impact

Annually the list of pesticides is replenished by new ones. One of the main criteria for their registration is toxicological and hygienic assessment and its impact on the environment. In order to register the new soy herbicide Damu - Safen, EC (fomesafen, 250 g/l) it was necessary to assess its toxicological and hygienic impact on the environment and humans. Therefore, for the first time we conducted studies of the environmental objects under the influence of Damu-Safen, EC (fomesafen, 250 g/l) and the risk assessment of the active substance fomesafen and pesticide Damu - Safen, EC on the workers. According to the results of the assessment of working conditions for the workers of the tanker and the tractor operator, an acceptable risk was obtained that meets regulatory and hygienic requirements. Residual amounts of fomesafen not exceeding the normative levels were found during conducted studies on environmental objects. Consequently, the results of the risk assessment in the application of pesticide Damu-Safen, EC (fomesafen, 250 g/l) and its impact on the working people and environmental objects indicate the possibility of its application in compliance with optimal environmental conditions and compliance with regulations for appliances and personal protective equipment.

The carried work has based on transient vibration response of multiple degrees of freedom (MDOF) system. By this work study of Time–history analysis and prediction of the displacement for excitation has done. For the MDOF system, we have taken the four-storey building to done transient vibration. We establish the equivalent spring-mass system. Transient analysis has done for both Undamped and Damped of the forced system of multiple degrees of freedom (MDOF) system. In the case of the Damped system, we have done three stages of damping, i.e., (1) Underdamped system, (2) Critically damped system, (3) Overdamped system. The time-history graph obtained for two different time stages i.e. 0.001 sec & 0.01 sec with initial time 0.000001 sec. The natural frequency has determined by both theoretical calculation and ANSYS. The whole study of transient vibration makes it possible to predict the damping values that oppose any kind of sudden impact or force vibration, such as blasts, earthquakes and tsunamis. The ANSYS is the modelling and simulation software is used to perform the transient vibration response. The Mode Superposition method is used by ANSYS to calculate the structure response

Assuming that the road infrastructure has been implemented in accordance with specifications and standards, poor adhesion between the two layers of asphalt mix can be a significant cause of pavement problems. The general problem observed with the weak adhesion between the layers is the slip failure. Slipping disruption in areas where transport acceleration increases, in areas where acceleration decreases or may occur in bumps. One of the criteria and a test method for measuring adhesion resistance between the hot mix asphalt layers is needed to improve the surface finish. The main objective of this study is to determine the effect of reducing the coefficient of friction between asphalt layers in the displacement of asphaltic layers. Because performing experimental experiments in the country is a deterrent to this goal, the use of analytical and numerical methods has been shown to play an important role in conducting studies. Therefore, in this paper, using vehicle simulation in ABAQUS software and analyzes, it has been found that decreasing the coefficient of friction (adhesion reduction) increases the interlayer deformation, which causes the surface of the pavement to fail. Three different thicknesses for asphalt cladding, including 4, 6, and 7 centimeters, and three different thicknesses for roller concrete layers of 18, 20 and 22 centimeters are used. Modeling and analysis of pavements with finite element method has been performed and the depth of the asphalt and tensile strain slope is calculated at the maximum level. The results show that the type of asphalt mix has a high impact on the amount of sloping and tensile strain at the maximum level. So that under different conditions it is estimated to be about 2-3 times in the amount of rotation at the surface. Also, the amount of groove and strain in the middle of the procedure is increased by a thickness of 11% the thickness of the roller concrete thickness has not changed, but the surface strain has been reduced by 9%.

