Drawing offers a way for young children to demonstrate what they understand about the world. This study reports on the findings from an eight-week intervention program called guided drawing designed to build vocabulary and content knowledge for dual language learners in Head Start settings. Four researcher-designed assessment measures were used to assess thirteen preschoolers’ vocabulary and concept knowledge at the receptive, expressive, and definitional levels in a pre/post-intervention design. Analysis of researcher-designed measures reveals positive changes in all vocabulary and concept knowledge areas targeted by the intervention. Thematic analysis of researcher–child interactions and drawing products indicates the guided drawing intervention provided opportunities and context for every participating child to explore new content and concepts related to science learning; reveal what they know; grow knowledge and vocabulary; reveal misunderstandings; and overhear and adopt new language. Full article

Hereditary fructose intolerance is a rare genetic disorder that is inherited in an autosomal recessive manner, with mutations sometimes occurring spontaneously. Consuming fructose triggers biochemical abnormalities, disrupting liver processes like glycogenolysis and gluconeogenesis. Recent studies have revealed elevated intrahepatic fat levels in affected individuals. Symptoms include aversion to fructose-containing foods, hypoglycemia, liver and kidney dysfunction, and growth delays, with severe cases leading to liver enlargement, fatty liver disease, kidney failure, and life-threatening hypoglycemia. In this case study, we present a 20-month-old child with symptoms including difficulty passing stool, abdominal rigidity, abdominal pain with bloating and hypoglycemia. Initial clinical findings revealed elevated liver enzymes, a mildly enlarged hyperechoic liver, hypercholesterolemia, and borderline alpha-fetoprotein values. Diagnostic assessments identified hereditary fructose intolerance (HFI) with pathogenic variants in the ALDOB gene, along with a diagnosis of celiac disease. Genetic testing of the parents revealed carrier status for pathological aldolase B genes. This case underscores the importance of comprehensive clinical evaluation and genetic testing in pediatric patients with complex metabolic presentations. Full article

In this study, an electrode slurry composed of molybdenum disulfide (MoS₂) and vapor-grown carbon fiber (VGCF) prepared through a solid-phase synthesis method was blade-coated onto copper foil to form a thick film as the anode for lithium-ion batteries. In previously reported work, MoS₂-based lithium-ion batteries have experienced gradual deformation, fracture, and pulverization of electrode materials during the charge and discharge cycling process. This leads to an unstable electrode structure and rapid decline in battery capacity. Furthermore, MoS₂ nanosheets tend to aggregate over charge and discharge cycles, which diminishes the surface activity of the material and results in poor electrochemical performance. In this study, we altered the density of the MoS₂–carbon fiber/Cu foil anode electrode by rolling. Three different densities of electrode sheets were obtained through varying rolling repetitions. Our study shows the best electrochemical performance was achieved at a material density of 2.2 g/cm³, maintaining a capacity of 427 mAh/g even after 80 cycles. Full article

Lifestyle interventions can prevent type 2 diabetes (T2DM). However, some individuals do not experience anticipated improvements despite weight loss. Biomarkers to identify such individuals at early stages are lacking. Insulin-like growth factor 1 (IGF- 1) and Insulin-like growth factor binding protein 1(IGFBP-1) were shown to predict T2DM onset in prediabetes. We assessed whether these markers also predict the success of lifestyle interventions, thereby possibly guiding personalized strategies. We analyzed the fasting serum levels of IGF-1, IGFBP-1, and Insulin-like growth factor binding protein 2 (IGFBP-2) in relation to changes in metabolic and anthropometric parameters, including intrahepatic lipids (IHLs) and visceral adipose tissue (VAT) volume, measured by magnetic resonance imaging (MRI), in 345 participants with a high risk for prediabetes (54% female; aged 36–80 years). Participants were enrolled in three randomized dietary intervention trials and assessed both at baseline and one year post-intervention. Statistical analyses were performed using IBM SPSS Statistics (version 28), and significance was set at p < 0.05. Within the 1-year intervention, overall significant improvements were observed. Stratifying individuals by baseline IGF-1 and IGFBP-1 percentiles revealed significant differences: higher IGF-1 levels were associated with more favorable changes compared to lower levels, especially in VAT and IHL. Lower baseline IGFBP-1 levels were associated with greater improvements, especially in IHL and 2 h glucose. Higher bioactive IGF-1 levels might predict better metabolic outcomes following lifestyle interventions in prediabetes, potentially serving as biomarkers for personalized interventions. Full article

