In this paper a novel and flexible solution for fault prediction based on data collected from Supervisory Control and Data Acquisition (SCADA) system is presented. Generic fault/status prediction is offered by means of a data driven approach based on a self-organizing map (SOM)and the definition of an original Key Performance Indicator (KPI). The model has been assessed on a park of three photovoltaic (PV) plants with installed capacity up to 10 MW, and on more than sixty inverter modules of three different technology brands. The results indicate that the proposed method is effective in predicting incipient generic faults in average up to 7 days in advance with true positives rate up to 95%. The model is easily deployable for on-line monitoring of anomalies on new PV plants and technologies, requiring only the availability of historical SCADA data, fault taxonomy and inverter electrical datasheet.

The increasingly used approach of combining different simulation software in testing of automated driving systems (ADS) increases the need for potential and convenient software designs. Recently developed co-simulation platforms (CSP) provide the possibility to cover the high demand on testing kilometers for ADS by combining vehicle simulation software (VSS) with traffic flow simulation software (TFSS) environments. The emphasis on the demand of testing kilometers is not enough to choose a suitable CSP. The complexity level of the used vehicle, object, sensors and environment models is essential for valid and representative simulation results. Choosing a suitable CSP raises the question of how the test procedures should be defined and constructed and what the relevant test scenarios are. Parameters of the ADS, the environments, objects, sensors in VSS as well as traffic parameters in TFSS can be used to define and generate test scenarios. In order to generate a large number of scenarios in a systematic and automated way, suitable and appropriate software designs are required. In this paper we present a software design for CSP based on the Model-View-Controller (MVC) design pattern and implementation of a complex CSP for virtual testing of ADS. Based on this design, an implementation of a CSP is presented using the VSS from IPG Automotive called CarMaker and the TFSS from PTV Group called Vissim. The results have shown that the presented CSP design and the implementation of the co-simulation can be used to generate relevant scenarios for testing of ADS.

We previously showed that, based on the frequency and distribution of specific cell types, rainbow trout (RT) intestinal mucosa is divided in two regions that form a complex nonlinear 3D pattern and have a different renewal rate. This work had two aims. First, to investigate whether the unusual distribution of cell populations reflects a similar distribution of functional activities. To this end, we determined the protein expression pattern of three well defined enterocytes functional markers: Peptide Transporter 1 (PepT1), Sodium-Glucose/Galactose Transporter 1 (SGLT-1) and fatty acid-binding protein 2 (Fabp2). Second, to characterize the structure of RT intestinal stem cells (ISC) niche and to determine whether the different proliferative rates correlate with a different organization and/or extension of the stem cells population. We studied the expression and localization of well-characterized mammal ISC markers: LGR5, HOPX, SOX9, NOTCH1, DLL1 and WNT3A. Our results indicate that morphological similarity is associated with similar function only between the first portion of the mid-intestine and the apical part of the complex folds in the second portion. Mammal ISC markers are all expressed in RT but their localization is completely different suggesting also substantial functional differences. Finally, higher renewal rates are supported by a more abundant ISC population.

We propose a novel transfer learning method for speech emotion recognition allowing us to obtain promising results when only few training data is available. With as low as 125 examples per emotion class, we were able to reach a higher accuracy than a strong baseline trained on 8 times more data. Our method leverages knowledge contained in pre-trained speech representations extracted from models trained on a more general self-supervised task which doesn’t require human annotations, such as the wav2vec model. We provide detailed insights on the benefits of our approach by varying the training data size, which can help labeling teams to work more efficiently. We compare performance with other popular methods on the IEMOCAP dataset, a well-benchmarked dataset among the Speech Emotion Recognition (SER) research community. Furthermore, we demonstrate that results can be greatly improved by combining acoustic and linguistic knowledge from transfer learning. We align acoustic pre-trained representations with semantic representations from the BERT model through an attention-based recurrent neural network. Performance improves significantly when combining both modalities and scales with the amount of data. When trained on the full IEMOCAP dataset, we reach a new state-of-the-art of 73.9% unweighted accuracy (UA).

Influence of particle size on the mechanical strength of alkali activated material from waste refractory monolithic was investigated in this study. Precursor was chemically and mineralogically analysed, separated on 4 fractions and alkali activated with Na-water glass. Alkali activated materials were thoroughly investigated under SEM and XRD to evaluate the not predicted differences in mechanical strength. Time dependence of curing temperature on mechanical strength was investigated in the sample prepared from a fraction that caused the highest compressive strength.

Within the task of replacing bronze journal bearings with aluminum the processes taking part on friction surface of high-alloyed aluminum alloys working with steel are investigated. The surface and subsurface layer of experimental aluminum bearings were studied before and after tribological tests by scanning electron microscopy including energy-dispersive analysis. Both structural and composition changes in surface layer are shown. It has been revealed that secondary structures are formed on the surface during friction process and include all the chemical elements of the tribosystem which is a consequence of its self-organization. The interaction behavior of some chemical elements of tribological system is discussed.

The increasing number of registered road crashes involving cyclists during the last decade, and the high proportion of road crashes resulting in severe injuries and fatalities among cyclists constitutes a global issue for community health, urban development, and sustainability. Nowadays, the incidence of many risk factors for road crashes of cyclists remains largely unexplained. Given the importance of this issue, the present study has been conducted with the aim of determining relationships between infrastructural, human factors and safety outcomes of cyclists. Objectives: This study aimed, first, to examine the relationship between key infrastructural and human factors present in cycling, bicycle-user characteristics, and their self-reported experience with road crashes. And second, to determine whether a set of key infrastructural and human factors may predict their self-reported road crashes. Methods: For this cross-sectional study, a total of 1064 cyclists (38.8% women, 61.2% men; M = 32.8 years of age) from 20 different countries across Europe, South America and North America, participated in an online survey composed of four sections: demographic data and cycling-related factors, human factors, perceptions on infrastructural factors, and road crashes suffered. Results: The results of this study showed significant associations between human factors, infrastructural conditions and self-reported road crashes. Also, a logistic regression model found that self-reported road crashes of cyclists could be predicted through variables such as age, riding intensity, risky behaviors, and problematic user/infrastructure interactions. Conclusions: The results of this study suggest that self-reported road crashes of cyclists are influenced by features related to the user and their interaction with infrastructural characteristics of the road.

Highly flexible manufacturing systems require continuous run-time (self-) optimization of processes with respect to various parameters, e.g. efficiency, availability, energy consumption etc. A promising approach for achieving (self-) optimization in manufacturing systems is the usage of the context sensitivity approach. Thereby the Cyber-Physical Systems play an important role as sources of information to achieve context sensitivity. In this paper it is demonstrated how context sensitivity can be used to realize a holistic solution for (self-) optimization of discrete flexible manufacturing systems, by making use of Cyber-Physical System integrated in manufacturing systems/processes. A generic approach for context sensitivity, based on self-learning algorithms, is proposed aiming at a various manufacturing systems. The new solution is propos encompassing run-time context extractor and optimizer. Based on the self-learning module both context extraction and optimizer are continuously learning and improving their performance. The solution is following Service Oriented Architecture principles. The generic solution is developed and then applied to two very different manufacturing processes. This paper proposes a holistic solution to achieve context sensitivity for Flexible Manufacturing Systems, whereby the knowledge created by applying the context sensitivity approach can be used for (self-) optimization of manufacturing processes.

Congenital heart disease (CHD) is a prevalent congenital disorder diagnosed with high frequency, affecting approximately 0.8% to 1.2% of all live births. Research has demonstrated that the use of pulse oximetry and clinical examination as a screening tool for CHD diagnosis has proven extremely valuable. We conducted a retrospective longitudinal study over a 3-year period that involved screening 1188 newborns admitted to the NICU during the first 72 hours of life within this timeframe. 201 newborns were diagnosed with CHD. Almost all (n=198) had a positive screening test during the 72-hour period, while 3 had a negative screening test, but were later diagnosed using echocardiography. The prevalence rate was 16.67%. A confusion matrix was constructed with 198 true positives (TP), 3 false negatives (FN), no false positives (FP), and 987 true negatives (TN). The sensitivity of the screening test was 98.51%, while the specificity 100%, with no false positives. In our study, a total of 9 deaths occurred. Using the Kaplan-Meier method, the survival probability appeared to be slightly above 0.9 (95.5%), indicating that almost all patients survived past 72 hours after being diagnosed with CHD. Pulse oximetry is an effective, low cost and easy-to-use method and a useful tool to assess and lead to the diagnosis of CHD.

Primary care pediatricians encounter a wide range of complex conditions in their daily clinical practice. It is not uncommon for their patients to get exposed to medical errors. Diagnostic errors, defined as missed, delayed, or wrong diagnosis, are of great importance as they may cause significant harm to the pediatric patient with severe disease. These errors often occur when the symptoms and signs of a disease are atypical or missing. Data on the most frequent misdiagnosed situations in pediatrics is scarce. One of these groups of conditions is that regarding cardiac diseases. The pediatric cardiology field has met rapid development over the past few decades. Primary care providers play a key role in diagnosis, management, and referral of children with heart disease, both congenital and acquired, because many common cardiac complaints are first addressed in the primary care setting. The scope of this review is to investigate the cardiac entities that are often missed by the general pediatricians. In particular, it aims to spot the most common of them, to describe their clinical presentation, their diagnostic options, red flags, and tips, and to provide the ways to avoid erroneous, delayed, or missed diagnosis.

Objective: To compare the incidence of skin abrasions caused by traditional straight edge flip flop straps versus rolled inner seam (RIS) designs in a controlled laboratory setting using preserved fetal pig skin as a proxy for human skin.Methods: This study utilized a custom-built apparatus to apply friction from two flip flop strap designs to preserved fetal pig skin samples. Three trials were conducted for each strap design to determine the time to initial abrasion onset. A paired t-test was employed for statistical analysis.Results: The RIS design demonstrated a statistically significant delay in abrasion onset compared to the standard design across all trials (p < 0.05), indicating a gentler interaction with the skin.Conclusion: The RIS strap design may offer a beneficial alternative to traditional straps by reducing the friction that can lead to skin abrasions, suggesting a potential to decrease the risk of dorsal foot ulcers. Further studies involving human subjects are warranted to validate these findings in a real-world context.Keywords: Flip flop strap design, skin abrasions, dorsal foot ulcers, footwear design, developing countries, diabetic foot care.

More than 13.5 billion COVID-19 vaccine doses have so far been delivered between 2021 and 2023 through a mix of delivery platforms, with mass vaccination campaigns being the main approach. In 2022, with the most likely scenario of continued circulation of SARS-CoV-2 and the need for periodic booster doses, there was a need for countries to plan for more sustainable approaches to provide COVID-19 vaccination. In this context of uncertainty, a global tool for integrating COVID-19 vaccines into immunization programmes and primary health care was published jointly by WHO and UNICEF to respond to country needs. The guidance leveraged existing health system frameworks, proposed four steps for the COVID-19 integration journey, and identified investment areas. The development process maximized robust global stakeholder and country engagement, and the timeframe was aligned with donor funding windows to support the integration of COVID-19 vaccination. The rapid dissemination of guidance allowed its use by countries to ascertain their readiness for integrating COVID-19 vaccination and inform the development of national plans and funding applications. While progress has been made in specific areas (e.g., optimizing cold chain and logistics leveraging COVID-19 vaccination), in the context of decreasing demand for COVID-19 vaccines, reaching adult COVID-19 vaccine high-priority-use groups and engaging and coordinating with other health programmes (beyond immunization) remains a challenge. We share the learning that despite the uncertainties of a pandemic, guidance documents can be developed and used within a short timeframe. Working in partnership with stakeholders beyond immunization towards a common objective is powerful and can allow progress to be made on integrating health services and preparing better for future pandemics.

Analytical chemistry applied to medical and diagnostic analysis, recently focused on the development of cost-effective biosensors able to monitor the health status or to assess the level of specific biomarkers that can be indicative for several diseases. The improvement of technologies relating to the possibility of non-invasive sampling of biological fluids, as well as sensors for the detection of analytical signals and the computational capabilities of the systems routinely employed in everyday life (e.g. smartphones, computers, etc.), make the complete integration of self-standing analytical devices more accessible. This review aims to discuss the biosensors that have been proposed in the last 5 years focusing on two principal detecting approaches, optical and electrochemical, which have been employed for quantifying different kind of target analytes reaching detection limits below the clinical sample levels required. These detection principles applied to Point-of-care (POC) devices, have been extensively reported in literature and even the limited examples found on the market are based on these strategies. This work will show the latest innovations considering the integration of optical and electrochemical detection with the most commonly reported analytical platforms for POC applications such as paper-based or wearable and implantable devices.

To ensure high-quality care, operationalize resilience and fill the knowledge gap regarding how to improve the prerequisites for resilient performance, it is necessary to understand how adaptive capacity unfolds in practice. Coronavirus 2019 stress-tested complex healthcare systems, and intensive care was driven to an unprecedented escalation. The main aim of this research was to explain the escalation process of intensive care from a microlevel perspective, including expressions of resilient performance, intervening conditions at the micro-meso-macrolevels and short- and long-term consequences. A secondary aim was to provide clinical recommendations regarding how to optimize the prerequisites for resilient performance in intensive care. A grounded theory methodology was used. First-person stories from different healthcare professionals (n70) in two Swedish regions were analyzed using the constant comparative method. A novel conceptual model of the escalation process of intensive care emerged, and 41 clinical recommendations concerning the optimal prerequisites for resilient performance were identified. Escalation was conceptualized as a transition from threatening chaos to temporary order through a complex process of adaptation. To prepare for the future, the components space, stuff, staff, system and science with associated continuity plans must be implemented, anchored and communicated to actors at all levels of the system.

