BACKGROUND Limited joint mobility is the proven risk factor for diabetic foot ulceration when present in the subtalar and first metatarsophalangeal joints. Evidence shows that a foot-related exercise program, combined with a health-promoting program, can improve the signs and symptoms of diabetic polyneuropathy, enhance gait, restore mobility in the foot and ankle joints, redistribute pressure while walking, and increase foot strength and function. As a result, these exercise programs can help mitigate the risk factors for diabetic foot ulceration. AIM To determine the effect of supervised stretching, strengthening, functional and walking exercises on joint mobility and muscle strength in patients with diabetic polyneuropathy. METHODS This was a randomized controlled trial conducted in a tertiary hospital. The study included 82 participants allocated into the intervention group (alpha-lipoic acid and exercise on 15 consecutive therapeutic days, n = 42) and control group (alpha lipoic acid only, n = 40). Muscle strength included dorsal and plantar flexors dynamometry and strength score, while range of motion included ankle, subtalar and first metatarsophalangeal joint goniometry. RESULTS Change of motion range was significantly higher in the intervention group compared to the control group regarding ankle joint on day 15 (9.9 ± 7.2 vs 0.1 ± 3.3; P = 0.006) and month 6 (2.8 ± 7.3 vs -0.9 ± 4.1; P < 0.001), subtalar joint on day 15 (7.5 ± 5.1 vs -0.25 ± 2.25; P < 0.001) and month 6 (3.9 ± 6.4 vs -0.13 ± 3.49; P < 0.001). Change in dorsal flexors was significantly higher in the intervention group compared to the control group on day 15 (2.62 ± 1.69 vs 0.10 ± 1.35; P < 0.001) and month 6 (0.66 ± 2.38 vs -0.75 ± 1.94; P = 0.004) as well as plantar flexors on day 15 (3.3 ± 1.6 vs 0.3 ± 1.5; P < 0.001) and month 6 (1.8 ± 2.2 vs -0.9 ± 2.1; P < 0.001). Muscle strength score change was significantly lower in the intervention group compared to the control group on day 15 (-1.45 ± 1.42 vs -0.03 ± 0.16; P < 0.001) and month 6 (-1.17 ± 1.53 vs 0.20 ± 0.56; P < 0.001). CONCLUSION Exercise in combination with alpha-lipoic acid can improve joint mobility, as well as strength of the foot and lower leg muscles in patients with diabetic polyneuropathy.

The rapid advancement of Large Language Models (LLMs) has transformed natural language processing, yet comprehensive evaluation methods are necessary to ensure their reliability, particularly in Retrieval-Augmented Generation (RAG) tasks. This study aims to evaluate and compare the performance of open-source LLMs by introducing a rigorous evaluation framework. We benchmark 20 LLMs using a combination of established metrics such as BLEU, ROUGE, BERTScore, along with and a novel metric, RAGAS. The models were tested across two distinct datasets to assess their text generation quality. Our findings reveal that models like nous-hermes-2-solar-10.7b and mistral-7b-instruct-v0.1 consistently excel in tasks requiring strict instruction adherence and effective use of large contexts, while other models show areas for improvement. This research contributes to the field by offering a comprehensive evaluation framework that aids in selecting the most suitable LLMs for complex RAG applications, with implications for future developments in natural language processing and big data analysis.

Interleukin 17 (IL17) is a cytokine involved in immune regulation and has been increasingly recognized for its role in cancer progression. This systematic review aims to integrate data on IL17's role in various tumors to better understand its implications for cancer prognosis and treatment. The review included 105 studies (27.6% experimental and 72.4% clinical). Clinical studies involved 9,266 patients: 31.2% males, 60.0% females, and 8.8% with undefined gender. IL17A and IL17 were the most studied subtypes (36.2% and 33.3%, respectively). Breast cancer (26.7%), colorectal carcinoma (13.3%), and hematologic malignancies (10.5%) were the most researched neoplasms. IL17A promoted tumor growth in breast cancer and correlated with poor outcomes in colorectal, breast, and lung cancers. IL17 also played a significant role in immune modulation in gliomas and other tumors. IL17A significantly influences tumor growth and prognosis across various cancers, with notable roles in immune modulation and poor outcomes in multiple cancer types.

