The subject of this research is the development of epoxy composites with a defined service life for the purpose of seat elements in rail vehicles, which will be more environmentally friendly. The produced materials based on epoxy resin filled with PLA or PLA and quercetin were subjected to solar aging tests for 800 h to investigate the impact of the additives used on the aging behavior of the epoxy matrix. Firstly, the TGA analysis showed that the use of the proposed additives allowed for the maintenance of the thermal stability of the epoxy resin. Moreover, based on an optical microscopy test, it was noticed that the introduction of PLA and PLA with quercetin did not contribute to an increase in matrix defects. The one-directional tensile tests carried out before and after solar aging showed that the presence of polylactide in epoxy composites causes a slight growth of the stiffness and strength. Based on contact angle and color change measurements, it was found that quercetin was oxidized, thus ensuring protection for the epoxy matrix. This phenomenon was confirmed by FTIR study, where the carbonyl index (CI) value for the R-PLA-Q composite was lower than for the reference sample. The obtained composite structures may be a good alternative to traditionally used systems as seat elements in rail vehicles, which are not only characterized by high aging resistance but are also more eco-friendly. Full article

Despite recent efforts in Peru to boost financial inclusion, significant issues of exclusion persist, especially among vulnerable groups. This article aims to identify and analyze areas at risk of financial exclusion using a multifaceted methodology: the Financial Access Survey (FAS) for comparative analysis (Peru versus other countries and regions), geographical-distribution analysis, and the Access to Cash Index (ACI) methodology. Findings reveal that remote rural areas of Peru, particularly those inland, as well as mountainous or jungle regions, face higher risks of financial exclusion due to low digital literacy, limited digital banking usage, sparse branch and ATM networks, and inadequate transportation infrastructure. These insights can inform targeted public policies to enhance financial inclusion in Peru, as well as the development. Full article

Research suggests that success in improving undergraduates’ diet quality can benefit from a multifaceted approach, incorporating nutrition education, mindful eating, and culinary skill-building. The current study aimed (1) to review the development of Master Chef, a mindful eating curriculum, and (2) assess its feasibility through an online expert review. Expert reviewers were recruited through an online mindful eating course. Survey questions included both Likert-style and open-ended questions. Quantitative survey data were analyzed using descriptive statistics. Two independent researchers coded qualitative data, which then underwent inductive thematic analysis. Reviewers (N = 7) were experts in the fields of nutrition, psychology, and mindful eating. Master Chef’s overall feasibility was rated highly. The overall curriculum was perceived positively. However, it was recommended that the program include more mindfulness. Master Chef was identified as a feasible program for improving the health behaviors of college students. Pilot dissemination and analysis will be necessary to assess the program’s effectiveness in supporting disease prevention among undergraduates. Full article

Respiratory tract infections (RTIs) are the leading cause of antibiotic prescriptions, primarily due to the risk for secondary bacterial infections. In this study, we examined whether Echinacea could reduce the need for antibiotics by preventing RTIs and their complications, and subsequently investigated its safety profile. A comprehensive search of EMBASE, PubMed, Google Scholar, Cochrane DARE and clinicaltrials.gov identified 30 clinical trials (39 comparisons) studying Echinacea for the prevention or treatment of RTIs in 5652 subjects. Echinacea significantly reduced the monthly RTI occurrence, risk ratio (RR) 0.68 (95% CI 0.61–0.77) and number of patients with ≥1 RTI, RR = 0.75 [95% CI 0.69–0.81] corresponding to an odds ratio 0.53 [95% CI 0.42–0.67]. Echinacea reduced the risk of recurrent infections (RR = 0.60; 95% CI 0.46–0.80), RTI complications (RR = 0.44; 95% CI 0.36–0.54) and the need for antibiotic therapy (RR = 0.60; 95% CI 0.39–0.93), with total antibiotic therapy days reduced by 70% (IRR = 0.29; 95% CI 0.11–0.74). Alcoholic extracts from freshly harvested Echinacea purpurea were the strongest, with an 80% reduction of antibiotic treatment days, IRR 0.21 [95% CI 0.15–0.28]. An equal number of adverse events occurred with Echinacea and control treatment. Echinacea can safely prevent RTIs and associated complications, thereby decreasing the demand for antibiotics. Relevant differences exist between Echinacea preparations. Full article

