Chylothorax is a rare condition where the extravasated chyle accumulates into the pleural space. It is most commonly associated with malignancies, infective or inflammatory disorders and iatrogenic causes. Extremely rarely, it could occur spontaneously. We present the case of a healthy 40-year-old woman who presented with acute right shoulder and neck pain associated with shortness of breath and loss of consciousness. This was preceded by a yoga class two weeks prior. Chest imaging showed right pleural effusion, and tapping revealed a milky fluid which was confirmed to be chylothorax. Conservative management failed and the patient was successfully treated with video-assisted thoracoscopic drainage, thoracic duct ligation and mechanical pleurodesis. Chylothorax association with yoga is not reported in the literature. Full article

Rheumatoid arthritis (RA) is a chronic, systemic, and inflammatory autoimmune condition characterized by synovitis, pannus formation (with adjacent bone erosion), and joint destruction. In the perpetuation of RA, fibroblast-like synoviocytes (FLSs), macrophages, B cells, and CD4⁺ T-cells—specifically Th1 and Th17 cells—play crucial roles. Additionally, dendritic cells, neutrophils, mast cells, and monocytes contribute to the disease progression. Monocytes, circulating cells primarily derived from the bone marrow, participate in RA pathogenesis. Notably, CCR2 interacts with CCL2, and CX3CR1 (expressed by monocytes) cooperates with CX3CL1 (produced by FLSs), facilitating the migration involved in RA. Canonical “classical” monocytes predominantly acquire the phenotype of an “intermediate” subset, which differentially expresses proinflammatory cytokines (IL-1β, IL-6, and TNF) and surface markers (CD14, CD16, HLA-DR, TLRs, and β1- and β2-integrins). However, classical monocytes have greater potential to differentiate into osteoclasts, which contribute to bone resorption in the inflammatory milieu; in RA, Th17 cells stimulate FLSs to produce RANKL, triggering osteoclastogenesis. This review aims to explore the monocyte heterogeneity, plasticity, antigenic expression, and their differentiation into macrophages and osteoclasts. Additionally, we investigate the monocyte migration into the synovium and the role of their cytokines in RA. Full article

Calf diarrhea caused by enterotoxigenic E. coli (ETEC) poses an enormous economic challenge in the cattle industry. Fimbriae and enterotoxin are crucial virulence factors and vaccine targets of ETEC. Since these proteins have complicated components with large molecular masses, the development of vaccines by directly expressing these potential targets is cumbersome Therefore, this study aimed to develop a multiepitope fusion antigen designated as MEFA by integrating major epitopes of FanC and Fim41a subunits and a toxoid epitope of STa into the F17G framework. The 3D modeling predicted that the MEFA protein displayed the epitopes from these four antigens on its surface, demonstrating the desired structural characteristics. Then, the MEFA protein was subsequently expressed and purified for mouse immunization. Following that, our homemade ELISA showed that the mouse antiserum had a consistent increase in polyclonal antibody levels with the highest titer of 1:2¹⁷ to MEFA. Furthermore, the western blot assay demonstrated that this anti-MEFA serum could react with all four antigens. Further, this antiserum exhibited inhibition on ETEC adhesion to HCT-8 cells with inhibitory rates of 92.8%, 84.3%, and 87.9% against F17⁺, F5⁺, and F41⁺ ETEC strains, respectively. Additionally, the stimulatory effect of STa toxin on HCT-8 cells was decreased by approximately 75.3% by anti-MEFA serum. This study demonstrates that the MEFA protein would be an antigen candidate for novel subunit vaccines for preventing ETEC-induced diarrhea in cattle. Full article

The main objective of the present study was to develop a concise predictive model to determine the likelihood of winning in female rink hockey based on various situational variables. Additionally, the study aimed to assess the individual impact of each predictor on match outcomes. The analysis encompassed a dataset of 840 matches during five consecutive seasons (from 2018–2019 to 2022–2023) in the Spanish first division (OkLiga). Employing the comprehensive method of all possible regressions, the most effective predictive logistic model for match outcomes was identified. This entire model featured five categorical predictor variables (match location, team level, opponent level, scoring first, and match status at halftime) and one binary outcome variable (match outcome). Subsequently, the final model, which exhibited a sensitivity and specificity surpassing 80% for a cut-off point of 0.439, emerged. This model was applied to predict winning a match in 18 frequent situations determined from a two-step cluster analysis. Within this predictive framework, match status at halftime emerged as the most influential predictor impacting the match outcome, followed by opponent level, team level, and match location. The implications of our findings extend to rink hockey coaches and practitioners. Recognizing the significant impact of situational variables on match outcomes empowers them to customize game plans and design more specific strategies, thereby enhancing game understanding and elevating the overall performance. Full article