The Kunming-Montreal Global Biodiversity Framework (GBF) is the most ambitious agreement on biodiversity conservation and sustainable use to date. It calls for a whole-of government and whole-of-society approach to halt and reverse biodiversity loss worldwide. The Monitoring Framework of the GBF lays out how Parties to the Convention on Biological Diversity (CBD) are expected to report their progress. A CBD expert group provided guidance on its implementation, including a gap analysis to identify the strengths and limitations of the indicators in the Monitoring Framework. We present the results of the gap analysis, highlight where more work is needed and provide recommendations on implementing and improving monitoring to allow effective and comprehensive tracking of the GBF’s ambition. We find that with the headline and binary indicators, which Parties are required to use, the Monitoring Framework fully covers 19% of the GBF’s ambition and partially covers an additional 40%. Including disaggregations of the headline indicators improves coverage to 22% fully and an additional 41% partially. Adding optional (component and complementary) indicators brings full coverage to 29% with an additional 47% partial coverage. No indicators are available for 12% of the GBF. In practice, the coverage of the Monitoring Framework will depend on which indicators (headline and binary as well as component and complementary) and disaggregations are used by countries. Disaggregations are particularly relevant to monitor the cross-cutting considerations defined under section C. Substantial investment is required to collect the necessary data to compute indicators, infer change, and effectively monitor progress. We highlight important next steps to progressively improve the efficacy of the Monitoring Framework.

The Kunming-Montreal Global Biodiversity Framework (GBF) is the most ambitious agreement on biodiversity conservation and sustainable use to date. It calls for a whole-of government and whole-of-society approach to halt and reverse biodiversity loss worldwide. The Monitoring Framework of the GBF lays out how Parties to the Convention on Biological Diversity (CBD) are expected to report their progress. A CBD expert group provided guidance on its implementation, including a gap analysis to identify the strengths and limitations of the indicators in the Monitoring Framework. We present the results of the gap analysis, highlight where more work is needed and provide recommendations on implementing and improving monitoring to allow effective and comprehensive tracking of the GBF’s ambition. We find that with the headline and binary indicators, which Parties are required to use, the Monitoring Framework fully covers 19% of the GBF’s ambition and partially covers an additional 40%. Including disaggregations of the headline indicators improves coverage to 22% fully and an additional 41% partially. Adding optional (component and complementary) indicators brings full coverage to 29% with an additional 47% partial coverage. No indicators are available for 12% of the GBF. In practice, the coverage of the Monitoring Framework will depend on which indicators (headline and binary as well as component and complementary) and disaggregations are used by countries. Disaggregations are particularly relevant to monitor the cross-cutting considerations defined under section C. Substantial investment is required to collect the necessary data to compute indicators, infer change, and effectively monitor progress. We highlight important next steps to progressively improve the efficacy of the Monitoring Framework.

Introduction: The World Health Organization states that health care is a science and art that requires a lot of understanding and practical application of knowledge and skills that are specific and based on research derived from biological, social, and humanistic sciences, and management.Aim: The main goal of this study is to determine the extent to which nurses implement the health care process based on scientific and professional evidence and evidence from clinical practice. Materials and methods: The study is quantitative, descriptive, cross-sectional, and comparative. The author's questionnaire was created based on a review of professional and scientific literature and evidence from practice was used for the research.Results: Analysis of knowledge about the meaning of evidence-based health care shows that 140 (61.4%) respondents answered correctly to this question “Providing health care based on scientific research, professional literature, and good practice”. Almost 80% of respondents (181) correctly answered that evidence-based health care should be provided by nurse technicians of all levels of education who work in the health care process.Conclusion: The results of this research support the statement that nurses-technicians implement the health care process based on scientific and expert evidence, evidence from clinical practice, and this is supported by the fact that evidence-based health care is applied fully or partially by 221, or 96, 6%, of respondents.

