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In the Internet of Things (IoT) healthcare sector, the wireless body area network (WBAN) is being used to optimize medical results by tracking and treating patients as they go about their daily lives. Health insurance has also been one of the cybercriminal's main goals. The Systematic Review of IoT Healthcare systems particularly wireless body area networks is significant, to reach the benefits and challenges faced by existing methods in the domain. This study provides a systematic survey of WBAN data protection. Various types of devices are used in medical science to detect and diagnose diseases. The network is an integral part of medical science in today's era. In medical sciences, sensors take data from a problematic place like cancerous cells. This research discussed a lot of techniques in the literature review. Most of them are not able to fulfill the requirements. If an unauthorized person reaches the data that can be a severe issue, like the diagnosed disease was blood cancer, and after unauthorized access manipulation can change even the diagnosed issue in the database. A doctor can prescribe the medication based on provided data that has been manipulated by unauthorized persons. Several existing schemes are explored in the literature to determine how the protection of sharing patients' healthcare data can be improved. The systematic literature review (SLR) of multiple security schemes for WBAN is presented in this survey paper.
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This article presents the data obtained from a Systematic Literature Review (SLR) on the use of metaverse and extended technologies for immersive journalism [1]. Boolean operators, both in English and Spanish, were used to retrieve scientific literature using Publish or Perish 8 software on Scopus, Web of Science and Google Scholar between 2017 and 2022. After finding all the scientific literature, a methodological process was carried out using selection criteria and following the PRISMA model to obtain a total sample of 61 scientific articles. The DESLOCIS framework was used for the evaluation and quantitative and qualitative analysis of the retrieved data. The first dataset [2] contains the metadata of the retrieved publications according to the phases of the PRISMA statement. The second dataset [3] contains the characteristics of these publications according to the DESLOCIS framework. The data offer the possibility to develop new longitudinal studies and meta-analyzes in the field of immersive journalism.
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Despite their critical roles in genetic sex determination, sex chromosomes remain unknown in many non-model organisms, especially those having recently evolved sex-linked regions (SLRs). These evolutionarily young and labile sex chromosomes are important for understanding early sex chromosome evolution but are difficult to identify due to the lack of Y/W degeneration and SLRs limited to small genomic regions. Here, we present SLRfinder, a method to identify candidate SLRs using linkage disequilibrium (LD) clustering, heterozygosity and genetic divergence. SLRfinder does not rely on specific sequencing methods or a specific type of reference genome (e.g., from the homomorphic sex). In addition, the input of SLRfinder does not require phenotypic sexes, which may be unknown from population sampling, but sex information can be incorporated and is necessary to validate candidate SLRs. We tested SLRfinder using various published datasets and compared it to the local principal component analysis (PCA) method and the depth-based method Sex Assignment Through Coverage (SATC). As expected, the local PCA method could not be used to identify unknown SLRs. SATC works better on conserved sex chromosomes, whereas SLRfinder outperforms SATC in analysing labile sex chromosomes, especially when SLRs harbour inversions. Power analyses showed that SLRfinder worked better when sampling more populations that share the same SLR. If analysing one population, a relatively larger sample size (around 50) is needed for sufficient statistical power to detect significant SLR candidates, although true SLRs are likely always top-ranked. SLRfinder provides a novel and complementary approach for identifying SLRs and uncovering additional sex chromosome diversity in nature.
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Desequilíbrio de Ligação , Cromossomos Sexuais , Cromossomos Sexuais/genética , Biologia Computacional/métodos , Animais , Masculino , Feminino , Análise por ConglomeradosRESUMO
INTRODUCTION: We evaluated a potential move from one rapid-acting insulin analog to another, or their biosimilars, to aid better and faster decisions for diabetes management. METHODS: A systematic literature review was performed according to PRISMA reporting guidelines. The MEDLINE/EMBASE/COCHRANE databases were searched for randomized control trials (RCTs) comparing aspart/lispro in type-1 (T1D) and type-2 (T2D) diabetes. The methodological quality of the included studies was assessed using the Cochrane Collaboration's risk of bias assessment criteria. RESULTS: Of the 753 records retrieved, the six selected efficacy/safety RCTs and the additional three hand-searched pharmacokinetics/pharmacodynamics RCTs showed some heterogeneity in the presentation of the continuous variables; however, collectively, the outcomes demonstrated that lispro and aspart had comparable efficacy and safety in adult patients with T1D and T2D. Both treatments yielded a similar decrease in glycated hemoglobin (HbA1c) and had similar dosing and weight changes, with similar treatment-emergent adverse events (TEAE) and serious adverse event (SAE) reporting, similar hypoglycemic episodes in both T1D and T2D populations, and no clinically significant differences for hyperglycemia, occlusions or other infusion site/set complications. CONCLUSIONS: Aspart and lispro demonstrate comparative safety and efficacy in patients with T1D/T2D. Since both are deemed equally suitable for controlling prandial glycemic excursions and both have similar safety attributes, they may be used interchangeably in clinical practice. PROSPERO REGISTRATION NUMBER: CRD42023376793.
