Otitis media with effusion (OME) is a common condition in children that can lead to hearing loss and developmental delays. Although tympanostomy tube (TT) placement is the standard treatment for persistent OME, recurrence after tube extrusion and the need for reoperation remain significant concerns. To evaluate the clinical effectiveness of autoinflation in reducing OME recurrence and reoperation rates after TT extrusion in pediatric patients. This prospective randomized clinical trial, conducted from September 2019 to August 2022 at a tertiary hospital, enrolled children with chronic OME who underwent TT placement with 2 years of follow-up after TT extrusion. The statistical analysis took place between March 2024 and February 2025. After TT extrusion, patients were randomized to receive autoinflation with the autoinflation device for 5 weeks or to undergo observation alone. The main outcomes were OME recurrence and reoperation rates using otoscopic and tympanometric evaluations. Sixty-six children enrolled in the study; 54 were included in the final analysis (26 in the autoinflation group and 28 in the observation group). Among 54 children (mean [SD] age, 55.5 [18.5] months; 30 [55.6%] male), the recurrence rate was 5 of 26 patients (19.2%) in the autoinflation group and much higher at 10 of 28 patients (35.7%) in the observation group (difference, 16.5 percentage points [pp]; 95% CI, -7.4 pp to 37.8 pp), while the reoperation rate was much lower in the autoinflation group at 2 of 26 patients (7.7%) compared to the observation group at 8 of 28 patients (28.6%; difference, 20.9 pp; 95% CI,-0.29 pp to 40.2 pp). In the autoinflation group, tympanometry showed minimal change from the first follow-up after TT extrusion to after 5 weeks of autoinflation therapy (type A tympanogram: 19 of 26 patients [73.1%] to 20 of 26 patients [76.9%]; type C tympanogram: 7 of 26 patients [26.9%] to 6 of 26 patients [23.1%]). In contrast, the observation group exhibited a decline in type A tympanograms (21 of 28 patients [75.0%] to 16 of 28 patients [57.1%]) and an increase in type C tympanograms (7 of 28 patients [25.0%] to 12 of 28 patients [42.9%]). In this randomized clinical trial, autoinflation after TT extrusion was safe, feasible, and associated with a reduced need for repeat surgical intervention. The observed difference in recurrence was compatible with a clinically meaningful reduction. These findings support the use of autoinflation as a noninvasive rehabilitative strategy to enhance eustachian tube function and maintain middle ear ventilation following TT extrusion. ClinicalTrials.gov Identifier: NCT07122999.

ABSTRACT Objective To compare morphological features between ruptured and unruptured internal carotid artery siphon aneurysms (ICSA) and identify predictors associated with rupture risk. Methods We retrospectively analyzd 156 patients with ICSA—49 with ruptured aneurysms (51 aneurysms) and 107 with unruptured aneurysms (120 aneurysms) – evaluated using volume computed tomographic digital subtraction angiography (VCTDSA). Twenty-one morphological and clinical indices, including aneurysm size, inclination angle and aspect ratio, were compared. Statistical analyses comprised univariate testing, receiver operating characteristic (ROC) curve analysis, and multivariate logistic regression. Results Univariate analysis revealed significant differences in aneurysm size, morphology, dimensions, angulation parameters, shape indices, maximal diameter, multiplicity and patient age between ruptured and unruptured ICSA (all p < 0.05). ROC curve analysis identified the inclination angle (AUC = 0.730), the inflow angle (AUC = 0.763) and aneurysm size (AUC = 0.755) as strong discriminators of rupture risk. Multivariate logistic regression identified three independent predictors of rupture: aneurysm size (OR = 12.607, 95% CI: 4.400–36.124; p < 0.001), inclination angle (OR = 4.062, 95% CI: 1.570–10.513; p = 0.004), and multiplicity (OR = 4.274, 95% CI: 1.620–11.272; p = 0.003). Conclusions Inclination angle, aneurysm size, and multiplicity are key morphological predictors of rupture in ICSA. These findings provide a valuable reference for morphologic assessing aneurysm rupture risk, enhancing clinical risk stratification.