Photoelectrocatalytic approaches show promise for contaminate removal in wastewater through redox reactions. However, the direct treatment of very low concentration heavy metals is a challenging task. Copper bismuth oxide is considered as a potential photocathode material due to its appropriate bandgap width and excellent light absorption properties. In this work, we utilize copper bismuth oxide photoelectrodes with micrometer-scale pores to achieve the efficient and complete reduction of micromolar-level hexavalent chromium(VI) in wastewater. In a continuous 180 min experiment, the reduction rate of 5 µM hexavalent chromium reached 97%, which is an order lower than the drinking standard. Such a process was facilitated by the unique hierarchical microstructure of the oxide thin film and the porous morphology. On the other hand, the structural evolution during the operation was analyzed. A surface passivation was observed, suggesting the possible long-term practical application of this material. This study serves as an important reference for the application of photoelectrocatalysis in addressing Cr(VI) pollution in wastewater, with implications for improving water quality and environmental protection. Full article

There are established reference ranges for many laboratory values during pregnancy. Fewer studies exist regarding the expected white blood cell (WBC) count after delivery. The aim of this study was to determine appropriate postpartum leukocytosis in a diverse patient cohort. Patients who delivered a live fetus at 37 weeks or later were retrospectively identified. Complete blood counts collected on hospital admission and postpartum day one were used to quantify the change in WBC count associated with delivery. A total of 2245 patients were included; of these patients, 1476 delivered vaginally and 769 delivered via cesarean section. The average change in WBC count was 2.99 × 10³/mm³. A WBC count of 20.19 × 10³/mm³ defined the 95th percentile. The average rise in WBC count was 3.31 × 10³/mm³ after vaginal delivery and 2.34 × 10³/mm³ after cesarean section (p < 0.001). Patients with chorioamnionitis or endometritis had an average postpartum WBC rise of 7.38 × 10³/mm³ compared to 2.99 × 10³/mm³ in controls (p < 0.001). There was no difference in WBC count rise with comorbid asthma, diabetes, or chronic hypertension. A greater WBC count rise was found in patients with pregnancy-induced hypertension. This study provides reference values for the average rise in WBC count after delivery and the 95th percentile postpartum WBC count in a diverse, medically complex patient population with and without delivery complications. Our findings further highlight maternal medical comorbidities that may contribute to the degree of postpartum leukocytosis. Full article

A series of new granular carbonaceous adsorbents was prepared via single-stage physical and chemical activation of walnut shells. Their suitability for removing various types of organic pollutants (represented by dyes, surfactants and water-soluble polymers) from the liquid phase was assessed. The activation of the precursor was carried out with CO₂ and H₃PO₄ using conventional heating. Activated biocarbons were characterized in terms of chemical composition, acidic–basic nature of the surface, textural and electrokinetic properties as well as thermal stability. Depending on the type of activating agent used during the activation procedure, the obtained biocarbons differed in terms of specific surface area (from 401 to 1361 m²/g) and the type of porous structure produced (microporosity contribution in the range of 45–75%). Adsorption tests proved that the effectiveness of removing organic pollutants from the liquid phase depended to a large extent on the type of prepared adsorbent as well as the chemical nature and the molecular size of the adsorbate used. The chemically activated sample showed greater removal efficiency in relation to all tested pollutants. Its maximum adsorption capacity for methylene blue, poly(acrylic acid), poly(ethylene glycol) and Triton X-100 reached the levels of 247.1, 680.9, 38.5 and 61.8 mg/g, respectively. Full article

