Abstract :Background : Generally speaking, urethral malignancies are uncommon urological tumors that are more frequent in women than in men. The etiology of female urethral adenocarcinoma is yet unknown, however it is an uncommon disorder. Recurrent UTIs and urethral diverticula are two common risk factors linked to it, though. Clinical presentations can differ and are not always specific. A complete history and physical examination are part of management; urethrocystoscopy with urethral biopsy is used for diagnosis; investigations such as magnetic resonance imaging or abdominal computed tomography scans are used for staging; and treatment options include monotherapy and multimodal therapy.Case Presentation: A 53-year-old female who presented with a nine-month history of lower urinary tract symptoms characterized by burning sensation when passing urine, increased urinary frequency, and feeling of incomplete bladder emptying associated with feeling of a vaginal mass. She was being managed for recurrent urinary tract symptoms at another facility. Examination revealed fungating fixed mass at the external urethral orifice. Pelvic magnetic resonance imaging reported a retropubic urethral mass with bilateral inguinal lymph nodes, and she underwent urethrocystoscopy with multiple urethral biopsies taken, and the specimen was sent for histopathology biopsy, which confirmed a well-differentiated urethral adenocarcinoma with mucin production, and she was treated with chemo-radiotherapy as per multidisciplinary team meeting recommendation. She developed symptoms of radiation proctitis, which was treated with argon plasma coagulation. She has since been on follow-up at our oncology clinic, and a subsequent Positron Emission Tomography CT scan reported no tumor recurrence or metastasis. She is currently faring well with no recurrence of her symptoms, and wounds have healed.Conclusion: Although female urethral adenocarcinoma is uncommon, it nevertheless requires a comprehensive investigation when it is suspected, particularly in women who have nonspecific or recurrent lower urinary tract symptoms. Management can involve a multidisciplinary team approach where available. Depending on the disease’s stage and location, treatment options may include surgery, nonsurgical such as radiotherapy and chemotherapy, or a combination. Patients should be monitored for any signs of recurrence of the illness. A better prognosis is said to exist for distal urethral cancers that are localized.

Aim: Most rheumatic diseases are caused by a complex interplay of genetic, physical, and environmental factors. Large-scale disasters affect all of these factors; however, their impact on rheumatic diseases are unknown. We aimed to investigate changes in anti-rheumatic drug prescriptions among victims and non-victims following the 2018 Japan flood. Methods: In this retrospective cohort study, we used data from the Japanese National Database of Health Insurance Claims, which included information on all drugs prescribed by physicians. We included all cases of prescription at medical institutions in disaster-stricken areas between July 2017 and June 2019. The newly initiated prescription of methotrexate (MTX, 2 mg tablets or capsules), which has been exclusively approved for rheumatoid arthritis, juvenile idiopathic arthritis, or psoriatic arthritis/ psoriasis in Japan, as well as those for other anti-rheumatic drugs within the first year after the disaster were evaluated for government-certified disaster victims and non-victims. Results: The number of individuals who had not been prescribed MTX before the disaster was 4,973,401, including 31, 006 victims. Among them, 14,908 (including 110 victims) had a history of MTX prescription after the disaster. In the MTX-naïve group, new MTX prescriptions within one year after the disaster were significantly more frequent in victims compared to non-victims (age- and sex-adjusted hazard ratio: 1.83; 95% confidence interval: 1.37–2.46). Similarly, a non-significant increase in prescriptions for conventional synthetic/biological disease-modifying anti-rheumatic drugs was observed. Conclusions: Victims of the 2018 Japan flood were more likely to be prescribed MTX for the first time.