Environmental impact of a recent oil spill incident in Bonny terminal using soil media was studied using a risk-based modeling approach. The establishment of the presence of contaminants of concern (CoC), evaluation/assessment, modeling spilled volume and ascertaining potential health risk associated with the spill incident was carried out. The Contaminant of Concern (CoC) included Total Petroleum Hydrocarbons (TPH) and Polycyclic Aromatic Hydrocarbons (PAHs). Soils and groundwater were sampled in the vicinity of the spill incident and further away into the surrounding communities. Soils were sampled into the depths (0.1 m, 0.5 m,1.0 m, 1.5 m), and the results of sieve analysis revealed that the area is predominantly silty sand in composition. This study also revealed that TPH concentration at all locations and depths exceeded DPR target value of 50 mg/kg. The TPH model revealed that a total volume of 222,500m3 of the spill area exceeded DPR intervention value of 5000 mg/kg. The results of PAH showed that only BS-1, BS-6, BS-8, BS-9 and BS-10 exceeded DPR target value of 1.0 mg/kg at some depths. All other sample depths and locations were within the target limit. The 3-D grid generated for PAH showed that 563,000m3 of the study area exceeded the DPR target value. The 3-D block models generated for TPH and PAH, along with the cross-sections and extracted time slices all showed that the concentration of the Contaminant of Concern (CoC) generally decreased with depth, and the centre of the spill located at the south-eastern part of the survey area. Based on these models, three spill zones were identified; Zone 1-highly contaminated areas (BS-8, BS-9, BS-10); Zone 2 - moderately contaminated areas (BS-1, BS-2, BS-6, BS-7); and low contaminated areas (BS-3, BS-4, BS-5). The entire soil in the area were contaminated with TPH and 47% of the area contaminated with PAH. This study has shown the effectiveness of the use of a model-based approach in quantifying hydrocarbon contamination volumes in the area. There is therefore the need for continuous monitoring of hydrocarbon spills in the area.

The silt fractions have a great impact in soil structural formation. If the soil forming rocks don’t disturb, crush and weather, the soil forming processes on them occur weakly, the organic substances cause formation of the loamy stratums without completely turning. This mostly influences the initial soil forming layers. The reproduction minerals in these soils cause initial minerals majority by occurring weakly. If these processes occur quickly then they cause a gradual increase of the reproduction minerals and reduction of the initial minerals. The heights of the zones where the geographical spreading of such stratums is situated depend on levels.

Introduction and goal: From the perspective of Islam, spiritual health means having a Sound Heart (a calm, confident and optimistic soul, with hope for God’s mercy, satisfaction with destiny and vitality). The way to achieve spiritual health is strengthening the faith and taking good deeds based on religious spirituality. This study was conducted with the aim of determining the impact of spiritual health (Sound Heart) on the other aspects of health at different levels of prevention. Methods: In nine phases of research in 16 years, after designing and validating the “Sound Heart Model”. The spiritual problems of patients and healthy clients were determined. Spiritual care guidelines and the spiritual counseling model in patients and healthy clients were designed. Then “Parent’s Spiritual Empowerment Program”, “inter-professional spiritual health care training program” was extracted. Based on the findings of the previous steps, the effect of spiritual health on other aspects of health at different levels of prevention was extracted. Findings: Belief in God and divine love creates spiritual health (Sound heart) with wisdom, chastity, courage, justice, dignity, kindness, and sincerity in action. Faith prevents neglecting from the God’s remembrance and its consequences such as: unhealthy lifestyle, risky behaviors, destructive excitements, psychosocial diseases in clients and eliminates the fear, anxiety, sadness and disappointment in patients. Spiritual health causes living in the present time with patience and grace of God, creates hope, optimism for the future, courage to face life crises. By creating mental health, it improves the psycho-neuron-immunologic function and improves physical health. Conclusion: Considering the great impact of spiritual health on the other aspects of health at all levels of prevention, it is imperative that students and health care staff, by referring to these concepts, carry out spiritual care/counseling.

In the paper a methodology that is elaborated for characterization of big-sized chambers of modern and future nuclear fusion reactors is described. It gives an opportunity to define distortions introduced by surroundings, systems and elements of the chamber into the neutron field generated during the reactors’ operation. The procedure is based on two types of experimental techniques supported by MCNP numerical modelling. These two classes are: 1) the neutron activation methods for measuring changes in anisotropy of the “absolute” neutron yields, and 2) the time-of-flight process for determination of neutron spectra deformations. MCNP calculations afterwards give an opportunity to fix just those elements of the surroundings that introduce the main impact in the perturbed neutron field characteristics.

