Hand hygiene is among the most important factors of infection control in healthcare settings. Healthcare workers are considered the primary source of hospital acquired infection. We assessed the current state of hand hygiene knowledge, perception and practice among the healthcare workers in Qassim, Saudi Arabia. In this cross-sectional study we used the hand hygiene knowledge and perception questionnaire developed by the World Health Organization. Knowledge and perceptions were classified into good (80 – 100%), moderate (60 – 79%) and poor (<60% score). Majority of the healthcare workers had moderate knowledge (57.8%) and perception (73.4%) of hand hygiene. Males were less likely to have moderate/good knowledge compared to females (OR: 0.52, p<.05). Private healthcare workers were less likely (OR: 0.33, p<0.01) to have moderate/good perception compared to the government healthcare workers. Healthcare workers who received training on hand hygiene were 3.2 times likely (p<.05) to have good/moderate perception and 3.8 times likely (p<0.05) to routinely use alcohol-based hand-rub than the ones without such training. Physicians were 4.9 times likely (p<0.05) to routinely use alcohol-based hand-rub than the technicians. Our research highlighted gaps on hand hygiene knowledge and perception and practice among healthcare workers in Qassim and importance of training in this regard.

Diabetes is a chronic disease that often causes progressive complications in the elderly. Along with the decline in cognitive function in the elderly, it causes dependence on disciplined management of diabetes mellitus. This dependence causes a very important mentoring role to be given. The purpose of this study is to provide knowledge, attitudes, and family skills to care for the elderly with diabetes mellitus at home through the empowerment of elderly cadres in Lampung. This research method is a quasi-experimental research with a control group design with a total of 64 elderly respondents and 64 families selected by simple random sampling technique. The assessment used an instrument for assessing family abilities that the researcher developed included aspects of knowledge, attitudes, and skills. The results of the dependent t-test analysis showed a significant increase in the knowledge and skills variable in the intervention group (0.000) but decreased in the attitude variable with p 0.198. Meanwhile, the increase in value also occurred in the attitude and skill variables in the control group. So that the results of the independent t-test only showed a significant difference in the attitude score (0.000) with the highest score in the control group. So that there is no significant increase in the ability of the family after the implementation of elderly cadres empowerment.

COVID-19 is an infectious disease spreading through human touch. This study explored the risk perception and knowledge towards COVID-19 infection among Bangladeshi adult participants. Two self-administered online surveys were administered at two different time points from 26-31 March 2020 (Early lockdown) and 11-16 May 2020 (Late lockdown) through social media on 1005 respondents (322 and 683 participants, respectively) during COVID-19 lockdown period in Bangladesh. Univariate and multiple linear regression models were used to examine factors associated with risk perception and knowledge towards COVID-19. The mean knowledge (8.4 vs. 8.1, P=0.022) and risk perception (11.2 vs. 10.6, P < 0.001) scores differ significantly between early and late lockdown. Compared to the early lockdown period, the scores for perceived risk of contracting COVID-19 decreased significantly while public knowledge about COVID-19 was lower but not statistically significant. Female participants who practiced high quarantine particularly those who did so at the public health order during the lockdown reported increased knowledge towards the spread of COVID-19 and perceived high risk of contracting COVID-19. Education intervention using awareness to increase public knowledge and perception towards COVID-19 in Bangladesh should target male participants who practiced low quarantine and are less worried about the spread of such novel coronavirus even as the physical distancing persists.

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.

