Dietary supplementation of yeast-derived mannan-rich fraction (MRF) could improve the gastrointestinal health and production efficiency of broilers, and, consequently, lower the environmental impacts of chicken production. The objective of this meta-analysis was to quantify the retrospective effects of feeding MRF (Actigen^®, Alltech Inc., Nicholasville, KY) on the production performance of broilers. The meta-analysis database included 27 studies and consisted of 66 comparisons of MRF-supplemented diets vs. basal (i.e., negative control) and antibiotic-supplemented (i.e., positive control) diets. A total of 34,596 broilers were involved in the comparisons and the average final age of the birds was 35 days. Additionally, the impact of feeding MRF on the carbon footprint (feed and total emission intensities) of chicken production was evaluated using the meta-analysis results of broiler performance (MRF vs. basal diets) to develop a scenario simulation that was analyzed by a life cycle assessment (LCA) model. A database of all trials (MRF vs. basal and antibiotic diets) indicated that feeding MRF increased (p < 0.01) average daily feed intake (ADFI; +3.7%), final body weight (FBW; +3.5%), and average daily gain (ADG; 4.1%) and improved (p < 0.01) feed conversion ratio (FCR; −1.7%) without affecting (p > 0.05) mortality. A subdatabase of MRF vs. basal diets indicated that dietary MRF increased ADFI (+4.5%), FBW (+4.7%), and ADG (+6.3%) and improved FCR (−2.2%) and mortality (−21.1%). For the subdatabase of MRF vs. antibiotic diets, both treatments exhibited equivalent effects (p > 0.05) on broiler performance parameters, suggesting that MRF could be an effective alternative to in-feed antibiotics. Subgroup analysis revealed that different study factors (year of study, breed/strain, production challenges, and MRF feeding duration) influenced the effect of dietary MRF on broiler performance. Simulated life cycle analysis (LCA) indicated that feeding MRF decreased feed and total emission intensities, on average, by −2.4% and −2.1%, respectively. In conclusion, these results demonstrate that dietary MRF is an effective nutritional solution for improving broiler performance, an effective alternative to in-feed antibiotic growth promoters, and reduces the environmental impact of poultry meat production. Full article

Background and Objectives: Hand septic arthritis is a potentially debilitating condition that can significantly affect patient functionality and quality of life. Understanding the demographic, clinical, and microbiological characteristics of this condition is crucial for its effective treatment and management. : This study aimed to analyze the demographic and clinical profiles of patients with hand septic arthritis, to identify common microbial pathogens, and to evaluate the impact of various factors on clinical course and treatment outcomes. Material and Methods: This cross-sectional retrospective study examined patients diagnosed with septic arthritis of the hand, focusing on their demographic data, clinical presentation, causative organisms, treatment methods, and outcomes. Data on age, sex, cause of infection, affected sites, surgical interventions, microbiological findings, and patient outcomes were also collected. Results: This study found a higher prevalence of septic arthritis in males and identified bite as the predominant cause. Staphylococcus aureus is the most common pathogen. A large number of patients did not exhibit bacterial growth, and bacterial resistance did not significantly affect the outcome. Outcomes were statistically influenced by the timing of medical presentation and the presence of comorbidities. Conclusions: Early diagnosis and intervention are critical for effective management of hand septic arthritis. This study underscores the need for a comprehensive approach that considers patient demographic and clinical characteristics to optimize treatment outcomes. Awareness and preventive measures are essential to reduce the incidence and severity of this condition. Full article