Medical Visual Question Answering (Med-VQA) faces significant limitations in application development due to sparse and challenging data acquisition. Existing approaches focus on multi-modal learning to equip models with medical image inference and natural language understanding, but this worsens data scarcity in Med-VQA, hindering clinical application and advancement. This paper proposes the ITLTA framework for Med-VQA, designed based on field requirements. ITLTA combines multi-label learning of medical images with the language understanding and reasoning capabilities of large language models (LLMs) to achieve zero-shot learning, meeting natural language module needs without end-to-end training. This approach reduces deployment costs and training data requirements, allowing LLMs to function as flexible, plug-and-play modules. To enhance multi-label classification accuracy, the framework uses external medical image data for pretraining, integrated with a joint feature and label attention mechanism. This configuration ensures robust performance and applicability, even with limited data. Additionally, the framework clarifies the decision-making process for visual labels and question prompts, enhancing the interpretability of Med-VQA. Validated on the VQA-Med 2019 dataset, our method demonstrates superior effectiveness compared to existing methods, confirming its outstanding performance for enhanced clinical applications. Full article

Age-related macular degeneration (AMD) is strictly linked to chronic oxidative stress, inflammation, loss of epithelial barrier integrity, and often with abnormal new blood vessel development. In this study, the retinal epithelial cell line ARPE-19 was treated with pro-inflammatory transforming growth factor-beta (TGF-β) to investigate the activity of vitamin D (VD) and sulforaphane (SF) in abating the consequences of oxidative stress and inflammation. The administration of VD and SF lowered reactive oxygen species (ROS) levels, and abated the related expression of the pro-inflammatory cytokines interleukin-6 and interleukin-8 induced by TGF-β. We evaluated mitochondrial respiration as a source of ROS production, and we discovered that the increased transcription of respiratory elements triggered by TGF-β was prevented by VD and SF. In this model of inflamed epithelium, the treatment with VD and SF also reduced the secretion of VEGF, a key angiogenic factor, and restored the markers of epithelial integrity. Remarkably, all the observed biological effects were potentiated by the co-stimulation with the two compounds and were not mediated by VD receptor expression but rather by the ERK 1/2 pathway. Altogether, the results of this study reveal the powerful synergistic anti-inflammatory activity of SF and VD and lay the foundation for future clinical assessment of their efficacy in AMD. Full article

The topic of efficiently finding the global minimum of multidimensional functions is widely applicable to numerous problems in the modern world. Many algorithms have been proposed to address these problems, among which genetic algorithms and their variants are particularly notable. Their popularity is due to their exceptional performance in solving optimization problems and their adaptability to various types of problems. However, genetic algorithms require significant computational resources and time, prompting the need for parallel techniques. Moving in this research direction, a new global optimization method is presented here that exploits the use of parallel computing techniques in genetic algorithms. This innovative method employs autonomous parallel computing units that periodically share the optimal solutions they discover. Increasing the number of computational threads, coupled with solution exchange techniques, can significantly reduce the number of calls to the objective function, thus saving computational power. Also, a stopping rule is proposed that takes advantage of the parallel computational environment. The proposed method was tested on a broad array of benchmark functions from the relevant literature and compared with other global optimization techniques regarding its efficiency. Full article