Humanity, culture, societal development and language issues are mutually reinforcing much as they are intricately interwoven in a non-ceasing dynamic interrelationships within the matrix defined by language standardization or development, acquisition and use that mostly take up central place as unifying and propelling forces in language discourse. Within the confines of globalization which is neither homogenization nor convergence; but the beginning of drawing on the strength of indigenous capabilities to create knowledge ecology that would enliven socio-economic and scientific development of the world in far reaching interconnectivities and relationships across every clime, issues pertaining to language development, acquisition and use become imperative. It is against this background that this paper examines the development/standardization, acquisition and use of Esan language as one of several Nigerian indigenous languages to promote scientific and technological development through knowledge creation, preservation and dissemination. The obsession of using western model and epistemological outlook to achieve appropriate scientific and technological development to the utter neglect of home grown and culturally distilled efforts were also examined. In the light of the dare consequences and the harsh conditions globalization imposes on developing nations, this paper highlights standardization and use of indigenous languages in chatting appropriate trajectory for effectual developmental efforts in fast shrinking contemporary world.

Colorectal cancer (CRC) is a weighty cause of mortality worldwide, with growing incidence in the Middle East. Understanding the level of awareness about CRC screening among the Syrian pop-ulation is crucial public health interventions. A cross-sectional study was conducted from Sep-tember 22, 2023, to October 15, 2023, involving 928 participants from six major governorates in Syria. An online questionnaire containing socio-demographic, knowledge, and attitude sections was used to collect data. Descriptive statistics and chi-square tests were employed for data analysis using (SPSS) v28.0. The survey revealed a lack of awareness regarding CRC screening among the Syrian population, with only 499(53%) of the proportion demonstrating adequate knowledge about the disease and its screening methods. Significant associations were observed between the level of knowledge and socio-demographic factors including gender, work status, and economic status (p < 0.05). The findings emphasize the need for public health initiatives to enhance awareness and knowledge about CRC and its early screening methods in Syria. Education is essential for improving early detection and reducing the burden of colorectal cancer in the region. Efforts to increase public understanding of CRC screening are critical for reducing the incidence and mortality.

The principal function of science education is to introduce students to core scientific concepts and practices; nevertheless, it is now impossible, in such a complex world, to neglect the ethical issues involved. Placing school science in a broader context motivates students and equips them with valuable critical skills. A meaningful example was from palm oil production and pervasive use worldwide: plantations result in major deforestation occurring in species-rich tropical regions, making the palm oil issue global in scope and highly critical for several aspects related to sustainability. This paper reports a sequence of didactic activities starting from palm oil chemistry, gradually extended initially by a multidisciplinary approach, then by interdisciplinary-systemic maps and, ultimately, through a holistic vision - involving anthropological and cultural considerations about indigenous people of deforested territories. This progressive broadening corresponds to an ever-greater penetration into the personal sphere, a condition for a real ethical consciousness. The increased students’ awareness was tested by qualitative considerations, supporting the teaching dimension more than the learning one. Contrary to disciplinary contents, the emergence of moral feelings cannot be measured but only perceived. Therefore, chemistry provides key concepts essential for global competences development in order to deal with sustainability issues with an increased ethical awareness.

Background: Schistosomiasis is the third most important Neglected Tropical Disease, with more than 4 million South Africans being infected. Cases of re-infection with schistosomiasis after being treated using modern medication has opened ways to seeking alternative treatment modalities using medicinal plants. This study aims to explore and understand the way traditional healers diagnose schistosomiasis, the types of traditional medicines they use to treat it in communities with a high prevalence of infection, and to establish whether the unavailability of prescribed anti-schistosomal medicines leads to the use of traditional medicine. Methods: A qualitative exploratory study was conducted using a questionnaire from December 2022 to March 2023 in the iLembe District, KwaZulu-Natal Province, South Africa. In-depth individual interviews were carried out among traditional health practitioners (THPs) involved in managing female urogenital schistosomiasis (FUS). Recorded narrative data was transcribed verbatim, read through thoroughly and coded, and analysed using thematic or content analysis Results: Traditional Health Practitioners provide services to many women who did not want to be treated in the mainstream health care system for their FUS. The disease was perceived and understood the same way by most of the respondents, that being caused by use of fresh water. Various plants species, either alone or in combination, were used to manage bilharzia in women. Senecio serratuloides (Asteraceae) and Hypoxis hemerocallidea (Hypoxidaceae) were prominently used by THPs in FUS management. Conclusion: Traditional Health Practitioners are playing a key role in managing bilharzia in women in rural areas of the iLembe District, this study reported that THPs can diagnose schistosomiasis symptoms based on their knowledge and experience. Respondents indicated that modern conventional treatment was readily available and free in public sector healthcare facilities; however, they consulted patients suffering from FUS. Various traditional herbal medicines are reportedly used by THPs to manage bilharzia in women. Further studies are needed to investigate the views and experiences of clients regarding the success of the treatments used and why they seek care from THPs.

