Search Results (122)

Network security courses rely on hands-on labs where students configure virtual Linux networks to practice attack and defense. Automated feedback is scarce because no standard exists for exchanging detailed configurations—interfaces, bridging, routing tables, iptables policies—between exercise software and large language models (LLMs) that could serve as tutors. We address this interoperability gap with an exercise-oriented YANG profile that augments the Internet Engineering Task Force (IETF) ietf-network module with a new network-devices module. The profile expresses Linux interface settings, routing, and firewall rules, and tags each node with roles such as linux-server or linux-firewall. Integrated into our LiNeS Cloud platform, it enables LLMs to both parse and generate machine-readable network states. We evaluated the profile on four topologies—from a simple client–server pair to multi-subnet scenarios with dedicated security devices—using ChatGPT-4o, Claude 3.7 Sonnet, and Gemini 2.0 Flash. Across 1050 evaluation tasks covering profile understanding (n = 180), instance analysis (n = 750), and instance generation (n = 120), the three LLMs answered correctly in 1028 cases, yielding an overall accuracy of 97.9%. Even with only minimal follow-up cues (≦3 turns) —rather than handcrafted prompt chains— analysis tasks reached 98.1% accuracy and generation tasks 93.3%. To our knowledge, this is the first exercise-focused YANG profile that simultaneously captures Linux/iptables semantics and is empirically validated across three proprietary LLMs, attaining 97.9% overall task accuracy. These results lay a practical foundation for artificial intelligence (AI)-assisted security labs where real-time feedback and scenario generation must scale beyond human instructor capacity. Full article

Background: Pediatric-onset multiple sclerosis (POMS) is a rare but often more aggressive form of multiple sclerosis, associated with early cognitive impairment and significant impact on quality of life. Multiple sclerosis and primary headaches, particularly migraine, are well established in adults, but data on pediatric populations remain limited. Methods: The purpose of this retrospective study was to examine 64 POMS patients, divided into groups with and without headaches, to determine potential correlations between headache presence, age at POMS onset, and MRI lesion burden. Results: Headaches were reported by 78% of patients, predominantly migraines (68%), with a significantly higher prevalence in females (74%). No significant differences were found in age at MS onset or lesion load on brain MRI between patients with and without headaches. Among those with headaches, migraines represented a higher frequency of attacks and a greater need for prophylactic treatment compared to other headache types. Headache characteristics, including pain location and associated symptoms, showed no correlation with age at MS onset or lesion burden. Conclusions: These findings indicate that while headaches are common in POMS and more frequent in females, their presence and features do not appear to directly influence the clinical or neuroradiological course of the disease. Further research with larger cohorts and longitudinal follow-up is warranted to better understand the underlying mechanisms and long-term impact of headaches in pediatric MS. Full article

Background/Objectives: IPMNs are a possible cause of acute pancreatitis (AP). IPMN-associated-AP is considered a relative indication for surgery for the prevention of recurrent attacks of pancreatitis and for a hypothesized increased cancer risk. The literature is based on surgical series, and no data on the clinical features of AP associated with IPMNs and on the risk of recurrent pancreatitis and pancreatic cancer are available. This study aimed to describe the clinical/radiological features of BD-IPMN-associated AP. Moreover, BD-IPMN-associated risk factors for AP recurrence and risk of pancreatic cancer were investigated. Methods: Patients with AP associated with branch-duct IPMN (BD-IPMN) without “worrisome- features” and “high-risk-stigmata” evaluated in a Gastroenterology Unit (University of Verona) between 1 January 2012 and 31 December 2022 were retrospectively analyzed. Cox proportional hazard models were used to analyze the time to recurrence after the first occurrence of AP. Results: One hundred and thirty-five patients were included, with a mean age of 55.8 ± 12.5 years. Necrosis was diagnosed in 15 patients (11.1%) and 1 patient (0.7%) was admitted to the ICU. One hundred and two (75.6%) patients had recurrent pancreatitis. The median size of the largest BD-IPMN was 8 mm (Q1–Q3: 5–12). Eighteen patients (13.3%) developed main pancreatic duct dilation ≥ 5 mm. No patients developed dilation of the main pancreatic duct ≥ 10 mm, mural nodules, thickened cystic walls, or jaundice. In the unadjusted analysis, no BD-IPMN-related features were associated with an increased risk of recurrent pancreatitis. None of the patients developed pancreatic cancer. Conclusions: BD-IPMN-associated AP appears to have a benign clinical course. Cystic features related to increased risk of recurrence were not identified. The risk of cancer appears extremely low. Full article