Physicists are generally trained in the Standard Model of Physics (SMP). This implies that they perceive and account for only 3 dimensions of space in a moment in time (3S-1t) (a 4-dimensional [4D] model). However, applying the SMP, more than fifty significant conundrums have arisen that are unexplained or incomplete. Explaining these within the SMP 4D fabric led to hypothesizing a ‘fifth force’, most recently the hypothetical ‘X17 particle’. We propose this hypothetical X17 may better be explained by a 9-dimensional model (9D) with gimmel. Our model, the Neppe-Close Triadic Dimensional Vortical Paradigm (TDVP) has amplified the ‘physics’ from 4 dimensions to 9D, specifically first postulating and then further demonstrating mathematically—starting with derivations of the Cabibbo angle—that 9 dimensions must exist. Moreover, this data is empirically demonstrated because the neutron, proton and electron mass-energy-gimmel equivalence in the Triadic Rotational Units of Equivalence (TRUE) as part of the TDVP model, exactly corresponds with the normalized data for the mass-energy equivalence volumetric data for these particles in the CERN Large Hadron Collider. This data shows definitively that we exist in a 9-dimensional finite, quantized, volumetric, spinning reality. This is, furthermore, embedded in an infinite continuity (9D+). Mathematically, applying this 9D+ model definitively requires an extra third component that is massless and energyless (‘gimmel’). Without gimmel, no particle in the universe would be stable. TDVP unifies nature because the same laws apply across the quantum, macro-world and cosmological reality. Our 4D experience is simply the physical component of 9D+ existence. Summary Amplification: At all levels, there is the consistent application of a 9-Dimensional quantized finite reality embedded within an infinite continuity. The application of gimmel specifically requires applying the 9-dimensional model and is based on necessary mathematical calculations not only at the quantal level (where the fifty plus unsolved, unexplained or contradictory conundrums can be explained somewhat, and there is no longer ‘quantum weirdness’), but at the macroscale level with more gimmel in the life elements (which, additionally, are consistently all cubic multiples of 108 cubed), as well as cosmologically, where the correlations with proportionate Dark Matter and Dark Energy are overwhelming. Moreover, these 9-dimensional plus factors together with Triadic Rotational Units of Equivalence (TRUE) and gimmel, allow numerous solutions that couldn’t otherwise be solved. For example, importantly, applying the simple mathematics of TRUE, we can demonstrate why gluons, while adequate in 4D, are impossible applying 9D. These solutions are simpler because we have markedly adapted George Spencer-Brown’s ‘Laws of Form’ to applying a new method of mathematical calculation, Edward Close’s ‘Calculus of Distinctions’ (COD) which recognizes quantal limits and that the nature of finite reality is quantized and volumetric. The COD includes distinguishing between content, extent, and impact. We emphasize the pioneering works of Wolfgang Pauli with his multidimensional model and his ‘Pauli Exclusion Principle’, Alfred Whitehead with ‘Process Philosophy’ and his ‘Principia Mathematica’ (with Bertrand Russell), Georg Cantor with Set Theory, and Roger Penrose with spinors and twistors. TDVP is a prime example of our broad new specialty of ‘Dimensional Biopsychophysics’ (DBP). DBP extends physics, consciousness, and the biopsychosocial to extra dimensions and applies mathematics empirically. Like Max Tegmark, we recognize the key role of mathematics as fundamental in nature, not just for application in calculation and operations.

Introduction: There is increasing published evidence confirming the long-term adult mental and physical health impact of childhood exposure to adverse events including different forms of abuse and family dysfunction. Looked-after Children and young people (LACYP) living in public care are known to be a highly vulnerable group, who have often experienced several pre-care poor socio-economic and family circumstances with subsequent placement instability, as well as inadequate compensatory care within the social care system. We aimed to evaluate the relationship between the adverse socio-emotional risk factors experienced by a cohort of LACYP and their emotional, behavioural and physical health needs within a South-West England Local Authority between Jan and Dec 2018. Methods: We carried out a retrospective review of the medical records of all looked-after children and young people (LACYP) within one year (Jan to Dec 2018) at the North Somerset Local Authority (NSLA). This was an audit project of the LAC Health team completed as part of the Clinical Governance strategies of the NSLA. Results: 93% (89/96) of the LACYP experienced at least one or more socio-emotional adverse risk factors. The commonest socio-emotional risk factors recorded were parent-related including poor mental health (67%), neglectful parenting (59%), drugs/alcohol abuse (45%) and domestic violence (47%). Forty-six (48%) of the LACYP had at least one or more emotional problems, 48 (50%) had neurodevelopmental conditions, while 63 (66%) had at least one or more physical problems. The most common emotional needs were behavioural problems (35%), anxiety/ depression (17%), nicotine/substance misuse (10%) and self-harm (6%). Conclusion: High levels of physical, emotional, behavioral, developmental and neurodisability disorders are prevalent among LACYP due to their high vulnerabilities to adverse life experiences and trauma while living within their biological families. Present and future clinical implications of the socio-emotional risk factors and the need for more integrated multi-agency services for addressing the diverse health needs of the LACYP were discussed. What is known? • There is increasing awareness of the relationship between childhood exposure to adverse events and long-term adult mental and physical health • Looked after children and young people (LACYP) are highly vulnerable to early traumatic and poor socio-economic circumstances exposure What this study adds: • Over 90% of LACYP experienced at least one ACE which disproportionately affected the youngest age-group • Parental factors such as childhood abuse, alcohol/substance abuse and mental health problems were the most common adverse factors experienced by the LACYP

