This study investigates the potential of speech-reception-threshold (SRT) estimation through electroencephalography (EEG) based envelope reconstruction techniques with continuous speech. Additionally, we investigate the influence of the stimuli’s signal-to-noise ratio (SNR) on the temporal response function (TRF). Twenty young normal-hearing participants listened to audiobook excerpts with varying background noise levels while EEG was recorded. A linear decoder was trained to reconstruct the speech envelope from the EEG data. The reconstruction accuracy was calculated as the Pearson’s correlation between the reconstructed and actual speech envelopes. An EEG SRT estimate (SRTneuro) was obtained as the midpoint of a sigmoid function fitted to the reconstruction accuracy versus SNR data points. Additionally, the TRF was estimated at each SNR level, followed by a statistical analysis to reveal significant effects of SNR levels on the latencies and amplitudes of the most prominent components. The SRTneuro was within 3 dB of the behavioral SRT for all participants. The TRF analysis showed a significant latency decrease for N1 and P2 and a significant amplitude magnitude increase for N1 and P2 with increasing SNR. The results suggest that both envelope reconstruction accuracy and the TRF components are influenced by changes in SNR, indicating they may be linked to the same underlying neural process.

Introduction/Background: Cardiovascular symptoms appear in a high proportion of patients in the few months following a severe SARS-CoV-2 infection. Non-invasive methods to predict disease severity could help personalizing healthcare and reducing the occurrence of these symptoms. Research Questions/Hypothesis: We hypothesized that blood long noncoding RNAs (lncRNAs) and machine learning (ML) could help predict COVID-19 severity. Goals/Aims: To develop a model based on lncRNAs and ML for predicting COVID-19 severity. Methods/Approach: Expression data of 2906 lncRNAs were obtained by targeted sequencing in plasma samples collected at baseline from four independent cohorts, totaling 564 COVID-19 patients. Patients were aged 18+ and were recruited from 2020 to 2023 in the PrediCOVID cohort (n=162; Luxembourg), the COVID19_OMICS-COVIRNA cohort (n=100, Italy), the TOCOVID cohort (n=233, Spain), and the MiRCOVID cohort (n=69, Germany). The study complied with the Declaration of Helsinki. Cohorts were approved by ethics committees and patients signed an informed consent. Results/Data: After data curation and pre-processing, 463 complete datasets were included in further analysis, representing 101 severe patients (in-hospital death or ICU admission) and 362 stable patients (no hospital admission or hospital admission but not ICU). Feature selection with Boruta, a random forest-based method, identified age and five lncRNAs (LINC01088-201, FGDP-AS1, LINC01088-209, AKAP13, and a novel lncRNA) associated with disease severity, which were used to build predictive models using six ML algorithms. A naïve Bayes model based on age and five lncRNAs predicted disease severity with an AUC of 0.875 [0.868-0.881] and an accuracy of 0.783 [0.775-0.791]. Conclusion: We developed a ML model including age and five lncRNAs predicting COVID-19 severity. This model could help improve patients’ management and cardiovascular outcomes.

Motivated by the article [Getz and Mills. Host–parasitoid coexistence and egg-limited encounter rates. Am Nat. 1996;148:301–315], in this paper, we explore a discrete model involving a host and a parasitoid with search and egg limitations and arbitrary host-escape function. We added proportional refuge for the hosts to the model. We focus on the system's behavior at the equilibrium points and the nearby regions. In addition to the topological classification of these points, we examined local behavior. In the case of the extinction equilibrium, we obtain the global result. We describe the dynamical behavior scenarios in the neighborhood of the non-isolated exclusion equilibrium point (1:1 resonant). For the unique coexisting equilibrium, we prove the emergence of the Neimark–Sacker bifurcation and calculate the first Lyapunov exponent. This bifurcation can be either super or sub-critical. We have also established the occurrence of the Chenciner bifurcation. Our findings indicate that proportional refuge may or may not stabilize the system, and the choice of host-escape function plays a crucial role in shaping the system's dynamics. We also provide numerical examples to support our theoretical results.

