Supercontinuum (SC) generation pumped by fiber lasers with short wavelengths below 2.0 μm is important since it can provide a compact light source for various applications. We review the progress of SC generation in various materials regarding the formation of the waveguides and point out the existing issues in the current investigations and possible solutions in the future. Full article

As blockchain becomes more widely used, a growing number of application fields are becoming interested in blockchain to benefit from its decentralised nature, invariability, security, transparency, quick transaction capabilities, and cost-effectiveness. Blockchain has a wide range of applications and uses in healthcare. Distributed ledger technology facilitates the secure transfer of patient medical records, manages the medicine supply chain, and creates an efficient, transparent, safe, and effective way of communicating data across global healthcare. The organ transplantation process (OTP) is one of the healthcare areas that benefit from the use of such technology to make its process more secure and transparent. In this article, we put forward a systematic literature review analysis on the application of blockchain to the OTP. Additionally, we address and highlight the barriers and challenges that arise while using blockchain technology for the OTP. We also offer some suggestions for future developments that would enhance blockchain’s implementation in the OTP domain. Full article

Pancreatic cancer is the sixth leading cause of cancer-related mortality globally. As the most common form of pancreatic cancer, pancreatic ductal adenocarcinoma (PDAC) represents up to 95% of all pancreatic cancer cases, accounting for more than 300,000 deaths annually. Due to the lack of early diagnoses and the high refractory response to the currently available treatments, PDAC has a very poor prognosis, with a 5-year overall survival rate of less than 10%. Targeted therapy and immunotherapy are highly effective and have been used for the treatment of many types of cancer; however, they offer limited benefits in pancreatic cancer patients due to tumor-intrinsic and extrinsic factors that culminate in drug resistance. The identification of key factors responsible for PDAC growth and resistance to different treatments is highly valuable in developing new effective therapeutic strategies. In this review, we discuss some molecules which promote PDAC initiation and progression, and their potential as targets for PDAC treatment. We also evaluate the challenges associated with patient outcomes in clinical trials and implications for future research. Full article

Structural hydroxide groups in layered magnesium–aluminum double hydroxides were partially replaced by fluoride ions. Fluorinated and fluorine-free materials were used as hosts for two dyes, carminic acid and hydroxyl naphthol blue, resulting in a hybrid pigment color palette. The pigments were produced by two ways, either incorporating chromophore during the synthesis of the layered double hydroxide or in a post-synthesis step through the memory effect of the LDHs. Additionally, the pigments were protected with a magnesium hydroxide phase to prevent the color from fading over time. The pigments were stable for periods as long as 10 years. The color properties of the pigments were significantly influenced by the host of dye since the presence of fluorine directly influences the acid–base properties of the layered double hydroxides. The pigments conferred their color to white cream in the preparation of colored creams. The colored creams acquired the color of the layered pigment. Full article

There is no current consensus on the parameters that determine the difficulty of mandibular third molar extraction in terms of the time required, which is essential to prevent complications and optimize the time of the intervention. This study aims to obtain, using the mathematical method of multiple linear regression, an equation that allows estimating the extraction time of a lower third molar according to its complexity, as well as to validate this equation in a sample of external wisdom teeth. Methods: A prospective cohort study on a sample of patients of the Master of Oral Surgery of the University of Seville in which multiple linear regression coefficients were calculated with a subsequent validation study of the results in the sample of patients operated in the Hospital Palmaplanas of Mallorca. Results: The regression line obtained after applying the statistical methodology to the cohort of patients from the University of Seville obtained significant dependent variables such as depth, roots, and odontosection. Once applied to the cohort of patients from the Palmaplanas Hospital in Mallorca, a regression coefficient was obtained between the data received and the estimated 0.770. Conclusions: The formula proposed in this article presents significant validity in the prediction of the surgical time of extraction of the lower third molars included. Full article

