als

Every society organizes itself to reduce the complexity of living together in order to ensure relative peace of mind for its members. Major technological accidents such as the Chernobyl or Fukushima nuclear accidents are violent disruptions that affect the quality of life of tens of thousands of people and generate increased distrust and anxiety among them as well as the questioning of the state system’s ability to restore some peace of mind. Past experience has shown that the measurement of radiation and the development of local projects with the support of professionals and experts prove to be effective levers for those affected to regain the ability to make decisions for their protection and to assess the protective actions implemented collectively. It also showed that restoring confidence and restoring the dignity of these people, seriously impaired by the accident, takes time.

Objective: To study clinical and immunological characteristics of depressive patients with high clinical risk of schizophrenia.Materials and methods: We examined 30 depressive patients with attenuated positive symptoms (APS), which indicates a clinically high risk of schizophrenia, 20 depressive patients without APS and 27 healthy volunteers with no mental disorders. APS identified according to the presence of three or more scores on at least one of the following items on the Scale of Prodromal Symptoms (SOPS) positive symptoms subscale: P1 (Unusual thought content/Delusional ideas), P2 (Suspiciousness/Persecutory ideas) and P4 (Perceptual abnormalities/Hallucinations). The psychometric assessment was carried out on the Hamilton Depression Rating Scale (HDRS), SOPS, and the Scale for Assessment of Negative Symptoms (SANS). The activity of leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI), the autoantibodies to neoantigens S100B and myelin basic protein, and the ratio of LE and α1-PI activity or Leukocyte Inhibitory Index (LII) were determined. Results: The activity of inflammatory markers LE and α1-PI was increased in patients in both clinical groups compared with controls. In the total group of patients, the associations between LII and the score on the positive subscale SOPS, and between LII and the score on the negative subscale SOPS and SANS scale with the most pronounced association with the SANS subscales «Affective Flattening or Blunting» and «Alogia» were established. Conclusion: The identified correlations between immune response features and positive and negative symptoms in depressive patients may have prognostic value for establishing a high risk of schizophrenia.

Purpose: Exercise has a positive regulatory effect on gut microbiota and is also involved in regulating multiple physiological functions of the human body. This article tested the effects of basketball exercises at different exercise intensities on the gut microbiota of college students. Methods: Athlete research subjects (male, aged 18 - 25) were selected from the basketball team and trained at different intensities to obtain a total of 101 fresh fecal samples. DNA was extracted by a DNA extraction kit and bacterial 16S rRNA gene V3-V4 region high-throughput sequencing using the Illumina Hiseq platform. The downstream data were spliced, filtered and de-trimerized and then used to study the difference in gut microbiota. Results: Key bacterial taxa in the gut that responded to exercise intensity differed among athletes of different exercise intensities but most belonged to Firmicutes. With increasing exercise intensity, Butyricicoccus, Anaerostipes, Oxalobacter and Clostridium_IV in basketball players enrich. Further analysis of the functional prediction revealed that carbohydrate metabolism, amino acid metabolism, metabolism of xenobiotics and glycans and metabolism were significantly expressed in the gut microbiota of basketball athletes with high intensity. Conclusion: The study demonstrated that after long-term professional training, the gut microbiota of athletes adapts to exercise stimulators and can quickly respond to changes in exercise intensity. In high-intensity training, the organism is protected from harm by enriching some beneficial bacteria.

