This article presents the case of a 27-year-old female patient with idiopathic congenital complete heart block who does not consent to the implantation of a cardiac pacemaker but was referred by her primary care physician for cardiological evaluation. The conduction disturbance was recognized at the age of 6 and was asymptomatic. The professional disqualification from pacemaker implantation included a detailed history of a patient’s symptoms, an echocardiographic assessment of the heart, exercise testing and ECG Holter monitoring. The aid of salbutamol administered orally was also useful. Full article

We previously reported that nano-pulse treatment (NPT), a pulsed power technology, resulted in 4T1-luc mammary tumor elimination and a strong in situ vaccination, thereby completely protecting tumor-free animals against a second live tumor challenge. The mechanism whereby NPT mounts effective antitumor immune responses in the 4T1 breast cancer predominantly immunosuppressive tumor microenvironment (TME) remains unanswered. In this study, orthotopic 4T1 mouse breast tumors were treated with NPT (100 ns, 50 kV/cm, 1000 pulses, 3 Hz). Blood, spleen, draining lymph nodes, and tumors were harvested at 4-h, 8-h, 1-day, 3-day, 7-day, and 3-month post-treatment intervals for the analysis of frequencies, death, and functional markers of various immune cells in addition to the suppressor function of regulatory T cells (Tregs). NPT was verified to elicit strong in situ vaccination (ISV) against breast cancer and promote both acute and long-term T cell memory. NPT abolished immunosuppressive dominance systemically and in the TME by substantially reducing Tregs, myeloid-derived suppressor cells (MDSCs), and tumor-associated macrophages (TAMs). NPT induced apoptosis in Tregs and TAMs. It also functionally diminished the Treg suppression capacity, explained by the downregulation of activation markers, particularly 4-1BB and TGFβ, and a phenotypic shift from predominantly activated (CD44⁺CD62L⁻) to naïve (CD44⁻CD62L⁺) Tregs. Importantly, NPT selectively induced apoptosis in activated Tregs and spared effector CD4⁺ and CD8⁺ T cells. These changes were followed by a concomitant rise in CD8⁺CD103⁺ tissue-resident memory T cells and TAM M1 polarization. These findings indicate that NPT effectively switches the TME and secondary lymphatic systems from an immunosuppressive to an immunostimulatory state, allowing cytotoxic T cell function and immune memory formation to eliminate cancer cells and account for the NPT in situ vaccination. Full article

Intensive increases in electrical energy storage are being driven by electric vehicles (EVs), smart grids, intermittent renewable energy, and decarbonization of the energy economy. Advanced lithium–sulfur batteries (LSBs) are among the most promising candidates, especially for EVs and grid-scale energy storage applications. In this topical review, the recent progress and perspectives of practical LSBs are reviewed and discussed; the challenges and solutions for these LSBs are analyzed and proposed for future practical and large-scale energy storage applications. Major challenges for the shuttle effect, reaction kinetics, and anodes are specifically addressed, and solutions are provided on the basis of recent progress in electrodes, electrolytes, binders, interlayers, conductivity, electrocatalysis, artificial SEI layers, etc. The characterization strategies (including in situ ones) and practical parameters (e.g., cost-effectiveness, battery management/modeling, environmental adaptability) are assessed for crucial automotive/stationary large-scale energy storage applications (i.e., EVs and grid energy storage). This topical review will give insights into the future development of promising Li–S batteries toward practical applications, including EVs and grid storage. Full article

Tooth decay, also known as caries, is a significant medical problem that harms teeth. Treatment is based on the removal of the carious material and then filling the cavity left in the tooth, most commonly with amalgam or composite resin. The consequences of filling failure include repeating the filling or performing another treatment such as a root canal or extraction. Dental amalgam contains mercury, and there is a global effort to reduce its use. However, no consensus has been reached regarding whether amalgam or composite resin materials are more durable, and which is the best restorative material, when using randomized clinical trials. To determine which material is superior, we performed a retrospective cohort study using a large database where the members of 58 dental clinics with 440 dental units were treated. The number of failures of the amalgam compared to composite resin restorations between 2014 and 2021 were compared. Our data included information from over 650,000 patients. Between 2014–2021, 260,905 patients were treated. In total, 19,692 out of the first 113,281 amalgam restorations failed (17.49%), whereas significantly fewer composite restorations failed (11.98%) with 65,943 out of 555,671. This study indicates that composite is superior to amalgam and therefore it is reasonable to cease using mercury-containing amalgam. Full article