Objective: In primary care, during treatments, nurses may need to wear surgical masks, namely for control of infection contamination, or to minimize unpleasant odors. The goal of this study is to inspect the effect of nurses wearing the mask on patient perception of the nurse-patient relation. Methods: A pre-post-test, control-experimental group design was employed with 60 patients treated in family health units. Patients responded to the Patient Satisfaction Questionnaire III (PSQ-III) regarding nurses’ communication, interpersonal manner, technical quality, as well regarding general satisfaction with the encounter. An additional question asked both patients and nurses how long they felt that the visit lasted. Results: Results show that nurses wearing the surgical mask had significantly negative effects in all dimensions of PSQ-III and increased the perceived visit duration among both nurses and patients. Conclusion: When a previous relationship exists, nurses wearing the surgical mask in primary care in Portugal negatively affects patient satisfaction with both the patient-nurse relation and the nurses’ technical quality. Practice implications: Is important the nurse understand this impact to discuss with the colleagues the best strategy to minimize the negative impact to the patient- family nurse relation and manager this situation in the best way to the patient. 

Actinic keratosis (AK) are scaly lesions caused by chronic ultraviolet-induced damage to the epidermis which are a proxy for excessive sun-exposure [1] that may evolve into squamous cell carcinoma [2-7]. Therefore, there is a need or continuous surveillance of such patients along with adapted information for an effective photo-protection, practical couselling on photoprotection towards the defined population, i.e. elderly with actinic keratosis. Thus, patient observance and adhesion to the dermatologist recommendations become a real public health issue. In this context, we aimed to evaluate through a non-interventional, real-life observational study, the impact of photoprotection counseling by the dermatologist on patients attitude towards sun exposure

Introduction: Endothelial progenitor cells (EPC) are involved in vascular repair and proliferation, contributing to the long-term outcomes of apheretic treatment. Aim of this study was to investigate the relationships between endothelial function, assessed by levels of bone marrow-derived progenitor cells and endothelial response to hyperaemia, and clinical and biohumoral parameters in high vascular risk patients before, immediately after, 24-hours and 72 hours after a single lipid apheresis procedure. Material and Methods: We evaluated lipid profile, endothelial function and endothelial progenitor cells before (T0), immediately after (T1), 24h after (T2) and 72h after (T3) a lipoprotein apheresis procedure, in 8 consecutive patients [Sex: 62.5% M; Age; 63.29(12), mean, (range) years] with a personal history of acute coronary syndrome, symptomatic peripheral arterial disease and elevated plasma levels of lipoprotein (a) [Lp(a)]. Patients were on regularly weekly or biweekly lipoprotein apheresis, and they were treated with the FDA-approved Heparin-induced Extracorporeal LDL Precipitation (H.E.L.P.) (Plasmat Futura, B.Braun, Melsungen, Germany) technique. PAT values were expressed as the natural logarithm (Ln-RHI, normal values≥0.4) of the reactive hyperaemia index (RHI), which is the parameter automatically calculated by the device. Results: We found a reduction in the natural logarithm of reactive hyperaemia index (Ln-RHI), assessed immediately after the procedure (0.57±0.21 vs 0.72± 0.29); difference between T2 and T0 was statistically significant (0.43±0.24 vs 0.72±0.29; p=0.006). Reduction in Ln-RHI values was documented in all patients, two subjects showing a Ln-RHI<0.4 at T1, and four at T2. At T3, PAT values were increased significantly (0.91±0.18) in comparison to T1 and T2, showing a median value higher than at T0. Cd34+/Kdr+ and Cd133+/Kdr+ showed a minimum increase in median values at T1, and a higher increase at T2, in comparison to baseline. Differences in Cd34+/133+/Kdr+ values at different times were not statistically significant. A significant reduction in circulating endothelial cells (CEC) count at T2 in comparison to T0 was found (12.00±8.85 vs 23.86±12.39; p=0.024). Discussion: At 24h and 72h after procedures, we found an improvement in endothelial function, expressed by an increase in PAT values and EPC levels, and by a reduction in CEC.

