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Background: Tuberculosis (TB) and depression are highly comorbid and linked to higher rates of death and disability. Several evidence-based treatments for depression have been successfully implemented in low- and middle-income countries, but more knowledge is needed on how to bring these innovations to scale within complex 'real world' public health systems. Objective: To explore whether the principles of social network analysis could be used to enhance receptivity to integrating depression treatment into primary care for individuals with and without TB in Brazil. Methods: We used existing scales to identify settings and providers with high receptivity and connectivity within the primary care network. We trained and supervised existing staff in three primary care sites to deliver a brief evidence-based intervention over one year, coupled with active dissemination activities. Afterwards, we reassessed receptivity among individuals involved, and not involved, in the pilot. Results: Highly significant changes were observed in mental health literacy, attitudes towards evidence-based practices, work self-efficacy, and implementation leadership supporting our hypothesis. Limited social connections between primary care clinics precluded the examination of the hypothesis that targeting settings with high connectivity could capitalize on the information flow between and transcend the decentralized structure of the network, but leveraging the centralized nature of the TB program to integrate mental health services emerged as a promising alternative. Conclusions: The findings of this study strongly suggest that social networks may be leveraged to change individual providers' attitudes, thereby contributing to the enhanced dissemination of evidence-based interventions.

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In the rapidly evolving urban advanced mobility (UAM) sphere, Vehicular Ad Hoc Networks (VANETs) are crucial for robust communication and operational efficiency in future urban environments. This paper quantifies VANETs to improve their reliability and availability, essential for integrating UAM into urban infrastructures. It proposes a novel Stochastic Petri Nets (SPN) method for evaluating VANET-based Vehicle Communication and Control (VCC) architectures, crucial given the dynamic demands of UAM. The SPN model, incorporating virtual machine (VM) migration and Edge Computing, addresses VANET integration challenges with Edge Computing. It uses stochastic elements to mirror VANET scenarios, enhancing network robustness and dependability, vital for the operational integrity of UAM. Case studies using this model offer insights into system availability and reliability, guiding VANET optimizations for UAM. The paper also applies a Design of Experiments (DoE) approach for a sensitivity analysis of SPN components, identifying key parameters affecting system availability. This is critical for refining the model for UAM efficiency. This research is significant for monitoring UAM systems in future cities, presenting a cost-effective framework over traditional methods and advancing VANET reliability and availability in urban mobility contexts.

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Simultaneous intracellular depolymerization of xylo-oligosaccharides (XOS) and acetate fermentation by engineered Saccharomyces cerevisiae offers significant potential for more cost-effective second-generation (2G) ethanol production. In the present work, the previously engineered S. cerevisiae strain, SR8A6S3, expressing enzymes for xylose assimilation along with an optimized route for acetate reduction, was used as the host for expressing two ß-xylosidases, GH43-2 and GH43-7, and a xylodextrin transporter, CDT-2, from Neurospora crassa, yielding the engineered SR8A6S3-CDT-2-GH34-2/7 strain. Both ß-xylosidases and the transporter were introduced by replacing two endogenous genes, GRE3 and SOR1, that encode aldose reductase and sorbitol (xylitol) dehydrogenase, respectively, and catalyse steps in xylitol production. The engineered strain, SR8A6S3-CDT-2-GH34-2/7 (sor1Δ gre3Δ), produced ethanol through simultaneous XOS, xylose, and acetate co-utilization. The mutant strain produced 60% more ethanol and 12% less xylitol than the control strain when a hemicellulosic hydrolysate was used as a mono- and oligosaccharide source. Similarly, the ethanol yield was 84% higher for the engineered strain using hydrolysed xylan, compared with the parental strain. Xylan, a common polysaccharide in lignocellulosic residues, enables recombinant strains to outcompete contaminants in fermentation tanks, as XOS transport and breakdown occur intracellularly. Furthermore, acetic acid is a ubiquitous toxic component in lignocellulosic hydrolysates, deriving from hemicellulose and lignin breakdown. Therefore, the consumption of XOS, xylose, and acetate expands the capabilities of S. cerevisiae for utilization of all of the carbohydrate in lignocellulose, potentially increasing the efficiency of 2G biofuel production.

