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The 3,3',5,5'-tetramethylbenzidine-H2O2 (TMB-H2O2) platform has gained widespread use for rapid detection of various analytes in foods. However, the existing TMB-H2O2 platforms suffer from limited accuracy, as their signal output is confined to the visible region, which is prone to interference from various food colorants in real samples. To address this challenge, a novel Au@Os-mediated TMB-H2O2 platform is developed for both rapid and accurate detection of analytes in foods. The prepared Au@Os NPs exhibit remarkable peroxidase-like activity, making the platform display dual absorption peaks in visible and near-infrared (NIR) regions, respectively. This Au@Os-mediated TMB-H2O2 platform exhibited three linear ranges across different concentrations of ziram from 1-100, 150-600, and 800-2000 nM with limit of detection (LOD) 7.9 nM and limit of quantification (LOQ) 24.15 nM respectively. Further, the Au@Os-mediated TMB-H2O2 platform was also used for rapid and accurate detection of ziram in real food samples like apple, tomato, and black tea.

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This research focused on distinguishing distinct matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) spectral signatures of three Enterococcus species. We evaluated and compared the predictive performance of four supervised machine learning algorithms, K-nearest neighbor (KNN), support vector machine (SVM), and random forest (RF), to accurately classify Enterococcus species. This study involved a comprehensive dataset of 410 strains, generating 1640 individual spectra through on-plate and off-plate protein extraction methods. Although the commercial database correctly identified 76.9% of the strains, machine learning classifiers demonstrated superior performance (accuracy 0.991). In the RF model, top informative peaks played a significant role in the classification. Whole-genome sequencing showed that the most informative peaks are biomarkers connected to proteins, which are essential for understanding bacterial classification and evolution. The integration of MALDI-TOF MS and machine learning provides a rapid and accurate method for identifying Enterococcus species, improving healthcare and food safety.

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Introducción: Diversas investigaciones han establecido la relación entre temperatura y duración del embarazo, la exposición a temperaturas altas durante el embarazo plantea interrogantes en especial el papel que esta juega frente a los partos prematuros y partos de bajo peso, es indispensable determinar si las temperaturas altas o bajas tienen un comportamiento protector o de riesgo sobre el feto durante la gestación en regiones tropicales. Objetivo: describir la relación entre la exposición a temperaturas altas y bajas durante el embarazo y su efecto en la edad gestacional y peso al momento del parto en los recién nacidos del departamento del Guaviare-Colombia. Metodología: Estudio tipo observacional, analítico, retrospectivo de corte transversal que busco determinar la relación entre exposición a temperaturas altas y bajas durante el embarazo y su efecto en la edad gestacional y peso al momento del parto en los recién nacidos, el universo estuvo conformado por 10.137 nacidos vivos, de los cuales 9.932 cumplieron los criterios de inclusión. Se determinó Odds Ratio para estimar la asociación entre las variables. Resultados: Dentro de la semana de retraso 3 el estar expuesto a temperaturas máximas percentil 90 es un factor protector para la ganancia ponderal de peso OR < 1, la exposición a temperaturas mínimas percentil 10 se asoció como factor protector para el parto prematuro en la semana de retraso 1 y 2 OR < 1.Conclusión: A pesar del beneficio de las altas y bajas temperaturas durante el embarazo en la ganancia ponderal de peso y disminución del parto prematuro, es recomendable prevenir la exposición a temperaturas extremas durante el periodo de gestación[AU]