The present study was designed to evealuate the influence of different substrates on the yield and antioxidant properties of oyster mushroom (Pleurotus ostrestus) cultivated in 'bag-logs'. The substrates used in this study were: (1) maize straw, (2) beech sawdust mixed with wheat bran, and (3 and 4) maize straw mixed with spent coffee grounds mixed in a different ratio. Total phenolics, total flavonoids and total antioxidant acitivity of oyster mushroom were determined by the Folin-Ciocalteu method, Aluminium chloride method and Ferric Reducing Antioxidant Power Assay, respectively. The highest fruiting bodies yield of oyster mushroom was obtained from substrate 4 (maize straw mixed with spent coffee grounds in a ratio of 50:50), while the least was from substrate 1 (maize straw). Total phenolic contents ranged from 3.80 mg in oyster mushroom grown on substrate 4 (maize straw mixed with spent coffee grounds in a ratio of 50:50) to 4.85 mg of gallic acid equivalents g-1 dry mass in oyster mushroom form substrate 2 (beech sawdust mixed with wheat bran). Total flavonoid contents were very low in all analysed mushroom extracts. There was no significant difference between total antioxidant activities of oyster mushroom grown on different substrates. 

U ovom radu analizirat će se upotreba diskursnih markera u spontanom govoru na suvremenom francuskom jeziku na temelju jednojezičnoga usmenog korpusa Les Vocaux na sveučilištima u Strasbourgu, Lorraineu i Liègeu. Analiza korpusa obuhvaća 745 audiodokumenata, odnosno više od deset sati glasovnih poruka koje su snimljene mobilnim aplikacijama. Rad će pokušati dokazati da diskursni markeri imaju ulogu artikulatora u govornim iskazima na francuskom jeziku. Iako se radi o neobaveznim partikulama u govoru na sintaktičkom planu, one su vrlo česte i važne su u primanju poruke na pragmatičkom planu. S obzirom na opsežnost korpusa i frekvenciju upotrebe markera, analizirat ćemo upotrebu samo jedanaest onih koji su najprisutniji u korpusu: du coup, genre, ben, mais, enfin, en fait, bon, voilà, après, quoi, donc. Rezultati istraživanja pokazuju da navedeni diskursni markeri imaju različite uloge na makrosintaktičkom planu te da, iako predstavljaju periferne elemente govora, doprinose razvoju i organizaciji ilokucijske snage.

This study aims to evaluate and comparatively assess the incidence and burden of knee ligament match injuries in the top five European football leagues (Italy, France, Germany, Spain, and England) throughout the 2022–2023 season. Beyond that, knee ligament match injury classification is based on layoff days and injury severity patterns for each registered injury. A total of 3015 players from “the big” five (UEFA, 2023) European football leagues (with a total of 98 football clubs), namely, Bundesliga, La Liga, Ligue 1, Premier League and Serie A, with an average of 30.8 players, a mean age of 25.1 (SD ± 4.6) years, were included in the study, also with an average of 14451.4 minutes exposure hours per league. The total exposure amounted to 71,382.7. The medical team recorded individual player time-loss knee ligament match injuries. In this investigation, descriptive and inferential statistical analysis methods were deployed. The football players' injury characteristics, along with other variables, were statistically evaluated using descriptive statistics of means, standard deviations (SDs), and frequencies. Based on descriptive statistics concerning the knee ligament match injury severity patterns, the data reflect that the Premier League (43.86%) and Ligue 1 (43.1%) have the highest percentage of severe injuries, suggesting that both leagues have a larger burden of severe injuries. Although they are still over 40%, the severe injury rates in the Bundesliga and Serie A are marginally lower. While the Premier League has the lowest percentage of mild injuries (15.79%), La Liga separates with a comparatively higher percentage of moderate injuries (30%) than the other leagues, indicating that injuries in the Premier League tend to be more severe in nature. In general, Minimal injuries are rare; the lowest percentage is found in Ligue 1 (3.45%). The collected data wasn't in line with a normal distribution therefore the non-parametric Kruskal-Wallis test was used to assess the incidence and burden of knee injuries within the five leagues. Subsequently, Dunn’s test was performed to determine exactly which leagues are different, the pairwise comparisons assessed differences in detail between every pair of leagues. The null hypothesis, as defined by which there is no difference in the knee ligament match incidence or knee ligament match burden of injuries between the leagues, was examined for every comparison. We reject the null hypothesis for the two analyses since the p-values for the incidence and burden of knee ligament match injuries are both 0.000, indicating substantial differences between the leagues for the knee ligament match injury incidence and burden