Introduction: Migraines are a prevalent neurovascular disorder that affects more than a billion people worldwide. Even though both women and men are affected by this neurological disorder, migraines are primarily recognized as a women’s health disruption factor. Pregnancy leads to significant hormonal changes, including a rise in estrogen, progesterone, and endogeny opioid levels, and, therefore, it can affect the course of migraines. Women dealing with migraines often experience migraine symptom reduction during the course of pregnancy, but in the setting of increased maternal body mass index and obesity, this common pattern may be altered. Due to the complexity of the interplay between pregnancy, obesity, and migraines, all mediated by hormonal changes, the aim of our study is to try to unravel the impact of migraines and obesity on maternal health and pregnancy outcomes. Methods: This study included 350 subjects who have suffered at least one migraine attack three months preceding pregnancy, or at any point during the course of pregnancy. Initially, the study subjects were divided into two groups. The first group included women suffering from migraines before pregnancy, but not during the course of pregnancy, and the other group included all subjects who remained symptomatic during the course of pregnancy or had a first migraine attack during their pregnancy. Further comparisons were made based on the patients’ BMI values, and correlations were made between the obese and non-obese study subjects. Results: Higher parity (p = 0.005), obesity (p = 0.005), earlier age of migraine onset (p = 0.004), and gestational diabetes mellitus (p = 0.004) were statistically significant predictors for migraine symptom persistence during pregnancy. Obese pregnant women were more likely to experience migraine intensity and frequency persistence during pregnancy (p < 0.001 and p < 0.001, respectively). They sought magnesium treatment more often (p < 0.001), but this had a modest therapeutic effect compared to non-obese pregnant women (p < 0.001). A diagnosis of hypertensive disorder of pregnancy and gestational diabetes mellitus was also more frequently established in the group of obese pregnant women (p = 0.002 and p < 0.001, respectively). Conclusions: Pregnancy induces substantial physiological changes that can both alleviate and exacerbate migraine symptoms. Obesity is a modifiable risk factor that not only may increase the intensity and frequency of migraine symptoms, but may also compromise pregnancy course and outcome. The co-occurrence of migraines and obesity during pregnancy may amplify health risks for the mother and fetus, including heightened susceptibility to gestational diabetes mellitus. Future research should prioritize focusing on better understanding the causal relationships between pregnancy, migraines, and obesity and providing treatment strategies the home in on weight management and the control of migraine symptoms and associated comorbidities. Full article

Here, we report an unusual case of a nonsmoker and hypertensive 72-year-old male who was admitted with a transient ischemic attack to the Neurology Department of Clinical County Emergency Hospital Bihor. He presented a first transient ischemic attack and paroxysmal atrial fibrilation 2 years before, when anticoagulation was started on top of his antihypertensive medication. At that time, carotid Doppler ultrasound revealed nonobstructive atherosclerosis and statin therapy was started, according to current guidelines, in order to lower the initial 70 mg/dL LDL-cholesterol level to under 55 mg/dL. Cardio-embolism was considered the mechanism of stroke at that time. Despite all the medication and the maintenance of LDL below 50 mg/dL, carotid atherosclerosis evolved to an important left internal carotid artery stenosis and transient ischemic attacks reappeared two years later. Carotid stenosis was then considered the most probable cause, although elucidating the exact mechanism was difficult. After medical treatment and subsequent endarterectomy, the patient had a good outcome. The progressive course of atheromatosis, despite maximal medication, urged us to look for further proper measures of prevention. No chronic disease was detected during the postoperative phase, except for early-stage periodontal disease, for which adequate preventive measures were applied. Considering that subclinical inflammation induced by periodontal disease can induce the progression of atherosclerosis, chronic treatment with colchicine was added, with a favorable outcome. Full article