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Hipoglicemiantes , Insulina Aspart , Insulina Lispro , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Insulina Lispro/uso terapêutico , Insulina Lispro/farmacocinética , Insulina Lispro/efeitos adversos , Insulina Aspart/uso terapêutico , Insulina Aspart/farmacocinética , Insulina Aspart/efeitos adversos , Insulina Aspart/administração & dosagem , Hipoglicemiantes/efeitos adversos , Hipoglicemiantes/uso terapêutico , Hipoglicemiantes/farmacocinética , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Resultado do Tratamento , Hemoglobinas Glicadas/metabolismo , Glicemia/efeitos dos fármacos , Glicemia/metabolismoRESUMO
PURPOSE: The aim of PRISTINE was to evaluate the 6 and 12 months safety and efficacy of the Selution Sustained Limus Release (SLR)™ sirolimus-coated balloon for treatment of complex lower limb occlusive lesions (TASC II C & D) in patients with chronic limb threatening ischemia (CLTI) from Singapore. METHODS: PRISTINE was a prospective, non-randomized, single arm, observational, multi-investigator, single-center clinical study. Complication-free survival at 30 days was the safety clinical endpoint. Immediate technical success (ability to cross and dilate the lesion and achieve residual angiographic stenosis < 30%), 6-month primary vessel patency, limb salvage, clinically driven target lesion revascularization (TLR) and amputation free survival (AFS) were the efficacy endpoints of interest. RESULTS: Seventy five patients were included. There were 50 (68.0%) males; mean age, 69.0 ± 10.7 years. CLTI severity was based on the Rutherford Scale (R5 = 51; R6 = 17). Significant co-morbidities included diabetes mellitus (n = 68; 91.0%) and end-stage renal failure (n = 28; 37.0%). 112 atherosclerotic lesions were treated (TASC II D = 58 (52%); 76 (67%) de novo). There was 100% technical success. Mean lesion length treated was 22.4 ± 13.9 cm. Primary vessel patencies at 6 and 12 months were 64/86 (74%) and 43/74 (58%) and freedom from clinically driven TLR were 72/86 (84%) and 55/74 (74%) respectively. AFS was 61/73 (84.0%; five deaths and seven major lower extremity amputation) at 6-months. Mean Rutherford score improved from 5.1 ± 0.55 at baseline to 1.1 ± 2.05 (p < 0.05) at one year and there was a wound healing rate of 38/48 (79%) at the same timepoint. CONCLUSIONS: The Selution SLR™ drug eluting balloon is safe and efficacious in treating highly complex infra-inguinal atherosclerotic lesions in an otherwise challenging frail population of CLTI patients with a high incidence of diabetes and end-stage renal failure. It is associated with highly satisfactory acute technical and clinical success, 12-month target lesion patency and AFS. LEVEL OF EVIDENCE: Level 2b, Individual Cohort Study.