In order to further exploit the production advantages of rice throwing, this paper proposes a systematically designed throwing device suitable for integration with unmanned aerial vehicles (UAVs). The device primarily comprises a seedling carrying and connection system, a seedling pushing mechanism, and a seedling guiding device. The operational principles and workflow of the device are initially elucidated. Subsequently, an analysis of factors influencing rice throwing effectiveness is conducted, with throwing height, working speed, and the bottom diameter of the seedling guide tube identified as key factors. Seedling spacing uniformity and seedling uprightness are designated as performance indicators. A three-factor, three-level response surface experiment is conducted, yielding regression models for the experimental indicators. Through an analysis of the response surface, the optimal parameter combination is determined to be a throwing height of 142.79 cm, a working speed of 55.38 r/min, and a bottom diameter of the seedling guide tube of 43.51 mm. At these parameters, the model predicts a seedling spacing uniformity of 88.43% and a seedling uprightness of 88.12%. Field experiments validate the accuracy of the optimized model results. Experimental data indicate that under the optimal operational parameters calculated by the regression model, the seedling spacing uniformity is 86.7%, and the seedling uprightness is 84.2%. The experimental results meet the design requirements, providing valuable insights for UAV rice-throwing operations. Full article

Generation of high energy few-fs pulses in the ultraviolet (UV) still represents challenges due to compression and phase control difficulties in this spectral range. Presented here is a pulse compression approach utilizing cross-phase modulation within a thin solid-state medium induced by a strong, spatially and temporally controllable near-infrared (NIR) pulse acting on a weaker, 400 nm UV pulse. Through this method, four-fold compression is attained within a single fused silica plate, resulting in a 13 fs UV pulse with preserved beam quality. With some further technical adjustments, this method’s applicability could be extended to deep or even vacuum UV, where direct compression is difficult. Full article

Biomedical information retrieval for diagnosis, treatment and prognosis has been studied for a long time. In particular, image recognition using deep learning has been shown to be very effective for cancers and diseases. In these fields, scaphoid fracture recognition is a hot topic because the appearance of scaphoid fractures is not easy to detect. Although there have been a number of recent studies on this topic, no studies focused their attention on surgical treatment recommendations and nonsurgical prognosis status classification. Indeed, a successful treatment recommendation will assist the doctor in selecting an effective treatment, and the prognosis status classification will help a radiologist recognize the image more efficiently. For these purposes, in this paper, we propose potential solutions through a comprehensive empirical study assessing the effectiveness of recent deep learning techniques on surgical treatment recommendation and nonsurgical prognosis status classification. In the proposed system, the scaphoid is firstly segmented from an unknown X-ray image. Next, for surgical treatment recommendation, the fractures are further filtered and recognized. According to the recognition result, the surgical treatment recommendation is generated. Finally, even without sufficient fracture information, the doctor can still make an effective decision to opt for surgery or not. Moreover, for nonsurgical patients, the current prognosis status of avascular necrosis, non-union and union can be classified. The related experimental results made using a real dataset reveal that the surgical treatment recommendation reached 80% and 86% in accuracy and AUC (Area Under the Curve), respectively, while the nonsurgical prognosis status classification reached 91% and 96%, respectively. Further, the methods using transfer learning and data augmentation can bring out obvious improvements, which, on average, reached 21.9%, 28.9% and 5.6%, 7.8% for surgical treatment recommendations and nonsurgical prognosis image classification, respectively. Based on the experimental results, the recommended methods in this paper are DenseNet169 and ResNet50 for surgical treatment recommendation and nonsurgical prognosis status classification, respectively. We believe that this paper can provide an important reference for future research on surgical treatment recommendation and nonsurgical prognosis classification for scaphoid fractures. Full article

Treatment of IgE-mediated food allergy involves avoiding the food causing the allergic reaction. In association, an action plan for allergic reactions is indicated, sometimes including self-injectable adrenaline. In addition to these dietary and medical implications, there are two equally important ones: nutritional and psychosocial. From a nutritional point of view, it is known that children suffering from food allergy have a growth delay in height and weight compared to their non-allergic peers. Specifically, this condition is directly related to the specific food excluded from the diet, the number of foods excluded and the duration of the elimination diet. From a psychosocial point of view, the child often cannot eat the foods other guests eat. Children with food allergy may perceive an aura of parental anxiety around their mealtime and may be afraid that what they eat could have harmful consequences for their health. Furthermore, children’s and their parents’ quality of life appears to be affected. The need to manage the allergy and the nutritional and psychosocial problems positions the pediatric nutritionist and the child neuropsychiatrist as support figures for the pediatric allergist in managing the child with food allergy. Full article

