: This study aims at exploring Turkish consumers’ behaviors toward purchasing green fashion. A mixed-methods approach was used in this study. Six experts from the main brands in the fashion industry in Türkiye were interviewed. A total of 268 questionnaires were collected from Turkish consumers, and their responses were analyzed. The theory of planned behavior (TPB) informed the theoretical framework of this study. The main components of the TPB were extended to include perceived consumer effectiveness. A thematic analysis was conducted to analyze and code the interviews. To test the hypotheses, structural equation modeling (SEM) was conducted. The findings show that the key factors of the TPB, i.e., attitudes (ATTs), subjective norms (SNs), and perceived behavioral control (PBC), as well as perceived consumer effectiveness, significantly impact the intentions of Turkish consumers to purchase sustainable fashion. However, the results highlight some inconsistencies, gaps, and barriers that discourage the purchase intentions of consumers, including a lack of information, misinformation, greenwashing, green skepticism, a lack of trust, and the high cost of sustainable fashion.

Numerous investigations have consistently underscored the impact of societal stigma on the well-being of transgender individuals, encompassing both those experiencing gender dysphoria (transgender) and those who have undergone gender-affirming interventions (transsexual). The primary objective of the current research is to translate and adapt the Attitudes Toward Transgendered Individuals Scale into the Greek language. This scale specifically assesses stigma, excluding components such as discreteness and violence, and is tailored to evaluate individuals within the general populace. Employing confirmatory factor analysis (CFA) and assessing gender metric equivalence, the analyses yielded highly favourable outcomes, demonstrating excellent scale fit, reliability, and content validity, reflecting the robustness of the adapted tool for the Greek population.

Keywords: gender equality policy; initial teacher education; teacher educators’ perceptions; gender perspective; university teaching; sustainable development; SDG5; SDG4.

The application of warm-mixing technology brings considerable economical and environment benefits by decreasing the mixing temperature during warm asphalt mixture(WMA) production. However, the possible water residue also generates concerns in moisture susceptibility. For deep investigation on the influencing factors and mechanism of the moisture susceptibility of WMA, surface free energy(SFE) test and laboratory tests are applied in this research. A novel indicator based on SFE namely effective adhesion work is proposed to assess the asphalt-aggregate adhesion with different moisture contents. Then, given the mixing procedure of dry mixing method, an advanced three-phase model as form of asphalt-aggregate-warm mixing additive is introduced improving from the conventional two-phase asphalt-aggregate model for better reflecting the separate addition of warm mixing additive during mixing. Afterwards, the influence of aggregate types, asphalt type, aggregate moisture contents, warm-mixing agent types and warm-mixing process on the moisture susceptibility of WMA is analyzed utilizing the models and indicators proposed. Finally, the validity of the SFE indicator is verified by comparing the calculation of effective adhesion work with freeze-thaw splitting test result. The results show that all of the above factors impact the moisture susceptibility of WMA by influencing the interfacial adhesion, with the effect of moisture content being the most significant. Meanwhile, effective adhesion work and the three-phase model brought out in this research are proven to be feasible to characterize the adhesion properties of WMA, offering theoretical support to the research on warm mixing technology.

The objective of this study was to identify the key elements used by prehospital emergency physicians (EP) to decide whether or not to attempt advanced life support (ALS) in asystolic out-of-hospital cardiac arrest (OHCA). From 01.01.2009 to 01.01.2017, all adult victims of asystolic OHCA in Geneva, Switzerland, were retrospectively included. Patients with signs of "obvious death" or with a Do-Not-Attempt-Resuscitation order were excluded. Patients were categorized as having received ALS if this was mentioned in the medical record, or, failing that, if at least one dose of adrenaline had been administered during cardio-pulmonary resuscitation (CPR). Prognostic factors known at the time of EP's decision were included in a multivariable logistic regression model. 784 patients were included. Factors favourably influencing the decision to provide ALS were witnessed OHCA (OR=2.14, 95%CI1.43–3.20) and bystander CPR (OR=4.10, 95%CI2.28–7.39). Traumatic aetiology (OR=0.04, 95%CI0.02–0.08), age >80 years (OR=0.14, 95%CI0.09–0.24) and a Charlson comorbidity index greater than 5 (OR=0.12, 95%CI0.06–0.27) were the factors most strongly associated with the decision not to attempt ALS. Factors influencing the EP’s decision to attempt ALS in asystolic OHCA are the relatively young age of the patients, few comorbidities, presumed medical aetiology, witnessed OHCA and bystander CPR.

Food security is the cornerstone of national security, and exploring the resilience of the grain industry chain is particularly important under the current complex and changing external environment. The study is to evaluate the grain industry chain resilience and identify its influencing factors. Based on the panel data of 30 provinces (cities) in China from 2011 to 2022, this paper adopted Partial Least Squares structural equation modeling method to carry out comprehensive evaluation, applied Dagum Gini coefficient to analyze spatial differences, and used geo-detectors to identify the influencing factors. The results showed that (1) from an overall perspective, the resilience of China's grain industry chain showed an overall upward trend, and each region had been greatly improved; (2) from the perspective of spatial differences, the overall spatial variability of China's grain industry chain is relatively small, and the gap mainly originates from inter-regional differences; (3) from the perspective of influencing factors, the level of grain foreign trade, regional market size and agricultural innovation level were important factors. In order to enhance the resilience of China's grain industry chain, based on the heterogeneous characteristics, the coordinated development of each region should be integrated, and the endogenous power should be given full play to enhance the resilience of the industry chain.

A comprehensive evaluation system of rural building energy consumption from a innovative composite perspective is established, which is suitable for southwest China. the brainstorming method and Delphi method were used to establish the indicator system, the ANP method was applied to calculate the weights of the comprehensive evaluation model, the scoring criteria of all evaluation indexes are constructed based on fuzzy evaluation theory, the applicability of the model is verified by an example of the countryside around Chengdu. The results showed that the score of some factors is low, whole or part area, just like the percentage of clean energy use(C24), the thermal performance of external walls(E21), the implementation of energy-saving measures(S22), were key factors affecting the target level, which has greater potential for improvement. The distribution of comprehensive indicators and evaluation factors have certain spatial distribution characteristics, the overall spatial distribution shows the characterwastic of "high in the southeast and low in the northwest". The key factors and spatial distribution characteristics found can be used as an important basis for the improvement of green energy-saving promotion measures, energy-saving retrofit programmes were proposed in terms of additional solar room, energy-saving of external walls and air-conditioning temperature setting guidance.

The advantageous location, port clusters, strong economic strength, developed financial system, rational and orderly urban division of labor and modern industrial system of Guangdong-Hong Kong-Macao greater bay area provide sustainable driving force for innovation activities in this region. This paper selected the Gini-coefficient, first degree index and concentration index to measure the spatial pattern characteristics of innovation output in Guangdong-Hong Kong-Macao greater bay area. The results show that the innovation output presented a spatial pattern of center-periphery in the study region with Shenzhen and Guangzhou as the dual centers and engines of innovation and Dongguan and Foshan as the main innovative areas. Further empirical analysis of the impact of various factors on innovation output in the study region found that R&D expenditure, the number of R&D personnel, the level of economic development and industrial structure all have significant promoting effects on innovation output. Accordingly, this paper put forward countermeasures and suggestions to promote the innovative development of Guangdong-Hong Kong-Macao greater bay area and build a world-class scientific and technological innovation bay area.

Current and dynamic developments in green technologies have led to several innovation practices in the manufacturing sector only to become the top approaches used for achieving and accelerating sustainable development (SD) in the current business markets. In addition, manufacturing firms is in need of green innovation to be able to monitor and control their operations and enhance their environmental performance. However, regardless of its many benefits, the level of green innovation adoption and implementation is still lower than expected among manufacturing industries. Thus, this study aimed to minimize the gap by developing and validating a study model underpinned by Resource based view and Institutional theories, along with the Technology-Organization-Environment (TOE) framework in combination to convince firms to adopt green innovation. The study gathered data from 179 respondents using a survey distributed to manufacturing firms, after which data was exposed to Structural Equation Modeling (PLS-SEM) approach, for analysis. Based on the approach deliverables, all the integrated constructs of the model, namely perceived benefits, top management support, coercive pressure, normative pressure and mimetic pressure all predicted green management accounting practices. Moreover, green management accounting practices were found to directly and significantly affect green environmental performance. The developed integrated model provides a clear implication to decision-makers, indicating the importance of adopting and using green practices and innovative technologies for enhancing environmental performance. Based on the results from the reviewed advanced green technologies studies, there is considerable connection between green management accounting practices and environmental performance in the context of developing economies.

This study aimed to investigate Romanian physicians' awareness, recommendation practices, and opinions regarding using Foods for Special Medical Purposes (FSMPs) products. A total of ten physicians were interviewed using a structured questionnaire, and their responses were analysed using thematic content analysis. The study found that physicians were aware of FSMPs and recommended them to their patients based on nutritional deficits, weight loss, or deglutition impairments. In addition, disease stage, treatment scheme, taste, affordability, and availability were identified as factors influencing the recommendation and use of FSMPs. While physicians generally did not consult clinical trials, clinical experience was deemed essential for recommending FSMPs to patients. Patients' feedback regarding the usage and sourcing of FSMPs was generally positive, with some expressing concerns about the availability of different flavours and the costs of purchasing the products. The study concludes that physicians play a vital role in recommending FSMPs to patients and ensuring they have the necessary nutritional support during treatment. However, more patient education materials and collaboration with nutritionists may be required to improve patient outcomes and reduce patient financial burden.

This study aims to evaluate the factors influencing the adherence to the 2nd and 3rd doses during each cycle of seasonal malaria chemoprevention (SMC) in Burkina Faso, Mali, and Niger. Overall, 3,132 people were interviewed during surveys between 2019 and 2020 in 15 health districts. The median age was 30 years. In Burkina , Mali, and Niger, the proportions of non-adherence were 4.15% , 5.60%, and 13.30%, respectively (95% CI (-3.27% -0.37 %, p = 0.114 ) for the 2nd dose and 3.98%, 5.60% and 14.39% for the 3rd dose. The main cause of non-adherence to the 2nd and 3rd doses was other illnesses in 28.5% and 29.78% respectively in Burkina, 5.35% and 5.35% in Mali and 1.6% and 0.75% in Niger. It was followed by vomiting in 12.24% and 10.63% for Burkina and 2.45% and 3.78% in Niger. The last causes were refusal in 6.12% and 4.25% in Burkina , 33.9% and 15.25% in Mali and 0.8% and 1.51% in Niger. Non-adherence of doses related to parents was primary due to their absence in 28.5% and 27.65% in Burkina , 16.07% and 16.07% in Mali and 7.37 % and 6.06% in Niger. Travelling was the second cause in 12.24 % and 12.76% in Burkina , 19.64% and 19.64% in Mali and 0.81% and 0.75% in Niger. Non-adherence related to community distributors was mainly due to missing of the doses in 4.08% and 4.25% in Burkina , 23.21% and 23.21% in Mali, 77.04% and 76.51% in Niger. Our study reported very small proportions of non-adherence to 2nd and 3rd doses of SMC and identified the main causes of non-adherence.

Apex predators were extirpated from the UK hundreds of years ago. Practitioners have recently advocated for reintroductions of predators in the UK given their role as keystone species. For a reintroduction to take place, a survey of public desirability needs to be conducted. We aimed to understand the perspectives of people across the United Kingdom on the reintroduction of Eurasian lynxes, grey wolves, and brown bears. We collected data via questionnaires from 78 key stakeholders, such as farmers, general public, nature conservationists, and those in environmental sectors, with these areas being seen as the most affected by these reintroductions. It was organizations which front these stakeholder groups which mainly distributed the survey, as well as social media groups. We ran a path analysis, which highlighted that there was a negative correlation between respondents viewing the species as a danger towards livestock and humans, and the respondent seeing it being good to have that species in their region. Overall, participants who stated that rewilding their region was a priority also stated that it would be good to have Eurasian lynx in their region. That said, 70% of farmers strongly disagreed with the reintroduction of Eurasian lynx. These findings showed that much of the United Kingdom would welcome the reintroduction of Eurasian lynx, but both farmers and the public would fear the loss of livestock that may come along with these species. Support can be gained through education and knowledge, a necessary step needed especially targeting farmers before any reintroduction plans can be made.

Keywords: Knowledge; Attitudes; Practices; Salt intake.

Future healthcare professionals can play a significant role in managing those with thoughts of suicide. This scoping review aims to determine healthcare students’ knowledge and attitude towards suicide. A systematic search was conducted across five databases: PubMed, CINAHL, EMBASE, PsycINFO, Cochrane, and DARE. Only primary studies written in English, from database inception until 31st December 2023 were included. A total of 44 studies were included. Overall, healthcare students demonstrated low to moderate confidence in managing patients with thoughts of suicide and low levels of relevant education despite acknowledging their importance in preventing suicide. Increased personal exposure to suicide was associated with increased suicide literacy, confidence in managing patients with thoughts of suicide, and reduced stigma. Demographics and culture were shown to affect knowledge and attitude as well. Further research is needed to better understand various contributing factors to healthcare students’ knowledge and attitude regarding suicide. Evaluating healthcare curricula should be considered to implement effective suicide training program.

The gas-water relative permeability curve plays a crucial role in reservoir simulation and development for condensate gas reservoirs. In this study, we conducted a series of high temperature and high pressure analysis experiments on real gas cores from Wells A and B in Block L of the Yinggehai Basin to investigate the effects of temperature, pressure, and different types of gas media on gas-water seepage. The experimental results demonstrate that: Temperature has a significant impact on both gas and water relative permeability, particularly on the former. As temperature increases, gas relative permeability shows a substantial increase while water relative permeability remains relatively unchanged. Under the same effective stress, increasing pressure causes downward shifts in both the gas and water relative permeability curves; however, there is a more pronounced decrease in gas relative permeability. Gas type has minimal influence on phase permeability except at higher water saturation where differences become apparent. When water saturation ranges from 80% to 50%, there is no significant variation observed in the measured relative permeability of different displacement gases; however, as water saturation exceeds 80%, distinctions gradually emerge. At bound water saturation conditions, nitrogen exhibits lower relative permeability compared to simulated gases with approximately 92% similarity between them. This investigation into the characteristics of gas-water relative permeability in high temperature and high pressure condensate reservoirs within Yinggehai Basin provides valuable insights for efficient development strategies for similar reservoirs.

