Locally advanced breast cancer (LABC) is a complex disease that requires a multidisciplinary approach. Neoadjuvant chemotherapy (NAC) is usually performed in order to achieve loco-regional radical resection; although its importance in the multidisciplinary approach to LABC is well recognized, a small number of patients show Progressive Disease (PD). No standard salvage treatment (ST) has been defined and different strategies can be adopted, such as second-line systemic therapies, radiation therapy, and surgery. Herein, a case of LABC in PD during NAC is reported with a literature review, with the aim of highlighting the importance of a tailored multidisciplinary treatment for each patient. Full article

Background/Objectives: Extrauterine growth restriction (EUGR) is associated with high mortality and an increased incidence of poor neurodevelopmental outcomes in preterm infants. In this study, we aimed to compare the Intergrowth-21^ST (IG-21^ST) and Fenton charts in predicting long-term neurodevelopmental and anthropometric outcomes of very low birth weight (VLBW) infants. Methods: Data were collected from 2649 VLBW infants registered in the Korean Neonatal Network born between 24^0/7 and 31^6/7 weeks of gestational age from January 2013 to December 2017. Follow-up assessments were conducted at 18–24 months of age, corrected for prematurity. Multiple logistic regression analysis was performed to evaluate the association between EUGR and long-term outcomes. Results: Among the 2649 VLBW infants, 60.0% (1606/2649) and 36.9% (977/2649) were diagnosed as having EUGR defined by the Fenton chart (EUGR_F) and by the IG-21^ST chart (EUGR_IG), respectively. The EUGR_IG group exhibited a higher proportion of infants with cerebral palsy, neurodevelopmental impairment (NDI), and growth failure. In multiple logistic regression analysis, adjusted for risk factors for long-term outcome, the EUGR_IG group showed higher risk of cerebral palsy (adjusted odds ratio [aOR], 1.66; 95% confidence interval [CI], 1.04–2.65), NDI (aOR, 2.09; 95% CI, 1.71–2.55), and growth failure (aOR, 1.57; 95% CI, 1.16–2.13). Infants with EUGR_F tended to develop NDI (aOR, 1.29; 95%CI, 1.03–1.63) and experience growth failure (aOR, 2.44; 95% CI, 1.77–3.40). Conclusions: The IG-21^ST chart demonstrated a more effective prediction of long-term neurodevelopmental outcomes, whereas the Fenton chart may be more suitable for predicting growth failure at 18–24 months. Full article

All water destined for human consumption must be subjected to disinfection processes via chlorination with the aim of eliminating the risk of the transmission of waterborne diseases. However, the treatment of water using this method leads to the formation of trihalomethanes (THMs), which are toxic compounds that may be ingested, inhaled, or absorbed by the skin, increasing the risk of carcinogenic and mutagenic processes. High trihalomethane concentrations in water may be directly related to physicochemical properties, such as temperature, pH, hardness, and potentially toxic metal concentrations. In this work, physicochemical characterization was performed and water quality was assessed with regard to the presence of trihalomethanes in 17 samples collected from points before and after storage in reservoirs. Atomic absorption spectroscopy to determine potentially toxic metals and the measurement of physicochemical properties demonstrated that all results were in accordance with the standards established by Brazilian legislation. Gas chromatography–mass spectrometry was used to determine levels of trihalomethanes in the water samples (trichloromethane, bromodichloromethane, chlorodibromomethane, and bromoform), which were also in accordance with the limits established by Brazilian legislation. Hierarchical clustering on principal components confirmed changes in the water quality depending on location. This work constitutes a paradigm for future studies on the monitoring of toxic organic compounds in water to avoid health problems in humans and animals. Full article

