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Introduction: Childhood obesity is one of the current themes of medical research, being considered not so much a multidimensional condition but primarily a real problem of worldwide interest.The aim of our randomized study was to evaluate and compare the effects of physical exercise associated with an educational program on clinical-functional status in overweight and obese children.Material and method: Participants were children hospitalized, through the emergency service, in the Pediatric Department, Craiova Municipal Clinical Hospital, between June and November 2023. 93 overweight and obese children, aged between 2 and 16 years, were evaluated (clinical, paraclinical and functional) by a multidisciplinary team and randomized into the control group (group C – 63 children) and the study group (group S – 30 children). After the resolution of the acute digestive or respiratory disease, the children in group S underwent a program to restore their functional status, based on educational measures (following the 5-2-1-0 rule) and physical exercises, for 12 weeks. Anthropometric data were measured (height, weight, body mass index); physical performance wasevaluated by gait analysis (we used the BTS G – WALK / BTS G – SENSOR 2 system, BTS Bioengineering Corp, Italy) with the determination of four parameters – the Timed Up-and-Go (TUG) test, the symmetry index, the walking test six minutes (6 MWT) and walking cadence or average cadence (steps/min) in both groups of children.The results were obtained by analyzing the differences in values obtained in the two moments T1 (initial) and T2 (after three months). The proportion of girls and boys was approximately equal within obesity class in each study group. Although we did not obtain statistically significant differences between the monitored parameters, between the two groups, for the two evaluation moments, the children in Group S had a clearly favorable evolution for physical performance parameters, whose average value was improved in T2. Anthropometric data did not change.Conclusion: The present study confirms the effectiveness of the multimodal (educational-kinetic) program for the physical performance of overweight/obese children. The sustained running of the program at home, with the involvement of the family and the school environment, is essential for the well-being of these children, with a favorable impact on the quality of life later.

The study is based on the characterization of different AI models applied in the public furniture design analyzing the conditions of risk, materiality, and integration of variables in two AI generative modeling algorithms. As risky since they contain flood-prone areas, low vegetation coverage, and underdevelopment of infrastructure; therefore, these characterizations are tested through artificial simulation. The experimental method is applied through laboratory tests of various material components and their structuring in 3D simulators to check their resistance and risk scenarios. The case study of one of the most risky and populated areas of the informal settlement area of the Northwest of Guayaquil, such as the Coop, is analyzed. Sergio Toral is the focal point for on-site testing. It is concluded that the generation of a planned scheme of ecological furniture with different materials responds more effectively to the territory and that through artificial simulation an advantage can be obtained in terms of execution time and results, thus demonstrating that artificial intelligence is an ideal tool. To generate furniture design proposals that are more diverse, innovative, and functional with the environment, but it generates a minimum level of error for specific designs in the experimental model_01 of 0.1% to 3% and a high level in the experimental model_02 with an increasing error from 20% to 70%. As a future line of research, it is proposed to generate a simulated system of all the new informal settlements in Guayaquil and establish focal points for the implementation of new ecological furniture.

Autologous Hematopoietic Stem Cell Transplantation (AHSCT) performed after induction therapy is the standard of care for newly diagnosed Multiple Myeloma (MM) patients who qualify. Our institution has performed AHSCT for MM since 1991, and in this study, we sought to retrospectively examine the outcomes of 303 MM patients who underwent AHSCT from 1991-2021. We focused on Overall Survival (OS) and Progression-Free Survival (PFS) in patients in addition to Landmark survival (1-year post-transplantation). We found that in elderly patients > 70 years of age there was no significant difference in OS at 12 years, with 51% for patients < 70 years of age and 50% > 70; these were the same numbers for PFS at 12 years as well. We also found that median overall survival is improving overall with each decade in our transplanted MM patients with patient survival improved to over > 80% regardless of age at 7 years, when the previous median overall survival was 6 - 6.6 years before 2001. Given our findings, supported by others, we show that survival is continually improving over time in MM AHSCT patients and that AHSCT can be performed safely with equivalent landmark and long-term PFS and OS in patients of advanced age.