In recent years, the global reduction in populations of the Apis mellifera species has generated a worrying deterioration in the production of essential foods for human consumption. This phenomenon threatens food security, as it reduces the pollination of vital crops, negatively affecting the health and stability of ecosystems. The three main factors generating the loss of the bee population are industrial agriculture, climate changes, and infectious diseases, mainly those of parasitic origin, such as the Varroa destructor mite. This article proposes an IoT system that uses accessible, efficient, low-cost devices for beekeepers in developing countries to monitor hives based on temperature, humidity, $C{O}_2$, and TVOC. The proposed solution incorporates nine-feature aggregation as a data preprocessing strategy to reduce redundancy and efficiently manage data storage on hardware with limited capabilities, which, combined with a machine learning model, improves mite detection. Finally, an evaluation of the energy consumption of the solution in each of its nodes, an analysis of the data traffic injected into the network, an assessment of the energy consumption of each implemented classification model, and, finally, a validation of the solution with experts is presented. Full article

The need for energy-efficient buildings must be based on strong effective passive-design techniques, which coordinate indoor air quality and thermal comfort. This research describes the principles, simulation, implementation, and monitoring of two different natural cross-ventilation algorithm scenarios applied to a school-building case study affected by a subtropical climate during the winter season. These ventilation protocols, the steady and dynamic versions, can control the carbon dioxide concentration and actuate the window openings according to pre-defined window-to-wall ratios. The implementation of the monitoring process during three non-consecutive days in the winter of 2021 validates the opening strategy to maintain carbon dioxide below 800 ppm, described by the protocol Hygiene Measures Against COVID-19, and the temperature within the comfort ranges suggested by the adaptive UNE-EN 16798. The study shows that a steady opening of 2.16% window-to-wall equivalent ratio can be enough to maintain the requested comfort and carbon dioxide conditions. The use of the dynamic window ratios, from 0.23% to 2.16%, modified according to the measured carbon dioxide concentration, can partially maintain the carbon dioxide below the required limits for ASHRAE 62.1, Hygiene Measures Against COVID-19 and UNE-EN 16798 between 48.28% to 74.14% of the time. However, the carbon dioxide limit proposed by RITE, 500 ppm, is only achieved for 15.52% of the time, which demonstrates the inadequacy of the natural ventilation to fulfil the standard. Further improvements in the dynamic control of the openings in these buildings could lead to lower carbon dioxide concentrations while maintaining the thermal comfort in mild winter climates. Full article

Drugged driving, the act of driving a vehicle under the influence of illicit drugs, by adolescents is a serious public health concern. Many factors contribute to this risk behavior, but much less is known regarding the role of parenting behaviors in this phenomenon. The purpose of this study was to examine specific parenting behaviors and their influence among a nationally representative sample of adolescents. Pooled data from the 2016–2019 National Survey on Drug Use and Health (NSDUH) among 17,520 adolescents ages 16–17 years old were analyzed. Differences were found in specific parenting behaviors and adolescent drugged/drunk driving, with parents not checking homework and not telling their children they are proud of them being the most influential. Findings from the present study may inform drugged driving prevention programs for parents and adolescents and enhance road safety interventions. Full article

Leptosphaerulina leaf spot, caused by Leptosphaerulina trifolii, is a major disease of alfalfa (Medicago sativa), leading to noticeable losses. From 2022 to 2023, we collected samples of alfalfa with symptoms of the disease from different locations in Inner Mongolia, China. Nine fungal isolates recovered from these samples were identified through morphological traits and a maximum likelihood phylogeny based on concatenated partial sequences of ITS, 28S, and rpb2. A pathogenicity test on alfalfa confirmed the pathogenicity of the isolates on alfalfa. Analysis of physiological traits of L. trifolii revealed optimal mycelium growth at 20 °C and a pH range of 5 to 7, with soluble starch as the preferred carbon source and yeast extract as the optimal nitrogen source. The pathogen thrived in V8-juice agar and oat agar media. This study confirms L. trifolii as the causative agent of Leptosphaerulina leaf spot of alfalfa in Inner Mongolia and provides valuable insights into its optimal growth conditions. These findings enhance the understanding and management of this disease in alfalfa fields. Full article