Liraglutide (LIRA) is a glucagon-like peptide-1 (GLP-1) receptor agonist renowned for its efficacy in treating type 2 diabetes mellitus (T2DM) and is typically administered via subcutaneous injections. Oral delivery, although more desirable for being painless and potentially enhancing patient adherence, is challenged by the peptide’s low bioavailability and vulnerability to digestive enzymes. This study aimed to develop LIRA-containing zein-based nanoparticles stabilized with eudragit RS100 and chitosan for oral use (Z-ERS-CS/LIRA). These nanoparticles demonstrated a spherical shape, with a mean diameter of 238.6 nm, a polydispersity index of 0.099, a zeta potential of +40.9 mV, and an encapsulation efficiency of 41%. In vitro release studies indicated a prolonged release, with up to 61% of LIRA released over 24 h. Notably, the nanoparticles showed considerable resistance and stability in simulated gastric and intestinal fluids, suggesting protection from pH and enzymatic degradation. Pharmacokinetic analysis revealed that orally administered Z-ERS-CS/LIRA paralleled the pharmacokinetic profile seen with subcutaneously delivered LIRA. Furthermore, in vivo tests on a diabetic rat model showed that Z-ERS-CS/LIRA significantly controlled glucose levels, comparable to the results observed with free LIRA. The findings underscore Z-ERS-CS/LIRA nanoparticles as a promising approach for oral LIRA delivery in T2DM management. Full article

Prolylcarboxypeptidase (PRCP, PCP, Lysosomal Pro-X-carboxypeptidase, Angiotensinase C) controls angiotensin- and kinin-induced cell signaling. Elevation of PRCP appears to be activated in chronic inflammatory diseases [cardiovascular disease (CVD), diabetes] in proportion to severity. Vascular endothelial cell senescence and mitochondrial dysfunction have consistently been shown in models of CVD in aging. Cellular senescence, a driver of age-related dysfunction, can differentially alter the expression of lysosomal enzymes due to lysosomal membrane permeability. There is a lack of data demonstrating the effect of age-related dysfunction on the expression and function of PRCP. To explore the changes in PRCP, the PRCP-dependent prekallikrein (PK) pathway was characterized in early- and late-passage human pulmonary artery endothelial cells (HPAECs). Detailed kinetic analysis of cells treated with high molecular weight kininogen (HK), a precursor of bradykinin (BK), and PK revealed a mechanism by which senescent HPAECs activate the generation of kallikrein upon the assembly of the HK–PK complex on HPAECs in parallel with an upregulation of PRCP and endothelial nitric oxide (NO) synthase (eNOS) and NO formation. The NO production and expression of both PRCP and eNOS increased in early-passage HPAECs and decreased in late-passage HPAECs. Low activity of PRCP in late-passage HPAECs was associated with rapid decreased telomerase reverse transcriptase mRNA levels. We also found that, with an increase in the passage number of HPAECs, reduced PRCP altered the respiration rate. These results indicated that aging dysregulates PRCP protein expression, and further studies will shed light into the complexity of the PRCP-dependent signaling pathway in aging. Full article

This paper proposes a performance analysis of a medium-range airliner powered by liquid hydrogen (LH₂) propulsion. The focus is on operating performance in terms of achievable payload and range. A non-conventional box-wing architecture was selected to maximize operating performance. An optimization-based multidisciplinary design framework was developed to retrofit a baseline medium-range box-wing aircraft by designing and integrating the fuel tanks needed to store the LH₂; several solutions were investigated for tank arrangement and layout by means of sensitivity analyses. As a main outcome, a performance analysis of the proposed LH₂-powered box-wing aircraft is provided, highlighting the impact of the introduction of this energy carrier (and the integration of the related tank systems) on aircraft operating performance; a comparative study with respect to a competitor LH₂-retrofitted tube-and-wing aircraft is also provided, to highlight the main possible operating differences between the two architectures. The findings reveal that the retrofitted box-wing can achieve long-range flights at the cost of a substantially reduced payload, mainly due to the volume limitations imposed by the installation of LH₂ tanks, or it can preserve payload capacity at the expense of a significant reduction in range, as the trade-off implies a reduction in on-board LH₂ mass. Specifically, the studied box-wing configuration can achieve a range of 7100 km transporting 150 passengers, or shorter ranges of 2300 km transporting 230 passengers. The competitor LH₂-retrofitted tube-and-wing aircraft, operating in the same category and compatible with the same airport apron constraints, could achieve a distance of 1500 km transporting 110 passengers. Full article