Platelets have a fundamental role in mediating hemostasis and thrombosis. However, more recently, a new idea is making headway, highlighting the importance of platelets as significant actors in modulating immune and inflammatory responses. In particular, platelets have an important role in the development of vascular amyloid-b-peptide(ab) deposits, known to play a relevant role in Alzheimer’s disease (AD) through accumulation and deposition within the frontal cortex and hippocampus in the brain. The involvement of platelets in the pathogenesis of AD opens up the highly attractive possibility of applying antiplatelet therapy for the treatment and/or prevention of AD, but conclusive results are scarce. Even less is known about the potential role of platelets in mild cognitive impairment (MCI). The aim to this brief review is to summarize current knowledge on this topic and to introduce the new perspectives on the possible role of platelet activation as therapeutic target both in AD and MCI. Full article

This study aims to investigate the relationship between returns and risk of Islamic stock under stable economic conditions, crises, and pandemics within the scope of Indonesian and Asian Islamic capital markets. How do economic conditions affect the risks and returns of investors in the Indonesian and Asian Islamic capital markets? Verification of the veracity of the Islamic capital market serves as a more resilient option for alternative investments. This study uses Granger causality to determine exogenous and endogenous variables when building the model. The model that is formed is then analyzed using regression with dummy variables of stable economic conditions, crises, and pandemics. The first research findings on differences in crisis, stable and pandemic times in the Asian stock market show that there is no significant difference in effect between stable times and during a crisis, but there are differences in the effect during stable and pandemic times. The second research finding states that the return on Asian market Shariah stocks has no influence on increasing or reducing the value of risk or value at risk. The third finding explains that Islamic stocks in Indonesia have a greater risk value during pandemics and crises than in stable times, but the effect of pandemic and crisis conditions is not as great as Islamic stocks in Asia as a whole. In order to stabilize markets and reduce risks, regulatory bodies and governments frequently employ a variety of actions during times of crisis. When applied to trading volume, risk, and return patterns, these findings can help determine the appropriate policy. Full article

This paper investigates the effects of such CEO characteristics as gender, age, and education on the CEOs’ risk-taking behavior during periods of economic policy uncertainty. The paper utilizes Execucomp, BoardEx, and Compustat data from 2005 to 2017 in order to give a novel perspective on how CEO characteristics may provide differing risk-taking positions when faced with varying levels of uncertainty. The results offer robust evidence that older CEOs generally take less risk—regardless of the level of economic policy uncertainty. However, more educated CEOs take less risk only during economically uncertain times. The results also indicate that while female CEOs tend to be younger and have lower levels of education, gender does not provide a significant difference in risk-taking behavior during periods of economic policy uncertainty. Furthermore, we do not find any significant effect of insider status or corporate governance variables on CEO risk-taking under economic policy uncertainty once gender, age, and education are controlled for. Full article

The Department of Beni, in the country of Bolivia, is thought to host a significant level of biodiversity as a result of its tropical, moist, and diverse climate and landscape. However, the biodiversity of Beni is also considered poorly known and understudied due to its inaccessible landscapes, socio-economic challenges, and an overall lack of biodiversity infrastructure. This emphasizes the need for comprehensive species inventories and the development of effective conservation policies and strategies. We conducted an assessment of biodiversity, environmental vulnerability, and conservation status of reptiles documented in Beni. We identified 169 reptile species, spanning three orders and twenty-five families that have been officially documented in Beni. Utilizing the Environmental Vulnerability Score (EVS), we classified these species into high (17.8%), medium (68.1%), and low (14.2%) vulnerability categories, while IUCN categorization revealed 1.8% of reptile species in Beni are classified as vulnerable and 0.6% as near threatened. We found significant differences in ecological drivers of vulnerability among species within all categories (high, medium, low), with habitat specificity and human persecution being significantly higher for high and medium-vulnerability species. Our results demonstrate the intricate vulnerabilities of Beni’s reptiles, highlighting the need for comprehensive, species-specific conservation strategies and planning. Most importantly, our results offer a consolidated framework of information on reptile biodiversity and conservation for researchers, conservationists, and policymakers to use and build upon in the future that will facilitate the development of biodiversity infrastructure not only in the Department of Beni but throughout Bolivia and the Neotropics Full article