Introduction: Various investigations have established the relationship between temperature and duration of pregnancy. Exposure to high temperatures during pregnancy raises questions, especially the role it plays in premature births and low-weight births. It is essential to determine whether high temperatures or low have a protective or risky behavior on the fetus during pregnancy in tropical regions.Objective: to describe the relationship between exposure to high and low temperatures during pregnancy and its effect on gestational age and weight at the time of delivery in newborns in the department of Guaviare-Colombia.Methodology:Observational, analytical, retrospective cross-sectional study that sought to determine the relationship between exposure to high and low temperatures during pregnancy and its effect on gestational age and weight at the time of delivery in newborns. The universe was made up of 10,137 births. alive, of which 9,932 met the inclusion criteria. Odds Ratio was determined to estimate the association between the variables.Results:Within the 3rd week of delay, being exposed to maximum temperatures at the 90th percentile is a protective factor for weight gain OR < 1, exposure to minimum temperatures at the 10th percentile was associated as a protective factor for premature birth in the week. of delay 1 and 2 OR < 1. Conclusion: Despite the benefit of high and low temperatures during pregnancy in weight gain and reduction in premature birth, it is advisable to prevent exposure to extreme temperatures during the gestation period[AU]

Introdução: Várias investigações estabeleceram a relação entre temperatura e duração da gravidez. A exposição a altas temperaturas durante a gravidez levanta questões, especialmente o papel que desempenha nos partos prematuros e nos nascimentos de baixo peso. É essencial determinar se as temperaturas altas ou baixas têm um comportamento protetor ou de risco para o feto durante a gravidez em regiões tropicais. Objetivo:descrever a relação entre a exposição a altas e baixas temperaturas durante a gravidez e seu efeito na idade gestacional e no peso no momento do parto em recém-nascidos no departamento de Guaviare-Colômbia. Metodologia: Estudo observacional, analítico, retrospectivo e transversal que buscou determinar a relação entre a exposição a altas e baixas temperaturas durante a gravidez e seu efeito na idade gestacional e no peso no momento do parto em recém-nascidos. O universo foi composto por 10.137 nascimentos. vivos, dos quais 9.932 preencheram os critérios de inclusão. O Odds Ratio foi determinado para estimar a associação entre as variáveis. Resultados:Na 3ª semana de atraso, a exposição a temperaturas máximas no percentil 90 é fator de proteção para ganho de peso OR < 1, a exposição a temperaturas mínimas no percentil 10 foi associada como fator de proteção para parto prematuro na semana. de atraso 1 e 2 OR < 1.Conclusão:Apesar do benefício das altas e baixas temperaturas durante a gravidez no ganho de peso e redução do parto prematuro, é aconselhável evitar a exposição a temperaturas extremas durante o período de gestação[AU]

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BACKGROUND: Contrast-enhanced ultrasound (CEUS) has been proposed as a valuable tool for detecting disease activity in patients with Crohn's disease (CD). However, previous studies have utilized different parameters, leading to variation in clinical assessment of this technique. PURPOSE: To assess the effectiveness of peak enhancement (PE) in CEUS for evaluating endoscopic disease activity in patients with CD. MATERIAL AND METHODS: Articles were obtained by searching PubMed, Embase, Web of Science, Wanfang, and CNKI databases. Only studies that investigated the effectiveness of PE in CEUS to discriminate endoscopic disease activity in patients with CD were considered. Pooled sensitivity and specificity were then calculated using a random effects model. RESULTS: Overall, seven studies were included. The endoscopic disease activity of CD was determined based on the simple endoscopic score for Crohn's disease and Crohn's Disease Endoscopic Index of Severity scores. Pooled results showed that a high PE was associated with increased detection efficacy for endoscopic disease activity in CD. Pooled sensitivity, specificity, and positive and negative likelihood ratios were 0.88 (95% confidence interval [CI] = 0.71-0.96), 0.88 (95% CI = 0.81-0.93), 7.60 (95% CI = 4.61-12.53), and 0.14 (95% CI = 0.05-0.35), respectively. The pooled receiver operating characteristic was 0.90 (95% CI = 0.87-0.92), suggesting a good discriminating efficacy of PE in CEUS for endoscopic disease activity of patients with CD. CONCLUSIONS: A high PE in CEUS displayed substantial distinguishing accuracy for assessing endoscopic disease activity of patients with CD.

