Phthalates are widely used in consumer products. Exposure to phthalates can lead to adverse health effects in humans, with early-life exposure being of particular concern. Phthalate exposure occurs mainly through ingestion, inhalation, and dermal absorption. However, our understanding of the relative importance of different exposure routes is incomplete. This study estimated the intake of five phthalates from the residential indoor environment for 455 Swedish pregnant women in the SELMA study using phthalate mass fraction in indoor dust and compares these to total daily phthalate intakes back-calculated from phthalate metabolite concentrations in the women's urine. Steady-state models were used to estimate indoor air phthalate concentrations from dust measurements. Intakes from residential dust and air made meaningful contributions to total daily intakes of more volatile di-ethyl phthalate (DEP), di-n-butyl phthalate (DnBP), and di-iso-butyl phthalate (DiBP) (11% of total DEP intake and 28% of total DnBP and DiBP intake combined). Dermal absorption from air was the dominant pathway contributing to the indoor environmental exposure. Residential exposure to less volatile phthalates made minor contributions to total intake. These results suggest that reducing the presence of low molecular weight phthalates in the residential indoor environment can meaningfully reduce phthalate intake among pregnant women.

This paper presents a novel hierarchical motion planning approach based on Rapidly-Exploring Random Trees (RRT) for global planning and Model Predictive Control (MPC) for local planning. The approach targets a three-wheeled cycle rickshaw (trishaw) used for autonomous urban transportation in shared spaces. Due to the nature of the vehicle, the algorithms had to be adapted in order to adhere to non-holonomic kinematic constraints using the Kinematic Single-Track Model. The vehicle is designed to offer transportation for people and goods in shared environments such as roads, sidewalks, bicycle lanes but also open spaces that are often occupied by other traffic participants. Therefore, the algorithm presented in this paper needs to anticipate and avoid dynamic obstacles, such as pedestrians or bicycles, but also be fast enough in order to work in real-time so that it can adapt to changes in the environment. Our approach uses an RRT variant for global planning that has been modified for single-track kinematics and improved by exploiting dead-end nodes. This allows us to compute global paths in unstructured environments very fast. In a second step, our MPC-based local planner makes use of the global path to compute the vehicle's trajectory while incorporating dynamic obstacles such as pedestrians and other road users. Our approach has shown to work both in simulation as well as first real-life tests and can be easily extended for more sophisticated behaviors.

The interference of matter waves is one of the intriguing features of quantum mechanics that has impressed researchers and laymen since it was first suggested almost a century ago. Nowadays, attosecond science tools allow us to utilize it in order to extract valuable information from electron wave packets. Intense laser fields are routinely employed to create electron wave packets and control their motion with attosecond and ångström precision. In this perspective article, which is based on our debate at the Quantum Battles in Attoscience virtual workshop 2020, we discuss some of the peculiarities of intense light-matter interaction. We review some of the most important techniques used in attosecond imaging, namely photoelectron holography and laser-induced electron diffraction. We attempt to ask and answer a few questions that do not get asked very often. For example, if we are interested in position space information, why are measurements carried out in momentum space? How to accurately retrieve photoelectron spectra from the numerical solution of the time-dependent Schrödinger equation? And, what causes the different coherence properties of high-harmonic generation and above-threshold ionization?

Parental involvement (PI) in education contributes to numerous positive outcomes in children, including educational outcomes and social competence. The goal of the present study was to examine differences in PI mechanisms between parents of children with autism spectrum disorder (ASD) and parents of typically developing (TD) children. An additional goal was to examine factors affecting PI mechanisms in education in parents of children with ASD. The sample for this study consisted of 50 parents of children with ASD and 50 parents of TD children. The results of this study indicate that parents of children with ASD had lower levels of PI mechanisms in education than parents of TD children. The strongest predictors of PI mechanisms in education in parents of children with ASD were subjective well-being and child’s emotional reactivity. Implications for future research and practice are discussed.

Introduction: Mixed adenoneuroendocrine carcinoma (MANEC) is a tumor of the gastrointestinal tract that contains both exocrine and endocrine components, with each component representing a minimum of 30% of the total tumor mass.

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From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.