A comprehensive understanding of parasitic diseases, which affect both human and animal health, is crucial for university students in health sciences as they prepare for their future roles as healthcare professionals. This study aims to assess the knowledge levels of university students in health sciences regarding parasitic diseases. This descriptive study was conducted with 498 students from the faculty of health sciences and the vocational school of health services at a state university in the Marmara Region. Data were collected using a questionnaire that included socio-demographic information and questions assessing students' knowledge of parasitic diseases. Statistical analyses were performed using SPSS 26.0®, with a significance level set at p≤0.05. The participants had a mean age of 20.84±2.63 years, and 82.3% were female. A total of 80.9% of the students lived with their parents, and 73.7% reported a moderate family income. Nearly half (44.2%) were first-year students, 30.1% were enrolled in the department of physiotherapy and rehabilitation, and 68.1% resided in state dormitories. Most students (92.4%) recognized the importance of hand hygiene in preventing parasitic diseases, and 71.3% acknowledged that the location of household toilets could contribute to the occurrence of such diseases. However, 70.1% reported not receiving specific training or certification on hygiene. Female students demonstrated the highest awareness of hand hygiene benefits in preventing parasitic infections, while nursing students had the most extensive hygiene training (course/certificate) (p<0.05). Our findings indicate that a significant proportion of students lack specialized courses or certifications on hygiene practices and have limited knowledge of parasitic diseases. Therefore, integrating scientific meetings and training sessions on parasitic diseases and preventive measures into the health sciences curriculum is essential.

Objectives: The objective of the study is to evaluate the prevalence and severity of lower urinary tract dysfunction (LUTD) in children with cerebral palsy (CP) through focused non-invasive ultrasound assessments of post-void residual urine (PVR) and average bladder wall thickness (aBWT). Materials and Methods: A prospective cross-sectional study was conducted from June 2023 to May 2024 at a tertiary care center in Northeast India. Forty-one children with CP and 41 age- and sex-matched controls (age range: 4–12 years) were enrolled. LUTD was assessed using the Dysfunctional Voiding Symptom Score (DVSS) questionnaire, and a blinded radiologist performed ultrasound measurements of PVR and aBWT. Statistical analyses were performed using Statistical Package for the Social Sciences version 25.0. Tests included the Student’s t -test, Chi-square test, and Pearson’s correlation coefficient. Results: The mean age of the CP group was 8 ± 3 years. Median DVSS score in the CP group was 12 (interquartile range [IQR] 9–15), significantly higher than the control group (median 4 [IQR 3–6], P &lt; 0.0001). LUTD was more prevalent in the CP group, with 70.7% showing bladder and bowel dysfunction ( P &lt; 0.0001). Mean aBWT was significantly greater in the CP group (2.22 ± 0.67 mm) compared to controls (1.02 ± 0.60 mm), with a mean difference of 1.20 mm (95% confidence interval: 0.94–1.46 mm; P &lt; 0.0001). Median PVR in the CP group was 10 mL (range: 3–48 mL), compared to 6 mL (range: 2–18 mL) in controls. A moderate positive correlation was found between DVSS scores and aBWT (r = 0.617, P &lt; 0.0001). Conclusion: Children with CP demonstrated significantly higher DVSS scores, aBWT, and PVR compared to controls, consistent with increased prevalence and severity of LUTD. The use of focused non-invasive ultrasound and symptom scoring showed good feasibility and acceptability in this population.