Apples are usually bagged during the growing process, which can effectively improve the quality. Establishing an in situ nondestructive testing model for in-tree apples is very important for fruit companies in selecting raw apple materials for valuation. Low-maturity apples and high-maturity apples were acquired separately by a handheld tester for the internal quality assessment of apples developed by our group, and the effects of the two maturity levels on the soluble solids content (SSC) detection of apples were compared. Four feature selection algorithms, like ant colony optimization (ACO), were used to reduce the spectral complexity and improve the apple SSC detection accuracy. The comparison showed that the diffuse reflectance spectra of high-maturity apples better reflected the internal SSC information of the apples. The diffuse reflectance spectra of the high-maturity apples combined with the ACO algorithm achieved the best results for SSC prediction, with a prediction correlation coefficient (Rp) of 0.88, a root mean square error of prediction (RMSEP) of 0.5678 °Brix, and a residual prediction deviation (RPD) value of 2.466. Additionally, the fruit maturity was predicted using PLS-LDA based on color data, achieveing accuracies of 99.03% and 99.35% for low- and high-maturity fruits, respectively. These results suggest that in-tree apple in situ detection has great potential to enable improved robustness and accuracy in modeling apple quality. Full article

Quantum computing (QC) has opened the door to advancements in machine learning (ML) tasks that are currently implemented in the classical domain. Convolutional neural networks (CNNs) are classical ML architectures that exploit data locality and possess a simpler structure than a fully connected multi-layer perceptrons (MLPs) without compromising the accuracy of classification. However, the concept of preserving data locality is usually overlooked in the existing quantum counterparts of CNNs, particularly for extracting multifeatures in multidimensional data. In this paper, we present an multidimensional quantum convolutional classifier (MQCC) that performs multidimensional and multifeature quantum convolution with average and Euclidean pooling, thus adapting the CNN structure to a variational quantum algorithm (VQA). The experimental work was conducted using multidimensional data to validate the correctness and demonstrate the scalability of the proposed method utilizing both noisy and noise-free quantum simulations. We evaluated the MQCC model with reference to reported work on state-of-the-art quantum simulators from IBM Quantum and Xanadu using a variety of standard ML datasets. The experimental results show the favorable characteristics of our proposed techniques compared with existing work with respect to a number of quantitative metrics, such as the number of training parameters, cross-entropy loss, classification accuracy, circuit depth, and quantum gate count. Full article

Background and objectives: The aim of this study was to evaluate the clinical–pathological profile in young patients with thyroid cancer. Materials and methods: We realized a retrospective study on patients with thyroid neoplasms who underwent surgery at the “Pius Brinzeu” County Clinical Emergency Hospital in Timisoara, Romania. A comparative analysis of some parameters between two groups, young patients (<45 years) versus patients ≥45 years, was performed. Results: A total of 211 patients met the study inclusion criteria, mostly females (86.26%) with a female/male ratio of 6.81:1. In patients <45 years old (25.64%), papillary thyroid carcinoma was identified in 51.85% of cases; in 53.85% of cases, the tumor was >1 cm; 13.46% had extrathyroidal extension (p = 0.0430); 21.15% capsule invasion (p = 0.1756); 23.08% lympho-vascular invasion (p = 0.0048); and 13.46% of cases locoregional nodal invasion (p = 0.0092). Conclusion: Thyroid cancer in young people was associated with chronic lymphocytic thyroiditis and tumor progression parameters, identifying more cases of extrathyroidal extension, locoregional nodal invasion, lympho-vascular invasion and perineural invasion in young patients compared to older ones. For a better understanding of this pathology and to improve diagnosis and therapeutic management, more studies are needed for these patients. Full article