INTRODUCTION: AI-based EKG has shown good accuracy for diagnosing heart failure. However, due to the heterogeneity of studies regarding cutoff points, its precision for specifically detecting heart failure with reduced ejection fraction (LVEF <40%) is not yet well established. Research question: What it is the sensitivity and specificity of artificial-based electrocardiogram to diagnose heart failure with low ejection fraction(cut-off of 40%) Aims: We conducted a meta-analysis and systematic review to evaluate the accuracy of artificial intelligence electrocardiograms in predicting an ejection fraction below 40%. METHODS: We searched PubMed, Embase and Cochrane Library for studies evaluating the performance of AI EKGs in diagnosing HFrEF. We computed true positives, true negatives, false positives and false negatives events to estimate pooled sensitivity, specificity and area under the curve, using R software version 4.3.1, under a random-effects model. RESULTS: We identified 8 studies,including 136151 patients with a paired artificial intelligence enabled electrocardiogram with an echocardiography. 9349(6.8%) patients had an ejection fraction below 40% according to the echocardiogram. The AI-ECG data yielded areas under the receiver operator of, sensitivity of 0.861(0.815-0.897), and specificity of 0.874(0.834-0.905) , and area under the curve of 0.929(0.876-0.949). Mean/median age ranged from 60±9 to 67.8±14.4 years. CONCLUSIONS: In this systematic review and meta-analysis, the use of electrocardiogram-based artificial intelligence models demonstrated high sensitivity and specificity for the diagnosis of heart failure with an ejection fraction below 40%

Background: Bruton Tyrosine Kinase inhibitors (BTKi) are targeted therapies that have demonstrated promising results in the treatment of hematological malignancies; however, they are associated with adverse cardiac events. Direct comparisons of the cardiotoxic profile between old-generation and new-generation BTKi are limited. Research Question: Are novel BTKi associated with a lower incidence of cardiac adverse events compared with ibrutinib? Aims: We aimed to perform a systematic review and meta-analysis of cardiac events from studies comparing new-generation BTKi versus ibrutinib in patients with hematological malignancies. Methods: We searched PubMed, Embase, and Cochrane Library for studies comparing any new-generation BTKi with ibrutinib in patients with hematological malignancies. Outcomes included 1) risk of cardiac events; 2) atrial fibrillation (AF); 3) rate of treatment discontinuations due to AF; and 4) hypertension. We pooled risk ratios (RR) with 95% confidence intervals (CI). Statistical analysis was performed using R software 4.3.1, under a random-effects model. Heterogeneity was assessed using I 2 statistics. Results: We included four randomized controlled trials with 1905 patients, of whom 957 (50%) received new-generation BTKi. Age ranged from 28 to 90 years, with 1337 (70%) male patients. Prior lines of systemic therapy ranged from none to 12. Overall cardiac events were significantly lower in patients who received novel BTKi compared with those who received ibrutinib (RR 0.75; 95% CI 0.63 to 0.90; p=0.002; I 2 =0%; Fig.1A). New-generation BTKis were associated with a statistically significant reduction in the risk of AF (RR 0.48; 95% 0.35 to 0.64; p<0.001; I2=0% Fig.1B) and treatment discontinuation due to AF (RR 0.07; 95% CI 0.01 to 0.34; p=0.001; I 2 =0%), compared with ibrutinib. However, there was no statistically significant reduction in the risk of hypertension with novel BTKi relative to ibrutinib (RR 0.58; 95% CI 0.34 to 1.01; p=0.053; I 2 =81%). Conclusion: Our findings suggest that treatment with new-generation BTKi is associated with a significant reduction in the risk of cardiac events, AF, and AF-related treatment discontinuation compared with the old-generation BTKi.

Background: Cyclophosphamide is an alkylating agent of the nitrogen mustard class that has become standard of care for graft-versus-host disease prophylaxis after hematopoietic stem cell transplantation. Although its cardiac toxicity in conditioning regimens is well-documented, data on cardiac events after administration of post-transplant cyclophosphamide (PT-Cy) administration remains limited. Research Question: Is PT-Cy associated with a higher incidence of cardiac adverse events compared with no PT-Cy? Aims: We aimed to perform a systematic review and meta-analysis of cardiac events from studies comparing PT-Cy versus no PT-Cy in patients with hematological disorders who received hematopoietic stem cell transplantation. Methods: We searched PubMed, Embase, and Cochrane Library for studies comparing PT-Cy versus no PT-Cy in patients with hematological conditions who received hematopoietic stem cell transplantation. We pooled risk ratios (RR) with 95% confidence intervals (CI). Statistical analyses were performed using Review Manager 5.4.1, under a random-effects model. Heterogeneity was assessed using I2 statistics. Results: We included four studies, all of which were retrospective, with 1,546 patients, of whom 826 (53%) received PT-Cy. Age ranged from 18 to 77 years, and 840 (54%) were male. A total of 1549 allogeneic transplants were performed, primarily for malignant hematological conditions. The conditioning regimens used were myeloablative (52%), reduced intensity (33%), non-myeloablative (8%), and sequential (7%). The most common cardiac events in patients receiving PT-Cy were heart failure (28%) and cardiomyopathy (27%), followed by arrhythmias (25%), pericarditis/pericardial effusion (14%) and acute coronary syndrome (5%). The incidence of adverse cardiac events was significantly higher in patients who received PT-Cy compared with those who did not receive PT-Cy (RR 2.05; 95% CI 1.36, 3.10; p<0.001; I 2 =44%). Conclusion: These findings suggest that PT-Cy is associated with a higher incidence of adverse cardiac events, the most common of which is heart failure/cardiomyopathy.