This study reports the quantitative results of middle leaders’ self-reported practices and compares their responses to the perceptions of the teachers who report to them (n = 158). Likert scale questionnaires were used to measure the extent to which middle leaders focused on goal orientation, professional collaboration, effective instructional practices, and supporting teacher development within their department. The analysis provides insight into this phenomenon within six different state-funded secondary schools, with results showing middle leaders almost always rate their practices more effectively than the teachers who report to them. Common areas identified as requiring increased effectiveness were middle leaders’ use of resources to support learning, use of data to support the instructional programme, and identification of effective professional learning opportunities for teachers. Reported levels of effectiveness compared with student academic achievement in the senior secondary school setting align with agreement ratings and the socio-economic status of students who attend the school. This paper highlights the need for the ongoing support of middle leaders to be provided with deliberate support and development for leading teachers. Full article

Degenerative disc disease (DDD) is a pervasive condition that limits quality of life and burdens economies worldwide. Conventional pharmacological treatments primarily aimed at slowing the progression of degeneration have demonstrated limited long-term efficacy and often do not address the underlying causes of the disease. On the other hand, orthobiologics are regenerative agents derived from the patient’s own tissue and represent a promising emerging therapy for degenerative disc disease. This review comprehensively outlines the pathophysiology of DDD, highlighting the inadequacies of existing pharmacological therapies and detailing the potential of orthobiologic approaches. It explores advanced tools such as platelet-rich plasma and mesenchymal stem cells, providing a historical overview of their development within regenerative medicine, from foundational in vitro studies to preclinical animal models. Moreover, the manuscript delves into clinical trials that assess the effectiveness of these therapies in managing DDD. While the current clinical evidence is promising, it remains insufficient for routine clinical adoption due to limitations in study designs. The review emphasizes the need for further research to optimize these therapies for consistent and effective clinical outcomes, potentially revolutionizing the management of DDD and offering renewed hope for patients. Full article

Vessel segmentation in fundus images is crucial for diagnosing eye diseases. The rapid development of deep learning has greatly improved segmentation accuracy. However, the scale of the retinal blood-vessel structure varies greatly, and there is a lot of noise unrelated to blood-vessel segmentation in fundus images, which increases the complexity and difficulty of the segmentation algorithm. Comprehensive consideration of factors like scale variation and noise suppression is imperative to enhance segmentation accuracy and stability. Therefore, we propose a retinal vessel segmentation method based on multi-scale feature extraction and decoupled representation. Specifically, we design a multi-scale feature extraction module at the skip connections, utilizing dilated convolutions to capture multi-scale features and further emphasizing crucial information through channel attention modules. Additionally, to separate useful spatial information from redundant information and enhance segmentation performance, we introduce an image reconstruction branch to assist in the segmentation task. The specific approach involves using a disentangled representation method to decouple the image into content and style, utilizing the content part for segmentation tasks. We conducted experiments on the DRIVE, STARE, and CHASE_DB1 datasets, and the results showed that our method outperformed others, achieving the highest accuracy across all three datasets (DRIVE:0.9690, CHASE_DB1:0.9757, and STARE:0.9765). Full article

This study investigates viscoelastic guided wave properties (e.g., complex−wavenumber−, phase−velocity−, and attenuation−frequency relations) for multiple modes, including different orders of antisymmetric, symmetric, and shear horizontal modes in viscoelastic anisotropic laminated composites. To obtain those frequency−dependent relations, a guided wave characteristic equation is formulated based on a Legendre orthogonal polynomials expansion (LOPE)−assisted viscoelastodynamic model, which fuses the hysteretic viscoelastic model−based wave dynamics and the LOPE−based mode shape approximation. Then, the complex−wavenumber–frequency solutions are obtained by solving the characteristic equation using an improved root−finding algorithm, which leverages coefficient matrix determinant ratios and our proposed local tracking windows. To trace the solutions on the dispersion curves of different wave modes and avoid curve−tracing misalignment in regions with phase−velocity curve crossing, we presented a curve−tracing strategy considering wave attenuation. With the LOPE−assisted viscoelastodynamic model, the effects of material viscosity and fiber orientation on different guided wave modes are investigated for unidirectional carbon−fiber−reinforced composites. The results show that the viscosity in the hysteresis model mainly affects the frequency−dependent attenuation of viscoelastic guided waves, while the fiber orientation influences both the phase−velocity and attenuation curves. We expect the theoretical work in this study to facilitate the development of guided wave−based techniques for the NDT and SHM of viscoelastic anisotropic laminated composites. Full article