(1) Background: Traumatic brain injury (TBI) is caused from rapid head acceleration/deceleration, focal blows, blasts, penetrating forces, and/or shearing forces, whereas hypoxic–anoxic injury (HAI) is caused through oxygen deprivation events, including strangulation. Most service-seeking domestic violence (DV) survivors have prior mechanistic exposures that can lead to both injuries. At the time of our study, some evidence existed about the exposure to both injuries over the course of a survivor’s lifetime from abuse sources, yet little was known about their co-occurrence to the same survivor within the same episode of physical intimate partner violence (IPV). To better understand the lived experience of service-seeking DV survivors and the context in which partner-inflicted brain injury (PIBI) is sustained, we sought to understand intentional brain injury (BI) exposures that may need to be addressed and accommodated in services. Our aims were to 1. characterize the lifetime co-occurrence of strangulation and intentional head trauma exposures from all abuse sources to the same survivor and within select physical episodes of IPV and 2. establish the lifetime prevalence of PIBI. (2) Methods: Survivors seeking DV services in the state of Ohio in the United States of America (U.S.) completed interview-administered surveys in 2019 (n = 47). Community-based participatory action approaches guided all aspects of the study development, implementation, and interpretation. (3) Results: The sample was primarily women. Over 40% reported having Medicaid, the government-provided health insurance for the poor. Half had less than a postsecondary education. Over 80% of participants presented to DV services with both intentional head trauma and strangulation exposures across their lifetime from intimate partners and other abuse sources (i.e., child abuse, family violence, peer violence, sexual assault, etc.), though not always experienced at the same time. Nearly 50% reported an experience of concurrent head trauma and strangulation in either the first or last physical IPV episode. Following a partner’s attack, just over 60% reported ever having blacked out or lost consciousness—44% experienced a loss of consciousness (LOC) more than once—indicating a conservative estimate of a probable brain injury by an intimate partner. Over 80% of service-seeking DV survivors reported either a LOC or two or more alterations in consciousness (AICs) following an IPV attack and were classified as ever having a partner-inflicted brain injury. (4) Conclusions: Most service-seeking IPV survivors experience repetitive and concurrent exposures to abusive strangulation and head trauma through the life course and by intimate partners within the same violent event resulting in brain injury. We propose the use of the term partner-inflicted brain injury (PIBI) to describe the physiological disruption of normal brain functions caused by intentional, often concurrent and repeated, traumatic and hypoxic neurologic insults by an intimate partner within the context of ongoing psychological trauma, coercive control, and often past abuse exposures that could also result in chronic brain injury. We discuss CARE (Connect, Acknowledge, Respond, Evaluate), a brain-injury-aware enhancement to service delivery. CARE improved trauma-informed practices at organizations serving DV survivors because staff felt knowledgeable to address and accommodate brain injuries. Survivor behavior was then interpreted by staff as a “can’t” not a “won’t”, and social and functional supports were offered. Full article