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Sistema de Registros , Sirolimo , Humanos , Masculino , Feminino , Idoso , Singapura , Estudos Prospectivos , Sirolimo/administração & dosagem , Resultado do Tratamento , Angioplastia com Balão/métodos , Pessoa de Meia-Idade , Salvamento de Membro/métodos , Isquemia Crônica Crítica de Membro , Isquemia/terapia , Extremidade Inferior/irrigação sanguíneaRESUMO
Although the investigation of mental health and wellbeing in education has shown an exponential increase on an international scale, attention has primarily been paid to students, leaving the concept of teacher wellbeing comparatively overlooked. Extant literature offers numerous divergent descriptions, with some academics even avoiding an explicit definition of the term. Thus, there are limitations and inconsistencies in understanding teacher wellbeing as a unique construct. The aim of the current study was three-fold; (1) to assess the extent to which existing research reflects the multidimensional nature of the term teacher wellbeing, (2) to determine whether a holistic construct of teacher wellbeing could be justified, and (3) to evaluate the methodological quality of studies identified. A systematic review following the PRISMA statement was applied to peer-reviewed papers published between 2016 and 2021. Following the screening of 1,676 studies, this paper reports on findings drawn from a final sample of 61 articles conceptualizing teacher wellbeing. Studies were organized by their dominant discourses, namely negativity/ deficiency, positivity/ flourishing, and/or professionalism. Findings illustrate that teacher wellbeing was primarily conceptualized with a professionalism approach (with 18 of the identified studies taking solely this perspective). This is not completely consistent with the prior work that focused on stress and burnout (negativity/ deficiency approach) while exploring teachers' mental health and wellbeing. More importantly, there were only 6 studies that considered all three discourses together. This paper argues that important information is lost through neglecting alternative lenses, requiring further attention in order to address teacher wellbeing comprehensively. Such an endeavor is essential for shaping interventions and strategies aimed not only at enhancing teacher wellbeing but also at improving student outcomes and, ultimately, the overall quality of education. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021278549PROSPERO, CRD42021278549.
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OBJECTIVES: Chronic viral hepatitis is associated with severe impairment and reduction in patient health-related quality of life because of the substantial morbidity associated with advanced liver disease. The aim of this study was to identify and synthesize utilities for chronic hepatitis B (cHBV), C (cHCV), and D (cHDV) through a systematic literature review (SLR) and meta-analyses. METHODS: Electronic databases were searched from inception to May 2023 to identify primary studies reporting health-state utilities in English in patients aged 18 years and over, with cHBV, cHCV, or cHDV in the United States, the United Kingdom, Europe, Canada, Australia, or New Zealand. Meta-analyses were conducted for studies reporting a measure of uncertainty; model selection (fixed and random) was based on the observed levels of heterogeneity among studies. RESULTS: A total of 24 studies met the inclusion criteria and were included in the meta-analyses. More studies meeting the inclusion criteria reported utilities for cHCV (n = 20) than for cHBV (n = 8); no studies reported utility values for cHDV. Although mean utilities were higher for cHBV compared with cHCV for any given health state, utilities decreased with disease progression toward cirrhosis health states. Meta-analyses in cHCV found a utility decline of 0.1 and 0.03, based on progression from noncirrhosis to compensated cirrhosis and for decompensation in established cirrhosis, respectively. CONCLUSIONS: Chronic viral hepatitis is associated with a considerable impairment in health-related quality of life. Despite our findings, there is a need for more evidence on the lived experience in patients living with chronic hepatitis, notably in cHBV and cHDV.
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The automatic speech identification in Arabic tweets has generated substantial attention among academics in the fields of text mining and natural language processing (NLP). The quantity of studies done on this subject has experienced significant growth. This study aims to provide an overview of this field by conducting a systematic review of literature that focuses on automatic hate speech identification, particularly in the Arabic language. The goal is to examine the research trends in Arabic hate speech identification and offer guidance to researchers by highlighting the most significant studies published between 2018 and 2023. This systematic study addresses five specific research questions concerning the types of the Arabic language used, hate speech categories, classification techniques, feature engineering techniques, performance metrics, validation methods, existing challenges faced by researchers, and potential future research directions. Through a comprehensive search across nine academic databases, 24 studies that met the predefined inclusion criteria and quality assessment were identified. The review findings revealed the existence of many Arabic linguistic varieties used in hate speech on Twitter, with modern standard Arabic (MSA) being the most prominent. In identification techniques, machine learning categories are the most used technique for Arabic hate speech identification. The result also shows different feature engineering techniques used and indicates that N-gram and CBOW are the most used techniques. F1-score, precision, recall, and accuracy were also identified as the most used performance metric. The review also shows that the most used validation method is the train/test split method. Therefore, the findings of this study can serve as valuable guidance for researchers in enhancing the efficacy of their models in future investigations. Besides, algorithm development, policy rule regulation, community management, and legal and ethical consideration are other real-world applications that can be reaped from this research.