Objective: The study aimed to describe the epidemiological profile of the homeless population and report the social impact on healthcare services provided by a voluntary initiative during one-year of follow-up. Method: This is an investigational study, carried out in an important capital-city of southern Brazil, which included 509 individuals in 2019. Findings were divided into three segments: sociodemographic, substance use/abuse and impact on healthcare. Results: The sociodemographic profile found was predominantly male, white, single, heterosexual, educated in elementary or high school, in regular use of legal and/or illegal substances, and living as homeless for less than a year. The impact of assistance provided on the perception of individuals who returned in subsequent actions was evident. Conclusion: The significant increase in the number of homeless people in large urban centers can benefit from the support of non-profit organizations to address the deficiencies faced in accessing basic health services. Based on this, we seek to advance in the development of new policies that improve local healthcare for the vulnerable population, to be more assertive to their needs.

Increased exposure to electromagnetic fields such as radio frequencies used by Wifi technology raise questions and concerns about their impact on health. For answer these questions, several scientific studies have carried out followed by results publication in prestigious scientific revues. Literature conducted on the effects of non-ionizing radiation and Wifi waves is vast and sometimes controversial. Epidemiological studies and the results of in vitro and in vivo experimental studies have showed the biological effects of electromagnetic field in different frequencies range. These effects caused disorders at the molecular and behavioral level. However, these studies were insufficient to confirm the directly related effects to the cause. Therefore, further research must be done to raise the controversy about the safety of wireless waves.

The global virome: The viruses have a global distribution, phylogenetic diversity and host specificity. They are obligate intracellular parasites with single- or double-stranded DNA or RNA genomes, and afflict bacteria, plants, animals and human population. The viral infection begins when surface proteins bind to receptor proteins on the host cell surface, followed by internalisation, replication and lysis. Further, trans-species interactions of viruses with bacteria, small eukaryotes and host are associated with various zoonotic viral diseases and disease progression. Virome interface and transmission: The cross-species transmission from their natural reservoir, usually mammalian or avian, hosts to infect human-being is a rare probability, but occurs leading to the zoonotic human viral infection. The factors like increased human settlements and encroachments, expanded travel and trade networks, altered wildlife and livestock practices, modernised and mass-farming practices, compromised ecosystems and habitat destruction, and global climate change have impact on the interactions between virome and its hosts and other species and act as drivers of trans-species viral spill-over and human transmission. Zoonotic viral diseases and epidemics: The zoonotic viruses have caused various deadly pandemics in human history. They can be further characterized as either newly emerging or re-emerging infectious diseases, caused by pathogens that historically have infected the same host species, but continue to appear in new locations or in drug-resistant forms, or reappear after apparent control or elimination. The prevalence of zoonoses underlines importance of the animal–human–ecosystem interface in disease transmission. The present COVID-19 infection has certain distinct features which suppress the host immune response and promote the disease potential. Treatment for epidemics like covid-19: It appears that certain nutraceuticals may provide relief in clinical symptoms to patients infected with encapsulated RNA viruses such as influenza and coronavirus. These nutraceuticals appear to reduce the inflammation in the lungs and help to boost type 1 interferon response to these viral infections. The human intestinal microbiota acting in tandem with the host’s defence and immune system, is vital for homeostasis and preservation of health. The integrity and balanced activity of the gut microbes is responsible for the protection from disease states including viral infections. Certain probiotics may help in improving the sensitivity and effectivity of immune system against viral infections. Currently, antiviral therapy is available only for a limited number of zoonotic viral infections. Because viruses are intracellular parasites, antiviral drugs are not able to deactivate or destroy the virus but can reduce the viral load by inhibiting replication and facilitating the host’s innate immune mechanisms to neutralize the virus. Conclusion: Lessons from recent viral epidemics - Considering that certain nutraceuticals have demonstrated antiviral effects in both clinical and animal studies, further studies are required to establish their therapeutic efficacy. The components of nutraceuticals such as luteolin, apigenin, quercetin and chlorogenic acid may be useful for developing a combo-therapy. The use of probiotics to enhance immunity and immune response against viral infections is a novel possibility. The available antiviral therapy is inefficient in deactivating or destroying the infecting viruses, may help in reducing the viral load by inhibiting replication. The novel efficient antiviral agents are being explored.