Background: Idiopathic histaminergic angioedema (IH-AAE) is a pathological entity poorly described in the literature. It overlaps with some forms of chronic urticaria, especially in pediatrics. Objective: This study is a descriptive analysis of this form of angioedema’s natural history and prognosis. The aim is to describe long-term data about the course of this clinical entity, including clinical presentation, recurrence, and response to therapy, emphasizing follow-up and outcome. Methods: We performed a retrospective monocentric descriptive study at the Allergy Unit, Department of Pediatrics of the Institute for Maternal and Child Health of Trieste, Italy. We selected pediatric patients (0–18 years old) visiting the outpatient clinic from January 2010 to December 2020 who received a diagnosis of IH-AAE. We analyzed the disease recurrence, the remission rate, the time and frequency of recurrences, and the body sites involved. Results: The median follow-up was 57 months. Among the 36 individuals examined at follow-up, 9 (25%) still had episodes of angioedema, while 27 (75%) reported the absence of attacks. Disease remission was established in 24 patients (66.6%). The median remission time was 13 months (IQR: 7–28). When comparing AE recurrence at onset and follow-up, in all children, the number of episodes decreased (in 4/9 patients) or remained unchanged over time (in 5/9 patients). Moreover, within this group, AE recurrence was recorded as high, intermediate, and low, respectively, in one (11.1%), two (22.2%), and six patients (66.7%). The median number of monthly episodes was one (IQR: 0.2–3), and eight was the maximum value. The initial recurrence of AE attacks has no impact on the time and rate of remission (p = 0.56). According to these data, 36% of the patients will go into remission in 1 year, 54% in 2 years, and 71% in 6.5 years, while 14% of the children will still present with AE after 8 years of disease. Conclusions: IH-AAE is a benign and self-limiting condition that can sometimes last several years. Over time, the number of episodes per month decreases or, at most, remains unchanged. No patients reported disease worsening. The frequency of attacks at onset does not correlate with the possibility of recovery or the remission time. Full article

Thaumatin-like proteins (TLPs) are a class of allergens that are predominantly found in fruits. These proteins are involved in plant defense mechanisms and exhibit antifungal activity. TLPs are classified as pathogenesis-related proteins (PR-5) and are typically synthesized in response to biotic stress, such as pathogen attacks. Sensitization to TLPs can result in a broad spectrum of allergic reactions, ranging from localized symptoms, such as oral allergy syndrome, to severe manifestations, including anaphylaxis. Key allergens within this group include Mal d 2 (apple), Pru p 2 (peach), and Pru av 2 (cherry). The list of allergens belonging to the TLP protein group continues to expand with newly discovered molecules. Diagnostic approaches for TLP allergies remain limited. Allergen component-resolved diagnostics can detect specific TLPs. The epidemiology of TLP-induced allergies is underexplored, and further research is needed to elucidate the prevalence, natural course, and clinical outcomes of these allergic conditions. Full article

Secondary hypertension and resistant hypertension may result from potentially treatable acquired or hereditary diseases. Inherited Metabolic Disorders are not routinely included in the differential diagnosis of these contexts associated with hypertension, despite the key importance of diagnosis for several of them which enable the early treatment of them. We aim to discuss the current evidence that indicates that a significant portion of cases of unknown resistant hypertension or suspected secondary hypertension may result from unrecognized Acute Hepatic Porphyria (AHP). Diagnostic work-up for AHP is not routinely performed during the evaluation of patients with resistant or refractory hypertension nor in the investigation of secondary hypertension. AHP may present both with neurological and systemic involvement, and hypertension may be observed as part of acute dysautonomia during acute neurovisceral attacks and as a chronic complication during disease course. As AHP represent a potentially treatable group of metabolic disorders, clinicians should consider the inclusion of this group in the diagnostic evaluation of patients with secondary or resistant hypertension. Full article

The aim of this study was to explore how artificial intelligence (AI) impacts the quality of financial reporting, providing insights into new opportunities in this field for the Saudi context. This study employed the UTAUT theory to examine the adoption of AI technology in auditing practices. This study also utilized bibliometric analysis techniques through an academic literature review and content analyses of the documentary evidence. The implication of this study is that non-Big 4 audit firms should adopt AI-powered drones, which consequently enhance decision making, decrease audit fees, and enhance the quality of financial reports, and the efficiency and accuracy of audits. Furthermore, this paper recommends that non-Big 4 audit firms adopting AI should foster a culture of change to ensure quality audits and consistency, overcome resistance to the change, and support the integration of technologies such as AI-driven audit automation. Our study also indicated the importance of integrating AI with the IFRS, developing a new framework for AI in auditing practices, incorporating AI into auditing courses, and modernizing auditing using AI. These implications lead to financial reports of enhanced quality. The results indicated four clusters, with artificial intelligence being the most significant keyword occurrence. This study has limitations, such as the lack of consideration of cyber-attack risks on drones, which may reduce the reliability of financial reports. Based on the findings of this research, audit companies and regulatory agencies in Saudi Arabia, like the Saudi Capital Market Authority (CMA), may evaluate the integration of AI to improve the quality of financial reporting. Implementing AI is expected to enhance the quality of audits, automate reporting, and support regulatory compliance to foster confidence and transparency in the financial industry. Full article