The shift towards Next Generation Science Standards represents a paradigmatic change in teaching, transitioning from knowledge transmission to knowledge generation approaches. This reform underscores the complexity of teaching expertise, extending beyond mere knowledge to require a profound comprehension of generative learning environments. In this study, we explore Adaptive Teaching Expertise (AdTex), defining it as a teacher’s capacity characterized by fluidity and reflexiveness in teaching dynamics, rather than just flexibility. Through a complexity framing approach, we delineate three layers of AdTex: the visible actions of teachers, the semi-visible use of epistemic tools such as language, dialogue, and argument, and the tacit orientations towards learning that encompass epistemological, ontological, and axiological dimensions. Our research primarily investigates the intricate relationship between the epistemic tool and orientation layers. Our findings highlight the significance of an interconnected understanding and the impact of philosophical orientations on adaptive teaching practices. A notable contribution of this study is the development of a framework that articulates the belief and knowledge systems crucial for fostering generative learning environments, alongside the introduction of complexity maps to illustrate the interplay among these subsystems. Full article

The adjoint function of connection number has unique advantages in solving uncertainty problems of water resource complex systems, and has become an important frontier and research hotspot in the uncertainty research of water resource complex problems. However, in the rapid evolution of the adjoint function, some problems greatly limit the application of the adjoint function in the research of water resources. Therefore, based on bibliometric analysis, development, practical application issues, and prospects of the hot directions are analyzed. It is found that the development of the connection number of water resource set pair analysis can be divided into three stages: (1) relatively sluggish development before 2005, (2) a period of rapid advancement in adjoint function research spanning from 2005 to 2017, and (3) a subsequent surge post-2018. The introduction of the adjoint function of connection number promotes the continuous development of set pair analysis of water resources. Set pair potential and partial connection number are the crucial research directions of the adjoint function. Subtractive set pair potential has rapidly developed into a relatively independent and important trajectory. The research on connection entropy is comparatively less, which needs to be further strengthened, while that on adjacent connection number is even less. The adjoint function of set pair potential can be divided into three major categories: division set pair potential, exponential set pair potential, and subtraction set pair potential. The subtraction set pair potential, which retains the original dimension and quantity variation range of the connection number, is widely used in water resources and other fields. Coupled with the partial connection number, a series of new connection number adjoint functions have been developed. The partial connection number can be mainly divided into two categories: total partial connection number, and semi-partial connection number. Among these, the calculation expression and connotation of total partial connection numbers have not yet reached a consensus, accompanied by the slow development of high-order partial connection numbers. Semi-partial connection number can describe the mutual migration movement between different components of the connection number, which develops rapidly. With the limitations and current situation described above, promoting the exploration and application of the adjoint function of connection number in the field of water resources and other fields of complex systems has become the focus of future research. Full article

Coffee leaf diseases are a significant challenge for coffee cultivation. They can reduce yields, impact bean quality, and necessitate costly disease management efforts. Manual monitoring is labor-intensive and time-consuming. This research introduces a pioneering mobile application equipped with global positioning system (GPS)-enabled reporting capabilities for on-site coffee leaf disease detection. The application integrates advanced deep learning (DL) techniques to empower farmers and agronomists with a rapid and accurate tool for identifying and managing coffee plant health. Leveraging the ubiquity of mobile devices, the app enables users to capture high-resolution images of coffee leaves directly in the field. These images are then processed in real-time using a pre-trained DL model optimized for efficient disease classification. Five models, Xception, ResNet50, Inception-v3, VGG16, and DenseNet, were experimented with on the dataset. All models showed promising performance; however, DenseNet proved to have high scores on all four-leaf classes with a training accuracy of 99.57%. The inclusion of GPS functionality allows precise geotagging of each captured image, providing valuable location-specific information. Through extensive experimentation and validation, the app demonstrates impressive accuracy rates in disease classification. The results indicate the potential of this technology to revolutionize coffee farming practices, leading to improved crop yield and overall plant health. Full article