Mesenchymal adipose stromal cells (ASCs) are considered the most promising and accessible material for translational medicine. ASCs can be used independently or within the structure of scaffold-based constructs, as these not only ensure mechanical support, but can also optimize conditions for cell activity, as specific features of the scaffold structure have an impact on the vital activity of the cells. This manuscript presents a study of the secretion and accumulation that occur in a conditioned medium during the cultivation of human ASCs within the structure of such a partial skin-equivalent that is in contact with it. It is demonstrated that the ASCs retain their functional activity during cultivation both within this partial skin-equivalent structure and, separately, on plastic substrates: they proliferate and secrete various proteins that can then accumulate in the conditioned media. Our comparative study of changes in the conditioned media during cultivation of ASCs on plastic and within the partial skin-equivalent structure reveals the different dynamics of the release and accumulation of such secretory factors in the media under a variety of conditions of cell functioning. It is also demonstrated that the optimal markers for assessment of the ASCs’ secretory functions in the studied partial skin-equivalent structure are the trophic factors VEGF-A, HGF, MCP, SDF-1α, IL-6 and IL-8. The results will help with the development of an algorithm for preclinical studies of this skin-equivalent in vitro and may be useful in studying various other complex constructs that include ASCs. Full article

Visualizing the decision-making process is a key aspect of research regarding explainable arrhythmia recognition. This study proposed a visualized lead selection method to classify arrhythmia for multi-lead ECG signals. The proposed method has several advantages, as it uses a visualized approach to select effective leads, avoiding redundant leads and invalid information. It also captures the temporal dependencies of ECG signals and the complementary information between leads. The method deployed a lead activation heatmap (LA heatmap) based on a lead-wise network to select the proper 5 leads from 12-lead ECG heartbeats extracted from the public 2018 Chinese Physiological Signal Challenge database (CPSC 2018 DB), which were then fed into a ResBiTime network combining bidirectional long short-term memory (Bi-LSTM) networks and residual connections for a classification task of nine heartbeat categories (i.e., N, AF, I-AVB, RBBB, PAC, PVC, STD, LBBB, and STE). The results indicate an average precision of 93.25%, an average recall of 93.03%, an average F1-score of 0.9313, and that the proposed method can effectively extract additional information from ECG heartbeat data. Full article

Naturally colored fermented foods currently represent the trend toward a global demand for healthier products. This work produced naturally blue and green ice creams using C-phycocyanin (C-PC) and spirulina residual biomass (RB). The ice creams were assessed based on microbiological analysis, color stability over 6 months, antioxidant activity before and after in vitro digestion, and sensory evaluation. Considering the microorganisms that must be analyzed in accordance with Brazilian legislation, no growth was detected during the storage period. L*, a*, and b* were maintained according to the expected colors. The blue color was intoned over the shelf life (SC-PC *b −9.46 to −19.44 and MC-PC *b from −9.87 to −18.04). The antioxidant activity of the fermented ice creams SC-PC and SRB increased from 15.4 to 41.3 and from 15.3 to 38.0 µM TE/g, respectively, after bioaccessibility analysis. The C-PC ice cream’s appearance received the highest rating, with 70.26% of volunteers expressing a strong preference, highlighting its attractiveness. However, there were no significant differences compared to control samples in the global acceptance. The RB ice cream presented lower results for flavor but moderate acceptance. Thus, these fermented ice creams presented color stability over 6 months, and their antioxidant activity increased after in vitro digestion, highlighting their biological potential. Full article

