The remove–compute–restore (RCR) approach is widely used in local quasi-geoid modeling. However, the classical RCR approach usually does not take into account the noise of the satellite-only global gravity field model (GGM), which may lead to a suboptimal result. This paper presents an approach for local quasi-geoid modeling based on spherical radial basis functions that combines local noisy datasets and a noisy satellite-only GGM. This approach includes an RCR procedure using a satellite-only GGM. This is a direct approach that takes the spherical harmonic coefficients of satellite-only GGM as a noisy dataset and includes the corresponding full-noise covariance matrix in the least-squares estimation, aiming to obtain a statistically optimal local quasi-geoid model. The direct approach goes beyond the indirect approach, which treats the height anomalies generated from the satellite-only GGM as a noisy dataset. However, the generated GGM height anomaly dataset is not an equivalent representation of the satellite-only GGM, which may result in the loss of information from the satellite-only GGM. Through mathematical deduction, we demonstrate the theoretical consistency between the direct approach and the indirect approach. The direct approach also has an advantage over the indirect approach in terms of computational complexity due to the simpler algorithm. We conducted a synthetic closed-loop test with a real data distribution in Colorado, and numerical results demonstrated the advantage of the direct approach in local quasi-geoid modeling. In terms of the root mean square of the differences between the predicted values and the true reference values, the direct approach provided an improvement of approximately 14% compared to the indirect approach. Full article

This study identified the practices of adaptation strategies to climate change in Jimma, Bedelle, Bonga, and Sokorru urban centers using a survey of 384 households, 55 key informant interviews, 4 focus group discussions, and field observations. A cross-sectional study design was employed from 2019 to 2021. The adaptive capacity of municipalities to reduce climate extreme events was rated as poor by the majority (51%), mostly reactive measures (76%). The climate hazards identified in four urban centers were riverine and flash floods, urban heat waves, landslides, and windstorms. The urban households practiced lifestyle modification, reduce paved surfaces, the use of air conditioner, planting trees, and multiple windows. The adaptation strategies practiced by municipalities include the relocation of prone areas, the support of basic amenities, the construction of protection walls, diversion ditches, the clearance of waterways and rivers, greenery, and park development. The adaptation actions were constrained by a lack of awareness, commitment, cooperation and coordination, adaptive capacity, and participation. Gray/physical infrastructures (costly but important) as adaptation actions were hampered by the low municipal capacity. We recommend that urban authorities should incorporate climate change adaptation strategies into urban planning and development proactively to ensure future resilient climate smart urban centers of southwest Ethiopia. Full article

Medical image processing has been used in medical image analysis for many years and has achieved great success. However, one challenge is that medical image processing algorithms ineffectively utilize multi-modality characteristics to further extract features. To address this issue, we propose SSGNet based on UNet, which comprises a selective multi-scale receptive field (SMRF) module, a selective kernel self-attention (SKSA) module, and a skip connection attention module (SCAM). The SMRF and SKSA modules have the same function but work in different modality groups. SMRF functions in the T1 and T1ce modality groups, while SKSA is implemented in the T2 and FLAIR modality groups. Their main tasks are to reduce the image size by half, further extract fused features within the groups, and prevent information loss during downsampling. The SCAM uses high-level features to guide the selection of low-level features in skip connections. To improve performance, SSGNet also utilizes deep supervision. Multiple experiments were conducted to evaluate the effectiveness of our model on the BraTS2018 dataset. SSGNet achieved Dice coefficient scores for the whole tumor (WT), tumor core (TC), and enhancing tumor (ET) of 91.04, 86.64, and 81.11, respectively. The results show that the proposed model achieved state-of-the-art performance compared with more than twelve benchmarks. Full article

This study aimed to investigate the effect of hospital staffing resources on medical practice in public versus private hospitals. We used exhaustive delivery data from a French district of 11 hospitals over an 11-year period, from 2008 to 2018, including 168,120 observations. We performed multilevel logistic regression models with hospital fixed or random effects, while controlling for factors known to influence obstetric practice. We found that hospital staff ratios of obstetricians and that of midwives affected caesarean rates, but with different effects depending on the hospital sector. In public hospitals, the higher the ratio of obstetricians and that of midwives, the lower the probability of planned caesareans. In private hospitals, the higher the ratio of obstetricians, the greater the probability of planned caesareans. Indeed, in public hospitals, obstetricians and midwives, both salaried employees, do not have financial or organizational incentives to perform more caesareans. In private hospitals, obstetricians, who are independent doctors, may have such incentives. Our results underline the importance of having an adequate supply of health professionals in healthcare facilities to ensure appropriate care, with specific regard to the different characteristics of the public and private sectors. Full article

