This paper presents empirical evidence to support the so-called syntactization of discourse, that is, the projection of relevant pragmatic features in the narrow syntax. In particular, it analyses deictic inversion in English, a construction which is used by the speaker to point at a proximal or distal location and bring the addressee’s attention to an entity related to that location (e.g., Here comes the bus). It offers a novel account of this construction, which takes it to be an evidential strategy in a language that does not have standard evidential markers; this evidential status explains its main differences with locative inversion, a construction with which it is pragmatically and structurally related. Deictic inversion therefore receives a natural explanation in a framework that maps syntax with the speech act and introduces in the derivation pragmatic information about the participants in the communicative exchange and about the source of the information for the proposition asserted. Full article

Background: new-onset atrial fibrillation remains a common complication in critical care settings, often necessitating treatment when the correction of triggers is insufficient to restore hemodynamics. The treatment strategy includes electric cardioversion in cases of hemodynamic instability and either rhythm control or rate control in the absence of instability. Landiolol, an ultrashort beta-blocker, effectively controls heart rate with the potential to regulate rhythm. Objectives This review aims to compare the efficacy of landiolol in controlling heart rate and converting to sinus rhythm in the critical care setting. Methods: We conducted a comprehensive review of the published literature from 2000 to 2022 describing the use of landiolol to treat atrial fibrillation in critical care settings, excluding both cardiac surgery and medical cardiac care settings. The primary outcome assessed was sinus conversion following landiolol treatment. Results: Our analysis identified 17 publications detailing the use of landiolol for the treatment of 324 critical care patients. While the quality of the data was generally low, primarily comprising non-comparative studies, landiolol consistently demonstrated similar efficacy in controlling heart rate and facilitating conversion to sinus rhythm in both non-surgical (75.7%) and surgical (70.1%) settings. The incidence of hypotension associated with landiolol use was 13%. Conclusions: The use of landiolol in critical care patients with new-onset atrial fibrillation exhibited comparable efficacy and tolerance in both non-surgical and surgical settings. Despite these promising results, further validation through randomized controlled trials is necessary. Full article

Background: Accurate malaria diagnosis constitutes a challenging task, necessitating the need for the implementation of targeted and effective diagnostic tools. The purpose of the current study was to evaluate the effectiveness of two different molecular methodologies in terms of sensitivity for the detection of External Quality Assessment (EQA) Plasmodium samples. Methods: A total of 104 lyophilized blood samples from 14 different UK-NEQAS (National External Quality Assessment Site) (2016–2021) and eight WHO-NEQAS distributions (2017–2020) were analyzed. An in-house multiplex PCR protocol, followed by single target real-time PCR protocols for all five Plasmodium species, was implemented. Results: The multiplex PCR had a success rate of 10/16 and 20/28 for P. vivax and P. falciparum species, respectively. On the other hand, the respective results for real-time PCR had a success rate of 13/16 (P. vivax), 28/28 (P. falciparum), 5/8 (P. malariae), 8/10 (P. ovale), and 10/14 (P. knowlesi). Plasmodium falciparum samples displayed the highest sensitivity of detection, 0.02 parasites/μL. Plasmodium vivax samples displayed a 0.1 parasites/μL cutoff value, greater than the respective value for whole blood samples, while P. ovale species displayed a respective cutoff value of 0.05 parasites/μL. Due to the limited number of tested samples, data obtained for P. malariae and P. knowlesi species samples were inconclusive. Conclusions: Real-time PCR comprises a credible molecular methodology in terms of sensitivity assessment and detection of low parasitemia levels of Plasmodium sp. in EQA lyophilized blood samples. Full article