Background: This study investigated the incidence, characteristics and functional outcomes associated with unplanned Acute Care Unit Readmissions (ACUR) during inpatient traumatic brain injury (TBI) rehabilitation in an Asian cohort. Methods: Retrospective review of electronic medical records from single rehabilitation unit was conducted from 1 Jan 2012 to 31 Dec 2014. Inclusion criteria were first TBI, aged &gt;18 years, admitted &lt; 6 months of TBI. ACUR were characterized into either of neurological, medical or neurosurgical subtypes. The main outcome measure was discharge Functional Independence Measure (FIM). Secondary outcomes included rehabilitation length of stay (RLOS). Results: Of 121 eligible TBI records, the incidence of ACUR was 14% (n=17), comprising neurologic (76.5%) and medical (23.5%) subtypes, occurring at median of 13 days (IQR 6, 28.5) after rehabilitation admission. Patients without ACUR had significantly higher admission mean (SD) FIM score compared to those with ACUR (FIM ACUR-negative 63.4 (21.1) vs FIM ACUR-positive 50.53(25.4), P =0.026). Significantly lower discharge FIM was noted in those with ACUR compared to those without. (FIM ACUR-positive 65.8(31.4) vs FIM ACUR-negative 85.4 (21.1), P = 0.023) Furthermore, a significant near-doubling of RLOS was noted in ACUR patients compared to non-ACUR counterparts [ACUR-positive median 55 days (IQR 34.50, 87.50) vs ACUR-negative median 28 days (IQR 16.25, 40.00), P = 0.002]. Conclusion: This study highlights the significant negative functional impact and lengthening of rehabilitation duration of ACUR on inpatient rehabilitation outcome for TBI.

Public Health Officers' (PHO) experiences in reaction to the COVID-19 pandemic can be based on whether the PHO is passive or active. Therefore, the study’s objectives are to identify the types of experiences and analyse the predictors of proactive practical experiences in solving COVID-19 among PHOs in the upper southern region of Thailand. Methods: An explanatory mixed-methods approach was used to collect data, through questionnaires and online in-depth interviews. The study was conducted from August 4, 2020, to August 3, 2021. Results: The results included 60 PHOs from 60 PCUs in 6 provinces, with 41 (68.3%) females and an average age of 35.57 years (SD = 11.61). The PHOs’ knowledge, understanding, and participation experience aspects were mostly proactive rather than passive. Factors that significantly predicted proactive practical experiences included sex (ORadj = 1.52, 95% CI = 1.04–2.21), age (ORadj = 1.69, 95% CI = 1.16-2.48), married status (ORadj = 1.69, 95% CI = 1.16-2.48), education level (ORadj = 1.50, 95% CI = 1.02–2.20), and position for work (ORadj = 1.69, 95% CI = 1.16-2.48). Conclusions: PHOs’ knowledge, understanding, opinion, and participation experiences were significant predictors of practical experience. Primary health care systems should promote proactive experiences in all four aspects to increase proactive practical experiences.

Older adults in low-and middle-income countries experience a disproportionate burden of non-communicable diseases (NCDs). Unintentional injuries are among the major NCDs, and falls are the second leading cause of these injuries and deaths worldwide, including in Thailand. We aimed to culturally adapt the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) for Thai older adults and explore the feasibility, appropriateness, and acceptability of using STEADI in primary care via trained community health workers (CHWs) and care managers (CMs). STEADI takes a coordinated care approach that consists of three steps: screening, assessing, and intervening. In Step a, CHWs screened fall risk in 20 community-dwelling older adults using three key questions and found that all of them had fall risk, then CHWs screened with a Stay Independent questionnaire (range 0-14) and found that 100% have high fall risk (total scores 9.7± 2.4). In Step b, CMs assessed balance, vision, footwear, postural hypotension, medications, and CHWs assessed home hazards. They found that 50% had poor balance, 70% took 4+ medications,75% fell on the walkway, and 70% had no bathroom modifications. In Step c, individual participants received fall prevention interventions to mitigate their specific fall risk factors. CHWs and CMs indicated high acceptability (19.20±.1.31 of 20 total), appropriateness (18.80± 1.79 of 20 total), and feasibility (18.60±1.67 of 20 total) of the Thai-STEADI intervention. Our study showed that the community-based multifactorial Thai-STEADI delivered by CHWs and CMs is feasible and acceptable to prevent falls in older adults with limited access to health care.

COVID-19 pandemic-related pressures on primary care may have driven inappropriate continuation of antibiotic prescriptions. Yet prescribing modality (repeat/non-repeat) has not previously been investigated in a pandemic context. Using the OpenSAFELY-TPP analytics platform, we analysed repeat/non-repeat prescribing frequency in monthly patient cohorts between Jan 2020–2022. In-depth analysis was conducted on Jan 2020 (“pre-pandemic”) and Jan 2021 (“pandemic”) cohorts. Per-patient prescribing and clinical conditions were determined by searching primary care record data using clinical code lists. Repeat prescribing was defined as >=3 prescriptions in a 6 month lookback period. Associations between demographics (e.g. age, sex, geography) and repeat/non-repeat prescribing were explored using unadjusted risk ratios. Antibiotic prescribing declined from May 2020; non-repeat prescribing declined more strongly than repeat prescribing (maximum declines -26% vs -11%, respectively). In the pandemic cohort, older patients were at higher risk of prescribing (especially repeat prescribing). The most common clinical conditions for repeat prescribing were COPD comorbidity and urinary tract infection. Comorbidities were more common among repeat vs non-repeat prescribed patients. In the pandemic cohort, vs pre-pandemic, repeat and non-repeat prescribing for comorbidities generally declined less compared with shorter-term conditions (infections, including COPD exacerbation/lower respiratory tract infection). Our findings inform ongoing development of stewardship interventions in England..

We sought to calculate the extra social costs resulting from child abuse in residential care facilities (RCFs) for children with disabilities (CWD) in Japan. We distributed a survey to 260 residential facilities for CWD in 2020 and obtained responses from 91 facilities. Among the children admitted to these facilities, 23–67% were affected by child abuse. We estimated the extra costs to be an average of USD 647.7 million. This study is meaningful in that there are no existing official statistics or research findings on the extra costs of residential care due to child abuse in Japan.

Background: Media coverage of Lyme disease (LD) has led to an increase in consultations for presumed LD in Europe. However, LD is confirmed in only 10-20% of patients, with a significant number remaining in a diagnostic dead-end. Objectives: To reach a deeper understanding of how patients themselves contribute to the diagnostic process. To describe the genesis of the LD hypothesis in care pathways. Methods: In 2019, 30 patients from a prospective cohort consulting in the infectious diseases department at University Hospital in Marseille for presumed LD were recruited for semi-structured interviews. The inclusion criteria were : suffering from subjective symptoms for 6 months, no clinical or paraclinical argument suggesting current LD. The patients’ medical trajectories were collected using a biographical approach. Results: The diagnosis of Lyme disease was primarily triggered by identification with personal testimonies found on the internet. Most of patients were leading their own diagnostic investigation. The majority of participants were convinced they had LD despite the lack of medical evidence and the scepticism of their referring GP. Conclusion: GPs should first systematically explore patients’ etiologic representations in order to improve adherence to the diagnosis especially in the management of medically unexplained symptoms. Long COVID-19 syndrome challenge offers an opportunity to promote active patient involvement in diagnosis.

Background and Objectives: Acute Heart Failure (AHF) is a common disease and a cause of high morbidity and mortality, constituting a major health problem. The main purpose of this study was to determine the impact of multiorgan ultrasound in identifying the pulmonary hypertension (PH) in patients admitted due to AHF, predict the evolution of the disease during hospitalization and identify areas of improvement in the care of patients with AHF. Materials and Methods: Patients were evaluated with a standard exam of lung ultrasound, echocardiography, inferior vena cava (IVC) and femoral, renal, hepatic, portal venous Doppler flow patterns at admission and on the day of discharge. Results: Thirty patients were enrolled during November 2021. The mean age was seventy-nine years (Standard Deviation – SD 13,4). Seven patients (23.3%) had a renal function worsening. Regarding ultrasound findings, venous excess ultrasonography score (VExUS) score was calculated at admission and at discharge, surprisingly remaining unchanged or even worsened in most of them (21 patients, 70.0%). The area under the curve for the Lung Score was 83.9% (p = 0.008), obtaining a cutoff value of 10 that showed a sensitivity of 82.6% and a specificity of 71.4% in the identification of intermediate and high PH. It was possible to monitor significant changes between both exams on the lung score (p &lt;0.001), hepatic vein Doppler (p &lt;0.001), portal vein Doppler (p = 0.030), intra-renal vein Doppler (p = 0.025) and VExUS score (p = 0.023), remaining similar the femoral vein Doppler (p = 0.177) and IVC (p = 0.132). Conclusions: Our study results suggest that performing serial multiorgan Point-of-Care ultrasound can help us to better identify high and intermediate probability of PH patients with AHF. Currently proposed multi-organ, venous Doppler scanning protocols, such as the VExUS score, should be further studied in different populations before expanding its use in AHF patients.

Glioblastoma (GBM) is one of the most aggressive solid tumors, particularly due to the presence of cancer stem cells (CSCs). Today the characterization of this type of cells with an efficient, fast and low-cost method remains an issue. Hence, we have developed a microfluidic lab-on-a-chip based on dielectrophoresis (DEP) single cell electro-manipulation to measure the two crossover frequencies: f_x01 in low frequency range (below 500 kHz) and f_x02 in Ultra High Frequency range (UHF, above 50 MHz). First, in vitro conditions were investigated. U87-MG cell lines were cultured in different conditions in order to induce an undifferentiated phenotype. Then, ex vivo GBM cells from patients’ primary cell culture, were passed through the developed microfluidic system and characterized in order to reflect clinical conditions. This article demonstrates that the usual exploitation of low frequency range DEP does not allow the discrimination of the undifferentiated from the differentiated phenotypes of GBM cells. However, the presented study highlights the use of UHF-DEP as a relevant discriminant parameter. The proposed microfluidic lab-on-a-chip is able to follow the kinetic of U87-MG phenotype transformation in a CSC enrichment medium and their cancer stem cells phenotype acquirement.

Maternal-child care is one of the foundations of primary health care. Nurses’ competency skills they have been taught. Community awareness is an important part of preventive healthcare, and nurses must be aware of the factors that impact the health of the community. This study examines the effectiveness of lecture-based instructions in maternal and child care and its implications to students' social competency skills and community awareness in Nursing Colleges in Nueva Ecija, Philippines. The researcher uses survey questionnaire and employed the descriptive design where fifteen (15) nursing students and five (5) teachers were purposively selected. The findings revealed that the weighted mean for the effectiveness of lecture based instruction in maternal and child care is 3.91 with verbal description of “Effective”, the effects of lecture based instruction in maternal and childcare to students’ social competency skills and community awareness got the weighted mean of 3.87 and interpreted as “very satisfactory” and the effectiveness of actual community-based instruction is very effective with weighted mean of 4.25 and is higher compare to lecture based instruction. The results also revealed that students and teachers were challenged in lecture-based instruction in maternal and chi8ldcare during distance learning. Recommendations for the enhancement of lecture-based instruction in maternal and childcare in social competency skills and community awareness were also made.

Background: Australia’s healthcare system is complex and fragmented which can create challenges in healthcare, particularly in rural and remote areas. Aboriginal people experience inequalities in healthcare treatment and outcomes. This study aimed to investigate barriers and enablers to accessing healthcare services for Aboriginal people living in rural and remote Australia. Methods: Semi-structured interviews were conducted with healthcare delivery staff and stakeholders recruited through snowball sampling. The communities were selected for their high proportion of Aboriginal people and geographical representation (coastal, rural, and border). Thematic analysis identified barriers and enablers. Results: Thirty-one interviews were conducted (n =5 coastal, n=13 remote, and n=13 border) and six themes identified: 1) Improved coordination of healthcare services; 2) Better communication between services and patients; 3) Trust in services and cultural safety; 4) Importance of prioritizing health services by Aboriginal people; 5) Importance of reliable, affordable and sustainable services; 6) Distance and transport availability. These themes were often present as both barriers and enablers to healthcare access for Aboriginal people. They were also present across the healthcare system and within all three communities. Conclusions: This study describes a pathway to better healthcare outcomes for Aboriginal Australians by providing insights into ways to improve access.

Smoking is a major risk factor for non-communicable diseases and remains a significant public health challenge in many lower- and middle-income countries (LMIC) including Namibia. The purpose of the study was to estimate the prevalence of smoking and its associated risk factors among HCWs and non-HCWs in Zambezi region. An exploratory cross-sectional survey was conducted between March and October 2020 among residents of the eight (8) constituencies of Zambezi region. Four hundred and sixty-one (461) respondents who had been residents of the selected constituencies for over five years and aged between 17-60 years were selected for the study. The main outcome measure was current cigarette smoking status. Descriptive statistics were used to summarize the socio-demographic characteristics of the respondents. We stratified data analysis by individual being health workers or non-health workers. A bivariate Pearson Chi-square test was used to determine the association between socio-demographic characteristics and the smoking status. Statistically significant variables in the bivariate analysis were used as predictors in the univariate and multivariate models. The response rate of potential participants was 95% (n=434). The mean (±SD) age of participant’s was 32.5 (± 11.34 years). Significant relationships were observed between smoking status and area of residency (constituency), gender, age category, level of education, age of onset of smoking and the daily smoking frequency. The majority of smokers (n=108) were none-HCWs with males being the majority (n=62). Age (p=0.001), education levels (p=0.001) and area of residency (p=0.022) were highly associated with smoking among none-HCW while marital status was associated with smoking among HCWs (p=0.013). In the final multivariate model, the odds of smoking among female non-HCWs were significantly lower (OR: 0.386; 95% CI: 0.228 – 0.655). Furthermore, the odds of smoking among this same group were lower among those who had secondary level education (OR: 0.178; 95% CI: 0.0659 – 0.483), post-secondary (OR: 0.117, 95% CI: 0.0412 – 0.330) and first stage tertiary (OR: 0.306: 95% CI: 0.106 – 0.881) compared to those who had primary school education. In conclusion, smoking prevalence among none HCWs and HCWs working in Zambezi included in the study was similar to that of the general Namibian population but higher than other neighboring countries within SADC. The results showed a need for the establishment of specific smoking related strategies that target HCWs to address smoking use parallel to the running of none HCWs which would ultimately decrease the smoking prevalence and improve health.