The malfunctioning of the brain synucleins is associated with pathogenesis of Parkinson’s disease. Synucleins’ ability to modulate various pre-synaptic processes suggests their modifying effects on the electroencephalogram (EEG) recorded from different brain structures. Disturbances in interrelations between them are critical for the onset and evolution of neurodegenerative diseases. Recently, we have shown that, in mice lacking several synucleins, differences between the frequency spectra of EEG from different brain structures are correlated with specificity of synucleins’ combinations. Given that EEG spectra are indirect characteristics of inter-structural relations, in this study, we analyzed a coherence of instantaneous values for EEGs recorded from different structures as a direct measure of “functional connectivity” between them. Methods: EEG data from seven groups of knock-out (KO) mice with combined deletions of alpha, beta, and gamma synucleins versus a group of wild-type (WT) mice were compared. EEG coherence was estimated between the cortex (MC), putamen (Pt), ventral tegmental area (VTA), and substantia nigra (SN) in all combinations. Results: EEG coherence suppression, predominantly in the beta frequency band, was observed in KO mice versus WT littermates. The suppression was minimal in MC-Pt and VTA-SN interrelations in all KO groups and in all inter-structural relations in mice lacking either all synucleins or only beta synuclein. In other combinations of deleted synucleins, significant EEG coherence suppression in KO mice was dominant in relations with VTA and SN. Conclusion: Deletions of the synucleins produced significant attenuation of intra-cerebral EEG coherence depending on the imbalance of different types of synucleins. Full article

Background: Globally, the prevalence of diabetes is increasing, especially in low- and middle-income countries (LMICs), including those in the sub-Saharan African region. However, the independent socioeconomic correlates of glycemic control as measured by hemoglobin A1C have yet to be identified. Therefore, the aim of this analysis was to understand the independent correlates of glycemic control in South Africa. Methods: Data from the 2016 South Africa Demographic and Health Survey on adults with diabetes were used for this analysis. The dependent variable, glycemic control, was defined using hemoglobin A1c (HbA1c). Independent variables included: age, gender, ethnicity, marital status, region, urban/rural residence, ability to read, education, insurance, wealth, occupation, and employment in the last year. Analysis of variance was used to test for differences in mean HbA1c for each category of all independent variables, and a fully adjusted linear regression model was used to identify independent correlates of glycemic control (HbA1c). Results: Among the 772 people included in this analysis, there were significant differences in mean HbA1c by age (p < 0.001), ethnicity (p < 0.001), place of residence (p = 0.024), wealth index (p = 0.001), and employment in the last year (p = 0.008). Independent correlates of HbA1c included age, ethnicity, and wealth index. Conclusions: This study used data from a large diverse population with a high prevalence of diabetes in sub-Saharan Africa and provides new evidence on the correlates of glycemic control and potential targets for interventions designed to lower HbA1c and improve diabetes-related health outcomes of adults in South Africa. Full article

Accurate and reliable pose estimation of boom-type roadheaders is the key to the forming quality of the tunneling face in coal mines, which is of great importance to improve tunneling efficiency and ensure the safety of coal mine production. The multi-laser-beam target-based visual localization method is an effective way to realize accurate and reliable pose estimation of a roadheader body. However, the complex background interference in coal mines brings great challenges to the stable and accurate segmentation and extraction of laser beam features, which has become the main problem faced by the long-distance visual positioning method of underground equipment. In this paper, a semantic segmentation network for underground laser beams in coal mines, RCEAU-Net, is proposed based on U-Net. The network introduces residual connections in the convolution of the encoder and decoder parts, which effectively fuses the underlying feature information and improves the gradient circulation performance of the network. At the same time, by introducing cascade multi-scale convolution in the skipping connection section, which compensates for the lack of contextual semantic information in U-Net and improves the segmentation effect of the network model on tiny laser beams at long distance. Finally, the introduction of an efficient multi-scale attention module with cross-spatial learning in the encoder enhances the feature extraction capability of the network. Furthermore, the laser beam target dataset (LBTD) is constructed based on laser beam target images collected from several coal mines, and the proposed RCEAU-Net model is then tested and verified. The experimental results show that, compared with the original U-Net, RCEAU-Net can ensure the real-time performance of laser beam segmentation while increasing the Accuracy by 0.19%, Precision by 2.53%, Recall by 22.01%, and Intersection and Union Ratio by 8.48%, which can meet the requirements of multi-laser-beam feature segmentation and extraction under complex backgrounds in coal mines, so as to further ensure the accuracy and stability of long-distance visual positioning for boom-type roadheaders and ensure the safe production in the working face. Full article