Anastomotic leaks in colorectal surgery increase mortality, local cancer recurrence, and hospital readmission rate. The Echelon Circular Powered Stapler (PCS) is marketed to reduce anastomotic leaks by minimizing operator errors through powered systems. We reviewed current evidence on the use of PCS in left-sided colorectal anastomoses to determine if there is a reduction in anastomotic leak rates versus manual circular staplers (MCS). This study followed PRISMA guidelines. MEDLINE, EMBASE, CINAHL, and OVID review databases were searched to January 2024. A broad search strategy for PCS versus MCS in colorectal surgery was used. Abstracts were reviewed for the primary outcome of anastomotic leaks, and data were extracted from full-text review. Statistical analysis was performed using RevMan 5.4 software. 109 articles were screened, 9 studies with 3110 patients were included. No randomized control trials (RCTs) were found. In pooled and sensitivity analysis excluding studies that used historic comparators, there was no significant difference in the rates of anastomotic leak (pooled RR 0.56, 95% CI [0.27-1.18], p = 0.13; sensitivity analysis RR 0.75, 95% CI [0.32-1.77], p = 0.52). Similarly, there was no significant difference in morbidity between PCS and MCS on pooled analysis (RR 0.84, 95% [CI 0.65-1.08], p = 0.17). However, on pooled analysis, there was a significantly lower rate of post-operative bleeding with the use of PCS (RR 0.2, 95% CI [0.08-0.51], p < 0.001). The current systematic review and meta-analysis is unable to support the claim of lower leak rate with the use of PCS; however, there is preliminary evidence to indicate that powered staplers may decrease the rate of post-operative bleeding. Further evidence from RCTs investigating anastomotic leaks and bleeding rate with PCS and assessments of environmental impact should be conducted prior to the widespread use of powered staplers.

&lt;b&gt;Background:&lt;/b&gt; The exploration of simple, cost-effective, and low-risk prognostic markers, such as the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) as predictive factors for survival in diffuse large B-cell lymphoma (DLBCL) patients receiving R-CHOP therapy has become increasingly important due to the variability in results seen in prior studies.&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; This observational cross-sectional study analyzed NLR, LMR, and PLR as predictors of survival in DLBCL patients treated with R-CHOP. Data was collected from DLBCL patients from June 2017 to June 2022. All statistical analyses were performed using R version 4.2.3 using pROC package for receiver-operating characteristic curves analyses. Univariate and multivariate logistic regression analyses were performed to assess predictors’ association with overall survival (OS).&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; There were 112 DLBCL patients receiving R-CHOP, 87 were classified as surviving, while 25 were not. Univariate logistic regression analyses revealed significant associations between overall survival (OS) and IPI scores (p &amp;lt; 0.001). Conversely, gender, response to R-CHOP therapy, and hematologic indicators of NLR &amp;gt; 2.0, PLR &amp;gt; 213.4, and LMR &amp;gt; 1.1 did not show significant associations with OS. Multivariable logistic regression analysis using backward selection identified LMR (p = 0.036; 0.24 (95%CI: 0.05 to 0.84) as independent predictors for OS in DLBCL patients.&lt;br /&gt; &lt;b&gt;Conclusions:&lt;/b&gt; Our study revealed several fundamental risk factors, including extranodal involvement, ECOG performance status, LDH, and LMR, were independently associated with 2-year mortality in DLBCL patients before initiating R-CHOP therapy. However, due to the limitations of this study, further research with larger sample sizes is warranted.

Background China is experiencing rapid population aging, accompanied by a rising prevalence of type 2 diabetes mellitus (T2DM) and its complex complications. Cognitive impairment is one of the major complications of T2DM and currently lacks effective treatment. These two conditions can interact and aggravate each other, forming a vicious cycle. Objective This study aimed to identify reliable early predictors of cognitive impairment among elderly individuals with T2DM, in order to facilitate early intervention and delay disease progression. Methods A total of 202 elderly patients with T2DM hospitalized at Tianyou Hospital, affiliated with Wuhan University of Science and Technology, between May and September 2025 were enrolled. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) with a cutoff score of 26. Seventy-two participants scoring ≥26 were assigned to the normal cognition group, and 130 participants scoring ≤25 were assigned to the cognitive impairment group. Demographic information, hematological and imaging parameters, and scale scores related to sleep quality, anxiety–depression status, and activities of daily living were collected. Statistical analyses were conducted using R version 4.5. Results Least absolute shrinkage and selection operator regression selected 14 predictors. After analyzing the data, four factors remained independently associated with T2DM related cognitive impairment: age (OR = 1.96, 95% CI: 1.31–2.95, P = 0.001), HADS-D score (OR = 1.87, 95% CI: 1.25–2.80, P = 0.002), WMD (OR = 2.44, 95% CI: 1.14–5.25, P = 0.022), and HbA1c (OR = 1.53, 95% CI: 1.01–2.30, P = 0.043). The model demonstrated an AUC of 0.812 (95% CI: 0.778–0.891) and was well-calibrated (Hosmer-Lemeshow P = 0.661). After bootstrap validation, the optimism-corrected AUC was 0.751, indicating minimal overfitting. At the optimal cut-off of 0.685, the model achieved a sensitivity of 69.2% and a specificity of 81.9%, with a positive predictive value of 87.4% and a negative predictive value of 59.6%. DCA demonstrated a positive net benefit across threshold probabilities from 0.02 to 0.86, supporting the model’s clinical value. Conclusion This study developed a prediction model for T2DM related cognitive impairment in elderly Chinese patients. The model showed good discrimination, calibration, and clinical value, supporting its potential role for identifying high-risk populations. However, before using this model, more research is needed to confirm it’s performance in different people.