Type 2 diabetes (T2DM) presents an enormous global healthcare challenge, especially among rural communities due to limited access. To overcome this, many low- and middle-income countries are resorting to task shifting, using community health workers (CHWs) for diabetes management. However, its successful implementation depends on the practice behaviours and knowledge of these workers. This cross-sectional study from rural South India aimed to evaluate the proficiency of 275 CHWs in diabetes screening and management. A customized questionnaire, developed through experts and government was used to evaluate the practice behaviours and knowledge. Analytical methodologies consisted of descriptive statistics, logistic regression, and mosaic plots for comprehensive data interpretation. Results showed significant deficiencies of mean correct practice behaviours at 48 and 50% respectively. The identified gaps included diabetes diagnosis, HbA1c testing, diet, self-management, complications screening and risk assessment. In several areas, correct practice behaviour was reported by a relatively large number of CHWs despite incorrect answers to the related knowledge questions such as referral to the health centres, self-management and calculation of diabetes risk assessment. Addressing these deficiencies requires a thorough needs assessment and tailored training for improved diabetes management by CHWs. Training of CHWs, should not only identify prior knowledge and/or behaviour but also their interrelationship to help create a robust and flexible set of practice behaviours.

(1) Background: It is crucial to provide safe and knowledgeable healthcare practices because no research has been done on the knowledge and usage patterns of NSAIDs among the Hail population. (2) Method: Structured questionnaires were utilized to gather data from 399 individuals in Hail, Saudi Arabia for the cross-sectional analysis. The study assessed participants' knowledge regarding NSAIDs, patterns of use, reasons for use, and awareness of potential side effects. (3) Results: In the study, the gender distribution indicated that 170 participants (42.61%) were male, while 229 (57.39%) were female. Gender, occupation, and marital status showed non-significant associations (p>0.01), except for menstrual cycle and joint pain, where marital status displayed significant associations. Age had significant associations with muscle pain, menstrual cycle, and joint pain (p<0.01). Education and monthly income exhibited non-significant associations for all the reasons. The regression analysis demonstrated that gender played a significant role, with females having higher odds of knowledge (AOR = 1.75, 95% CI 1.10-2.88) than males. Age also had a notable impact, with individuals aged 50-59 (AOR = 0.21, 95% CI 0.07-0.66) exhibiting lower odds of knowledge. Education holding a Ph.D (AOR = 3.50, 95% CI 0.54-22.51) and business as an occupation (AOR = 6.12, 95% CI 1.10-35.10) had significantly higher odds of knowledge while housewives (AOR = 0.76, 95% CI 0.25-2.27) had lower odds. Meanwhile, >50% of the participants had knowledge of adverse events related to the use of NSAIDs while 25% had no knowledge. Moreover, 59 (25.766%) participants reported discomfort with the use of NSAIDs. In addition, 50% and >75% of participants’ considered NSAIDs can cause peptic ulcers and damage kidneys, respectively (4) Conclusions: This study shed light on the knowledge and patterns of NSAIDs use in the population of Hail, Saudi Arabia. While NSAIDs are commonly utilized for pain management, there exists a need for improved public awareness regarding potential risks and safe usage practices. Healthcare providers and policymakers should consider these insights to develop targeted educational initiatives and healthcare interventions to promote safe and informed NSAID utilization in the region.