The genome of the osmophilic Aspergillus wentii, unlike that of the osmotolerant Aspergillus nidulans, contains only the gfdA, but not the gfdB, glycerol 3-phosphate dehydrogenase gene. Here, we studied transcriptomic changes of A. nidulans (reference strain and ΔgfdB gene deletion mutant) and A. wentii (reference strain and An-gfdB expressing mutant) elicited by high osmolarity. A. nidulans showed a canonic hyperosmotic stress response characterized by the upregulation of the trehalose and glycerol metabolism genes (including gfdB), as well as the genes of the high-osmolarity glycerol (HOG) map kinase pathway. The deletion of gfdB caused only negligible alterations in the transcriptome, suggesting that the glycerol metabolism was flexible enough to compensate for the missing GfdB activity in this species. A. wentii responded differently to increased osmolarity than did A. nidulans, e.g., the bulk upregulation of the glycerol and trehalose metabolism genes, along with the HOG pathway genes, was not detected. The expression of An-gfdB in A. wentii did not abolish osmophily, but it reduced growth and caused much bigger alterations in the transcriptome than did the missing gfdB gene in A. nidulans. Flexible glycerol metabolism and hence, two differently regulated gfd genes, may be more beneficial for osmotolerant (living under changing osmolarity) than for osmophilic (living under constantly high osmolarity) species. Full article

Although grading is defined by the highest histological grade observed in a glioma, most high-grade gliomas retain areas with histology reminiscent of their low-grade counterparts. We sought to achieve the following: (i) identify proteins and molecular pathways involved in glioma evolution; and (ii) validate the high mobility group protein B2 (HMGB2) as a key player in tumor progression and as a prognostic/predictive biomarker for diffuse astrocytomas. We performed liquid chromatography tandem mass spectrometry (LC-MS/MS) in multiple areas of adult-type astrocytomas and validated our finding in multiplatform-omics studies and high-throughput IHC analysis. LC-MS/MSdetected proteomic signatures characterizing glioma evolution towards higher grades associated with, but not completely dependent, on IDH status. Spatial heterogeneity of diffuse astrocytomas was associated with dysregulation of specific molecular pathways, and HMGB2 was identified as a putative driver of tumor progression, and an early marker of worse overall survival in grades 2 and 3 diffuse gliomas, at least in part regulated by DNA methylation. In grade 4 astrocytomas, HMGB2 expression was strongly associated with proliferative activity and microvascular proliferation. Grounded in proteomic findings, our results showed that HMGB2 expression assessed by IHC detected early signs of tumor progression in grades 2 and 3 astrocytomas, as well as identified GBMs that had a better response to the standard chemoradiation with temozolomide. Full article

This study explores the impact of China’s low-carbon city policy on employment using a quasi-natural experiment approach based on microdata from A-share listed companies (2007–2021). The findings indicate a statistically significant positive effect on employment levels, with an average increase of 7.27% in pilot compared to non-pilot cities. This boost in employment is primarily linked to green innovation, improved financing conditions, and increased sales activities. The policy disproportionately benefits high-skilled workers and positively affects employment in sales, research and development, and management while having a lesser impact on low-skilled and production workers. The employment gains are particularly significant in non-polluting sectors, regions with high marketization, and in the eastern areas of China. This study underscores the complex interplay between environmental policies and labor markets, emphasizing the need for skill differentiation in policy frameworks. Full article

The quality of rice, evaluated using multiple quality-related traits, is the main determinant of its market competitiveness. In this study, two japonica rice varieties with significant differences in quality-related traits were used as parents to construct two populations, BC₃F₂ and BC₃F_2:3, with Kongyu131 (KY131) as the recurrent parent. A genetic linkage map was constructed using the BC₃F₂ population based on 151 pairs of SSR/InDel polymorphic markers selected between the parents. Grain-shape-related traits (grain length GL, grain width GW, and length-to-width ratio LWR), chalkiness-related traits (white-core rate WCR, white-belly rate WBR, white-back rate BR, and chalkiness rate BR), and amylose content (AC) were investigated in the two populations in 2017 and 2018. Except for BR and CR, the traits showed similar characteristics with a normal distribution in both populations. Genetic linkage analysis was conducted for these quality-related traits, and a total of 37 QTLs were detected in the two populations. Further validation was performed on the newly identified QTLs with larger effects, and three grain shape QTLs and four chalkiness QTLs were successfully validated in different environments. One repeatedly validated QTL, qWCR3, was selected for fine mapping and was successfully narrowed down to a 100 kb region in which only two genes, LOC_0s03g45210 and LOC_0s03g45320, exhibited sequence variations between the parents. Furthermore, the variation of LOC_Os03g45210 leads to a frameshift mutation and premature protein termination. The results of this study provide a theoretical basis for positional cloning of the qWCR3 gene, thus offering new genetic resources for rice quality improvement. Full article