The chemical, electrochemical and microbiological corrosive degradation of metals is a versatile harmful problem that causes significant economic loss all over the world. The mitigation of these undesired processes needs basic knowledge on the mechanisms of processes in order to control these reactions with environmentally acceptable chemicals and techniques. This paper focuses on the up-to-date possibilities that help in the mitigation of chemical/electrochemical corrosion and, at the same time, decrease the deposition of corrosion relevant microorganisms, as the microbes in biofilms are more dangerous than the planktonic cells. Some chemicals or coatings due to their specific properties can fulfill multiple functions; they are able to control the corrosion caused by aggressive materials (that could be the metabolites of a corrosion relevant microorganism) and, at the same time, reduce the microbial adhesion. These additives that have important application possibilities in the chemical industry, marine environment, medical field, nanoelectronics, etc., can save energy, materials consumption and cost, and, at the same time, the efficiency is improved. All resolutions will be brought into prominence when the same chemicals (either in dissolved form or in coatings/nanolayers) can effectively control the different appearance of corrosion and, additionally, the microbial adhesion and microbiologically influenced corrosion. Full article

Plant cryobanks play a significant role in modern science and breeding. They contribute to the recovery of lost species, the emergence of new plant varieties, and help preserve and explore the diversity of the plant world. The IPPRAS Cryobank collection is constantly supplemented with new samples, while, at the same time, the stored samples are being monitored. In order to test seed germination, seeds of Allium and Veratrum species were thawed. Rare Allium species seeds, such as A. nutans, A. schoenoprasum, and A. victorialis were stored in liquid nitrogen for 17, 19, and 30 years, respectively. Long-term cryopreservation decreased germination rates for A. nutans from 96.55 to 50.00%, for A. schoenoprasum from 72.00 to 62.75%, and for A. victorialis from 90.00 to 83.05%. Seeds of a rare medicinal species, Veratrum lobelianum, were stored in liquid nitrogen for 18 years; the seed germination rate during this storage period has been significantly decreased from 75.00 to 14.81%. V. nigrum seeds were also collected and frozen in liquid nitrogen for 3 days. Short-term cryopreservation did not result in a statistically significant change in germination rates (from 79.71 to 82.69%). The seeds of an endangered ornamental species, Cypripedium calceolus, were collected and kept frozen for 3 days. After cryopreservation, the seeds were planted on three different media, as follows: ½ MS, MS with 10% coconut milk, and BM1. On ½ MS medium, 24.98% seeds formed protocorms, while on MS medium with 10% coconut milk, this number was 10.02%, and on BM1 medium, it was 15.02%, respectively; however, after 2.5 months, all of the protocorms died. Thus, it appears that the existing protocol for seed cryopreservation of C. calceolus needs further improvement. The size, weight, and free water content (WC) of six previously cryopreserved Stipa species and three Allium species were measured. For all the Allium and Stipa species studied, we found no correlation between seed size, WC, and cryotolerance. We also found no correlation between the life form, which reflects the water requirement of the species, and cryotolerance. Full article

Background: With increased life expectancy, the coexistence of functional impairment and multimorbidity can negatively impact life quality and coherence in geriatric individuals. The self-report 10-item Internal Coherence (ICS) measures how individuals cope with and make sense of disease-specific life challenges. The aim of this study was to validate the ICS in a sample of geriatric individuals. Methods and Procedure: In a cross-sectional study, geriatric individuals with and without chronic diseases were recruited. A factor analysis with principal component extraction (PCA) and a structural equation model (SEM) was conducted to assess the ICS factor structure in a geriatric sample. To measure convergent validity, the following scales were used: Short Health Survey (SF-12), Karnofsky Performance Index (KPI), Trait autonomic regulation (Trait aR), Sense of Coherence Scale (SOC), and Geriatric Depression Scale (GDS). Results: A sample of n = 104 (70–96 years of age) patients with Diabetes Mellitus Type 2 (n = 22), cancer diseases (n = 31) and healthy controls (n = 51) completed the ICS. PCA and SEM yielded the original two-factor solution: 1. Inner resilience and coherence and 2. Thermo coherence. Overall internal consistency for this cohort was satisfying (Cronbach’s α with r_α = 0.72), and test-retest reliability was moderate (r_rt = 0.53). ICS scores were significantly correlated to all convergent criteria ranging between r = 0.22 * and 0.49 ** (p < 0.05 *; p < 0.01 **). Conclusion: Study results suggest that the ICS appears to be a reliable and valid tool to measure internal coherence in a geriatric cohort (70–96 years). However, moderate test-retest reliability prompts the consideration of potential age-effects that may bias the reliability for this specific cohort. Full article