Background The correlation of metastatic organotropism between osteosarcoma (OS) and lung adenocarcinoma (LUAD) suggests a potential metastatic niche connecting bone and lung tumors. This study aims to analyze and identify the metastatic factors and underlying mechanisms influencing tumor behavior. Methods Data were sourced from the public repositories TCGA and TARGET. The Limma package, along with WGCNA, was utilized to pinpoint differentially expressed genes. To uncover genes associated with lung metastasis in osteosarcoma, we conducted survival analysis and employed the LASSO regression. Candidate genes were further explored through enrichment analyses, as well as immune infiltration studies. Diagnostic effectiveness was assessed via nomograms and ROC. Additionally, potential small molecule drugs were identified using the Connectivity Map database. Results The TARGET dataset contained 1,698 DEGs, while LUAD comprised 17,110 DEGs and 1,778 module genes. Analyzing the overlap between DEGs associated with OS and key genes identified in LUAD resulted in 52 shared genes. Following univariate survival analysis alongside machine learning methodologies, six essential genes were identified for constructing the nomogram, which demonstrated substantial prognostic potential. Immune infiltration analyses indicated a disruption in associated immune cell populations. Conclusion Six hub genes were identified, leading to the nomogram establishmentfor diagnosing lung metastasis in OS.

30.0 Hydrogen vehicles are on track to enter the race as a clean and viable alternative to traditional fossil fuel-based vehicles transport, and this could bring about real change in the way our transport systems evolve in the future. In a hydrogen vehicles, the fuel cell converts hydrogen into direct current, which supplies a power electronic converter to drive the electric motor. Some key elements that determine the reliability of the vehicles are the hydrogen tank, fuel cell, power electronic converter, control system, mechanical transmission, body, chassis and wheels. The power electronic converter is most susceptible to this because it contains temperature-sensitive semiconductor components. The study considers two operating condition parameters, namely torque and vehicle speed. These are the input variables that are being investigated in current research to understand the impact on the repair rate, failure rate, and availability of the power electronic converters in hydrogen vehicles. Using Arrhenius' law, the results show that with higher torque, failure and repair rates increase, while vehicle speed has little influence. In addition, permanent magnet synchronous motors have higher reliability and availability compared to three-phase induction motors, so permanent magnet synchronous motors in hydrogen vehicles are more robust. Numerical results are provided to highlight such trends and demonstrate the need for optimization of the power converter design to maximize the overall reliability of the vehicle.

The IUCN Red List is the most extensive source of information on the global extinction risk including over 157000 species. The sheer scale of this initiative presents challenges in data standards and reporting, especially given that legacy issues may reduce accuracy. Here, we assess the bibliographic underpinnings of Red List assessments for five taxa with fairly complete assessments (four terrestrial vertebrate and one invertebrate group, including 41647 species). We assess the number of publications referenced, their age, their specificity, and use of primary data. Body-size and popularity are then explored as potential drivers of bibliographic trends. Disturbingly, many references are old and general (especially in smaller and less popular taxa), with many lacking specific references (e.g., only 1.3% of Odonata species have species-specific references). Public data are virtually never mentioned (GBIF is cited once in Odonata and Reptiles) and private databases are often cited. Furthermore, the use of data for mapping of species remains completely opaque. Better methods and standards are urgently needed for data inclusion, wider participation, mapping, and data citation if the Red List is to fulfil its remit.

Restoring invaded ecological communities requires understanding whether native declines are driven directly by invader competition versus changes to abiotic conditions that are associated with invader presence. In forest understory communities, declines in spring ephemerals could result from invasion or alternatively by loss of leaf litter layers, from which native spring ephemerals evolved to emerge annually. Here, we investigate how native spring ephemerals (Erythronium spp.) are affected by leaf litter absence and direct competition with the functionally similar invader lesser celandine (Ficaria verna). The absence of a litter layer alone reduced Erythronium asexual reproduction (corm biomass), with reductions magnified when celandine was also present. Celandine impacts occurred despite celandine having limited aboveground growth under common garden conditions, indicating belowground competition with celandine is sufficient to elicit substantial impacts on Erythronium. This reduced clonal growth would eventually hinder Erythronium sexual reproduction because flowering only occurs in large individuals. Both Erythronium species responded similarly to experimental conditions: in response to shading from litter, Erythronium produced larger, heavier petioles and invested less in leaf blade tissue as a proportion of total shoot tissue. Though reduced leaf blade investment was correlated with reduced corm growth, the net benefits of litter on growth outweighed any negative effects of this biomass allocation tradeoff. These results demonstrate how, although direct competition from invasive plants can impact co-occurring natives, invader-induced changes to local environmental conditions also have important indirect effects. Management to support native spring ephemerals should include preventing losses of or restoring depleted forest litter layers as well as reducing invasive competition.