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INTRODUCTION: Health technology assessment (HTA) agencies express a clear preference for randomized controlled trials when assessing the comparative efficacy of two or more treatments. However, an indirect treatment comparison (ITC) is often necessary where a direct comparison is unavailable or, in some cases, not possible. Numerous ITC techniques are described in the literature. A systematic literature review (SLR) was conducted to identify all the relevant literature on existing ITC techniques, provide a comprehensive description of each technique and evaluate their strengths and limitations from an HTA perspective in order to develop guidance on the most appropriate method to use in different scenarios. METHODS: Electronic database searches of Embase and PubMed, as well as grey literature searches, were conducted on 15 November 2021. Eligible articles were peer-reviewed papers that specifically described the methods used for different ITC techniques and were written in English. The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: A total of 73 articles were included in the SLR, reporting on seven different ITC techniques. All reported techniques were forms of adjusted ITC. Network meta-analysis (NMA) was the most frequently described technique (in 79.5% of the included articles), followed by matching-adjusted indirect comparison (MAIC) (30.1%), network meta-regression (24.7%), the Bucher method (23.3%), simulated treatment comparison (STC) (21.9%), propensity score matching (4.1%) and inverse probability of treatment weighting (4.1%). The appropriate choice of ITC technique is critical and should be based on the feasibility of a connected network, the evidence of heterogeneity between and within studies, the overall number of relevant studies and the availability of individual patient-level data (IPD). MAIC and STC were found to be common techniques in the case of single-arm studies, which are increasingly being conducted in oncology and rare diseases, whilst the Bucher method and NMA provide suitable options where no IPD is available. CONCLUSION: ITCs can provide alternative evidence where direct comparative evidence may be missing. ITCs are currently considered by HTA agencies on a case-by-case basis; however, their acceptability remains low. Clearer international consensus and guidance on the methods to use for different ITC techniques is needed to improve the quality of ITCs submitted to HTA agencies. ITC techniques continue to evolve quickly, and more efficient techniques may become available in the future.
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Background: Oncologists are prescribing checkpoint inhibitors with greater frequency, and an awareness of and ability to recognize immune-related adverse events (irAEs) is a key part of the safe administration of these drugs. Case Description: Herein, we report the case of a 26-year-old male diagnosed with de novo metastatic right-sided colon cancer to the liver, with tumor immunohistochemistry demonstrating loss of MSH2 and MSH6, and a pathogenic mutation in MSH2 identified on germline testing, consistent with Lynch Syndrome. The patient received first-line treatment with pembrolizumab. Following 7 months of immune checkpoint blockade (ICB), new pulmonary findings on routine imaging were felt to be concerning for disease progression, despite ongoing excellent clinical status, disease control in the liver, and stable tumor markers. An endobronchial biopsy of one of the mediastinal lymph nodes demonstrated granulomatous inflammation consistent histologically with sarcoidosis, and a diagnosis of sarcoid-like reaction (SLR) secondary to immunotherapy was established. Pembrolizumab was discontinued, and the patient continued active monitoring off of active therapy, with durable cancer control. After 8 months of watchful waiting, new hepatic lesions and increasing abdomino-pelvic lymphadenopathy were identified on imaging, concerning for progression of disease. Inguinal lymph node biopsy demonstrated findings consistent with ongoing SLR. The patient remains with durable cancer control, now 24 months since receipt of ICB. In addition, he remains asymptomatic of the SLR. Conclusions: This case highlights the propensity of SLRs to imitate progression of disease, and the importance of awareness of this adverse effect, to prompt appropriate investigation and management.
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Introduction: The purpose of this study is to provide an overview of extant research regarding XR technology and its effect on consumer wellbeing. With the hopes of informing marketing practitioners on XR consumer psychology, in preparation for the Metaverse. Methods: To achieve the above aim, two types of analysis took place. Firstly, a bibliometric analysis was conducted which was then followed by a framework-based structured literature review. The latter entailed an analysis of 81 articles evaluated from a positive psychological approach. Findings: Following the TCCM framework, the analysis revealed the most common psychological theories demonstrating potential avenues for XR to impact consumer wellbeing. Moreover, researchers found preliminary links between, theory, characteristics, and contexts. Giving a preliminary description of how theory manifests into reality. Finally, the overview of extant literature was used to propose new avenues for future research pertaining to marketing, the Metaverse, and consumer effects. Conclusion: In conclusion, the paper provides stakeholder insights which can ensure minimal consumer risk and sustainable use of the XR technology and Metaverse. While addressing the need for more research that uncovers the psychological effects of emerging technologies, so to prepare for the Metaverse. This is especially important when considering the current upsurge of these technologies and the uncertainties associated with their novelty and the idea of an 'always on' consumer.