Post-injury confusional state is a common phenomenon following acquired brain injury. A multi-faceted approach for decreasing confusion is recommended, but there is a paucity of research related to non-pharmacological management. The main objective was to present a conceptual model of multi-faceted approaches for confusion, and secondly to investigate the rehabilitation outcome following these approaches. The setting is a specialized ward for rehabilitation of patients with severe cognitive difficulties following acquired brain injury. The conceptual model encompasses neurobehavioral strategies, pharmacological treatment, engagement in meaningful occupations, next of kin involvement, organizational demands, the physical environment, along with differential diagnostics. Patient cases are provided to illustrate the impact of each approach. A total of 141 of 281 patients were in a confusional state at admission. At discharge, 62% had emerged from the confusional state. Patients in a confusional state due to traumatic brain injury and subarachnoid hemorrhage had clinically important differences of >22 points in the functional independence measure from admission to discharge, following rehabilitation efforts based on the conceptual model. No clinically important difference was seen in patients with non-SAH stroke and patients with other types of brain injuries. The proposed conceptual model should be further evaluated in complex intervention studies. Full article

The memory-enhancing activity of Matricaria chamomilla hydroalcoholic extract (MCE) is already being investigated by behavioral and biochemical assays in scopolamine-induced amnesia rat models, while the effects of scopolamine (Sco) on cerebral glucose metabolism are examined as well. Nevertheless, the study of the metabolic profile determined by an enriched MCE has not been performed before. The present experiments compared metabolic quantification in characteristic cerebral regions and behavioral characteristics for normal, only diseased, diseased, and MCE- vs. Galantamine (Gal)-treated Wistar rats. A memory deficit was induced by four weeks of daily intraperitoneal Sco injection. Starting on the eighth day, the treatment was intraperitoneally administered 30 min after Sco injection for a period of three weeks. The memory assessment comprised three maze tests. Glucose metabolism was quantified after the 18F-FDG PET examination. The right amygdala, piriform, and entorhinal cortex showed the highest differential radiopharmaceutical uptake of the 50 regions analyzed. Rats treated with MCE show metabolic similarity with normal rats, while the Gal-treated group shows features closer to the diseased group. Behavioral assessments evidenced a less anxious status and a better locomotor activity manifested by the MCE-treated group compared to the Gal-treated group. These findings prove evident metabolic ameliorative qualities of MCE over Gal classic treatment, suggesting that the extract could be a potent neuropharmacological agent against amnesia. Full article

Despite their relatively low incidence globally, central nervous system (CNS) tumors remain amongst the most lethal cancers, with only a few other malignancies surpassing them in 5-year mortality rates. Treatment decisions for brain tumors heavily rely on histopathological analysis, particularly intraoperatively, to guide surgical interventions and optimize patient outcomes. Frozen sectioning has emerged as a vital intraoperative technique, allowing for highly accurate, rapid analysis of tissue samples, although it poses challenges regarding interpretive errors and tissue distortion. Raman histology, based on Raman spectroscopy, has shown great promise in providing label-free, molecular information for accurate intraoperative diagnosis, aiding in tumor resection and the identification of neurodegenerative disease. Techniques including Stimulated Raman Scattering (SRS), Coherent Anti-Stokes Raman Scattering (CARS), Surface-Enhanced Raman Scattering (SERS), and Tip-Enhanced Raman Scattering (TERS) have profoundly enhanced the speed and resolution of Raman imaging. Similarly, Confocal Laser Endomicroscopy (CLE) allows for real-time imaging and the rapid intraoperative histologic evaluation of specimens. While CLE is primarily utilized in gastrointestinal procedures, its application in neurosurgery is promising, particularly in the context of gliomas and meningiomas. This review focuses on discussing the immense progress in intraoperative histology within neurosurgery and provides insight into the impact of these advancements on enhancing patient outcomes. Full article

(1) Background: Bacterial contamination has been shown to occur during angiographies, although data on its frequency and relevance are sparse. Our aim was to evaluate the incidence of bacterial contamination of syringes used under sterile conditions during neuroangiographies. We sought to differentiate between contamination of the outside of the syringes and the inside and to detect the frequency, extent and germ spectrum of bacterial contamination. (2) Methods: We prospectively collected 600 samples from 100 neuroangiographies. Per angiography, fluid samples from the three routinely used syringes as well as the syringes themselves were analyzed. We analyzed the frequency and extent of contamination and determined the germ spectrum. (3) Results: The majority of samples (56.9%) were contaminated. There was no angiography that showed no contamination (0%). The outer surfaces of the syringes were contaminated significantly more frequently and to a higher extent than the inner surfaces. Both the frequency and extent of contamination of the samples increased with longer duration of angiographic procedures. Most of the bacterial species were environmental or skin germs (87.7%). (4) Conclusions: Bacterial contamination is a frequent finding during neuroangiographies, although its clinical significance is believed to be small. Bacterial contamination increases with longer duration of angiographic procedures. Full article