Background: At altitudes beyond 2500 m the risk of developing high altitude pulmonary edema (HAPE) grows with the increases in pulmonary arterial pressure. HAPE is characterized by severe pulmonary hypertension, though the incidence and relevance of individual risk factors are not yet predictable. However, the systolic pulmonary pressure (SPAP) and peak in tricuspid regurgitation velocity (TVR) are crucial factors when diagnosing pulmonary hypertension by echocardiography. Methods: The SPAP and TVR of 27 trekkers aged 20-65 years en route in the Solu Khumbu region of Nepal was assessed. Echocardiograph measurements were performed at Lukla (2,860 m), Gorak Shep (5170 m), and the summit of Kala Patthar (5,675 m). The altitude profile and the participant’s characteristics were also compiled for correlation with the measured data. Results: The results showed a highly significant increase of SPAP and TVR after ascending Kala Patthar. The study revealed a lower increase of SPAP and TVR in the group of older participants, although the initial respective measurements in Gorak Shep were significantly higher for this group. A similar finding occurred in those using Diamox® as prophylaxis. There was an inverse relationship between TVR and SPAP, the peripheral capillary oxygen saturation and heart rate. Conclusions: The echocardiograph results indicate that older people are a risk group for developing a HAPE. The prophylactic use of acetazolamid led to higher initial SPAP values in Gorak Shep, and a lower increase of SPAP as well as TRV after ascending Kala Patthar. Arterial oxygen saturation measurements can provide an indicator for the self-assessment for the risk of developing HAPE and provide a rule of thumb for the altitude profile but does not replace a HAPE diagnosis. The collected data variables concerning backpack weight, sex, workload (actual ascent speed), and pre-existing diseases were not statistically significant factors related to SPAP and TVR (p=<0.05).

Industrial green technology innovation has become an important content in achieving high-quality economic growth and comprehensively practicing the new development concept in the new era. This paper measures the efficiency of industrial green technology innovation and regional differences based on Chinese provincial panel data from 2005 to 2018, using a combination of the super-efficient SBM model for considering undesirable outputs and the Dagum Gini coefficient method, and discusses and analyses the factors influencing of the industrial green technology innovation efficiency by constructing a spatial econometric model. The results show that: firstly, the industrial green technology innovation efficiency in China shows a relatively stable development trend, going through three stages: " stationary period", " recession period " and "growth period ". However, the efficiency gap between different regions is obvious, specifically in the eastern > central > western regions of China, and the industrial green technology efficiency innovation in the central and western regions is lower than the national average. Secondly, regional differences in the efficiency of industrial green technology innovation in China are evident but tend to narrow overall, with the main reason for the overall difference being regional differences. In terms of intra-regional variation, variation within the eastern region is relatively stable, variation within the central region is relatively low and shows an inverted 'U' shaped trend, and variation within the western region is high and shows a fluctuating downward trend. Thirdly, the firm size, government support, openness to the outside world, environmental regulations and education levels contribute to the efficiency of industrial green technology innovation. In addition, the industrial structure hinders the efficiency of industrial green technology innovation, and each influencing factor has different degrees of spatial spillover effects.

Green innovation has become an important combination of high-quality economic growth and sustainable development of ecological environment. In this paper, the super-efficiency network SBM model is used to measure the two-stage green innovation efficiency of industrial science and technology R&amp;D and achievement transformation in 30 provinces and cities from 2009 to 2019, and exploratory Data Analysis (ESDA) and spatial econometric model are used to investigate the spatial-temporal evolution characteristics and influencing factors of green innovation efficiency. The results show that: firstly, the overall efficiency of industrial green innovation is low, and the efficiency of scientific research and development and achievement transformation has experienced three stages of "upward-declining-revitalized period". The low efficiency of achievement transformation is an important factor hiding the improvement of the efficiency of industrial green innovation. Secondly, The industrial green innovation efficiency gradually increases from northwest to southeast, forming a centralized "line" and "block" distribution. The high efficiency area is still concentrated in the eastern coastal region, and the balanced development trend is obvious in the central and western regions. Finally, openness has a positive impact on the two-stage green innovation efficiency; Industrial structure and government investment in science and technology have a positive impact on the efficiency of science and technology research and development, but have no significant effect on the efficiency of achievement transformation. Enterprise size has a positive effect on achievement transformation efficiency, but has no significant effect on R&amp;D efficiency. Environmental regulation has a positive impact on R&amp;D efficiency and a negative impact on achievement transformation efficiency.

1) Background: The environmental, financial and social questions in Africa remain unanswered up-to-date, with the rapid increase in human population and the demand for fuel energy, trigger the need to generate data on the socio-economic factors influencing the knowledge of use and adoption of family-sized bio-digesters. The increasing prices of fossil fuels and taxes on energy sources require finding the alternative, clean and economical sources of energy for households in developing countries. Moreover, in Africa, the consumption of firewood and charcoal continues to increase, with wood fuel consumption predicted to increase by 2030 to over 140%. The study objectives were 1) to determine the socio-economic characteristics of the people in Ngoma district, 2) to assess socio-economic factors influencing people to use and adopt family-sized bio-digesters. 2) Methods: Quantitative data collected with semi-structured questionnaires and interviews were analyzed using descriptive statistics. 3) Results: The results show that many households had not realized the potential benefits of biogas use and adoption in Rwanda. The study further found that a number of factors such as household income levels, socio-economic, technological, and institutional influence the household use and adoption of biogas energy. 4) Conclusions: At the end, the study suggests the need for all players such as Government, Non-Governmental Organizations (NGO's) and local communities to work together to provide incentives and favorable environment that can attract individual households to invest in biogas energy production and utilization.

The Particulate Matter (PM), particles of variable but small diameter could penetrate the respiratory system via inhalation, causing respiratory and/or cardiovascular diseases. This study aims to evaluate the association of environmental particulate matter (PM2.5) and black carbon (BC) with respiratory health and physical activity in users traveling by transportation modes over four roads in Bogotá. This was a mixed-method study, in 300 healthy participants, based on a convergent parallel design. Including a descriptive qualitative component focused on asserting the individual perception of air pollution by semi-structured interviews and a cross-sectional study measuring the individual exposure to PM2.5 and BC to evaluate the pulmonary function by spirometry. The analysis included concurrent triangulation and a Poisson regression. This study provides integration of air pollution exposure variables and respiratory health effects in different transport microenvironments. To our knowledge, this is the first mixed-methods study focused on PM2.5, BC, and respiratory health effects in a city above 2.000 meters above sea level.

Objective: This study aims to identify the impact of nutritional factors on mechanical ventilation duration for critical patients. Patients and Methods: The current study was a single-center, prospective observational design which enrolled one-hundred critically ill patients who were admitted to an intensive care unit (ICU). It demonstrates purposive sampling and also performs the descriptive nutritional factors influencing the mechanical ventilation duration. Daily calories target requirement scale (DCRS), subjective global assessment form (SGA), dyspnea assessment form, and APACHE II have been used as methods in the study along with time to initial enteral nutrition (EN) after 24-hour admission and daily calories target requirement over 7 days to assess patients. Data is analyzed using the multiple regressions. Results: As a result, nutritional status monitoring, time to initial EN, calories and target requirements are statistically positive significance associated with the mechanical ventilation duration respectively (R = 0.54, R = 0.30, R= 0.40, p < 0.05). However, age, illness severity, and dyspnea scales are not associated with the mechanical ventilation duration (p> 0.05). Therefore, the nutritional status, malnutrition scores and calorie target requirements can be used to significantly predict the mechanical ventilation duration. The predictive power is 58 and 28.0% of variance. The most proper influencer to predict the mechanical ventilation duration is nutritional status or malnutrition scores. Conclusion: The research findings show that the nutritional status, time to initial EN, and calorie target requirement within 7 days of admission are associated with the mechanical ventilation duration in the critical patients. Therefore, it can be used to develop guidelines reducing the mechanical ventilation duration and to promote the ventilator halting for critical patients.

Surface urban heat island (SUHI) depicts the deteriorating thermal environment in high-density cities and local climate zone (LCZ) classification provides a universal protocol for SUHI identification. In this study, taking the central urbanized area of Guangzhou in the humid subtropical region of China as the study area, the maps or images of LCZ, land surface temperature (LST), SUHI and urban design factors were achieved by using Landsat satellite data, GIS database and a series of retrieval and classification algorithms, and the urban design factors influencing SUHI were investigated based on 625 samples of LCZs. The results show that in the summer daytime under the clear sky condition, the LST varied greatly from 26 °C to 40 °C and the SUHI changed in a wide range of -6 °C to 8 °C in the LCZs of the study area. Seven and five urban design factors influencing the summer daytime SUHI were identified for the two dominant LCZ of LCZs 1-5 (LCZ 1 to LCZ 5) and the mixed LCZ (containing at least three types of LCZs), respectively. The summer daytime SUHI prediction models were obtained by using the step-wise multiple linear regression, with the performance of R2 of 0.697, RMSE of 1.21 °C, and the d value of 0.81 for the model of LCZs 1-5, and the values of 0.666, 1.66 °C, and 0.76 for the model of the mixed LCZ, indicating that the models can predict the changes of SUHI with LCZs to a large and satisfactory extent. This study presents a methodology to efficiently achieve a large sample of SUHI and urban design factors of LCZs in the largely urbanized cities, and provides information beneficial to the urban designs and regenerations in the humid subtropical region.

The Gulf Cooperation Council (GCC), locally known as Khaliji, is a group of six Arab nations, including Saudi Arabia, Bahrain, Kuwait, Oman, Qatar, and the United Arab Emirates (UAE). Intimate partner violence (IPV) is a significant public health concern in the GCC region, but the research that synthesized the trend has received scant attention. The present narrative review examines existing research on the prevalence and frequency of IPV among Khaliji women in GCC nations. This review synthesized studies on physical violence, sexual violence, emotional abuse, and controlling behaviors perpetrated by an intimate partner. The prevalence rates of IPV among Khaliji women are observed to be high: women reported facing different types of abuse from their partners, namely physical (7% - 71%), sexual (3.7% - 81%), financial (21.3% - 26%) and psychological (7.5% - 89%), which is a culmination of controlling behavior (36.8%), emotional (22% - 69%) and social violence (34%). The extant studies in the GCC suggest that the most endorsed IPV was psychological abuse (89%) followed by sexual violence (81%). Qualitative content analysis of the associated factors resulted in four meaningful descriptors such as demographics of the victim, sociocultural factors, socioeconomic, and perpetrator-related issues. The study on IPV is still nascent and few. The way forward will require developing culturally appropriate interventions that address unique risk factors for IPV among Khaliji populations, strengthening institutional responses, and increasing awareness and social support for the victim of IPV.

Artificial intelligence (AI)-based models hold the potential to transform higher education if adopted properly and ethically. A prime example is ChatGPT with earlier studies indicating its widespread adoption in academia and by university students. The current study aimed to identify the factors influencing the attitude towards ChatGPT and its usage among university students in Arab countries. A previous survey instrument termed Technology Acceptance Model Edited to Assess ChatGPT Adoption (TAME-ChatGPT) was administered online using a convenience-based approach among the contacts of the authors. Confirmatory factor analysis (CFA) for the survey constructs was done using root mean square error of approximation (RMSEA), standardized root mean square residual (SRMR), comparative fit index (CFI), and Tucker-Lewis index (TLI). The final study sample comprised a total of 2240 participant divided as follows: Iraq (n=736, 32.9%), Kuwait (n=582, 26.0%), Egypt (n=417, 18.6%), Lebanon (n=263, 11.7%), and Jordan (n=242, 10.8%). A total of 1048 respondents heard of ChatGPT before the study (46.8%), of which 551 used ChatGPT (52.6%). The mean scores of TAME-ChatGPT constructs showed that the ease of ChatGPT use, positive attitude towards technology and social influence, higher perceived usefulness, the influence of behavioral/cognitive factors, low perceived risks and low anxiety were the determinants of positive attitude to ChatGPT and its use. For both the attitude and usage scales of TAME-ChatGPT, CFA collectively yielded satisfactory fit indices as indicated by low RMSEA and SRMR together with high CFI and TLI. Multivariate analysis showed that attitude to ChatGPT use was significantly influenced by country of residence, age, university type, and the latest grade point average of the students. The current study confirmed the validity of TAME-ChatGPT as a survey instrument to assess the possible determinants of ChatGPT use among university students in Arab countries. The study findings highlighted that successful adoption of ChatGPT in higher education could be dependent on perceived ease of use, usefulness, positive attitudes to technology, social influence, behavioral/cognitive factors, lower anxiety, and minimal perceived risks. The utility of ChatGPT in higher education requires policies that should be tailored for various settings, considering the differences observed in attitude towards ChatGPT among participating students in this study.

Introduction: This study explores exposure to misinformation, COVID-19 risk perception, and confidence towards the government as predictors to negative attitudes toward the COVID-19 vaccine. Methods: A cross-sectional survey was carried out from 30 June to 30 August 2021 involving 775 respondents. The survey instrument for the questionnaire is an adaptation from various different studies consisting of five main variables: 1) misinformation about vaccination; 2) risk perception toward COVID-19; 3) attitudes toward the vaccination programme; 4) intention to get vaccinated; and 5) public confidence in the government in executing the vaccination programme. Results: The results of this study indicate that higher exposure to misinformation led to higher levels of negative attitudes toward the COVID-19 vaccine. When the perceived risk of COVID-19 infection was high, mistrust of vaccine benefits was low but there were also higher worries about the future effects of the vaccine. Confidence in government was associated with lower negative attitudes toward the COVID-19 vaccine. Conclusion: The results of this study may help develop an understanding of negative attitudes toward vaccinations in Malaysia and its contributing factors.

Entrepreneurship education has become increasingly relevant. For some years now, the business environment for starting a new company in the Dominican Republic has been considered very propitious. This has generated that many universities have incorporated training in entrepreneurship in their study plans. This study aims to analyse whether the cognitive and affective components, the country's business environment, university training in entrepreneurship and attitudes towards entrepreneurship are antecedents of the entrepreneurial intention of university students. It also seeks to investigate the relationship between entrepreneurial intention and entrepreneurial behaviour of students. Data were collected through a structured questionnaire from a sample of 523 students who had taken courses on entrepreneurship. The data have been analysed through the SPSS and Smart-PLS programs. The results of this research highlight the importance of the affective component and attitudes towards entrepreneurship in the formation of students' entrepreneurial intentions. This reinforces the importance of cultivating positive attitudes through educational interventions. These results contribute to the understanding of the factors that drive entrepreneurial intentions among university students and provide a foundation for future research.