Previous research has shown that exercise interventions requiring increased activation of the tibialis anterior (TA), the primary ankle dorsiflexor, can improve walking performance in individuals with foot drop. Correspondingly, heightened drag forces experienced during walking performed in water may augment TA activation during the swing phase of gait, potentially leading to improved walking gait on land. Therefore, this study aimed to compare surface electromyographic (sEMG) activation in the TA and medial gastrocnemius (GM) during gait performed in water versus on land. Thirty-eight healthy, recreationally active young adults, comprising 18 females and 20 males, participated in the study. Each participant completed 2 min walking trials under five conditions: land 2.5 mph, land 3.5 mph, water 2.5 mph, water 3.5 mph, and water 3.5 mph with added jet resistance. Stride kinematics were collected using 2-dimensional underwater motion capture. TA and GM, muscle activation magnitudes, were quantified using sEMG root-mean-square (RMS) amplitudes for both the swing and stance phases of walking. Additionally, TA and GM co-activation (Co-A) indices were estimated. Two-way within-subjects repeated measures analyses of variance were used to evaluate the main effects of and interactions between the environment and walking speed. Additionally, paired sample t-tests were conducted as a secondary analysis to investigate differences between walking in water at 3.5 mph with and without added jet resistance. Main effects and interactions were observed across various stride kinematics and sEMG measures. Notably, TA sEMG RMS during the swing phase of walking gait performed at 2.5 mph was 15% greater in water than on land (p < 0.001). This effect increased when walking gait was performed at 3.5 mph (94%; p < 0.001) and when jet resistance was added to the 3.5 mph condition (52%; p < 0.001). Furthermore, TA Co-A was increased during the stance phase of gait in water compared to on land (p < 0.001), while GM Co-A was reduced during the swing phase (p < 0.001). The findings of this study offer compelling evidence supporting the efficacy of aquatic treadmill walking as a potential treatment for individuals suffering from foot drop. However, further research is needed to evaluate whether a causal relationship exists between heightened TA activation observed during aquatic treadmill walking and improvements in voluntary dorsiflexion during gait. Full article

As the expected cost of conservation agriculture (CA) inputs becomes an issue for farmers, financial institutions (FIs) play an essential role in promoting CA, a set of agricultural management practices with multiple positive effects. This research aimed to determine influencing factors, to rank challenges, and identify mechanisms for farmers to access agricultural credit for adoption of CA management practices in Cambodia. It was administered by conducting a survey of 242 randomly selected households for face-to-face interviews and conducting key informant interviews from purposive samples of 28 participants in Battambang and Preah Vihear provinces. The results indicated that influencing factors, including the family, adult labor and total farm size, had a positive relationship with farmers’ accessibility to agricultural credit, whereas age was negative. However, education year, farm size for main crops, on-farm income and farm experience were not significantly associated. High interest rates were the significant first-order challenge ranked, followed by document process complication, limited agricultural credit information, limited collateral security and a few other challenges. Support and improved process mechanisms to enhance credit accessibility are required to engage with multiple stakeholders, including farmers, FIs, non-government organizations (NGOs) and government officers. There has been a reduction in agricultural credit interest rates and incentives for importing CA inputs by the government, while provision of information support for agribusiness plans by NGOs which have implemented development project activities were considered as the main support mechanism. An improved process mechanism at the farmers’ level needs to include access to credit with low interest rates and a straightforward documentation process, whereas the FI level requires a business plan for lending decisions. It is evident that high lending rates hinder access to agricultural credit and the improvement of support and improved process mechanisms are necessary to better promote CA practices among farmers in Cambodia. Full article