Spontaneous Coronary Artery Dissection (SCAD) represents a significant cause of acute coronary syndrome (ACS) in patient populations with low-risk cardiovascular profiles and, therefore can be sometimes underdiagnosed. On the other hand, it often preserves the typical clinical presentation of ACS which makes coronary artery angiography (CAG) execution mandatory. A 62-year-old woman with a history of recurrent SCAD presented to the emergency department for a new episode of acute chest pain with troponin elevation. CAG revealed an ambiguous angiography image suggesting a sub-occlusive type 2 SCAD involving the distal segment of the left circumflex artery. The patient was managed conservatively due to the absence of ongoing ischemia or hemodynamic instability. At the seven-day follow-up, a computed tomography coronary angiography (CTCA) was performed to better assess SCAD and detect concomitant associated arteriopathies. Optimized medical therapy was prescribed at the discharge and at one-month follow-up, no recurrence of symptoms was referred.

Bloodstain Pattern Analysis (BPA) is a crucial forensic technique in crime scene investigation, employing the interpretation of blood spatter patterns to reconstruct event sequences and determine spatial relationships between victims and surfaces. This study explores BPA’s application in forensic science, emphasizing its role in establishing links between crimes and culprits, as posited by Edmond Locard’s exchange principle. The research examines how bloodstain shape, size, and distribution reveal critical information about impact angles, areas of convergence, and points of origin, while also providing insights into blood flow direction, force applied, suspect positioning, and weapons used. The investigation delves into various bloodstain types, including void patterns, spikes, and satellite stains, and their formation on different surfaces. To enhance understanding of blood behaviour from various sources, the study compares blood samples from three species: human (Homo sapiens), obtained from a professional doctor from discarded piles with precaution from a government hospital in Laxmangarh, Rajasthan and goat (Capra aegagrus hircus), and chicken (Gallus gallus domesticus), obtained from butcher shops in Laxmangarh, Rajasthan. The experimental setup involves dropping blood from a height of 50 centimetre’s and measuring the resulting stain dimensions. This comprehensive approach to BPA research aims to refine crime scene analysis techniques, ultimately contributing to more accurate event reconstructions and enhanced forensic investigations. The study underscores the importance of BPA in modern forensic science while acknowledging the need for its integration with other investigative methods to ensure robust and reliable crime scene interpretations.

This editorial explores the crucial yet often overlooked role of sleep in enhancing student-athlete performance and well-being. It highlights sleep’s impact on physical recovery, cognitive function, and emotional stability, emphasizing the unique benefits for athletes. The editorial examines the detrimental effects of early school start times on adolescent sleep patterns and their subsequent impact on academic and athletic performance. By advocating for policy changes that prioritize sleep, such as delaying school start times, this editorial presents a novel approach to optimizing student-athlete success. Through a synthesis of current research and practical insights, it urges stakeholders in education and sports to recognize and act upon the foundational importance of sleep, positioning it as a key component of athletic and academic excellence.

Social insects have eradicated the instincts inherited from their solitary ancestors that were harmful to communities. The elimination of these instincts was accomplished by natural selection, the units of which were communities. Man has not yet eradicated the instincts inherited from their solitary animal ancestors that were harmful to communities. But their eradication is underway. And it is also being accomplished by natural selection, the units of which are societies. Completion of evolution in this direction will probably lead to the disappearance of human instincts harmful to society, as they have disappeared in social insects. This will happen after a period of time measured not by historical standards, but by geological.

Atherosclerosis Ischemic Cardiovascular Disease (ASICD), one of the leading causes of global deaths, is mainly caused due to the development of plaque on the inner walls of arteries of the human heart. Ischemia refers to the lack of enough oxygen (O2), nutrient delivery, and improper waste removal in the cardiac cells. About 90% of cardiovascular diseases in the present world are due to the formation of lipid/cholesterol-based plaques that can form under the lining of the smooth epithelial blood cells. In the US, a study published in the Journal of the American College of Cardiology estimated that poor diet is responsible for about 45% of Cardiovascular Disease. Atherosclerosis doesn’t cause much effect until and unless the plaque becomes unstable due to the accumulation of thrombus that shows Acute Coronary Syndrome. Acute Coronary Syndrome is the result of blockage of blood vessels leading to Myocardial Infarction (Unstable Angina Pectoris). Cardiac Cells require a sufficient amount of Oxygen to function properly. Thus, the demand and supply of oxygen to the cardiac cells should be properly balanced. Atherosclerosis Ischemic Cardiovascular syndrome can worsen if the person is more involved in exercise or emotional stress because at that time their body requires higher oxygen but blood flow gets disrupted due to the formation of plague. Later in the paper, we will discuss the New York Heart Association classification, followed by the top 3 poor diets that are considered to be increasing the cases of cardiovascular disease around the world.