We aimed to assess awareness, knowledge, and attitudes of healthy pregnant women towards human papillomavirus (HPV), to estimate factors associated with a positive attitude towards HPV immunization and to assess the uptake of the vaccine among their children. A cross-sectional study was conducted at the University Clinic of Gynecology and Obstetrics, Belgrade, Serbia among pregnant women attending their regular gynecological check-ups at the 12th gestational week. Knowledge about HPV and HPV vaccine was assessed using a specifically designed 12-item and 5-item questionnaires. Out of total 265 included women, 79.3% had heard of HPV, and 37.5% knew that HPV vaccine exists. HPV vaccine knowledge score was associated with higher odds for a positive attitude towards vaccination of both female (OR = 4.10, 95% CI 1.50-11.29) and male (OR = 3.71, 95% CI 1.52-9.01) child. The number of children (OR = 1.32, 95% CI 1.04-1.67) and high vaccine knowledge score (OR = 1.64 95% CI 1.13-2.39) were independent predictors associated with willingness to vaccinate child against HPV. The gynecologist was the preferable point of reference for information seeking about the HPV vaccine. Despite relatively high HPV awareness and knowledge among pregnant women in Serbia, about one-third of them are HPV vaccine aware, and are willing to vaccinate their children against HPV.

This study examines the attitudes and practices of dentists and dental students towards envi-ronmental issues within their professional context. Data was selected based on their responses on a Google Forms e-questionnaire, designed specifically for the study. The sample consisted of 78 professional dentists and 75 dental students in Greece and their attitudes towards environmental protection, awareness of the environmental impact of dental practices, and factors influencing the adoption of environmentally friendly practices were assessed. Results reveal generally positive attitudes towards environmental protection, with students demonstrating higher levels of proper waste management practices. Dentists express awareness of their environmental impact but ex-hibit varying levels of engagement in eco-friendly practices. Factors such as moral consciousness and believing in the severity of climate change significantly influence environmental awareness in dental practice. Notably, dental students exhibit greater environmental awareness compared to practicing dentists. These findings emphasize the importance of integrating environmental edu-cation into dental curricula and continuing education programs to foster sustainable practices in dental care. Future research could explore interventions to enhance environmental consciousness among practicing dentists and assess the long-term impact of environmental education initiatives on dental care sustainability.

Background/Objectives: This study aims to investigate the influence of root canal morphology and various treatment variables on the outcomes of root canal treatments (RCT) in mandibular second molars, assessed through cone-beam computed tomography (CBCT) imaging. Methods: A total of 150 CBCT images were examined, comprising 100 cases of persistent endodontic infections and 50 from previously treated root canals with normal apices in mandibular second molars. CBCT was utilized to evaluate root canal configuration, the radiographic quality of coronal restorations and treated canal systems, and the presence of periapical lesions. Statistical analyses were performed to explore correlations between these factors. Results: The presence of a C-shaped root canal configuration did not demonstrate a significant correlation with periapical lesions (p=0.05). Factors influencing endodontic treatment outcomes included the presence of missing canals (p=0.018), underfilling or overfilling (p=0.045), and inadequate coronal restoration (p=0.006). The presence of a missing canal was identified as the variable most significantly associated with periapical lesions (OR=3.103). Leaky canals were more commonly observed in C-shaped root canals (p&lt;0.001). Conclusions: Regardless of the root canal morphology of mandibular second molars, successful RCT depends on thorough disinfection to eliminate any untreated canals, precise three-dimensional filling of the canals at the correct working length, and a securely sealed coronal restoration to prevent leakage.

Background: Maternal mortality remains dire in Nigeria, claiming 40,000 lives yearly due to pregnancy complications. Factors like limited healthcare access, poverty, and early marriage worsen the crisis. Despite efforts to improve skilled birth attendance, Nigeria struggles to meet MDG targets, underscoring the urgent need for more effective interventions. Objectives: The objective of the study is to assess and understand the knowledge of community members regarding the risk factors influencing maternal mortality in the Ede South Local Government Area of Osun State, Nigeria. Methodology: A descriptive cross-sectional study was conducted. The study methodology involves employing the Leslie Kish formula to select 185 participants from the Ede South Local Government Area in Osun State, Nigeria. The selection process involved the use of a systematic sampling technique to ensure a representative sample based on population demographics and characteristics, ensuring a balanced and accurate selection process. Quantitative data was collected through a self-administered questionnaire and analysed using SPSS version 21. Results: The study encompassed 185 participants. 64.9% females with a mean age of 27.3 + 8.3 years. Among them, 60.5% were single, 46.6% being students, 55.7% held a BSc degree, 64.9% were Yoruba and 61.1% identified as Christian. 91.4% were aware about maternal mortality, 74.6% recognized maternal deaths in reproductive-aged women. Participants identified that maternal deaths mostly occur during labour (91.4%). Direct causes, such as bleeding (88.1%), unsafe abortion (88.6%), infection (49.2%), and hypertension (64.9%), were recognized. Results indicated substantial awareness concerning specific risk factors: lack of education (98.9%), poverty (91.6%), poor health care services in facilities (94.0%), alcohol consumption (87.6%) and poor transportation (78.4%). Conclusion: Findings revealed good awareness of maternal deaths and critical factors such as ANC impact and direct causes of maternal mortality like bleeding and unsafe abortion. However, gaps persisted in SDG awareness, suggesting the need for targeted interventions to enhance overall understanding and address identified knowledge gaps.

Evaluating the efficacy of the traceability systems (TS) plays an important role not only for planning system implementation before development, but also for analyzing system performance once the system is in use. In the present work, we evaluate the traceability granularity using a comprehensive and quantifiable model and try find its influencing factors via an empirical analysis with 80 vegetable companies in Tianjin city, China. Granularity indicators were collected mostly by the TS platform to ensure the objectivity of the data, and the granularity score was evaluated by using a TS granularity model. The results show a clear imbalance in the distribution of companies as a function of score. The number of companies (21) scoring in the range [50,60] exceeded the number in the other score ranges. Furthermore, the influencing factors on traceability granularity were analyzed by using a rough set method based on nine factors pre-selected by using a published method. The results show that the factor “number of TS operation staff” is deleted because it is unimportant. The remaining factors rank according to importance as follows: Expected revenue &gt; Supply chain (SC) integration degree &gt; Cognition of TS &gt; Certification system &gt; Company sales &gt; Informationization management level &gt; System maintenance investment &gt; Manager education level. Based on these results, the corresponding implications are given with the goal of (i) establishing the market mechanism of high price with high quality, (ii) increasing government investment for constructing the TS, and (iii) enhancing the organization of SC companies.

In recent years, the Chinese government pays more and more attention to agricultural development and ecological protection. While improving the cultivated land green use efficiency(CLGUE) is the key to promote the sustainable development of agriculture. This study aims to study the current situation and influencing factors of agricultural production from the perspective of green utilization efficiency of cultivated land. It takes 39 cities in the upper, middle and lower reaches of the Yangtze River basin in China as an example. The CLGUE values in those 39 cities from 2011 to 2020 were specifically measured, using the Super-SBM model, kernel density estimation and geographic detector method. Their temporal and spatial heterogeneity was described, and the influencing factors were detected at both single and interactive levels. The results showed that: （1）From 2011 to 2020, the green utilization efficiency value of cultivated land in the Yangtze River Basin showed an upward trend on the whole; （2）There is a clear spatial heterogeneity the CLGUE values in the Yangtze River Basin cities, as shown by: downstream region > midstream region > upstream region; (3) Cultivated land resource endowment, socioeconomic development, and agricultural production technology are important factors affecting the variability of CLGUE values. However, there are some differences in the degree and direction of influence of different influencing factors on different sample subgroups.

The principal aim of this descriptive-survey investigation is to ascertain the factors influencing individuals' choice to purchase organic commodities in Tehran. The statistical populace for this examination comprised all patrons of food retail establishments in Tehran, with the sample size determined using the Cochran formula for an unknown community size, involving the distribution of 30 questionnaires to customers (n=439). Data collection was carried out through a random sampling technique. The survey instrument consisted of a questionnaire with two sections consisting of general queries (7 questions) and specific inquiries (23 items) categorized into four dimensions (product, price, place, and promotion) for the clientele. The questionnaire's validity was confirmed through face and content validation, while its reliability was assessed utilizing Cronbach’s alpha. Data analysis was conducted using SPSS25 software, encompassing both descriptive and inferential statistical analyses. The results revealed a positive and significant correlation between customers' inclination to consume organic goods and the characteristics of the product, price, and promotion. However, no association was found between the propensity to consume organic products and location characteristics. Concerning contextual variables, a solely positive and significant correlation was identified between the willingness to purchase organic items and consumer income levels. No significant relationships were detected between other contextual variables and organic product consumption. A notable contrast was observed between respondents' gender and their readiness to buy organic products, while no significant variances were noted regarding age, income, occupation, and education in relation to the propensity to purchase organic commodities.

Air pollution has recently gained much attention from the general population. Despite pollution control being an issue in both urban and rural regions, most of the available research has concentrated on urban districts. Hence, investigations into how urban-rural transition affects PM2.5 are warranted within the framework of urban-rural integration. Using the Yellow River Basin as a case study, this study employed the entropy method and Analytic Hierarchy Process (AHP) to uncover the extent of urban-rural transformation. It then used the spatial autocorrelation method to investigate the spatiotemporal features of PM2.5 and the spatial econometric model to investigate the mechanisms that influence the relationship between urban-rural transformation and PM2.5. The results are as follows: (1) Over time, there was a discernible upward tendency in the change in urban-rural areas. The development has progressed from asymmetrical north-east and south-west elevations to a more balanced pattern of north-east, middle-east, and west-west elevations. (2) The PM2.5 concentration increased steadily, then fluctuated, and finally decreased. Notably, the general pattern has not changed much, and it is high in the east and low in the west. (3) Different subsystems of the urban-rural transformation have different impacts on air pollution at different stages. The influence of industrial transformation (IT) on PM2.5 showed an inverted “N-shaped” curve of negative-positive-negative changes, and the industrial structure played a leading role in the spatiotemporal evolution of PM2.5. Currently, an inverted "U-shaped" curve forms the left side of the impact of population transition (PT) on PM2.5. Land development (LT) has a "U-shaped" curve for its effect on PM2.5. This research provides a new perspective on the topic of PM2.5 and its connection to urban-rural integration, which is crucial to understanding the dynamics of this shift. To achieve its goal of high-quality development, it supports regional initiatives to reduce PM2.5 emissions in the Yellow River Basin. Moreover, it can provide a reference for decision-makers in the world’s densely populated areas that suffer from serious air pollution.

This study aimed to identify and categorize the influencing factors on the purchase of dairy products among customers of dairy companies in Mashhad city. This study is a mixed research (qualitative and quantitative), conducted with the aim of identifying and categorizing the influencing factors on consumers’ purchase. Therefore, the theoretical foundations were examined in the initial step, after which the customers and their needs and demands were addressed in terms of the company and its products. In the qualitative part, interviews were conducted in the focus group (23 people in 5 groups) to identify and extract these factors using the theme analysis technique. The reliability of the interviews was confirmed by retesting and the reliability between two encoders. Sixty themes (factors) that affected the purchase of dairy products were collected. In quantitative part, 517 questionnaires were collected from 13 regions of Mashhad city to perform statistic tests. A questionnaire was designed using the extracted themes in the previous (qualitative) stage to assess customers’ feedback. The validity of the questionnaire was confirmed by content and structure validity (exploratory and confirmatory factor analysis), and its reliability was checked by Cronbach’s alpha. Fourteen components were obtained by exploratory and confirmatory factor analyses, after which the variables were labeled as intrinsic, psychological, and personality factors, the identity of the company, production power of the company, competitive power of the company, competitive prices, social awareness, and store capabilities. The construct validity was confirmed using confirmatory factors.

This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement to synthesizes the existing literature with a goal to review current conceptual frameworks of mental health of forced migrants for further practice research priorities in social work. The search was done between January 2015 to January 2021. As a result, 29 studies met inclusion criteria. Medicalizing mental health issues by relying solely on the effectiveness of medicine was a controversial risk factor that negatively affected the daily life activities of refugees and reduced their willingness for seeking professional mental health services. Empowering vulnerable minorities by giving them back their power and agency to be able to speak for themselves and raise voices of trauma and recovery was the missing protective factor for sustainable mental health practice. The benefits of group-based interventions are highlighted in which communities and individuals address mental health issues as well as isolation through building collective identities and support networks. Information and communication technologies (ICTs) can add more strength to any kind of mental health intervention. Finally, the benefits of applying ecological perspective for the mental health of refugees, and its implications for a sustainable intercultural practice are discussed. Social workers in this model are the representatives of at-risk groups, thus need more agency and creativity in reflecting client’s concrete needs.

Knowing professionals’ attitudes is the basis for the development of skills for dealing with drug dependence. These attitudes may affect patients’ clinical safety and the cost-benefit ratio of the interventions. The goal of this study was to assess emergency and mental health nurses’ attitudes and perceptions towards alcoholics. A multicenter prospective descriptive study was conducted in six hospitals with 167 emergency and mental health nurses. Nurses classified alcoholics as sick individuals, although there was a tendency to feel comfortable working with them. Results indicated that these professionals had a rejecting attitude towards moderate alcohol consumption. We found a significant association between the attitude of the nurse and gender, with the degree of rejection towards the alcoholic being higher in men than in women and with less punitive attitudes in professionals from 0 to 11 years of professional experience.

While obesity is recognized as a key global public health issue, there has been no research to date on the perceptions of care for people with this condition held by individuals in positions of organizational power. The aim of this study was therefore to describe the perceptions and experiences of clinical leaders and managers of providing care to inpatients with obesity at a metropolitan public health service. This study applied an interpretative phenomenological analysis (IPA) approach to qualitative research, conducting interviews with 17 participants. Their perceptions of care for inpatients with obesity encompassed both their personal understanding as an individual, and their observations about the organizational, patient and carer perspectives. Three overall themes were identified: 1) The problem of inpatients with obesity, 2) Inpatients with obesity as sources of risk and 3) Personal and professional perceptions of inpatients with obesity. While clinical leaders and managers were aware of potential impact of stigma and weight bias on the care given to this cohort, elements of implicit bias, stereotyping, ‘othering’ and ambivalence were frequently present in the data. Ongoing efforts to improve care for patients with obesity must therefore include efforts to address perceptions and attitudes at all organisational levels of the workforce.