Marshes are an important ecosystem, acting as a biodiversity hotspot, a carbon sink and a bioremediation site, breaking down anthropogenic waste such as antibiotics, metals and fertilizers. Due to their participation in these metabolic activities and their capability to contribute to primary productivity, the microorganisms in such habitats have become of interest to investigate. Since Proteobacteria were previously found to be abundant and the waters are well aerated and organic-rich, this study on the presence of anoxygenic phototrophic bacteria, purple non-sulfur bacteria and aerobic anoxygenic phototrophs in marshes was initiated. One sample was collected at each of the seven Manitoban sites, and anoxygenic phototrophs were cultivated and enumerated. A group of 14 strains, which represented the phylogenetic diversity of the isolates, was physiologically investigated further. Aerobic anoxygenic phototrophs and purple non-sulfur bacteria were present at each location, and they belonged to the α- and β-Proteobacteria subphyla. Some were closely related to known heavy metal reducers (Brevundimonas) and xenobiotic decomposers (Novosphingobium and Sphingomonas). All were able to synthesize the photosynthetic complexes aerobically. This research highlights the diversity of and the potential contributions that anoxygenic phototrophs make to the essential functions taking place in wetlands. Full article

The purpose of this mixed-method study was to (1) examine the effect of an adapted physical activity program, Fitness Access McGill (FAM), on leisure-time physical activity (LTPA), autonomous and controlled motivation, and the basic psychological needs of self-determination theory among university students/staff with a physical disability and/or chronic conditions, and (2) explore participants’ experiences after completing FAM. Nineteen participants completed validated questionnaires for all study outcomes pre- and post-FAM. Nine participants partook in a 30–60 min semi-structured interview conducted within three months of completing FAM. Quantitative data were analyzed using repeated measures effect size calculations. Qualitative data were analyzed using directed content analysis. Participants reported an increase in total LTPA (dRMpooled = 0.58), with the greatest positive change on strenuous intensity (dRMpooled = 0.81). Large effects were found for changes in autonomous motivation (dRMpooled = 0.52), autonomy (dRMpooled = 0.79), competence (dRMpooled = 0.79), and relatedness (dRMpooled = 0.89). Participants reported FAM being supportive towards their psychological needs, the development of a LTPA routine, and enhanced overall well-being. Future research can be built upon this study to develop a robust understanding as to how need-supportive, adapted LTPA programs could be implemented within community settings or out-patient rehabilitation to support exercise engagement, physical health and overall well-being among adults with disabilities. Full article

To clarify the hydrodynamic interference characteristics of flows around multiple cylinders under the wall effect, the two-dimensional (2D) flows around the near-wall single, two tandem and parallel cylinders are simulated under different gap ratios (0.15 ≤ G/D ≤ 3.0) and spacing ratios (1.5 ≤ T/D ≤ 4.0) at a Reynolds number of Re = 6300. We also examine the wake patterns, the force coefficients, and the vortex-shedding frequency with emphases on the wall effect and effects of the two-cylinder interference. A critical wall gap of G/D = 0.6 is identified in the single-cylinder case where the wall can exert significant influences. The two near-wall tandem cylinders exhibit three wake states: stretching mode, attachment mode, and impinging mode. The force coefficients on the upstream cylinder are significantly affected by the wall for G/D ≤ 0.6. The downstream cylinder is mainly influenced by the upstream cylinder. For G/D > 0.6, the force coefficients on the two cylinders exhibit a similar variation trend. In the parallel arrangement, the two cylinders exhibit four wake states in different G/D and T/D ranges: double stretching mode, hetero-vortex scale mode, unilateral vortex mode, and free vortex mode. Moreover, the two parallel cylinders in the hetero-vortex scale or free vortex mode have two states: synchronous in-phase state and synchronous out-of-phase state. The mean drag coefficients on the two cylinders decrease, while the mean lift coefficients exhibit opposite variation trends, as the T/D grows. Full article