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This review compares the safety and effectiveness of volume control ventilation (VCV) and pressure control ventilation (PCV) during laparoscopic surgery. Nine studies were chosen for in-depth examination following the application of stringent inclusion and exclusion criteria to the 184 publications that the literature search turned up. PCV is well-known for its capacity to preserve lower peak airway pressures during laparoscopic procedures, lowering the risk of volutrauma and barotrauma and enhancing oxygenation under these conditions of elevated intra-abdominal pressures. On the other hand, VCV guarantees a constant tidal volume and offers accurate ventilation management, both of which are essential for preserving stable carbon dioxide levels. VCV, however, may result in higher peak airway pressures, raising the risk of lung damage brought on by a ventilator. Research indicates that PCV provides better respiratory mechanics management during laparoscopic surgery, but VCV consistent tidal volume delivery is useful in some clinical situations. When choosing between PCV and VCV, the anesthesia team's experience, the demands of each patient, and the surgical circumstances should all be taken into consideration. Real-time monitoring tools and sophisticated ventilatory technology are essential for maximizing ventilation techniques. Further improving patient outcomes can be achieved by incorporating multimodal anesthesia approaches, such as the use of muscle relaxants and customized intraoperative fluid management. Muscle relaxants optimize conditions for mechanical ventilation by ensuring adequate muscle relaxation, reducing the risk of ventilator-associated lung injury, and enabling more precise control of ventilation parameters. Tailored intraoperative fluid management helps maintain optimal lung mechanics by avoiding fluid overload, which can lead to pulmonary edema and compromised gas exchange, necessitating adjustments in ventilation strategy. While both ventilation modalities can be utilized efficiently, the research suggests that PCV may be more advantageous in controlling oxygenation and airway pressures. In the dynamic and demanding world of laparoscopic surgery, ongoing research and clinical innovation are crucial to improving these tactics and guaranteeing the best possible treatment. In order to obtain the best possible patient outcomes during laparoscopic surgeries, this review emphasizes the significance of customized breathing techniques.

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This study aimed to determine the reliability and concurrent validity of a low-cost pressure mapping system (Smart mat) and reference standard pressure mapping (MatScan). Thirty healthy volunteers aged 29.57 ± 4.50 years who could sit still for at least one minute and had a hip width of less than 40 cm (36 ± 2.05 cm) were recruited. The participants sat on the Smart mat system and MatScan for 60 s per trial for 3 trials. The reliability of Smart mat using intraclass correlation coefficients (ICC) showed an excellent ICC of normalised total force (nTF) and normalised ischial width (nIW) in sitting (0.93, 0.98). The validity was assessed using Spearman correlation coefficients, which showed that nTF in sitting had a significantly strong correlation (r = 0.70**) and nIW in sitting had a significantly moderate correlation (r = 0.67**). This study's satisfactory results indicated that a low-cost pressure mapping system could be used for assessing forced distribution and ischial width during sitting.

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OBJECTIVE: To analyze whether there are differences in the cepstral measures obtained in different speech tasks, depending on the presence and degree of vocal deviation, and to analyze if there is a correlation between the cepstral measures obtained from different speech tasks and the general degree of vocal deviation. METHOD: Analysis of 258 vocal samples of the sustained vowel [a] and connected speech (counting numbers) from a database, including 160 dysphonic and 98 nondysphonic voices. The counting number samples were edited in three different durations: counting from 1 to 10, from 1 to 11, and from 1 to 20. Five speech-language pathologists (SLPs), voice specialists, carried out the perceptual-auditory judgment of the overall degree of vocal deviation (ODD) using the G from the overall dysphonia grade, roughness, breathiness, asthenia, and strain (GRBAS) scale. We extracted the cepstral peak prominence (CPP) and smoothed cepstral peak prominence (CPPS) measurements from all the vocal samples using an extraction script in the free software Praat. RESULTS: CPP and CPPS were different between dysphonic and nondysphonic individuals, regardless of the speech task, with lower values for dysphonic. Also, CPP values between the vowel and the connected speech tasks were different between both groups. Only the CPPS showed differences between all the speech tasks depending on the degree of vocal deviation. There was a strong negative correlation between the CPPSVowel, CPPS10, CPPS11, CPPS20, and the ODD, and a moderate negative correlation between CPPVowel, CPP10, CPP11, CPP20, and ODD. CONCLUSIONS: There are differences in the cepstral measures obtained in different speech tasks, depending on the presence of dysphonia and ODD. CPP and CPPS values are different between dysphonic and nondysphonic individuals in all speech tasks. There is a moderate negative correlation between CCP in the different speech tasks and ODD, while there is a strong negative correlation between CPPS in the different speech tasks and ODD.