Remote video imagery using shoreline edge detection is widely used in coastal monitoring in order to acquire measurements of nearshore and swash features. Some of these systems are constrained by their long setup time, positioning requirements and considerable hardware costs. As such, there is a need for an autonomous low-cost system (~EUR 500), such as Timex cameras, that can be rapidly deployed in the field, while still producing the outcomes required for coastal monitoring. This research presents an assessment of the effect of the sampling strategy (time-lapse intervals) on the precision of shoreline detection for two low-cost cameras located in a remote coastal area in western Ireland, overlooking a dissipative beach–dune system. The analysis shows that RMSD in the detected shoreline is similar to other studies for sampling intervals ranging between 1 s and 30 s (i.e., RMSD_mean for Camera 1 = 1.4 m and Camera 2 = 0.9 m), and an increase in the sampling interval from 1 s to 30 s had no significant adverse effect on the precision of shoreline detection. The research shows that depending on the intended use of the detected shorelines, the current standard of 1 s image sampling interval when using Timex cameras can be increased up to 30 s without any significant loss of accuracy. This positively impacts battery life and memory storage, making the systems more autonomous; for example, the battery life increased from ~10 days to ~100 days when the sampling interval was increased from 1 to 5 s. Full article

Disorders/differences of sex development (DSDs) are defined as broad, heterogenous groups of congenital conditions characterized by atypical development of genetic, gonadal, or phenotypic sex accompanied by abnormal development of internal and/or external genitalia. NR5A1 gene mutation is one of the principal genetic alterations implicated in causing DSD. This review outlines the role of NR5A1 gene during the process of gonadal development in humans, provides an overview of the molecular and functional characteristics of NR5A1 gene, and discusses potential clinical phenotypes and additional organ diseases due to NR5A1 mutations. NR5A1 mutations were analyzed in patients with 46,XY DSD and 46,XX DSD both during the neonatal and pubertal periods. Loss of function of the NR5A1 gene causes several different phenotypes, including some associated with disease in additional organs. Clinical phenotypes may vary, even among patients carrying the same NR5A1 variant, indicating that there is no specific genotype–phenotype correlation. Genetic tests are crucial diagnostic tools that should be used early in the diagnostic pathway, as early as the neonatal period, when gonadal dysgenesis is the main manifestation of NR5A1 mutation. NR5A1 gene mutations could be mainly associated with amenorrhea, ovarian failure, hypogonadism, and infertility during puberty. Fertility preservation techniques should be considered as early as possible. Full article