On global level there is a large supply-demand imbalance for the worker with the right set of skills. Similarly, it is observed in Bosnia as well. Even though the unemployment rate is high in the country, the industry is struggling to get talents they need from the local market. On the other hand, the job seekers are rather preferring to look for job opportunities in EU countries since the packages of benefits are more attractive there. Bosnian industry is mainly based on labor intensive business and it is focused on lower cost as competitive advantage. Using this competitive advantage, the industry generates insufficient added value to offer competitive package of benefit to demanded talents from the global labor market. They have to switch to a new competitive advantage on differentiated unique solutions to target groups that will provide them with increased added value.

Rahmanzadeh et al. quantify—for the first time in vivo—the relative damage to myelin and axons across the multiple sclerosis spectrum, in different types of lesions and in normal-appearing tissue. The data confirm neuropathological findings and extend them by revealing the complexity of the disease in living patients.

Differentiated vulvar intraepithelial neoplasia (dVIN) is a premalignant lesion that is known to progress rapidly to invasive carcinoma. Accurate histological diagnosis is therefore crucial to allow appropriate treatment. To identify reliable diagnostic features, we evaluated the inter-observer agreement in the histological assessment of dVIN, among a bi-national, multi-institutional group of pathologists. Two investigators from Erasmus MC selected 36 hematoxylin-eosin-stained glass slides of dVIN and no-dysplasia, and prepared a list of 15 histological features of dVIN. Nine participating pathologists (i) diagnosed each slide as dVIN or no-dysplasia, (ii) indicated which features they used for the diagnosis, and (iii) rated these features in terms of their diagnostic usefulness. Diagnoses rendered by > 50% participants were taken as the consensus (gold standard). p53-immunohistochemistry (IHC) was performed for all cases, and the expression patterns were correlated with the consensus diagnoses. Kappa (ĸ)-statistics were computed to measure inter-observer agreements, and concordance of the p53-IHC patterns with the consensus diagnoses. For the diagnosis of dVIN, overall agreement was moderate (ĸ = 0.42), and pair-wise agreements ranged from slight (ĸ = 0.10) to substantial (ĸ = 0.73). Based on the levels of agreement and ratings of usefulness, the most helpful diagnostic features were parakeratosis, cobblestone appearance, chromatin abnormality, angulated nuclei, atypia discernable under × 100, and altered cellular alignment. p53-IHC patterns showed substantial concordance (ĸ = 0.67) with the consensus diagnoses. Histological interpretation of dVIN remains challenging with suboptimal inter-observer agreement. We identified the histological features that may facilitate the diagnosis of dVIN. For cases with a histological suspicion of dVIN, consensus-based pathological evaluation may improve the reliability of the diagnosis.

Aims. To investigate morbidity and mortality in a real‐life cohort of patients with type 2 diabetes (T2D) in relation to prevalence and severity of nonalcoholic fatty liver disease (NAFLD). Methods. Patients with T2D were referred for assessment of liver fibrosis by the FIB‐4 test and liver stiffness measurement (LSM) by vibration‐controlled transient elastography (VCTE). Liver steatosis was quantified by the controlled attenuation parameter (CAP). These patients were followed until death or censored date. Results. Among 454 patients (52% males, mean age 62.5 years, BMI 30.9 kg/m2), 82.6% was overweight, 77.8% had fatty liver, and 9.9% and 3.1% had LSM and FIB‐4 values suggestive of advanced fibrosis, respectively. During the follow‐up period of median 2 years, 106 (23%) patients experienced adverse event (11% cardiovascular) and 17 (3.7%) died, whereas no liver‐related morbidity or mortality was observed. Independent predictors of adverse outcomes were age and higher platelet count, while FIB‐4, LSM, and CAP were not. Conclusion. In a cohort of T2D patients, no liver‐related morbidity or mortality occurred during 2 years. Our patients probably have low real prevalence of advanced fibrosis which is likely overestimated by LSM ≥ 9.6 kPa. Liver fibrosis may be safely reassessed in the 2 years interval in noncirrhotic patients with T2D.