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BACKGROUND: Exercise optimizes peak bone mass accrual, particularly if the loading is high magnitude and distributed in abnormal directions. Little is known about the influence of early intense training in sport during peak bone mass accrual, especially in boys. METHODS: Ninety-eight males aged 6-24 years (gymnasts, swimmers, and controls) completed the bone-specific physical activity questionnaire and a 7-day exercise diary. Dual-energy X-ray absorptiometry determined bone mineral properties of the total body (less head) and lumbar spine (LS, L1-L4) and total lean mass. Subgroup analyses were conducted for juniors (prepubescent), adolescents (11-16 y), and seniors (17-24 y). RESULTS: Lean mass was positively associated with total body less head and LS bone outcomes in all 3 age groups (R2 = .632-.770, P < .05), and bone-specific physical activity questionnaire scores were associated with LS bone mineral density in adolescents and seniors (R2 = .440 and .591, P < .05). Senior gymnasts had significantly higher LS bone mineral density (in grams per square centimeter) and Z-scores than swimmers (P = .004) and controls (P = .012). CONCLUSIONS: Elite gymnastics is associated with superior peak bone mass accrual in young males. The benefits appear more pronounced during young adulthood compared with prepuberty, potentially reflecting an extended time course for bone adaptation.

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BACKGROUND: The role of objective nasal airflow measures using peak nasal inspiratory flow (PNIF) and rhinospirometry in supporting clinical examination findings when offering patients septoplasty remain undefined. OBJECTIVE: To explore the baseline relationships between clinical examination findings, subjective reported symptoms and objective nasal patency measures in nasal obstruction. METHODS: This is a sub-study of the NAIROS trial. Participants with nasal obstruction secondary to septal deviation were included in this NAIROS sub-study. The side of septal deviation, enlargement of inferior turbinate (IT), the need for IT reduction if septoplasty was being performed, the area of septum deflecting into the airway and observer rated airway block (ORAB-arbitrarily divided by <50% and >50% blockage) were assessed by clinicians. The subjective score of nasal obstruction was assessed using the Double Ordinal Assessed Subjective Scale (DOASS). Objective nasal patency measures (e.g., nasal partitioning ratio, [NPR] and PNIF) were measured using PNIF and rhinospirometry. RESULTS: The mean NPR for left-sided, both-sided and right-sided septal deviation was -0.35, -0.02 and 0.51, respectively (p < 0.001). There was very weak correlation between the requirement for IT reduction and PNIF change (0.13, p < 0.01). There was no difference in mean PNIF (94 L/min vs. 93 L/min) and mean DOASS (0.33 vs. 0.38) for participants with ORAB rated <50% and >50%. The mean NPR for participants with ORAB >50% was higher than for those with ORAB <50% (0.51 vs. 0.41, p = 0.002). There was strong correlation between the DOASS and NPR (+0.737, p < 0.001). The mean DOASS score for right-sided, both-sided and left-sided septal deviation was 0.32, 0.05 and -0.29, respectively (p < 0.001). CONCLUSION: This study identified strong relationships between the clinician rated side of septal deflection, the patient reported DOASS and the objective NPR measurements. NPR and the clinician rated degree of airway blockage were concordant.