DNA damage is fundamental to tumorigenesis, and the inability to repair DNA damage is a hallmark of many human cancers. DNA is repaired via the DNA damage repair (DDR) apparatus, which includes five major pathways. DDR deficiencies in cancers give rise to potential therapeutic targets, as cancers harboring DDR deficiencies become increasingly dependent on alternative DDR pathways for survival. In this review, we summarize the DDR apparatus, and examine the current state of research efforts focused on identifying vulnerabilities in DDR pathways that can be therapeutically exploited in pediatric extracranial solid tumors. We assess the potential for synergistic combinations of different DDR inhibitors as well as combinations of DDR inhibitors with chemotherapy. Lastly, we discuss the immunomodulatory implications of targeting DDR pathways and the potential for using DDR inhibitors to enhance tumor immunogenicity, with the goal of improving the response to immune checkpoint blockade in pediatric solid tumors. We review the ongoing and future research into DDR in pediatric tumors and the subsequent pediatric clinical trials that will be critical to further elucidate the efficacy of the approaches targeting DDR. Full article

This paper presents the development and validation of a cost-efficient and uncomplicated real-time localization system (RTLS) for use in mobile robotics, specifically within indoor and storage environments. By harnessing ultrasonic waves to measure distances from three beacons, the system provides stable and reliable localization. This method utilizes the time-of-flight (TOF) principle, allowing for accurate distance calculations with simple microcontrollers. The system is designed to update the robot’s position at a frequency of at least 10 times per second, ensuring smooth navigation. Our trilateration-based approach allows for the precise determination of the robot’s position with a notable standard deviation accuracy of up to 15 mm. The aim was to design a simple yet sufficiently accurate system and verify its precision through experimental measurements. The experimental results demonstrate the system’s efficacy and lay a solid foundation for advancing this technology. Furthermore, the cost for the components required to build this indoor localization system (ILS) with three beacons and one tag is remarkably low, under EUR 80. Full article

Background: The dreaded sensation of pain in the dental chair has a significant impact on children’s behavior. This study aimed to compare and contrast the perception of pain and patient behavior between the use of INJEX and the conventional syringe needle technique during pulpotomy among children. Methods: A randomized clinical trial was designed and conducted among pediatric dentistry patients aged 6–12 years old. Fifty-eight children were divided into two groups, conventional syringe needle and INJEX, using simple randomization method applying the sequentially numbered, opaque, sealed envelope method of allocation concealment. Anesthesia was administered to the groups as local infiltration by a single operator following routine behavior guidance techniques. After 3 min, pulpotomy was performed using the standard protocol. The Face, Legs, Activity, Cry, Consolability (FLACC) scale and Wong–Baker FACES Pain Rating Scale (WBS) were used to assess the intensity of pain, while the Frankl behavior rating scale (FBRS) was used to assess the children’s behavior. Results: During anesthesia, most of the participants in the INJEX group (median = 3) had higher FBRS scores compared with the conventional syringe needle group (median = 2), and the difference was very highly significant (p-value < 0.001). Analyzing the FLACC scores during local anesthesia administration revealed a high statistical significance (p-value < 0.01) across the two groups. A very high statistically significant difference (p-values < 0.001) with higher WBS scores for pain intensity was seen in the group using conventional syringe needles. Conclusions: INJEX administration significantly reduced the intensity of pain experienced by the children and helped maintain a positive attitude among them during pulpotomy. It provided a positive and comfortable experience for both the child and the practitioner. Therefore, it can serve as an excellent alternative to conventional needle anesthesia. Full article

Overlap syndrome (OVS) is a distinct clinical entity that seems to result in potential cardiovascular consequences. We aimed to estimate the prevalence and risk factors for OVS in OSA patients and analyze clinical and PSG characteristics associated with OVS. In this cross-sectional study, 2616 patients evaluated for OSA underwent type-1 polysomnography (PSG). They were grouped as pure OSA (AHI > 15/h) and OVS patients. Demographics, PSG data, pulmonary function tests and arterial blood gases (ABGs) were compared between groups after adjustments for confounders. OSA was diagnosed in 2108 out of 2616 patients. Of those, 398 (19%) had OVS. Independent predictors of OVS were older age [OR: 5.386 (4.153–6.987)], current/former smoking [OR: 11.577 (7.232–18.532)], BMI [OR: 2.901 (2.082–4.044)] and ABG measurements [PaCO₂ ≥ 45 OR: 4.648 (3.078–7.019), PO₂ [OR: 0.934 (0.920–0.949)], HCO₃⁻ [OR: 1.196 (1.133–1.263), all p < 0.001]. OVS was also associated with prevalent hypertension [OR: 1.345 (1.030–1.758), p = 0.03] and cardiovascular disease [OR: 1.617 (1.229–2.126), p < 0.001], depressive symptoms [OR: 1.741 (1.230–2.465), p = 0.002] and nocturia [OR: 1.944 (1.378–2.742), p < 0.001], as well as with indices of OSA severity. Disturbances in sleep architecture were more prominent in OVS expressed by lower %N3 and REM% and higher arousal index. Our data suggest that OVS is prevalent among OSA patients, with distinct clinical and PSG characteristics. These characteristics could be utilized as predictive factors for early identification and further evaluation of these patients towards desirable patient-reported outcomes. Full article