Background: Autologous hematopoietic stem cell transplants (HSCT) is the standard of care for transplant-eligible patients with newly diagnosed multiple myeloma (MM) and patients with relapsed and refractory Hodgkin lymphoma (R/R-HL) who achieve chemosensitivity after salvage therapy. Although autologous HSCT is routinely performed in an  inpatient setting, the procedure can safely be performed in an  outpatient setting.Methods and materials: A retrospective study of patients with MM and R/R- HL who received outpatient autologous HSCT at King Fahad Specialist Hospital (KFSH) in Dammam, Saudi Arabia between the first of April 2017 and the 31st of January 2022 was performed.Results: Over the study period of 4 years and 10 months, a total of 90 outpatient autologous HSCTs were performed for 79 patients (54 patients with MM; 4 of them received planned tandem autografts and 7 other myeloma patients received second autologous HSCTs for relapsed or progressive disease; and 25 patients with R/R-HL) at our institution. The median ages of patients with MM and those with R/R-HL at HSCT were 50.4 years and 27.8 years respectively.At the presentation of their MM, the following high-risk (HR) features were encountered: stage II and III diseases according to the revised international scoring system (RISS) in 53.7%; adverse cytogenetics in 42.6% and extensive bone involvement in 53.7% of patients. In patients with HL at presentation, 48% of patients had stage IV disease according to Ann Arbor staging classification and 84% of patients had B symptoms.Survival for 100 days post-HSCT for all patients with MM and HL who received outpatient autologous transplants was 100%. For patients with MM, the overall survival (OS) rates at 3 years and 4 years post-HSCT were 80% and 67%, while the progression-free survival (PFS) rates over 3 years and 4 years were 58% and 38% respectively. For patients with HL, the OS at 6 years post-HSCT was 95% while the PFS rates at 3 years and 6 years post-HSCT were 84% and 62% respectively.Conclusion: Outpatient autologous HSCT for patients with MM and HL is safe, and feasible and can lead to short-term as well as long-term outcomes that are comparable to autologous transplantation performed in an  inpatient setting. Additional benefits of outpatient autologous include saving beds and reducing hospital costs.

Introduction: Self-harm and depression are two related mental health issues that often co-occur and can have serious impacts on individuals and their well-being. Major Depressive Disorder (MDD) is a complex and multifaceted mental health condition that is prevalent among young adults. It is a significant public health concern that affects individuals, families and society as a whole, contributing to considerable social, economic, and health-related costs. Despite the high prevalence of depression in young adults, there is a lack of understanding of its etiology, risk factors, and optimal treatment strategies. Self-harm behavior is a concerning manifestation of MDD that can have serious consequences, including injury, infection, or even death.Methods: In this article, we report a case of an MDD patient with self-harm behavior and discuss the assessment method and treatment options. Our aim is to raise awareness of these pathologies among psychiatrists and the general population and to highlight the importance of early diagnosis and effective treatment in reducing the risk of self-harm behavior and suicide.Conclusion: In light of the case presented, it is evident that early detection and targeted intervention are crucial in mitigating the risk of self-injurious behavior in MDD patients. The utilization of a comprehensive assessment methodology, inclusive of a thorough review of the patient’s clinical history and utilization of standardized rating scales, proved indispensable in the tailoring of an individualized treatment regimen. The amalgamation of pharmacotherapy and psychotherapy proved to be a successful strategy in the amelioration of depressive symptoms and consequent self-harm behavior. As such, we trust that this case report will serve to sensitize clinicians to the importance of early identification and prompt management of these pathologies, in the quest for enhanced mental health outcomes.

Hereditary spherocytosis is a common inherited type of hemolytic anemia that results from abnormal morphology of erythrocytes. It has a high occurrence in North Americans and northern Europeans with a prevalence of 1/2000. There is a wide range in age and symptoms at presentation with some individuals being asymptomatic and others having severe diseases requiring blood transfusions. Based on the severity of symptoms, management may vary from simple observation to frequent blood transfusions, cholecystectomy for gallstones, and splenectomy. Timely diagnosis may be critical to minimize complications. Diagnostic tests have been available with varying degrees of accuracy. However new diagnostic tests with greater specificity and sensitivity are now available for more accurate diagnosis of Hereditary Spherocytosis in individuals of all ages including newborns. Illustrative cases are presented that show the variability in presentation, symptoms, complications, and care. Information is presented updating diagnostic testing that allows earlier diagnosis of children with hereditary spherocytosis. Additionally, the hematologic findings suspicious and consistent for this diagnosis are presented, serving as a guide when testing should be initiated.