The Eurasian Iron Age Scythians, in all their regional iterations, are known for their lavish burials found in various kinds of tumuli. These tumuli, of varying sizes, are located throughout the Eurasian steppe. Based, at least partially, on the amounts and types of grave goods found within these mounds, the Scythians are usually modeled as militant, patriarchal mobile pastoralists, with rigid social structures. Yet, such interpretations are also due to accounts of Scythian lifeways provided by “classical” societies from the Greeks to the Persians, who saw the Scythians largely as barbarians, much like their neighbors to the north of the Greeks, the “Celts”. Despite recent interrogations of the barbarian trope, and the opportunity to dissect the classic formula of large mounds = elevated status, I contend that many studies on Scythian mortuary practices remain monolithic and under-theorized, especially by Western scholars. Drawing upon different conceptual and methodological frameworks, I present alternative, multi-scalar understandings of Scythian mortuary landscapes. Utilizing a spacetime-oriented, dialogical approach supplemented with geographic information systems, I interrogate how and why various meanings and experiences may have intersected in these protean Scythian landscapes of the dead, rather than reducing them to monolithic symbolic proxies of ideological status. Full article

The detection of objects on water surfaces is a pivotal technology for the perceptual systems of unmanned surface vehicles (USVs). This paper proposes a novel real-time target detection system designed to address the challenges posed by indistinct bottom boundaries and foggy imagery. Our method enhances the YOLOv8s model by incorporating the convolutional block attention module (CBAM) and a self-attention mechanism, examining their impact at various integration points. A dynamic sample assignment strategy was introduced to enhance the precision of our model and accelerate its convergence. To address the challenge of delineating bottom boundaries with clarity, our model employs a two-strategy approach: a threshold filter and a feedforward neural network (FFN) that provides targeted guidance for refining these boundaries. Our model demonstrated exceptional performance, achieving a mean average precision (mAP) of 47.1% on the water surface object dataset, which represents a 1.7% increase over the baseline YOLOv8 model. The dynamic sample assignment strategy contributes a 1.0% improvement on average precision at the intersection over union (IoU) threshold of 0.5 (AP^0.5), while the FFN strategy fine-tunes the bottom boundaries and achieves an additional 0.8% improvement in average precision at IoU threshold of 0.75 (AP^0.75). Furthermore, ablation studies have validated the versatility of our approach, confirming its potential for integration into various detection frameworks. Full article

The case report by Mabry et al. (1970) of a family with four children with elevated tissue non-specific alkaline phosphatase, seizures and profound developmental disability, became the basis for phenotyping children with the features that became known as Mabry syndrome. Aside from improvements in the services available to patients and families, however, the diagnosis and treatment of this, and many other developmental disabilities, did not change significantly until the advent of massively parallel sequencing. As more patients with features of the Mabry syndrome were identified, exome and genome sequencing were used to identify the glycophosphatidylinositol (GPI) biosynthesis disorders (GPIBDs) as a group of congenital disorders of glycosylation (CDG). Biallelic variants of the phosphatidylinositol glycan (PIG) biosynthesis, type V (PIGV) gene identified in Mabry syndrome became evidence of the first in a phenotypic series that is numbered HPMRS1-6 in the order of discovery. HPMRS1 [MIM: 239300] is the phenotype resulting from inheritance of biallelic PIGV variants. Similarly, HPMRS2 (MIM 614749), HPMRS5 (MIM 616025) and HPMRS6 (MIM 616809) result from disruption of the PIGO, PIGW and PIGY genes expressed in the endoplasmic reticulum. By contrast, HPMRS3 (MIM 614207) and HPMRS4 (MIM 615716) result from disruption of post attachment to proteins PGAP2 (HPMRS3) and PGAP3 (HPMRS4). The GPI biosynthesis disorders (GPIBDs) are currently numbered GPIBD1-21. Working with Dr. Mabry, in 2020, we were able to use improved laboratory diagnostics to complete the molecular diagnosis of patients he had originally described in 1970. We identified biallelic variants of the PGAP2 gene in the first reported HPMRS patients. We discuss the longevity of the Mabry syndrome index patients in the context of the utility of pyridoxine treatment of seizures and evidence for putative glycolipid storage in patients with HPMRS3. From the perspective of the laboratory innovations made that enabled the identification of the HPMRS phenotype in Dr. Mabry’s patients, the need for treatment innovations that will benefit patients and families affected by developmental disabilities is clear. Full article