Food waste is a common issue arising from grinding of food by experimental animals, leading to excessive food scraps falling into cages. In the wild, animals grind food by gnawing vegetation and seeds, potentially damaging the ecological environment. However, limited ecology studies have focused on food grinding behavior since the last century, with even fewer on rodent food grinding, particularly recently. Although food grinding function is partially understood, biological purposes remain under-investigated and driving factors unclear. This review aims to explain potential causes of animal food grinding, identify influencing factors, and discuss contexts and limitations. Specifically, we emphasize recent progress on gut microbiota significance for food grinding. Moreover, we show abnormal food grinding is determined by degree of excess normal behavior, emphasizing food grinding is not meaningless. Findings from this review promote comprehensive research on the myriad factors, multifaceted roles, and intricate evolution underlying food grinding behavior, benefiting laboratory animal husbandry and ecological environment protection, and identifying potential physiological benefits yet undiscovered.

The increasing enrollments in the English Departments at Palestinian universities highlight the need to understand the attitudes and expectations of students, as these factors can significantly impact their motivation and proficiency in learning English as a foreign language (EFL). This study aimed to explore the attitudes and expectations of Palestinian first-year English majors in relation to EFL learning. A total of 244 students participated in the study, completing a questionnaire and participating in interviews to provide a comprehensive understanding of their perspectives. The results revealed a high level of enthusiasm among the students towards EFL, as evidenced by their strong attitudes and exceptionally high expectations. Moreover, the study identified specific student characteristics, including gender and the required hours dedicated to English learning, as well as the experience of studying abroad, which served as predictive factors for their attitudes and expectations. The findings emphasize the importance of regularly assessing the attitudes and expectations of learners in English departments to effectively cater to their needs and attract more students. By understanding the motivating factors and aligning instructional strategies accordingly, English departments can create a more engaging and tailored learning environment for students pursuing English as a foreign language.

Psycho-social factors are key factors to the powerlessness of infant mothers who breastfeed. As the theory of planned behavior (TPB) is widely used to investigate the correlation between psycho-social factors and breastfeeding behavior, this study aims to examine the utility of TPB constructs to predict breastfeeding behavior and understand TPB-based psycho-social factors’ effectiveness on breastfeeding behavior. A narrative review consulting Web of Science, Scopus, Ebsco, PubMed, and PsycInfo in English and Chinese has been conducted, with the inclusion of twenty studies published between January 2000 and May 2022. It is reported that psycho-social factors based on TPB for breastfeeding such as affective attitude, instrumental attitude, subjective norm, perceived behavioral control (including self-efficacy), moral norm, breastfeeding knowledge, and self-identity can effectively explain the breastfeeding behavior. Future research should improve the theoretical model of TPB-based breastfeeding and implement more localized prediction and intervention studies on breastfeeding.

Indonesia is among the countries developing the concept of smart city. The national government envisions Indonesia 2030 which shall implement the smart city towards sustainable development. Many regions in Indonesia have already implemented the concept of smart city, but still on the level of smart government and smart technology, lacking on the smart citizen component of a smart city. This paper aims to analyze the citizens behavior of using technology on Sleman smart citizen 2021 through the lapor sleman mobile application. This research uses mixed method of quantitative and qualitative approaches in examining the data. The authors distributed 100 questionares and conducted interviews to the government which is department of communication and information, Sleman and the several community that ever use the lapor sleman application. The result of the study reveals the following: firstly, performance expectancy, social influence, and behavioral intention are three independent variables which affect the users’ behavior. Secondly, the behavioral intention has the biggest significant effect on users’ behavior. Thirdly, the citizen behavior of using technology has affect the making a smart citizen. Therefore, using technology in term of lapor sleman mobile application can make the citizens as active participants in public life, in terms of social cooperation, freedom of expression and flexibility. However, there are still many problems in the use of lapor sleman mobile application such as the limited access to only android smartphones, lack of technical know-how, and people’s reluctance to use the lapor sleman mobile application.

Historic sites are important components of every city's cultural history because they preserve rich historical knowledge and distinctive values passed down from previous generations to the present. Due to the progress of urbanization and modernization, many historic sites face pressure from damage and transformation. In this paper, a method for assessing cultural heritage damage was developed to measure the extent of spatial damage in historic sites. Using sample data obtained in Xiyang, Qixian, and Xiaoyi, all historic cities in Shanxi Province, Mainland China, and combined weights were estimated using the Delphi technique and the CRITIC weight method. Following this, the Spatial Damage Degree Model (SDDM) based on K-means cluster analysis and K-nearest neighbor (KNN) classification was developed. The findings show that the model efficiently solves the problem of assessing spatial damage levels in historic sites. Through multiple linear regression analysis, it was shown that the damage to historic sites was predominantly caused by three factors: natural erosion, construction damage, and planning and policy. SDDM was used to calculate the spatial damage levels of historic sites, allowing conservators to fully comprehend the features and concerns related to historic sites. As a result, more scientific and rational preservation approaches may be developed, improving the efficiency of historic site restoration and conservation and encouraging the sustainable development of urban and rural heritage.

Microfinance institutions (MFIs) play an significant role in financial inclusion and poverty alleviation activities. A critical challenge facing MFIs is how on all to build its own capacity for sustainable and healthy development. By using the data from the pilot survey of 65 microcredit companies in Zhejiang of China, this paper explores the factors affecting MFIs activities by principal component analysis and analyzes the key Influencing factors and sustainable development performance with the analysis of variance and multi-regression model.The results indicate that four key factors of operational technology, external environment, financial condition and institution size have a significant positive effect on the economic sustainability performance of MFIs, while the adjusted institution size is insignificant positive effect on operational sustainability performance,which means that key factors of MFIs sustainability have a greater impact on economic sustainability performance than operational sustainability performance.

Among the most popular learning management systems available worldwide is Moodle [1]. This current study examines how learners' attitudes toward English as a foreign language (EFL) and their language proficiency are affected by Moodle's interactive language learning activities. Thirty-three undergraduate students participated in this study. We investigated the effects of engaging language learning exercises that were practiced on Moodle using an experimental re-search design. To find out if the experimental and control groups differed significantly from one another on pre- and post-measures regarding the development of language skills and attitudes toward language classrooms, a number of statistical tests were employed. We conducted data analysis using SPSS software. Results demonstrated that there were differences favoring the ex-perimental group in the language skills developments and attitudes of learners toward the lan-guage classroom. There were no apparent differences in the forming structures, speaking, or listening of the control group's learners. On the other hand, there were notable differences in the overall score, writing and reading skills, and lexical item mastery. Additionally, significant dif-ferences in the language acquisition growth of the experimental and control groups were found using an Independent Samples T-test in the post-test, with the experimental group benefiting.

Asthma causes chronic coughing, wheezing, dyspnea, and chest pressure. This study assessed asthmatic patients' knowledge, attitudes and awareness of bronchial asthma and proper education on its meaning, risk factors, symptoms, diagnosis, management, and prevention practice. We performed a cross-sectional interventional asthma KAP survey in Erbil, Iraq. We adapted a validated study questionnaire from KAP studies in other nations to the Erbil situation and culture. In Erbil, Kurdistan, Iraq, two major hospitals' asthma clinics were studied. We chose 250 asthmatic ICU patients from October 2018 to July 2019. Health education was comprehensive. The health education program used a Kurdish PowerPoint with a printout. 25 groups got two-weeks of one-hour health education pre-intervention. Each group was questioned before, 2 and 12 weeks after health education. All data were analyzed by SPSS v26. The mean age of the respondent was 37.52±15.16 with 48.7 % respondent having a positive family history of asthma. After 2weeks of health education intervention, respondent have a higher knowledge score, positive attitudes compared to pre-education and after 12 weeks of education with a significant difference (P < 0.001) with improvised prevention practice. Health education programs led to considerable improvements in asthmatic patients' knowledge, attitudes, and practices regarding their condition. After receiving health education for a period of two weeks, the majority of the participants answered correctly regarding asthma, its causes, and the elements that trigger asthma attacks.

Abstract: Transcription factors are crucial pre-transcriptional regulatory mechanisms that can modulate the expression of downstream genes by binding to their promoter regions. DOF (DNA binding with One Finger) proteins are a unique class of transcription factors with extensive roles in plant growth and development. Our previous research indicated a decrease in iron content in chlorotic bamboo leaves. However, to our knowledge, genes related to iron metabolism pathways in bamboo species have not yet been studied. Therefore, in the current study, we identified iron metabolism-related (IMR) genes in bamboo and determined the transcription factors that significantly influence them. Among these, DOFs were found to have widespread effects and potentially significant impacts on their expression. We identified specific DOF members in Dendrocalamus latiflorus with binding abilities through homology with Arabidopsis DOF proteins, and established connections between some of these members and IMR genes using RNA-seq data. Additionally, molecular docking confirmed the binding interactions between these DlDOFs and the DOF binding sites in the promoter regions of IMR genes. The co-expression relationship between the two gene sets was further validated using q-PCR experiments. This study paves the way for research into iron metabolism pathways in bamboo and lays the foundation for understanding the role of DOF transcription factors in D. latiflorus.

Street vended foods are ready-to-eat food and beverages prepared and/ or sold in the streets. This trade provides for 85-99% of total employment in most African countries and 50% or more is constituted by women. The preparation of street vended foods is normally under unsatisfactory conditions and these may lead to the contamination of food. This descriptive survey was conducted in Maseru around the taxi ranks amongst 141 participants (48 food handlers and 93 consumers) using a semi structured questionnaire, open ended questionnaire and observation checklist. Majority of the food handlers were females (n=35, 60%) and males constituted only (n=23, 40%). On average the vendor population that participated in this study was considered to have poor knowledge of food safety since they scored 49%±11. With regard to the consumers, 63% were males and 37% were females, and only 6% reported that they never buy street vended foods mainly due to the food safety issues and hygiene. Based on the results of this study, it is thus recommended that educational interventions be implemented. The observation study showed that they also operated under unhygienic conditions and 95% of food handlers had the incorrect knowledge that washing utensils with detergent leaves them free of contamination. Regarding the consumer perceptions, they highlighted that the trade has the potential to grow and be profitable on condition that hygiene is emphasized and infrastructure improved so as to provide safe quality food.

Eating disorders (EDs) refer to a group of diseases characterized by a strong tendency toward chronicity, often involving distortions in body image distortion and other related symptoms The prevalence of EDs has increased in recent years, specifically in athletic populations. Therefore, the purpose of this study was to analyse risky eating attitudes in a sample of 1102 subjects from Se-ville (Spain): 142 women and 960 men aged between 15-25 years old. An online survey, designed using Google Forms, consisted of three questionnaires (EAT-26, SCOFF, and BITE), were com-pleted individually and anonymously. With regards to the cut-off points, the percentage of posi-tive cases with significant scores was 11.43% for EAT-26, 31.22% for SCOFF and 4.36% for BITE. The study found that the probability of testing positive for EDs is significantly higher in women than in men (p < 0.001). Specifically, the risk attitude for EDs in female athletes measured by the EAT-26 test is three times higher than in male athletes, while the risk attitude measured by the SCOFF test is twice as high in females. Risk attitude for EDs in athletes measured by the BITE test is 8 times higher in females than in males. This study’s findings confirm several important as-sumptions made at the outset of the research. There is indeed a higher risk of EDs in athlete populations. Moreover, all three tests therefore show a higher frequency of possible events of EDs in women, with very similar percentages of difference between sexes. The tests also confirm the role played by the coaches in the prevention of EDs in sports and their capacity to reduce ab-normal food-related behaviours. Thus, the future inclusion of these tests in the screening of athletes is highly recommended.

In the context of digital empowerment, the digital literacy level of tea farmers has a significant impact on the intelligent development and transformation of the tea industry. This study extends the original model of UTAUT theory by introducing Personal innovativeness theory and Self-efficacy theory, and constructs a new model to explore the influencing factors of moderate scale tea farmers' digital literacy improvement behavior. There are a total of 22 research hypotheses. Using structural equation modeling and collecting questionnaire data for analysis, the following research results were obtained: (1) Performance expectancy, social influence, effort expectancy, personal innovativeness and self-efficacy all significantly positively affect the willingness of tea farmers to improve their digital literacy, and then according to the path coefficient, in descending order, social influence (0.226)>self-efficacy (0.224)>effort expectancy (0.178)>performance expectancy (0.157)> personal innovativeness (0.155); (2) Facilitating condition and willingness to improve digital literacy have a significant positive impact on tea farmers' digital literacy improvement behavior，and then from the size of the path coefficient, the willingness to improve (0.271)>facilitating condition (0.106); (3) The willingness of tea farmers to improve their digital literacy plays a complete mediating role between personal innovativeness and self-efficacy on their digital literacy improvement behavior, and partially mediates between performance expectancy, social influence, and effort expectancy on their digital literacy improvement behavior, and according to the proportion of indirect effects, the order is effort expectancy (27%), performance expectancy (47%), and social influence (49%); (4) The gender and age of tea farmers have a significant positive moderating effect on the impact of performance expectancy on the willingness to improve digital literacy; age and experience have a significant positive moderating effect on the impact of effort expectancy on the willingness to improve digital literacy; the age of tea farmers has a significant positive moderating effect on the improvement of digital literacy behavior through facilitating condition. This study extends the applicability of the UTAUT theoretical model and proposes strategies to improve the digital literacy of tea farmers, providing practical guidance for tea farmers to improve their digital literacy and providing reference for research related to farmers' digital literacy.

What drives an individual police officer to activate his body-worn camera (BWC)? Some evidence suggests officer attitudes and resistance to the technology contributes to the equivocal results in studies testing for BWCs effect on use-of-force, complaints, and other outcomes of interest. Leveraging a novel survey and administrative dataset, we investigate the predictors of BWC activation among 147 police officers in a single agency. With a test of three nested models, we find job function covariates offer robust predictive power of how often an officer activates her or his BWC. Neither demographic nor attitudinal measures significantly predict BWC activations, except for a negative relationship with how officers perceive BWC impacts on professional discretion. The study furnishes empirical support for understanding officers as Principled Agents: job function, guided by administrative policy is the most explanatory and parsimonious, while models of attitudes and demographics fail to improve upon the job function model.

