BACKGROUND: Disasters can cause casualties and significant financial loss. In accordance with the Sendai Framework for Disaster Risk Reduction, areas affected by disasters must be built back better. Accurate post-disaster damage and loss assessments are critical for the success of recovery programs. This scoping review aimed to identify the components and entities of the healthcare sector\'s post-disaster damage and loss assessment program.
METHODS: An comprehensive search for relevant literature was performed using several databases, including the Web of Science, PubMed, Scopus, ProQuest, and Magiran. The search was limited to papers published between 2010 and 2022. In addition, we searched the grey literature for resources related to post-disaster damage and loss assessments. Study selection and data extraction were evaluated by a third reviewer. The main themes were determined through a consensus process and agreement among team members.
RESULTS: A total of 845 papers were identified, 41 of which were included in the review. The grey literature search yielded 1015 documents, 23 of which were associated with the study\'s purpose. The findings were classified into five main themes, 20 subthemes, and 876 codes. The main-themes include the following: Concepts and Definitions; Post-Disaster Damage and Loss Assessment Procedures; Healthcare sector procedures; Assessments Tools, and Methods; Intra-sectoral, Inter-sectoral, and cross-cutting issues.
CONCLUSIONS: The existing corpus of literature on post-disaster damage and loss assessment programs within the healthcare sector offers only limited insights into the entities and components involved. It is of great importance that stakeholders have an extensive grasp of these pivotal concepts and principles, as they are fundamental in enabling effective responses to disasters, informed decision-making, and facilitating rehabilitation and reconstruction efforts. Consequently, there is a considerable scope for further investigation in this area. SCOPING REVIEW REGISTRATION NUMBER: https://osf.io/nj3fk .

We present a corrosion internal state variable (ISV) damage model based upon the integrated computational materials engineering (ICME) hierarchical multiscale paradigm. Structure-property experiments for magnesium alloys were used where the only inputs were the volume fractions of each element of the periodic table. This macroscale ISV corrosion model finds its basis in Horstemeyer\'s mechanical damage model, which includes three separate ISVs for damage nucleation, growth, and coalescence, as well as Walton\'s inclusion of corrosion, which introduces five new ISVs for pit nucleation, growth, and coalescence, along with general corrosion and intergranular corrosion. While Walton\'s corrosion ISVs are phenomenological in nature, herein we develop a multiscale physical basis for the corrosion ISVs. The parameters for the macroscale corrosion ISVs were garnered from the mesoscale Butler-Volmer equations. Pure magnesium with differing amounts of aluminum were used in corrosion tests to exemplify the different pitting, general corrosion, and intergranular corrosion rates, and the macroscale ISV model was calibrated with said data, in which the only inputs to the model are the volume percentages of the elements magnesium and aluminum. Although magnesium alloys were used to motivate and calibrate the model, the model is abstract enough to possibly capture other material systems as well.

Acoustic emission (AE) is well suited for the real-time monitoring and detection of damage in reinforced concrete structures. In this study, loading/unloading cycles up to failure were applied on three different full-scale beams, each with varying defect morphologies. An intensity analysis method was employed to assess the damage sensitivities of the defective structures under stress conditions. Specifically, the calm ratio, load ratio, severity, and historical index were identified as statistical parameters that can provide global information on the damage level. Consequently, they can be easily used as damage evolution indexes for reinforced concrete structures. Correlations between these parameters were investigated to better discriminate between their potentials and identify critical levels that might not be evident using parametric analysis. The AEI chart helps locate damaging areas, aiding focused repairs. For defected beams with broken strands, at low load, HI and SI fall in zone B (damage detected). At cycles 4 and 6, with significant deflection, they fall into a critical zone, E (severe damage). Comparing post-tensioned beams revealed defects correlating with damage susceptibility. B3 beams with diffused defects displayed high activity at higher loads. Applying a load-calm ratio chart, initial minor damage worsened progressively. Severe damage was prominent in defective B2 and B3 beams, reaching zone 3. The variation in the acquired parameters over time can then be considered as an affordable and reliable indicator of damage progression.