Background and Objectives: As brain lesions present complex diagnostic challenges, accurate tissue sampling via biopsy is critical for effective treatment planning. Traditional frame-based stereotactic biopsy has been complemented by navigated biopsy techniques, leveraging advancements in imaging and navigation technology. This study aims to compare the navigated and frame-based stereotactic biopsy methods in a clinical setting, evaluating their efficacy, safety, and diagnostic outcomes to determine the optimal approach for precise brain lesion targeting. Materials and Methods: retrospective analysis was conducted on patients who underwent brain biopsies between January 2017 and August 2023 at an academic medical center. Data on patient demographics, clinical characteristics, biopsy technique (navigated vs. frame-based), and outcomes including accuracy, complications, and hospital stay duration were analyzed. Results: The cohort comprised 112 patients, with no significant age or gender differences between groups. Symptoms leading to biopsy were predominantly diminished muscle strength (42.0%), cognitive issues (28.6%), and aphasia (24.1%). Tumors were most common in the deep hemisphere (24.1%). The median hospital stay was 5 days, with a rehospitalization rate of 27.7%. Complications occurred in 4.47% of patients, showing no significant difference between biopsy methods. However, navigated biopsies resulted in fewer samples (p < 0.001) but with comparable diagnostic accuracy as frame-based biopsies. Conclusions: Navigated and frame-based stereotactic biopsies are both effective and safe, with comparable accuracy and complication rates. The choice of technique should consider lesion specifics, surgeon preference, and technological availability. The findings highlight the importance of advanced neurosurgical techniques in enhancing patient care and outcomes. Full article

There is a significant need to develop new environmentally friendly, extraction-free sample collection mediums that can effectively preserve and protect genetic material for point-of-care and/or self-collection, home-collection, and mail-back testing. Systematic evolution of ligands by exponential enrichment (SELEX) was used to create anti-ribonuclease (RNase) deoxyribonucleic acid (DNA) aptamers against purified RNase A conjugated to paramagnetic carboxylated beads. Following eight rounds of SELEX carried out under various stringency conditions, e.g., selection using Xtract-Free™ (XF) specimen collection medium and elevated ambient temperature of 28 °C, a panel of five aptamers was chosen following bioinformatic analysis using next-generation sequencing. The efficacy of aptamer inactivation of RNase was assessed by monitoring ribonucleic acid (RNA) integrity via fluorometric and real-time RT-PCR analysis. Inclusion of aptamers in reaction incubations resulted in an 8800- to 11,200-fold reduction in RNase activity, i.e., digestion of viral RNA compared to control. Thus, anti-RNase aptamers integrated into XF collection medium as well as other commercial reagents and kits have great potential for ensuring quality intact RNA for subsequent genomic analyses. Full article

The upcoming energy transition requires not only renewable energy sources but also novel electricity storage systems such as batteries. Despite Li-ion batteries being the main storage systems, other batteries have been proposed to fulfil the requirements on safety, costs, and resource availability. Moving away from lithium, materials such as sodium, magnesium, zinc, and calcium are being considered. Water-based electrolytes are known for their improved safety, environmentally friendliness, and affordability. The key, however, is how to utilize the negative metal electrode, as using water-based electrolytes with these metals becomes an issue with respect to oxidation and/or dendrite formation. This work studied magnesium, where we aimed to determine if it can be electrochemically deposited in aqueous solutions with alginate-based additives to protect the magnesium. In order to do so, atomic force microscopy was used to research the morphological structure of magnesium deposition at the local scale by using a probe—the tip of a cantilever—as the active electrode, during charging and discharging. The second goal of using the AFM probe technology for magnesium deposition and stripping was an extension of our previous study in which we investigated, for lithium, whether it is possible to measure ion current and perform nonfaradaic impedance measurements at the local scale. The work presented here shows that this is possible in a relatively simple way because, with magnesium, no dendrite formation occurs, which hinders the stripping process. Full article

The high nutritional value of alfalfa hay makes it a widely utilized component in animal feed. However, the current prevalent drying methods for forage have a significantly detrimental impact on the quality of alfalfa during the drying process. This study investigates the effects of high-voltage corona discharge (HVCD) treatment on post-cut alfalfa. Gradient experiments are conducted by adjusting the air-gap spacing at a voltage of 25 kV. The results demonstrate that as the distance decreases, there is an observed increase in the drying rate, rehydration rate, and color intensity of the HVCD-treated material. HVCD treatment significantly enhances crude protein content, which increases with decreasing air-gap spacing. Meanwhile, it negatively affects lignin, neutral detergent fiber (NDF), and acid detergent fiber (ADF) levels. The relative forage quality (RFQ) of alfalfa reaches its peak at an air-gap spacing of 7 cm. The application of HVCD disrupts the fiber structure and induces significant electroporation effects in cells. Minimal changes in functional groups preserve nutrient integrity. Furthermore, HVCD exhibits lower energy consumption compared to hot air dryers. The HVCD treatment is a highly efficient and effective method, with a gradual improvement in alfalfa hay quality as the air-gap distance decreases. Full article