Background: This study aimed to systematically review case reports documenting rare adverse events in patients with small cell lung cancer (SCLC) following the administration of immune checkpoint inhibitors (ICIs). Methods: A systematic literature review was conducted to identify case reports detailing previously unreported adverse drug reactions to ICIs in patients with SCLC. The scope of the literature reviewed was restricted to case studies on SCLC published up to 31 December 2023. Results: We analyzed twenty-four studies on ICI use for patients with SCLC. There were six reports on atezolizumab, four on durvalumab, and three on adverse events from monotherapy with nivolumab. Reports involving combination treatments were the most frequent, with a total of six, predominantly involving using nivolumab in combination with ipilimumab. Additionally, there was one report each on using pembrolizumab, nofazinilimab, sintilimab, tislelizumab, and toripalimab. We collected detailed information on the clinical course, including patient and disease characteristics, symptoms, treatment for each adverse event, and recovery status. Among the patients included in the case reports, 21 out of 24 (87.5%) had extensive-stage SCLC when initiating ICI therapy, with only 1 patient diagnosed with limited-stage SCLC. Respiratory system adverse events were most common, with seven cases, followed by neurological, endocrinological, and gastroenterological events. Three case reports documented adverse events across multiple systems in a single patient. In most cases, patients showed symptom improvement; however, four studies reported cases where patients either expired without symptom improvement or experienced sequelae. Conclusions: Efforts to develop reliable biomarkers for predicting irAEs continue, with ongoing research to enhance predictive precision. Immunotherapy presents diverse and unpredictable adverse events, underscoring the need for advanced diagnostic tools and a multidisciplinary approach to improve patient management. Full article

Background: Chronic obstructive pulmonary disease (COPD) has significant systemic manifestations, including cardiovascular morbidity. The main aim of our study was to evaluate the effect of short-term COPD treatment with tiotropium/olodaterol (TIO/OLO) 5/5 μg on cardiac function and autonomic integrity. Methods: Twenty-nine patients with newly diagnosed moderate-to-severe COPD were enrolled. We performed pulmonary function tests, cardiac magnetic resonance, cardiac 123I-metaiodobenzylguanidine (123I-MIBG) imaging and analysis of blood biomarkers on our study subjects. The correlations between the tests’ results were evaluated at baseline. The changes in pulmonary and cardiac parameters from baseline through 12 weeks were assessed. Results: Significant associations between pulmonary function tests’ results and high-sensitivity C-reactive protein (hs-CRP), as well as interleukin-22 (IL-22), were observed at baseline. Treatment with TIO/OLO significantly improved lung function as measured by spirometry and body plethysmography. Moreover, we found that the cardiac index increased from 2.89 (interquartile range (IQR) 1.09) to 3.21 L/min/m² (IQR 0.78) (p = 0.013; N = 18) and the late heart-to-mediastinum ratio improved from 1.88 (IQR 0.37) to 2 (IQR 0.41) (p = 0.026; N = 16) after 12 weeks of treatment. Conclusions: Treatment with TIO/OLO improves lung function and positively impacts cardiac function and autonomic integrity, suggesting that dual bronchodilation might have a potential in decreasing the risk for cardiac events in COPD. Hs-CRP and IL-22 might be beneficial in determining the intensity of systemic inflammation in COPD. Further research with a larger cohort is needed to enhance the initial results of this study. Full article

In this paper, we discussed a new subclass ${\mathcal{J}\mathcal{Q}}_{⅁,A}^B\left(q\right)$ of bi-univalent functions in the unit disk $\mathbb{U}$ using q-generalized Janowski function and q-derivative. Additionally, certain properties were examined and effectively demonstrated, such as the second Hankel determinant, Fekete–Szegö estimates, and Coefficients Bounds. Each of these bounds were precise and were confirmed by finding the extremal function for the new class. Furthermore, there are in-depth conversations available regarding certain intriguing specific cases of the outcomes achieved. Full article

Reverse transcription followed by quantitative polymerase chain reaction (RT-qPCR) is a commonly used tool for gene expression analysis. The selection of stably expressed reference genes is required for accurate normalization. The aim of this study was to identify the optimal reference genes for RT-qPCR normalization in various brain regions of rats at different stages of the lithium–pilocarpine model of acquired epilepsy. We tested the expression stability of nine housekeeping genes commonly used as reference genes in brain research: Actb, Gapdh, B2m, Rpl13a, Sdha, Ppia, Hprt1, Pgk1, and Ywhaz. Based on four standard algorithms (geNorm, NormFinder, BestKeeper, and comparative delta-Ct), we found that after pilocarpine-induced status epilepticus, the stability of the tested reference genes varied significantly between brain regions and depended on time after epileptogenesis induction (3 and 7 days in the latent phase, and 2 months in the chronic phase of the model). Pgk1 and Ywhaz were the most stable, while Actb, Sdha, and B2m demonstrated the lowest stability in the analyzed brain areas. We revealed time- and region-specific changes in the mRNA expression of the housekeeping genes B2m, Actb, Sdha, Rpl13a, Gapdh, Hprt1, and Sdha. These changes were more pronounced in the hippocampal region during the latent phase of the model and are thought to be related to epileptogenesis. Thus, RT-qPCR analysis of mRNA expression in acquired epilepsy models requires careful selection of reference genes depending on the brain region and time of analysis. For the time course study of epileptogenesis in the rat lithium–pilocarpine model, we recommend the use of the Pgk1 and Ywhaz genes. Full article