Due to the urgent need for water in all parts of industrial or developing societies, water supply, and transmission facilities are suitable targets for biological risks. Given that even a short interruption in water supply and water supply operations has a great impact on daily activities in the community, the deliberate contamination of urban water resources has irreparable consequences in the field of public health, and the economy of society will follow. Unfortunately, most officials in the public health control departments in our country have received limited training in detecting accidental or intentional contamination of water resources and dealing with the spread of waterborne diseases both naturally and intentionally. For this reason, there is low preparedness in the responsible agencies to deal with waterborne diseases during biological risks. In the first step of this research, a review study has been conducted on water biological risks and operational strategies to deal with them. In the following, it has studied how Escherichia coli (E. coli) bacteria spread in aqueous media. In this regard, the kinetic model of the studied microorganism was analyzed based on the implementation of (Fick Law) in polar coordinates and the combination of (Dirac Distribution) with (Legendre polynomial) distribution. Finally, after studying the factors affecting the microbial pollutant emission coefficient, the effects of all three factors of linear velocity, linear motion time period, and angle of motion on the pollutant emission flux and biofilm diffusion time in the water supply network environment were investigated. Studies have shown that the linear velocity parameter of Escherichia coli with a nonlinear relationship has the greatest effects on the release of microbial contaminants.

The present article extends the PVSG-WHO criteria into a simplified set of Rotterdam and European Clinical, Molecular and Pathological (RCP/ECMP) criteria to diagnose and classify the myeloproliferative neoplasms (MPNs). The crude WHO criteria still miss the masked and early stages of ET and PV. Bone marrow histology has a near to 100% sensitivity and specificity to distinguish thrombocythemia in BCR/ABL positive CML and ET, and the myelodysplastic syndromes in RARS-T and 5q-minus syndrome from BCR/ABL negative thrombocythemias in myeloproliferative disorders (MPD). The presence of JAK2V617F mutation with increased erythrocytes above 6x1012/L and hematocrit (>0.51 males and >0.48 females) is diagnostic for PV obviating the need of red cell mass measurement. About half of WHO defined ET and PMF and 95% of PV patients are JAK2V617F positive. The combination of molecular marker screening JAK2V617F, JAK2 exon 12, MPL515 and CALR mutations and bone marrow pathology is 100% sensitive and specific for the diagnosis of latent, early and classical ECMP defined MPNs. The translation of WHO defined ET, PV and PMF into ECMP criteria have include the platelet count above 350 x109/l, mutation screening and bone marrow histology as inclusion criteria for thrombocythemia in various MPNs. According to ECMP criteria, ET comprises three distinct phenotypes of true ET, ET with features of early (“forme fruste” PV), and ET with a hypercellular erythrocythemic, megakaryocytic granulocytic myeloproliferation (EMGM or masked PV). The ECMP criteria clearly differentiate early erythrocythemic, prodromal and classical PV from congenital polycythemia and idiopathic or secondary erythrocytosis. The burden of JAK2V617F mutation in heterozygous ET and in homozygous PV is of major clinical and prognostic significance. JAK2 wild type MPL515 mutated normocellular ET and MF lack PV features in blood and bone marrow. JAK2/MPL wild type hypercellular ET associated with primary megakaryocytic granulocytic myeloproliferation (PMGM) is the third distinct CALR mutated MPN. The translation of WHO into ECMP criteria for the classification of MPNs have a major impact on prognosis assessment and best choice for first line non-leukemogenic approach to postpone potential leukemogenic myelopsuppressive agents as long as possible in ET, PV and PMGM patients.