Fibrosarcoma cells exhibit low sensitivity to chemotherapy and significant drug resistance, emphasizing the urgent need for effective, low-toxicity therapeutic agents with reliable production methods and novel treatment strategies. Cordycepin (3’-deoxyadenosine) has shown promising therapeutic potential in cancer treatment. In this study, cordycepin was produced using a genetically engineered Pichia pastoris strain cultured in an inorganic salt medium and purified to over 98% purity via macroporous resin chromatography, providing a cost-effective production alternative. The effects of cordycepin on the human fibrosarcoma cell line HT1080 were assessed using microscopic examination, scratch assays, CCK-8 assays, and flow cytometry (Annexin V-FITC/PI staining). The results demonstrated that cordycepin significantly inhibited cell activity at an effective concentration of 100 μmol/L. Key observations included changes in cell morphology, reduced migration, inhibited proliferation, cell cycle arrest at the G0/G1 and G2/M phases, and induction of apoptosis. Network pharmacology analysis identified 31 potential targets of cordycepin in fibrosarcoma, with its effects on Akt1 (protein kinase B) and disruption of protein phosphorylation pathways emerging as key mechanisms underlying its therapeutic efficacy.

Negative Video Head Impulse Test in Acute Vestibular Syndrome Does Not Exclude Vestibular Neuritis: Insights and Challenges in DiagnosisPavol Skacik, MD (1)( 2) , e-mail: pavolskacik@gmail.com, skacik1@uniba.sk, ORCID: 0000-0001-5630-9822, Stefan Sivak MD, PhD, Associate Professor(1)(2) , e-mail:sivakste@gmail.com, ORCID: 0000-0002-0348-3082 Egon Kurca MD, PhD, FESO, Professor(1)(2) , e-mail: egonkurca@gmail.com, ORCID: 0000-0002-1025-6830Neurology Department, University Hospital Martin, Kollarova 2, 036 01 Martin, SlovakiaJessenius Faculty of Medicine in Martin, Comenius University Bratislava

The spread of non-native species continues to increase around the globe, making it important we understand the dynamics of the resulting communities in which non-natives comprise a high percentage of the total fauna. As non-native species continue to invade, the resulting community may become saturated, at which point limited resources would prevent colonization by new non-native species and native or already established species might decline. As the global hotspot for non-native reptiles and amphibians, South Florida’s herpetofaunal community has a higher probability of having reached the saturation point than any other comparable system. Surveys conducted in Miami-Dade County in 2017 demonstrated that non-native species already dominated both native and non-native habitat types and provided a baseline to examine dynamic changes such as signatures of community saturation or negative impacts on native species. In 2022, we replicated the surveys from 2017 at the same 30 sites. We found that non-native richness and abundance have increased significantly (19% and 33% increase in overall alpha diversity and abundance, respectively), showing no signs of community saturation. We also found no correlation between these non-native increases and decreases in either native species richness or abundance. Non-native species richness increased more rapidly at sites dominated by non-native habitats, with two rock-loving species, Agama picticauda and Leiocephalus carinatus, standing out as the most rapidly spreading non-native herpetofauna. Our findings demonstrate that open niche space allows the continued expansion of non-native herpetofaunal populations even in the highly invaded community of Miami-Dade County, and that protection of native habitat may help slow the spread of non-native species.