Dielectric barrier discharge plasma actuators (DBD-PAs) have the potential to improve the performance of fluid machineries such as aircrafts and wind turbines by preventing flow separation. In this study, to identify the multiple flow control mechanisms in high Reynolds number flow, parametric experiments for an actuation parameter F+ with a wide range of Re values (10⁵–10⁶) for NACA0015 airfoil was conducted. We conducted wind tunnel tests by applying a DBD-PA to the flow field around a wing model at the leading edge. Lift characteristics, turbulent kinetic energy in the flow field, shear layer height, and the separation point of the boundary layer were evaluated based on pressure distributions on the wing surface and velocity of the flow field, with the effect of DBD-PA on the post-stall flow around the wing and the mechanism behind the increase in the lift coefficient C_L analyzed based on these evaluation results. The following phenomena contributed to the increase in C_L: (1) increase in turbulent kinetic energy; (2) increase in circulation; and (3) acceleration of the flow near the leading edge. Thus, this study effectively investigated the dependence of the increase in lift on F+ and the lift-increasing mechanism for a wide range of Re values. Full article

(1) Background and Objectives: This review aims to identify the latest literature on the possible effect of bilingualism on the linguistic skills of children with autism spectrum disorder (ASD) residing in Greece. (2) Materials and Methods: The literature was searched in the databases of Scopus and PubMed by selecting articles and by reviewing four studies published in peer-reviewed journals. This Scoping Review is based on the standards of PRISMA recommendations for scoping reviews, while the PCC framework was used as a guide to construct clear and meaningful objectives and eligibility criteria. (3) Results: The publications included in the review addressed a variety of language-related skills, including morphology, the syntax–pragmatics interface, narrative ability, as well as both receptive and expressive language skills. (4) Conclusions: Three out of four studies provide evidence that bilingual ASD children are not disadvantaged compared to monolingual peers but rather enjoy some benefits, to a certain extent, due to bilingualism. However, the number of the reviewed studies as well as the limitations of the studies themselves render this conclusion tentative. Additionally, the findings set guidelines that speech therapists, educators, psychologists, and doctors in the Greek context need to follow when treating or educating bilingual children with ASD. Full article

Recently, environmental regulations have been strengthened due to climate change. This change comes in a way that limits emissions from ships in the shipbuilding industry. According to these changes, the trend of ship construction is changing installing pollutant emission reduction facilities such as scrubbers or applying alternative fuels such as low sulfur oil and LNG to satisfy rule requirements. However, these changes are focused on large ships. Small ships are limited in size. So, it is hard to install large facilities such as scrubbers and LNG propulsion systems, such as fishing boats that require operating space. In addition, in order to apply the pure electric propulsion method, there is a risk of marine distress during battery discharge. Therefore, the application of the electric–diesel hybrid propulsion method for small ships is being studied as a compromised solution. Since hybrid propulsion uses various energy sources, a method that can estimate effective efficiency is required for efficient operation. Therefore, in this study, a Bond graph is used to model the various energy sources of hybrid propulsion ships in an integrated manner. Furthermore, based on energy system modeling using the Bond graph, the study aims to propose a method for finding the optimal operational scenarios and reduction ratios for the entire voyage, considering the navigation feature of each different maritime region. In particular, the reduction gear is an important component at the junction of the power transmission of the hybrid propulsion ship. It is expected to be useful in the initial design stage as it can change the efficient operation performance with minimum design change. Full article