Psychiatric disorders often require pharmacological interventions to alleviate symptoms and improve quality of life. However, achieving an optimal therapeutic outcome is challenging due to several factors, including variability in the individual response, inter-individual differences in drug metabolism, and drug interactions in polytherapy. Therapeutic drug monitoring (TDM), by measuring drug concentrations in biological samples, represents a valuable tool to address these challenges, by tailoring medication regimens to each individual. This review analyzes the current landscape of TDM in psychiatric practice, highlighting its significance in optimizing drug dosages, minimizing adverse effects, and improving therapeutic efficacy. The metabolism of psychiatric medications (i.e., mood stabilizers, antipsychotics, antidepressants) often exhibits significant inter-patient variability. TDM can help address this variability by enhancing treatment personalization, facilitating early suboptimal- or toxic-level detection, and allowing for timely interventions to prevent treatment failure or adverse effects. Furthermore, this review briefly discusses technological advancements and analytical methods supporting the implementation of TDM in psychiatric settings. These innovations enable quick and cost-effective drug concentration measurements, fostering the widespread adoption of TDM as a routine practice in psychiatric care. In conclusion, the integration of TDM in psychiatry can improve treatment outcomes by individualizing medication regimens within the so-called precision medicine. Full article

Biochar (Bc) and liquid vermicompost extracts (LVEs) are increasingly being used as biofertilizers in agriculture to promote soil-microbe-crop interactions. However, although both these products can potentially act synergistically due to their complementary characteristics, their co-application in different soils has not yet been investigated. Therefore, firstly, an LVE-activated biochar (B_LVE) was experimentally formulated and the persistence of LVE bacteria over a 60-day storage period was determined. The total number of LVE bacteria increased by 10-fold after 7 days and was stable throughout the entire biochar storage period. In addition, changes in the composition of the bacterial community were observed after 30 days of storage, indicating that taxa less represented in pure LVE may be advantaged upon biochar colonization. Secondly, a microcosm experiment was performed to evaluate whether the biological fertility and enzyme activities of two soils, differing in organic matter content, could be enhanced by the addition of LVE-activated biochar. In this experiment, three different doses of Bc, LVE, and B_LVE against the carbon-related biological fertility index (i.e., biological fertility index, BFI) and three enzyme activities over a 21-day incubation period were tested. The B_LVE treatment yielded the best results (i.e., BFI +32%, enzyme activities +38%). This indicates that Bc and LVEs can act synergistically to promote soil fertility, quality, and microbial activity. By integrating LVE-activated biochar into their soil management practices, farmers could achieve higher crop yields and healthier products. Full article

Peripheral artery disease (PAD) is a common circulatory disorder characterized by the accumulation of fats, cholesterol, and other substances in the arteries that restrict blood flow to the extremities, especially the legs. The ankle brachial index (ABI) is a highly reliable and valid non-invasive test for diagnosing PAD. However, the traditional method has limitations. These include the time required, the need for Doppler equipment, the training of clinical staff, and patient discomfort. PWV refers to the speed at which an arterial pressure wave propagates along the arteries, and this speed is conditioned by arterial elasticity and stiffness. To address these limitations, we have developed a system that uses electrocardiogram (ECG) and photoplethysmography (PPG) signals to calculate pulse wave velocity (PWV). We propose determining the ABI based on this calculation. Validation was performed on 22 diabetic patients, and the results demonstrate the accuracy of the system, maintaining a margin of ±0.1 compared with the traditional method. This confirms the correlation between PWV and ABI and positions this technique as a promising alternative to overcome some of the limitations of the conventional method. Full article

In human–computer interaction interfaces, icons serve as highly symbolic elements that convey information and significantly influence the performance of visual search and other tasks. Thus, the selection of appropriate colors plays a crucial role in the design of human–computer interfaces. This study aimed to investigate the effects of icon color combinations on human visual search task performance across various cognitive load conditions. The experiment was divided into two parts, involving a cognitive load test experiment and an icon search task, wherein the former required participants to select the target icon from 16 de-colored icons, and the latter involved selecting the target icon from 16 color combinations of 8 colors (background colors: black, red, blue, and purple; foreground colors: white, yellow, green, and turquoise). A total of 20 participants (11 females and 9 males, all aged between 18 and 24 years) were recruited for this experiment to perform both tasks sequentially. Through a comprehensive consideration of factors such as the NASA-TLX scale, retrieval time, etc., the experimental results revealed that cognitive load increased with time pressure, resulting in varying optimal color combinations for different cognitive load levels. Additionally, background colors did not affect task response time under different cognitive loads, whereas white foreground color was superior to turquoise foreground color in a medium cognitive load environment. Meanwhile, our results recommend prioritizing white-on-black as the preferred color combination, given that it demonstrated excellent cognitive performance in all three cognitive load environments. Conversely, white-on-blue is not recommended as a color combination for the design of high cognitive load environments. Concerning medium cognitive load environments, yellow-on-red or white-on-purple color combinations were preferred. Finally, in low cognitive load environments, white-on-purple is recommended as the primary color combination. Overall, this study provides a theoretical reference for the future design of interactive interface icons across various contexts. Full article