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The glymphatic system is crucial for clearing metabolic waste from the brain, maintaining neural health and cognitive function. This study explores the glymphatic system's role in Moyamoya disease (MMD), characterized by progressive cerebral artery stenosis and brain structural lesions. We assessed 33 MMD patients and 21 healthy controls using diffusion tensor imaging along the perivascular space (DTI-ALPS) and global cortical gray matter-cerebrospinal fluid (CSF) coupling indices (gBOLD-CSF), which are indirect measurements of the glymphatic system. Cerebral perfusion in patients was evaluated via computed tomography perfusion imaging. We also measured the peak width of skeletonized mean diffusivity (PSMD), white matter hyperintensity (WMH) burden, and cognitive function. MMD patients exhibited lower ALPS and gBOLD-CSF coupling indices compared to controls (P < 0.01), indicating disrupted glymphatic function. Significant cognitive impairment was also observed in MMD patients (P < 0.01). ALPS indices varied with cerebral perfusion stages, being higher in earlier ischemic stages (P < 0.05). Analysis of brain structure showed increased CSF volume, PSMD index, and higher WMH burden in MMD patients (P < 0.01). The ALPS index positively correlated with white matter volume and cognitive scores, and negatively correlated with CSF volume, PSMD, and WMH burden (P < 0.05). Mediation analysis revealed the number of periventricular WMH significantly mediated the relationship between glymphatic dysfunction and cognitive impairment. In summary, MMD patients exhibit significant glymphatic system impairments, associated with brain structural changes and cognitive deficits.

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To investigate the effects of high temperature and carbon fiber-bar reinforcement on the dynamic mechanical properties of concrete materials, a muffle furnace was used to treat two kinds of specimens, plain and carbon fiber-bar reinforced concrete, at high temperatures of 25, 200, 400 and 600 °C. Impact compression tests were carried out on two specimens after high-temperature exposure using a Hopkinson pressure bar (SHPB) test setup combined with a high-speed camera device to observe the crack extension process of the specimens. The effects of high temperature and carbon fiber-bar reinforcement on the peak stress, energy dissipation density, crack propagation and fractal dimension of the concrete were analyzed. The results showed that the corresponding peak strengths of the plain concrete specimens at 25, 200, 400, and 600 °C were 88.37, 93.21, 68.85, and 54.90 MPa, respectively, and the peak strengths after the high-temperature exposure first increased slightly and then decreased rapidly. The mean peak strengths corresponding to the carbon fiber-bar reinforced concrete specimens after high-temperature action at 25, 200, 400, and 600 °C are 1.13, 1.13, 1.21, and 1.19 times that of plain concrete, respectively, and the mean crushing energy consumption densities are 1.27, 1.31, 1.73, and 1.59 times that of plain concrete, respectively. The addition of carbon fiber-bar reinforcement significantly enhanced the impact resistance and energy dissipation of the concrete structure, and the higher the temperature was, the more significant the increase. An increase in temperature increases the number of crack extensions and width, and the high tensile strength of the carbon fiber-bar reinforcement and the synergistic effect with the concrete material reduce the degree of crack extension in the specimen. The fractal dimension of the concrete ranged from 1.92 to 2.68, that of the carbon fiber-bar reinforced concrete specimens ranged from 1.61 to 2.42, and the mean values of the corresponding fractal dimensions of the plain concrete specimens after high-temperature effects at 25, 200, 400, and 600 °C were 1.19, 1.21, 1.10, and 1.11 times those of the fiber-reinforced concrete specimens, respectively. The incorporation of carbon fiber-bar reinforcement reduces the degree of rupture and fragmentation of concrete under impact loading and improves the safety and stability of concrete structures.