The traditional training methods in radiological hot laboratories involve significant challenges, including the risk of radiation exposure and the development of radiophobia among learners. Virtual reality (VR) presents an innovative educational solution by simulating realistic hot lab environments and procedures without associated risks. This mixed-method study investigates the efficacy of VR in enhancing cognitive retention and practical skills and reducing radiophobia among students. All participants (video and VR cohorts) were given a pre-test, same-day training post-test, after 1 month, and after 3 months. In the 3-month test, 13% of the control group scored > 80%, and 87% of the VR group scored > 80% (6.69-fold more significant). VR simulated the real-world hot lab more accurately than training videos, resulting in increased confidence and safety. Resulting in the control group (video training), radiophobia decreased by 1.52-fold; in contrast, the VR training group reduced by 2.42-fold. These reductions indicate that VR training was significantly more effective in reducing radiophobia than traditional video training. VR enhanced knowledge retention, reduced radiophobia, increased safety confidence, and reduced fear about pursuing a career in nuclear medicine. Overall, VR created a safer working environment, and RT students responded more positively than the instruction videos. Consequently, a mixed-method study revealed key codes of engagement, easy understanding, memory, safety, confidence, learning experiences, implementation in the curriculum, and getting ready for clinical practice. Full article

Groundwater contaminated by benzene and toluene is a common issue, posing a threat to the ecosystems and human health. The removal of benzene and toluene under sulfate-reducing condition is well known, but how the bacterial community shifts during this process remains unclear. This study aims to evaluate the shift in bacterial community structure during the biodegradation of benzene and toluene under sulfate-reducing condition. In this study, groundwater contaminated with benzene and toluene were collected from the field and used to construct three artificial samples: Control (benzene 50 mg/L, toluene 1.24 mg/L, sulfate 470 mg/L, and HgCl₂ 250 mg/L), S1 (benzene 50 mg/L, toluene 1.24 mg/L, sulfate 470 mg/L), and S2 (benzene 100 mg/L, toluene 2.5 mg/L, sulfate 940 mg/L). The contaminants (benzene and toluene), geochemical parameters (sulfate, ORP, and pH), and bacterial community structure in the artificial samples were monitored over time. By the end of this study (day 90), approximately 99% of benzene and 96% of toluene could be eliminated in both S1 and S2 artificial samples, while in the Control artificial sample the contaminant levels remained unchanged due to microbial inactivation. The richness of bacterial communities initially decreased but subsequently increased over time in both S1 and S2 artificial samples. Under sulfate-reducing condition, key players in benzene and toluene degradation were identified as Pseudomonas, Janthinobacterium, Novosphingobium, Staphylococcus, and Bradyrhizobium. The results could provide scientific basis for remediation and risk management strategies at the benzene and toluene contaminated sites Full article

The present study reports on the preparation of a cellulose fiber (CF) composite from D. lutescens, combined with copper oxide nanoparticles (DL@CF/CuO), to prolong the shelf life of tomatoes after harvest. The isolated cellulose fiber material was comprehensively characterized using XRD, FTIR, and FE-SEM analyses. The DLCF and DL@CF/CuO nanoparticles exhibited crystalline cellulose, as indicated by the XRD investigation. Both DLCF and DL@CF/CuO showed O-H and C-H FTIR spectra with identifiable vibrational peaks. The FE-SEM images depicted the dispersion of DL@CF/CuO-based fibers in a cellulose fiber matrix containing CuO nanoparticles. A 0.3% (wt/wt), a solution of DL@CF/CuO was coated onto the surface of early ripening tomato fruits. After a 25-day storage period at 25–29 °C and 85% RH, the results showed a significant extension in the shelf life of the tomato fruits, in line with changes in physiological properties and fruit quality. The extension of shelf life in tomato fruit epidermis treated with DL@CF/CuO was confirmed through FE-SEM analysis. L929 fibroblast cells were treated with the developed DL@CF/CuO nanocomposite, and no signs of toxicity were detected up to 75 µg/mL. Additionally, the DL@CF/CuO nanocomposite exhibited significant antifungal activity against Aspergillus flavus. In conclusion, this study provides novel insights for sustainable food security and waste control in the agricultural and food industries. Full article