Objective: The private healthcare providers (PHCP) are believed to improve access to healthcare services in Public-Private Mix (PPM) projects, as they are considered first point of contact for healthcare. The purpose of this study was to know the satisfaction level of TB patients. Design: A questionnaire-based, cross-sectional study was carried out during November and December 2017 for 572 under-treatment patients registered with PHCPs in the PPM project. Lot quality assurance sampling technique was used to randomly select 19 districts from sample frame of 75 districts. In each selected district, data collector retrieved TB register of 8 months (Jan – Aug 2017) and systematically selected patients by fixed periodic interval. SPSS (version 24.0) was used to analyze the data. Results: Study included 53% (n=301) of males and 47% (n=271) of females, with mean age of 38 years (SD, ±18). Almost half of the participants were illiterate (51%, n=289) and 64% (n=365) were non-earning members of the family. In practice, most of the participants visit private providers (71%, n=407), including private hospital/clinic (44%) and traditional practitioners (27%; n=153). 55% of participants visited the current doctor because of clinic’s proximity to residence. 82% of the participants (n=469) were satisfied with the TB care services and 85% (n=488) said that they would recommend this clinic to others. Conclusion: PHCPs are preferred providers for individuals, which is consistent with findings of other studies. Though they are satisfied with TB care and services, interventions should be introduced to reduce the financial burden on the patient. Partnering PHCP is a way forward to ensure universal health coverage, health system strengthening and better health outcomes of the population.

Age-in-place can reduce the progress of dementia syndrome and improve the quality of life of the sufferers and their families. This work proposes an innovative information home support system to be established at the houses of people suffering from dementia. The main innovation of the system are its transparent character that overcomes the need for training of the sufferer, as well as the exploitation of a well-known technique for dementia, namely music therapy. It addresses the need of people suffering from dementia as well as their familiars to be recognized by them and have better interaction and collaboration. The system offers a ubiquitous recognition system, just by using smart devices like smart-phones or smart-wristbands. When a familiar person is detected in the house, then a sound file is reproduced on smart speakers placed in the house, in order to trigger the memory, based on the principles of music therapy. The system reproduced the appropriate time at 100% of the cases and the benefits of music therapy are evident daily. To the best of the authors' knowledge, this is the first system of its kind ever reported in the literature.

The role of vitamin D in the prevention and treatment of non-skeletal health issues has received significant media and research attention in recent years. Costs associated with clinical management of low vitamin D (LVD) have increased exponentially. However, no clear evidence supports vitamin D screening to improve health outcomes. Authoritative bodies and professional societies recommend against population-wide vitamin D screening in community-dwelling adults who are asymptomatic or at low risk of LVD. In order to assess patterns of physician management of LVD in this conflicting environment, we conducted a scoping review of three electronic databases and gray literature. Thirty-eight records met inclusion criteria and were summarized in an evidence table. Results from seven countries showed a consistent increase in vitamin D lab tests and related costs. Many vitamin D testing patterns reflected screening rather than targeted testing for individuals at high risk of vitamin D deficiency or insufficiency. Interventions aimed at managing inappropriate clinical practices related to LVD were effective in the short term. Variability and controversy were pervasive in many aspects of vitamin D management, shining light on physician practices in the face of uncertainty. Future research is needed is needed to inform better clinical guidelines and to assess implementation practices that encourage evidence-based management of LVD in adult populations.

This is the second of a series of two papers comparing the end of life issues in human and veterinary medicine. We outline the main differences between human and animal patients such as patient communication, finance and ‘conflicts of interest’ between animal, owner and veterinarian. We discuss striking similarities between human and veterinary issues such as assessing quality of life and the primary role of the attending veterinarian or doctor being the welfare and care of the patient. This paper takes the form of an ethical argument in favour of allowing euthanasia in human medicine, by providing insights into end of life issues for humans from an independent veterinary perspective. Veterinary surgeons are well trained in the ethics of euthanasia and put it to good use in the best interest of their animal patients. Doctors in the UK are limited and unwilling to put forward a case for the option of euthanasia for those patients who face a slow and agonizing death. With advances in medical science being able to significantly prolong the dying process, autonomy for the patient demands a review of the law regarding patient choice in the UK.

Such rapidly changing external conditions as the COVID-19 pandemic and the war in Ukraine, being pure crisis phenomena, not only determine the geopolitical and geoeconomic situation on the global markets, but also cause structural changes in individual countries. Under these conditions, the level of food self-sufficiency becomes particularly important, as it is one of the factors determining the food security of any country. The aim of the research is to assess Ukraine's food self-sufficiency compared to the European Union and Poland. The self-sufficiency ratio (SSR) index was used to assess food self-sufficiency. This is the ratio of the volume of production of the most important products of plant and animal origin to the volume of domestic consumption. Domestic consumption was defined as the volume of domestic production increased by the volume of imports, reduced by the volume of exports and also included changes in domestic stock levels. The surveyed time frame is 2019–2021. The analyzed data were taken from the State Statistics Service of Ukraine, FAOSTAT, USDA and Statistics Poland. A comparative analysis of self-sufficiency for the main agri-food sectors of Ukraine, the EU, and Poland showed significant differences. Taking into account the production potential and food self-sufficiency indicators of Ukraine, Ukraine's possible accession to the EU can be expected to have a major impact on the EU's supply and demand situation, as it may pose a threat to many EU agri-food sectors.

Quinacridone (QA) and 2,9-dimethylquinacridone (DQA) are synthetic substances suitable as a hard, abrasion-resistant, self-organizing gliding layer on ice, snow, and water. For sustainable use, a large number of parameters must be considered to demonstrate that these non-biogenic substances and their by-products and degradation products are harmless to humans and the environment in the quantities released. For this task, available experimental data are used and supplemented for all tautomers by numerous relevant physical, chemical, toxicological and ecotoxicological estimated values based on various Quantitative Structure Activity Relationship (QSAR) methods. On the one hand, the low solubility of QA and DQA leads to stable gliding layers and thus low abrasion and uptake by plants, animals, and humans. On the other hand, the four hydrogen bond forming functional groups per molecule allow nanoparticle decomposition and enzymatic degradation in natural environments. All available data justify a sustainable use of QA and DQA as a gliding layer. The assessment of the toxicological properties is complemented with an investigation of the size and morphology of DQA particles as well as field tests indicating an excellent performance as a gliding layer on snow.

Stroke causes disability and significantly affects patient quality of life. Post-stroke rehabilitation of upper limb function is crucial, as it affects daily activities and individual autonomy. Traditional rehabilitation methods often require frequent visits to specialized centers, which can be costly and challenging. This study investigated the effectiveness of a home-based self-training device, "Kenko Yusuri," in improving upper limb function in patients with chronic stroke. This multicenter prospective intervention study used a quasi-randomized controlled trial design. Ninety-three outpatients from five hospitals in Japan were enrolled and assigned to either the intervention group who used the "Kenko Yusuri" device or the control group who underwent conventional rehabilitation. All patients received botulinum toxin type A (BoNT-A) injections to treat upper limb spasticity. The primary outcome measure was the Fugl-Meyer Assessment (FMA) of upper-extremity motor function. Secondary outcomes included the modified Ashworth scale (MAS) score, range of motion (ROM), and chronic pain assessments. The intervention group demonstrated significantly greater improvements in FMA total scores than the control group. Patients with moderate paralysis experienced the greatest benefits from the intervention. There were no significant between-group differences in MAS scores or ROM measurements. Pain and wrist ROM showed improvement in the intervention group. Home-based training with a shaking device significantly improved upper limb function in patients with moderate chronic post-stroke paralysis. This approach aligns with the principles of use-dependent plasticity and offers a feasible and cost-effective alternative to traditional rehabilitation methods.

This study presents the chemical synthesis, purification, and characterization of a novel non-natural synthetic amino acid. The compound was synthesized in solution, purified, and characterized using NMR spectroscopy, polarimetry, and melting point determination. Dynamic Light 22 Scattering (DLS) analysis demonstrated its ability to form aggregates with an average size of 391 nm, extending to low micrometric sizes. Furthermore, cellular biological assays revealed its ability to enhance fibroblast cell growth, highlighting its potential for tissue regenerative applications. Circular dichroism (CD) spectroscopy showed the ability of the synthetic amino acid to bind serum albumins (using bovine serum albumin (BSA) as a model), and CD deconvolution provided insights into the changes in secondary structures of BSA upon interaction with the amino acid ligand. Additionally, molecular docking using HDOCK software elucidated the most likely binding mode of the ligand inside the BSA structure. We also performed in silico oligomerization of the synthetic compound in order to obtain a model of aggregate to investigate computationally. More in detail, in the dimer formation achieved by molecular self-docking, two distinct poses were observed, corresponding to the lowest and comparable energies, with one pose exhibiting a quasi-coplanar arrangement characterized by a close alignment of two aromatic rings from the synthetic amino acids within the dimer, suggesting the presence of π-π stacking interactions. In contrast, the second pose displayed a non-coplanar configuration, with the aromatic rings oriented in a staggered arrangement, indicating distinct modes of interaction. Both poses were further utilized in the self-docking procedure. Notably, iterative molecular docking of amino acid structures resulted in the formation of higher-order aggregates, with a model of a 512-mer aggregate obtained through self-docking procedures. This model of aggregate presented a cavity capable of hosting therapeutic cargoes and biomolecules, rendering it a potential scaffold for cell adhesion and growth in tissue regenerative applications. Overall, our findings highlight the potential of this synthetic amino acid for tissue regenerative therapeutics and provide valuable insights into its molecular interactions and aggregation behavior.

In the face of escalating climate concerns and the push for sustainable development, the global shift towards renewable and decentralized energy systems presents new challenges and opportunities. This study investigates integrating decentralized energy production, particularly photovoltaic (PV) systems, into national energy planning, aiming to optimize energy strategies that balance local production and consumption with national objectives. By analyzing the Swiss energy model, the research employs the EnergyScope and REHO models to assess the strategic implications of decentralized versus centralized energy systems. Results show that a decentralized approach can significantly reduce PV installation needs to 35 GW, about 23% of potential capacity, and decrease annual system costs by 10% to CHF 1230 per capita. This strategy emphasizes local consumption, minimizes grid reinforcement demands, and leverages economic advantages while addressing overproduction challenges through effective energy storage and grid management. Conclusions underline the strategic value of combining centralized and decentralized methods for resilient and sustainable energy planning. The study contributes to the discourse on energy policy and infrastructure planning, advocating for a hybrid model that accommodates both local conditions and broader energy objectives, urging further research into climate impacts and technology integration for a comprehensive energy future.

This study proposed to use wearable EEG to study the impact of vipassana mindfulness practice on beginner's physiological and neurological responses. Mindfulness meditation has been shown to have numerous benefits, including stress reduction, improved attention and cognitive function, and enhanced emotional regulation. The roots of mindfulness meditation in Buddhism emphasize cultivating present-moment awareness and insight. However, the neural mechanisms together with physiological mechanism and their interaction underlying these benefits remain poorly understood. Method: One middle age man (50 years old) participated in this longitudinal study using wearable EEG to investigate the neurophysiological change during a one-month consecutive vipassana mindfulness practice. Both EEG and heart rate responses were recorded each time, before (5 minutes), during (20 minutes), and after (5 minutes) meditation sessions. The EEG and HR data were analyzed by Matlab and EEGlab to examine changes in brainwave activity and heart rate. Results: alpha peak frequency (APF) is significantly lower after mindfulness meditation, as shown by comparison of APF before mindfulness (pre-5) and during mindfulness practice (med-20), and comparison between APF of pre-5 and after mindfulness practice (post-5). The same is with the beta peak power. While for theta peak frequency, it is significant lower during mindfulness meditation (med-20), when comparing to either pre-5 or post-5. See figure 1a. However, peak power index is not so sensitive, and it is more obvious in theta wave band. That is, the theta power peak is significantly lower after meditation, as can be observed in comparison between pre-5 and med-20, also between pre-5 and med-20. See figure 1b. STATE Heart-mean (bpm) Heart-std(bmp) pre-5 69.88 3.88 med-20 68.36 2.81 post-5 69.55 4.13 t-value test (pre-med) 0.0694 0.0003 t-value test (pre-post) 0.7934 0.3656 t-value test (post-med) 0.3193 0.0001 Table 1. The difference of Heart rate (mean and SD) in before (pre-5), during (med-20) and after (post-5)mindfulness meditation. We find significant change in standard deviation (SD) of heart rate between meditation and non-meditation mental states, as shown in table 1. The study provides insights into the underlying neurophysiological mechanisms of mindfulness meditation using wearable EEG devices. It demonstrates that in term of EEG measurement, spectrum frequency can be more sensitive than spectrum power; also heart rate variability as measured by SD is more sensitive to mean of HR. The proposed study contributes to the literature by using wearable EEG devices to collect data in a more accessible and convenient manner.