Over the years, the imbalance between population needs and urban spaces’ organized development has been accentuated by increasing urbanization. The implementation of smart city actions began in the 1990s, with the development of integrated solutions in cities, harmonizing social, environmental, and economic aspects. This research measures the impact of thematic areas on smart cities’ management performance. The multi-criteria Decision Making Trial and Evaluation Laboratory (DEMATEL) method was used to identify the interdependent relations between smart cities’ thematic areas, structuring a diagram of cause-and-effect relations using threshold quantification values. Considering their degree of importance in smart city management, the thematic areas of technology and innovation, living environment and infrastructure, education and training, and governance and engagement are highlighted. For the degree of influence, the most influential thematic areas are coexistence and reciprocity, living environment and infrastructure, entrepreneurship, and healthcare. Also, the cause-and-effect analysis identified governance and engagement, education and training, and mobility as central thematic areas for smart city management. Finally, the research construct was developed by ranking the thematic areas’ performance in urban space planning. Full article

In this paper, a generalized fractional three-species food chain model with delay is investigated. First, the existence of a positive equilibrium is discussed, and the sufficient conditions for global asymptotic stability are given. Second, through selecting the delay as the bifurcation parameter, we obtain the sufficient condition for this non-control system to generate Hopf bifurcation. Then, a nonlinear delayed feedback controller is skillfully applied to govern the system’s Hopf bifurcation. The results indicate that adjusting the control intensity or the control target’s age can effectively govern the bifurcation dynamics behavior of this system. Last, through application examples and numerical simulations, we confirm the validity and feasibility of the theoretical results, and find that the control strategy is also applicable to eco-epidemiological systems. Full article

Shallow gas reservoirs play a crucial role in the gas hydrate system. However, the factors influencing their distribution and their relationship with the gas hydrate system remain poorly understood. In this study, we utilize three-dimensional seismic data to show the fluid pathways and shallow gas reservoirs within the gas hydrate system in the Qiongdongnan Basin. From the deep to the shallow sections, four types of fluid pathways, including tectonic faults, polygonal faults, gas chimneys, and gas conduits, are accurately identified, indicating the strong spatial interconnection among them. The gas pipes are consistently found above the gas chimneys, which act as concentrated pathways for thermogenic gases from the deep sections to the shallow sections. Importantly, the distribution of the gas chimneys closely corresponds to the distribution of the Bottom Simulating Reflector (BSR) in the gas hydrate system. The distribution of the shallow gas reservoirs is significantly influenced by these fluid pathways, with four reservoirs located above tectonic faults and polygonal faults, while one reservoir is situated above a gas chimney. Furthermore, all four shallow gas reservoirs are situated below the BSR, and their distribution range exhibits minimal to no overlap with the distribution of the BSR. Our findings contribute to a better understanding of shallow gas reservoirs and the gas hydrate system, providing valuable insights for their future commercial development. Full article

Endemic island species face heightened extinction risk from climate-driven shifts, yet standard models often underestimate threat levels for those like Quercus alnifolia, an iconic Cypriot oak with pre-adaptations to aridity. Through species distribution modelling, we investigated the potential shifts in its distribution under future climate and land-use change scenarios. Our approach uniquely combines dispersal constraints, detailed soil characteristics, hydrological factors, and anticipated soil erosion data, offering a comprehensive assessment of environmental suitability. We quantified the species’ sensitivity, exposure, and vulnerability to projected changes, conducting a preliminary IUCN extinction risk assessment according to Criteria A and B. Our projections uniformly predict range reductions, with a median decrease of 67.8% by the 2070s under the most extreme scenarios. Additionally, our research indicates Quercus alnifolia’s resilience to diverse erosion conditions and preference for relatively dry climates within a specific annual temperature range. The preliminary IUCN risk assessment designates Quercus alnifolia as Critically Endangered in the future, highlighting the need for focused conservation efforts. Climate and land-use changes are critical threats to the species’ survival, emphasising the importance of comprehensive modelling techniques and the urgent requirement for dedicated conservation measures to safeguard this iconic species. Full article