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BACKGROUND: Non-ordinary states of consciousness induced by psychedelics can be accompanied by so-called "peak experiences," characterized at the emotional level by their intensity and positive valence. These experiences are strong predictors of positive outcomes following psychedelic-assisted therapy, and it is therefore important to better understand their biology. Despite growing evidence that the autonomic nervous system (ANS) plays an important role in mediating emotional experiences, its involvement in the psychedelic experience is poorly understood. The aim of this study was to investigate to what extent changes in the relative influence of the sympathetic (SNS) and parasympathetic nervous systems (PNS) over cardiac activity may reflect the subjective experience induced by the short-acting psychedelic N,N-Dimethyltryptamine (DMT). METHODS: We derived measures of SNS and PNS activity from the electrocardiograms of 17 participants (11 males, mean age = 33.8 years, SD = 8.3) while they received either DMT or placebo. RESULTS: Results show that the joint influence of SNS and PNS ("sympathovagal coactivation") over cardiac activity was positively related to participants' ratings of "Spiritual Experience" and "Insightfulness" during the DMT experience, while also being related to improved well-being scores 2 weeks after the session. In addition, we found that the state of balance between the two ANS branches ("sympathovagal balance") before DMT injection predicted scores of "Insightfulness" during the DMT experience, as well as subsequent sympathovagal coactivation. CONCLUSION: These findings demonstrate the involvement of the ANS in psychedelic-induced peak experiences and may pave the way to the development of biofeedback-based tools to enhance psychedelic therapy.

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During peak height velocity, adjusting training intensity is crucial for optimizing performance and minimizing injury risk. This cross-sectional study compares external and internal intensities in different training tasks (analytical tasks, small-sided games, and training matches) and analyzes their effect on the maturation age of young players. Fifty-five U-15 and U-16 boys from two soccer clubs in southwestern Spain were monitored using inertial movement units and heart rate monitors to report training intensities. Anthropometric data and birthdates were collected to estimate maturation age. The Friedman test and Durbin-Conover post hoc test identified specific differences between groups, and Spearman's rank correlation coefficients assessed variable impacts. Training matches showed significantly higher distance covered, maximum and average speed, and average heart rate compared to small-sided games and analytical tasks. High-intensity actions and sprints were significantly higher (p < 0.0001) during training matches compared to analytical tasks and during small-sided games compared to analytical tasks. Player load per minute was significantly highest (p < 0.05) during training matches, followed by small-sided games, and lowest in analytical tasks. Positive correlations between maturational age and high-intensity actions, accelerations, and decelerations indicated higher intensity (p < 0.05) in more mature players. A negative correlation between player load per minute and maturational age suggested more efficient intensity management in mature players. These findings highlight the importance of considering biological maturation and training task variability in youth athletes' development.

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Low-cost, portable devices capable of accurate physiological measurements are attractive tools for coaches, athletes, and practitioners. The purpose of this study was primarily to establish the validity and reliability of Movesense HR+ ECG measurements compared to the criterion three-lead ECG, and secondarily, to test the industry leader Garmin HRM. Twenty-one healthy adults participated in running and cycling incremental test protocols to exhaustion, both with rest before and after. Movesense HR+ demonstrated consistent and accurate R-peak detection, with an overall sensitivity of 99.7% and precision of 99.6% compared to the criterion; Garmin HRM sensitivity and precision were 84.7% and 87.7%, respectively. Bland-Altman analysis compared to the criterion indicated mean differences (SD) in RR' intervals of 0.23 (22.3) ms for Movesense HR+ at rest and 0.38 (18.7) ms during the incremental test. The mean difference for Garmin HRM-Pro at rest was -8.5 (111.5) ms and 27.7 (128.7) ms for the incremental test. The incremental test correlation was very strong (r = 0.98) between Movesense HR+ and criterion, and moderate (r = 0.66) for Garmin HRM-Pro. This study developed a robust peak detection algorithm and data collection protocol for Movesense HR+ and established its validity and reliability for ECG measurement.