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This paper systematically and critically reviews the literature on the intersection of circular economy practices (CEPs) and sustainability performance (SP). We synthesize and analyze the extant literature to uncover the knowledge gaps, highlight the contradictory views, and provide a comprehensive overview of the field. Following a detailed database search, we selected 104 empirical studies published in peer-reviewed journals for analysis. Our review reports the publication trends, top publishing journal outlets, research methodologies, and empirical contexts. We outline the theoretical underpinnings, identify the diverse circular economy practices and the key factors that impact circular economy practices and sustainable performance. The review shows a propensity for most authors to reuse established theories or not use theory at all, revealing the need for theory development. Furthermore, our analysis revealed that R&D and innovation, digital technologies, organizational capabilities/resources, and stakeholder and institutional pressure substantially influence the CEPs - SP relationship. Through our detailed assessment of the existing literature, we identified and proposed several themes and avenues for future research.
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Conservação dos Recursos Naturais , Desenvolvimento SustentávelRESUMO
It is imperative to assess coastal vulnerability to safeguard coastal areas against extreme events and sea-level rise. In the Niger Delta region, coastal vulnerability index assessment in the past focused on open-access parameters without comparing the open-access parameters, especially coastal elevation and shoreline change. This sensitivity to the shoreline method and open-access coastal elevation limits the information for the planning of coastal adaptation. The area under investigation is the Niger Delta, which is distinguished by its low-lying coastal plains and substantial ecological and economic significance. In light of the selected parameters, Sentinel-1 GRD images from 2015 to 2022 during high tidal conditions were used to delineate the shoreline position and change rate. Also, different open-access DEMs were used to derive the coastal elevation using the Geographic Information System (GIS) approach. The study employs 5 parameters, such as shorelines obtained from Sentinel-1 SAR images and several Digital Elevation Models (DEMs), geomorphology, mean sea level rise, significant wave height, and mean tide range, in conjunction with the initial Coastal Vulnerability Index (CVI) approach. The study reveals that the type of DEM used significantly influences the coastal elevation ranking and, subsequently, the CVI. Differences in shoreline change rate estimation methods (EPR and LRR) also impact the vulnerability rankings but to a lesser extent. The findings highlight that 40.1% to 58.9% of the Niger Delta coastline is highly or very highly vulnerable to sea-level rise, depending on the shoreline change rate or DEM used. The study underscores the potential of using CVI methods with open-access data in data-poor countries for identifying vulnerable coastal areas that may need protection or adaptation. Lastly, it points out the need for higher resolution DEMs.
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This study aimed to find a unique method to assess the textural properties of Niangao (glutinous rice cakes), to determine the relationship between the textural properties of rice cakes and the indicators of glutinous rice, and to identify the key indicators that significantly affect the textural properties of Niangao. The study encompassed the analysis of the chemical composition and pasting characteristics of 22 glutinous rice varieties, revealing the substantial impact of variety on lipid content, straight-chain starch content, and pasting performance. Subsequently, the textural features of the resulting Niangao were subjected to principal component analysis (PCA) to derive a mathematical method for evaluating their textural attributes, with the obtained scores employed in hierarchical cluster analysis (HCA) to identify 12 key textural characteristics. Further analysis using stepwise linear regression (SLR) demonstrated that the regression model incorporating final and peak viscosities of the glutinous rice significantly predicted the composite score of the Niangao's textural properties. This highlights the importance of final and peak viscosities as key indicators for assessing the textural quality of Niangao.