Endoscopic Mucosal Resection of a Colonic Hemangioma: A Case Report and Literature ReviewWang Zhenwen1†，Yan Wenjun2†，Xiong Liling1，Chen Yun1，Zhou Yu3，Wu Qianqian3，Zeng Hao1*1Department of Gastroenterology, Gaoxin Branch of The First Affiliated Hospital Nanchang University, Nanchang, Jiangxi ,China,2Jiangxi University of Traditional Chinese Medicine Graduate School, Nanchang, Jiangxi ,China, 3Digestive endoscopy center, Gaoxin Branch of The First Affiliated Hospital Nanchang University, Nanchang, Jiangxi ,China† These authors contributed equally to this workAuthor contribution statement: Wenjun Yan: Writing - original draft, Writing - review & editing, zhenwen wang: Resources, riting - review & editing, yun chen: Supervision, Writing - review & editing, Liling Xiong: Writing - review & editing, qianqian wu: Writing - review & editing: yu zhou: Writing - review & editing, hao zeng: Conceptualization, Data curation, Supervision, Writing - review & editingCorresponding author: Zeng Hao, First Affiliated Hospital of Nanchang University, Department of Gastroenterology, Gaoxin Branch Of The First Affiliated Hospital, Medical College, Nanchang University, 7889 Changdong Ave, Gaoxin District, Nanchang,330000, Jiangxi, China. Email: 13247762502@163.comFunding Information：Project of Plan of Traditional Chinese Medicine Science and Technology in Jiangxi Province (2023B0074)；Nanchang University First Affiliated Hospital High-Tech Hospital Internal Funding Project (Hospital KYZZ202308)；Key Discipline of Construction Projects of Gaoxin Branch Of The First Affiliated Hospital Of Nanchang UniversityAbstract: Colonic hemangiomas are rare worldwide. However, with the continuous advancement of endoscopic technology, an increasing number of cases of colonic hemangiomas being successfully treated via endoscopic techniques have been reported. Colonic hemangiomas often present with non-specific symptoms such as bleeding, bowel obstruction, intussusception, and anemia, leading to a high rate of misdiagnosis. In this case report, we describe a colonic hemangioma incidentally discovered during a routine colonoscopy performed as part of a physical examination. The lesion was successfully treated with endoscopic mucosal resection (EMR), and the patient had a well postoperative recovery.Keywords: Colonic hemangioma; mucosal resection; case reportStatement: The patient was informed and signed the relevant informed consent form.

Anthropogenic climate and land-use change pose major threats to island floras worldwide, yet few studies integrate these drivers in a single vulnerability assessment. Here, we examine the endemic flora of Evvia, the second largest Aegean island in Greece and an important biodiversity hotspot, as a model system to address how these disturbances may reshape biodiversity patterns. We used species distribution models integrating climate projections and dynamic land-use data to forecast potential range shifts, habitat fragmentation, and biodiversity patterns for 74 endemic taxa through 2100. Our findings reveal pronounced projected range contractions and increased habitat fragmentation for all studied taxa, with more severe impacts on single-island endemics. Current biodiversity hotspots, primarily located in mountainous regions, are expected to shift towards lowland areas, probably becoming extinction hotspots. Emerging hotspot analysis identified new biodiversity centres in lowland zones, while high-altitude areas showed sporadic hotspot patterns. Temporal beta diversity analysis indicated higher species turnover of distantly related taxa at higher elevations, with closely related species clustering at lower altitudes. This pattern suggests a homogenisation of plant communities in lowland areas. Assessment of protected area effectiveness revealed that while 94.6% of current biodiversity hotspots are within protected zones, this coverage is projected to decline by 2100. Our analysis identified conservation gaps, highlighting areas requiring urgent protection to preserve future biodiversity. Our study reveals valuable information regarding the vulnerability of island endemic floras to global change, offering a framework applicable to other insular systems. Our findings demonstrate that adaptive conservation strategies should account for projected biodiversity shifts and serve as a warning for other insular biodiversity hotspots, urging immediate actions to maintain the unique evolutionary heritage of islands