Successful implementation of antibiotic stewardship programs (ASP) requires a well-structured approach involving all stakeholders. Despite embracing key responsibilities, nurses’ role remains poorly defined, preventing consistent engagement. We conducted a scoping survey to assess knowledge, attitude and perception of nurses towards nurse-led initial sepsis risk evaluation using the sepsis risk calculator (SRC) of newborns admitted to the mother-baby unit. Single-center, cross-sectional study. Study link was sent to all full-time nurses in mother-baby unit. Survey centered around knowledge of unit’s ASP and attitude and perception towards nurse-led initial sepsis risk evaluation. 89% response rate. 100% agreed that SRC reduced antibiotic use and 66% felt nurse-led sepsis risk evaluation will enhance nurse involvement, but this was offset by extra burden of work (66%) and low confidence in differentiating stable from clinically unstable infants (46%). Other facilitating factors included greater nurse/patient ratio (100%), targeted education (89%) and incorporation of the SRC into EMR (78%). Only 11% were willing to serve as champions for it. There was no significant correlation to age or experience however, greater number of fresh grads were interested in championing this effort. Our study identifies a need for strong foundation of knowledge and greater nurse/patient ratio as two main factors for improving nurse-led use of the SRC. Multi-site studies scoping barriers to nursing involvement for successful implementation of ASPs are necessary.

For women giving birth, every moment of delay in receiving skilled care significantly increases the risks of stillbirth, neonatal and maternal death. More than half of all births in developing countries including South Africa, take place outside a health facility and without skilled birth attendants. This has therefore, made it difficult to achieve the Sustainable Development Goals of global reduction in maternal mortality, which is a key health challenge globally, especially in developing countries and sub-Saharan Africa in particular. The aim of this study was to explore and describe the views of pregnant women regarding facility-based delivery. Focus group discussions were used to gather information from the pregnant women. Information was collected from six groups of pregnant women who had delivered babies at the antenatal care facilities in the past years. Results showed several factors associated with the failure to use institutional delivery service, such as long distance from the health care facility, lack of transport, lack of transport fare, shortages of skilled staff, failure to disclose pregnancy, cultural and religious beliefs, and staff attitudes.

The aims of this study were to assess oral health knowledge, attitudes, and practices among orthodontic patients between the ages of 15 and 17 years old compared to adolescents without orthodontic treatment. This cross-sectional study included 392 adolescents drawn from various French teaching hospitals. A closed-ended questionnaire was used to collect data. Adolescents undergoing orthodontic treatment had a higher knowledge of oral health than adolescents without orthodontic treatment. The majority of adolescents for both groups (69%) claimed to brush their teeth twice a day. Regarding complimentary dental material, 81.9% of adolescents without orthodontic treatment never used an interdental brush and 78.8% never used dental floss. For those undergoing orthodontic treatment, 48.5% never used interdental brush. Only 4% of adolescents without and 3% of adolescents with orthodontic treatment never consumed fizzy drinks, 4.9% and 3% never consumed sweets, 4% and 8.4% never ate fast-food. Adolescents without treatment consumed more sodas (p=0.04) and more fast food (p=0.03). Adolescents had insufficient knowledge of oral health. Health education programmes should be implemented to improve adolescents' knowledge and individual oral prophylaxis with interdental brushes.