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BACKGROUND: The impact of cirrhosis and portal hypertension on perioperative outcomes of minimally invasive left lateral sectionectomies remains unclear. We aimed to compare the perioperative outcomes between patients with preserved and compromised liver function (noncirrhotics versus Child-Pugh A) when undergoing minimally invasive left lateral sectionectomies. In addition, we aimed to determine if the extent of cirrhosis (Child-Pugh A versus B) and the presence of portal hypertension had a significant impact on perioperative outcomes. METHODS: This was an international multicenter retrospective analysis of 1,526 patients who underwent minimally invasive left lateral sectionectomies for primary liver malignancies at 60 centers worldwide between 2004 and 2021. In the study, 1,370 patients met the inclusion criteria and formed the final study group. Baseline clinicopathological characteristics and perioperative outcomes of these patients were compared. To minimize confounding factors, 1:1 propensity score matching and coarsened exact matching were performed. RESULTS: The study group comprised 559, 753, and 58 patients who did not have cirrhosis, Child-Pugh A, and Child-Pugh B cirrhosis, respectively. Six-hundred and thirty patients with cirrhosis had portal hypertension, and 170 did not. After propensity score matching and coarsened exact matching, Child-Pugh A patients with cirrhosis undergoing minimally invasive left lateral sectionectomies had longer operative time, higher intraoperative blood loss, higher transfusion rate, and longer hospital stay than patients without cirrhosis. The extent of cirrhosis did not significantly impact perioperative outcomes except for a longer duration of hospital stay. CONCLUSION: Liver cirrhosis adversely affected the intraoperative technical difficulty and perioperative outcomes of minimally invasive left lateral sectionectomies.

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BACKGROUND: Preserving health-related quality of life (HRQOL) is an important goal during renal cell carcinoma treatment. We report HRQOL outcomes from a phase II trial (NCT03173560). PATIENTS AND METHODS: HRQOL data were collected during a multicenter, randomized, open-label phase II study comparing the safety and efficacy of 2 different starting doses of lenvatinib (18 mg vs. 14 mg daily) in combination with everolimus (5 mg daily), following one prior vascular endothelial growth factor-targeted treatment. HRQOL was measured using 3 different instruments-FKSI-DRS, EORTC QLQ-C30, and EQ-5D-3L-which were all secondary endpoints. Change from baseline was assessed using linear mixed-effects models. Deterioration events for time to deterioration (TTD) analyses were defined using established thresholds for minimally important differences in the change from baseline for each scale. TTD for each treatment arm was estimated using the Kaplan-Meier method. RESULTS: Baseline characteristics of the 343 participants randomly assigned to 18 mg lenvatinib (n = 171) and 14 mg lenvatinib (n = 172) were well balanced. Least-squares mean estimates for change from baseline were favorable for the 18 mg group over the 14 mg group for the FKSI-DRS and most EORTC QLQ-C30 scales, but differences between treatments did not exceed the minimally important thresholds. Median TTD was longer among participants in the 18 mg group than those in the 14 mg group for most scales. CONCLUSIONS: Participants who received an 18 mg lenvatinib starting dose had favorable HRQOL scores and longer TTD on most scales compared with those who received a 14 mg starting dose.

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In urban mobility, Vehicular Ad Hoc Networks (VANETs) provide a variety of intelligent applications. By enhancing automobile traffic management, these technologies enable advancements in safety and help decrease the frequency of accidents. The transportation system can now follow the development and growth of cities without sacrificing the quality and organisation of its services thanks to safety apps that include collision alerts, real-time traffic information, and safe driving applications, among others. Applications can occasionally demand a lot of computing power, making their processing impractical for cars with limited onboard processing capacity. Offloading of computation is encouraged by such a restriction. However, because vehicle mobility operations are dynamic, communication times (also known as link lifetimes) between nodes are frequently short. VANET applications and processes are impacted by such communication delays (e.g., the offloading decision when using the Computational Offloading technique). Making an accurate prediction of the link lifespan between vehicles is therefore challenging. The effectiveness of the communication time estimation is currently constrained by the link lifespan prediction methods used in the computational offloading process. This work investigates five machine learning (ML) algorithms to predict the link lifetime between nodes in VANETs in different scenarios. We propose the procedures required to carry out the link lifetime prediction method using existing ML techniques. The tactic creates datasets with the features the models need to learn and be trained. The SVR and XGBoost algorithms that were selected as part of the assessment process were trained. To make the prediction using the trained models, we modified the lifespan prediction function from an offloading approach. To determine the viability of applying link lifespan predictions from the models trained in the road and urban scenarios, we conducted a performance study. The findings indicate that compared to the conventional prediction strategy described in the literature, the suggested link lifetime prediction via regression approaches decreases prediction error rates. An offloading method from the literature is extended by the selected SVR. The task loss and recovery rates might be significantly reduced using the SVR. XGBoost outperformed its ML competitors in task recovery or drop rate by 70% to 80% in an assessed hypothesis compared to an offloading choice technique in the literature. With greater offloading rates from an application on the VANET, this effort is intended to give better efficiency in estimating this data using machine learning in various vehicular settings.