The Basal Stem Rot (BSR) disease brought by the Ganoderma Boninense pathogen is regarded as a huge killer for oil palm producers’ countries, particularly Malaysia and Indonesia oil palm plantations. Thus, this research tends to analyze BSR disease infection with plant physiology reaction through water use efficiency (WUE) in oil palm to provide a comprehensive understanding since none of the previous studies analyzed this aspect. The objective of this research is to assess WUE performance in BSR disease severity for mature oil palm tree levels through fronds 17 (March and July). Based on general findings, the BSR severity had varying degrees of impact on the WUE parameter especially when compared between the healthy categories (T0) and infected (T1, T2, T3) individuals. Secondly, identify the most significant variables that affect WUE performance in oil palm BSR disease severity. The outcome shows that from both data, photosynthetic rate (P r), transpiration rate (T r), intercellular CO 2 concentration (Ci), and temperature leaf (TempL) variables contribute significantly to the WUE value. Finally, the analysis focused on correlation variables employed with the BSR disease severity. The outcome demonstrates that, except for Chlorophyll Content (F), there is a substantial correlation (0.5 and -0.5) to all variables analyzed.

Aim: This study aimed to investigate the correlation between trauma and risk perception resulting from the earthquake in Southeast Turkey and the use of alcohol, tobacco, and illicit drugs. Method: This cross-sectional study was conducted between October and December 2023, utilizing a sample size of 623, determined through the G.Power program with a minimum required sample size for a type-I error rate of α=0.05, a test power of 1-β=0.9, and an effect size of 0.25. Data were collected using surveys. Results: A noteworthy disparity was observed in the affective earthquake risk perception sub-dimension, which was significantly influenced by the motives behind individuals’ experimentation with addictive substances (p<0.05). In comparing the mean total scores of the Trauma Level Determination Scale sub-dimensions, higher total scores were found in relation to sadness and distress, which were identified as reasons for substance use (p<0.05). A statistically significant positive and moderate relationship was established between the Scale for Determining the Level of Post-Earthquake Trauma and the Earthquake Risk Perception Scale, determined through correlation. Conclusion: The study revealed that earthquake risk perceptions and high degrees of trauma significantly influenced individuals’ engagement in addictive substance use following the earthquake event, highlighting the need for targeted interventions and support systems.

In this paper, the problem of ellipsoidal set-membership estimation of systems with quantized measurement output is studied. The output is quantized by a logarithmic quantizer. With the sector bound property of the logarithmic quantizer, the quantized problem is converted into a robust control problem. An ellipsoidal set-membership filter with two parameters to be designed is used to estimate the system state. The estimation is obtained by solving the linear matrix inequality optimization problem. Some special cases of the estimation problem are analyzed in detail. A simulation example is given to show the effectiveness of the proposed results in the end.

Kawasaki Disease presentation by an uncommon presentation of torticollis: A case reportHassan Mottaghi Moghaddam Shahri1, Faeze Keihanian2*, Mohammad Hassan Nezafati3, Mohammad Saeid Sasan4

Strains of Bacillus species, plant growth-promoting rhizobacteria, have been commercialized as biofertilizers; they are ideal for this, because these species form spores that can be stored stably for a long time. However, for these spores to exert their full beneficial effects, they must germinate. The specific germination signals in the rhizosphere, particularly those from plant root exudates, remain largely unknown. Here, we investigated the germination signals from different growth states of cucumber ( Cucumis sativus) for spores of B. velezensis SQR9 and B. subtilis NCIB 3610. We identified the corresponding germination receptors and compared them biochemically between the Bacillus species. Larger plants better stimulated spore germination. Five amino acids – L-isoleucine, L-ornithine, L-valine, L-serine, and β-alanine – were identified as spore germination signals. Combined application of a mixture of these amino acids with bacterial spores markedly enhanced the cucumber-growth-promoting properties of B. velezensis SQR9. The germination receptor for these amino acids was GerA in both Bacillus spp. Differences in spore germination efficiency between B. subtilis and B. velezensis may be attributable to variations in the GerA ligand-recognition sites. Expression of GerA from B. subtilis NCIB 3610 in B. velezensis SQR9 enhanced the spore germination rate of the latter. Our study highlights the pivotal role of amino acids in regulating spore germination of Bacillus and subsequent plant root colonization, emphasizing their potential to enhance the efficacy of Bacillus-based biofertilizers. Engineering of germination receptors is a promising approach to enhance the spore germination efficiency of biofertilizer strains.