The present study examined whether perception of critical community issues was dependent on respondents’ rurality, geographic region, or extension district in the state of Georgia, located in the southeastern United States. A non-probability sampling procedure was employed. A total of 3,374 responses were collected. Five critical community issue themes were analyzed: (1) youth and family development, (2) civic engagement and community development, (3) agriculture and economic development, (4) nutrition education and food availability, and (5) water. Descriptive statistics were analyzed. A series of chi-squared tests of independence were used to test for significant relationships between perception of critical community issues and geographic grouping. Statistically significant differences were observed between all groups (rurality, region, and district). Specifically, significant relationships were observed between all groups and perception of youth and family development and agriculture and economic development. A significant relationship between region and perception of civic engagement and community leadership was observed. Additionally, there was a significant relationship between rurality and water observed. The results indicate that programming efforts should be informed both by proximal communities as well as non-proximal communities sharing common characteristics. Full article

Agricultural industries rely on physical fences to manage livestock. However, these present practical, financial, and ecological challenges, which may be solved using virtual fencing. This study aimed to identify how experienced cattle through social facilitation and the introduction method influence inexperienced cattle. Based on three stocks held in Fanø, Denmark, containing 12, 17 and 13 Angus (Bos taurus), we examined the virtual fence learning in three case studies using one gradual introduction with zero experienced cattle (A) and two different instant introductions with one (B) and ten (C) experienced cattle. Gradual introduction had the virtual fence moved 20 m every other day for eleven days, and in the two instant introductions, the physical fence was removed in one day. Warnings and impulses were recorded during an 11-day learning period and a 26-day post-learning period, using the impulses per warning to quantify if the cattle adapted. Case studies A and B showed a significant reduction in the warnings and impulses, but only A showed a significant reduction in the impulses per warning when comparing the learning period to the post-learning period. Due to the non-standardised experiments, it was not possible to conclude if the number of experienced cattle or the introduction method had an effect on the results. Full article

NUT (nuclear-protein-in-testis) carcinoma (NC) is a highly aggressive tumor disease. Given that current treatment regimens offer a median survival of six months only, it is likely that this type of tumor requires an extended multimodal treatment approach to improve prognosis. In an earlier case report, we could show that an oncolytic herpes simplex virus (T-VEC) is functional in NC patients. To identify further combination partners for T-VEC, we have investigated the anti-tumoral effects of T-VEC and five different small molecule inhibitors (SMIs) alone and in combination in human NC cell lines. Dual combinations were found to result in higher rates of tumor cell reductions when compared to the respective monotherapy as demonstrated by viability assays and real-time tumor cell growth monitoring. Interestingly, we found that the combination of T-VEC with SMIs resulted in both stronger and earlier reductions in the expression of c-Myc, a main driver of NC cell proliferation, when compared to T-VEC monotherapy. These results indicate the great potential of combinatorial therapies using oncolytic viruses and SMIs to control the highly aggressive behavior of NC cancers and probably will pave the way for innovative multimodal clinical studies in the near future. Full article