There is a need to assess the knowledge of healthcare providers on the use of maternal analgesics during lactation, while a valid instrument is not yet available. This study aimed to develop a valid and reliable questionnaire on the knowledge of analgesics (acetaminophen, ibuprofen, aspirin, tramadol, codeine, oxycodone) during lactation, using a prospective, stepwise approach. To generate a pool of item subgroups, literature was assessed as first step. This preliminary version was subsequently reviewed in two focus groups [midwives (n=4), pediatric nurses (n=6)], followed by an expert panel (n=7, 2 rounds) to confirm content validity [item-level and scale content validity]. This resulted in a instrument consisting of 33 questions, and 5 clincial case descriptions specific for both disciplines. Based on known-groups validity between midwives and pediatric nurses (assuming an a priori difference related to their curricula), high construct validity was subsequently demonstrated in a pilot e-survey (86 midwives, 73 pediatric nurses). We therefore conclude that an instrument to assess knowledge on lactation-related exposure to analgesics was generated, that can be further developed and validated. Furthermore, pilot findings suggest suboptimal knowledge for both professions, so that adaptations in their curricula and postgraduate training are warranted.

This study aimed to understand the status of knowledge, attitudes, and practices (KAP) of norovirus infection among primary and junior middle school students in Chizhou City, explore its influencing factors. A multistage stratified random sampling method was used to randomly select 1200 students from 8 primary and junior middle schools for the effective questionnaire survey in Chizhou City. A multivariate logistic regression analysis was used to analyse the possible influencing factors. Of 1176 participants, the average knowledge score of norovirus infection was (9.8 ± 3.6), and the scoring rate was 65.3%. The average attitude score was (11.6 ± 1.2), and the scoring rate was 96.3%. The average practice score was (10.4 ± 1.5), and the scoring rate was 86.9%. The difference in the average scoring rate among the three was statistically significant (P < 0.001). The four independent variables of county, education level, sex and age group statistically correlated with the knowledge score. Primary and junior middle school students in Chizhou City had a good attitude and practice compliance in the prevention and control of norovirus infection; however, their professional knowledge still needed further improvement.

The aim of this paper is to study the main areas in which Artificial Intelligence (AI) will impact the field of project management that relates to cost, risk and scheduling. The research model was based on a previous study of the ten project management knowledge areas presented in the PMI’s PMBOK 6th edition where project schedule-, cost- and risk management knowledge areas were identified as being the ones most likely to be affected by the development of AI. A group of experts that participated in the study agreed that AI will affect the project management profession in the future. Different elements of the three knowledge areas were considered to be affected more by AI than others. The schedule baseline is the element believed to be affected the most out of the project schedule management elements. For project cost management, the estimation of resource cost is believed to be affected the most. In the case of project risk management, the application of AI will have the strongest impact on the probability and impact format.

The mantis shrimp Rissoides pallidus (Giesbrecht, 1910) is among the rarely reported crustacean species in the Central Mediterranean Sea. In December 2020, during a trawl survey off Mazara del Vallo harbour (Strait of Sicily), two specimens of R. pallidus were captured on coastal detritus and coastal terrigenous mud bottoms at about 132 and 152 m depths. This current note, therefore, updates the existing knowledge of R. pallidus in the Strait of Sicily. Additional information specific to biometrics, bottom types, depth preference, habitats, and geographic distribution of this crusta-cean species are provided.

The Covid-19 pandemic and the subsequent implementation of lockdown measures have significantly impacted global electricity consumption, necessitating accurate energy consumption forecasts for optimal energy generation and distribution during a pandemic. In this study, we propose a new forecasting model called the Multivariate Multilayered LSTM with Covid-19 case injection ($\proposedModel$) for improved energy forecast during the next occurrence of a similar pandemic. We utilize data from commercial buildings in Melbourne, Australia during the Covid-19 pandemic to predict energy consumption and evaluate the model's performance against commonly used methods such as LSTM, Bi-LSTM, Linear Regression, Support Vector Machine and the previously published work of Multilayered LSTM (M-LSTM). The proposed forecasting model was analyzed using the following metrics of mean percent absolute error (MPAE), normalized root mean square error (NRMSE), and $R^2$ score values. The model $\proposedModel$ demonstrates superior performance, achieving the lowest MPAE values of 0.061, 0.093, and 0.158 for data sets from 3 different buildings, respectively. Our results highlight the improved precision and accuracy of the model, providing valuable information for energy management and decision-making during the challenges posed by the occurrence of a pandemic like Covid-19 in the future.