The biochemical model explains the intricate mechanisms of psychobiological life. He still cannot explain what the transition from inanimate to living matter is all about. Where is the threshold and what is its essence, what role do biochemical processes play in the coherence of the soma with consciousness and its impact on the soma and vice versa? A similar problem is with other mental processes, their nature does not fit into the biochemical model of life and is inexplicable on the basis of biochemical interactions, again it is much easier to describe it in the light of quantum processes - including wave physics. It is similar to the functioning of the heart or other organs, where only the biochemical processes of the cell are considered, ignoring the bioelectronic processes. Man is not only a purely biological construct but also contains the basis of biochemical, bioelectronic, information, and cybernetic processes that are responsible for shaping the psychobiological processes of man. Contemporary biosystems in science are considered at the level of corpuscular structures, ignoring energy and information structures. By shifting the cognitive emphasis towards energy and information structures, the organism can be perceived as a quantum generator of information: electromagnetic, soliton, acoustic, spin and bioplasma. This bioelectronic construction creates homo electronics with his electronic personality.

The review article examines the production of molecular hydrogen from the decomposition of water by various irradiation methods. The article shows different types of radiation: UV radiation, visible radiation, gamma radiation, X-ray radiation and neutron radiation. Electrons generated by radiation inside a nanoparticle of radius R suspense in fluid water are diffused with equal probability in all directions inside the particle and gradually lose their kinetic energy as a result of elastic and inelastic collisions. Some of these electrons are transported to the nanoparticle surface during the physical and physicochemical stages of the process and emitted into the water. It is extremely important for the formation of nanostructured materials after exposure to ordered nanostructure from the new phase with a period of a few nanometers, promoting the preservation of the properties of materials under high irradiation.

Today, there are said to be some 590 million people of all ages around the world, who are suffering from a range of swallowing problems – probably about 4 million in the UK. Either living at home or as residents in some 20,000 Care Homes, with perhaps another 25,000 as patients in hospitals every day.Professor David Smithard, of the Lewisham and Greenwich NHS Trust, has been leading a national campaign for some years to raise general awareness of Dysphagia and to improve the treatment of patients with varying conditions. He and his team at the Queen Elizabeth Hospital have now completed a detailed Review of the use of carbonated water (CW) in the treatment of Dysphagia, which has just been published and can be accessed here: https://www.mdpi.com/2308-3417/8/1/6The Review concludes that further evidence-based research is essential before CW can be adopted as standard in clinical practice – but that although the amount of evidence is small, there is a suggestion that swallows are safer and that secretion management improves, and consequently until further studies are undertaken, Carbonated Water should be limited to individual patient use.My experience as a Dysphagia sufferer is that the use of CW has resulted in life-changing benefits, and this paper is devoted to describing how CW worked for me, and what the practical requirements are, so that many others may be able to benefit as I have done. The paper has three sections: My Personal Experience, Practical Considerations, and Conclusions.

The emergence of dramatic urinary tract infections (UTIs) caused by the members of the Enterobacteriales is an important public health problem in the community as well as in Tunisian hospitals. This study aims to investigate the prevalence of extended-spectrum β-lactamase (ESBL) and carbapenemase-producing uropathogenic isolates of Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae). Based on decreased susceptibility to β-lactams antibiotics and analyzed for the presence of ESBL and carbapenemase genes by Real Time- polymerase chain reaction (RT-PCR), 56 uropathogenic isolates of E. coli (n = 36) and K. pneumoniae (n = 20) were confirmed positive for ESBLs. The CTX-M-type β-lactamases were mostly detected in E. coli isolates (21 strains, 58.33% [95% CI 38.09% - 72.06%]) followed by blaSHV-like (18 strains, 50% [95% CI 32.92% - 67.07%]), blaTEM-like and blaCMY-2-like simultaneously (15 strains, 41.67% [95% CI 25.51% - 59.24%]). Furthermore, the RT-PCR system on the K. pneumoniae strains demonstrated that blaSHV-12-like was the most predominant (16 strains, 80% [95% CI 56.33% - 94.26%]) followed by blaTEM-like (14 strains, 70% [95% CI 45.72% - 88.10%]), blaCTX-M belonging to groups 9 and 1 (11 strains, 55% [95% CI 31.52% - 76.94%]) and finally blaCMY-2-like (10 strains, 50% [95% CI 27.19% - 72.80%]). In addition, E. coli and K. pneumoniae strains harbored a carbapenemase gene blaOXA-48-like with 22.2% [95% CI 10.11% - 39.15%]; 20% [95% CI 12.83% - 43.66%], respectively.Our results confirm the need to monitor the resistance to extended-spectrum β-lactams and to carbapenems among enterobacteria in Tunisia.