The chiral aziridine-containing vicinal iminophenol tridentate ligands (named salazins) are a class of readily prepared chiral ligands from enantiopure aziridines and salicylaldehydes. Their scandium and yttrium triflate complexes show excellent reactivity and enantioselectivities in the catalytic asymmetric aldol condensation of electron-deficient aromatic aldehydes and ketones, including acetone and cycloalkanones. The stereoselectivity is rationalized to the strong π–stacking interaction between aromatic aldehydes and the vicinal iminophenol group in the chiral ligands. Full article

In the context of growing demand for road infrastructure expansion, sustainability is of key importance. Enhancing road construction technology ensures efficient, durable transportation infrastructure, vital for economic growth. Responsible road construction, especially in areas of historical and environmental significance, is essential. Preserving ecosystems and local heritage in road planning protects valuable areas and supports regional sustainability. Rural roads, often in forested areas, should maintain natural aesthetics. Economic challenges require flexible, efficient roads. Many existing unpaved roads, especially in rural and forest environments, fail to meet increasing traffic and load of heavy agricultural and maintenance vehicles. Soil stabilization methods, discussed in various publications, offer sustainable solutions. Research on ecofriendly binding additives provides the opportunity to reduce cement consumption and CO₂ emissions. Such innovations enhance road efficiency, reduce maintenance costs, and benefit the environment. Investing in modern road technologies mitigates climate change effects by reducing emissions and protecting ecosystems. Our research indicates that soil stabilization technologies significantly improve road strength and durability. Additives can increase compressive strength by over 50% with minimal cement content. Continued research into road quality and durability is vital for sustainable transport infrastructure development. The results presented in this paper were obtained after two periods of solidification: after 7 and 30 days, with three types of ads (ion-exchangeable, chemical, and polymeric) to cement. In all tests, compaction strength improved by at least 35% in samples with the lowest cement content. Full article

The interfacial bonding capacity between cement emulsified asphalt composite binder (CEACB) and reclaimed asphalt pavement (RAP) plays a critical role in improving the pavement performance of cold recycled asphalt emulsion mixtures (CRAEMs). This study aims to investigate the formation and development of the interfacial bonding capacity between CEACB and RAP. First, the dynamic wettability and the spreading behaviors of CEACB on RAP surfaces were explored according to the surface free energy theory. Second, digital image processing (DIP) technology was employed to recognize interfacial failure patterns. Lastly, the influence of internal and external factors on the interfacial bonding capacity between CEACB and RAP during the curing process was analyzed via grey relational analysis (GRA). The results indicate that a moderate cement content with a mass ratio of asphalt to cement equivalent to 1.0 can significantly enhance the wettability of CEACB on RAP surfaces. By appropriately prolonging the curing time and controlling the curing temperature, it is possible to increase the bonding strength between CEACB and RAP. Additionally, a strong correlation exists between initial wettability and ultimate bonding capacity during the bonding strength curing process. The good wettability that developed in the initial stage of interfacial strength formation relates to the decreased spalling rate of CEACB on the RAP surface. This study is not only devoted to understanding the mechanisms that can enhance CRAEM performance but also provides important guidance for practical engineering applications of cold recycled asphalt pavements. Full article