Recently, community detection has emerged as a prominent research area in the analysis of complex network structures. Community detection models based on non-negative matrix factorization (NMF) are shallow and fail to fully discover the internal structure of complex networks. Thus, this article introduces a novel constrained symmetric non-negative matrix factorization with deep autoencoders (CSDNMF) as a solution to this issue. The model possesses the following advantages: (1) By integrating a deep autoencoder to discern the latent attributes bridging the original network and community assignments, it adeptly captures hierarchical information. (2) Introducing a graph regularizer facilitates a thorough comprehension of the community structure inherent within the target network. (3) By integrating a symmetry regularizer, the model’s capacity to learn undirected networks is augmented, thereby facilitating the precise detection of symmetry within the target network. The proposed CSDNMF model exhibits superior performance in community detection when compared to state-of-the-art models, as demonstrated by eight experimental results conducted on real-world networks. Full article

This paper explores the development of a smart Structural Health Monitoring (SHM) platform tailored for long-span bridge monitoring, using the Forth Road Bridge (FRB) as a case study. It discusses the selection of smart sensors available for real-time monitoring, the formulation of an effective data strategy encompassing the collection, processing, management, analysis, and visualization of monitoring data sets to support decision-making, and the establishment of a cost-effective and intelligent sensor network aligned with the objectives set through comprehensive communication with asset owners. Due to the high data rates and dense sensor installations, conventional processing techniques are inadequate for fulfilling monitoring functionalities and ensuring security. Cloud-computing emerges as a widely adopted solution for processing and storing vast monitoring data sets. Drawing from the authors’ experience in implementing long-span bridge monitoring systems in the UK and China, this paper compares the advantages and limitations of employing cloud- computing for long-span bridge monitoring. Furthermore, it explores strategies for developing a robust data strategy and leveraging artificial intelligence (AI) and digital twin (DT) technologies to extract relevant information or patterns regarding asset health conditions. This information is then visualized through the interaction between physical and virtual worlds, facilitating timely and informed decision-making in managing critical road transport infrastructure. Full article

Sustainability of biological, social, and economic systems is crucial for protecting our common future and preserving the balance between nature and humans. Environmental concerns should be adopted by all units of society and sustainability awareness should be adapted to all processes through optimum technologies both in daily life and in business management. The basic objective of this article is to determine the effects of green core competencies, green process innovation, and firm performance variables on each other and to examine the moderating role of sustainability consciousness on these effects. A survey and semi-structured interview forms were preferred as data collection methods. In the analysis of the survey data, AMOS was adopted to test the hypothetical model and the Hayes Process macro was employed to determine the moderating effect. The data of interview forms were analyzed with the bag of words model. The research results show that green core competencies positively affect green process innovation and green process innovation positively affects firm performance. In addition, the moderating effect of the attitudinal and behavioral dimensions of sustainability awareness on the impact of green process innovation on firm performance is supported, while the moderating effect of the sustainability knowingness dimension is not supported. Full article