Anti-glomerular basement membrane (GBM) antibody glomerulonephritis is an extremely rare glomerular disease. Around 90% of the patients are positive for serum anti-GBM antibodies while up to 10% can be negative. In such patients, only a kidney biopsy can reveal the anti-GBM disease it is then labeled as an atypical anti-GBM disease. Though anti-GBM disease can be associated with Anti Neutrophil Cytoplasmic Antibodies (ANCA) positivity, it is extremely rare to find atypical anti-GBM with ANCA positivity so much so that till now there are very few such cases reported from across the world.The case presented here is one such case where the patient presented with adult-onset nephrotic syndrome features with active urinary sediments and mildly deranged renal function. Myeloperoxidase (MPO) ANCA was positive and it was considered ANCA-associated crescentic glomerulonephritis (GN) but after the renal biopsy the picture was of anti-GBM disease. She was treated with pulse methylprednisolone but her creatinine increased in the meantime and considering anti-GBM she was put on Plasma Exchange (PLEX). She received 5 sessions of PLEX after which her renal function improved. She was also planned for Rituximab which could not be given due to local infection. As there are no protocols for treating such cases because of the extremely rare nature of the presentation, this case will increase the understanding of such presentations for the clinicians. This will help to plan for building the approach for such cases.

A significant obstacle to agricultural productivity that jeopardizes the availability of food is crop diseases and farmer livelihoods by reducing crop yields. Traditional visual assessment methods for disease diagnosis are effective but complex, often requiring expert observers. Recent advancements in deep learning indicate the potential for increasing accuracy and automating disease identification. Developing accessible diagnostic tools, such as web applications leveraging CNNs, can provide farmers with efficient and accurate disease identification, especially in regions with limited access to advanced diagnostic technologies. The main goal is to develop a productive system that can recognize tomato plant diseases. The model was trained on a collection of images of healthy and damaged tomato leaves from PlantVillage using transfer learning techniques. The images from the dataset were cleansed by resizing them from 256 × 256 to 224 × 224 to match the dimensions used in pre-trained models using min-max normalization. An evaluation of VGG16, VGG19, and DenseNet121 models based on performance accuracy and loss value for 7 categories of tomatoes guided the selection of the most effective model for practical application. VGG16 achieved 84.54% accuracy, VGG19 achieved 84.62%, and DenseNet121 achieved 98.28%, making DenseNet121 the chosen model due to its highest performance accuracy. The web application development based on the DenseNet121 architecture was integrated using the Django web framework, which is built on Python. This enables real-time disease diagnosis for uploaded images of tomato leaves. The proposed system allows early detection and diagnosis of tomato plant diseases, helping to mitigate crop losses. This supports sustainable farming practices and increases agricultural productivity.

Wheat bran and groundnut shell powder have been used to study the mechanism of diclofenac sodium adsorption from aqueous solution using batch as well as column modes and maximum uptake is 84.3% for wheat bran and 82.4% for groundnut shell powder at pH 6, drug concentration 1mg/L at 298 K for 30min. Isotherm and error analysis reveals that Freundlich and Langmuir isotherms fitted well. Kinetic studies show that the adsorption process follows second-order kinetics and thermodynamic study shows endothermic adsorption process. Column adsorption study is important for industrial scale adsorption and column studies have been carried out using vertical bed and sequential bed adsorption columns at pH 6 which is the optimum pH for maximum adsorption for batch experiments. Vertical and sequential bed columns setup is simple and economical which provides flow under gravity. The effect of varying inlet feed concentration and flow rate on the breakthrough and exhaustion time of columns has been studied to determine the bed capacities of both columns. Thomas model and Yoon-Nelson models fitted well with experimental data for continuous flow column studies.