Purpose: To assess the feasibility and the diagnostic accuracy of the new tool, DEvice© (AI, Rome, Italy), for screening patients with dry eye disease (DED). Methods: This study was performed at the University Magna Græcia of Catanzaro. Enrolled patients were classified as affected by DED (group 1) or not (group 2) using an already validated tool (Keratograph 5M, Oculus, Germany), evaluating the noninvasive keratograph breakup time (NIKBUT), tear meniscus height (TMH), meibomian gland loss (MGL), and bulbar redness. All the patients were then examined by means of DEvice©, which allowed the measurement of the relative humidity (RH) and temperature of the ocular surface. Symptoms were scored using the Ocular Surface Disease Index (OSDI) questionnaire. Results: Overall, 40 patients (17 males and 23 females, mean age 38.0 ± 17.1 years) were included: of these, 20 belonged to group 1 and the remaining 20 to group 2. Using Keratograph 5M, significant differences between groups 1 and 2 were detected for NIKBUT-first (respectively, 4.97 ± 1.85 vs. 13.95 ± 4.8 s; p < 0.0001) and for NIKBUT-average (10.55 ± 4.39 vs. 15.96 ± 4.08 s; p = 0.0003). No statistically significant changes were detected for TMH (p = 0.565), MGL (p = 0.051), and bulbar redness (p = 0.687). Using Device©, a statistically significant higher value of RH was found in group 1 compared to group 2 (respectively, 85.93 ± 10.63 vs. 73.05 ± 12.84%; p = 0.0049). A statistically significant correlation was found between RH and OSDI (r = 0.406; p = 0.009). The value RH showed a discriminating power to detect DED with an AUC = 0.782 (standard error 0.07264; 95% CI 0.6401–0.9249; p = 0.0022). Conclusions: The DEvice© can effectively discriminate DED patients from healthy subjects. The parameter RH showed good sensitivity, making this tool ideal for a fast and noninvasive DED screening. Full article

Traditional animal pose estimation techniques based on images face significant hurdles, including scarce training data, costly data annotation, and challenges posed by non-rigid deformation. Addressing these issues, we proposed dynamic conditional prompts for the prior knowledge of animal poses in language modalities. Then, we utilized a multimodal (language–image) collaborative training and contrastive learning model to estimate animal poses. Our method leverages text prompt templates and image feature conditional tokens to construct dynamic conditional prompts that integrate rich linguistic prior knowledge in depth. The text prompts highlight key points and relevant descriptions of animal poses, enhancing their representation in the learning process. Meanwhile, transformed via a fully connected non-linear network, image feature conditional tokens efficiently embed the image features into these prompts. The resultant context vector, derived from the fusion of the text prompt template and the image feature conditional token, generates a dynamic conditional prompt for each input sample. By utilizing a contrastive language–image pre-training model, our approach effectively synchronizes and strengthens the training interactions between image and text features, resulting in an improvement to the precision of key-point localization and overall animal pose estimation accuracy. The experimental results show that language–image contrastive learning based on dynamic conditional prompts enhances the average accuracy of animal pose estimation on the AP-10K and Animal Pose datasets. Full article

Landscapes have been shaped and reshaped by humans to meet the changing needs of shifting subsistence strategies and demographic patterns. In the Mediterranean region, a widespread subsistence strategy that has left a major imprint is pastoralism, often tied with transhumance. Pastoralism and the associated tensions between pastoralists and settled agriculturalists have political and legal dimensions which are sometimes overlooked in mainstream accounts of national “patrimony”. The rapid transformations of subsistence strategies witnessed in the twentieth century have changed pastoral landscapes in diverse ways. This paper focusses on the central Mediterranean archipelago of Malta to explore how the values and management of such landscapes require holistic assessment, taking into account the intangible practices and embedded legal rights and obligations that maintained these systems. While in Malta pastoralism has practically disappeared, its physical imprint persists in the form of a network of droveways, which was once a carefully regulated form of commons. Burgeoning demographic growth is erasing large tracts of the historic environment. Against this backdrop of contestation, this paper draws on interdisciplinary approaches to interrogate the shifting legal and historical narratives through which pastoral landscapes have been managed, in the process revealing how dominant epistemological and legal frameworks are also implicated in the erasure of these landscapes. Full article