Lipophilic oligonucleotide derivatives are a potent approach to the intracellular delivery of nucleic acids. The binding of these derivatives to serum albumin is a major determinant of their fate in the body, as its structure contains several sites of high affinity for hydrophobic compounds. This study focuses on the features of self-association and non-covalent interactions with human serum albumin of novel self-penetrating oligonucleotide derivatives. The study revealed that the introduction of a triazinyl phosphoramidate modification bearing two dodecyl groups at the 3' end region of the oligonucleotide sequence has a negligible effect on its affinity for the complementary sequence. Dynamic light scattering verified that the amphiphilic oligonucleotides under study can self-assemble into micelle-like particles ranging from 8 to 15 nm in size. The oligonucleotides with dodecyl groups form stable complexes with human serum albumin with a dissociation constant of approximately 10-6 M. The oligonucleotide micelles are simultaneously destroyed upon binding to albumin. Using an electrophoretic mobility shift assay and affinity modification, we examined the ability of DNA duplexes containing triazinyl phosphoramidate oligonucleotides to interact with Ku antigen and PARP1, as well as the mutual influence of PARP1 and albumin or Ku antigen and albumin upon interaction with DNA duplexes. These findings, together with the capability of dodecyl-containing derivatives to effectively penetrate different cells, such as HEK293 and T98G, indicate that the oligonucleotides under study can be considered as a platform for the development of therapeutic preparations with a target effect.

Background: Coronavirus disease (COVID-19) has caused one of the worst global pandemics in recent decades. It has disrupted education systems worldwide, leading to a forced shift from traditional face-to-face to blended or fully distanced learning, requiring a higher level of student readiness for self-directed learning (SDL) and a more internal locus of control (LOC). Objective: This study explored the relationship between locus of control and level of readiness for SDL among Saudi nursing students and whether the COVID-19 pandemic has impacted this relation-ship. Methods: a cross-sectional correlational descriptive study was conducted to survey 277 Saudi nursing students enrolled in the bachelor program at one of the reputable universities in Saudi Arabia. An E-questionnaire containing two scales, the Self-Directed Learning Readiness Scale for Nursing Education, and the Locus of Control Scale, was used to collect data in addition to the selected participants’ characteristics. Results: Nursing students had a moderate-to-low level of readiness for SDL (mean = 144.0), and the majority had an external LOC. There was a significant association between the locus of control and level of readiness for self-directed learning (r = 0.19*, p = 0.001), and the internal locus of control was more significantly associated with self-directed learning (r = 0.22*, p = 0.0001) than with external locus of control. Conclusion: The study findings indicate a propensity of respondents towards an external locus of control, whereas most of the respondents’ reported levels of readiness ranged between low and moderate across all dimensions of self-directed learning. This study was not registered.

Conclusion: When applied to the air-abraded Filtek™ Bulk Fill Flowable Restorative composite surface, 10-MDP-containing adhesives perform better than 10-MDP-free adhesives. The binding strength was unaffected by the 10-MDP-containing adhesives' chemical makeup. The bond strength endurance of adhesives containing 10-MDP decreases with age. Keywords: keyword 1; keyword 2; keywords: low-viscosity bulk fill composite, universal adhesives, self-etch adhesive, 10-MDP, aging, bond strength.

Disassembly is a pivotal technology to enable the circularity of electric vehicle batteries by applying circular economy strategies that extend the life cycle of their components, like remanufacturing and repurposing, or by using efficient recycling to reintegrate the gained materials in producing new battery systems. This paper aims to develop a multi-method self-configuring simulation model for investigating disassembly scenarios while considering the battery design as well as the configuration and layout of the disassembly station. We demonstrate the developed model in a case study using a battery of Mercedes-Benz and the automated disassembly station of the project DeMoBat at Fraunhofer IPA. Furthermore, we introduce two disassembly scenarios, the component-oriented and the accessibility-oriented disassembly, and compare them using the simulation model to determine several indicators, such as the frequency of tool change, the number and distribution of robot routes, the tool utilization, and the disassembly time.

Algal-bacterial granular sludge, a new biological technology, has been widely recognized due to its highly effective pollutant treatment and energy efficiency. This study investigated the effects of environmental concentrations of Cr(VI) (0.5-2.5 mg/L) on the performance of algal-bacterial gran-ular sludge and self-defensive responses after 90 days of cultivation. The results showed that Cr(VI) affected chemical oxygen demand (COD), ammonia-N and phosphate removal with different trends being apparent. A linear decline in COD removal was observed, whereas an initial de-creasing and then increasing ammonia-N and phosphate removal took place. Algal-bacterial granular sludge effectively removed Cr(VI) from wastewater through biological adsorption and reduction, showing the potential to treat Cr(VI)-contaminated wastewater. Cr(VI) affected the community abundance of the algal-bacterial granular sludge, in which Chlorophyceae and cya-nobacteria were vulnerable under Cr(VI)-induced stress. To reduce the toxicity of Cr(VI), over-produced EPS-PN and antioxidant enzymes (MDA, SOD and CAT) acted as self-defensive responses to resist oxidative damage. This study showed that algal-bacterial granular sludge can remove 00.5 mg/L of Cr(VI) without performance loss. It is hoped that this study can provide useful information for improved engineering feasibility of algal-bacterial granular sludge.

DFT-D3 calculations based on structural X-ray diffraction data obtained for 3-oxo-camphorsulfonyl imine (1), camphorsulfonyl chloride (2) and seven camphor sulfonimines (O2SNC10H13NR, L1-L7) from which L2 (R=4-OHC6H4), L4 (R=4-ClC6H4) and L6 (R=3,5-(CH3)2C6H3) are new, provide information into the intra and inter molecular interactions with concomitant elucidation of the supramolecular arrangement of the compounds. The DFT D3 calculations performed in small clusters of 2 or 3 molecular units reproduce the interactions observed by X-ray analyses showing that as a general trend the structural arrangement of the molecules is driven by electronic rather than by packing parameters. In all compounds the self-assembly of 3D structures involves the sulfonyl imine group ( NSO2) either to establish hydrogen bonds, through the oxygen atoms or non-classic oxygen-aliphatic hydrogen or non-bonding interactions (NBI) which also involve the sulfonyl oxygens. Interestingly, the camphor sulfonimine compounds (L2, L3) having protic groups (R=C6H4X: X=OH, L2 or X=NH2, L3) at the aromatic imine substituents (=NR) present an extra π-π stacking which is absent in the other compounds aromatic derivatives. The X-ray analysis shows that all the reported camphor sulfonimine compounds display the E configuration with respect to the imine substituent (R). The study of the redox behavior of the compounds by cyclic voltammetry allows an insight into the solution properties of the compounds and the rationalization of the molecular interactions that stand in the solid and solution states. Camphor sulfonimine compounds (L) display appropriate binding atoms to coordinate transition metals. The herein results show that monodentate coordination through the nitrogen atom of the sulfonimine 5-membered ring to the {Ag(NO3)} metal center is favored. When this imine nitrogen atom is not itself involved in the Organic Framework DFT-D3 calculations shows that the complexation does not affect the non-covalent interactions that are reproduced in the MOF structure.

In swarm-robotics foraging, the purpose of task allocation is to adjust the number of active foraging robots dynamically based on the task demands and changing environment. It is a difficult challenge to generate self-organized foraging behavior in which each robot can adapt to environmental changes. To complete the foraging task efficiently, this paper presents a novel self-organized task allocation strategy known as the dynamic response threshold model (DRTM). To adjust the behavior of the active foraging robots, the proposed DRTM newly introduces the traffic flow density, which can be used to evaluate the robot density. First, the traffic flow density and the amount of obstacle avoidance are used to adjust the threshold which determines the tendency of a robot to respond to a stimulus in the environment. Then, each individual robot uses the threshold and external stimulus to calculate the foraging probability that determines whether or not to go foraging. Simulation and physical experiments are carried out to evaluate the performance of the proposed method. The experimental results show that the DRTM is superior to and more efficient than the adaptive response threshold model (ARTM) in swarm foraging.

Material selection for product design is a complex task. Thus, one of the objectives of this work is to analyze, understand and promote the importance of selection of materials to conceive quality products with help of designers' that promote green self-identity in the early stage of the conception of new products. A questionnaire was sent to professional designers and engineers. 38 responses were validated, this being the sample of our study. The aspects that influence the complex selection of materials and the final quality of the products through the design and production process is presented. As a result of the answers carried out with product designers who work in the market, with students who are graduating and with some engineers, a new approach for the selection of materials was developed. Based on a collection of main ideas from traditional and non-traditional methods of material selection, seeking to group the maximum requirements of both methods, inspired by the "Canvas" model on the basic modular methodology, a new model for a project of new product is presented. Our study focuses on the selection of materials, since this aspect is one of the most relevant steps in early stage of the prototyping phase of new products, with a view to reducing CO² from the air in the atmosphere that we all breathe. The classification of materials is complex, due to the diversity of available options. The novelty of this model is that all properties of the newly designed product, such as technical, aesthetic, productive, environmental and other properties, are all grouped in a model, which serves as an innovative support. Thus, the designer has at his disposal a tool that can help him in the selection of the best material for the products he designs. This study intends to make a contribution in the field of material selection, quality and design of new products, promoting a green self-identity for designers in the initial phase of product design. Consequently, all consumers in search of a sustainable planet will profit from it.

This study compares the effects of lecture-based instruction and process-oriented guided inquiry learning (POGIL)-based instruction on the self-efficacy performance of Grade 12 students. A quasi-experimental, pretest-posttest design was adopted to investigate and assess the impact of POGIL-based instruction versus lecture-based instruction on students’ performance as measured by three types of cognitive outcomes; Knowing, Applying and Reasoning (KAR). Two government high schools in Alain were selected as research sites, one for the boys and one for the girls. The total number of participants was approximately 110 students (N=110); 54 were assigned to treatment groups (25 girls and 29 boys), and 56 were assigned to control groups (27 girls and 29 boys). The treatment group was taught a circular motion unit in physics using POGIL-based instruction, while the control group was taught the unit using lecture-based instruction. The study's findings showed statistically significant differences between students of the control group and the treatment group in favour of the latter regarding their science performance, self-efficacy and science-related attitudes. Moreover, positive correlations were found between participants’ performance at the KAR test, self-efficacy and scientific attitudes towards scientific inquiry after the intervention. In conclusion, it is recommended to shift teaching towards POGIL-based instruction due to its positive impact on students’ performance and self-efficacy. It is also suggested to replicate the study to include government and private schools, elementary and high schools, teachers and advisors.

Body Expression (BE) has been defined in the past decades as a discipline within Physical Education (PE) with very particular characteristics and a strong emotional component. In this study, a programme of this discipline was applied to university Physical Activity and Sports Sciences (PASS) students from six consecutive academic years: three prior to and three during the pandemic. A pre-post design was used to determine how the BE programme affected the university students' self-concept (SC). To do so, a questionnaire with a multidimensional approach to this construct was administered, whose dimensions were closely related to the BE programme's characteristics. The results revealed significant improvements in the final SC, compared to the initial SC. Men reported lower SC values than women before the programme implementation, but higher at the end. Therefore, the change was larger in men, so the programme may have had an equalising effect between groups. It was also verified that the pandemic had particularly affected women.

Quantitative differential phase contrast (qDPC) imaging has become an important method of optical measurement and life science research in microscopy because of its high reconstruction resolution and non-invasive, high-contrast and quantitative imaging of biological samples. Despite the continuous development of the principle and algorithm, the frame rate of the existing qDPC algorithm is still much lower than that of camera acquisition, so it is hardly applied to real-time image the fast-moving biological samples. In this paper, based on color-coded multiplexing strategy, a compact real-time quantitative phase imaging system is designed to realize multi-mode imaging. The system employs a programmable LED array to illuminate directly, and the phase reconstruction algorithm is deployed in the graphics processing unit (GPU) of the laptop to accelerate the calculation. The system can achieve high-speed quantitative phase imaging of non-stained biological samples, and the frame rate can reach 60fps. The device has the advantages of compact structure, low cost and portability. Thus, it is suitable for mobile medical applications.

In remote sensing applications, one of the key points is the acquisition, real-time pre-processing and storage of information. Due to the large amount of information present in the form of images or videos, compression of this data is necessary. Compressed sensing (CS) is an efficient technique to meet this challenge. It consists in acquiring a signal, assuming that it can have a sparse representation, using a minimal number of non-adaptive linear measurements. After this CS process, a reconstruction of the original signal must be performed at the receiver. Reconstruction techniques are often unable to preserve the texture of the image and tend to smooth out its details. To overcome this problem, we propose in this work, a CS reconstruction method that combines the total variation regularization and the non-local self-similarity constraint. The optimization of this method is performed by the augmented Lagrangian which avoids the difficult problem of non-linearity and non-differentiability of the regularization terms. The proposed algorithm, called denoising compressed sensing by regularizations terms (DCSR), will not only perform image reconstruction but also denoising. To evaluate the performance of the proposed algorithm, we compare its performance with state-of-the-art methods, such as Nesterov's algorithm, group-based sparse representation and wavelet-based methods, in terms of denoising, and preservation of edges, texture and image details, as well as from the point of view of computational complexity. Our approach allows to gain up to 25% in terms of denoising efficiency, and visual quality using two metrics: PSNR and SSIM.

We reveal the significance of plasmonic nanoparticle’s (NP) shape and its surface morphology en route to an efficient self-assembled plasmonic nanoparticle cluster. A simplified model is simulated in the form of free-space dimer and trimer nanostructures (NPs in shape of sphere, cube, and disk). A ~ 200 % to ~ 125% raise in near field strength (gap mode enhancement) is observed for spherical NPs in comparison with cubical NPs (from 2 nm to 8 nm gap sizes). Full-width three-quarter maximum reveals better broad-spectral optical performance in a range of ~ 100 nm (dimer) and ~ 170 nm (trimer) from spherical NPs as compared to a cube (~ 60 nm for dimer and trimer). These excellent properties for sphere-based nanostructures are merited from its dipole mode characteristics.