This work theoretically investigates cyanopolyynes (with the general molecular formula HCnN, n = 3, 5, 7…), which are chemical species detected in various regions of space, including the interstellar medium and Titan’s atmosphere (Saturn’s largest moon). These molecules are relevant, for example, in astrochemistry and molecular electronics. Using computational quantum chemistry methods at the DFT/B3LYP/6-311G(3df,3pd) theory level with ORCA software, we calculated rotational constants and dipole moments, which are essential for their detection in the ISM by rotational spectroscopy. The study proposes two correlation models: the ”Dipole_Model”, which correlates the rotational constant with the dipole moment, and the ”Mass_Model”, which correlates the rotational constant with the molecular mass. Both are consistent with the experimental data, however, the “Mass_Model” proved to be more accurate for larger molecules, suggesting that molecular mass is a more reliable parameter in predicting rotational constants and the consequent detection of new species in space.

In this paper, fatigue tests were conducted on specimens of 2024 aluminum alloy welded joints before and after ultrasonic impact treatment (UIT). The test results show that after UIT, the fatigue life of the specimens significantly increased under identical stress levels (Δσ of 200MPa, 175MPa, 150MPa, and 125MPa), all reaching 10 7 cycles, indicating a substantial increase in the fatigue limit of the specimens.Building on these findings, a new model for studying fatigue life was employed, effectively integrating Continuous Damage Mechanics (CDM) theory with Artificial Neural Networks (ANN). Initially, a CDM model considering residual stresses was developed theoretically, and fatigue life was numerically calculated based on this model. More than 400 sets of data were collected to train the ANN; subsequently, predictions and validations of fatigue life were performed.The research results demonstrate that the proposed predictive model can accurately evaluate the effect of UIT on the fatigue life of 2024 aluminum alloy welded joint specimens, showcasing its effectiveness and applicability in predicting fatigue behavior.

Balamuthia mandrillaris, belonging to the family Acanthamoebidae, primarily causes skin and central nervous system (CNS) disease. To date, over 200 cases have been reported worldwide, predominantly in warmer regions [1]. In China, most cases present with cutaneous infections as the initial symptom, followed by neurological manifestations several months or years later. Balamuthia mandrillaris encephalitis is characterized by rapid progression, high misdiagnosis rates, and high morbidity and mortality, highlighting the importance of early diagnosis and treatment [2]. This article reports a case of Balamuthia mandrillaris infection in an elderly Chinese female who developed recurrent red infiltrative plaques on her left hand, which eventually progressed to fatal encephalitis. The patient died despite resuscitation attempts. The authors reviewed relevant literature, summarized clinical manifestations, and provided insights for early diagnosis and treatment.

The impact of Cervus nippon browsing on vegetation in grasslands in Japan has become pronounced. In obtaining useful information for the management of grasslands affected by C. nippon browsing, we aimed to evaluate vegetation changes caused by browsing on multiple axes based on vegetation survey data from two time periods and to use UAV-mounted LiDAR data to determine the distribution of indicator species of vegetation change on an areal scale. The study area was approximately 23 ha around the Ochiai Pass in Higashi Iya Ochiai, Miyoshi City, Tokushima Prefecture. A vegetation survey was conducted in 2022 at the same 35 sites as in 2002 to understand the changes in vegetation. The ordination using nonmetric multidimensional scaling (NMDS) revealed that the changes in the cover of Sasa hayatae and Miscanthus sinensis and in the current cover of M. sinensis caused by the changes affected the vegetation in the study area. NMDS revealed that the entire study area is not changing along a single axis. The data acquired by the UAV-mounted LiDAR were used to estimate the density of S. hayatae and M. sinensis, which are indicators of vegetation change, on an areal basis. A high correlation was determined between the mean values of the reflected intensity at heights of 0.7–0.8 m for S. hayatae and 1.4–1.5 m for M. sinensis. The methods used in this study were useful for monitoring spatial and temporal changes in vegetation, and they could be applied to the management of different types of grasslands.