Hypertension is a risk factor for the development of heart failure and has a negative impact on the survival of these patients. Although patients with these two conditions usually take different antihypertensive medications, some patients do not achieve adequate blood pressure control and their hypertension becomes resistant or refractory. In this scenario, percutaneous renal denervation has emerged in recent years as an alternative to achieve blood pressure control goals. We present the case of a 53-year-old woman with a medical history of essential hypertension, hypercholesterolemia, unipolar depression, and diabetes, who was diagnosed with dilated cardiomyopathy with reduced left ventricular ejection fraction (33%). Despite the initiation of multiple antihypertensive medications and placement of a cardiac resynchronization therapy pacemaker, the patient remained hypertensive with a left ventricular ejection fraction of 40%. At that time, percutaneous renal denervation was performed without complications, and one year after the procedure, the patient had improved better blood pressure control and the left ventricular ejection fraction increased to 51%. This case illustrates one of the clinical scenarios in which it has been suggested that renal denervation may be more beneficial, as in the situation of patients with refractory hypertension and heart failure.

The complex requirements of a database system for recording regulated chemicals exceed the capabilities of a relational database system. Inheritance, which is part of object-oriented programming, must also be logically transferred to chemical objects. This issue is illustrated here by means of examples of the Chemical Weapons Convention (CWC) and the German version of the New Psychoactive Substances Law (NpSG).

Recent clinical, experimental and epidemiological studies report that ALS is thought possibly due to a multi-stage process, arising from a combination of genetic susceptibility and environmental factors, which alone or superimposed, perhaps on genetic polymorphism yet to be identified, may contribute to the incidence rate of sporadic ALS. In particular, a large amount of evidence suggests that mercury is toxic to motor neurons and may be a risk factor for ALS, playing a part in its pathogenesis. In fact, there have been case reports of ALS or ALS-like symptoms associated with mercury exposure, thus raising the possibility that mercury could be one of the non-genetic factors of the multistep process that is thought to underlie ALS. In order to give recent elucidations on the putative relationship between mercury exposure and ALS, we reviewed all the papers reported in the literature and published on Pubmed from 2006 to 2022. Despite a number of pathogenetic mechanisms that have been linked to mercury, evidence linking exposure to mercury to ALS is not consistent and discordant and, based on the evaluation of the articles, which emerged from our analysis that to date no convincing correlation between mercury and ALS has been established and no conclusive evidence has been enlightened suggesting increased mercury exposure is associated with ALS.

Resource recovery provides an opportunity to transform limited and abundant materials in form of waste into biobased products. In the production system, this technique could offer an economic means to utilize wastes to generate valuable products which are fundamental to a sustainable economy.

Cardiovascular diseases are the leading cause of mortality in the industrialized world. Among these diseases, aortic dissection affects the aorta wall and is a surgical emergency with a low survival rate. This pathology occurs when an injury leads to a localized tear of the innermost layer of the aorta. It allows blood to flow between the layers of the aortic wall, forcing the layers apart and creating a false lumen. Endovascular treatment seeks to obliterate the entrances to the false lumen with a covered stent. There are very few studies on the postoperative demonstration of blood flow phenomena in the aortic dissection endovascular treatment. It is crucial to study the hemodynamics of blood in the aorta after an intervention because the new geometrical configuration of the aorta with a stent leads to modifications in blood flow. For the surgeons, the procedure can only be performed empirically, using MRI-4D images to view the postoperative flow of the patient’s blood in the aorta with the stent.This paper aims to present a numerical tool developed from the open-source software FOAM- Extend®, allowing for multiphysics numerical simulations. Using MRI data, a bio-faithful model of the patient-specific case was built. Numerical simulations were performed to predict preoperative and postoperative (endovascular treatment) hemodynamics. The modifications of the flow in the aorta were analyzed focusing on the postoperative perfusions. The results were compared with the corresponding MRI data and have a good qualitative agreement. Biomarkers are calculated to localize possible zones of post-operative pathological developments and recommendations may be suggested to the surgeons.