Background/Objectives: Migraine is a common neurological disorder with highly variable characteristics. While genome-wide association studies have identified genetic risk factors that implicate underlying pathways, the influence of genetic susceptibility on disease characteristics or treatment response is incompletely understood. We examined the relationships between a previously developed standardized integrative migraine polygenic genetic risk score (PRS) and migraine characteristics in a real-world, treated patient cohort. Methods: This retrospective cohort study used covariate-adjusted regression to comprehensively evaluate associations between the PRS and clinical characteristics in 1653 treated migraine cases with European ancestry at baseline and, in 800 cases, after one year. Cases were deeply phenotyped by neurologists during extensive interviews, using structured clinical documentation tools to record ~200 discrete data elements. Results: In treated patients, higher standardized PRS showed associations with two common migraine symptoms: photophobia (odds ratio [confidence interval]: 1.33 [1.13–1.56], p = 0.001) and stabbing pain (1.21 [1.08–1.36], p = 0.001]; both retained significance at Q = 0.05. Associations with phonophobia, nausea, emesis, and unilateral headache had similar effect sizes but did not survive correction for multiple tests. In this population, the PRS was not associated with other symptoms of migraine attacks, objective measures of migraine disability, frequency, severity, average duration, time-to-peak intensity of migraine attacks, chronification, emergency department visits, triptan responsiveness, or changes at follow-up. Conclusions: In treated patients, genetic risk was associated with common migraine symptoms but not with the severity of migraine characteristics or treatment outcomes. This suggests that in treated patients, other genetic and non-genetic factors influence migraine symptom severity and disease course more strongly than genetic susceptibility. Full article

Adhesive joining has the severe limitation that damages/defects developed in the bondline are difficult to assess. Conventional non-destructive examination (NDE) techniques are adequate to reveal disbonding defects in fabrication and delamination near the end of service life but are not helpful in detecting and monitoring in-service degradation of the joint. Several techniques suitable for long-term joint integrity monitoring are proposed. Fiber Bragg grating (FBG) sensors embedded in the joint are one of the promising candidates. It has the advantages of being close to the damage and immune to environmental attack and electromagnetic interference. Damage and disbonding inside an adhesive joint will give rise to a non-uniform strain field that may bring about peak splitting and chirping of the FBG spectrum. It is shown that the evolution of the full spectral responses can closely reveal the development of damages inside the adhesive joints during tensile and fatigue failures. However, recording and comparing the successive full spectra in the course of damage is tedious and can be subjective. An energy modulation interrogation technique is proposed using a pair of tunable optical filters. Changes in the full FBG spectral responses are modulated by the filters and converted into a conveniently measurable voltage output by photodiodes. Monitoring damage development can then be easily automated, and the technique is well-suited for practical applications. Filter spectrum width of 5 nm and initial overlap with the FBG spectrum to give 40% of the maximum output voltage is found to be optimal for measurement. The technique is tested on embedded FBGs from different adhesive lap-joint specimens and successfully reflected the severity of changes in the full spectral shapes during the course of tensile failure. Moreover, the trends in these PD outputs corroborate with the V value previously proposed to describe the qualitative change in FBG spectral shape. Full article