Background Deep infiltrating endometriosis (DIE) is a severe subtype of endometriosis, often associated with dysmenorrhea and significant diagnostic challenges. Conventional biomarkers, such as cancer antigen 125 (CA125), lack sufficient specificity for accurate DIE diagnosis. Estrogen receptor α36 (ERα36) is a novel isoform of the estrogen receptor, distinct from the classic estrogen receptor α66 (ERα66), and has been implicated in the pathogenesis of several gynecologic disorders, including breast and endometrial cancer. However, the expression pattern of ERα36 in DIE tissues and its potential role as a diagnostic biomarker for DIE have not yet been investigated. This study aimed to examine the expression of ERα36 in DIE tissues, explore its association with disease presence, and evaluate its potential as a diagnostic biomarker and a candidate for future therapeutic targeting. Methods A case-control study was conducted between 2014 and 2016, enrolling 80 DIE patients as the case group and 132 healthy women as the control group. The expression of ERα36 was evaluated at both the mRNA and protein levels: reverse transcription-polymerase chain reaction was used for mRNA expression and immunohistochemistry was performed for protein detection. Statistical analyses were performed using SPSS version 26.0, and receiver operating characteristic curve analysis was employed to assess the diagnostic performance of ERα36 for DIE. Results No significant differences were observed between control and endometriosis groups in demographic or reproductive characteristics (all P &amp;gt;0.05). ERα36 mRNA was detected in 71.2% of endometriosis tissues, compared with 36.4% of controls ( P &amp;lt; 0.01). Among 80 patients with endometriosis, ERα36 expression was observed in 57 cases and absent in 23. ERα36-positive patients exhibited younger age, higher rFAS (revised American Fertility Society) stage, more severe and longer-lasting dysmenorrhea, increased absenteeism during menstruation, greater adnexal adhesions, and a higher prevalence of DIE (all P &amp;lt; 0.05). Protein gene product 9.5 (PGP9.5) was present in eutopic endometrium, with significantly higher density in DIE lesions compared with ovarian and superficial peritoneal endometriosis ( P &amp;lt; 0.01). Notably, ERα36-positive patients showed a higher proportion of strong PGP9.5 expression than ERα36-negative patients ( P &amp;lt; 0.05). These findings indicate that ERα36 expression is associated with more severe disease phenotypes and increased neural marker expression in endometriosis, particularly in DIE. Conclusion ERα36 is highly expressed in DIE tissues and exhibits good diagnostic performance with high sensitivity and specificity. These findings suggest that ERα36 may serve as a novel tissue-level biomarker for DIE, representing a potential target for future therapeutic strategies.

Abstract This study aimed to design, develop, and evaluate prototype hands-free stethoscope chest piece holders to facilitate manual blood pressure (BP) measurement by freeing one of the operator's hands. The objective was to assess whether these prototypes could maintain measurement accuracy while improving usability and ergonomics. An iterative design process was employed, guided by Quality Function Deployment (QFD) to identify user requirements. Two prototype devices were fabricated using Material Extrusion (MEX) Additive Manufacturing (AM) with polylactic acid (PLA) material. The prototypes were tested with 19 examinees and 11 operators. BP measurements obtained using the prototypes were compared to the standard auscultatory method. Statistical analysis (ANOVA) was performed to assess accuracy, and user feedback was collected through questionnaires and qualitative analysis. Both prototypes demonstrated comparable accuracy to the standard auscultatory method, with ANOVA showing no statistically significant differences in systolic or diastolic BP measurements. User feedback indicated positive perceptions of comfort and usability, though improvements in adjustability, cushioning, and ease of use were recommended. Almost all participants recognised the potential advantages of the devices for clinical and educational applications.