Each year, agro-foods produce thousands of tonnes of by-products that contain high-value, unique nutrients. The application of plant by-products enables agro-food corporations to obtain value from them and avoid using natural resources. The idea of the bio economy protects against environmental pollution and leads to a cheap source of bioactive components, which can be transformed into value-added products for other industries. The numerous publications on the positive impact of sea buckthorn (SBT, Hippophae rhamnoides L., Elaeagnaceae family) and its products on human health mainly concern its fruits and seeds. However, there are few data relating to the properties of SBT leaves. The leaves of SBT can be a rich source of nutrients and biologically active substances. In this investigation, we report the study of the leaves of four SBT cultivars. We determined their antioxidant capacities, measured total polyphenols and total flavonoids, and quantified their major polyphenols and alkaloids. The results show that SBT leaves are a source of antioxidants and alkaloids. Additionally, in this raw material, we identified the presence of individual flavonols (rutoside and quercetin), individual anthocyanidins (cyaniding, delphinidin, and peonidin), and chelerythrine by high-performance thin-layer chromatography (HPTLC) for the first time. Through these types of studies, we aim to revalue this raw material, which is not well known in the world. Considering its nutritional properties, we seek to increase the use of its high-value, unique nutrients in food processing, medicine, and animal nutrition, in accordance with the goals of a closed-loop bioeconomy. Full article

Under the current energy crisis and climate change, sustainable urban planning and building design are a priority to achieve a net-zero future, as energy use in buildings for thermal comfort is one of the major carbon emission contributors. To adapt to a rapidly growing and stringent urban environment, where buildings are causing more emissions due to more frequent and severe extreme hot weather events, the parametric design approach has great potential and flexibility in providing a sustainable solution by simulating different design scenarios. This study aims to analyse urban geometry and identify the impact of various built environment scenarios on outdoor thermal comfort under certain climates. The Grasshopper program was used along with the Ladybugs plug-in to provide visualised outcomes of outdoor thermal comfort, with simulation models on Rhinoceros 3D Version 7 SR37 (7.37.24107.1500). Comparing the thermal comfort performance of different design scenarios, based on building height, orientation and urban geometry, helps to identify which factors are more impactful on building design. This study demonstrates the workflow of parametric design in analysing the microclimate pattern and outdoor thermal comfort performance of the existing built environment in Melbourne, Australia, to provide an insight for stakeholders and builders to inform better decision-making in urban planning and building design in order to achieve a zero-emission future. Full article

The advent of induced pluripotent stem cell (iPSC) technology has brought about transformative advancements in regenerative medicine, offering novel avenues for disease modeling, drug testing, and cell-based therapies. Patient-specific iPSC-based treatments hold the promise of mitigating immune rejection risks. However, the intricacies and costs of producing autologous therapies present commercial challenges. The hair follicle is a multi-germ layered versatile cell source that can be harvested at any age. It is a rich source of keratinocytes, fibroblasts, multipotent stromal cells, and the newly defined Hair Follicle-Associated Pluripotent Stem Cells (HAP). It can also be obtained non-invasively and transported via regular mail channels, making it the ideal starting material for an autologous biobank. In this study, cryopreserved hair follicle-derived iPSC lines (HF-iPS) were established through integration-free vectors, encompassing a diverse cohort. These genetically stable lines exhibited robust expression of pluripotency markers, and showcased tri-lineage differentiation potential. The HF-iPSCs effectively differentiated into double-positive cKIT⁺/CXCR4⁺ definitive endoderm cells and NKX6.1⁺/PDX1⁺ pancreatic progenitor cells, affirming their pluripotent attributes. We anticipate that the use of plucked hair follicles as an accessible, non-invasive cell source to obtain patient cells, in conjunction with the use of episomal vectors for reprogramming, will improve the future generation of clinically applicable pancreatic progenitor cells for the treatment of Type I Diabetes. Full article