Background/Objectives: Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome, often referred to as PFAPA syndrome, may enigmatically recur for an undetermined time in affected children: a potential reason to explain its recurring pattern for an unpredictable period or its self-limitation is currently unknown. We explored the relationship between different general, demographic, clinical, and laboratory features of PFAPA children and disease evolution over the course of a decade. Methods: We have retrospectively screened 150 Italian children with a history of PFAPA syndrome attending the Outpatients Clinic of Pediatric Rheumatology in our Institution during the period 2014–2024, all without any recognized chronic diseases: 88 males, 62 females, mean age at onset of 2.5 ± 1.7 years, age range of 0.3–9.4 years, and mean age at diagnosis of 4.5 ± 2.0 years. The whole cohort of PFAPA patients had been followed up for a median period of 5 years (IQR: 4–7). Results and Conclusions: After dividing patients into two groups based on either the disappearance or persistence of PFAPA symptoms during follow-up, we found that positive family history of recurring fevers, cervical lymphadenopathy, arthralgia, myalgia, and breastfeeding for more than 6 months were associated with the disappearance of febrile attacks for at least six months. Performing a multivariate analysis adjusted for sex and age, we found that only breastfeeding duration longer than 6 months and higher education level of PFAPA patients’ mothers were independently associated with the resolution of PFAPA symptoms. Full article

We have found that the dye 1,3,3-trimethyl-2-((1′E,3′E,5′E)-5’-(1″,3″,3″-trimethylindol-(2′E)-ylidene)-penta-1″,3″-dien-1″-yl)-3H-indol-1-ium (DTMI-5) can be successfully used for the simple green determination of H₂O₂ and Fe(III)/Fe(II) species. The dye is characterized by a successful combination of spectral, protolytic, and redox properties, and the process of its decolorization in the Fenton reaction is monitored using an optical immersion probe. Theoretical calculations of the reactive sites in the DTMI-5 molecule under free radical attack reveal that the methine groups of the penta-1′,3′-dien-1′-yl linker serve as the primary reactive centers in Fe³⁺ or Fenton-type oxidation conditions. Density functional theory (DFT) calculations indicate that the redox potentials of the examined structures range from 0.34 to 1.65 eV. The experimentally observed broad peak at 340–360 nm, which appears after the interaction of DTMI-5 with the Fenton reagent, is attributed to the formation of aldehyde-type oxidation products, whose theoretical CIS(D) absorption maxima were 358.1 and 337.4 nm. The influence of various factors on the course of the reaction was experimentally investigated. The most important analytical characteristics of the methods, such as linearity intervals of calibration graphs, precision, LOD and LOQ values, selectivity coefficients, etc., were determined. The developed methods were applied to model and real samples (water, oxidation emulsion, and fertilizer). Full article

Global climate change is leading to increased wildfire activity in many parts of the world, and with increasing development, a heightened threat to communities in the wildland urban interface. Evaluating the potential for fire to affect communities and critical infrastructure is essential for effective response decision-making and resource prioritization, including evacuation planning, with changing weather conditions during the fire season. Using a receptor–pathway–source assessment framework, we estimate the potential source area from which a wildfire could spread to a community in British Columbia by projecting fire growth outward from the community’s perimeter. The outer perimeter of the source area is effectively an evacuation trigger line for the forecast period. The novel aspects of our method are inverting fire growth in both space and time by reversing the wind direction, the time course of hourly weather, and slope and aspect inputs to a time-evolving fire growth simulation model Prometheus. We also ran a forward simulation from the perimeter of a large fire that was threatening the community to the community edge and back. In addition, we conducted a series of experiments to examine the influence of varying environmental conditions and ignition patterns on the invertibility of fire growth simulations. These cases demonstrate that time-evolving fire growth simulations can be inverted for practical purposes, although caution is needed when interpreting results in areas with extensive non-fuel cover or complex community perimeters. The advantages of this method over conventional simulation from a fire source are that it can be used for pre-attack planning before fire arrival, and following fire arrival, it does not require having an up-to-the-minute map of the fire location. The advantage over the use of minimum travel time methods for inverse modeling is that it allows for changing weather during the forecast period. This procedure provides a practical tool to inform real-time wildfire response decisions around communities, including resource allocation and evacuation planning, that could be implemented with several time-evolving fire growth models. Full article