The main aim of this work was to assess the influence of alcoholism on the workplace in Kerala, India. The study assessed the workplace consequences of alcohol addiction by comparing alcoholic workers with non-alcoholic workers across several indicators, including work incapacity, punctuality, wage loss due to misconduct, borrowing from colleagues, absenteeism, income loss resulting from absence, and job loss. A cross-sectional study was conducted where 210 alcoholic respondents were selected from various Alcoholics Anonymous groups through multi-stage sampling technique. The same number of non-alcoholic respondents with the same socio-economic background were also selected as control group. Statistical analysis was performed using binomial logistic regression and the Mann–Whitney U test. In this study, we observed a direct relation of alcohol addiction with the inability to work [Odds Ratio (OR) = 40.24], with not being punctual in work (OR = 7.7), and with payment loss due to misbehaviour (OR = 4.25). Similarly, the paper also revealed a direct association of alcohol addiction with monthly absence from work (U=36245.00) and with job loss (U =29706.50). Thus, alcoholism has led to a negative impact on the workplace compared to the families of non-alcoholics.

Background Diabetic neuropathy is one of the most common complications of diabetes, affecting about half of all people with the disease. Among these, 30%-50% experience nerve-related pain, characterized by abnormal sensations, burning, or stabbing pain, a condition known as painful diabetic neuropathy (PDN). PDN not only severely impairs quality of life but is also closely associated with sleep disturbances, depression or anxiety, and foot complications. Together, these problems substantially increase healthcare costs and place a considerable economic burden on both families and society. Methods We systematically searched multiple databases from their inception to 1 November 2025 to identify randomized controlled trials evaluating pregabalin combined with duloxetine for the treatment of painful diabetic neuropathy. The methodological quality and risk of bias of the included trials were assessed using the Cochrane risk-of-bias tool (version 2.0). Statistical analyses were performed with RevMan 5.4. Results Three randomized trials involving a total of 471 patients were included. In two studies that could be pooled, combination therapy produced significantly greater pain relief than monotherapy (MD=-1.82, 95%CI=-2.10, -1.54, P &amp;lt;0.00001). For secondary continuous outcomes reported in single studies, all results favored the combination, pain intensity on the visual analogue scale (VAS, MD=-1.42, 95%CI=-1.83, -1.01, P &amp;lt;0.00001), brief pain inventory-modified short form (BPI-MSF, MD=-1.46, 95%CI=-2.35, -0.57, P = 0.001), and neuropathic pain symptoms on the pain detect questionnaire (PDQ, MD=-3.00, 95%CI=-5.55, -0.45, P = 0.02). The proportion of patients achieving at least 50% pain reduction was also higher with the combination than with duloxetine 120 mg alone (RR = 1.81, 95%CI=1.17, 2.81, P = 0.008). In contrast, there were no significant differences between combination therapy and monotherapy in the overall risk of adverse events (RR = 1.10, 95%CI=0.84, 1.46, P = 0.48) or in key individual adverse effects, including somnolence (RR = 0.79, 95%CI=0.30, 2.08, P = 0.63) and nausea/vomiting (RR = 2.02, 95%CI=0.77, 5.27, P = 0.15). The certainty of evidence ranged from very low to low for most outcomes (GRADE). Conclusion Low-certainty evidence suggests that pregabalin plus duloxetine may improve short-term pain scores compared with monotherapy in painful diabetic neuropathy. Safety outcomes remain uncertain due to few trials and imprecision. Systematic review registration https://www.crd.york.ac.uk/prospero/ , identifier CRD420251179997.