In order to improve the plugging performance of high-temperature and high-salt oil reservoir plugging agents, this paper utilizes a copolymer composed of acrylamide and 2-acrylamide-2-methylpropanesulfonic acid (AM/AMPS) as the polymer, polyethyleneimine as the cross-linking agent, and nylon fiber as the stabilizer to develop a high-temperature- and high-salt-resistant gel system. This study analyzed and evaluated the temperature resistance, salt resistance and blocking performance of the gel system. The evaluation results show that the gel-forming strength of this gel system can reach an H level, and it has good thermal stability at the high temperature of 130 °C. At the high salinity of 240,720 mg/L, the syneresis rate remains below 2.5%, and the gel-forming time is greater than 15 h; the higher the temperature, the shorter the gelling time. The results of our sand-filled pipe-plugging experiment show that the gel system can adapt to sand-filled pipes with different levels of permeability, and reaching a plugging rate of 94%. Full article

Exact biopsy planning and careful execution of needle injection is crucial to ensure successful procedure completion as initially intended while minimizing the risk of complications. This study introduces a solution aimed at helping the operator navigate to precisely position the needle in a previously planned trajectory utilizing a mixed reality headset. A markerless needle tracking method was developed by integrating deep learning and deterministic computer vision techniques. The system is based on superimposing imaging data onto the patient’s body in order to directly perceive the anatomy and determine a path from the selected injection site to the target location. Four types of tests were conducted to assess the system’s performance: measuring the accuracy of needle pose estimation, determining the distance between injection sites and designated targets, evaluating the efficiency of material collection, and comparing procedure time and number of punctures required with and without the system. These tests, involving both phantoms and physician participation in the latter two, demonstrated the accuracy and usability of the proposed solution. The results showcased a significant improvement, with a reduction in number of punctures needed to reach the target location. The test was successfully completed on the first attempt in 70% of cases, as opposed to only 20% without the system. Additionally, there was a 53% reduction in procedure time, validating the effectiveness of the system. Full article

As the population ages, the incidence of age-related neurodegenerative diseases is rapidly increasing, and novel approaches to mitigate this soaring prevalence are sorely needed. Recent studies have highlighted the importance of gut microbial homeostasis and its impact on brain functions, commonly referred to as the gut–brain axis, in maintaining overall health and wellbeing. Nonetheless, the mechanisms by which this system acts remains poorly defined. In this review, we will explore how (poly)phenols, a class of natural compounds found in many plant-based foods and beverages, can modulate the gut–brain axis, and thereby promote neural health. While evidence indicates a beneficial role of (poly)phenol consumption as part of a balanced diet, human studies are scarce and mechanistic insight is still lacking. In this regard, we make the case that dietary (poly)phenols should be further explored to establish their therapeutic efficacy on brain health through modulation of the gut–brain axis, with much greater emphasis on carefully designed human interventions. Full article

Livestock monitoring is a task traditionally carried out through direct observation by experienced caretakers. By analyzing its behavior, it is possible to predict to a certain degree events that require human action, such as calving. However, this continuous monitoring is in many cases not feasible. In this work, we propose, develop and evaluate the accuracy of intelligent algorithms that operate on data obtained by low-cost sensors to determine the state of the animal in the terms used by the caregivers (grazing, ruminating, walking, etc.). The best results have been obtained using aggregations and averages of the time series with support vector classifiers and tree-based ensembles, reaching accuracies of 57% for the general behavior problem (4 classes) and 85% for the standing behavior problem (2 classes). This is a preliminary step to the realization of event-specific predictions. Full article