This brief report aimed to show the utility of photon-counting technology alongside standard cranial imaging protocols for visualizing shunt valves in a patient’s cranial computed tomography scan. Photon-counting CT scans with cranial protocols were retrospectively surveyed and four types of shunt valves were encountered: proGAV 2.0^®, M.blue^®, Codman Certas^®, and proSA^®. These scans were compared with those obtained from non-photon-counting scanners at different time points for the same patients. The analysis of these findings demonstrated the usefulness of photon-counting technology for the clear and precise visualization of shunt valves without any additional radiation or special reconstruction patterns. The enhanced utility of photon-counting is highlighted by providing superior spatial resolution compared to other CT detectors. This technology facilitates a more accurate characterization of shunt valves and may support the detection of subtle abnormalities and a precise assessment of shunt valves. Full article

Implant-supported-screw-retained prostheses are highly popular. Some of the most frequent complications are connected with the mechanical properties of the fixing elements. These include abutment screw loosening or even screw fracture. Using an intermediate abutment can offer several advantages. However, few studies detail how this affects the mechanical behavior of dental restorations. This study focuses on understanding the mechanical behavior of implant-supported restorations with a transepithelial component compared to direct implant-supported restoration. It was carried out using the finite element method (FEM) and was experimentally validated. The results showed that in the case of transepithelial-supported restoration, the prosthetic screw mounted over the transepithelial component suffered higher stress than the one screwed directly into the implant. After applying a cyclic fatigue load, it was experimentally proven that, in the transepithelial-supported restorations, the fuse changed from being the screw that went into the implant to being the upper one. In conclusion, we can state that the use of an intermediate abutment in dental restoration not only provides better protection for the rest of the dental restoration but also allows for easier repair in the event of a fracture. This can potentially lead to more efficient procedures and improved patient outcomes. Full article

The HIV-1 capsid (CA) protein forms the outer shell of the viral core that is released into the cytoplasm upon infection. CA binds various cellular proteins, including CPSF6, that direct HIV-1 integration into speckle-associated domains in host chromatin. Upon HIV-1 infection, CPSF6 forms puncta in the nucleus. Here, we characterised these CPSF6 puncta further in HeLa cells, T-cells and macrophages and confirmed that integration and reverse transcription are not required for puncta formation. Indeed, we found that puncta formed very rapidly after infection, correlating with the time that CA entered the nucleus. In aphidicolin-treated HeLa cells and macrophages, puncta were detected for the length of the experiment, suggesting that puncta are only lost upon cell division. CA still co-localised with CPSF6 puncta at the latest time points, considerably after the peak of reverse transcription and integration. Intriguingly, the number of puncta induced in macrophages did not correlate with the MOI or the total number of nuclear speckles present in each cell, suggesting that CA/CPSF6 is only directed to a few nuclear speckles. Furthermore, we found that CPSF6 already co-localised with nuclear speckles in uninfected T-cells, suggesting that HIV-1 promotes a natural behaviour of CPSF6. Full article

This population-based study aimed to assess the prevalence of congenital hypothyroidism (CH) and overt hypothyroidism (OH) and their association with congenital heart defects (CHDs) in patients with Down syndrome (DS). The population included all live births residing in Tuscany (Italy) diagnosed with DS recorded in the Registry of Congenital Defects and in the Registry of Rare Diseases of Tuscany in the years 2003–2017. The prevalence of CH and OH in DS patients was calculated by sex and by period. The association of CH and OH with CHDs in DS patients was assessed using multivariate logistic regression. The cohort included 228 subjects. The prevalence of CH and OH was 11.4% (95%CI: 7.4–16.7%) and 12.7% (95%CI: 8.5–12.3%), respectively, with no significant difference by sex. A significant increase in the prevalence of CH (p < 0.0001) was found in the years 2010–2017 compared to the previous period, and among preterm infants (p = 0.009). The presence of CH was associated with a higher prevalence of CHDs (adjusted OR = 2.24, p = 0.082). A significant association between ventricular septal defects (VSDs) and the occurrence of OH (adjusted OR = 3.07, p = 0.025) was also observed. This study confirmed the higher prevalence of both CH and OH in DS compared to the general population. Furthermore, the risk of association between DS and CHDs was higher in the presence of CH, while VSDs are associated with OH, providing relevant insights into the epidemiology of hypothyroidism in DS and associated anomalies. Full article