The objective of this research work was to determine the yield, texture, and quality of artisan goat cheese produced in a housed and extensive grazing production system in northern Mexico. Milk from ten adult local goats, at the beginning of lactation, with an average weight of 42±2.25 kg and 2.5 births, randomly distributed in two treatments (housed n=5 and grazing n=5), was used to make cheese. The goats had an adaptation period of 14 days and were milked manually for 28 days. Yield, texture, chemical composition (concentration of fat, protein, moisture, salt, and total solids), and fatty acid profile of the cheese were evaluated. Statistical analysis was performed as a repeated measures design with the MIXED procedure. The fatty acid profile was analyzed by one-factor ANOVA with the GLM procedure and the comparison of means was performed with Tukey’s test (p&lt;0.05). There were differences between treatments, with higher values (p&lt;0.05) under the housed system for milk yield, cheese yield, fat concentration (22.281 %), protein (20.173 %), total solids (45.162 %), salt (0.966 %), saturated fatty acids (p&lt;0.001), and textural parameters (p&lt;0.05). Under grazing, there was an increase in conjugated linoleic (p&lt;0.001), cis-10-heptadecanoic (p=0.001), heptadecanoic acid (p=0.001), acid oleic (p&lt;0.001), elaidic (p&lt;0.001), and α-linolenic (p&lt;0.001) acids. It is concluded that the extensive grazing production system offers better benefits regarding nutritional quality of cheese, highlighting conjugated linoleic acid and milk fat, although with a negative effect on milk production. By linking product quality to husbandry practices and breed resources, the research provides an evidence base for reinforcing traditional cheese making as a driver of economic resilience, cultural continuity, and agro ecosystem sustainability in northern Mexico.

This study examines the influence of external auditors’ organizational commitment on the job satisfaction of Zakat and Tax examiners. The research aims to identify the organizational factors within audit firms that contribute to enhancing professional satisfaction and improving the effectiveness of audit and tax examination processes. A descriptive–analytical methodology was adopted, and data were collected through a structured questionnaire distributed to external auditors, Zakat and Tax Authority employees, and company managers, yielding 180 valid responses. Statistical analyses, including correlation, multiple regression, Kruskal–Wallis, and Mann–Whitney tests, were employed to assess the relationships among the study variables.The results revealed that most dimensions of organizational commitment (X1–X10) have positive and statistically significant effects on job satisfaction across the three professional groups. Independence, compliance with professional standards, professional reputation, and experience emerged as the strongest predictors. While most variables showed consistent perceptions across groups, significant differences were observed regarding audit firm size. The findings confirm the validity of the proposed quantitative model and highlight the importance of organizational commitment in improving job satisfaction and strengthening cooperation between external auditors and tax examiners.The study concludes that enhancing organizational and administrative environments within audit firms contributes to more effective auditing and tax assessment processes, ultimately supporting higher performance quality within the Zakat and Tax sector.

Purpose : to determine the value and labour orientations of Russian youth in the context of current modernization of the society. Methods : the methodology is based on the integrated application of general scientific methods (analysis, synthesis, systems approach) and specialized sociological techniques. The empirical base consisted of a survey of the representative sample of Penza Oblast youth followed by a statistical data analysis, comparative intergenerational analysis of semi-structured interviews with the youth to identify qualitative characteristics of value transformations. Result s: the study confirms the adaptive transformation of traditional orientations across different generations of youth in the context of economic modernization and digitalization. It clarifies the mechanism for selective continuity of values, ensuring the integration of traditional attitudes into modern work strategies without losing core cultural patterns. Conclusions and Relevance : the study refutes the hypothesis of generational conflict of values, demonstrating adaptive transformation of traditional youth orientations. Synthesis of traditional (stability, duty, respect) and modern (flexibility, self-realization) values is identified, shaping work strategies without breaking with cultural patterns. An evolution of value orientations is established, from idealism (Generation A) through pragmatism (Z) to ethical-practical synthesis (Y), reflecting natural process of socialization. The results provide an analytical basis for developing targeted public policy in education, human resources management, and implementation of national projects, considering value profiles of young people. The research prospects include studying the mechanisms of adaptive value transformation, analyzing the translation of traditional patterns in the digital environment, and comparative studies of intergenerational dynamics in different sociocultural contexts.