Human activities cause global losses of soil microbiome diversity and functionality. Microbiota transplants offer a potential solution, but the factors influencing transplant success remain unclear. We investigated how microbiota origin affects microbiome mergers, hypothesizing that native strains through niche preference are better adapted to their habitat and will outcompete non-native ones. To test this, we contrasted transplants between soil microcosm-cultured topsoil or lakewater communities with a community of 21 soil bacteria (SynCom). In both cases, SynCom transplant increased resident productivity but permanently shifted compositions, although its abundance dropped from an initial 50-80% to <1% within two months. Both merged and non-merged communities resembled natural soil microbiota in comparisons with over 81,000 soil, sediment and lake compositional data. Our results show that habitat filtering and niche competition, more than microbiota origin, determine transplant outcomes. Despite the limited proliferation of SynCom transplants, their capacity to instill lasting community trajectory changes opens new paths for microbiome engineering. TEASER Even transiently present microbiota transplants can alter resident microbiome composition through processes governed by habitat filtering.

Objective. The goal of this research was to examine the morphological characteristics and exact anatomical positioning of the greater palatine foramen (GPF), with reference to nearby anatomical landmarks. Material and Method. The research was performed on dry human skulls belonging to the Bosnian and Herzegovina population, using digital vernier calipers. The study began by noting the GPF’s position relative to the maxillary molars, then measuring its distance from the median palatine suture (MPS), the incisive fossa (IF), the posterior border of the hard palate (PBHP), and the posterior nasal spine (PNS). Measurements were conducted bilaterally, and afterwards the data were analyzed using Student’s t-test and Chi-squared test. A statistical significance was set at P<0.05. Results. The statistical analysis revealed that: the distance of the greater palatine foramen (GPF) from the midline is approximately 15.80±1.28 mm on the right side and 15.86±1.19 mm on the left side. The distance of the GPF from the incisive fossa measures about 40.12±2.19 mm on the right side and 40.34±2.08 mm on the left side. The GPF is positioned around 4.00±1.07 mm on the right side and 4.35±1.34 mm on the left side from the posterior border of the hard palate. Lastly, the distance from the GPF to the posterior nasal spine means 17.55±1.99 mm on the right side and 17.61±1.81 mm on the left side in the entire study population. The highest percentage of skulls (73.05%) showed the GPF positioned at the level of the third molar. Conclusion. The findings of this study further emphasize the variations in the location of the greater palatine foramen and underline the importance of thorough preoperative assessment in patients undergoing maxillofacial surgeries and regional block anesthesia.

Accurate variant classification is critical for genetic diagnosis. Variants without clear classification, known as “variants of uncertain significance” (VUS), pose a significant diagnostic challenge. This study examines AlphaMissense performance in variant classification, specifically for VUS. A systematic comparison between AlphaMissense predictions and predictions based on curated evidence according to the ACMG/AMP classification guidelines was conducted for 5845 missense variants in 59 genes associated with representative Mendelian disorders. A framework for quantifying and modeling VUS pathogenicity was used to facilitate comparison. Manual reviewing classified 5845 variants as 4085 VUS, 1576 pathogenic/likely pathogenic, and 184 benign/likely benign. Pathogenicity predictions based on AlphaMissense and ACMG guidelines were concordant for 1887 variants (1352 pathogenic, 132 benign, and 403 VUS/ambiguous). The sensitivity and specificity of AlphaMissense predictions for pathogenicity were 92% and 78%. Moreover, the quantification of VUS evidence and heatmaps weakly correlated with the AlphaMissense score. For VUS without computational evidence, incorporating AlphaMissense changed the VUS quantification for 878 variants, while 56 were reclassified as likely pathogenic. When AlphaMissense replaced existing computational evidence for all VUS, 1709 variants changed quantified criteria while 63 were reclassified as likely pathogenic. Our research suggests that the augmentation of AlphaMissense with empirical evidence may improve performance by incorporating a quantitative framework to aid in VUS classification.