The present study aimed to examine precision and variability in dart throwing performance and the relationships between these outcomes and bouncing, throwing and catching tasks in children with and without DCD. Children between the ages of 8 and 10 years (n = 165) were classified according to results obtained on the Movement Assessment Battery for Children (MABC-2) and divided into three groups: 65 children with severe DCD (s-DCD), 45 with moderate DCD (m-DCD) and 55 typically developing children (TD). All children performed the dart throwing test and the ball skill items of the Performance and Fitness Test (PERF-FIT). The accuracy and variability of dart throwing tasks were significantly different between TD and s-DCD (p < 0.01), and also between m-DCD and s-DCD (p < 0.01). Participants with s-DCD were also found to perform significantly worse on all PERF-FIT ball skill items than m-DCD (p < 0.001), and m-DCD were significantly poorer than TD (p < 0.001). The dart score and coefficient of variation of the long-distance task appear to be significant predictors for the ball skills and explain between 24 to 29% of their variance. In conclusion, poor results in aiming tasks using darts in children with DCD corroborate with the explanation of deficits in predictive control since the tasks require ballistic movements. Full article

Most of the current studies on autonomous vehicle decision-making and control based on reinforcement learning are conducted in simulated environments. The training and testing of these studies are carried out under the condition of rule-based microscopic traffic flow, with little consideration regarding migrating them to real or near-real environments. This may lead to performance degradation when the trained model is tested in more realistic traffic scenes. In this study, we propose a method to randomize the driving behavior of surrounding vehicles by randomizing certain parameters of the car-following and lane-changing models of rule-based microscopic traffic flow. We trained policies with deep reinforcement learning algorithms under the domain-randomized rule-based microscopic traffic flow in freeway and merging scenes and then tested them separately in rule-based and high-fidelity microscopic traffic flows. The results indicate that the policies trained under domain-randomized traffic flow have significantly better success rates and episodic rewards compared to those trained under non-randomized traffic flow. Full article

Carbon emissions present a pressing challenge to the traditional construction industry, urging a fundamental shift towards more sustainable practices and materials. Recent advances in sensors, data fusion techniques, and artificial intelligence have enabled integrated digital technologies (e.g., digital twins) as a promising trend to achieve emission reduction and net-zero. While digital twins in the construction sector have shown rapid growth in recent years, most applications focus on the improvement of productivity, safety and management. There is a lack of critical review and discussion of state-of-the-art digital twins to improve sustainability in this sector, particularly in reducing carbon emissions. This paper reviews the existing research where digital twins have been directly used to enhance sustainability throughout the entire life cycle of a building (including design, construction, operation and maintenance, renovation, and demolition). Additionally, we introduce a conceptual framework for this industry, which involves the elements of the entire digital twin implementation process, and discuss the challenges faced during deployment, along with potential research opportunities. A proof-of-concept example is also presented to demonstrate the validity of the proposed conceptual framework and potential of digital twins for enhanced sustainability. This study aims to inspire more forward-thinking research and innovation to fully exploit digital twin technologies and transform the traditional construction industry into a more sustainable sector. Full article

Hepatitis B virus (HBV) infections affect approximately 296 million people around the world, and the prevalence of any past or present HBV infection during the years 2015–2018 was as high as 4.3%. Acute HBV infection often presents with nonspecific symptoms and is usually self-limited, but 5% of patients can have persistent infections leading to chronic HBV infection and the risk of turning into chronic HBV infection is significantly higher in babies with vertical transmission (95%). Patients with chronic HBV infection are usually asymptomatic, but 15 to 40% of chronic HBV carriers develop cirrhosis and/or hepatocellular carcinoma. In addition to liver-related disorders, HBV is also associated with several extrahepatic complications, including glomerulonephritis, cryoglobulinemia, neurologic disorders, psychological manifestations, polyarthritis, and dermatologic disorders. Making the diagnosis of HBV can be challenging since patients with chronic infections can remain symptom-free for decades before developing cirrhosis or hepatocellular carcinoma, and patients with acute HBV infection may have only mild, nonspecific symptoms. Therefore, understanding how this virus causes extrahepatic complications can help clinicians consider this possibility in patients with diverse symptom presentations. The pathophysiology of these extrahepatic disorders likely involves immune-related tissue injury following immune complex formation and inflammatory cascades. In some cases, direct viral infection of extrahepatic tissue may cause a clinical syndrome. Currently, the American Association for the Study of Liver Diseases recommends treatment of chronic HBV infections with interferon therapy and/or nucleos(t)ide analogs, and this treatment has been reported to improve some extrahepatic disorders in some patients with chronic HBV infection. These extrahepatic complications have a significant role in disease outcomes and increase medical costs, morbidity, and mortality. Therefore, understanding the frequency and pathogenesis of these extrahepatic complications provides important information for both specialists and nonspecialists and may help clinicians identify patients at an earlier stage of their infection. Full article