Verrucous hyperplasia is a wart-like lesion that can develop on amputation stumps, often due to poor-fitting prostheses, venous stasis, friction, and bacterial infections. While surgical excision is sometimes necessary for intractable cases, many instances can be managed non-surgically. We present the case of a 35-year-old male with a slowly growing verrucous plaque on his amputated stump that had caused repeated infections. His prosthesis was loose, allowing the stump to hang loosely inside the socket. After histological confirmation of verrucous hyperplasia, he was advised to change his prosthesis and use compression bandaging. Over 5 months, the lesion resolved without surgery. Early recognition and non-surgical management, including proper prosthetic fit, compression, and hygiene, can often successfully treat verrucous hyperplasia of amputation stumps. This avoids the need for excision in many cases. Patients and clinicians should be aware of this condition and the importance of prosthetic fit and limb care to prevent and treat it.

Probiotic gummy candy is an innovative food that can be used as a carrier to deliver probiotics. This study aimed to manufacture healthy gummy candy (HGC) as a carrier for probiotic capsules. The ingredients' effect on the viability of probiotic capsules and free cells was evaluated for 48 days under refrigerated conditions. Also, the textural properties, overall acceptability of products, and physicochemical properties were tested. The encapsulation probiotics in sodium alginate and chitosan provided a high efficiency of 88.16%. At the same time, the encapsulated cells-based HGC (HGC-C) had higher counts of probiotics than free cells-based HGC, and it remained above the 3 log CFU/g at the end of the 48-day storage period in HGC-C, while the free cells reached zero at 30 days. The HGC product showed a low hardness value and high antioxidant capacity as well as, and the colour coordinates for the product showed more yellow, with an intense red colour. Using mango pulp and probiotics in gummy candies is an innovative and viable alternative to the confectionery industry; therefore, combining fruits as a source of prebiotics and probiotic bacteria could be a promising formula for probiotics gummy supplement preparation.

According to a 2022 systematic review on the prevalence of psychiatric disorders in general hospitals, it was estimated that approximately one-third of medical inpatients present with a coinciding psychiatric condition. However, other studies have reported that a low rate of patients actually obtain an inpatient psychiatric consult; and even fewer patients receive a consultation when it would not be traditionally indicated. Therefore, we have seen an emergence of the use of Proactive Consultation-Liaison (C-L) Psychiatry across many hospital settings. This model of care utilizes systematic screening for active mental health concerns, proactive interventions tailored to individual patients, team-based delivery, and care integration with primary services to provide psychiatric consultation earlier. This study conducted a focused PubMed search to review the research to date on proactive C-L psychiatry and its impact on hospital length of stay (LOS) in patients over 18 years old. Results show a consequential reduction in average hospital LOS when proactive C-L psychiatry services are used compared to reactive, on-request consultation services. A shortened LOS is seen with this practice when there is a quicker time for consultation or referral. Thus, there is evidence of proactive C-L psychiatry’s success in decreasing average hospital LOS and improving patient care. Additional studies are necessary to determine its significance, as little research to date has been completed on the topic. It is recommended to expand the scope of investigation to different patient populations, including but not limited to pediatrics and patients without an underlying mental health illness.

It is important for sustainable use of soil water resource and high-quality development to forecast the soil moisture in forestland of water-limited regions. There are some soil water models. However, there is not the best model to forecast the change of soil moisture in the caragana shrubland. In this paper, the plant water relationship has been investigated at the same time for a long term in the caragana shrubland of semiarid region of the Loess Plateau of China. The data of soil moisture was divided and then NARX neural network was used to build model I and model II. For model I, low frequency component was the input variable, and for model II, low frequency component and high frequency component were predicted. The results showed the average relative error for model I is 3.5% and for model II is 0.3%. The average relative error of predicted soil moisture in 100 cm layer using model II is 0.8%, then soil water content in the 40 cm and 200 cm soil depth is selected and the forecast errors are 4.9% and 0.4%. The results showed that using model II to predict soil water is well Predicting soil water using model II will be important for sustainable use of soil water resource and high-quality development.