This study examines the sustainability of livestock farming in Jordan’s arid regions, focusing on smallholder Awassi sheep and Baladi goat farming. It assesses breeders, economic factors, herd productivity, and sustainability, evaluating the vitality of these breeds by examining reproductive success through birth and survival rates. In 2021–2022, a total of 53 traditional Awassi sheep and Baladi goat farms in Northern Jordan’s Mafraq Governorate were surveyed using a comprehensive questionnaire to gather data on breeders’ information, farm economics, and herd indicators. Dry seasons in arid lands are tough on sheep and goats, with limited fodder and water availability harming their health and reproductive capacity. While wet seasons bring relief, they can also introduce diseases. Special care for these animals throughout the year is crucial to maintain healthy herds in arid regions. Linear models were employed to analyze sample data, with variance and correlation tests used to explore relationships among variables. Additionally, chi-squared analysis was utilized to assess the impact of male replacement plans on these herds. The main outcomes of this study reveal that breeder indicators pose challenges to the sustainability and growth of Awassi sheep and Baladi goat farming. Conversely, economic indicators suggest a blend of financial stability alongside obstacles related to profitability and resource ownership. Breeder age emerges as a significant factor in livestock herd management, influenced by elements such as experience, resource availability, and adherence to traditional practices. Experience notably influences breeders’ decisions regarding male insemination replacements, likely due to acquired skills. Crop cultivation is shown to reduce fodder costs, thereby enhancing profitability for each young animal sold and consequently increasing the breeders’ returns. Winter conditions elevate animal mortality rates due to cold stress, while other animals within herds contribute to increased kid mortality by facilitating disease transmission. Breeder experience significantly impacts lamb survival, underscoring its importance in ensuring proper care. Increasing ewe proportions within herds enhances lamb production and lowers lamb mortality rates. Effective ram management and yearling lamb sales further contribute to herd health and productivity. A higher proportion of goats within a herd positively correlates with the number of young yearlings sold but inversely affects breeding males and overall kid numbers, indicating a delicate balance that influences herd productivity and mortality rates. Sheep (92.5%) and goat herds (90.6%) demonstrate reproductive success, indicative of superior long-term vitality. While sheep excel in birth rates, survival, and sales, they exhibit lower ewe and lambing percentages. Goat farming demonstrates high birth rates, sales, and overall success but requires particular attention to ensuring kid survival, especially during the winter months. Improving the characteristics of the Awassi sheep and Baladi goat flocks is crucial for ensuring sustainability, achievable through proper care practices in dry lands. In conclusion, despite the challenges, there are promising opportunities to enhance sheep and goat farming in Jordan. Effective management, informed by the breeders’ experience and economics, is crucial. Empowering small-scale herders and implementing targeted interventions, like winter mortality solutions and selective breeding, is vital for sustainable growth. Full article

The studies of thymic structure were performed predominantly in cohorts of younger individuals. Here, we established a cohort of body donors whose age at the time of death ranged from 57 to 103 to study the relationship between thymic structure and factors that, in the younger subjects, have shown to affect the organ’s anatomy, including the presence of the organ’s capsule, its weight, size of the left and right lobes, and a transverse diameter. We explored the relationships between these thymic parameters and the subjects’ age, sex, and cause of death (COD), asking how the thymus in the elderly differed from the organ’s macro-anatomy in a broader and younger human population, and whether age, sex, COD, and BMI could influence the thymic parameters in the elderly. Our analyses revealed that the thymic size but not thymic weight in the KYCOM cohort differed significantly from the younger individuals. The size of the thymus in males progressively decreased, but in females, the size of the right lobe increased. The encapsulated thymus was detected with a higher frequency in females than males. We found no associations between thymic parameters and the person’s COD, age, or sex. However, the person’s BMI was associated with thymic weight, suggesting that obesity may influence the aging of the immune system. Full article

Background: This investigation assesses the prognostic value of lactate levels and their clearance in septic shock patients, particularly emphasizing the comparative analysis between COVID-19 and non-COVID-19 patients in the emergency department. This study aims to elucidate the unique prognostic implications of lactate dynamics in these distinct patient groups, thereby enhancing the management of septic shock. Methods: An observational prospective study was conducted, enrolling 114 septic shock patients from the Emergency County Hospital Resita, Romania, categorizing them into COVID-19 and non-COVID-19 groups to examine their initial lactate levels, clearance rates, and their correlation with patient outcomes. Results: This study identified significant differences in the initial lactate levels and clearance rates between the two groups, indicating higher initial lactate levels and slower clearance rates in COVID-19 patients. Survivors demonstrated significantly lower initial lactate levels (1.5 ± 0.4 mmol/L) and higher lactate clearance rates (33 ± 15%) compared to non-survivors (2.5 ± 0.5 mmol/L and 24 ± 9%, respectively; lactate levels p = 0.001, clearance rates p = 0.002). Conclusions: Lactate monitoring, particularly clearance rates, is crucial in the prognostic assessment of septic shock patients. These findings highlight the need for targeted interventions in COVID-19 patients to improve outcomes, underscoring lactate dynamics as a vital component of septic shock management in differing patient populations. Full article

With the increasing dominance of artificial intelligence (AI) techniques, the important prospects for their application have extended to various medical fields, including domains such as in vitro diagnosis, intelligent rehabilitation, medical imaging, and prognosis. Breast cancer is a common malignancy that critically affects women’s physical and mental health. Early breast cancer screening—through mammography, ultrasound, or magnetic resonance imaging (MRI)—can substantially improve the prognosis for breast cancer patients. AI applications have shown excellent performance in various image recognition tasks, and their use in breast cancer screening has been explored in numerous studies. This paper introduces relevant AI techniques and their applications in the field of medical imaging of the breast (mammography and ultrasound), specifically in terms of identifying, segmenting, and classifying lesions; assessing breast cancer risk; and improving image quality. Focusing on medical imaging for breast cancer, this paper also reviews related challenges and prospects for AI. Full article