In light of the self-simulation hypothesis, a simple form implementation of the principle of efficient language is discussed in a self-referential geometric quasicrystalline state sum model in three dimensions. Emergence is discussed in context of geometric state sum models.

An extension of the models used to generate fractal traffic flows is presented by means of the formulation of a model that considers the use of one-dimensional chaotic maps. Based on the disaggregation of the temporal series generated by the model, a valid explanation of behavior of the values of Hurst exponent is proposed and the feasibility of their control from the parameters of the proposed model is shown.

Solar cell layers technology has achieved global standing in the solar cell layers deposition process, and it covers the innovative methods and techniques in significant applications. Recent solar cell layers technology has an advanced interest in a refined approach to enhance performance and highlights the importance of recent proficient procedures for manufacturing. For example, the application is used to search for novel materials for solar cells' layers to clarify the current energy crisis. The technological process and various types of solar cells depend on climate change. Among them, layers of solar cells and silicon wafer solar cells are very encouraging. Solar cell layers technology has led to solar cells being a more reasonable active option in design and production. The productivities facilitated by new solar cells still need to be enhanced for the various processes involved in the additional enhancement from Copper Indium Gallium Selenide (CIGS) microfilms to solar cell crystal structure dye-sensitized solar cells. The hydrophobic coating works as an anti-dust coating, enhancing efficiency and decreasing the cost of cleaning solar cells. In Saudi Arabia Majmaah City, most solar projects are in dry regions, where the dusty weather reduces solar cell efficiency. Therefore, combining these two properties and applying an anti-reflective and superhydrophobic coating will increase solar cell efficiency by 20%. Solar cells' crystal structure results are substituted with layers or new materials to balance environmental impact and toxic nature.

The notion of hierarchy is a key characteristic of any complex system. This paper explores which notions of hierarchy are being used in the field of management and organization studies. Four distinct types of hierarchy are identified: a ladder of formal decision-making authority, a ladder of achieved status, a self-organized ladder of responsibility, and an ideology-based ladder. A social mechanism-based perspective serves to define and distinguish these four types. Subsequently, the typology is further developed by comparing the four hierarchy types in terms of their tacit/explicitness, (in)transitivity, and behavior- versus cognition-centeredness. This review article contributes to the literature by dissecting the general metaphor of hierarchy into four different constructs and their social mechanisms, which serves to create a typology of the various ways in which complex systems can be characterized as being hierarchical. This typology can inform future research drawing on any type of hierarchy.

Climate change is likely to have a complex effect on the growth of plants, their phenology, plant-pollinator interactions, and reproductive success. Therefore, we tested the impact of three key factors (temperature, water, and nitrogen supply) on traits, pollination, and seed production in Sinapis alba (Brassicaceae). We grew the plants in different combinations of temperature, water, and nitrogen supplementation, measured multiple vegetative and floral traits, and assessed the response of pollinators in the field. We also evaluated the effect of growing conditions on seed set in plants exposed to pollinators and hand-pollinated plants. Our results show that water stress impaired vegetative growth, decreased flower production, reduced visitation by pollinators and seed set, while nitrogen availability played an important role in nectar production. Temperature modulated the effect of water and nitrogen availability on vegetative and floral traits and strongly affected flowering phenology and flower production. We demonstrated that changes in temperature, water, and nitrogen availability induce changes in plant vegetative and floral traits which impact flower visitation and consequently plant reproduction. Climate change, particularly increasing temperature combined with reduced precipitation, thus may impact plant-pollinator interactions with negative consequences for the reproduction of wild plants and insect-pollinated crops.

Since the emergence of the quantified self movement, users aim at health behavior change, but only those who are sufficiently motivated and competent with the tools will succeed. Our literature review shows that theoretical models for quantified self exist but they are too abstract to guide the design of effective user support systems. Here, we propose principles linking theory and implementation to arrive at a hierarchical model for an adaptable and personalized self-quantification system for physical activity support. We show that such a modeling approach should include a multi-factors user model (activity, context, personality, motivation), a hierarchy of multiple time scales (week, day, hour), and a multi-criteria decision analysis (user activity preference, user measured activity, external parameters). This theoretical groundwork, which should facilitate the design of more effective solutions, has now to be validated by further empirical research.

In this article we explore the limiting behavior of the universal prior distribution obtained when applied over multiple meta-level hierarchy of programs and output data of a computational automata model. We were motivated to alleviate the effect of Solomonoff's assumption that all computable functions or hypotheses of the same length are equally likely, by weighing each program in turn by the algorithmic probability of their description number encoding. In the limiting case, the set of all possible program strings of a fixed-length converges to a distribution of self-replicating quines and quine-relays - having the structure of a constructor. We discuss how experimental algorithmic information theory provides insights towards understanding the fundamental metrics proposed in this work and reflect on the significance of these result in digital physics and the constructor theory of life.

Intranasal (i.n.) administration became an alternative strategy to bypass the blood-brain barrier and improve drug bioavailability in the brain. The main goal of this work was to preliminarily study the biodistribution of mixed amphiphilic mucoadhesive nanoparticles made of chitosan-g-poly(methyl methacrylate) and poly(vinyl alcohol)-g-poly(methyl methacrylate) and ionotropically crosslinked with sodium tripolyphosphate in the brain after intravenous (i.v.) and i.n. administration to Hsd:ICR mice. After i.v. administration, the highest nanoparticle accumulation was detected in the liver, among other peripheral organs. After i.n. administration of a 10-times smaller nanoparticle dose, the accumulation of the nanoparticles in off-target organs was much lower than after i.v. injection. In particular, the accumulation of the nanoparticles in the liver was 20 times lower than by i.v. When brains were analyzed separately, intravenously administered nanoparticles accumulated mainly in the “top” brain, reaching a maximum after 1h. Conversely, in i.n. administration, nanoparticles were detected in the “bottom” brain and the head (maximum reached after 2 h) owing to their retention in the nasal mucosa and could serve as a reservoir from which the drug is released and transported to the brain over time. Overall results indicate that i.n. nanoparticles reach similar brain bioavailability, though with a 10-fold smaller dose, and accumulate in off-target organs to a more limited extent and only after redistribution through the systemic circulation. At the same time, both administration routes seem to lead to differential accumulation in brain regions and thus, they could be beneficial in the treatment of different medical conditions.

Dentin bonding is a key in restorative dentistry. Herein, we developed self-etching two-bottle adhesive system containing 10-methacryloyloxidecyl dihydrogen phosphate monomer (MDP) and the physical, mechanical, and biocompatible properties were evaluated. The characteristics of MDP were analyzed using nuclear magnetic resonance (NMR). The water sorption and solubility, the shear-bond strengths to dentin and enamel, and cytotoxicity tests were performed. The newly blended experimental group showed the lowest thickness and water sorption and solubility values. The shear bond strength to enamel and dentin were comparable to control groups (the three other products) all test groups showed 60% of cell viability. In this study, the properties of the newly synthesized adhesive are comparable with the others. The fundamental goal of this study is to get the MDP patent released, as it is intended for domestic production. For this purpose, this dentin adhesive was developed and compared with the commercial product.

In our recent works we reported that physical and chemical characteristics of serum can vary in relation to the psychic activity of an individual depending on whether it is oriented to stress or relaxation. We wandered if these observations could be accompanied by an appreciable modification of the Ph, electric conductivity and Delayed Luminescence of the same serum samples. Our preliminary data may suggest that the serum pH could significantly increase during a Relaxation Response intervention while electric conductivity seems to decrease. Moreover, Delayed Luminescense could vary in the same subject according to the Relaxation Response practice. According to our proof of concept study, we postulate the appearance of a coherent system within the blood samples analyzed after the Relaxation Response. Further researches and some technical development are needed to support our preliminary findings.

In the author's opinion, many global problems that face humanity - in the fields of education, medicine, management etc can be tackled more effectively if the cyclic nature of self-reproducing systems – including living beings – is taken into account. Summarizing the main physiological findings of the last decades on "adaptation reactions", one can very roughly say that the way of action which is effective in the sense of productive activity of people happens at the same time to be healthy, and it gives the participants of the process the feeling of happiness. The present paper represents a very short overview of the contemporary concepts of the adaptation reactions based on the fundamental understanding of their cyclic nature due to general properties of self-reproducing systems. One interesting feature of self-reproduction cycles is its first "phase of orientation" which was not discussed in detail in the past but plays a key role in the whole cycle.

Hierarchical honeycomb patterns were manufactured with the breath-figures self-assembly by drop-casting on the silicone-oil lubricated glass substrates. Silicone oil promoted spreading of the polymer solutions. The process was carried out with the industrial grade polystyrene and polystyrene with the molecular weight Mw=35.000. Both of polymers gave rise to the patterns, built from micro- and nano-scaled pores. Ordering of the pores was quantified with the Voronoi tessellations and calculating the Voronoi entropy. Measurement of the apparent contact angles evidenced the Cassie - Baxter wetting regime of the porous films.

A new circuit model of the self-powered device for heart rate measurement is presented in this paper. This device consists of piezoelectric energy harvester (PEH), power management circuit (PMC) with energy storage, microcontroller, Photoplethysmography (PPG) sensor, and Wi-Fi module. The PEH is placed under the insole to harvest the pressure energy from human foot-step to generate ac power. In our model, a PEH is represented by sine voltage source, where its parameters were taken from experiments with 20 volunteers. The PMC is simplified by a switch with gain δ placed in series with the main circuit. The model of the main circuit is RC elements in parallel, where C is the capacitance of the storage device, and R is the equivalent parallel resistance of the microcontroller, PPG sensor, and Wi-Fi modules, respectively. The value of R depends on the power and current absorbed by those modules during sleep, deep sleep, sense, and transmit modes which collected from the datasheet. Finally, the proposed circuit model of the self-powered device was built and simulated in SPICE. The simulation results were compared with the laboratory experiment using commercial devices. Based on the results, the proposed model had small gaps compared to the real self-powered devices in terms of average current, voltage, power and efficiency.

Health of migrant is a widely studied topic. It has been argued that migrant health may deteriorate over time. Though migrants are ‘a hard to reach’ population in survey data, this paper builds on a unique dataset provided by Médecins du Monde from five countries. We study self perceived health (SPH) in connection with socio-economic and demographic factors and length of stay. Results show different results for men and women. Asylum seekers compared to other documented migrants have a worse health. Migrants with better living conditions tend to be in better health. Employment and stable accommodation has a positive effect on SPH. Women from poorer countries have a better physical SPH after 3 months of residing in the host country. This paper contributes widely to knowledge of health of migrants. Contrarily to other evidence, health of migrants tends to improve for some migrants.

2-Hydroxypropyl-β-cyclodextrin (HPβCD) has unique properties to enhance the stability and the solubility of low water-soluble compounds by inclusion complexation. Understanding of the structural properties of HPβCD and its derivatives based on the number of 2-hydroxypropyl (HP) substituents at the a-D-glucopyranose subunits is rather important. In this work, replica exchange molecular dynamics simulations were performed to investigate the conformational changes of single- and double-sided HP-substitution called as 6-HPβCDs and 2,6-HPβCDs, respectively. The results show that glucose subunits in both 6-HPβCDs and 2,6-HPβCDs have lower chance to flip than in βCD. Also, HP groups are occasionally blocking the hydrophobic cavity of HPβCDs, thus hindering the drug inclusion. We found that HPβCDs with high number of HP-substitutions are more likely to be blocked, while HPβCDs with double-sided HP-substitution are even more probable to be blocked. Overall, 6-HPβCDs with three and four HP-substitutions are highlighted as the most suitable structures for guest encapsulation based on our conformational analyses such as structural distortion, radius of gyration, circularity and cavity self-closure of the HPβCDs.

It is shown that structuring at the microlevel is the intrinsic property of water and aqueous solutions. At room conditions water (including "ultrapure" one) and aqueous solutions are dispersed systems in which microcrystals of NaCl, surrounded by a layer of hydrated water (average diameter - 10-15 microns), are "elementary microparticles", which form the basis of the dispersed phase. Possible ways of formation of these microparticles and their evolution in the process of evaporation of unstructured part of water - dispersion medium - are considered. It is shown, in particular, that they are present in the air as aerosol contaminants. When the ionic strength of the solution increases, the water-salt particles coagulate, forming a new phase - coacervates, remaining on the substrate after evaporation of the liquid part of the water. The aggregates of coacervate structures, formed in a liquid medium, are disordered during heating, which can cause a change in a number of physicochemical properties of water at the temperatures of 50°-60°C range that have not been correctly explained in the framework of atomic-molecular concepts.