Neurodegenerative disorders, including traumatic injuries to the central nervous system (CNS) and neurodegenerative diseases, are characterized by early axonal damage, which does not regenerate in the adult mammalian CNS, leading to permanent neurological deficits. One of the primary causes of the loss of regenerative ability is thought to be a developmental decline in neurons\' intrinsic capability for axon growth. Different molecules are involved in the developmental loss of the ability for axon regeneration, including many transcription factors. However, the function of microRNAs (miRNAs), which are also modulators of gene expression, in axon re-growth is still unclear. Among the various miRNAs recently identified with roles in the CNS, miR-17, which is highly expressed during early development, emerges as a promising target to promote axon regeneration. Here, we used adeno-associated viral (AAV) vectors to overexpress miR-17 (AAV.miR-17) in primary cortical neurons and evaluate its effects on neurite and axon regeneration in vitro. Although AAV.miR-17 had no significant effect on neurite outgrowth and arborization, it significantly enhances neurite regeneration after scratch lesion and axon regeneration after axotomy of neurons cultured in microfluidic chambers. Target prediction and functional annotation analyses suggest that miR-17 regulates gene expression associated with autophagy and cell metabolism. Our findings suggest that miR-17 promotes regenerative response and thus could mitigate neurodegenerative effects.

Glucocorticoids (GCs) are one of the most effective first-line treatments for systemic lupus erythematosus (SLE). However, GC burden is associated with damage. The initial GC dose and tapering schedule should be tailored to the severity of the clinical scenario. As lupus therapy should prompt remission while minimising damage, recent guidelines recommend a more accurate approach to the use of GCs, setting lower starting doses and rapid tapering schemes, and encouraging maintenance prednisolone doses <5 mg/day. Methylprednisolone pulses (MP) help to reduce the dose of oral GCs and improve the clinical response in both severe and non-severe manifestations, without significant side effects. Fixed-tapering GC scheme provides a useful strategy to reduce GCs exposure. Long-term antimalarial treatment and early initiation of immunosuppressive drugs improve clinical efficacy while reducing GC toxicity. Besides, withdrawal of GCs is an achievable goal in patients in prolonged remission on stable treatment, and recent studies have attempted to identify the most suitable candidates. In this article, we review the pharmacological basis, clinical evidence of efficacy, dose-related harms, and potential withdrawal of GCs. We also review guidelines recommendations and finally give a personal and practical approach to dealing with the use of GCs in SLE patients.

The molecular mechanisms that drive muscle adaptations after eccentric exercise training are multifaceted and likely impacted by age. Previous studies have reported that many genes and proteins respond differently in young and older muscles following training. Keratin 18 (Krt18), a cytoskeletal protein involved in force transduction and organization, was found to be upregulated after muscles performed repeated bouts of eccentric contractions, with higher levels observed in young muscle compared to older muscle. Therefore, the purpose of this study was to determine if Krt18 mediates skeletal muscle adaptations following eccentric exercise training. The anterior crural muscles of Krt18 knockout (KO) and wild-type (WT) mice were subjected to either a single bout or repeated bouts of eccentric contractions, with isometric torque assessed across the initial and final bouts. Functionally, Krt18 KO and WT mice did not differ prior to performing any eccentric contractions (p≥0.100). Muscle strength (tetanic isometric torques) and the ability to adapt to eccentric exercise training were also consistent across strains at all time points (p≥0.169). Stated differently, immediate strength deficits and the recovery of strength following a single or multiple bouts of eccentric contractions were similar between Krt18 KO and WT mice. In summary, the absence of Krt18 does not impede the muscle\'s ability to adapt to repeated eccentric contractions, suggesting it is not essential for exercise-induced remodeling.

Intracavitary brachytherapy with a remote after-loading system (RALS) is performed as a part of radical radiation therapy in cervical cancer. The radiation source is delivered directly through an applicator placed inside the uterus or vagina. Thorough quality control is important to prevent accidents that can lead to serious irradiation error, and an applicator check is one such quality control measure. We experienced a clinical situation in which a small volume of water was observed in the lumen of a post-sterilized applicator on treatment-planning CT. Although the submersion test was negative and no air bubbles emerged from the applicator, ultra-high-resolution computed tomography (U-HRCT) showed a linear crack reaching the inside of the applicator. This abnormality was not identified on treatment-planning CT, which has lower spatial resolution than U-HRCT. In addition, no linear cracks were seen on U-HRCT images of eight other applicators considered to be free from damage. U-HRCT may have superior potential to detect applicator damage and could be useful for quality assurance of the RALS procedure.