In species with obligate bi-parental care, investment by both parents in a current reproductive bout is critical to offspring growth and survival. The degree to which an individual can invest in their offspring relies on their quality as a parent. Parental quality can be communicated between individuals in a mated pair via ornamental features, as they may honestly reflect aspects of direct or indirect offspring contribution. In this study, we investigated whether the red-orange bill colouration in Atlantic puffins Fratercula arctica reflects two proxies of parental quality: hatch date and offspring growth. No aspect of paternal colouration predicted hatch date, but several metrics of maternal colouration predicted offspring peak mass and normalized wing growth. We also explored whether hatch date influenced patterns of chick growth and found that timing (early hatch vs. late hatch) but not synchrony with food availability significantly predicted mass and skeletal growth. Specifically, early hatching chicks achieved higher peak masses but exhibited reduced wing growth, potentially reflecting alternative strategies between investing primarily in weight gain or structural development. Together, these results highlight chick growth as a complex metric of parental quality, associated with both phenology and parental phenotype.

Greg Maguire, Ph.D.The California Physiological SocietyBerkeley, CA 94720gregmaguire5@gmail.comAbstractMuch evidence has accumulated that vaccines not only cause inflammation but also induce autoimmunity. While the efficacy for many vaccines has been demonstrated in some form, such as prevention of infection or reduction in severity of symptoms, the safety profile, especially for the long-term, has not been well studied. Further, the long-term efficacy of some vaccines is worse than normal immunity. All drugs, including vaccines, need thorough studies of risk versus benefits. For many drugs, the risks, and especially the long-term risks, have not been thoroughly studied and therefore the risk versus benefit of the vaccine is not understood. Long-term scientific studies from non-sponsors performed by non-conflicted scientific groups in academia are needed to evaluate the long-term safety of vaccines, and then the use of these data to develop safer and more efficacious vaccines can be accomplished.

Device hematoma is common complication of pacemaker procedures. Hematoma increases infection risk, causes patient discomfort, and may require surgical evacuation. We present a case of pacemaker pocket hematoma treated with a combination of phototherapy devices (X39®, Glutathione®, Carnosine®, from LifeWave Inc), achieving complete resolution in 6 days. A survey among experts found that healing time was 500% faster than anticipated. These adhesive patches contain natural compounds that reflect back infrared frequencies emitted by the skin. Biologic activity includes elevation of glycyl-l-histidyl-l-lysine (GHK), having a plethora of effects. This non-pharmacologic wellness device is used conveniently to expedite wound healing.

Europe aims to achieve climate neutrality by 2050. Transitioning to a net-zero society requires research and innovations in energy, transport, manufacturing, and sustainable practices globally, as emissions and climate change are transboundary issues. Materials play a key role in this transition, which also increases Europe's dependence on import of critical raw materials. These are crucial for green technologies. While the shift to green energy offers climate benefits, the irresponsible sourcing of raw materials for the transition can lead to environmental harm, human rights violations, and supply challenges, particularly as most critical materials are sourced and produced outside Europe. To ensure sustainability and energy self-sufficiency, Europe must aim for greater reliance on recycling, circular economy practices, and strategic sourcing. While electric vehicles can significantly reduce emissions, their environmental benefits depend heavily on the electricity mix used for charging, as well as the energy-intensive processes involved in battery production. Transition to electric vehicles is essential for decarbonizing transport, which however is not without challenges. Solar panels do provide renewable energy, but their production is energy-intensive and may have significant environmental impacts. Also in the case of wind turbines, essential for green energy, limited sources and energy-intensive production of rare-earth elements combined with issues such as local climate impacts present ongoing environmental and societal challenges. Finally, in the case of green hydrogen the main challenges revolve around the source of energy for production, storage, and transportation, with all presenting significant energy and material challenges.