It is of great significance for scientific land use planning and ecological security protection to clarify the impacts of land use changes on an ecosystem’s health. Based on the dynamic evolution of land use and ecosystem health on the Northern Slope of Tianshan Mountain (NSTM) from 2000 to 2020, this study utilized the patch-generating land use simulation (PLUS) model, the Vitality–Organization–Resilience–Services (VORS) model, and the elasticity approach to assess the impacts of land use changes on ecosystem health under four different scenarios: Natural Development Scenario (ND), Farmland Conservation Priority Scenario (FP), Ecological Conservation Priority Scenario (EP), and Urban Development Priority Scenario (UD). The results indicate that (1) land use on the NSTM from 2000 to 2020 was predominantly characterized by barren land and grassland. (2) The overall level of ecosystem health on the NSTM was poor from 2000 to 2020 but showed a gradual improvement trend. (3) Ecosystem health levels vary greatly across scenarios. In general, ecosystem health improves under FP and EP scenarios but deteriorates significantly under ND and UD scenarios. The resilience of ecosystem health varies significantly across different land categories. In the future, optimizing the current land use pattern and refining the ecological protection policy are essential to enhance ecosystem health and services in the NSTM. Full article

The superior extensor ankle retinaculum (SEAR), a transversely fascial thickening positioned above the tibia–talar joint, serves as a crucial anatomical structure in ankle stability. The purpose of this study was to measure and compare by ultrasound (US) imaging the bilateral thickness and echogenicity of SEAR in football players with previous multiple ankle sprains (group 1) and healthy volunteers (group 2). A cross-sectional study was performed using ultrasound imaging to measure longitudinal and transversal axes using a new protocol in a sample of 50 subjects: 25 football players with previous multiple ankle sprains and 25 healthy subjects. The findings for SEAR thickness revealed statistically significant differences for both axes (p = 0.0011 and p = 0.0032) between the healthy side and the previously sprained side, and with the corresponding side of group 2 (p = 0.003 and p = 0.004). Moreover, in group 1, regarding the ROI echogenicity, a statistically significant difference was found between the sides (p = 0.0378). These findings suggest that the football players with previous ankle sprains showed a thicker and inhomogeneous SEAR on the sprain side, unveiling a remodeling of this structure compared to the other side and to the healthy volunteers. In these athletes, during US examination, one needs to keep “a US eye” on side-to-side SEAR comparisons. Full article

This study introduces a specialized Automatic Speech Recognition (ASR) system, leveraging the Whisper Large-v2 model, specifically adapted for radiological applications in the French language. The methodology focused on adapting the model to accurately transcribe medical terminology and diverse accents within the French language context, achieving a notable Word Error Rate (WER) of 17.121%. This research involved extensive data collection and preprocessing, utilizing a wide range of French medical audio content. The results demonstrate the system’s effectiveness in transcribing complex radiological data, underscoring its potential to enhance medical documentation efficiency in French-speaking clinical settings. The discussion extends to the broader implications of this technology in healthcare, including its potential integration with electronic health records (EHRs) and its utility in medical education. This study also explores future research directions, such as tailoring ASR systems to specific medical specialties and languages. Overall, this research contributes significantly to the field of medical ASR systems, presenting a robust tool for radiological transcription in the French language and paving the way for advanced technology-enhanced healthcare solutions. Full article

This study introduces a novel method for analyzing vibration data related to drill bit failure. Our approach combines explainable artificial intelligence (XAI) with convolutional neural networks (CNNs). Conventional signal analysis methods, such as fast Fourier transform (FFT) and wavelet transform (WT), require extensive knowledge of drilling equipment specifications, which limits their adaptability to different conditions. In contrast, our method leverages XAI algorithms applied to CNNs to directly identify fault signatures from vibration signals. The signals are transformed into their frequency components and then employed as inputs to a CNN model, which is trained to detect patterns indicative of drill bit failure. XAI algorithms are then employed to generate attention maps, highlighting regions of interest in the CNN. By scrutinizing these maps, engineers can identify critical frequencies associated with drill bit failure, providing valuable insights for maintenance and optimization. This method offers a transparent and interpretable framework for analyzing vibration data, enabling informed decision-making and proactive maintenance strategies to enhance drilling efficiency and minimize downtime. The integration of XAI with CNNs facilitates a deeper understanding of the root causes of drill bit failure and improves overall drilling performance. Full article