Screening for osteoporosis is crucial for early detection and prevention, yet it faces challenges due to the low accuracy of calcaneal quantitative ultrasound (QUS) and limited access to dual-energy X-ray absorptiometry (DXA) scans. Recent advances in AI offer a promising solution through opportunistic screening using existing medical images. This study aims to utilize deep learning techniques to develop a model that analyzes chest X-ray (CXR) images for osteoporosis screening. This study included the AI model development stage and the clinical validation stage. In the AI model development stage, the combined dataset of 5122 paired CXR images and DXA reports from the patients aged 20 to 98 years at a medical center was collected. The images were enhanced and filtered for hardware retention such as pedicle screws, bone cement, artificial intervertebral discs or severe deformity in target level of T12 and L1. The dataset was then separated into training, validating, and testing datasets for model training and performance validation. In the clinical validation stage, we collected 440 paired CXR images and DXA reports from both the TCVGH and Joy Clinic, including 304 pared data from TCVGH and 136 paired data from Joy Clinic. The pre-clinical test yielded an area under the curve (AUC) of 0.940, while the clinical validation showed an AUC of 0.946. Pearson’s correlation coefficient was 0.88. The model demonstrated an overall accuracy, sensitivity, and specificity of 89.0%, 88.7%, and 89.4%, respectively. This study proposes an AI model for opportunistic osteoporosis screening through CXR, demonstrating good performance and suggesting its potential for broad adoption in preliminary screening among high-risk populations. Full article

Oxidative stress represents a critical facet of the array of abiotic stresses affecting crop growth and yield. In this paper, we investigated the potential differences in the functions of two highly homologous Arabidopsis DSS1 proteins in terms of maintaining genome integrity and response to oxidative stress. In the context of homologous recombination (HR), it was shown that overexpressing AtDSS1(I) using a functional complementation test increases the resistance of the Δdss1 mutant of Ustilago maydis to genotoxic agents. This indicates its conserved role in DNA repair via HR. To investigate the global transcriptome changes occurring in dss1 plant mutant lines, gene expression analysis was conducted using Illumina RNA sequencing technology. Individual RNA libraries were constructed from three total RNA samples isolated from dss1(I), dss1(V), and wild-type (WT) plants under hydrogen peroxide-induced stress. RNA-Seq data analysis and real-time PCR identification revealed major changes in gene expression between mutant lines and WT, while the dss1(I) and dss1(V) mutant lines exhibited analogous transcription profiles. The Kyoto Encyclopedia of Genes and Genomes enrichment analysis revealed significantly enriched metabolic pathways. Notably, genes associated with HR were upregulated in dss1 mutants compared to the WT. Otherwise, genes of the metabolic pathway responsible for the synthesis of secondary metabolites were downregulated in both dss1 mutant lines. These findings highlight the importance of understanding the molecular mechanisms of plant responses to oxidative stress. Full article

Background: There is limited evidence on the association between psychological distress, academic stress, and burnout among Saudi nursing students. Clarifying such an association is crucial to understanding the factors associated with psychological distress and developing interventions to prevent it. Aim: To explore the prevalence and association of psychological distress with academic stress and burnout among Saudi nursing students. Methods: A cross-sectional design was used, and 237 students participated from a nursing college in Riyadh, Saudi Arabia. Students’ demographics; the Depression, Anxiety, and Stress Scale; the Academic Stress Inventory; and the Maslach Burnout Inventory were used for data collection. Results: Most of the participants reported no-to-mild depression, anxiety, and stress. Stress related to studying in groups, time management, emotional exhaustion, depersonalization, and personal accomplishment were the significant predictors of psychological distress, explaining 52.1% of the variance. Conclusions: This study suggest implementing tailored mental health screenings and support services for nursing students, embedding mental health professionals in the program, and using telehealth or mobile apps for remote monitoring to ensure comprehensive care for nursing students. Future research should consider these predictors while designing strategies to decrease psychological distress among students. Full article