Globally, education systems are faced with dual workforce crises: a shortage of teachers and a lack of affordable housing. Attracting and retaining teachers through improved renumeration, working conditions, and quality preparation have been central. However, initiatives to attract and retain teachers mean little if the workforce cannot find appropriate (quality and affordable) housing within commuting distance to their workplaces. The present study undertakes a scoping review of research on the intersection of housing and the school education workforce. Specifically, we examine the volume, variety, and characteristics of evidence through the question of ‘What empirical studies have been published on the relationship between housing and the school education workforce?’ Online databases were used to identify 23 studies published in 2000–2024 from Australia, China, England, Kenya, Malaysia, New Zealand, Tanzania, Uganda, the UK, and the USA. Publications drew on a range of methods and housing was rarely the focal unit of analysis. This study finds that beyond establishing unaffordability through salary and housing costs ratios, and the peripheral inclusion of housing issues in studies, there is insufficient published peer reviewed evidence available to purposefully inform and measure interventions. Greater interdisciplinarity is required in research to highlight the complexity of issues at the intersection of housing (availability, affordability, and distance from workplaces) and workforce distribution. More rigorous data should be collected to support robust reporting on the state of housing for the school education workforce to deliver the type of evidence necessary to develop targeted and tailored interventions to improve outcomes for the workforce and ultimately students. Full article

The objective of this study was to investigate the feasibility of the mixture of tremella polysaccharide (TP) and citrus pectin (CP) as an emulsifier by evaluating its emulsifying ability/stability. The results showed that the TP:CP ratio of 5:5 (w/w) could effectively act as an emulsifier. CP, owing its lower molecular weight and highly methyl esterification, facilitated the emulsification of oil droplets, thereby promoting the dispersion of droplets. Meanwhile, the presence of TP enhanced the viscosity of emulsion system and increased the electrostatic interactions and steric hindrance, therefore hindering the migration of emulsion droplets, reducing emulsion droplets coalesce, and enhancing emulsion stability. The emulsification and stabilization performances were influenced by the molecular weight, esterified carboxyl groups content, and electric charge of TP and CP, and the potential mechanism involved their impact on the buoyant force of droplet size, viscosity, and steric hindrance of emulsion system. The emulsions stabilized by TP-CP exhibited robust environmental tolerance, but demonstrated sensitivity to Ca²⁺. Conclusively, the study demonstrated the potential application of the mixture of TP and CP as a natural polysaccharide emulsifier. Full article

Insulin-like peptide 3 (INSL3) is a biomarker for Leydig cells in the testes of vertebrates, and it is principally involved in spermatogenesis through specific binding with the RXFP2 receptor. This study reports the insl3 gene transcript and the Insl3 prepropeptide expression in both non-reproductive and reproductive tissues of Danio rerio. An immunohistochemistry analysis shows that the hormone is present at a low level in the Leydig cells and germ cells at all stages of Danio rerio testis differentiation. Considering that the insl3 gene is transcribed in Leydig cells, our results highlight an autocrine and paracrine function of this hormone in the Danio rerio testis, adding new information on the Insl3 mode of action in reproduction. We also show that Insl3 and Rxfp2 belonging to Danio rerio and other vertebrate species share most of the amino acid residues involved in the ligand–receptor interaction and activation, suggesting a conserved mechanism of action during vertebrate evolution. Full article

Long-baseline neutrino experiments represent the optimal platforms for probing the lepton Yukawa sector of the Standard Model, and significant experiments are either under construction or in the planning stages. This review delves into the scientific motivations behind these facilities, which stem from the pivotal 2012 discovery of the ${\theta }_{13}$ mixing angle. We provide an overview of the two ongoing projects, DUNE and HyperKamiokande, detailing their physics potential and the technical hurdles they face. Furthermore, we briefly examine proposals for forthcoming endeavors and innovative concepts that could push beyond conventional Superbeam technology. Full article

Frontline doctors’ clinical leadership (CL) is key to addressing healthcare sustainability challenges. Research shows CL requires professional learning. Significant investments into CL development notwithstanding, little evidence exists of how frontline clinicians learn leadership, highlighting an educational sustainability challenge. We propose a fundamental constitutive step towards understanding CL professional development (PD) through theorising and analysing CL-learning mechanisms and their association with clinicians’ leadership competences required for sustainable healthcare development. This mixed-methods study developed a concept of leadership learning patterns to assess doctors’ learning processes associated with sustained innovation. It analysed a post-course dataset of past participants of a CL-PD course (N = 150) and a pre-post dataset of an online CL-PD (N = 34). EFA demonstrated a reasonable factor model for the Leadership Learning Inventory, measuring two dimensions of doctors’ leadership learning patterns: Meaning-oriented and Problematic learning. Qualitative and quantitative analyses showed that Meaning-oriented learning increased significantly during CL-PD and is linked with sustainable leadership competences. This study suggests that the concept of leadership learning patterns is useful for evaluating the quality of clinical leadership learning processes during PD. It offers a conceptually and empirically sound way to assess clinical leadership learning involved in sustainable healthcare improvement, and the sustainability of educational interventions to support it. Full article