Although the water extract of Eucommia ulmoides leaf (WEE) promotes egg laying in hens, its palatability is poor. To improve the palatability of E. ulmoides leaf, probiotic fermentation was used, and fermented extract E. ulmoides leaf (FEE) was prepared using Lactiplantibacillus plantarum. The safety of FEE was investigated using a long-term toxicity test, and no oxidative damage, inflammatory reactions, or histological lesions were observed in the experimental rats receiving dietary supplementation of FEE at 200 mg/kg, suggesting that FEE is suitable for long-term feeding. Subsequently, dietary supplementation of FEE (group C) in comparison with dietary supplementation of WEE (group B), as well as a control (group A), was applied in the hen industry. Laying performance, egg quality, egg nutrition, egg flavor, and the gut microbiome were analyzed comparatively. Interestingly, the laying rate was observed to be four percentage points higher with dietary supplementation of FEE at 200 mg/kg compared with the control and two percentage points higher compared with the dietary addition of WEE at the same dosage. Simultaneously, a slight upregulation in daily feed consumption was determined in the FEE-supplemented group compared with the blank control and the WEE-supplemented group, indicating that the inclusion of FEE stimulated the hens’ appetite. Moreover, variations in egg amino acids, fatty acids, and volatile components were obtained with either dietary addition, FEE or WEE, implying that dietary supplementation of the fermented and water-extracted E. ulmoides leaf extracts contributed to egg flavor change. Furthermore, variations in the gut microbiota were mediated by FEE, increasing the relative abundance of the genus Lactobacillus. These alterations in gut microbiota were tightly related to improved laying performance and egg flavor changes. Our results indicate that FEE is a better alternative feed additive in the hen industry than WEE. Full article

In this paper, we present an approach to the price-optimized charging of electric vehicles (EVs) based on energy flexibility. Fleet operators determine the minimum and the maximum power demand to charge EVs at a specific time and share this information as so-called power corridors (PCs) with an energy aggregator. The energy aggregator collects the predicted PCs from the fleet operators located in the same market area and aggregates the PCs. The energy provider periodically sends energy prices from the market to the energy aggregator, which purchases energy when its price is opportune. The energy aggregator calculates and delivers charge plans for each fleet operator involved and thus can pass along the purchase prices. The incentive design must ensure that fleet operators are better off by disclosing their flexibility data to the aggregator. This study can contribute to a new data-driven energy market communication system by providing insights on how to leverage the energy flexibility that EVs can offer to the energy system. Full article

The negatively charged extracellular matrix plays a vital role in intervertebral disc tissues, providing specific cues for cell maintenance and tissue hydration. Unfortunately, suitable biomimetics for intervertebral disc regeneration are lacking. Here, sulfated alginate was investigated as a 3D culture material due to its similarity to the charged matrix of the intervertebral disc. Precursor solutions of standard alginate, or alginate with 0.1% or 0.2% degrees of sulfation, were mixed with primary human nucleus pulposus cells, cast, and cultured for 14 days. A 0.2% degree of sulfation resulted in significantly decreased cell density and viability after 7 days of culture. Furthermore, a sulfation-dependent decrease in DNA content and metabolic activity was evident after 14 days. Interestingly, no significant differences in cell density and viability were observed between surface and core regions for sulfated alginate, unlike in standard alginate, where the cell number was significantly higher in the core than in the surface region. Due to low cell numbers, phenotypic evaluation was not achieved in sulfated alginate biomaterial. Overall, standard alginate supported human NP cell growth and viability superior to sulfated alginate; however, future research on phenotypic properties is required to decipher the biological properties of sulfated alginate in intervertebral disc cells. Full article

The purpose of this paper is to investigate the intertemporal relationship between the non-performing loan ratio and bank lending and to analyze factors affecting loan growth using data from Mongolian commercial banks. There has been a lack of research on Mongolian banks’ lending behavior due to their short history. Thus, this paper investigates the effect of the non-performing loan ratio on total loan growth using an ordinary least squares (OLS) regression model with panel data. We used bank-related variables such as the loan-to-deposit ratio, provision-to-gross loan portfolio ratio, equity-to-asset ratio, and liquidity ratio, and economic variables such as the real gross domestic product (GDP) growth rate, interest rate, and inflation rate. The results of this paper show that non-performing loans have a significant negative impact on total loan growth. The implication of this result is that non-performing loans affect banking efficiency, which, in turn, affects financial stability and the real economy. Moreover, high non-performing loans reduce banks’ profits. Also, this paper found that loss reserve and the liquidity ratio have a positive effect on total loan growth, while the effects of the loan-to-deposit ratio and the equity capital ratio were not found to be significant. Additionally, from a macro perspective, the inflation rate has a positive effect on the total loan growth rate, while the interest rate has a positive effect on total loan growth rather than a negative effect. And real gross domestic product (GDP) growth does not affect the total loan growth rate. Full article