Based on the driving force-pressure-state-impact-response (DPSIR) model, 19 indicators were selected to construct a comparison between Zhuhai and Macao, two adjacent cities at the estuary of the Pearl River in China, which have different development models and water resource sustainable development strategies. Factors that may affect the sustainability of water resources were screened and placed according to the relationships of the five subsystems in the DPSIR model, establishing a sustainable evaluation model for water resources in the two cities. The results analyzed by Principal Component Analysis and Entropy methods showed that (1) Zhuhai City was greatly affected by the driving force, while Macao was greatly affected by the state system from 2012 to 2021. (2) From the trend changes, it can be seen that, in recent years, the water resources of the two cities have been moving towards sustainable development, and the management and protection of water resources have achieved remarkable results. From the evaluation results, it can be seen that implementing urban water-saving activities, strengthening the proportion of environmental water conservancy, public measures in public investment, upgrading sewage treatment machinery to improve sewage treatment rates, and other measures can effectively improve the current situation of water resources in both regions. In the future, the Zhuhai and Macao cities may continue to face a series of water resource pressures brought on by socio-economic developments. Therefore, an active adjustment of the development of the measurement of controlling wastewater discharge and saving water resources was proposed, adhering to the direction of sustainable development, and ensuring the benign development of socio-economic conditions and the ecological environment. This study can provide data to support regional water resource security and policy formulation with different political systems. Full article

This paper proposes the design of virtual antenna arrays with frequency diversity for radar systems in fifth-generation flying ad hoc networks. These virtual arrays permit us to detect targets from the sky with flying drones. Each array element is composed of a microstrip antenna mounted on quadcopter drones and is virtually connected with the other elements. The antennas are tuned to work at the lower fifth-generation frequency band of 3.5 GHz. The design process considers the optimization of frequency offsets and positions for each element to obtain a side lobe level reduction. This methodology is carried out by particle swarm optimization. Several design examples are presented with random frequency offsets and non-uniform positions. These designs are compared to uniform-spaced arrays excited with Hamming frequency offsets. The simulation results show that using random frequency offsets and non-uniform positions provides a minor side lobe level reduction. This research demonstrates the feasibility of using virtual arrays for radar systems in fifth-generation flying ad hoc networks. Full article

The main purpose of the present paper is to prove the existence of periodic solutions of the three-body problem in the 3D Kepler formulation. We have solved the same problem in the case when the three particles are considered in an external inertial system. We start with the three-body equations of motion, which are a subset of the equations of motion (previously derived by us) for any number of bodies. In the Minkowski space, there are 12 equations of motion. It is proved that three of them are consequences of the other nine, so their number becomes nine, as much as the unknown trajectories are. The Kepler formulation assumes that one particle (the nucleus) is placed at the coordinate origin. The motion of the other two particles is described by a neutral system with respect to the unknown velocities. The state-dependent delays arise as a consequence of the finite vacuum speed of light. We obtain the equations of motion in spherical coordinates and split them into two groups. In the first group all arguments of the unknown functions are delays. We take their solutions as initial functions. Then, the equations of motion for the remaining two particles must be solved to the right of the initial point. To prove the existence–uniqueness of a periodic solution, we choose a space consisting of periodic infinitely smooth functions satisfying some supplementary conditions. Then, we use a suitable operator which acts on these spaces and whose fixed points are periodic solutions. We apply the fixed point theorem for the operators acting on the spaces of periodic functions. In this manner, we show the stability of the He atom in the frame of classical electrodynamics. In a previous paper of ours, we proved the existence of spin functions for plane motion. Thus, we confirm the Bohr and Sommerfeld’s hypothesis for the He atom. Full article

Venous thromboembolism (VTE) is a challenging clinical obstacle in oncological settings, marked by elevated incidence rates and resulting morbidity and mortality. In the context of cancer-associated thrombosis (CAT), endothelial dysfunction (ED) plays a crucial role in promoting a pro-thrombotic environment as endothelial cells lose their ability to regulate blood flow and coagulation. Moreover, emerging research suggests that this disorder may not only contribute to CAT but also impact tumorigenesis itself. Indeed, a dysfunctional endothelium may promote resistance to therapy and favour tumour progression and dissemination. While extensive research has elucidated the multifaceted mechanisms of ED pathogenesis, the genetic component remains a focal point of investigation. This comprehensive narrative review thus delves into the genetic landscape of ED and its potential ramifications on cancer progression. A thorough examination of genetic variants, specifically polymorphisms, within key genes involved in ED pathogenesis, namely eNOS, EDN1, ACE, AGT, F2, SELP, SELE, VWF, ICAM1, and VCAM1, was conducted. Overall, these polymorphisms seem to play a context-dependent role, exerting both oncogenic and tumour suppressor effects depending on the tumour and other environmental factors. In-depth studies are needed to uncover the mechanisms connecting these DNA variations to the pathogenesis of malignant diseases. Full article