Nowadays, the research and development of on-chip LiDAR sensors for vehicle collision avoidance is growing very fast. Therefore, the assessment of the reliability in obstacle detection using the information provided by LiDAR sensors has become a key issue to be explored by the scientific community. This paper presents the design and implementation of a self-tuning method in order to maximize the reliability of an Internet-of-Things sensors network and to minimize the number of sensors to localize with the required accuracy obstacles by a detection threshold. In order to achieve this goal, models that predict accuracy (i.e., prediction error) for object localization using data collected by LIDAR sensors are designed and implemented in Webots Automobile 3D simulation tool. The approach is based on combining different techniques. Firstly, point-cloud clustering technique and an error prediction model library composed by a multilayer perceptron neural network with backpropagation, k-nearest neighbors and linear regression are explored. Secondly the above-mentioned techniques for modeling are also combined with a supervised and reinforcement machine learning technique, Q-learning in order to minimize the detection threshold. In addition, a IoT driving assistance simulated scenario with a LiDAR sensor network is designed in order to validate the prediction model and the optimal configuration of the sensor network to guarantee reliability in obstacle localization. The results demonstrate that the self-tuning method is appropriate to increase the reliability of the sensor network whereas minimizing the detection threshold

The proposal that the genetic code was formed on the basis of protein synthesis directed by tRNA dimers is reviewed and updated. The tRNAs paired through the anticodon loops are an indication on the process. Dimers are considered mimics of the ribosomes – structures that hold tRNAs together and facilitate the transferase reaction, and of the translation process – anticodons are at the same time codons for each other. The primitive protein synthesis system gets stabilized when the product peptides are able to bind the producers therewith establishing a self-stimulating production cycle. The chronology of amino acid encoding starts with Glycine and Serine, indicating the metabolic support of the Glycine-Serine C1-assimilation pathway, which is also consistent with evidence on origins of bioenergetics mechanisms. Since it is not possible to reach for substrates simpler than C1 and compounds in the identified pathway are apt for generating the other central metabolic routes, it is considered that protein synthesis is the beginning and center of a succession of sink-effective mechanisms that drive the formation and evolution of the metabolic flow system. Plasticity and diversification of proteins construct the cellular system following the orientation given by the flow and implementing it. Nucleic acid monomers participate in bioenergetics and the polymers are conservative memory systems for the synthesis of proteins. Protoplasmic fission is the final sink-effective mechanism, part of cell reproduction, guaranteeing that proteins don’t accumulate to saturation, which would trigger inhibition.

In the context of modern healthcare, the concept of patient-centered care (PCC) has emerged as a crucial aspect, prompting the need for innovative frameworks to empower patients and enhance healthcare outcomes. This paper introduces the Patient-Oriented Medical Ontology Conceptual Framework (POMOCF), a powerful framework aimed at giving patients control over their personal and healthcare information. It prioritizes patient independence by allowing for direct control of electronic health records (EHRs) and facilitates the gathering of information through document upload or scanning. In the POMOCF front-end framework, we propose to maintain scalability, along with robust authorization, authentication, and secure data protocols, all of which are detailed within the framework. This approach enhances data accuracy and security, improving data management efficiency. As part of our ongoing development, we are planning to implement an innovative inference system that will automatically analyze and extract relevant details from the uploaded authorized document, provide real-time updates, and maintain data accuracy. This approach further strengthens data accuracy and prevents unauthorized modifications, thereby making the data management process more efficient. POMOCF leverages medical ontology principles to ensure standardized clinical concepts and improved semantic interoperability. Our integration plans involve integrating genotypic data for personalized medicine initiatives and strengthening the front-end infrastructure. By linking front-end interfaces with advanced technological solutions, we aim to provide effective healthcare delivery, promoting personalized care and enhancing patient outcomes.

In the context of evolving perceptions of sexuality, particularly within the realm of health and disability, this study investigates the impact of multiple sclerosis (MS) on female sexual function and quality of life. A quantitative study involving 130 female MS patients aged 35 to 50 was conducted, employing measures such as The Female Sexual Function Index (FSFI), The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), and The Fatigue Severity Scale (FSS). Results indicate a significant association between greater sexual dysfunction and poorer quality of sex life, alongside the correlation of increased fatigue with diminished sexual satisfaction. Factors such as education level, time of diagnosis, and treatment regimen also influenced outcomes. Findings underscore the importance of supportive interventions, including counseling, to enhance the quality of sex life for women with disabilities, particularly those with MS.

Increasingly large numbers of people are using digital weight-loss services (DWLSs) to treat overweight or obesity. Although it is widely agreed that digital modalities improve access to care in general, obesity stakeholders remain concerned that many DWLSs are not comprehensive or sustainable enough to deliver meaningful health outcomes. This study adopted a mixed-methods approach to assess why and after how long patients tend to discontinue Austral-ia’s largest DWLS, a program that combines behavioural and pharmacological therapy under the guidance of a multidisciplinary care team. We found that in a cohort of patients who commenced the Eucalyptus DWLS between January and June 2022 (n=5604), mean program adherence was 171.2 (±158.2). Inadequate supply of a patient’s desired Glucose-like peptide-1 receptor agonist medication was the most common reason for discontinuation (43.7%), followed by program cost (26.2%), result dissatisfaction (9.9%), and service dissatisfaction (7.2%). Statistical tests revealed that ethnicity and age both had a significant effect on patient adherence. These findings suggest that DWLSs have the potential to improve access to comprehensive, continuous obesity care, but that care models need to improve upon the one observed in the Eucalyptus Australia DWLS to maximise program adherence.

Open science, accessibility and knowledge sharing, especially of articles and monographs stemming from a publicly funded research, seem to be quite a positive direction in the development of science and have received almost unanimous approval from a scientific community. However, when it comes to data sharing, the data obtained by qualitative methodology deserve special attention and treatment. Although FAIR principles provide ways to anonymise the data and interlocoutors (as explained in Celjak et al 2020) individuals coming from smaller communities or even communities of practice can sometimes be easily regcognized by members of the same communitiy, especially if the data refers to audio files! The researcher is obliged to thoroughly describe the ways in which the data will be managed and used, and if it will state that the data will be managed in line with FAIR principles, this will inevitably impact the narratives collected. The prerogative to make all the data open will inevitably lead to autocesorship i.e. in creating a kind of FAIRy Tales for the future, interlocutors will share with researchers. Having all that in mind I argue for a more vigilant approach when embracing the idea that all the data should be made FAIR. Not all the data should be made FAIR because this could, in the end, compromise the research process itself. Some data must remain in the space of trust created between main actors in the research process. These data should be treated with CARE principles.

Abstract: (1) Background: Post-COVID syndrome is defined as symptoms that occur simultane-ously with or after COVID-19 infection, last for 12 weeks, and are not due to another diagnosis. Limited data are available on people’s long-term quality of life (QoL) following COVID-19 infection. The aim of this cross-sectional study was to investigate long-term QoL after COVID-19 among employees of the St. Josef Hospital in Paderborn, Germany, and to identify risk factors. (2) Methods: A monocentric, cross-sectional study was conducted using the validated and digitized WHOQOL-BREF questionnaire via Netigate® between 10/2022 and 02/2023. Data on QoL and global health status were collected in the following four domains: physical health, mental health, social relationships, and environment. (3) Results: The response rate was 73.84% (923/1250). Furthermore, 63.45% of hospital staff respondents reported at least one persistent symptom after COVID-19 infection, leading to significant differences in QoL. Pre-existing conditions, persistent symptoms, and disability after COVID-19 infection, as well as high BMI, no partnership, and low educational level were found to significantly contribute to long-term low QoL. (4) Conclusions: Obesity, lack of partnership, and a low level of education were independent risk factors for lower QoL post-COVID-19 infection in this cohort of hospital staff. Further multicenter studies are re-quired to validate the incidence and their suitability as independent risk factors for post-COVID syndrome.

Background: In America, vaccine-related deaths constitute a significant contributor to child mortality. An essential means of reducing this is through broad vaccine coverage. The COVID-19 pandemic has posed a potential disruption to vaccine coverage due to its effects on the healthcare system. Objectives: This study aims to evaluate the impact of the COVID-19 pandemic on DTP3 vaccination coverage in the Americas, investigating trends from 2012 to 2022 to identify significant changes, regional disparities, and the overall effect of the pandemic on progress towards global immunization targets. Methods: This study used the coverage data for the third dose of the Diphtheria, Tetanus, and Pertussis Vaccine (DTP3) pulled from UNICEF databases spanning 2012 to 2022. We conducted a JoinPoint regression to identify points of significant trend changes. The annual percentage change (APC) and 95% confidence intervals (95% CI) were calculated for America and its regions. We also used segmented regression analysis. Using the Chi-square test, we compared DTP3 vaccination coverage for each country between 2019 and 2022. Results: Overall, America saw a decrease in vaccine coverage during this period, with an APC of -1.4 (95% CI -1.8.; -1.0). This trend varied across regions. In North America, the decrease was negligible (-0.1% APC). South America showed the steepest decrease, with an APC of -2.5%. Central America also signif-icantly declined, with an APC of -1.3%. Our findings suggest a concerning trend of declining DTP vaccination rates in the Americas, exacerbated in certain regions, in the wake of the COVID-19 pandemic. The absolute decrease in vaccine coverage in the Americas was -4 % between 2019 and 2022, with the most significant drop observed in Central America (-7 %). However, six countries reported increased vaccination rates post-COVID-19, led by Brazil, with a 7% increase. Conversely, twenty-two countries registered a decline in DTP3 vaccine coverage, with the average decrease being -7.37%. This decline poses a significant challenge to achieving the WHO's target of 90% coverage for the third dose of DTP by 2030, as evidenced by the reduction in the number of countries meeting this target from 2019 to 2022. Conclusions: The COVID-19 pandemic has impacted vaccine coverage in America, leading to a decrease, especially across Central America.

Low-complexity ultrasound systems are increasingly desired for wearable point-of-care ultra-sound and massive-channel ultrasound for 3-D matrix imaging. However, the system complexity is closely associated with the imaging capabilities, remaining as a challenge. To resolve this limitation, this study revisits the general structures of analog and digital beamformers and in-troduces a hybrid approach to implement efficient ultrasound systems. The suggested hybrid beamforming takes two stages, where the first analog stage partially beamforms M-channel RF signals to N sum-out data (M-to-N beamforming), and the second digital stage beamforms N partial sums to single final beamformed data (N-to-1 beamforming). Our approach was systematically designed and implemented, which was demonstrated with a customized 64-channel 1-D phased array using a tissue mimicking phantom. The demonstrated results indicate that the analog-digital hybrid beamforming can be applied to any kind of arrays for sophisticated 3-D imaging and tiny wearable ultrasound applications.

: Early and accurate detection of infectious diseases is a key step for surveillance, epidemiology, and control, notably timely disease diagnosis, patient management and follow-up. In this study, we aimed to develop hand-held ultra-fast duplex PCR assays coupled to amplicon detection by lateral flow (LF) immunoassay to deliver a rapid, and simple molecular diagnostic test for con-comitant detection and identification of the main Leishmania parasites encountered in Tunisia and the Old World. We selected two DNA targets to amplify L. major/L. tropica and L. infantum/L. tropica group of species DNAs, respectively. We optimized the experimental conditions of a du-plex ultra-fast PCR. The amplification is performed by a portable Palm convection PCR machine within 18 min and the products are detected by a LF cassette within 10 minutes. The test allows the identification of the infecting species according to the position and number of test lines re-vealed. Tested on a selection of DNAs of representative Leishmania strains of the three studied species (N=37), the ultra-fast duplex PCR-LF showed consistent, stable, and reproducible results. The analytical limit of detection of the test was 0.4pg for L. major, 4pg for L. infantum and 40pg for L. tropica.

Blood gas analysis plays a central role in modern medicine. Advances in technology have expanded the range of available parameters and increased the complexity of their interpretation. By applying user-centered design principles, it is possible to reduce the cognitive load associated with interpreting blood gas analysis. In this international, multicenter study, we explored anesthesiologists' perspectives on Visual Blood, a novel visualization technique for presenting blood gas analysis results. We conducted interviews with participants following two computer-based simulation studies: the first utilizing Virtual Reality (VR) (50 participants) and the second without VR (70 participants). Employing the template approach, we identified key themes in the interview responses and formulated six statements, which were rated using Likert scales: from 1 (strongly disagree) to 5 (strongly agree) in an online questionnaire. The most frequently mentioned theme was the positive usability features of Visual Blood. The online survey revealed that participants found Visual Blood to be an intuitive method for interpreting blood gas analysis (median 4, IQR 4-4, p<0.001). Participants noted that minimal training was required to effectively learn how to interpret Visual Blood (median 4, IQR 4-4, p<0.001). However, adjustments are necessary to reduce visual overload (median 4, IQR 2-4, p<0.001). Overall, Visual Blood received a favorable response. The strengths and weaknesses derived from these data will help optimize future versions of Visual Blood to improve the presentation of blood gas analysis results.

This study assessed health inequality trends and the degree of maternal healthcare services utilization in the DRC, using two consecutive Demographic and Health Surveys, 2007 and 2013-2014. First, we assessed the changes in the magnitude of inequality in the utilization of MHCS using logistics and regressions. Second, we analyzed the distribution of inequality in each MHCS utilization variable using the Gini coefficient and the Lorenz curve. Third, we used the Wagstaff two groups concentration indices comparison method to assess health inequality trends. Finally, we fitted the concentration curves to estimate the inequality in the utilization of MHCS to the economic condition of women. Women were less likely to have their first ANC visit within the first trimester, less likely to receive checkups during ANC visits, and less likely to attend more ANC visits when living in eastern DRC compared to western DRC. Women in rural areas were less likely to have their last birth by C-section, and less likely to receive PNC than women in urban areas. Women with middle, richer, and richest wealth indexes were more likely to complete more ANC visits, more likely to deliver by C-section, most likely to receive PNC, and more likely to receive ANC than those with lower wealth indexes. Over time, inequality in the utilization of MHCS decreased for ANC and PNC but increased for the delivery by C-sections. These findings suggest that innovative strategies are still needed to improve the utilization of MHC services among poorer, rural, and underserved women in post-conflict DRC.