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In the present study, a systematic literature review (SLR) is conducted to collect, compile, and summarize the findings of previous studies in a meaningful and systematic way. This review focuses on the ideal blending ratios, mixing parameters, and the physical, thermal, and rheological performance of waste plastic-modified asphalt. It highlights the most significant research results about the challenges like phase separation, low-temperature performance, and workability for waste plastic-modified asphalt and progress in this domain. The results point out that the use of chemical and physical additives can help in the reduction of phase separation. Furthermore, this paper debates the aging characteristics and it was seen that the integration of waste plastic in asphalt has shown to slow down the aging process of the binder. The review article put forward details of various field projects across the globe utilizing waste plastic. The review concludes by presenting key findings, identifying research gaps, and suggesting future directions to advance the knowledge and to fully comprehend the possible application of waste plastic-modified bitumen in sustainable road construction.
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Hidrocarbonetos , Plásticos , Reologia , Plásticos/química , Hidrocarbonetos/químicaRESUMO
Cyanobacteriochromes (CBCRs) are linear tetrapyrrole bilin-binding photoreceptors of cyanobacteria that exhibit high spectral diversity, gaining attention in optogenetics and bioimaging applications. Several engineering studies on CBCRs were attempted, especially for designing near-infrared (NIR) fluorescent proteins with longer fluorescence wavelengths. However, despite continuous efforts, a key component regulating fluorescence emission property in CBCRs is still poorly understood. As a model system, we focused on red/green CBCR Slr1393g3, from the unicellular cyanobacterium Synechocystis sp. PCC 6803 to engineer Pr to get far-red light-emitting property. Energy profiling and pairwise structural comparison of Slr1393g3 variants effectively reveal the mutations that are critical to the fluorescence changes. H497 seems to play a key role in stabilizing the chromophore environment, especially the α3 helix, while H495, T499, and Q502 are potential key residues determining fluorescence emission peak wavelength. We also found that mutations of α2 and α4 helical regions are closely related to the chromophore binding stability and likely affect fluorescence properties. Taken together, our computational analysis suggests that the fluorescence of Slr1393g3 is mainly controlled by the stabilization of the chromophore binding pocket. The predicted key residues potentially regulating the fluorescence emission property of a red/green CBCR will be advantageous for designing improved NIR fluorescent protein when combined with in vitro molecular evolution approaches.
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Cianobactérias , Luz , Fluorescência , Cianobactérias/química , Proteínas de Bactérias/químicaRESUMO
The crosstalk between gibberellin (GA) and abscisic acid (ABA) signaling is crucial for balancing plant growth and adaption to environmental stress. Nevertheless, the molecular mechanism of their mutual antagonism still remains to be fully clarified. In this study, we found that knockout of the rice NAC (NAM, ATAF1/2, CUC2) transcription factor gene OsNAC120 inhibits plant growth but enhances drought tolerance, whereas OsNAC120 overexpression produces the opposite results. Exogenous GA can rescue the semi-dwarf phenotype of osnac120 mutants, and further study showed that OsNAC120 promotes GA biosynthesis by transcriptionally activating the GA biosynthetic genes OsGA20ox1 and OsGA20ox3. The DELLA protein SLENDER RICE1 (SLR1) interacts with OsNAC120 and impedes its transactivation ability, and GA treatment can remove the inhibition of transactivation activity caused by SLR1. On the other hand, OsNAC120 negatively regulates rice drought tolerance by repressing ABA-induced stomatal closure. Mechanistic investigation revealed that OsNAC120 inhibits ABA biosynthesis via transcriptional repression of the ABA biosynthetic genes OsNCED3 and OsNCED4. Rice OSMOTIC STRESS/ABA-ACTIVATED PROTEIN KINASE 9 (OsSAPK9) physically interacts with OsNAC120 and mediates its phosphorylation, which results in OsNAC120 degradation. ABA treatment accelerates OsNAC120 degradation and reduces its transactivation activity. Together, our findings provide evidence that OsNAC120 plays critical roles in balancing GA-mediated growth and ABA-induced drought tolerance in rice. This research will help us to understand the mechanisms underlying the trade-off between plant growth and stress tolerance and to engineer stress-resistant, high-yielding crops.