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BACKGROUND: Paced QRS morphology may vary during left bundle branch area pacing (LBBAP) as per the pacing location. It remains unclear whether electrocardiographic changes observed during LBBAP can predict clinical outcomes. OBJECTIVE: To assess correlation between characteristics of paced QRS on electrocardiogram and clinical outcomes in heart failure (HF) patients with non-ischemic cardiomyopathy. METHODS: Of 79 consecutive HF patients receiving LBBAP, 59 patients were included in this prospective study after exclusions. LBBAP was performed using Medtronic 3830 lead. Patients were categorized into various groups based on paced QRS morphology in lead V1 (qR and Qr), QRS axis (normal, left or right) and V6 R wave peak time (RWPT, ≤80 or >80 ms) to compare echocardiographic outcomes. RESULTS: RWPT was significantly shorter (75.7±17.5 vs 85.3±11.3 ms, P=0.014), transition during threshold test more commonly observed (81.5% vs 53%, P=0.02) and improvement in left ventricular ejection fraction (LVEF) was significantly greater in qR group (21.4±6.4 vs 16.4±8.3%, P=0.013) compared to Qr group. RWPT or LVEF did not differ in patients with different paced QRS axis (P>0.05). While qR morphology and presence of transition during threshold test independently predicted LVEF improvement, RWPT lacked predictive value. Non-responders had greater incidence of loss of 'R' prime (P=0.009) and prolonged RWPT (P=0.003) on follow up compared to average and super-responders. CONCLUSIONS: Paced qR morphology and transition during threshold test predicted greater improvement in LVEF while RWPT lacked predictive value. Loss of terminal 'R' in lead V1 and prolongation of RWPT on follow up prognosticated non-response to LBBAP.

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Chronic Myeloid Leukemia (CML) requires consistent medication adherence to Imatinib (IM) for optimal outcomes, however, adherence to oral chemotherapy is challenging. This observational study explores the relationship between patient knowledge, motivation, and adherence to IM therapy, and their collective impact on clinical outcomes. A prospective, observational study was conducted with 101 CML patients. The 6-Item Morisky Medication Adherence Scale (MMAS-6) was used to assess adherence, motivation, and knowledge levels. The study found that high motivation was significantly associated with lower BCR-ABL expression (p = 0.025). Patients with high knowledge and motivation had a 71% favorable response rate, compared to 0% in those with low knowledge and motivation (p = 0.01). As conclusion both patient motivation and knowledge are crucial for favorable treatment outcomes in CML. High levels of both significantly correlate with better clinical responses. Tailored interventions to enhance patient knowledge and motivation are essential.

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Solid materials that deviate from the harmonic crystal paradigm exhibit characteristic anomalies in the specific heat and vibrational density of states (VDOS) with respect to Debye's theory predictions. The boson peak (BP), a low-frequency excess in the VDOS over Debye lawg(ω)∝ω2, is certainly the most famous among them; nevertheless, its origin is still subject of fierce debate. Recent simulation works provided strong evidence that localized one-dimensional string-like excitations (stringlets) might be the microscopic origin of the BP. In this work, we study the dynamics of acoustic phonons interacting with a bath of vibrating 1D stringlets with exponentially distributed size, as observed in simulations. We show that stringlets strongly renormalize the phonon propagator and naturally induce a BP anomaly in the VDOS, corresponding to the emergence of a dispersionless BP flat mode. Additionally, phonon-stringlet interactions produce a strong enhancement of sound attenuation and a dip in the speed of sound near the BP frequency, consistent with experimental and simulation data. The qualitative trends of the BP frequency and intensity are predicted within the model and shown to be in good agreement with previous observations. In summary, our results substantiate with a simple theoretical model the recent simulation results by Hu and Tanaka claiming the origin of the BP from stringlet dynamics.

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PURPOSE: In the modeling of beam data for proton therapy planning systems, absolute dose measurements are performed utilizing a Bragg peak chamber (BPC), which is a parallel-plate ionization chamber. The long-term stability of the BPC is crucial for ensuring accurate absolute dose measurement. The study aims to assess the long-term stability of the BPC in clinical proton pencil beam scanning delivery. METHODS: The long-term stability evaluation focused on the BPC-Type 34070 (PTW Freiburg, Germany), utilizing clinical proton scanning beams from December 2022 to November 2023. Monthly investigations were conducted to evaluate the response and cross-calibration factor of the BPC and a reference chamber, employing the spread-out Bragg peak (SOBP) field. Additionally, assessments were made regarding the BPC's response to monoenergetic beams, along with an examination of the impact of polarity and ion recombination on the BPC. RESULTS: The response and cross-calibration factor of the BPC varied up to 1.9% and 1.8%, respectively, while the response of the reference chamber remained within a 0.5% range. The BPC's response to the mono-energetic beams varied up to 2.0% across all energies, demonstrating similar variation trends in both the SOBP field and mono-energetic beams. Furthermore, the variations in polarity and ion recombination effect remained stable within a 0.4% range throughout the year. Notably, the reproducibility of the BPC remained high for each measurement conducted, whether for the SOBP field or mono-energetic beams, with a maximum deviation observed at 0.1%. CONCLUSIONS: The response and cross-calibration factor of the BPC demonstrated significant variations, with maximum changes of 1.9% and 1.8%, respectively. However, the reproducibility of the BPC remained consistently high for each measurement. It is recommended that when conducting absolute dose measurements using a BPC, its response should be compared and corrected against the reference chamber for each measurement.