Background: Portable oxygen concentrators (POCs) have shown efficacy in delivering adequate oxygen for various patient scenarios; however, there is a lack of research on POCs’ efficacy across different respiratory rates specifically among COPD patients. Methods: This bench study was conducted using the IngMar Medical Active Servo Lung 5000 attached to flexible tubing, which simulated an adult patient’s nares. An oxygen analyzer (Maxtec Handi+) was connected to the tubing 6 inches below the nares to estimate the inspired oxygen concentration at the adult trachea. A standard nasal cannula was placed in the simulated patient nares, which was also attached to each POC. The IngMar Lung was programmed to simulate a COPD patient at the following respiratory rates: 15, 20, 30, and 40 breaths/min. POC devices were then compared to an oxygen wall outlet and a standard oxygen concentrator (non-portable CAIRE device). The POCs included the CAIRE FreeStyle Comfort (with Autosat), CAIRE FreeStyle Comfort (without Autosat), Inogen G4, Inogen G5, Phillips SimplyGo Mini, GCE Zen-O lite, Drive Medical iGo2, and Kingon POCs. Descriptive statistics and ANOVAs were computed to determine statistically significant differences between POCS and control devices (wall oxygen and standalone oxygen concentrator). Results: Across most respiratory rate scenarios, the wall oxygen and standalone oxygen concentrator (control group) resulted higher oxygen measurements compared to the POCs. Among the POCs on setting 2, the highest oxygen measurement for 15, 30, and 40 breaths/min was the CAIRE FreeStyle Comfort with AutoSat on sensitivity 5 (24.43%, 24.81%, and 25.0%, respectively). On setting 2, the 20 breaths/min highest oxygen measurement was the Inogen G4 (24.43%). For setting 5, the highest oxygen measurement for 15 breaths/min and 40 breaths/min was the CAIRE FreeStyle Comfort without AutoSat (31.56% and 26.13%, respectively), while the highest oxygen measurement for 20 breaths/min was the Inogen G5 (30.26%), and the highest oxygen measurement for 30 breaths/min was the CAIRE FreeStyle Comfort with AutoSat on sensitivity level 5 (27.89%). Conclusions: The oxygen administered through the wall and the standalone CAIRE oxygen concentrator all delivered higher oxygen levels compared to the POCs (with the exception of the 40 breaths/min scenario on setting 2). However, among the POCs, the CAIRE Freestyle Comfort with AutoSat, CAIRE Freestyle Comfort without AutoSat, and the Inogen G4 all performed the best among the various breathing rate scenarios.

Background. Cardiorespiratory fitness (CRF) is a predictor of chronic disease that is impractical to routinely measure in primary care settings. We used a new estimated cardiorespiratory fitness (eCRF) algorithm that uses information routinely documented in electronic health care records to predict abnormal blood glucose incidence. Methods: Participants were adults (17.8% female) 20-81 years old at baseline from the Aerobics Center Longitudinal Study between 1979 and 2006. eCRF was based on sex, age, body mass index, resting heart rate, resting blood pressure, and smoking status. CRF was measured by maximal treadmill testing. Cox proportional hazards regression models were established using eCRF and CRF as independent variables predicting the abnormal blood glucose incidence while adjusting for covariates. Results: Of 8,602 participants at risk at baseline, 3,580 (41.6%) developed abnormal blood glucose during an average of 4.9 years follow-up. The average eCRF of 12.03 ± 1.75 METs was equivalent to the CRF of 12.15 ± 2.40 METs within the 10% equivalence limit. In fully adjusted models, the estimated risks were the same (HRs = 0.96), eCRF (95% CIs = 0.93−0.99), and CRF (95% CI of 0.94−0.98). Each 1-MET increase was associated with a 4% reduced risk. Conclusion: Higher eCRF is associated with a lower risk of abnormal glucose. eCRF can be a vital sign used for research and prevention.

Abstract: Ambulatory cancer centers face fluctuating patient demand and deploy specialized personnel who have variable availability. This undermines operational stability through misa-lignment of resources to patient needs, resulting in overscheduled clinics, budget deficits, and wait times exceeding provincial targets. We describe deployment of a Learning Health System framework for operational improvements within the entire ambulatory center. Known methods of value stream mapping, operations research and statistical process control were applied to achieve organizational high performance that is data-informed, agile and adaptive. We transitioned from a fixed template model by individual physician to a caseload management by disease site model that is realigned quarterly. We adapted a block schedule model for the ambulatory oncology clinic to align the regional demand for specialized services with optimized human and physical resources. We demonstrated improved utilization of clinical space, increased weekly consistency and im-proved distribution of activity across the workweek. Increased value, represented as the ratio of monthly encounters per nursing worked hours, and increased percentage of services delivered by full-time nurses were benefits realized in our cancer system. The creation of a data-informed demand capacity model enables application of predictive analytics and business intelligence tools that will further enhance clinical responsiveness..

The COVID-19 pandemic has exposed the inadequacies of the current healthcare system and needs a paradigm change, which is holistic, and community based illustrated by the healing wheel. The present paper proposes that existential positive psychology (PP 2.0) represents a promising approach to meet the rising needs in palliative care. This framework has a twofold emphasis on (a) How to transcend and transform suffering as the foundation for wellbeing, and (b) how to cultivate our spiritual and existential capabilities to achieve personal growth and flourishing. We propose that these objectives can be achieved simultaneously through dialectical palliative counselling, as illustrated by Wong’s integrative meaning therapy (Wong, 2020) and Lo’s Conceptual Model of CALM Therapy in palliative care (Lo et al., 2014). We then discuss existential suffering in general and at the last stage of life in particular; we also review recent research and interventions on existential suffering in palliative patients. Finally, we outline the objectives and the strategies of IMT in providing palliative counselling for palliative care and hospice patients.

Survivors of severe brain injury may require care in a neurointensive care unit (neuro-ICU), where the brain is vulnerable to secondary brain injury. Thus, there is a need for noninvasive, bedside, continuous cerebral blood flow monitoring approaches in the neuro-ICU. Our goal is to address this need through combined measurements of EEG and functional optical spectroscopy (EEG-Optical) instrumentation and analysis to provide a complementary fusion of data about brain activity and function. The present case demonstrates in a patient with traumatic brain injury, noninvasive cerebral blood flow transients can be recorded that correlate with gold-standard invasive measurements and with the frequency content changes in the EEG data during clinical care.

To identify gender- and age-related associations between adult dental checkups and unmet dental care needs, we analyzed data of 14,000 participants, ages ≥ 19, from the 7th Korea National Health and Nutrition Examination Survey (2016–2018) (KNHANES VII). Data was collected via self-report questionnaires and interviews. Complex sample chi-square test and multiple logistic regression analysis indicated 31.7% of participants had unmet dental care needs; in the prior 12months, 67.1% had not utilized dental services, and 43.3% had not received dental checkups. Odds ratios (ORs) for dental checkups and unmet dental needs were 8.87 (CI:7.80–10.09, p < 0.001) for those who used dental services and 1.28 (CI: 1.13–1.44, p < 0.001) for those who had not. Significant age-dependent associations between those not receiving dental checkups and the rate of unmet dental care include men and women aged 50–59 years (OR: 1.77; CI = 1.22–2.58 and OR: 1.43; CI: 1.02–2.02; p = 0.040, respectively) and women ≥ 70 years (OR = 1.79, CI = 1.20–2.66, p = 0.004). Reducing unmet dental care needs requires greater public health promotion and education regarding regular dental checkups; additional practical strategies could enhance dental checkup compliance.

Background: A malfunction of the innate immune response in COVID-19 is associated with eosinopenia particularly in more severe cases. This study tested the hypothesis that this eosinopenia is COVID-19 specific and is associated with systemic activation of eosinophils.. Methods: Blood of 15 healthy controls and 75 adult patients with suspected COVID-19 at the ER were included before PCR testing and analyzed by point-of-care automated flow cytometry (CD10, CD11b, CD16 and CD62L) in the absence or presence of a formyl peptide (fNLF). 45 SARS-CoV-2 PCR positive patients were grouped based on disease severity. PCR negative patients with proven bacterial (n=20) or other viral (n=10) infections were used as disease controls. Eosinophils were identified with the use of the FlowSom algorithm. Results: Low blood eosinophil numbers (<100 cells/microL; p<0.005) were found both in patients with COVID-19 and with other infectious diseases albeit less pronounced. Two discrete eosinophil populations were identified in healthy controls both before and after activation with fNLF based on the expression of CD11b. Before activation, the CD11bbright population consisted of 5.4% (CI95% = 3.8, 13.4) of total eosinophils. After activation, this population of CD11bbright cells comprised nearly half the population (42.21%, CI95% = 35.9, 54.1). Eosinophils in COVID-19 had a similar percentage of CD11bbright cells before activation (7.6%, CI95% = 4.5, 13.6), but were clearly refractory to activation with fNLF as a much lower percentage of cells end up in the CD11bbright fraction after activation (23.7%, CI95% = 18.5, 27.6; p<0.001). Conclusion: Low eosinophil numbers in COVID-19 are associated with refractoriness in responsiveness to fNLF, which is likely caused by migration of fully functional cells to the tissue. Such homing might be beneficial as eosinophils have been implicated in viral killing.

With a reduction in the mortality rate of burn patients, patient length of stay (LOS) is increasingly adopted as an outcome measure. Some studies have attempted to identify factors that explain a burn patient's expected LOS. However, few have investigated the association between LOS and a patient's mental and socioeconomic status. There is anecdotal evidence for links between these factors and uncovering these will aid in better addressing the specific physical and emotional needs of burn patients, and facilitate the planning of scarce hospital resources. Here, we employ machine learning (clustering) and statistical models (regression) to investigate whether a segmentation by socioeconomic/mental status can improve the performance and interpretability of an upstream predictive model, relative to a unitary model derived for the full adult population of patients. Although we found no significant difference in the performance of the unitary model and segment-specific models, the interpretation of the segment-specific models reveals a reduced impact of burn severity in LOS prediction with increasing adverse socioeconomic and mental status. Furthermore, the models for the socioeconomic segments highlight an increased influence of living circumstances and source of injury on LOS. These findings suggest that, in addition to ensuring that the physical needs of patients are met, management of their mental status is crucial for delivering an effective care plan.

Low back pain (LBP) is a pandemic and costly musculoskeletal condition in the United States. Patients with LBP may endure surgery, injections, and expensive visits to emergency departments. Some suggest that using physical therapy or chiropractic in the earlier stage of LBP reduces the utilization of expensive health services and lowers the treatment costs. Nevertheless, there is no consistent evidence to declare which one of these methods is a cost-effective treatment within a short (less than a year) period of time. The purpose of this study was to investigate the cost-effectiveness of chiropractic versus physical therapy in the United States. A decision tree analytic model was used for estimating the economic outcomes. The findings showed that in the chiropractic group, the total average cost was $48.56 lower than the physical therapy group, and daily adjusted life years (DALY) was 0.0043 higher than the physical therapy group. Chiropractic care was shown to be a cost-effective alternative compared with physical therapy for adults with at least three weeks of low back pain over six months.

It is estimated that pancreatic cancer will be the 2^nd leading cause of cancer-related deaths globally by 2030, highlighting the ongoing lack of effective treatment options in this devastating condition. There is a lack of reliable prognostic or predictive markers in pancreatic cancer to guide management decisions, whether for systemic chemotherapy, molecularly targeted therapies, or immunotherapies. To date, the results for targeted agents and immunotherapies in unselected populations of chemo-refractory pancreatic cancer have not met expectations. The reasons for this lack of efficacy of immunotherapy in pancreatic cancer are incompletely understood. The challenges in pancreatic cancer include the physical barrier created by the dense desmoplastic stroma surrounding the tumor, chemokine-mediated exclusion of T cells, poor antigenicity, paucity of infiltrating T cells within the tumor, ultimately leading to an immunosuppressive microenvironment. A better understanding of the role of inflammation in pancreatic cancer, its tumor microenvironment and individualized patient-related features, be they molecular, clinical or histopathological would enable a more effective tailored approach to the management of pancreatic cancer. In this review, the role of inflammation, the immune tumor microenvironment and potential immune biomarkers in pancreatic cancer are explored.

Chronic pain is a serious health concern and potentially debilitating condition, leading to anxiety, depression, reduced productivity and functionality, and poor quality of life. This condition can be even more detrimental and incapacitating in the pediatric patient population. In low and middle income countries (LMICs), pain services are inadequate or unavailable, leaving most of the world's pediatric population with chronic pain untreated. Many of these children in LMICs are suffering without treatment, and often die in pain. Awareness and advocacy for this population must be prioritized. We reviewed the available literature on the chronic pediatric pain burden in LMICs, barriers to treatments, and current efforts to treat these patients.

Current theories of autoimmunity are diverse, sometimes contradictory, and suffer from incompleteness. Although substantial evidence exists that adaptive and innate immunity, sex, genetic predisposition, and the microbiome all play essential roles in autoimmune disease etiologies and pathogenesis, and that antigen processing is altered during disease induction, no existing theory integrates all of these factors through a single, coherent mechanism. In an attempt to focus the field on the need to elucidate such an integrative mechanism, I propose one possibility here that, if nothing else, helps to identify the nature of the problems that need to be addressed. My theory is that autoimmune diseases are induced by normal immunological responses to unique pairs of complementary antigens, at least one of which is a molecular mimic of a host target. Each antigen in the complementary pair induces a complementary immune response (T or B cell); although each immune response is idiotypic in origin, the antigenic complementarity results in what appears to be an idiotype-anti-idiotype relationship between the responses. Additionally, because of the antigenic complementarity, each immune response mimics one of antigens, abrogating the distinction between self and non-self. If at least one of the antigens mimics a host antigen, then the resulting immunological civil war spreads to a host tissue. Complementary antigens also alter antigen processing so that antigens that would normally be proteolytically digested are presented by the major histocompatibility complex (MHC) to T and B cell receptors inducing a cross-reactive immune response. The resulting civil war is supported by the innate immune system due to the complementarity of the initiating antigens.. Complementary antigens stimulate synergistic toll-like receptors (TLR) and/or nucleotide-binding oligomerization receptors (NOD) resulting in up-regulation of cytokine production and further stimulation of the adaptive immune response. Because the immune responses (e.g., antibodies) mimic the initiating antigens, this synergistic activation of innate immunity becomes chronic. Additionally, TLR and NOD function are highly sensitive to sex hormones, some becoming up-regulated and some down-regulated in the presence of either testosterone or estrogens. This sensitivity explains how sex modifies susceptibility to autoimmune diseases. Genetic mutations in TLR, NOD and MHC further alter antigen presentation and the degree to which antigens stimulate an immune response explaining how genetics also modifies susceptibility. Finally, sex hormones also alter the host microbiome, which in turn modulates autoimmune disease risk by shaping the immunological nature of self and by mediating susceptibility to microbial infection. Moreover, it appears that the microbiome camouflages itself from the immune system by mimicking the host antigenic repertoire; the mimicry between the antigens of the microbiome and the host results in selective attacks on microbiome constituents concomitant with any autoimmune attack on host tissues. This antigenic complementarity theory thereby integrates all major elements known to affect, or be affected by, autoimmune diseases and provides a set of testable implications.