Comprehensive evaluations of global precipitation datasets are imperative for gaining insights into their performance and potential applications. However, the existing evaluations of global precipitation datasets are often constrained by limitations regarding the datasets, specific regions, and hydrological models used for hydrologic predictions. The accuracy and hydrological utility of eight precipitation datasets (including two gauged-based, five reanalysis and one merged precipitation datasets) were evaluated on a daily timescale from 1982 to 2015 in this study by using 2404 rain gauges, 2508 catchments, and four lumped hydrological models under varying climatic conditions worldwide. Specifically, the characteristics of different datasets were first analyzed. The accuracy of precipitation datasets at the site and regional scale was then evaluated with daily observations from 2404 gauges and two high-resolution gridded gauge-interpolated regional datasets. The effectiveness of precipitation datasets in runoff simulation was then assessed by using 2058 catchments around the world in combination with four conceptual hydrological models. The results show that: (1) all precipitation datasets demonstrate proficiency in capturing the interannual variability of the annual mean precipitation, but with magnitudes deviating by up to 200 mm/year among the datasets; (2) the precipitation datasets directly incorporating daily gauge observations outperform the uncorrected precipitation datasets. The Climate Precipitation Center dataset (CPC), Global Precipitation Climatology Center dataset (GPCC) and multi-source weighted-ensemble precipitation V2 (MSWEP V2) can be considered the best option for most climate regions regarding the accuracy of precipitation datasets; (3) the performance of hydrological models driven by different datasets is climate dependent and is notably worse in arid regions (with median Kling–Gupta efficiency (KGE) ranging from 0.39 to 0.65) than in other regions. The MSWEP V2 posted a stable performance with the highest KGE and Nash–Sutcliffe Efficiency (NSE) values in most climate regions using various hydrological models. Full article

In this article, to further improve the accuracy and speed of grasp detection for unknown objects, a new omni-dimensional dynamic convolution grasp detection network (ODGNet) is proposed. The ODGNet includes two key designs. Firstly, it integrates omni-dimensional dynamic convolution to enhance the feature extraction of the graspable region. Secondly, it employs a grasping region feature enhancement fusion module to refine the features of the graspable region and promote the separation of the graspable region from the background. The ODGNet attained an accuracy of 98.4% and 97.8% on the image-wise and object-wise subsets of the Cornell dataset, respectively. Moreover, the ODGNet’s detection speed can reach 50 fps. A comparison with previous algorithms shows that the ODGNet not only improves the grasp detection accuracy, but also satisfies the requirement of real-time grasping. The grasping experiments in the simulation environment verify the effectiveness of the proposed algorithm. Full article

Accurate and reliable quantification of organic acids with carboxylic acid functional groups in complex biological samples remains a major analytical challenge in clinical chemistry. Issues such as spontaneous decarboxylation during ionization, poor chromatographic resolution, and retention on a reverse-phase column hinder sensitivity, specificity, and reproducibility in multiple-reaction monitoring (MRM)-based LC–MS assays. We report a targeted metabolomics method using phenylenediamine derivatization for quantifying carboxylic acid-containing metabolites (CCMs). This method achieves accurate and sensitive quantification in various biological matrices, with recovery rates from 90% to 105% and CVs ≤ 10%. It shows linearity from 0.1 ng/mL to 10 µg/mL with linear regression coefficients of 0.99 and LODs as low as 0.01 ng/mL. The library included a wide variety of structurally variant CCMs such as amino acids/conjugates, short- to medium-chain organic acids, di/tri-carboxylic acids/conjugates, fatty acids, and some ring-containing CCMs. Comparing CCM profiles of pancreatic cancer cells to normal pancreatic cells identified potential biomarkers and their correlation with key metabolic pathways. This method enables sensitive, specific, and high-throughput quantification of CCMs from small samples, supporting a wide range of applications in basic, clinical, and translational research. Full article

