected. Four polymeric ECM-mimic hydrogels, including sacchachitin (SC), hyaluronic acid (HA) and chitosan (CS) and three composite hydrogels of combining SC either with aECMHCl,25 (aECMHCl/SC), HA (HA/SC) or CS (SC/CS) were prepared and evaluated for WS-1 cell viability and wound-healing effectiveness. Cell viability study confirmed that no hydrogel dressings possessed any toxicity at all concentrations examined and ECMHCl, HA and ECMHCl/SC at higher concentrations (>0.05%) induced statistically significant proliferation. Diabetic wound healing study and histological examinations revealed that ECMHCl/SC hydrogel was observed to synergistically accelerate wound healing and ultimately stimulated the growth of hair follicles and sweat glands in the healing wound indicating the wound had healed as functional tissues. The results support the great potential of this newly produced ECMHCl/SC composite hydrogel for healing and regeneration of diabetic wounds.

This study demonstrates how algorithms can assist humans in decision-making in the apparel industry. A two-stage method including suggestions and intelligent forecasting was proposed. In the first stage, a web crawler was used to browse a B2C apparel website to identify popular products. In the second stage, machine learning methods were used to predict the sales demand for new products. Additionally, we used Google Trends to collect external information indices to adjust the demand forecasting. Our numerical study shows that the intelligent forecasting approach can effectively reduce the Mean Square Error (MSE), Root Mean Square Error (RMSE), and Mean Absolute Percentage Error (MAPE) by at least 45.79, 26.35, and 26.34 %, respectively. [ABSTRACT FROM AUTHOR]