The outbreak of COVID-19 in 2020 caused significant disruptions to global shipping and the world economy. This paper aims to investigate the impact of the pandemic on global shipping by analyzing the Baltic Dry Index (BDI). The BDI is a metric that reflects the worldwide shipping costs and directs related to supply and demand conditions, making it an indicator of economic production. The study utilizes data from 2019 to 2021, before and after the outbreak of COVID-19, and considers 13 independent variables, including raw materials, energy, stock market indexes, global port calls, and confirmed COVID-19 cases to investigate how to influent the BDI. The study employs stepwise regression to select variables and build models before and after the pandemic. The findings reveal that the key factors affecting the freight index BDI before the outbreak are: international scrap steel prices, iron ore prices, and the Commodity Research Bureau Index. However, after the COVID-19 outbreak, the factors affecting the BDI changed to the Shanghai Index, global port calls, and the number of confirmed COVID-19 cases.

Background: Health inequity (HI) remains a major challenge in public health. Improving the health of children with low socioeconomic status (SES) can help to reduce overall HI in children. Childhood obesity is a global problem, entailing several adverse health effects. It is crucial to assess influencing factors for adoption, implementation and sustainment of interventions. This review aims to identify articles reporting about influencing factors for the implementation of school-based interventions promoting obesity prevention behaviors in children with low SES. It aims to critically appraise the articles’ quality, assess influencing factors, categorize and evaluate them, and to discuss possible implications. Methods: A systematic search was conducted in 7 databases with the following main inclusion criteria: 1) school-based interventions and 2) target group aged 5–14 years. The Consolidated Framework for Implementation Research, its five domains (intervention characteristics, inner setting, outer setting, characteristics of individuals, process) along with 39 constructs within these domains were used to deductively analyze the data. We grouped the articles with regard to the characteristics of the interventions in simple and complex interventions. For each domain, and for the groups of simple and complex interventions, the most commonly reported influencing factors are identified. Results: 6452 articles were screened, and 16 met all eligibility criteria. Included articles applied mixed methods (n=10), qualitative (n=5) and quantitative design (n=1). Of these, five were considered to report simple interventions and eleven were considered to report complex interventions. In total, 295 influencing factors were assessed. Aspects of the inner setting were reported in every study, aspects of the outer setting were the least reported domain, and in the group of simple interventions not reported at all. In the inner setting, most reported influencing factors were time (n=7), scheduling (n=6) and communication (n=6). Conclusion: This review found a wide range of influencing factors for implementation. Most important influencing factors need to be assessed for every setting. Including all stakeholders involved in the implementation process enhances the prioritization of the most important influencing factors for the specific setting. More empirical research and practical guidance are needed to promote obesity prevention behaviors among children with low SES.

Domestic violence (DV) has been reported high in minorities across the US. Among minorities, refugees and immigrants encounter several barriers that may influence their responses and actions regarding DV. This scoping review examined three decades of literature (1980-2022) on resettled Afghan and Arab refugee women's attitudes and behaviors toward DV in their host countries, and to summarize research, practice, and policy recommendations. Based on Arksey and O'Malley model, our scoping review conducted extensive searches in SCOPUS, PubMed, PsychInfo, CINAHL, Web of Science, the Directory of Open Access Journals, and Embase databases. Searches identified articles that examined resettled Afghan and/or Arab refugees’ responses to DV in Western countries. The search identified 439 unique citations; 17 met the inclusion/exclusion criteria. Major themes included acculturative changes in refugee attitudes and behaviors and in stakeholders’ perspectives and roles. Significant acculturative attitudinal changes (acknowledgment, silence, justification, or disapproval of DV) contrasted with minimal behavioral changes (help-seeking behaviors, action plans, or barriers to actions) and with a resistance to change in stakeholders (cultural norms and beliefs, community patriarchal normalization of violence, service providers unfamiliarity with client diversity and refugee cultures) in supporting women decision-making regarding DV. Not a single article made explicit policy recommendations.

This study uses machine learning to identify key factors influencing the cost-effectiveness of over-the-counter (OTC) medications. By developing a novel cost-effectiveness rating (CER) from user ratings and prices, we analyzed data from Amazon. The findings indicate that FSA/HSA eligibility, symptom treatment range, safety warnings, special effects, active ingredients, and packaging size significantly impact cost-effectiveness across cold, allergy, digestion, and pain relief medications. Medications eligible for FSA or HSA funds, treating a broader range of symptoms, and having smaller packaging are perceived as more cost-effective. Cold medicines with safety warnings were found to be cost-effective due to their lower average price and effective ingredients like phenylephrine and acetaminophen. Allergy medications with kid-friendly features showed higher cost-effectiveness, and ingredients like calcium, famotidine, and magnesium boosted the cost-effectiveness of digestion medicines. These insights help consumers make informed purchasing decisions and assist manufacturers and retailers in enhancing product competitiveness. Overall, this research supports better decision-making in the pharmaceutical industry by highlighting factors that drive cost-effective medication purchases.

In order to better realize rural revitalization, this paper analyzes the spatial and temporal char-acteristics and influencing factors of agricultural surface source pollution in the Yangtze River Economic Belt from the three perspectives of government, enterprise and agriculture by using the spatial Durbin model and the dynamic GMM method in the period of 2006-2021, and further re-searches the threshold characteristics of the distortion of the factor market on the agricultural surface source pollution under the different strengths of environmental regulation. The results show that there is a positive spatial correlation between agricultural surface pollution in the Yangtze River Economic Belt, and government environmental regulation, input factor market distortion and labor force transfer all have a significant impact on agricultural surface pollution. Among them, factor market distortion has a significant spatial spillover effect on agricultural surface pollution in the Yangtze River Economic Zone, and has a significant single-threshold ef-fect on environmental regulation. Accordingly, the government should strengthen environmental regulation, continuously improve the agricultural factor market mechanism, and pay attention to the construction of talents to provide support for rural revitalization.

Food safety in dairy shops has gained increasing attention. Consequently, this study aims to evaluate dairy handlers' knowledge of food safety practices, assess compliance with food safety codes regarding facility maintenance and personal hygiene, and understand retail dairy shops' capacity to implement food safety standards. This research involved surveys and interviews with 110 dairy retail workers to gauge their grasp of food safety principles, their recognition of its importance, and the obstacles they encounter in implementing proper food safety measures. Among the participants, 93% were males under 35 years old, with experience ranging from 1 to 8 years. The study revealed that while over 83% of participants were familiar with standard procedures ensuring dairy product safety, only 37% understood “HACCP” in relation to food safety. Additionally, 42% believed that freezing food at -18°C eliminates food bacteria, and 56% thought food contamination could be identified by taste, indicating misconceptions among respondents. Results showed that 90% of survey participants had a strong awareness of food safety, with 98% emphasizing the importance of regular inspection of production areas for cleanliness to ensure a safe dairy production environment. However, less than 45% had received formal training on dairy-specific food safety practices, and only 53.6% had a documented system for correctly labeling and providing production dates for dairy products. These findings have significant implications for public health and food safety policies in Jordan. Furthermore, the study provides valuable insights to enhance food safety practices among dairy retail vendors.

We aimed at developing and validating a scale on the beliefs and attitudes of mental health professionals towards services users’ rights in order to provide a valid evaluation instrument for training activities with heterogeneous mental health professional groups. Items were extracted from a review of previous instruments, as well as from several focus groups which have been conducted with different mental health stakeholders, including mental health service users. The preliminary scale consisted of 44 items and was administered to 480 mental health professionals. After eliminating non-discriminant and low weighting items, a final scale of 25 items was obtained. Exploratory and confirmatory factor analyses produced a four-factor solution consisting of the following four dimensions; system criticism/justifying beliefs, freedom/coercion, empowerment/paternalism, and tolerance/discrimination. The scale shows high concordance with our theoretical model as well as adequate parameters of explained variance, model fit, and internal reliability. Additional work is required to assess the cultural equivalence and psychometrics of this tool in other settings and populations, including health students.

Cervical cancer is one of the ailments that endangers the health of women all over the world and causes infertility. Fortunately, this disease can be avoided. Both the results and participation rates of the current preventative strategy remain poor. Hence, preventative or early detection methods remain challenging and open. In gynecology and computer science fields, few studies on identifying cervical cancer are based on behavior risk factor and machine learning. Moreover, various social and behavioral aspects might often make it more difficult to detect cervical cancer especially in low‑ and middle‑income countries (LMICs). Accordingly, focus on predicting the presence of cervical cancer through behavioral risk factors is the basic structure of this research. We proposed an approach to classify cervical cancer from a social-behavioral perspective using logistic regression to predict cervical cancer. We got significantly improved outcomes than the existing methods. Moreover, we used feature engineering to formulate less dimensionality as a pre-processing step and optimized parameters to be prepared for classification phase. The results proved that using the logistic regression with regularization type L1 had a promising performance. The accuracy of Logistic Regression (LR) L1 was 97.2%. Such results support the proposed work as a reliable classification predictive tool.

Heat waves are a significant consequence of climate change threatening public health by increased morbidity and mortality. The aim of this study was to estimate individuals’ knowledge, attitudes and practice related to heat waves. We conducted an exploratory cross-sectional study in Greece during September 2023. We employed a convenience sample of 1055 participants. We used the heat wave knowledge, awareness, practice and behavior scale (HWKAPBS) to measure our outcome. We measured several socio-demographic variables, such as gender, age, educational level, etc. as potential determinants. Mean scores for the knowledge, awareness, practice and behavior factors were 12.5, 22.7, 22.2 and 12.1 respectively. Females had higher scores on the four factors compared with males. We found a positive relationship between self-perceived health status and awareness, practice and behavior about heat waves. Similarly, we identified a positive relationship between self-perceived financial status and awareness and behavior about heat waves. Increased age was associated with increased practice score, while increased educational level was associated with increased knowledge score. Additionally, behavior score was higher among participants in urban areas than those in rural areas. We found statistically significant positive correlations between the four factors. Levels of knowledge, awareness, practice and behavior about heat waves were high in our sample. Several socio-demographic variables affect participants’ knowledge, awareness, practice and behavior concerning heat waves.

Despite epidemiological findings of improvements in cardiovascular risk factors with a light-to-moderate intake of alcohol, many misconceptions remain regarding alcohol intake and the risks and benefits of consumption. We sought to examine physician attitudes and recommendations regarding alcohol intake in a cohort of Argentine physicians and to establish their sources of knowledge. An online national survey was distributed through the Argentine Federation of Cardiology (FAC) to cardiologists, internal medicine specialists, general and other subspecialty physicians in Argentina. The survey was completed by 745 physicians, of whom 671 (90%) were cardiologists. In total, 35% of physicians viewed moderate alcohol intake to be beneficial for cardiovascular health, 36% believed only wine offered such benefits, 24% viewed any intake to be harmful, and 5% had other opinions. More than half (57%) self-reported their knowledge to come from academic sources. Regarding knowledge of drinking guidelines, only 41% of physicians were aware of the concept of ‘standard drink’. Physicians were generally not comfortable converting ‘standard drinks’ into other metric units, however men tended to be more comfortable than women (p=0.052). Physicians were not satisfied with their knowledge of drinking guidelines (3.01 ± 2.73, on a 0-10 scale). Physicians were generally comfortable in counselling patients regarding safe-limits of consumption (6.22 ± 3.20, on a 0-10 scale). Argentine physicians were not satisfied with their knowledge of alcohol consumption guidelines or their understanding of the reported metrics. Only one-third of study participants viewed moderate alcohol intake as beneficial for cardiovascular health. This study shows the necessity to optimize the sources of knowledge.

The aim of the study was to determine the attitude of dentist toward learning communication skills and to recognize the factors influencing attitude toward learning communication skills. A cross-sectional study using a self-administered, 26-item, adapted Communication Skills Attitude Scale (CSAS) was carried out among dentist working in a public sector hospital in Qatar. Overall, two scores could be ascertained from the adapted CSAS: the mean positive attitude score (PAS) and negative attitude score (NAS). Non-parametric tests for statistical significance were utilized to assess relation between PAS and NAS scores and demographics. Fifty-nine dentists completed the survey giving an overall response rate of 53.6%. The mean (SD) PAS and NAS scores were 3.98 (SD=0.54) and 3.26 (SD=0.49) respectively. Female dentist was more positive towards learning communication skills than male. No statistically significant correlation was found between both PAS and NAS scores and respondents’ age. Dentists’ had both positive and negative attitudes towards learning communication skills. Considering the high NAS scores, it is recommended to introduce communication skills formal training sessions

Introduction: The attitudes of doctors and nurses toward patient safety is a significant factor in hospital safety climates and medical error rates. Yet, there are very few studies of patient safety attitudes in Saudi hospitals and none conducted in hospital emergency departments. Aims: The current study aims to investigate the discrepancy between the patient safety attitudes of doctors and nurses in a Saudi hospital emergency department. Materials and Method: The study employed a qualitative research designvia semi-structured interviews with Saudi and non-Saudi doctors and nurses working in a Saudi hospital emergency department to determine their attitudes and experiences about the patient safety climate. Results: The findings showed doctors and nurse held some similar safety attitudes, however, nurses reported issues with doctors with respect to their teamwork, communication, and patient safety attitudes. Moreover, several barriers to the patient safety climate were identified such as limits to resources, teamwork, communication, and incident reporting. Conclusion: The findings provide one of the few research contributions to knowledge on the differential patient safety attitudes of Saudi and non-Saudi doctors and nurses and suggest the application of such knowledge would enhance positive patient outcomes in emergency departments.

Transitioning towards sustainable food systems and sustainable diets is critical in reducing environmental impact and achieving the Sustainable Development Goals established by the United Nations General Assembly. This transition requires collaborative efforts across multiple stakeholders, including the general public’s knowledge and attitudes. To assess the knowledge and attitudes towards food sustainability we carried out a cross-sectional study among Kuwait University students with a total of 278 participants aged ≥18 years (78% females and 22% males). A validated questionnaire was used for this study. Most respondents (&gt;70%) recognized the concept of “local food” and “environmental impact.” The concept “green water-blue water” was least recognized among respondents (75%). Participants perceived that a sustainable diet was rich in vegetables, included plenty of fresh products and was affordable. Participants (&gt;66%) perceived that a positive impact of meat and its derivatives towards sustainability, a misconception most common among males. Overall, participants with more knowledge about environmental concepts showed favorable attitudes towards a sustainable diet. Women showed more interest in changing their current dietary habits towards food sustainability. In conclusion, despite participants’ positive attitude towards food sustainability, lack of understanding persists, necessitating public health interventions aimed at educating consumers about sustainable diets and its impact on the environment.