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Oryza , Oryza/genética , Resistência à Seca , Proteínas de Plantas/genética , Giberelinas/metabolismo , Plantas Geneticamente Modificadas/genética , Plantas Geneticamente Modificadas/metabolismoRESUMO
Background: Pulmonary resection can present technical challenges for surgeons due to the dissection and closure of tissues, which vary in thickness and elastic properties, occasionally leading to prolonged air leaks. Staple line reinforcements (SLRs) are widely utilized tools for fortifying the stability and integrity of closures in thoracic surgery, however, materials available and ease of use for both surgeon and scrub nurse have been suboptimal. A novel "click-and-go" device pre-loaded with bioabsorbable buttress material was recently developed, the Echelon Endopath SLR (ESLR, Ethicon, Inc., Cincinnati, OH, USA). This prospective study examines the safety and efficacy of this novel device in lung resections. Methods: Adult surgical candidates undergoing primary pulmonary resection (both open and thoracoscopic) where the ESLR would be used were enrolled. Exclusion included reoperation/revision in same anatomical location, hypersensitivity to polyglactin or related products, and body mass index (BMI) ≥46.0 kg/m2. The primary endpoint assessed the incidence of specific device-related adverse events (AEs): prolonged air leak and empyema. Additional endpoints included number of devices replaced during surgery due to slippage or bunching, and surgeon-reported usability responses. Data was summarized for AEs deemed device-related and usability questionnaire responses. Results: A total of 131 subjects were included in the primary endpoint analysis data set with 120 subjects completing the study (91.6%). The mean age at consent was 62.8±12.0 years and 55.7% were female. The most common primary indication for the procedure was malignancy 61.1%, and primary non-malignant lung disease (non-chronic obstructive pulmonary disease) 12.2%. Common procedures performed were wedge resection (58.0%) and lobectomy (34.4%). There were zero reported device-specific/-related AEs which counted toward the primary endpoint. Responses from a usability questionnaire found all surgeons (100.0%) reported the ease of setup was superior to previous devices utilized. Surgeons expressed greater confidence in the buttress material of the ESLR than that of previous SLR devices (strongly agree 88.9%; slightly agree 11.1%). Most also felt that there was less wastage with the click-and-go ESLR (strongly agree 77.8%, slightly agree 11.1%, neutral 11.1%). Conclusions: The ESLR device demonstrates safe and effective performance in this post-market study of specific thoracic procedures. Furthermore, surgeons found this was easier to use.
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This study conducts a semi-systematic literature review of research pertaining to employability to identify essential employability skills that employers seek in recent graduates. The comprehensive analysis of the existing literature review aims to present a set of global employability skills, identify similarities, variations, or changes in these skills across time, and explore the most relevant existing employability skills for the 21st-century workplace. The review includes 30 years of research articles and government reports published in English and considers 25 studies based on the Scientific Procedures and Rationales for Systematic Literature Reviews (SPAR-4-SLR). After removing duplicates, 87 unique skills were identified and listed under three distinct temporal themes (the 1990s, 2000s, and 2010s), with problem-solving, communication, teamwork, adaptability, and willingness to learn among the most commonly reported skills over time. The study found a mismatch between employers' expectations and graduates' possessed skills. Therefore, the list of employability skills identified in this study can serve as a valuable tool for addressing this mismatch. The study's findings can also help educators and employers to better align their efforts to prepare students for the modern workplace.
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Communication between Deaf and hearing individuals remains a persistent challenge requiring attention to foster inclusivity. Despite notable efforts in the development of digital solutions for sign language recognition (SLR), several issues persist, such as cross-platform interoperability and strategies for tokenizing signs to enable continuous conversations and coherent sentence construction. To address such issues, this paper proposes a non-invasive Portuguese Sign Language (Língua Gestual Portuguesa or LGP) interpretation system-as-a-service, leveraging skeletal posture sequence inference powered by long-short term memory (LSTM) architectures. To address the scarcity of examples during machine learning (ML) model training, dataset augmentation strategies are explored. Additionally, a buffer-based interaction technique is introduced to facilitate LGP terms tokenization. This technique provides real-time feedback to users, allowing them to gauge the time remaining to complete a sign, which aids in the construction of grammatically coherent sentences based on inferred terms/words. To support human-like conditioning rules for interpretation, a large language model (LLM) service is integrated. Experiments reveal that LSTM-based neural networks, trained with 50 LGP terms and subjected to data augmentation, achieved accuracy levels ranging from 80% to 95.6%. Users unanimously reported a high level of intuition when using the buffer-based interaction strategy for terms/words tokenization. Furthermore, tests with an LLM-specifically ChatGPT-demonstrated promising semantic correlation rates in generated sentences, comparable to expected sentences.