The consumption of fish in food may contain mercury, a harmful element and dangerous chemical detrimental to human health. The purpose of this study was to determine the mercury level in the hair of pregnant women with different fish intakes in their diets. The concentration of total mercury in hair was determined using an atomic absorption spectrometer. In this study, 98 pregnant women were invited to participate (aged from 18 to 48 years). The mean content of mercury in the hair of pregnant women in Northwestern Russia was 0.428 mg/kg (ranging from 0.018 to 3.1 mg/kg). As a result, 22% of women had mercury values above 0.58 mg/kg, which is considered dangerous for the fetus. The hair mercury concentration in a village area was higher than that in a city area (i.e., 0.548 mg/kg and 0.326 mg/kg). Moreover, the maximum level of mercury was noted for a group of pregnant women who consumed more than 5 kg/month of fish and fish products. Furthermore, the consumption of freshwater fish in the diet leads to a higher mercury content in the hair of pregnant women than the consumption of marine fish. Full article

Calmodulin (Calm), a crucial Ca²⁺ sensor, plays an important role in calcium-dependent signal transduction cascades. However, the expression and the relevance of Calm in stress and immune response have not been characterized in Megalobrama amblycephala. In this study, we identified the full-length cDNA of Calm (termed MaCalm) in blunt snout bream M. amblycephala, and analyzed MaCalm expression patterns in response to cadmium and Aeromonas hydrophila challenges. MaCalm was 1603 bp long, including a 5′-terminal untranslated region (UTR) of 97 bp, a 3′-terminal UTR of 1056 bp and an open reading frame (ORF) of 450 bp encoding a polypeptide of 149 amino acids with a calculated molecular weight (MW) of 16.84 kDa and an isoelectric point (pI) of 4.09. Usually, MaCalm contains four conservative EF hand motifs. The phylogenetic tree analysis indicated that the nucleotide sequence of MaCalm specifically clustered with Ctenopharyngodon idella with high identity (98.33%). Tissue distribution analysis demonstrated that the ubiquitous expression of MaCalm mRNA was found in all tested tissues, with the highest expression in the brain and the lowest expression in muscle. MaCalm showed significant upregulation at 14 d and 28 d post exposure to varying concentrations of cadmium in the liver; HSP70 transcripts in the liver significantly upregulated at 14 d post exposure to different concentrations of cadmium. Moreover, in response to the A. hydrophila challenge in vivo, MaCalm transcripts in the liver first increased and then decreased, but MaCalm transcripts in the kidney declined gradually with prolonged infection. After the A. hydrophila challenge, the expression level of HSP70 was significantly downregulated at 24 h in the liver and its expression level was notably downregulated at 12 h and at 24 h in the kidney. Collectively, our results suggest that MaCalm possesses vital roles in stress and immune response in M. amblycephala. Full article

Half-grouted sleeve connectors are a primary method for connecting rebar in prefabricated concrete structures. However, due to limitations in the construction environment, all kinds of grouting defects are inevitable, especially grouting voids. Additionally, fire disasters, among the most common types of disasters, significantly threaten the structural performance and safety of these prefabricated structures. Therefore, it is imperative to determine the mechanical properties of half-grouted sleeve connectors with grouting voids after high temperatures. This study designed and prepared 48 groups of half-grouted sleeve specimens with different grouting voids and defect locations. These specimens were heated to the specified temperature (25 °C, 200 °C, 300 °C, 400 °C, 500 °C, 600 °C), followed by unidirectional tensile testing after natural cooling. The experimental results showed that rebar fracture failure and rebar pulled-out failure were the failure modes of specimens. With the increase in temperature, bearing capacity, safety factor and ductility coefficient of specimens all decreased. When the temperature was lower than 400 °C, the specimen with void length less than twice the diameter of the rebar (i.e., 2d) had sufficient connection performance. For specimens with the same total void lengths, the bearing capacity of discrete voids is lower than concentrate voids at the same temperature. The load-displacement curve, safety coefficient, ductility coefficient and grey correlation degree of half-grouted sleeve specimens with grouting voids at different temperatures are analyzed and discussed, and the bond stress slip constitutive model is given. Grouting defects have greater influence on specimens after grey correlation analysis. Findings from this study provide valuable references for the safety performance evaluation of prefabricated structures with half-grouted sleeve connectors after exposure to fire. Full article