This study explored the effectiveness of a virtual music therapy program, based on positive psychotherapy principles, for college students during the COVID-19 pandemic. Twenty-four undergraduate students with partial PTSD were initially assigned to either an experimental group or a control group, with 11 participants in each group by the study's end. The experimental group underwent 15 video sessions of the therapy program, completing one session per weekday over three weeks. The program involved worksheets targeting goals aligned with positive psychology, such as positive affect, life meaning, personal strengths, gratitude, hope, and happiness. Activities included writing music autobiographies, creating and analyzing song lyrics, and exploring various music pieces. The effectiveness of the intervention was measured using the 21-item Depression Anxiety Stress Scale and the Korean Version of Positive Psychological Capital (K-PPC) before, immediately after, and three weeks post-program. The experimental group showed significant improvements in stress, anxiety, depression, self-efficacy, resilience, and the K-PPC total score compared to the control group. These improvements were maintained at the three-week follow-up. The findings suggest that positive psychology-based virtual music therapy can significantly enhance the mental health of highly stressed college students, especially during challenging times like the COVID-19 pandemic.

: This study aimed to validate the effects of self-compassion-based forest healing therapy as an intervention for reducing stress and promoting coping resources. Therefore, we investigated the effects of self-compassion-based forest healing therapy on stress, self-compassion, and connectedness to nature. A total of 30 participants were divided into an experimental and control group. Two sessions of forest healing meditation activities were held at the Forest of Healing every two weeks between October and November 2023. As a repeated measures experiment, data were collected before the intervention, after the first intervention, and after the second intervention. Perceived stress, positive and negative affect, and salivary cortisol were measured to assess physiological and psychological stress in participants. Connectedness to nature and self-compassion were measured to evaluate stress-coping resources. The results showed that the forest healing program had significant positive effects on stress and emotional states in the experimental group after the intervention. Further, there was a significant incremental effect on connectedness to nature and self-compassion in the experimental group. Therefore, self-compassion meditation-based forest healing therapy is a feasible and efficient approach for facilitating stress management and coping resource building.

A theoretical account of development in mesocortical anatomy is derived from the free energy principle, operating in a neural field with both Hebbian and anti-Hebbian neural plasticity. An elementary structural unit is proposed, in which synaptic connections at mesoscale are arranged in paired patterns with mirror symmetry. Exchanges of synaptic flux in each pattern form coupled spatial eigenmodes, and the line of mirror reflection between the paired patterns operates as a Markov blanket, so that prediction errors in exchanges between the pairs are minimized. The theoretical analysis is then compared to the outcomes from a biological model of cortical neurodevelopment, in which neuron precursors are selected by apoptosis for cell body and synaptic connections maximizing synchrony and also minimizing axonal length. It is shown that this model results in patterns of connection with the anticipated mirror symmetries, at micro-, meso- and inter-arial scales, among lateral connections, and in cortical depth, explaining the spatial organization and functional significance of neuron response preferences, and compatible with features of both columnar and noncolumnar cortex. Multi-way interactions of mirrored representations provide a preliminary anatomically realistic model of cortical information processing.

This article introduces existential wellbeing (EWB) as one of the most ignored but also the most important kind of wellbeing, especially for people who experience life-limiting diseases and need palliative care (Wong & Yu, 2021). This article will not only review the literature regarding the nature and practice of existential wellbeing in palliative care, but also propose a preliminary Existential Wellbeing Scale. EWB is defined as the quality-of-life characterized by living well and dying well in spite of pain, obstacles, and the shadow of death; wellbeing within the context of human suffering can only be fully understood from the perspective of existential positive psychology (EPP), dedicated to the study of sustainable wellbeing based on the foundation of transcending suffering. The basic tenets of EPP are (1) redefining positivity or wellbeing in terms of seeing and being the light in the darkness; (2) focusing on the dialectical process of navigating an adaptive balance; and (3) re-orienting one’s life attitude from egotism to self-transcendence (Wong, 2023a). More specifically, EWB depends on some combination of the following experiences: (1) Prior experience of overcoming adversity; (2) Existential intelligence (Gardner, 2020) in addressing existential concerns; (3) Existential wisdom of the soul (Wong 2022a; Wong, Ho, et al, 2023a) to achieve existential wellbeing and sustainable flourishing; (4) Spiritual wellbeing based on spiritual values such as faith, hope, and love (Wong, 2023); (5) Knowledge of meaning-focused coping (Eisenbeck et al., 2021); and (6) The new paradigm of self-transcendence (Reed & Haugan, 2021; Wong, Arslan et al., 2021; Wong, Ho et al., 2023b) to transcend and transform suffering into wellbeing and triumph.

Matter grows and self-assembles to produce complex structures such as virus capsids, carbon fullerenes, proteins, glasses, etc. Due to its complexity, performing pen-and-paper calculations to explain and describe such assemblies is cumbersome. Many years ago, Richard Kerner presented a pen-and-paper path integral approach to understand self-organized matter. Although successfully addressed many important problems including the yield of fullerene formation, the glass transition temperature of doped chalcogenide glasses, the fraction of boroxol rings in B2O3 glasses, the first theoretical explanation for the empirical recipe of window and Pyrex glass and the understanding of virus capsid self-assembly, still is not the primary choice when tackling similar problems. The reason lies in the fact that it diverges from mainstream approaches based on the energy landscape paradigm and non-equilibrium thermodynamics. In this context, a critical review is presented, demonstrating that the Richard Kerner method is, in fact, a clever way to identify relevant configurations. Its equations are simplified, common physical sense versions to those found in the energy landscape kinetic equations. Subsequently, the utilization of equilibrium Boltzmann factors in the transition Markov chain probabilities is analyzed within the context of local two-level energy landscape models kinetics. This analysis demonstrates that their use remains valid when the local energy barrier between reaction coordinate states is small compared to the thermal energy. This finding places the Richard Kerner model on par with other more sophisticated methods and, hopefully, will promote its adoption as an initial and useful choice for describing the self-agglomeration of matter.

The impact of the COVID-19 pandemic and the quarantine measures on children and adolescents’ hospitalization psychiatric has been poorly studied, especially in Italy, the first European country to adopt social restrictions. To fill this gap, this retrospective study examined changes in admissions to our child and adolescent psychiatry ward from the emergency department during the two COVID-19 quarantine periods in Italy (March to June 2020; October 2020 to January 2021) compared with two reference periods (defined as 12 months prior to the respective quarantine periods). Specifically, we examined data on the number of inpatients and the distribution of psychopathological disorders (i.e., psychosis, mood disorder) and self-injurious behaviors. The results revealed significantly fewer admissions during the first quarantine period relative to the first reference period and, conversely, significantly more admissions during the second quarantine period relative to the second reference period. Of note, the results showed an increased frequency of mood disorders, non-suicidal self-injurious behaviors and suicidal ideation during the quarantine periods, compared to the reference periods. The findings underline the need to focus on the psychopathological profile of children and adolescents with patient-tailored therapeutic interventions and suggest the importance of developing psychological healthcare services for future emergency periods..

Research on image-inpainting tasks has mainly focused on enhancing performance by augmenting various stages and modules. However, this trend does not consider the increase in the number of model parameters and operational memory, which increases the burden on computational resources. To solve this problem, we propose a Parametric Efficient Image InPainting Network (PEIPNet) for efficient and effective image-inpainting. Unlike other state-of-the-art methods, the proposed model has a one-stage inpainting framework in which depthwise and pointwise convolutions are adopted to reduce the number of parameters and computational costs. To generate semantically appealing results, we selected three unique components: spatially-adaptive denormalization (SPADE), dense dilated convolution module (DDCM), and efficient self-attention (ESA). The SPADE was adopted to conditionally normalize activations according to the mask to distinguish between damaged and undamaged regions. The DDCM was employed at every scale to overcome the gradient-vanishing obstacle and gradually fill-in pixels by capturing global information along the feature maps. The ESA was utilized to obtain clues from unmasked areas by extracting long-range information. In terms of efficiency, our model has the lowest operational memory compared with other state-of-the-art methods. Both qualitative and quantitative experiments demonstrate the generalized inpainting of our method on three public datasets: Paris StreetView, CelebA, and Places2.

Neurodegeneration is becoming one of the leading causes of death worldwide as the population expands and grows older. There is a growing desire to understand the mechanisms behind prion proteins as well as the prion-like proteins that make up neurodegenerative diseases (NDs) including Alzheimer’s Disease (AD). Both amyloid β (Aβ) and hyperphosphorylated tau (p-tau) proteins behave in ways similar to that of the infectious form of the prion protein, PrPSc, such as aggregating, seeding, and replicating under not yet fully understood mechanisms, thus the designation of prion-like. This review aims to highlight the shared mechanisms between prion-like proteins and prion proteins in the structural variations associated with aggregation and disease development. These mechanisms are largely focusing on the dysregulation of protein homeostasis, self-replication, and protein aggregation, and how this knowledge could contribute to diagnoses and treatments for the given NDs.

The vast majority of autonomous driving systems are limited to applications on roads with clear lane markings and are implemented using commercial grade sensing systems coupled with specialized graphic accelerator hardware. This research reviews an alternative approach for autonomously steering vehicles that eliminates the dependency on road markings and specialized hardware. A combination of machine vision, machine learning and artificial intelligence based on popular pre-trained Convolutional Neural Networks (CNN) and Recurrent Neural Networks (RNN) was used to drive a vehicle along roads lacking lane markings (unmarked roads). The team developed and tested this approach on the ACTor (Autonomous Camus TranspORt) vehicle - an autonomous vehicle development and research platform coupled with a low-cost webcam based sensing system and minimal computational resources. The proposed solution was evaluated on real-world roads and varying environmental conditions. It was found that this solution may be used to successfully navigate unmarked roads autonomously with acceptable road following behavior.

Durability of concrete requires a dense microstructure which can be achieved by using self-compacting concrete (SCC). Both calcined clay (CC) and rice husk ash (RHA) are promising supplementary cementitious materials (SCMs) that can partially replace cement, but their use in SCC is critical due to their higher water demand and specific surface area (SSA) compared to cement. Empirical method of SCC design was adopted considering the physical properties of both CC and RHA. The influence of partially substituting cement at 20 vol-% with binary and ternary blends of CC and RHA were investigated. The fresh properties of SCC were investigated using a variety of tests. The time dependent workability was monitored by plunger method and flow resistance determined based on the rheological measurements of SCC. The evolution of the hydrate phases of the binder in SCC was determined by thermogravimetric analysis, while the durability was evaluated by rapid chloride migration test. Cement partial replacement with 20 vol-% CC has no significant effect on SCC fresh, time dependent, compressive strength and durability properties. 20 vol-% RHA on the other hand requires higher dosage of SP to achieve self-compactability and increased the viscosity of SCC. Its workability retention is only up to 30 min after mixing and exhibited higher flow resistance. It consumes more CH and improves compressive strength and chloride resistance of SCC. The ternary blending with CC and RHA yielded better fresh SCC properties compared to the binary blend with RHA, while an improved chloride penetration resistance could be achieved compared to binary CC blend.

The multivariate Gaussian random fields with matrix-based scaling laws are widely used for inference in statistics and many applied areas. In such contexts interests are often in symmetry and in the rates of change of spatial surfaces in any given direction. This article analyzes the almost sure sample function behavior for operator fractional Brownian motion, including multivariate fractional Brownian motion. We obtain the estimations of small ball probability and the strongly locally nondeterministic for operator fractional Brownian motion in any given direction. Applying these estimates we obtain Chung's laws of the iterated logarithm for spatial surfaces of operator fractional Brownian motion. Our results show that the precise rates of change of spatial surfaces are completely determined by the self-similarity exponent.

The ability to self-direct a research program determines graduate degree completion. Yet, research on incompletion of graduate physics programs assume students’ present level of self-direction adequate and neglects to recognize a lack of self-directed learning as key. One theoretical mathematical physicist focused on changing this challenge of physics graduate education by promoting self-directed learning through the type research flow that has been found to bring the greatest satisfaction to researchers with respect to their insights. This he provided through his space, time, open mindedness and theoretical contributions with his students and in collaboration with his colleagues. A self-directed learner himself, David J. Rowe developed methods of mentoring for encouraging physics graduate students to recognize symmetry as valuable in identifying solutions to problems quickly—helping these students take the lead in finding insightful resolutions to complex, multidimensional, mathematical physics uncertainties. How Rowe set about supporting self-directed learning in his graduate physics education interactions will be examined with the use of narrative research to interpret the texts and conversations with the author he made available. His techniques will be presented and recommendations made regarding how Rowe’s work in this regard can be modeled to improve self-direction in STEM graduate education.