Introduction: The efficacy and safety of use and impact of pulmonary artery catheter (PAC) in patients with cardiogenic shock (CS) treated with Impella remains unclear. The use of PAC in conjunction with Impella for patients with CS might be associated with improved clinical outcomes and increased safety compared to the use of Impella alone. We aimed to perform a systematic review and meta-analysis comparing Impella with versus without PAC for patients with CS. Methods: We systematically searched PubMed, Embase, and Cochrane databases for studies comparing PAC use in patients with CS treated with Impella. We pooled odds ratios (OR) with 95% confidence intervals (CI) applying random-effects model. We used R version 4.3.2 for statistical analyses. Results: We included two observational studies comprising 11,463 patients, of whom 6,058 (53%) had PAC. Compared with no PAC, the use of PAC was associated with a significantly lower in short-term mortality rates (37% vs. 42%; OR 0.83; 95% CI 0.77-0.90; p<0.01; Figure 1A). There was no significant difference in the incidence of arrhythmias 59% vs. 63%; OR 1.14; 95% CI 0.92-1.41 p=0.44; Figure 1B) or renal complications between groups (47% vs. 50%; OR 1.08; 95% CI 1.00-1.17; p=0.06; Figure 1C). Conclusions: In patients with CS, adjunctive PAC to Impella is associated with lower mortality rates, but no significant difference in arrhythmias and renal complications. Randomized controlled trials are warranted to further validate this results.

Microscopic signs indicative of drowning are not specific to drowning but also to any other form of suffocation where mechanical obstruction is involved. Our study aimed to evaluate both macroscopic and microscopic findings across different groups sharing a common mechanism of death but differing causes and to compare the diatom test with pathohistological examination.Twenty-nine adult Wistar rats, weighing within recommended ranges, were divided into four groups (L1-L4). The diatom test followed established guidelines for diatoms in water from the Bosna River. Microscopic examination revealed diatoms in the lungs of rats in L3 and L4 groups. Pathohistological findings showed varying degrees of changes including consolidation and inflammatory cell infiltration, dominated by lymphocytes and macrophages, with some samples also showing eosinophilic leukocytes.Significant differences were observed between animals whose cause of death was mechanical asphyxia (suffocatio) and those that were submersed for1 hour versus those that were submersed for 72 hours after death. Diatoms identified in group L4 samples 3, 4, and 5 included Navicula sp. (U3 and U6) and Ulnaria ulna (U4).Our findings suggest combining the diatom test with pathohistological analysis to support a drowning diagnosis. Further examination of other organs could enhance result reliability.

This paper introduces a conceptual evaluation learning analytics (LA) model developed by Keypath Education and Melbourne Business School to analyse student engagement in an online learning environment. The paper describes how a targeted LA intervention was grounded within the ICAP theory for active learning to identify, visualise and analyse student engagement metrics in a 100% online setting. The architecture of the model, including its design principles and underlying assumptions, are broadly examined against the latest research in educational, LA, and data analytics research. This includes a discussion of our initial phase testing results of captured student data alongside a discussion of key questions and desired study outcomes for the upcoming phase 2 of the data intervention. As a result, this paper provides both specific insights into how we created an evidence based and pedagogically sound evaluation model of online student engagement within a specific suite of asynchronous educational tools, as well as more general and practical insights into how other universities could develop similar approaches to enhance understanding and support of a growing online student population.

In deaf students, there is no contextual understanding and recognition of word types through linguistic competence testing compared to the hearing population, because 67.10% do not understand, and 10.00% of deaf children partially understand the contextual application of word types in a written text task. The aim of the study is to determine the distance of language discourse between deaf and hearing respondents and to establish a discrimination factor that can be used for practical purposes in a classification sense, with the aim of determining the priority of linguistic education and language elements of deaf children in relation to their lagging behind hearing children. The study was conducted on a sample of 140 respondents. The first subsample of respondents, the experimental group consisted of 70 deaf students, and the second subsample, the control group of 70 hearing students, of the same chronological age and gender. The measuring instrument “Test of comprehension of the written form of expression” was applied. The collected data were processed using the discriminant analysis method. The results of the study showed that the discrimination factor is in the sequence of the use of words, adjectives, exclamations and adverbs. Nouns and prepositions have a negative correlation, which points to the fact that these four types of words are in direct implication with nouns and prepositions, and represents information that these four types of words must be more represented in the educational materials of written expression of deaf children. The results of the study also open up a series of questions focused on the quality of the educational processes of deaf children, as well as the level of lag in written communication compared to hearing children. The results of the study can influence the raising of general rehabilitation procedures to a higher level of responsibility in education centers where deaf children are educated.