Severe early childhood caries remains the most common chronic disease affecting children. Its multifactorial etiology has established a controversy about which risk factors were more significant to its development. Therefore our study aimed through meticulous statistical analysis to arrange the “well agreed upon” common risk factors in order of significance, to aid the clinician in tailoring an adequate preventive program for this affected age group. The study reshuffled the risk factors contributing to severe early childhood caries and placed them in the order of their significance as follows: snacking of sugary food several times a day, increased number of siblings to 3 or more, night feeding, child self-employed brushing, mother caries experience, 2 siblings, on demand feeding, once/day sugary food, sharing utensils, 1 Sibling, male gender, father’s education, late first child dental visit, brushing time, mother’s education, no dental visit, decreased brushing frequency & no night brushing.

The present study explained factors influencing citizen satisfaction service in the Investment and One-Stop Service Agency of Tanah Bumbu Regency. In particular, this research analyses the level of citizen satisfaction and the extent to which Awareness, Rules, Organizational, Income, Skill-Ability, and Service Facility Factor influence Citizen Satisfaction. This study uses a mixed methodology with a sequential explanatory strategy. Using the incidental sampling with Slovin's Formula to calculate the number of samples is 93 respondents. The quantitative data were analyzed by the SmartPLS 3.0 program. The findings showed that the level of citizen satisfaction is included in the category "Satisfied". Furthermore, the variable of Citizen Satisfaction is influenced by variables of Awareness, Rules, Organizational, Income, Skill-Ability dan Service Facility Factor for 70,5%. Whereas Awareness, Rules, Organizational, and Skill-Ability Factor has a significant influence on Citizen Satisfaction. Besides, Income and Service Facility Factor do not have a significant influence on Citizen Satisfaction.

There is a noticeable absence of health education among college students. This study aimed to evaluate the extent of general nutrition knowledge among Chinese university students and explore its association with eating attitudes. Data were collected from a group of 273 students in Spring of 2023, using a valid and reliable research instrument consisting of three sections: demographic variables, the General Nutrition Knowledge Questionnaire (GNKQ), and the Eating Attitudes Test (EAT-26). The results were analyzed using SPSS, with correlations and t-tests to examine the relationships between nutritional knowledge and dietary attitudes. Furthermore, the present study employed the Random Forest (RF) algorithm, a machine learning technique, utilizing the Mean Decrease Impurity (MDI) method to investigate the influence of various features on participants' eating attitudes. The findings revealed that Chinese university students had an average accuracy of over 60% in their nutritional knowledge, but their understanding of the relationship between diet and disease still needs improvement. Moreover, male students had significantly lower nutritional knowledge than female students, and there was a positive correlation between nutritional knowledge and parents’ income. The study also found a significant correlation between the level of nutritional knowledge and eating attitudes. RF results indicated that family income level exhibited the most substantial impact on the eating attitudes of the participants. The study highlights the need for nutrition education curriculum developers to focus more on improving students' nutritional knowledge, with particular attention given to male students, low-income individuals, and those with an abnormal BMI.

University students, particularly those in the healthcare disciplines, constitute a category of particular interest in regard to COVID-19 vaccines and the attitudes to vaccination, as their future professional role will enable them to inform and educate citizens regarding vaccination. The objectives of the study were to investigate the vaccination coverage with a COVID-19 vaccine among students from different degree programs at the Medical universities in Bulgaria behaviors and attitudes toward vaccination with a COVID-19 vaccine. A prospective cross-sectional study in the period September 2021- March 2022 was conducted. Information on demographics, university program, year of study, general attitudes and behavior towards vaccines and attitudes and personal experience with COVID-19 and COVID-19 vaccines were collected. The chi-square test was used to test for associations and binominal logistic regression was used to identify possible predictors for vaccination. A total of 3050 students with a median age of 22 years, predominantly female took part in the study. Three-thirds of the students (73.5%) have been vaccinated against COVID-19. The main reasons for vaccine hesitancy in both group of students were the fear of side effects and the doubts about the safety of the vaccines although non-vaccinated students significantly more frequently express those fears. Respondents who considered to have: a) limited access to sufficient information to inform COVID-19 vaccine uptake; b) lack of public awareness and education campaigns about effectiveness and safety of COVID-19 vaccines; c) insufficient information about COVID-19 vaccines during the University education; and d) had a positive COVID-19 diagnosis were less likely to be vaccinated. Students who have not completed the mandatory immunization cycle according to country schedule were also less likely to have completed COVID-19 vaccination. The students showed an overall positive attitude towards the COVID-19 vaccines. Promoting informational campaigns that emphasize the vaccine's safety will be more effective to further increase the vaccination coverage with COVID-19 vaccines.

Background This study aimed to identify the prominent risk factors that may trigger danger signals of early onset of vascular deregulation in T1D. The risk factors we have identified may serve as dual-purpose biomarkers of rapid diagnosis that offer prospective tailor-made resolution therapeutics. Methods The healthy control (HC) was compared with individuals diagnosed with T1D for the risk factors of vascular deregulation in published research studies from year 2013 to 2023. The PubMed, Web of Science and Google Scholar databases were searched from 1/1/2013 to 1/9/2023. The risk of bias was assessed with the Cochrane (ROBINS-I ) tool, which is relevant to clinical subjects. A random effect model for continuous data was followed and analysed by RevMan 5.4 and GraphPad Prism software. Results 80 relevant case-control studies having 5293 HC and 7492 T1D patients were included. The age and sex-matched HC consisted of persons free of disease and not under any medication while clinical subjects of all age groups were included. 28 risk factors were grouped into six primary outcome models, all of which favoured the T1D synonymous with a high risk of CVD. Conclusions Our findings have strong implications for improving the quality of life and health economics related to vascular disease in T1D. HbA1c% is the most effective biomarker, followed by FBG, LDL-C, and AI% which the clinicians could evaluate using a simple blood test or non-invasive techniques. (Protocol registered at https://www.crd.york.ac.uk/prospero/ CRD42022384636).

Healthy eating behaviour of women is critical not only for their health but also for their children's health and well-being. The present study examined the dietary pattern, nutrition knowledge and attitudes of working women in Western Province, Sri Lanka. In addition, identify the factors associated with Dietary Diversity Score (DDS). A cross-sectional study was conducted among 300 working women, aged 20-60 years, in Western Province, Sri Lanka. The data on so-cio-demography, dietary patterns, and nutrition-related knowledge and attitudes were collected. Overall, 38% of the women were overweight and 13% were obese. The median frequency of intake of chicken, fish, eggs, milk and milk products, green leafy vegetables and fruits were 2, 5, 2, 9, 5 and 10 respectively, per week. A large majority of the women (70%) had tea/coffee with sugar and snacks (60%) at least four times a week. Only a third of the women met the minimum DDS, while more than half of the women had good nutrition-related knowledge and attitudes. Multiple regression analysis showed that age and household income were significantly independently related to DDS, while attitudes were negatively associated. While there was a trend, the association of nutrition-related knowledge with DDS was not statistically significant (p=0.057). The overall F ratio (8.46) was highly significant (p=0.000) and the adjusted R2 was 0.093. The results demonstrated that a significant proportion of working women have good basic nutrition-related knowledge and attitudes, while two-thirds of them do not meet the minimum DDS. Furthermore, age, family income and knowledge were positively associated with DDS, while attitudes were negatively associated. Before designing any intervention, further research is needed using a qualitative approach to understand how nutrition knowledge and eating behaviour are related in this population group.

Recently, both global and domestic environmental events have been occurring more frequently, bringing catastrophic consequences to humans and the environment. These adverse events have caused widespread concern among the general public. In positive terms, these devastating events could potentially enhance people’s environmental awareness, which, in turn, could instill a greater sense of environmental responsibility. This study aims to investigate how university students concern themselves with global and domestic catastrophic environmental events and to examine how global and domestic environmental concerns mediate the effect of environmental knowledge and attitudes on university students’ environmental responsibility. Students of King Mongkut’s University of Technology Thonburi in Bangkok, Thailand were selected as the participants. A simple random technique was applied to select the research participants. Questionnaire surveys with 863 students were carried out during September–October 2019. A path analysis was performed to test how global and local environmental concerns mediate the effect of environmental knowledge and attitudes on university students’ environmental responsibility. The results demonstrated that domestic environmental concerns, taken alone, contributed less to the students’ sense of environmental responsibility. Domestic environmental concerns had a stronger effect on environmental responsibility when taken together with global environmental concerns. In addition, both domestic and global environmental concerns could help transform environmental knowledge and attitudes into environmental responsibility. Only environmental attitudes had no direct effect on responsibility. These results show that domestic and global catastrophic environmental events could raise students’ levels of concern for the environment, and, ultimately, enhance their sense of responsibility to protect the environment.

Obesity has increasingly become a worldwide epidemic, as demonstrated by epidemiological and clinical studies. Obesity may lead to development of a broad spectrum of cardiovascular diseases (CVDs), such as coronary heart disease (CHD), hypertension, heart failure (HF), cerebrovascular disease, atrial fibrillation (AF), ventricular arrhythmias, and sudden cardiac death (SCD). In addition to hypertension, there are other cardiometabolic risk factors (CRFs) such as visceral adiposity, dyslipidemia, insulin resistance, diabetes, elevated levels of fibrinogen, and C-reactive protein and others, all of which increase the risk of CVD events. Mechanisms involved between obesity and CVD mainly include insulin resistance, oxidative stress, inflammation, and adipokines dysregulation, which cause maladaptive structural and functional alterations of the heart, particularly left ventricular (LV) remodeling and diastolic dysfunction. Natural products of plants, provide a diversity of nutrients and different bioactive compounds, including phenolics, flavonoids, terpenoids, carotenoids, anthocyanins, vitamins, minerals, fibers, and others, which possess a wide range of biological activities including antihypertensive, antilipidemic, antidiabetic, and other activities, thus conferring cardiometabolic benefits. In this review, we discussed the main therapeutic interventions using extracts from herbs and plants in preclinical and clinical trials with protective properties targeting CRFs. Molecular mechanisms and therapeutic targets of herbs and plants extracts for the prevention and treatment of CRFs are also reviewed.

By repeated unloading and loading of the excavation dynamic and static loads, repeated train dynamic and static loads of multi-factors, the underpass tunnel, cross tunnel engineering influence area rock layer, the existing tunnel structure of the three constitutes a multifaceted structure, multi-factor interaction system. Existing tunnels into the prediction theory model of the new tunnel excavation process of dynamic and static loads, dynamic and static loads of existing tunnels are mostly analyzed individually, the results of synergistic analysis needs to be improved. Based on the theory of the current layer method, the paper comprehensively considers the stiffness of the existing tunnel, the stiffness of the new tunnel, the excavation method load and the existing tunnel load, coupled with Peck's empirical formula, the theoretical model of deformation prediction for excavation of a two-lane highway tunnel under the tunnel through the existing railroad is proposed, and verified and optimized by numerical calculations and monitoring data, which proves the applicability and reliability of the theoretical model in the similar strata and the project promotion.

The African continent has the highest prevalence of hypertension globally, with South Africa reporting the highest prevalence in Southern Africa. While the influence of genetic variability in the pathogenesis of hypertension is well described internationally, limited reports are available for African populations. This study aimed to assess the association of genetic variants and essential hypertension in a cohort of two ethnic South African population groups. Two hundred and seventy-seven hypertensive and one hundred and seventy-six normotensive individuals were genotyped for 79 variants. Genotyping was performed using the Illumina GoldenGate Assay and allele-specific polymerase chain reaction. The association of variants was assessed using the Fisher Exact test under the additive and allelic genetic models, while multivariate logistic regression was used to predict the development of hypertension. Five variants (CYP11B2 rs179998, AGT rs5051 and rs699, AGTR1 rs5186 and ACE rs4646994) were significantly associated with essential hypertension in the cohort under study. Furthermore, AGTR1 rs5186 and AGT rs699 were identified as risk factors for the development of hypertension in both ethnic groups. In two ethnic South African populations an association was observed between Renin-Angiotensin-Aldosterone System (RAAS) related genes and the development of hypertension.

Objective: The goal of this study was to analyse the attitudes and perceptions of emergency and mental health nurses through the validation of the SM-GIBED scale in specialised care in Spain on alcoholics and other drug-dependent patients. Design and Setting: This cross-sectional study was developed using the Spanish hospital version of the Seaman-Mannello scale to denominate the SM-GIBED scale. Participants: 170 Emergency and Mental Health Nursing from five Spanish Hospitals. Intervention: Self-administered questionnaire to analiyse the perceptions and attitudes about the drug addict and the alcoholic. Primary and Secondary Outcome Measures: A descriptive and inferential analysis of the study variables was carried out. A psychometric analysis was performed to validate the scale. Results: A total of 170 questionnaires were collected from 257 healthcare workers. Overall, 99.1% of the participants had contact with drug-dependent patients during their professional experience. Nearly 75% had difficulties in treating them. The psychometric analysis of the SM-GIBED scale in the Spanish context obtained values of KMO = 0.655 and Bartlett's test p < 0.000. Cronbach's alpha of 0.738 was obtained from the reliability analysis. A reliability analysis of each of the SM-GIBED questions found no case with an alpha lower than 0.71. In conclusion, positive aspects include an ingratiating attitude and subject-to-subject communication when nurses self-define as empathic and non-paternalistic. Among the negative aspects, there is a lack of communication skills and assertiveness with these patients. This highlights a certain degree of resignation and dissatisfaction when working with drug addicts.

Despite numerous interventions to promote gender equality, sub-Saharan Africa has one of the highest prevalence rates of non-partner sexual assault in the world, thus constituting a major social and public health issue in the region. As social workers frequently provide services to this population, an exploratory cross-sectional study was conducted to explore rape myth acceptance among undergraduate social work students studying in Namibia. Findings revealed the positive influence of social work education in reducing rape myth acceptance as well as highlighted the influence of age, gender, country of origin, self-identification as a feminist, and religiosity on rape myth acceptance among this population.