This is a work based on the extension of the work of Professor James Clerk Maxwell and Albert Einstein into a new framework of science built on provable mathematical theorem which serves as a basis for unifications of the fundamental forces which all together have become impossible to unify under the current framework of General relativity and Quantum Field theory.It is to be used as a piece for inspiring new innovations, discovering and exploring the terrains of the difficult pathways in physics where our modern physical theories have failed.This work is meant to be adapted and used by various physics professionals who are working on extending the frontiers of physics or providing solutions to problems that cannot be handled by current physics framework. In summary it is an inspirational tool that hopefully will help our professional in physics out there.It interpretations and applications is subject to the personal inspirations the reader who is a professional can derived from the work for his or her personal usage.

Acute myeloid leukaemia (AML) is the forefront disorder of the bone marrow among others that disrupt the normal production of blood cells and platelets. The bone marrow microenvironment or the bone marrow niche (BM niche) that orchestrates the proliferation and survival of Leukaemic stem cells (LSC) is the reason for relapse after complete remission and also chemotherapy drug resistance. As for most cancers oxidative phosphorylation, a fundamental mitochondrial process of energy production, is under focus for the treatment of AML and a novel strategy of targeting heat shock proteins appears as a promising route for further research.

Between coronary artery anomalies, myocardial bridging means an epicardial coronary artery, mostly left anterior descending artery (LAD), running through an intramyocardial “tunnel” (usually in the middle segment), leading during systolic contraction, flow reduction, through the vessel. When this anomaly is associated with a coronary fistula, which “steals” more from the bloodstream, the symptoms are more pronounced, and the management complex is surgical in particular. Despite the presence from birth remains asymptomatic and it becomes clinically manifest later in the third to fourth decade of life, with a diverse palette of symptoms; angina, arrhythmias, and acute myocardial infarction up to sudden death. Diagnosis and particular management, medical, interventional, and surgical should avoid major cardiac complications and sudden death. We present two adult patients, with coronary artery bridging, one case associated with coronary artery fistula, LAD to pulmonary artery trunk, very symptomatic with surgical management, and the second only myocardial bridging controlled with medication and supervision.

Vacuum therapy has become a new option in the treatment of wounds in surgery. More recently this therapy has also been used as a treatment for anastomotic leakages in association or not to emergency surgery. The management of these devices should be familiar to all the staff in a surgical ward.

A survey was conducted in the agricultural farms in Dhulikhel Municipality, mid-hill, Kavre, Nepal aiming at assessing the status of agrobiodiversity with the purpose of understanding its role in food security taking altogether 133 farming households scattered in several settlements with lowland, upland, and home garden being the general agricultural land use systems. Biodiversity index: Shannon-Wiener Index was used to assess diversity of plant. The main purpose was to assess the farm agrobiodiversity and to find out whether biodiversity level has a direct link to household food self-sufficiency. For descriptive analysis frequency, percentage, mean and standard errors were used. In the case of inferential statistics independent sample t - test and binary logistic was used to find the odd ratio of practicing home garden. The result showed that the average landholding size was 0.66 ha/household with 0.37 ha, 0.3 ha, and 0.06 ha being upland, low land, and home garden, respectively. A total of 136 plant species were documented out of which 74 were the effective number of species in the study area. Among the used plants, fodder shared 27% of the total plant diversity followed by fruit (21%), vegetable (19%), medicinal plants (8%), pulses (8%), spices (7%), oilseeds (5%) and cereals (5%). Similarly, the mean livestock unit (LSU) was 2.65. The overall Shannon-Wiener Index was 4.30 indicating high diversity of species and 87.7% of the species were evenly distributed. The Index was higher for vegetable (3.11) followed by fruits (2.9) and fodder (2.85). Higher diversity was found in fodder trees in lowlands whereas vegetable species were more diverse in upland and home garden. Similarly, the Index was 4.29 in the upland whereas it was 4.078 in the home garden followed by 3.13 in the lowland. The evenness was 0.899, 0.87, and 0.74 in upland, home garden and lowland, respectively. Higher species diversity revealed that the site was rich in agrobiodiversity. A significant positive correlation (0.22) was observed between Shannon-Wiener Index and farming years. Similarly, positive correlation (0.33) was found between an increase in the level of agrobiodiversity and food self-sufficiency. The result demonstrated that increasing crop diversity increases the household’s ability towards food sufficiency implying the need for the formulation and implementation of efficient policy to conserve the agrobiodiversity at municipality as well as national levels.