Polymers are omnipresent in our daily life thanks to their low production cost and their ease of implementation, which makes thermoplastics more usable in supplying drinking water, distributing cold and hot water, and transporting hot corrosive fluids and industrial chemicals, including inorganic acids. The material of our study is chlorinated polyvinyl chloride (CPVC); it has better thermal insulation and a wide operating temperature range. This paper deals with the impact of thermal aging over time on the behavior of CPVC by performing two types of tests according to ISO 15877 (EN ISO 15877) two types of tests; the first is thermal aging (Fig. 1) at a temperature of 95 °C and a pressure of 10 bars for periods of up to 2000 h and the second test exposure of the pipeline to pressure until bursting. On the basis of the test results, we can predict the rupture of the pipeline and thus avoid the dangerous accidents due to the bursting under the effect of the pressure and the high temperature; by using the results of this study, the inspectors change CPVC structures at the right time, neither too early when the part is still in good condition nor too late after failure; this will be very useful to save water and money and of course save the environment.

OBJECTIVE: To investigate the severe haematological involvement in children with SLE and assess its clinical associations, treatments, outcome and damage accrual.
METHODS: The medical charts of children with SLE in whom haematological involvement was observed were reviewed. Severe haematological indices were defined as autoimmune haemolytic anaemia with a haemoglobin concentration < 8 g/dL, thrombocyte count < 30 000/µL, and neutrophil count < 500/µL.
RESULTS: Among the 224 patients included, 102 (45.5%) displayed severe indices, predominantly at the initial involvement, and most frequently as severe anaemia in 54 (24.1%) and severe thrombocytopenia in 45 (20.1%). Disease activity did not differ according to the presence of severe disease indices. In addition, the presence of severe indices at initial involvement did not affect the damage accrual. However, a higher rate of damage (51.1% vs. 29.9%, p = 0.002) and steroid-induced damage (28.9% vs. 8.2%, p < 0.001) was evident in patients with flares of the haematological system. Regression analysis revealed that rituximab treatment during the initial episode (OR:4.5, p = 0.006) and the presence of anticardiolipin antibodies (OR:2.3, p = 0.014) significantly increases the odds for haematological system flare. However, severe indices at initial involvement did not increase the odds of a haematological flare.
CONCLUSIONS: Severe haematological indices at onset are common but not related with disease outcomes. Prevention of flares is important to improve outcomes, and a more rigorous maintenance strategy would benefit most to children who display haematological indices refractory to conventional immunosuppressants and those with anti-cardiolipin antibodies.

Carbon Fiber Reinforced Polymers (CFRP) have become increasingly significant in real-world applications due to their superior strength-to-weight ratio, corrosion resistance, and high stiffness. These properties make CFRP an ideal material for reinforcing concrete structures, particularly in scenarios where weight reduction is crucial, such as in bridges and high-rise buildings. The transformative potential of CFRP lies in its ability to enhance the durability and load-bearing capacity of concrete structures while minimizing maintenance costs and extending the lifespan of the infrastructure. This research explores the impact of reinforcing structural elements with advanced composite materials on the strength and durability of concrete and reinforced concrete structures. By integrating Carbon Fiber Reinforced Polymer (CFRP) reinforcements, we subjected both rectangular and T-section concrete beams to comprehensive three-point bending tests, revealing a substantial increase in flexural strength by 45% and crack resistance due to CFRP reinforcement. The study revealed that CFRP reinforcement increased the flexural strength of concrete beams by 45% and improved crack resistance significantly. Additionally, the load-bearing capacity of the beams was enhanced by 40% compared to unreinforced specimens. These improvements were validated through finite element simulations, which showed a close alignment with the experimental data. Furthermore, an innovative simulation study was conducted using a finely tuned finite element numerical model within the Abaqus calculation code. This model accurately replicated the laboratory specimens in terms of shape, dimensions, and loading conditions. The simulation results not only validated the experimental observations but also provided deeper insights into the stress distribution and failure mechanisms of the reinforced beams. Novel aspects of this study include the identification of specific failure patterns unique to CFRP-reinforced beams and the introduction of an enhanced interaction model that more accurately reflects the composite behavior under load. In CFRP-reinforced beams, specific failure patterns were identified, including flexural cracks in the tension zone and debonding of the CFRP sheets. These patterns indicate the points of maximum stress concentration and potential weaknesses in the reinforcement strategy. The study revealed that while CFRP significantly improves the overall strength and stiffness, careful attention must be given to the bonding process and the quality of the adhesive used to ensure optimal performance. These findings contribute significantly to the understanding of material interactions and structural performance, offering new pathways for the design and optimization of composite-reinforced concrete structures. This research underscores the transformative potential of composite materials in elevating the structural integrity and longevity of concrete infrastructures.