Survivin’s dual function as apoptosis inhibitor and regulator of cell proliferation is mediated via its interaction with the export receptor CRM1. This protein–protein interaction represents an attractive target in cancer research and therapy. Here, we report a sophisticated strategy addressing Survivin’s nuclear export signal (NES), the binding site of CRM1, with advanced supramolecular tweezers for lysine and arginine. These were covalently connected to small peptides resembling the natural, self-complementary dimer interface which largely overlaps with the NES. Several biochemical methods demonstrated sequence-selective NES recognition and interference with the critical receptor interaction. These data were strongly supported by molecular dynamics simulations and multiscale computational studies. Rational design of lysine tweezers equipped with a peptidic recognition element thus allowed to address a previously unapproachable protein surface area. As an experimental proof-of-principle for specific transport signal interference, this concept should be transferable to any protein epitope with a flanking well-accessible lysine. Survivin’s dual function as apoptosis inhibitor and regulator of cell proliferation is mediated via its interaction with the export receptor CRM1. Here authors report a strategy addressing its dimer interface overlapping with the nuclear export signal, the binding site of CRM1, with advanced supramolecular tweezers for lysine and arginine.

Abstract It was not known whether the polygenic risk scores (PRSs) that predict colorectal cancer could predict colorectal cancer for people with inherited pathogenic variants in DNA mismatch repair genes—people with Lynch syndrome. We tested a PRS comprising 107 established single-nucleotide polymorphisms associated with colorectal cancer in European populations for 826 European-descent carriers of pathogenic variants in DNA mismatch repair genes (293 MLH1, 314 MSH2, 126 MSH6, 71 PMS2, and 22 EPCAM) from the Colon Cancer Family Registry, of whom 504 had colorectal cancer. There was no evidence of an association between the PRS and colorectal cancer risk, irrespective of which DNA mismatch repair gene was mutated, or sex (all 2-sided P > .05). The hazard ratio per standard deviation of the PRS for colorectal cancer was 0.97 (95% confidence interval = 0.88 to 1.06; 2-sided P = .51). Whereas PRSs are predictive of colorectal cancer in the general population, they do not predict Lynch syndrome colorectal cancer.

We address the problem of robust state reconstruction for discrete-time nonlinear systems when the actuators and sensors are injected with (potentially unbounded) attack signals. Exploiting redundancy in sensors and actuators and using a bank of unknown input observers (UIOs), we propose an observer-based estimator capable of providing asymptotic estimates of the system state and attack signals under the condition that the numbers of sensors and actuators under attack are sufficiently small. Using the proposed estimator, we provide methods for isolating the compromised actuators and sensors. Numerical examples are provided to demonstrate the effectiveness of our methods.

Introduction: Potential benefits of implementing an electronic health record (EHR) to increase the efficiency of health services and improve the quality of health care are often obstructed by the unwillingness of the users themselves to accept and use the available systems. Aim: The aim of this study was to identify factors that influence the acceptance of the use of an EHR by physicians in the daily practice of hospital health care. Material and Methods: The cross-sectional study was conducted among physicians in the General Hospital Pancevo, Serbia. An anonymous questionnaire, developed according to the technology acceptance model (TAM), was used for the assessment of EHR acceptance. The response rate was 91%. Internal consistency was assessed by Cronbach’s alpha coefficient. A logistic regression analysis was used to identify the factors influencing the acceptance of the use of EHR. Results: The study population included 156 physicians. The mean age was 46.4 ± 10.4 years, 58.8% participants were female. Half of the respondents (50.1%) supported the use of EHR in comparison to paper patient records. In multivariate logistic regression modeling of social and technical factors, ease of use, usefulness, and attitudes towards use of EHR as determinants of the EHR acceptance, the following predictors were identified: use of a computer outside of the office for reading daily newspapers (p = 0.005), EHR providing a greater amount of valuable information (p = 0.007), improvement in the productivity by EHR use (p < 0.001), and a statement that using EHR is a good idea (p = 0.014). Overall the percentage of correct classifications in the model was 83.9%. Conclusion: In this research, determinants of the EHR acceptance were assessed in accordance with the TAM, providing an overall good model fit. Future research should attempt to add other constructs to the TAM in order to fully identify all determinants of physician acceptance of EHR in the complex environment of different health systems.