The primary objective of this study is to examine the statistically homogeneous clustering in the hierarchical arrangement of the use of adverbial clauses for location, recognition, and comprehension of words presented in three-dimensional, rebus, and distorted forms. The study was conducted on a sample of 140 participants. The first subset of participants constituted the experimental group, consisting of 70 deaf students, while the second subset formed the control group, comprising 70 hearing students of the same chronological age. A battery of tests was utilized as a measurement instrument, including the “Test of Writing and Comprehending Adverbial Clauses for Location,” “Test of Reading, Writing, and Comprehending Words Presented in Three-Dimensional Form,” “Test of Reading, Writing, and Comprehending Words Presented in Rebus Form,” and “Test of Reading, Writing, and Comprehending Words Presented in Distorted Form.” In the descriptive analysis, frequencies of the total words achieved by both deaf and hearing participants were computed for the different types of measurement instruments employed. To identify the most robust homogeneity of participants concerning the applied variables, non-hierarchical and hierarchical Cluster Analyses were employed. The research results indicate a significant lag in the use of adverbial clauses for location, writing, reading, and understanding words presented in three-dimensional, rebus, and distorted forms among deaf children in comparison to their hearing peers. The Cluster Analysis revealed the most significant linkage between the variable “Number of used adverbial clauses for location” and the variable “Number of recognized words presented in three-dimensional form.” This link was clustered with the variable “Number of written words presented in rebus form” and the variable “Number of written words presented in three-dimensional form.” An analysis of variance for isolated clusters identified a statistically significant difference in the entire measurement space of adverbial clauses for location, three-dimensional, rebus, and distorted forms of words, with a level of statistical significance at p=0.00.

Syringocystadenoma papilliferum is a benign cutaneous adnexal tumor of eccrine and apocrine glands, with a warty appearance that is usually found on the scalp, neck and face, much less frequently appears in the chest or abdomen and extremely rarely on the female genital organs, i.e. the vulva. We present a case of Syringocystadenoma papilliferum on the vulva of a 64-year-old woman. This case illustrates the atypical location of this rare disease and adds to the differential diagnosis of lesions on the vulva.

Honey and honeydew are natural foods with a very complex composition that contain both, organic and inorganic ingredients. Regardless of the progress of the industry, it can't be replaced by some production process.The quality of honey varies from year to year, and bees can never produce the same honey and honeydew. Weather conditions, grazing, treatment of bees, proximity to industry, roads, etc., greatly affect the quality of the obtained honey. Although minerals and heavy metals are minor constituents of honey, they play a vital role in determining its quality.The goal of the research is to assess the qualitative status of honey based on the content of contaminants, heavy metals from the area of the Tuzla Canton.The research was conducted on 30 (thirty) honey samples. The samples were collected in the period September/October 2022 and constitute the grazing of the specified year.In the samples that were the subject of research, As and Cd did not exceed the limit of quantification (LOQ = 0.009 mg/kg). Current regulations does not define MRL’s for these two metals. As for the quantified amount of lead (Pb), it was the same in 12 samples and in 11 samples there was an evident deviation from the MRL. The measured lead (Pb), values range from 0.06 to 5.34 mg/kg.The quality of bee products from the aspect of contamination with heavy metals can serve as bioindicator of environmental pollution, that is, as an indicator of the level of good beekeeping practices. KEYWORDS:honey; honeydew; heavy metals; Tuzla canton

COVID-19 offers many valuable lessons, many of which could be found in unique societies like Hong Kong. The metropolis is special for its drastically varying—good and bad—COVID-19 performances. Hong Kong was widely considered a pandemic control and containment success for maintaining a remarkably low number of COVID-19 infections and deaths, until it was not. In March 2022, for instance, Hong Kong had the world’s highest COVID-19 infection rates. As Hong Kong shares many similarities with other metropolises around the world, it is important to learn the hard-earned lessons from its failure to control infections. Drawing insights from the literature and our own research, this analysis aims to identify key lessons societies could gain from Hong Kong’s COVID-19 responses to ensure better preparation for future pandemics.