Background: We previously reported, for the first time, serum levels of the C-terminal fragment of fibroblast growth factor 23 (C-FGF23) in patients undergoing hemodialysis (HD). Most HD patients have undergone treatment with either recombinant erythropoietin (r-EPO) or hypoxia-inducible factor (HIF) proline hydroxylase domain (PHD) inhibitor, both of which stimulate FGF23 production and cleavage. Methods: This cross-sectional observational study involved analyzing measuring FGF-related parameters and comparing results for subgroups of patients who received either r-EPO and or a PHD inhibitor. Results: No significant difference was observed for iron-related parameters or serum hepcidin levels in both subgroups of patients. Significant differences were found for certain FGF-23-related parameters. Conclusion: Both FGF23 production and cleavage were stimulated more in patients treated with the PHD inhibitor than in patients treated with r-EPO.

A prospective cross-sectional study of diabetic patients registered at the Eye department of Tobruk Medical Center in Tobruk-Libya between (01.06.2023 to 29.02.2024). At the same time data was collected in the eye department in Alwahda Derna Teaching Hospital, Data was collected using the same administered questionnaire. Grading of DR was done by slit-lamp examination and Fundoscopy by an ophthalmologist. Descriptive analysis included percentage mean, median, and p - value by using SPSS 25. There were 185 diabetic patients, ages ranging between 30 and 90 years, with a mean of 58, the majority (97.6%) were of Libyan nationality. There were 86 males and 99 females. Patients with a duration of diabetes ranging between 11 and 15 years were at almost a five-fold risk of developing DR compared to those with a duration of < 10 years. Most of advanced complicated diabetic retinopathy cases had diabetes for more than fifteen years, and no advanced disease in the cases with a duration of less than 10 years.

Cutaneous Angioleiomyoma is a very rare benign tumour of which incidence is unknown. We report a case of a 42-year-old male patient who presented with a symptomless solitary nodule over the left nostril for one and a half years duration. Complete surgical excision of the tumour was done and the sample was sent for histopathological examination. Diagnosis of this tumour was done on the evidence of histopathological examination with haematoxylin and eosin mounts. Sometimes achieving the best aesthetically accepted results may be challenging due to the site of involvement. 

Carbon footprint refers to the total amount of greenhouse gas emitted in the atmosphere by an individual or by an organization causing global warming. There are various causes of greenhouse gas emissions and anaesthetic gases are one amongst them. Greenhouse gases warm the earth by absorbing infrared energy and slowing the rate at which the energy escapes into space. Each greenhouse gas has two important properties. One is the amount of infrared energy that a gas can absorb and the other is the lifetime of that gas in the atmosphere. Anaesthesia as a speciality contributes to carbon footprinting in three ways: direct emission, energy use, and operating room wastes and supplies. Direct emission of Waste Anaesthetic Gases (WAG) from anaesthesia workstations can either be scavenged and thrown out into the environment causing a green greenhouse gas effect or can pollute the operating room due to poor scavenging. Various techniques such as reducing direct emissions, energy use optimisation, and waste management have been tried in minimising carbon footprint in anaesthesia practice but providing safety to the patient is considered of utmost importance.

With the integration of mobile systems into daily life, social media applications used especially on Android and iOS platforms contain a significant amount of sensitive information. Social media applications on mobile systems have huge personal and sensitive content. Therefore, it is important to design effective techniques for forensic analysis of social media applications and to detect personal data. In this research, three different paid mobile forensic software and 4 different brands and models of smartphones with different operating systems were used and analyzed. The study shows that private messages, e-mails, time information, shared data, location and time information, and other personal data can be obtained by a forensic expert who performs an examination, and it is seen that one software can access the deleted data, but another software cannot access it. In proportion to the technology used in today’s world, mobile forensics incidents are increasing day by day, and a competitive environment is created among the software used to illuminate these incidents. With this competition, software companies dealing with forensic informatics are trying to obtain different data to illuminate forensic events that may occur due to the active use of social media accounts with the developing technology, and software that does not meet the needs in the face of this situation remains in the background. The criminal elements in the investigation areas of mobile forensics differ daily, and the scope of crimes in the virtual environment is expanding with the developing technology. Therefore, mobile forensic analysis applications should be successful in social media applications other than standard data.