Successful strategies that can contribute to poverty reduction and improve the livelihoods of the poor, particularly in Sub-Saharan Africa (SSA), are critically needed to address the technology adoption constraints. The objectives of this study were to assess the adoption rate of improved technologies and management practices and to identify the key factors influencing their adoption in the major wheat-producing areas of Sudan's irrigated, dry, and heat-prone environments. A farm survey was conducted in 2021 using a structured questionnaire that included all recommended technological options for optimum and sustainable wheat production. A total of 300 farmers, 93, 101, and 106 from Northern (NS), Kassala (KS), and Gezira (GS) states, respectively, were selected and interviewed. Besides descriptive statistics, a binary logistic model was used to identify the socioeconomic and production factors affecting farmers' perceptions of improved and recommended technological options. The study found a wide range of adoption rates depending on the specific technology practice and the area surveyed. The lowest adoption rate was observed for land preparation (6.5%) in NS. Adoption rates ranging from 26-100% were observed for technologies such as sowing date, seed rate, seed treatment, awareness of released varieties, nitrogen and phosphorus fertilizers application, and chemical weed control. The difference in the productivity of technological options adopters was significant (P = 0.015) compared to non-adopters. The binary logistic regression results showed that five out of seven explanatory variables hypothesized to influence wheat farmers' perceptions on the decision to adopt improved and recommended technologies significantly influenced farmers' decision to adopt the technologies. In particular, access to quality seed, financial credit, and extension services were found to be the most critical determinants of adopting improved technologies. Approaches that bring together all stakeholders along the crop value chain, including policymakers, to jointly analyze, identify, and prioritize challenges, develop and apply solutions and work plans using feedback and learning mechanisms are expected to increase farmer awareness and adoption of improved technologies, ultimately leading to sustainable wheat production.

Background: Low-level physical activity (PA) among Chronic Low Back Pain (cLBP) is associated with various biopsychosocial factors. This research aimed to study the predictors of PA behavior among cLBP patients. Methods: In the present study 300 eligible patients with cLBP who referred to comprehensive health service centers in the Shahid Beheshti University of Medical Sciences (SBUMS) in Tehran, Iran were random selected.To diagnose the predictors of PA behavior, all the Theory of Reasoned Action (TRA) constructs were examined as risk factors to see if they influence on the probability of PA behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 280 cLBP patients with mean age of 57.07 ±13.09 years old participated in the study. This study showed that motivation to comply significant predictor the cLBP patients for subjective norm OR (%95CI): 2.095(0.116-2.792), p-value<0.001), intention was significant predictor for perform the PA behavior OR (%95CI): 1.431(0.138-1.538), p-value <0.001), behavior beliefs could predictor for attitude OR (%95CI): 1.276(0.106-1.355), p-value= 0.002). attitude, normative beliefs, subjective norm ,and evaluation outcome behavior could predictors the cLBP patients for intention to perform the PA behavior OR (%95CI): 1.188(0.032-1.312), p-value<0.001)., OR (%95CI): 1.158(0.076-2.208), p-value=0.003) ., OR (%95CI): 1.104(0.076-1.128), p-value<0.001) ., OR (%95CI): 0.814(0.301-1.440), p-value=0.007). Conclusions: This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm).

Fossil-based plastics are significant contributors to global warming through CO₂ emissions. For more sustainable alternatives to be successful, it is important to ensure that consumers become aware of the benefits of innovations such as bio-based plastics, in order to create demand and a willingness to initially pay more. Given that consumer attitudes and (inaccurate) beliefs can influence the uptake such new technologies, we investigated participants’ attitudes towards fossil-based and bio-based plastic, their perceived importance of recycling both types of plastic, their willingness to pay, and their perceptions of bio-based plastic in four studies (total N = 961). The pre-registered fourth study experimentally manipulated information about bio-based plastic and measured willingness to pay for different types of plastic. The results suggest participants hold very favourable attitudes and are willing to pay more for bio-based products. However, they also harbour misconceptions, especially overestimating bio-based plastic’s biodegradability, and they find it less important to recycle bio-based than fossil-based plastic. Study 4 provided evidence that educating consumers about the properties of bio-based plastic can dispel misconceptions, retain a favourable attitude and a high willingness to pay. We found mixed evidence for the effect of attitudes on willingness to pay, suggesting other psychological factors may also play a role. We discuss how attitudes and misconceptions affect the uptake of new sustainable technologies such as bio-based plastics and consumers’ willingness to purchase them.

The present research aimed to identify if consumption values influence the attitudes of Millennials who intend to purchase organic products. The research was quantitative, with a correlational scope and a cross-sectional design, and it was conducted on 509 Peruvian millennials. A questionnaire consisting of 23 questions was administered, and responses were quantified using a five-point Likert scale. The results were processed through an Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and Structural Equation Modeling (SEM) conducted using Statistical Package for Social Sciences 24 and AMOS 24. The study identified that environmental attitudes of Millennials do influence their intentions to purchase organic products, and the antecedents of these attitudes are functional and social values, whereas emotional, conditional, and epistemic values do not. The study confirmed that consumption values, either as a second-order variable or as a single construct, do not influence the attitudes of Millennials who intend to purchase organic products, thus confirming that these dimensions should be measured independently.

The food system, the most important driver of planetary transformation, is in a deep crisis. Therefore, seeking a sustainable and socially-fair transition pathway becomes an issue of utmost priority for our own survival. The consideration of food as a commodity, a social construct that played a central role in driving this crisis, remains the uncontested narrative to lead the different transition pathways what seems rather contradictory. By exploring the normative values in the transition landscape, this paper seeks to understand how relevant is the hegemonic narrative of “food as commodity” and its alternative of “food as commons” to determine transition trajectories and food policy beliefs. Applying the Multi-level Perspective framework and developing the ill-studied “agency in transition”, this research enquired food-related professionals that belong to an online community of practice (N=95) on valuation of food dimensions and agency in food transitions to check whether the valuation of food is relevant to explain personal stances in transition. Results suggest the socially-constructed view of food as commodity is positively correlated to the gradual reforming attitude, whereas food as commons is positively correlated to the counter-hegemonic transformers regardless the self-defined position in the transition landscape (regime or niches). At personal level, there are multiple loci of resistance with counter-hegemonic attitudes in varied institutions of the regime and the innovative niches, many of them holding this discourse of food as commons. Conversely, alter-hegemonic attitudes are not positively correlated to this alternative discourse and they may inadvertently or purportedly reinforce the ‘‘neoliberal narrative’’. Food as commons, a different narrative whose rationale is explained in the paper, seems to be a relevant framework that could enrich the multiple transformative constituencies that challenge the industrial food system and therefore facilitate the convergence of movements that reject the commodification of food.

Graphene hybrid-filler polymer composites have emerged as prominent materials that revolutionize heavy industries. This study encapsulates the in-depth analysis of different influential factors such as filler/graphene type, aspect ratios, dispersion methods, filler-matrix compatibility, fiber orientation, synergistic effects, different processing techniques, and post-curing conditions that affect the processing, properties and determine the resultant applications of graphene hybrid polymer composites. Additionally, it discusses the substantial role of graphene collaboration with other fillers such as carbon nanotubes, silica, nano-clays and metal oxides to produce functionalized hybrid polymer composites with synergistically enhanced tailored properties to offer solutions for heavy industries like aerospace, automotive, electronics, and energy harvesting. The review concludes with some suggestions and outlook on the future of these composite materials by emphasizing the need for continued research to fully optimize their potential.

Partial Differential Equations (PDEs) constitute a fundamental framework for modeling various physical phenomena across diverse fields such as physics, engineering, and finance. Solving PDEs accurately and efficiently remains a significant challenge, particularly when dealing with complex systems or high-dimensional data. In this paper, we present a novel approach based on deep learning techniques to investigate the effective factors in solving PDEs. Our methodology leverages the expressive power of deep neural networks to learn and represent the underlying relationships between input parameters and the solutions of PDEs. By incorporating domain knowledge into the network architecture and training process, our approach aims to provide insights into the key factors influencing the solution of PDEs. We demonstrate the effectiveness of our method through numerical experiments on various PDEs, showcasing its capability to identify important features and improve predictive accuracy. Our findings suggest that deep learning techniques offer a promising avenue for understanding and analyzing the complex dynamics inherent in PDEs, paving the way for enhanced computational methods in scientific and engineering applications.

Ovarian cancer (OC) represents a significant challenge in the realm of gynecological cancers, characterized by poor survival rates and complex etiology. In this review, we delve into the se-lected genetic, environmental, and hormonal factors underpinning OC development. We have reviewed scientific databases searching for ovarian cancer genetic and epigenetic factors. We have included studies based on their relevancy. As a result of exploring ovarian carcinogen-esis, this systematic review contains data collected from 126 various works. The role of prominent genetic players such as BRCA mutations, DNA repair mechanisms, un-derscores the intricate landscape of OC susceptibility. We explore Li-Fraumeni and Lynch syn-drome, which impart a heightened predisposition to OC development. Hormonal factors such as estrogen, progesterone, and androgens are also discussed. Environmental alterations, ranging from lifestyle influences on OC to microbiome dysbiosis and lifestyle factors such as obesity, al-cohol consumption, and physical activity intersect with genetic and epigenetic pathways, shaping the risk landscape for OC. Through a meticulous examination of current literature, this review provides a nuanced under-standing of the multifactorial nature of OC, emphasizing the need for holistic approaches to prevention, diagnosis, and treatment.

This research follows the publication of recent scoping and systematic reviews of existing literature on vaccine literacy (VL), its relationship to vaccine hesitancy (VH), and associated variables, such as vaccination beliefs, attitudes, and behaviors towards immunization. In this review, 17 articles were selected, published between December 2022 and November 2023, in which VL tools were used, most of which support the notion of a negative association between VL and VH, although not confirmed by others. Moreover, the definitions of the variables under consideration were not homogeneous between studies, some aimed to evaluate the association of VL with vaccine confidence, while others were more focused on outcomes such as willingness to be vaccinated or vaccine uptake. The complexity of the factors underlying VL, and the heterogeneity of the methods applied in the studies, in particular the limitations of cross-sectional surveys, still make it difficult to have a comprehensive understanding of the role of VL. Therefore, it is important to develop future assessment tools that consider not just the measurement of psychological factors connected to the motivational aspect of VL, but also those related to knowledge and competencies. For this purpose, a theoretical framework is proposed, where the positioning of VL at the intersection between antecedents and beliefs/attitudes leading to behaviors explains why and how VL serves as a tool and a critical, direct, or mediating driver of vaccination choices, overcoming VH and increasing vaccination rates, operating at personal, as well as at organizational and community level.

Gastrointestinal bleeding (GIB) after heart transplantation (HT) remains a significant clinical issue. The study aimed to explore its incidence, trends, outcomes and clinical predictors of GIB in HT patients. Adult patients who underwent HT between 2015 and 2021 at Union Hospital were recruited and divided into two groups based on the presence or absence of postoperative GIB. Primary outcomes were evaluated by follow-up. Independent predictors of GIB after HT were identified by logistic regression analysis. A nomogram prediction model was constructed according to these independent variables, and the accuracy of the model was assessed using the receiver operating characteristic (ROC) curve and the calibration curve. Among 461 patients, 40 (8.7%) developed GIB post-HT. HT patients with postoperative GIB exhibited higher in-hospital, 30-day, 90-day and 1-year mortality (all P < 0.05). Multivariate analysis identified age, preoperative warfarin, postoperative continuous renal replacement therapy and postoperative nasogastric tube as independent risk factors for GIB following HT. The nomogram prediction model was performed using the 4 variables. The area under the curve (AUC) of this model was 0.852(95% CI: 0.787-0.917, P < 0.001) and the calibration curve was close to the ideal diagonal line. GIB following HT is associated with a poor clinical prognosis. The constructed nomogram, incorporating its independent risk factors, demonstrated a favorable predictive value for GIB.

Background and Objectives: The aim of this study was to determine the job-related and individual features that influence BS and depression levels among dentists working in faculties, oral and dental health centres (ODHC) and private clinics. Materials and Methods: This prospective, cross sectional study was carried out on dentists working in different regions of Turkey. Data were collected using an on-line questionnaire created using Google Forms. The questionnaire consisted of demographic data, Maslach BS Inventory (MBI) and Beck Depression Inventory (BDI) sections. Demographics were age, height, weight, marital status, blood type, gender, monthly income, income satisfaction and having enough free time. The dentists were divided into 3 groups as faculty, private clinic and ODHC according to the institutions in which they worked. Results: Of the total 290 dentists enrolled in the study, there were 172 males and 118 females with a mean age of 36.98±5.6 years. 128 of the dentists worked in faculties, 72 in private clinics and 90 in ODHCs. It was observed that women's EE scores were higher than men's (P&lt;0.05). No statistically significant difference was found between the groups when comparing BS and depression scores according to marital status and blood group (P&gt;0.05). There was no significant relationship between emotional exhaustion (EE), depersonalisation (DP), personal accomplishment (PA) and depression scores according to age, BMI and work experience, age, work experience and BMI (P&lt;0.05). It was found that the EE scores of the dentists working in the faculty and private clinic were lower than those of the dentists working in the ODHC (P&lt;0.05). Monthly income was associated with depression (r = -0.35). Conclusions: This study showed that dentists working in ODHCs had more EE. These findings suggest that there is a need for improvement in the working conditions of dentists, particularly in ODHCs.

The present study identified the influence of green advertising and eco-labels on the attitude and environmental awareness of millennials who purchase ecological products in shopping centers in Ecuador. The research was quantitative, correlational and with a cross-sectional design. A total of 430 millennials participated in the study. A 20-question survey was applied in person outside the shopping centers of Quito and Guayaquil - Ecuador. The convergent and discriminant validity of the research model was verified using Confirmatory Factor Analysis (CFA) and Structural Equation Models (SEM). SPSS 20 and AMOS 24 programs were used for statistical analysis. The results show that green advertising influences environmental attitudes (β: 0,245) and awareness (β: 0,110) and specifically influences purchasing behaviour (β: 0,154) for green products. Although eco-labels do not directly influence purchasing behaviour (β: 0,128), they influence the attitudes (β: 0,406) and ecological awareness (β: 0,277) of millennials who buy organic products. This article is one of the first studies to identify the relationship between green advertising elements and green product purchasing behaviors among millennials in a developing country, concluding that marketing strategies based on green advertising and eco-labels have an impact on the attitude and environmental awareness of millennials, but only advertising directly affects purchasing behaviour while eco-labels do not. This research has social implications since it corroborates that millennials are concerned about environmental problems and are willing to contribute to sustainability.