In the realm of medical image analysis, the cost associated with acquiring accurately labeled data is prohibitively high. To address the issue of label scarcity, semi-supervised learning methods are employed, utilizing unlabeled data alongside a limited set of labeled data. This paper presents a novel semi-supervised medical segmentation framework, DCCLNet (deep consistency collaborative learning UNet), grounded in deep consistent co-learning. The framework synergistically integrates consistency learning from feature and input perturbations, coupled with collaborative training between CNN (convolutional neural networks) and ViT (vision transformer), to capitalize on the learning advantages offered by these two distinct paradigms. Feature perturbation involves the application of auxiliary decoders with varied feature disturbances to the main CNN backbone, enhancing the robustness of the CNN backbone through consistency constraints generated by the auxiliary and main decoders. Input perturbation employs an MT (mean teacher) architecture wherein the main network serves as the student model guided by a teacher model subjected to input perturbations. Collaborative training aims to improve the accuracy of the main networks by encouraging mutual learning between the CNN and ViT. Experiments conducted on publicly available datasets for ACDC (automated cardiac diagnosis challenge) and Prostate datasets yielded Dice coefficients of 0.890 and 0.812, respectively. Additionally, comprehensive ablation studies were performed to demonstrate the effectiveness of each methodological contribution in this study. Full article

Background: The pandemic caused by the SARS-CoV-2 virus demonstrated the importance of prevention through a healthy diet and lifestyle, the most vulnerable people being those with severe chronic conditions, those who are overweight, and those with an unbalanced immune system. This study aims to examine the nutritional status and lifestyle behaviors of the Romanian population. Methods: The evaluation of the eating habits and lifestyle of the Romanian population in the post-pandemic period was carried out based on a cross-sectional observational study with the help of a questionnaire. Results: A total of 4704 valid answers were registered (3136 female and 1568 male respondents). Among the respondents, most of them belong to the young population, 2892 between the ages of 18 and 40, i.e., 61.5%. Most male respondents are overweight (1400) and obese (780). Most respondents indicated a tendency to consume 1–2 meals per day irregularly (p = 0.617). Only 974 respondents adopted a healthy diet, and 578 a healthy lifestyle. Conclusions: The present study reports low adherence to a healthy diet (20.7%) and healthy lifestyle (12.28%), especially among the young population (<30 years). In the current context, it reports a reduced tendency to consume vegetables and fruits among the population, below the daily average recommended by the nutrition guidelines, a tendency towards sedentary behavior, and even deficient hydration of some of the respondents; these negative aspects can create a long-term series of nutritional and psycho-emotional imbalances. Our results evidence that complex surveys among the population are regularly required to investigate nutritional or lifestyle deficiencies; moreover, it could be helpful in further educational measures in nutrition, food, and environmental safety. Full article

The CRP/albumin ratio (CAR) is a mortality predictor in intensive care unit (ICU) patients. The aim of the current study was to investigate the ability of CAR to predict in-hospital mortality (IHM) in patients with isolated traumatic brain injury (iTBI). We performed a retrospective analysis including 200 patients with iTBI admitted to our neurosurgical intensive care unit (NICU) between September 2014 and December 2016. Serum biomarkers, demographic and radiological data, several ICU scores, and cardiopulmonary parameters were analyzed. The rate of IHM was 27.5% (55/200) and significantly associated with a higher AIS head score (p < 0.0001), a lower albumin level (p < 0.0001), and the necessity of a higher level of inspiratory oxygen fraction (p = 0.002). Furthermore, advanced age (odds ratio [OR] = 0.953, 95% confidence interval [CI] = 0.927–0.981, p = 0.001), a lower GCS score (OR = 1.347, 95% CI = 1.203–1.509, p < 0.0001), a higher level of lactate (OR = 0.506, 95% CI = 0.353–0.725, p < 0.0001), a higher CAR (OR = 0.547, 95% CI = 0.316–0.945, p = 0.031) and a higher norepinephrine application rate (OR = 0.000, 95% CI 0.000–0.090, p = 0.016) were identified as independent predictors of IHM. ROC analysis showed an association between IHM and a CAR cut-off value of >0.38 (Youden index 0.073, sensitivity: 27.9, specificity: 64.8, p = 0.044). We could identify a CAR > 0.38 as a new independent predictor for IHM in patients with iTBI. Full article