High-frequency (HF) skywave propagation relies on the ionosphere, making it susceptible to ionospheric variability. This study analyzes long-term Doppler residual measurements of a 10 MHz HF link between Fort Collins, CO, and Newark, NJ, to characterize the impact of ionospheric conditions on the link. We report that daytime measurements of Doppler variability exhibit Cauchy statistics, while nighttime measurements show a combination of exponential and log-normal statistics. These patterns correlate with solar activity and solar zenith angle. We also use PHaRLAP numerical ray tracing simulations through the IRI 2020 ionosphere to provide insights into signal ray paths and the altitudes of the ionosphere contributing to the observed Doppler shifts. By examining diurnal variations and statistical properties of Doppler residuals, this study aims to enhance our understanding of ionospheric dynamics and their influence on HF signal characteristics.

In this study, attempts are made to utilize the deep reinforcement learning (DRL)-based models for predicting stock market and investment strategy optimization. We compare three DRL architectures, Deep Q-Network (DQN), Double Deep Q-Network (Double DQN) and Dueling Deep Q-Network (Dueling DQN), on the Pakistan Stock Exchange. We adopt an empirical approach from a set of 30 stocks in combination with descriptive statistical analysis to evaluate representativeness. The results indicate that the three kinds of models can all earn positive profits and Double DQN maintains the most average profits in both training dataset and test dataset. We then attempt to mitigate the potential overfit and analyze implications for trading strategies. In addition, we consider personality and nonconvex heuristic money and risk management in a mathematical agent-based model to study the foraging behavior of a population of interacting, moving agents in an assigned background.

Abstract Large-scale filaments ubiquitously exist in the Galactic interstellar medium, and their radial profiles offer insights into their formation mechanisms. We present a statistical analysis of molecular hydrogen column density (N(H 2 )) and dust temperature ( T d ) radial profiles for 35 Galactic large-scale filaments. We divided their spines into 315 segments, extracted the radial profiles of each segment using N(H 2 ) and T d maps derived from Herschel Hi-GAL data, and estimated the asymmetry degree within the radial profiles ( α asy ), as well as the length proportion of segments with asymmetric profiles across the entire filament ( f asy ). We found that Galactic large-scale filaments reside in surroundings distinctly asymmetric and varied in N(H 2 ), and mildly asymmetric yet stable in T d . Different filament morphology types do not show significant differences in α asy or f asy . A bent filament shape does not necessarily correspond to an asymmetric radial profile, whereas a straight filament shape may be associated with a symmetric profile. Segments with asymmetric surroundings in N(H 2 ) may not simultaneously appear asymmetric in T d , and vice versa. We found three filaments with 4%–44% of their spine show asymmetric N(H 2 ) and T d radial profiles in inverse trends, likely caused by a nearby H ii region. H ii regions of similar scale to large filaments can induce asymmetric radial profiles within them, indicating their influence on filament evolution. However, they are unlikely to independently trigger the formation of an entire Galactic large-scale filament, in contrast to their role in small-scale filament formation.

Polycyclic aromatic hydrocarbons (PAHs) are long-lasting organic pollutants which have toxic, mutagenic, and carcinogenic effects, making them of significant concern for both environmental and human health. This study determined the PAH levels in soils around the Rajiv Gandhi Thermal Power Plant, Khedar, Hisar (Haryana, India). Among 16 USEPA PAHs, 9 were detected. Descriptive statistics used in the study revealed that the concentration of Σ9PAHs in soils varied from 3354 to 44,648μgkg-1 with a mean of 7513.51μgkg-1. Diagnostic ratios (LMW/HMW = 0.61) revealed the prevalence of high-molecular-weight (HMW) PAHs, which validated a signature of combustion. The correlation patterns suggested a common pyrogenic source for most of the PAHs, with DahA suggesting another, sporadic one. PCA revealed two major source categories, coal-fired emissions and traffic contributions. Overall, the study reveals that 39 soil samples collected from the agricultural lands around the thermal power plant are dominated by high-molecular-weight PAHs. The lack of a big traffic route, as well as industrial activities in the area, indicates little impact from other sources. As a result, the PAH profile is primarily explained by pyrogenic sources, which can be attributed to the emissions from the thermal power plant. The ecological and carcinogenicity risks of PAHs in soils surrounding the RGTPP area were assessed by applying the risk quotient approach and the toxic equivalency approach. Some of the PAHs had risk levels above safe levels, and when they are combined, the ecological threat is very high. There is an imperative necessity for strategic management and remediation of the PAH polluted soil in the surroundings of RGTPP.