The aim of the article is to verify differences in the perception of selected factors of sustainability among small and medium-sized enterprises (SMEs) in Central Europe. The subjects of analysis are factors such as corporate social responsibility (CSR), business risk sources (market, financial, personnel, and operational), reputation and social media, national support, social changes, and crisis events in business. The questionnaire was completed by 1,090 SMEs from the business environments of Visegrad Group countries. Statistical hypotheses were verified using Z-scores for two population properties. The most negatively perceived factors among owners and managers in the SME segment are national support and legislative changes. The most positively perceived factor is reputation and social media. The country of doing business is a significant factor. The perception of crisis events in business is most negative among Czech SMEs. More than 80% of Hungarian SMEs perceive their companies as sustainable. In comparison with Slovak and Polish SMEs, Hungarian perceptions are more positive in the context of sustainability. The country of doing business is the strongest factor in evaluating CSR indicators. The positive perception of CSR in Czech SMEs (43.9%) is lower than in other countries.

Measuring the impact of land use regulation on the land market involves identifying and classifying relevant impact factors related to the land market. The objective of this study was to identify land market impact factors in the context of the introduction of land use regulation in Nepal. A desktop review was carried out to identify preliminary set of impact factors, which were reclassified through intuitive analysis based on the degree of thematic closeness. Perspective-based impact factors were identified through the qualitative analysis of primary data collected through semi-structured interviews with the Nepalese land market stakeholders. These independently derived impact factors were compared with the desktop literature review impact factors resulting in fourteen land market impact factors across four dimensions, including transaction cost, valuation, mortgage availability, taxation, and compensation across the economic dimension; lot size, subdivision restrictions, and coordination across the institutional dimension; awareness, expectation and proximity across the social dimension; and risk reduction, quality of residential land, and suitability of zoning classification across the environmental dimension. There was significant overlap and commonality across factors identified from both the literature review and semi-structured interviews. The land market impact factors determined in the study may be adapted and generalized across other countries and could be utilized to better understand the impacts of land policy decisions on urban planning and development. Further research is recommended on the process to operationalize the use of these factors to quantify the impact of land use regulation on different land markets.

Following the transfer of hospital services to provincial government oversight, it is essential to understand how such changes impact service quality and efficiency. This study aims to identify the factors affecting hospital service quality post-transfer and evaluate the role of professional nurses in maintaining service standards under new governance.We conducted the study at sub-district health-promoting hospitals using a mixed-methods design based on the Global Fund-HSS framework (2012), which categorizes factors into accessibility, processes, productivity, and outcomes. We collected data from 340 nurses and 400 patients using structured questionnaires. We divided the questionnaires into seven sections, which captured a range of metrics such as the personal data of nurses, hospital service activities, and leadership qualities. We employed a Likert scale to gauge perceptions and expectations of service quality. We used paired t-tests to compare performance metrics before and after the administrative transfer, one-way ANOVA to assess variability among different service units, and binary logistic regression to identify key determinants of service quality in our statistical analysis. The analysis revealed a significant correlation between the attitudes and competencies of healthcare teams and the levels of service quality. Notably, service units transferred less than 50% exhibited minimal changes, indicating that the degree of transfer significantly impacts service outcomes. Despite these variations, the fundamental mission of promoting health remained consistent. The study emphasizes the critical role of nurses and recommends further research to identify additional factors that could improve service quality in transferred healthcare facilities. This could contribute to improved healthcare delivery across restructured health systems.

Background: Colorectal cancer (CRC) patients experienced multiple chemotoxicity affecting treatment compliance, survival, and quality of life (QOL). Prior research shows clinician-reported chemotoxicity (i.e., grading scales or diagnostic codes) predicts rehospitalization and cancer survival. However, a comprehensive synthesis of clinician-reported chemotoxicity is still lacking. Objectives: We conducted a systematic review and meta-analysis to determine the chemotoxicity's prevalence and risk factors in CRC. Methods: A systematic search from 2009 to 2024 yielded 30 studies for review, with 25 included in the meta-analysis. Results: Pooled prevalences of overall, non-hematological, and hematological moderate-to-severe toxicities were 45.7%, 39.2%, and 25.3%, respectively. The most common clinician-reported chemotoxicities were gastrointestinal (GI) toxicity (22.9%) and neuropathy or neutropenia (17.9%). Significant risk factors at baseline were malnutritional status, frailty, impaired immune or hepato-renal functions, short telomere lengths, low gut lactobacillus levels, age, female sex, aggressive chemotherapy, and low QOL. Age was associated with neutropenia (β: -1.44) and GI toxicity (β:1.85) (Ps 65 y.o.) had higher prevalences of overall (OR: 1.14) and GI (OR: 1.65) toxicities, but a lower prevalence of neutropenia (OR: 0.65) than younger adults (Ps

In the context of the new crown epidemic, remote physical training will already be in order under the guidance of the Ministry of Education. There is a global focus on current lifestyle behaviors and the future health and well-being of youth. Youth physical activity, aerobic activity and muscle fitness levels are declining.[1] Research on the effects of youth physical training and group attitudes is still in its infancy. This study conducted in-depth interviews with online physical training students, parents, teachers involved in the construction of online physical training, and sports practitioners through interview methods, documentation, and mathematical statistics. The results of the interviews were qualitatively coded using NVivo to summarize the attitudes of different subjects toward physical fitness training and the influencing factors, (1) students were basically satisfied with the teaching effect of online physical fitness training (2) parents thought the teaching effect of online physical fitness training was average (3) physical education teachers thought the effect of online physical fitness training was average (4) physical education practitioners thought the effect of online teaching was poor.

Scientific literature shows increased interest in the aged and the aging phenomenon. The Aging Attitudes Questionnaire - AAQ was validated for the Portuguese population to understand the importance of attitudes towards old age and their impact on the subjective well-being of the elderly. A sample of 400 subjects (from 18 to 93 years) answered a socio-demographic questionnaire, and the AAQ was composed of three subscales (psychosocial losses, physical change, and psychological growth). The CFA confirmed the tri-factorial structure with very good adjustment of the model to the data with the Cronbach alpha of the total scale scoring .84 and ranging from .65 to .77 for each factor. A total of 9 items were omitted both for poor factor loadings (<0.50. Notwithstanding, 3 items below the criteria were maintained, as they conceptually fit into the factor. Of the final 15 AAQp items, 5 belong to the Psychosocial Loss factor, 6 to Physical Change, and 4 to Psychosocial Growth. This tree factor model explained 50.1 % of the total variance. In conclusion, this study supports that AAQ has acceptable validity, confirming the composite reliability and the discriminant validity, but not the convergent validity. Through multi-group analysis, the invariance of the scale was confirmed. This validation is of pivotal importance once it allows measuring the attitudes towards aging, thus facilitating the promotion of wellbeing across the lifespan.

This study seeks to interrogate the degree to which lecturers and students of higher institutions in Nigeria perceive the role of lecturers doubling as parents under the term lecturenting, i.e., a coinage used to refer to a person who performs the dual roles of lecturing and parenting students of higher institutions. The study is based on Professor Obiora Ike’s ideology of communication of values, normally applicable to traditionally homes only. The research used a quantitative survey of 266 undergraduates and 109 lecturers, totaling 375 respondents from two purposively selected higher institutions in Nigeria, namely: Edo state University Uzairue and Federal Polytechnic Auchi, both in Etsako West Local Government Area of Edo state, Nigeria. A questionnaire with a set of nine semi-structured questions was used to obtain data from the students during the school semesters between July 15 and August 31, 2022. The study was based on the value theory. Findings indicate that lecturers frequently engage in lecturenting which helped improve the academic performance of students but shows that students do not want lecturenting on their behavioral change. The study concludes that the more lecturers engage in Lecturenting, the more positive impact it will have on their students. It is recommended that lecturers should engage in the practice of lecturenting as it helps to improve student academic performance and that students should perceive lecturenting as positive as well as be favorably disposed to it and approach their lecturers for counselling frequently.

Pakistan is under developing country and it has an unpredictable market nature of shareholder-investors observe the company’s performance. This research could help to companies in understanding financial behavior, attitude and investors’ satisfaction in stock trade. Financial behavior is comparatively new subject in Pakistan therefore; this study has examined the financial behavior and attitude of investors. The behavioral finance that has been attempted to understand the positive experiences influences investors’ financial behavior. This study has find out that investor satisfaction is strongest in influence of positive financial behavior of investor and trader in stock trading; positive experience and brokers suggestions are strengthens the investment decision of investors and increases behavior loyalty to prefer over competitor. The main purpose of research to determine the effect of financial behavior on investors’ attitude and behavioral loyalty and investors’ satisfaction to preference over competitor. The research framework links with experiences in stock trade for positive (negative) experiences, attitude and financial behavior is developed. The research framework is measured data from sample of Karachi and Karachi Stock Exchange; the data is analyzed in smart PLS based on PLS-SEM. This study focused on trading experience with company’s active investors and traders in banking industry in Pakistan. The future research could be research in other sectors with inter-related issue of investors and traders (brokers) in stock trade. This is the first study in this research area; this study will be determine the experiences with positive (negative) financial behavior, attitude, satisfaction and behavioral loyalty of investors and traders in stock trade. Therefore, adding in this area of study which will help understanding the investors and traders attitude, preference and financial behavior in financial market.

In the context of sustainable development, integrating the work aspect into health promotion systems is essential, ensuring that employees maintain a healthy balance between their professional and personal lives, which respects and amplifies the potential of every individual. Lately, there has been a noticeable shift of medical professionals from the public to the private sector. This trend paints a bleak picture, highlighting the vulnerabilities of a system teetering on the brink of failure, with significant impacts on patient care. Among the myriad reasons behind this shift, burnout stands out prominently. Medical professionals face increasing pressures due to understaffing, limited organizational support, and insufficient resources, leading to feelings of cynicism, exhaustion, and detachment from their roles. Utilizing the Maslach et al. questionnaire, we assessed the risk of burnout among physicians in public hospitals to identify and underscore preventive measures and improvements, correlating our findings with key aspects of organizational empowerment. Our research indicates that enhancing interpersonal relationships and resources—both within teams and between the organization and its physicians—is crucial for the revival of the healthcare system. This approach aims at improving the delivery of healthcare services and offering appropriate recognition to healthcare professionals, aligning with the principles of sustainable employment.

Purpose: This integrated review aims to identify and analyze the multifactorial contributors to the longevity of direct restorations, focusing on tooth-, patient-, and dentist-related factors. Materials and Methods: A literature search was performed using an electronic database, PubMed/Medline, Web of Science, and Scopus, between 1980 and 2024. Titles and abstracts of papers that evaluated aspects categorized into tooth-related, patient-related, and dentist-related factors influencing restoration failure were selected and screened. Full-text assessments were conducted, and the extracted data were compiled, summarized, and synthesized. The reference lists of the collected papers were also screened, and relevant citations were included in this review. Data were gathered from clinical and laboratorial studies, systematic reviews, and meta-analyses to provide a comprehensive understanding of restoration longevity. Results: Among the tooth-related factors, multiple-surface restorations, deep margins, tooth location, and tooth vitality significantly impact restoration survival. Patient-related factors such as medical conditions, risk predictors of caries, age, sex, parafunctional habits, smoking, periodontal health, number of restorations, and socioeconomic status all play crucial roles. Regarding dentist-related factors, the decision-making process, age, experience, and dentist manual dexterity are vital aspects. Furthermore, the technique used, including isolation methods for moisture control, as well as the type of dental practice (large group vs. small practice), notably influenced the restoration survival. Conclusions: The longevity of dental restorations is influenced by a complex interplay of tooth-related, patient-related, and dentist-related factors. Strategies to improve restoration outcomes should consider all these multifactorial contributors. Continuing professional education, diligent patient guidance on the factors that influence restoration survival, careful material selection and restorative technique, and tailored individual treatment are crucial factors to reduce failure rates and improve the lifespan of restorations.

Polycystic ovary syndrome (PCOS) is a common condition in reproductive-age women. Women with PCOS are at higher risk of pregnancy complications including gestational diabetes (GDM). The prevalence of PCOS and GDM varies according to the diagnostic criteria used. The mechanism for the occurrence of GDM in women with PCOS is still unclear. Materials &amp; Methods- A systematic search of the electronic database was done using keywords like PCOS, and GDM to include studies between April 2008 and March 2023 where uniform diagnostic criteria were used. Studies were excluded with high-risk of bias after the assessment of bias, and meta-analysis was done with relative risks and confidence intervals. Results &amp; Discussion-Out of 1896 search results, 95 were selected for full-text. The quality of the studies was scrutinized and a total of 28 studies were included as they fulfilled the inclusion criteria. The incidence of GDM in women with PCOS was found to be 10.55 % (2.9- 54.9%) from pooled data involving 1,280,245. The prevalence of PCOS in women diagnosed with GDM was found from pooled data of 36,351 women in retrospective studies to be 2.47% (1.5- 50.1%). Selection predominantly included cohort studies, most commonly from China. The meta-analysis reported the risk of GDM is higher in women with PCOS than in those without PCOS (HR: 1.59, 95% CI: 1.27–1.91, p &lt; 0.001). Family history of diabetes, ethnicity, pre-pregnancy BMI, insulin resistance, gestational weight gain, use of assisted reproductive techniques, and multifetal gestation were the risk factors for GDM in women with PCOS. Conclusion- The prevalence of GDM in patients with PCOS is high, but the causality is complex. The newer predictive models are promising in clarifying the causative relationships, yet use various parameters at different cut-offs. There is a need for the development of universally acceptable parameters for the early prediction of GDM in women with PCOS.

An important step towards COVID-19 pandemic control is adequate knowledge and adherence to mitigation measures, including vaccination. We assessed the level of COVID-19 knowledge, attitudes, and practices among residents from an urban informal settlement in the City of Nairobi (Kibera), and a rural community in western Kenya (Asembo). A cross-sectional survey was implemented from April to May 2021 among randomly selected adult residents from a population-based infectious diseases surveillance (PBIDS) cohort in Nairobi and Siaya Counties. Factors associated with the level of COVID-19 KAP, were assessed using multivariable regression methods. COVID-19 vaccine acceptance was 83.6% for the participants from Asembo and 59.8% in Kibera. The reasons cited for vaccine hesitancy in Kibera were safety concerns (34.0%), insufficient information available to decide (18.0%), and a lack of belief in the vaccine (21.0%), while the reasons in Asembo were safety concerns (55.0%), insufficient information to decide (26.0%) and lack of belief in the vaccine (11%). Our study findings suggest the need for continued public education to enhance COVID-19 knowledge, attitudes, and practices to ensure adherence to mitigation measures. Urban informal settlements require targeted messaging to improve vaccine awareness, acceptability, and uptake.