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BACKGROUND: Amikacin, an aminoglycoside antibiotic, is widely used for the treatment of nontuberculous mycobacterial (NTM) infections. To date, therapeutic drug monitoring (TDM) of amikacin has primarily relied on the measurement of peak and trough levels as indicators rather than the 24-hr area under the concentration-time curve (AUC24). METHODS: NTM patients referred for amikacin TDM from March 2021 to May 2023 were assessed for the AUC24 values based on administered dose. We investigated re-admission rates, all-cause mortality and AFB smear results to evaluate clinical outcome based on the actual AUC24 values. Ototoxicity and nephrotoxicity were also investigated as adverse effects in correlation with TDM parameters. RESULTS: Among 65 patients, the mean and median values of AUC24 were 234 and 249 mg·hr/L, respectively. In a group of patients with AUC24 values less than 250 mg·hr/L, 42.4 % of patients were re-admitted for pulmonary symptoms. On the contrary, another group with AUC24 values equal to or more than 250 mg·hr/L, had lower re-admission rates (25.0 %). They also showed lower all-cause mortality rates and more improvement on acid-fast bacilli smear results. Moderate to poor correlation between AUC24 values and peak/trough levels were observed. Ototoxicity and nephrotoxicity were revealed to be associated with drug exposure duration rather than AUC24 values. CONCLUSION: In this study, we performed comparative assessment of trough/peak level, traditional clinical marker for amikacin TDM, and AUC24 value. Although AUC24 values showed poor to moderate correlation to trough/peak levels, higher AUC24 correlated with favorable clinical outcomes without additional risk of toxicity.

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OBJECTIVE: To evaluate the performance (i.e., agreement between set and measured parameters) and safety (adverse events, device malfunctions, and ventilator alarms) of the fabian HFOi neonatal ventilator in volume guaranteed (VG) mode during conventional ventilation. To analyze the impact of leakage around the endotracheal tube and the set maximum allowed inflating pressure (Pmax). DESIGN: Prospective multicenter observational study. METHODS: Clinical and ventilator data were collected from 71 infants receiving VG ventilation for ≥12 h in four neonatal intensive care units (NICUs). Ventilator settings, parameters, and alarms were downloaded with 0.5 Hz sampling rate. RESULTS: Data from 4,341 h of ventilation were analyzed. The median (interquartile range, IQR) of the absolute difference between the target and measured expired tidal volume was 0.76 (0.51-1.16) mL/kg. It was less when leak was <50% (median 0.36, IQR: 0.25-0.64 mL/kg, p < .001) and even less when the required peak inflating pressure (PIP) was also below Pmax (median: 0.09 mL/kg, IQR: 0.00-0.16 mL/kg, p < .001). On NICUs setting Pmax higher, tidal volume was maintained significantly closer to target. In 56 patients VG was continued until extubation. Two ventilator malfunctions were reported, none of them resulting in patient harm. "Tidal volume not reached" alarm occurred 32 times hourly, usually lasting for <10 s. CONCLUSION: The fabian HFOi ventilator maintains tidal volume close to its target, particularly when leak is <50% and when PIP is below Pmax. In most patients VG can be continued until extubation. Despite frequent ventilator alarms, ventilator malfunctions occur very rarely.