Prenatal maternal feeding plays an important role in fetal development and has the potential to induce long-lasting epigenetic modifications. MicroRNAs (miRNAs) are non-coding, single-stranded RNAs that serve as one epigenetic mechanism. Though miRNAs have crucial roles in fetal programming, growth, and development, there is limited data regarding the maternal diet and miRNA expression in sheep. Therefore, we analyzed high and low maternal dietary protein for miRNA expression in fetal longissimus dorsi. Pregnant ewes were fed an isoenergetic high-protein (HP, 160–270 g/day), low-protein (LP, 73–112 g/day), or standard-protein diet (SP, 119–198 g/day) during pregnancy. miRNA expression profiles were evaluated using the Affymetrix GeneChip miRNA 4.0 Array. Twelve up-regulated, differentially expressed miRNAs (DE miRNAs) were identified which are targeting 65 genes. The oar-3957-5p miRNA was highly up-regulated in the LP and SP compared to the HP. Previous transcriptome analysis identified that integrin and non-receptor protein tyrosine phosphatase genes targeted by miRNAs were detected in the current experiment. A total of 28 GO terms and 10 pathway-based gene sets were significantly (p_adj < 0.05) enriched in the target genes. Most genes targeted by the identified miRNAs are involved in immune and muscle disease pathways. Our study demonstrated that dietary protein intake during pregnancy affected fetal skeletal muscle epigenetics via miRNA expression. Full article

Objective: Percutaneous electrical nerve stimulation (PENS) appears to be effective for the treatment of musculoskeletal pain. The aim of this trial was to investigate the effects on disability and pain, as well as on the psychological aspects of adding PENS into an exercise program in patients with subacromial pain syndrome. Methods: A randomized, parallel-group clinical trial was conducted. Sixty patients with subacromial pain were allocated into exercise alone (n = 20), exercise plus PENS (n = 20), or exercise plus placebo PENS (n = 20) groups. Patients in all groups performed an exercise program twice daily for 3 weeks. Patients allocated to the PENS group also received four sessions of ultrasound-guided PENS targeting the axillar and suprascapular nerves. Patients allocated to the exercise plus placebo PENS received a sham PENS application. The primary outcome was related disability (Disabilities of the Arm, Shoulder, and Hand, DASH). Secondary outcomes included mean pain, anxiety levels, depressive symptoms, and sleep quality. They were assessed at baseline, one week after, and one and three months after. An analysis was performed using intention-to-treat with mixed-models ANCOVAs. Results: The results revealed no between-group differences for most outcomes (related disability: F = 0.292, p = 0.748, n²_p = 0.011; anxiety: F = 0.780, p = 0.463, n²_p = 0.027; depressive symptoms: F = 0.559, p = 0.575, n²_p = 0.02; or sleep quality: F = 0.294, p = 0.747, n²_p = 0.01); both groups experienced similar changes throughout the course of this study. Patients receiving exercise plus PENS exhibited greater improvement in shoulder pain at one month than those in the exercise (Δ −1.2, 95%CI −2.3 to −0.1) or the placebo (Δ −1.3, 95%CI −2.5 to −0.1) groups. Conclusions: The inclusion of four sessions of ultrasound-guided PENS targeting the axillar and suprascapular nerves into an exercise program did not result in better outcomes in our sample of patients with subacromial pain syndrome at one and three months after treatment. Full article

This paper sheds light on the manufacturing processes, techniques, and materials used in the splendid illuminations of the oldest surviving copy of De Balneis Puteolanis, preserved at the Angelica Library in Rome (Ms. 1474). The codex is one of the masterpieces of mid-13th-century Italian-Southern illumination, traditionally referred to as the commission of Manfredi, son of Frederick II. The findings reported in the article result from the interdisciplinary study conducted in 2021–2023 in the framework of “Codex 4D: journey in four dimensions into the manuscript”, a multidisciplinary project involving many competences and dealing with art-historical studies on manuscripts, diagnostic and conservative analyses, scientific dissemination, storytelling, and public engagement. The considerations we present aims at increasing the knowledge of book artefacts while respecting their extraordinary complexity; data from non-invasive diagnostic investigations (X-ray fluorescence, Vis-NIR reflectance and Raman spectroscopies, hyperspectral imaging, and multi-band imaging techniques as ultraviolet, reflectography, and thermography), carried out in situ with portable instruments on the book, have been integrated with observations resulting from the historical-artistic study, and the reading of some ancient treatises on the production and use of the pigments and dyes employed in illumination. Full article