Inflaming public opinion about narcotics was the collective goal of anti-narcotics organizers who emerged from the battlefields of the war on alcohol. The most famous was Richmond P. Hobson, who used newspapers, radio, pamphlets, speaking tours, and networking with civic organizations to agitate for reform. This article draws on archival and newly accessible electronic sources to draw a picture of Hobson’s anti-narcotics propagandizing and put it in historical context. Full article

It is well known that the brain is quite vulnerable to oxidative stress, initiating neuronal loss after ischemia-reperfusion (IR) injury. A potent protective mechanism is ischemic preconditioning (IPC), where proteins are among the primary targets. This study explores redox-active proteins’ role in preserving energy supply. Adult rats were divided into the control, IR, and IPC groups. Protein profiling was conducted to identify modified proteins and then verified through activity assays, immunoblot, and immunohistochemical analyses. IPC protected cortex mitochondria, as evidenced by a 2.26-fold increase in superoxide dismutase (SOD) activity. Additionally, stable core subunits of respiratory chain complexes ensured sufficient energy production, supported by a 16.6% increase in ATP synthase activity. In hippocampal cells, IPC led to the downregulation of energy-related dehydrogenases, while a significantly higher level of peroxiredoxin 6 (PRX6) was observed. Notably, IPC significantly enhanced glutathione reductase activity to provide sufficient glutathione to maintain PRX6 function. Astrocytes may mobilize PRX6 to protect neurons during initial ischemic events, by decreased PRX6 positivity in astrocytes, accompanied by an increase in neurons following both IR injury and IPC. Maintained redox signaling via astrocyte-neuron communication triggers IPC’s protective state. The partnership among PRX6, SOD, and glutathione reductase appears essential in safeguarding and stabilizing the hippocampus. Full article

Cardiac surgery-associated acute kidney injury (CSA-AKI) is a complication of cardiopulmonary bypass surgery that frequently occurs in children. The increased availability of pediatric cardiac surgery leads to yearly increases in congenital heart disease (CHD) procedures performed worldwide. The number of complications, including pediatric CSA-AKI, has also increased. Children with CSA-AKI have worse postoperative periods and require more complex post-op intensive care. Thus, the timely commencement of interventions to prevent and to treat kidney injury in CHD children are one of a leading goals of pediatric cardiac intensive care. Full article

In Thailand, diesel buses are notorious for their poor energy efficiency and contribution to air pollution. To combat these issues, battery electric buses (BEBs) have emerged as a promising alternative. However, their high initial costs have posed challenges for fleet management, especially for agencies such as the Bangkok Mass Transit Authority (BMTA). This study aims to revolutionize BEB fleet management by developing an energy model tailored to the BMTA’s needs. The methodology consists of two crucial steps: analyzing BMTA bus routes and designing fleet management and charging systems. Through this process, the study seeks to determine the maximum number of BEBs that can be operated on each route with the fewest chargers possible. The results reveal exciting possibilities. Within the city bus landscape, two out of five BMTA bus routes show potential for transitioning to BEBs, provided they meet a maximum energy requirement of 200 kWh every two rounds. This analysis identifies routes ripe for BEB adoption while considering the limitations of battery size. In the next step, the study unveils a game-changing strategy: a maximum of 13 BEBs can operate on two routes with just four chargers requiring 150 kW each. This means fewer chargers and more efficient operations. Plus, the charging profile peaks at 600 kW from 4:00 to 8:00 p.m., showing when and where the fleet needs power the most. However, the real eye-opener? Significant energy savings of THB 10.44 million per year compared to diesel buses, with an initial investment cost savings of over 37%. These findings underscore the potential for BEB fleet management to revolutionize public transportation and save money in the long run. However, there is more work to be done. The study highlights the need for real-time passenger considerations, the development of post-service charging strategies, and a deeper dive into total lifetime costs. These areas of improvement promise even greater strides in the future of sustainable urban transportation. Full article