Currently brain connectivity modelling, constructed from data acquired by non-invasive technique such as functional magnetic resonance imaging (fMRI), is a well-received approach to illustrate brain function. However, not all connectivity models contains equal amount of information. There are two types of connectivity model that could be constructed from fMRI data, functional and effective connectivity. Effective connectivity includes information about the direction of the connection, while functional connectivity does not. This makes interpretation of effective connectivity more meaningful than functional connectivity. The objective of this study is to show the improvement in interpretability of effective connectivity model in comparison to functional connectivity model. In this study, we show how the difference in the information contained within these two model impacts the interpretation of the resulting connectivity model by analyzing resting-state fMRI data on episodic memory-related cognitive function using CONN Toolbox bivariate correlation measurement for functional connectivity analysis and Tigramite causal discovery framework for effective connectivity analysis on an episodic memory related resting-state fMRI dataset. The comparison between functional and effective connectivity results show that effective connectivity contains more information than the functional connectivity, and the difference in the information contained within these two types of model could significantly impact the intepretation of true brain function. In conclusion, we show that for the connectivity between specific pair of brain regions, effective connectivity analysis reveals more informative characteristic of the connectivity in comparison to functional connectivity where the depicted connectivity lack any additional characteristic information such as the direction of the connection or whether it is a unidirectional or bidirectional. These additional information improve interpretability of brain connectivity study. Thus, we would like to emphasis the important of brain function study using effective connectivity modelling to obtain valid interpretation of true brain function as currently a large body of research in this field focuses only on functional connectivity model.

Sleep related breathing disorders (SRBD) are among seven well-established major categories of sleep disorders defined in the third edition of The International Classification of Sleep Disorders (ICSD-3), and Obstructive Sleep Apnea (OSA) is the most common SRBD [1,2]. Several studies have demonstrated that obstructive sleep apnea treatment increases the quality of life in OSA patients [3-8]. Indeed, excessive daytime sleepiness (EDS), cognitive impairment (e.g., deficits in attention-concentration, memory, dexterity, and creativity), traffic accidents, and deterioration of social activities are frequently reported in untreated patients [9-11]. Furthermore, an increase in cardiovascular morbidities and mortality (systemic hypertension, stroke, cardiac arrhythmias, pulmonary arterial hypertension, heart failure) [12], metabolic dysfunction, cerebrovascular ischemic events and chemical/structural central nervous system cellular injuries (gray/white matter) has been reported in OSA patients [13-17].  Continuous positive airway pressure (CPAP) therapy is considered the gold standard for treatment of moderate-severe OSA, nevertheless there is an increasing body of evidence supporting the usefulness of mandibular advancement devices (MADs) for improving quality of life and respiratory parameters even among patients with a high severity of OSA burden [5,10,18,19]. According to the standard of care of the American Academy of Sleep Medicine (AASM), MADs are indicated for mild to moderate OSA particularly in the context of CPAP intolerance or refusal, surgical contraindication, or the need for a short-term substitute therapy [9,15,20-22]. In Cuba, CPAP machines are not readily available; they are expensive and the majority of OSA patients cannot obtain this mode of therapy. Taking into account this problem, our hypothesis was based in the scientific evidences of MAD effectiveness, considering that low cost MADs could offer a reasonable alternative treatment for patients with OSA where CPAP technology are not handy. In this way our purpose was to assess the efficacy of one of the most simple, low cost, manufactured monoblock MAD models (SAS de Zúrich) in terms of improvements in cerebral function, sleep quality and drowsiness reports in a group of Cuban OSA patients with mild to severe disease. Outcome measures included changes in the brain electrical activity, sleep quality, and respiratory parameters, measured by EEG recording with qEEG analysis and polysomnographic studies correspondingly, which were recorded before and during treatment with an MAD, as well as subjective/objective improvements in daytime alertness. 

In Portugal, around 2500 patients with end-stage chronic kidney disease (CKD stage 5) start a renal replacement therapy (RRT) for the first time each year [1]. They have four main treatment options: kidney transplantation (TX); haemodialysis (HD); peritoneal dialysis (PD) and conservative treatment (CT). RRT selection is quite complex due to the specificities of each option and to their profound effect on patient’s quality of life. Patients must play a decisive role in the choice of treatment modality and select the option that best suits to their values and needs.