Background: Hemophilia A is an inherited bleeding disorder characterized by factor VIII deficiency that frequently leads to recurrent hemarthrosis, resulting in joint pain, swelling, and progressive musculoskeletal dysfunction. Physiotherapy plays an important role in managing hemophilic arthropathy; however, evidence comparing the effectiveness of different therapeutic modalities remains limited. Objective: To compare the effects of therapeutic ultrasound and infrared therapy, combined with conventional physiotherapy, on pain, swelling, range of motion, and joint health in patients with Hemophilia A experiencing hemarthrosis. Methods: A randomized clinical trial was conducted involving 30 male patients with Hemophilia A recruited from a specialized hemophilia care center. Participants were randomly assigned to an ultrasound group (n = 15) or an infrared therapy group (n = 15). Both groups received conventional physiotherapy consisting of range-of-motion exercises, isometric strengthening, and stretching for four sessions per week over four weeks. Outcome measures included the Numerical Pain Rating Scale (NPRS), Hemophilia Joint Health Score (HJHS), joint swelling measured by circumferential tape measurement, and joint range of motion assessed using a goniometer. Non-parametric statistical analyses were performed using Mann–Whitney U and Wilcoxon signed-rank tests with significance set at p &lt; 0.05. Results: Both treatment groups demonstrated improvements in pain, swelling, and joint mobility after intervention. The ultrasound group showed greater reductions in severe pain (93.3% to 0%), higher rates of swelling resolution (73.3% reporting no swelling), and significantly greater improvement in flexion limitation compared with the infrared group (p = 0.011). Improvements in extension range of motion and muscle atrophy were observed in both groups but were not statistically different. Conclusion: Therapeutic ultrasound demonstrated superior effectiveness compared with infrared therapy in reducing pain, resolving swelling, and improving joint mobility in patients with Hemophilia A with hemarthrosis, supporting its use as a preferred adjunct modality in physiotherapy-based rehabilitation

The hardening soil small-strain (HSS) model is widely recognized for its ability to simulate complex soil stress paths, leading to improved prediction accuracy in geotechnical engineering. However, its practical application is often hindered by the large number of required parameters and their significant regional variability, making determination costly and time-consuming. To address this, we propose a machine learning-based framework for efficient determination of locality-specific HSS parameters. The method begins with a statistical analysis of parameter ratios relative to the compression modulus [Formula: see text] to identify sensitive and non-sensitive parameters. For sensitive parameters with high regional variability, a parameter sampling design is implemented within established value ranges. A BP neural network is then trained to establish a nonlinear mapping between parameter combinations and foundation pit displacements, enabling intelligent inverse analysis. The proposed method is applied to typical strata in Qingdao, China-plain fill, silty clay, and medium-fine sand-where regional HSS parameters were previously unavailable. Through validation with two independent cases, numerical simulations using inversion parameters showed a high consistency with on-site monitoring data: the root mean square error (RMSE) for both the lateral displacement of the retaining structure and ground settlement was below 0.51mm, and the mean absolute error was below 0.4mm. The key inversion parameter ratios for the Qingdao region have been determined as follows: the results show that the values of HSS parameters in Qingdao obtained by machine learning are as follows: [Formula: see text]:[Formula: see text]:[Formula: see text]:[Formula: see text]:[Formula: see text] can be taken as 5.24:4.64:1:1:1 for plain fill; 14.74:6.00:1:1:1 for silty clay; and 11.50:5.02:1:1:1 for medium-fine sand.