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SUMMARY: Anatomic variation of the biceps brachii muscle (BBM) is frequently observed; its pattern is diverse and clinically important. During the educational dissection of a 78-year-old Korean male cadaver, six additional asymmetrical heads of the biceps brachii muscle (BBM) were found on both sides. On the right side, two additional heads originated from the humerus; the musculocutaneous nerve passed between these heads and the short head of the BBM. Four additional heads were found on the left side, anterior to the BBM, one of which originated from the pectoralis major muscle. Posterior to the BBM, two heads of tendons originated from the coracobrachialis muscle and one head of the muscle belly originated from the humerus. The left musculocutaneous nerve pierced the coracobrachialis muscle and continued distally passing between the short head of the BBM and the additional heads located posterior to the BBM. It then gave off the variant musculocutaneous nerve to the median nerve. On both sides, the short and long heads of the BBM had normal origins, insertions, and courses. This novel variation has various clinical and embryological implications.

RESUMEN: Con frecuencia se observa una variación anatómica del músculo bíceps braquial (MBB); su patrón es diverso y clínicamente importante. Durante la disección de un cadáver masculino coreano de 78 años, se encontraron seis cabezas asimétricas adicionales del músculo bíceps braquial en ambos lados. En el lado derecho, dos cabezas adicionales se originaban en el húmero; el nervio musculocutáneo atravesaba entre estas cabezas y la cabeza corta del MBB. Se encontraron cuatro cabezas adicionales en el lado izquierdo, anterior al MBB, una de las cuales se originaba en el músculo pectoral mayor. Posterior al MBB, dos cabezas tendinosas se originaban en el músculo coracobraquial y una cabeza de vientre muscular se originaba en el húmero. El nervio musculocutáneo izquierdo perforaba el músculo coracobraquial y continuaba distalmente pasando entre la cabeza corta del MBB y las cabezas adicionales ubicadas por detrás del MBB. Luego emitía la variante el nervio musculocutáneo al nervio mediano. En ambos lados, las cabezas corta y larga del MBB tenían orígenes, inserciones y trayectos normales. Esta nueva variación tiene varias implicaciones clínicas y embriológicas.

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Crop landraces have unique local agroecological and societal functions and offer important genetic resources for plant breeding. Recognition of the value of landrace diversity and concern about its erosion on farms have led to sustained efforts to establish ex situ collections worldwide. The degree to which these efforts have succeeded in conserving landraces has not been comprehensively assessed. Here we modelled the potential distributions of eco-geographically distinguishable groups of landraces of 25 cereal, pulse and starchy root/tuber/fruit crops within their geographic regions of diversity. We then analysed the extent to which these landrace groups are represented in genebank collections, using geographic and ecological coverage metrics as a proxy for genetic diversity. We find that ex situ conservation of landrace groups is currently moderately comprehensive on average, with substantial variation among crops; a mean of 63% ± 12.6% of distributions is currently represented in genebanks. Breadfruit, bananas and plantains, lentils, common beans, chickpeas, barley and bread wheat landrace groups are among the most fully represented, whereas the largest conservation gaps persist for pearl millet, yams, finger millet, groundnut, potatoes and peas. Geographic regions prioritized for further collection of landrace groups for ex situ conservation include South Asia, the Mediterranean and West Asia, Mesoamerica, sub-Saharan Africa, the Andean mountains of South America and Central to East Asia. With further progress to fill these gaps, a high degree of representation of landrace group diversity in genebanks is feasible globally, thus fulfilling international targets for their ex situ conservation.

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The spread of the Coronavirus (COVID-19) pandemic across countries all over the world urges governments to revolutionize the traditional medical hospitals/centers to provide sustainable and trustworthy medical services to patients under the pressure of the huge overload on the computing systems of wireless sensor networks (WSNs) for medical monitoring as well as treatment services of medical professionals. Uncertain malfunctions in any part of the medical computing infrastructure, from its power system in a remote area to the local computing systems at a smart hospital, can cause critical failures in medical monitoring services, which could lead to a fatal loss of human life in the worst case. Therefore, early design in the medical computing infrastructure's power and computing systems needs to carefully consider the dependability characteristics, including the reliability and availability of the WSNs in smart hospitals under an uncertain outage of any part of the energy resources or failures of computing servers, especially due to software aging. In that regard, we propose reliability and availability models adopting stochastic Petri net (SPN) to quantify the impact of energy resources and server rejuvenation on the dependability of medical sensor networks. Three different availability models (A, B, and C) are developed in accordance with various operational configurations of a smart hospital's computing infrastructure to assimilate the impact of energy resource redundancy and server rejuvenation techniques for high availability. Moreover, a comprehensive sensitivity analysis is performed to investigate the components that impose the greatest impact on the system availability. The analysis results indicate different impacts of the considered configurations on the WSN's operational availability in smart hospitals, particularly 99.40%, 99.53%, and 99.64% for the configurations A, B, and C, respectively. This result highlights the difference of 21 h of downtime per year when comparing the worst with the best case. This study can help leverage the early design of smart hospitals considering its wireless medical sensor networks' dependability in quality of service to cope with overloading medical services in world-wide virus pandemics.

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