Based on the driving force-pressure-state-impact-response (DPSIR) model, 19 indicators were selected to construct a comparison between Zhuhai and Macao, two adjacent cities at the estuary of the Pearl River in China, which have different development models and water resource sustainable development strategies. Factors that may affect the sustainability of water resources were screened and placed according to the relationships of the five subsystems in the DPSIR model, establishing a sustainable evaluation model for water resources in the two cities. The results analyzed by Principal Component Analysis and Entropy methods showed that (1) Zhuhai City was greatly affected by the driving force, while Macao was greatly affected by the state system from 2012 to 2021. (2) From the trend changes, it can be seen that, in recent years, the water resources of the two cities have been moving towards sustainable development, and the management and protection of water resources have achieved remarkable results. From the evaluation results, it can be seen that implementing urban water-saving activities, strengthening the proportion of environmental water conservancy, public measures in public investment, upgrading sewage treatment machinery to improve sewage treatment rates, and other measures can effectively improve the current situation of water resources in both regions. In the future, the Zhuhai and Macao cities may continue to face a series of water resource pressures brought on by socio-economic developments. Therefore, an active adjustment of the development of the measurement of controlling wastewater discharge and saving water resources was proposed, adhering to the direction of sustainable development, and ensuring the benign development of socio-economic conditions and the ecological environment. This study can provide data to support regional water resource security and policy formulation with different political systems. Full article

Although scales that evaluate postpartum stress exist, they lack specificity in maternal postpartum stress. The MPSS was created because there was a need to assess maternal stress during the postpartum stage. The introduction of the MPSS has enriched the evaluation tools for postpartum stress and has helped understand maternal stress at various postpartum time points and identify women at high risk for postpartum stress during this period. The aim was to translate the MPSS into Spanish and study its psychometric properties. Postpartum women (N = 167) with a mean age of 34.26 (SD = 4.71) were involved in this study. In addition to the MPSS, a battery of instruments was administered: a demographic sheet, the Birth Satisfaction Scale (BSS) and the Edinburgh Postnatal Depression Scale (EPDS). The MPSS data were analyzed, checking item communality first. As a result, three items showed unsatisfactory communality values (h² < 0.40). Confirmatory Factor Analysis was conducted, comparing factor models using the full pool of MPSS items or the version without items with unacceptable communality. As a result, the original three-factor structure was endorsed on the Spanish MPSS, with better fit indices when removing items with low communality (RMSEA = 0.067, CFI = 0.99, TLI = 0.99). The reliability of this version was satisfactory (ω = 0.93). Finally, group comparisons for some perinatal variables were performed, showing no significant differences between groups of interest (p = 0.05 and above). To conclude, the MPSS will contribute to the existing literature, having a wider capacity to assess perinatal mental health difficulties in Spanish-speaking populations. Full article

In this article, the authors will describe a creative writing therapeutic group program they developed based on narrative therapy and narrative medicine principles. This was a Social Science and Humanities Research Council—Partnership Engagement Grant funded project, the aim of which was to develop a facilitator’s manual for people interested in offering this group, titled “Journey through Words”. The link to the agency partner’s website, where the manual is available, is provided. The group program is structured over 6 weeks and includes a writing prompt each week, focusing on the storyline of resilience rather than the storyline of diagnosis or disease. Using a narrative inquiry approach, the facilitators kept brief field notes following group meetings. These field notes indicate that although spirituality was not planned as an identified focus of the program, due to the space narrative therapy provides for people to describe their values, preferences, and hopes during hardship, the experience of the group was that members shared reflections which were deeply spiritual in nature. Full article