During continuous slab casting, strand electromagnetic stirring (S-EMS) has a significant effect on improving the slab quality. In the current work, a numerical model based on the practical slab continuous casting machine and coupled electromagnetic field, flow field, solidification, and solute transport was established to investigate and evaluate the effect of the S-EMS installation position with various current intensities on metallurgical behavior. The model was verified by magnetic field measurement, infrared camera, and nail shooting experiments. The results show that moving the S-EMS installation position to the solidification end reduces the stirring effect due to the skin effect and the increasing thickness of the slab shell. A higher installation position is beneficial for improving the equiaxed grain rate, while a lower one is beneficial for reducing carbon segregation. The maximum segregation index and range decrease from 1.26 to 1.2 and from 0.42 to 0.36 with the installation position being decreased from −3 m to −12.8 m, respectively. The industrial trials show that S-EMS installed at 3 m has a significant effect on expanding the equiaxed grain zone and a deteriorating effect on reducing carbon segregation. Full article

Background: The intensive care unit (ICU) is a scarce resource in all health care systems, necessitating a well-defined utilization. Therefore, benchmarks are essential; and yet, they are limited due to heterogenous definitions of what an ICU is. This study analyzed the case distribution, patient characteristics, and hospital course and outcomes of 6,204,093 patients in the German Helios Hospital Group according to 10 derived ICU definitions. We aimed to set a baseline for the development of a nationwide, uniform ICU definition. Methods: We analyzed ten different ICU definitions: seven derived from the German administrative data set of claims data according to the German Hospital Remuneration Act, three definitions were taken from the Helios Hospital Group’s own bed classification. For each ICU definition, the size of the respective ICU population was analyzed. Due to similar patient characteristics for all ten definitions, we selected three indicator definitions to additionally test statistically against IQM. Results: We analyzed a total of 5,980,702 completed hospital cases, out of which 913,402 referred to an ICU criterion (14.7% of all cases). A key finding is the significant variability in ICU population size, depending on definitions. The most restrictive definition of only mechanical ventilation (DOV definition) resulted in 111,966 (1.9%) cases; mechanical ventilation plus typical intensive care procedure codes (IQM definition) resulted in 210,147 (3.5%) cases; defining each single bed individually as ICU or IMC (ICUᴧIMC definition) resulted in 411,681 (6.9%) cases; and defining any coded length of stay at ICU (LOSi definition) resulted in 721,293 (12.1%) cases. Further testing results for indicator definitions are reported. Conclusions: The size of the population, utilization rates, outcomes, and capacity assumptions clearly depend on the definition of ICU. Therefore, the underlying ICU definition should be stated when making any comparisons. From previous studies, we anticipated that 25–30% of all ICU patients should be mechanically ventilated, and therefore, we conclude that the ICUᴧIMC definition is the most plausible approximation. We suggest a mandatory application of a clearly defined ICU term for all hospitals nationwide for improved benchmarking and data analysis. Full article

Cannabinoids (the endocannabinoids, the synthetic cannabinoids, and the phytocannabinoids) are well known for their various pharmacological properties, including neuroprotective and anti-inflammatory features, which are fundamentally important for the treatment of neurodegenerative diseases. The aging of the global population is causing an increase in these diseases that require the development of effective drugs to be even more urgent. Taking into account the unavailability of effective drugs for neurodegenerative diseases, it seems appropriate to consider the role of cannabinoids in the treatment of these diseases. To our knowledge, few reviews are devoted to cannabinoids’ impact on modulating central and peripheral immunity in neurodegenerative diseases. The objective of this review is to provide the best possible information about the cannabinoid receptors and immuno-modulation features, peripheral immune modulation by cannabinoids, cannabinoid-based therapies for the treatment of neurological disorders, and the future development prospects of making cannabinoids versatile tools in the pursuit of effective drugs. Full article