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive genetic defects in cortisol synthesis and shows elevated ACTH concentrations, which in turn has downstream effects. The most common variant of CAH, 21-hydroxylase deficiency (21OHD), is the result of pathogenic variants in the CYP21A2 gene and is one of the most common monogenic disorders. However, the genetics of 21OHD is complex and challenging. The CYP21A2 gene is located in the RCCX copy number variation (CNV), a complex, multiallelic, and tandem CNV in the major histocompatibility complex (MHC) class III region on chromosome 6 (band 6p21.3). Here, CYP21A2 and its pseudogene CYP21A1P are located 30 kb apart and share a high nucleotide homology of approximately 98% and 96% in exons and introns, respectively. This high-sequence homology facilitates large structural rearrangements, copy number changes, and gene conversion through intergenic recombination. There is a good genotype–phenotype correlation in 21OHD, and genotyping can be performed to confirm the clinical diagnosis, predict long-term outcomes, and determine genetic counseling. Thus, genotyping in CAH is clinically relevant but the interpretations can be challenging for non-initiated clinicians. Here, there are some concrete examples of how molecular diagnosis can sometimes require the use of multiple molecular strategies. Full article

The inhibition of co-stimulation during T-cell activation has been shown to provide effective immunosuppression in kidney transplantation (KT). Hence, the conversion from calcineurin inhibitor (CNI) to belatacept is emerging as a potential alternate maintenance immunosuppressive therapy in those with transplant-associated thrombotic microangiopathy (TA-TMA) or in the prevention of TA-TMA. We present a 17-year-old male who presented with biopsy-proven CNI-associated TA-TMA immediately post-KT. The administration of eculizumab led to the reversal of TMA. Tacrolimus was converted to belatacept with excellent efficacy and safety during a short-term follow-up of one year. Further larger controlled studies are required to demonstrate the efficacy of this approach in children who present with early-onset TMA post-KT. Full article

Investigational drug services need to be organised in a structured approach, especially for sites with a large number of ongoing clinical trials. The aim of this study was to develop a tool to assess the complexity of pharmacy involvement in a sponsored oncology clinical trial. Categorisation into ordinal complexity categories was used to assess the complexity of the clinical trials for consistent pharmacy grant applications. The 15 items of the tool were divided into three sections, and individual item scores were agreed upon among four pharmacists with experience in the conduct of clinical trials at two different centres. A final version of the tool, named Pharm-CAT, was approved. The pharmacists were instructed to use Pharm-CAT to assign a score to each new sponsored trial. To determine the cut-offs for the complexity categories, the scores were sorted in ascending order and the cut-offs corresponding to the first and third tertiles of the score distribution were selected. To verify the reproducibility of the results, Pharm-CAT was applied by two pharmacists independently for each trial. Pharm-CAT proved to be user-friendly. Sixty clinical trials were evaluated and a total of 120 scores were recorded. Low-complexity scores ranged from 0 to 19, medium-complexity scores ranged from 20 to 25, and high-complexity scores were 26 or higher. The average score recorded was 22.88 points. Prospective multicentre validation of Pharm-CAT is needed to confirm its applicability. Full article

Locally advanced breast cancer (LABC) is a complex disease that requires a multidisciplinary approach. Neoadjuvant chemotherapy (NAC) is usually performed in order to achieve loco-regional radical resection; although its importance in the multidisciplinary approach to LABC is well recognized, a small number of patients show Progressive Disease (PD). No standard salvage treatment (ST) has been defined and different strategies can be adopted, such as second-line systemic therapies, radiation therapy, and surgery. Herein, a case of LABC in PD during NAC is reported with a literature review, with the aim of highlighting the importance of a tailored multidisciplinary treatment for each patient. Full article