Education for Sustainable Development (ESD) is crucial in higher education, providing students with the knowledge, skills, and values necessary for a sustainable future. ESD seeks a holistic understanding of sustainability and promotes critical thinking and innovative approaches. Specifically, ESD is very important to address in engineering careers, as engineers will need to establish sustainable solutions in the future. For this reason, the integration of sustainability into university curricula has been studied for some time. In this way, this research analyses the perceptions (attitudes towards teachers; knowledge about sustainable development; environmental, economic and social attitudes; sustainable behaviours) that engineering students in the Dominican Republic have towards sustainable development. 626 questionnaires completed by engineering students were obtained. Subsequently, the data was analysed in SPSS and PLS-SEM. The results showed that attitudes towards teachers have an impact on engineering students' knowledge of sustainable development. In turn, the results also showed that knowledge about sustainable development influences both attitudes (economic, social and environmental) and sustainable behaviours of engineering students. Contrary to other research, this study suggested that economic attitudes are not identified as an antecedent of sustainable behaviours among engineering students. From these results, implications and future lines of research are generated.

Social networking opened up new avenues for learning and knowledge sharing. Due to its document exchange, virtual communication, and knowledge production capabilities, social media is a helpful tool for learning and teaching. The research embraces multiple goals. First, this study examines Bangladeshi university students' social value, communication and collaboration, trust, and perceived benefits of knowledge sharing through social media in academic advancement. The second goal is to examine how families and technology support mediates those aspects of social media knowledge sharing with student academic development. We used Technology Acceptance Model and Social Exchange Theory as examples of how social media sharing of knowledge impacts academic progress in Bangladeshi university students through family and technological support. PLS-SEM was used using survey data from 737 Bangladeshi students to test the model. Social value, communication and collaboration, trust, and perceived benefits of sharing knowledge through social media significantly enhance Bangladeshi students' academic growth. In the case of mediation, family and technological support mediates the relationship between communication and collaboration, trust, perceived benefits and academic development. However, there is no mediation with the social value of knowledge sharing in social media with student’s academic development. The article concludes with implications, limitations, and future research.

Forestry workers play a crucial role in implementing forest management programs, but their outdoor work exposes them to rising temperatures caused by global climate change, which poses potential health risks related to heat. This study focuses on Indonesian forestry workers and examines the relationship between their knowledge of heat-related issues, risk perception, and precautionary behavior in dealing with increasing workplace heat exposure. Developing effective precautionary behavior is essential for preventing heat-related health disorders and promoting health protection programs. To facilitate a comprehensive comparison of the three variables, interviews were conducted with two groups of outdoor workers, comprising 210 forestry workers and 215 paddy farmers. The findings indicate that increasing knowledge about heat-related issues promotes precautionary behavior, and risk perception acts as a mediator between knowledge and behavior. Additionally, the study highlights that the emotion of "dread" intensifies perceived risk and predicts positive behavior change. To enhance heat-related knowledge, exploring the potential use of a "fear" tone is important. In conclusion, comprehensive strategies need to be implemented to promote precautionary behavior among vulnerable forestry workers, particularly manual laborers.

Despite the strong links between sleep, circadian rhythms, and mental health, sleep education has been neglected in mental healthcare provider training programs. The current pilot study examined the potential efficacy and acceptability of a sleep education workshop for trainee psychologists, called the Sleep Psychology Workshop. Eleven students completing their Master of Psychology degrees (90% female, 24.4 ± 1.6 years old) attended the Sleep Psychology Workshop as part of their Health Psychology course, delivered as three, two-hour lectures (total six hours). Trainees’ sleep psychology knowledge quiz scores (% correct) demonstrated significant improvement from pre- (M = 60%, SD = .09) to post-workshop (M = 79%, SD = .08), t (6) = -5.18, p = .002. Trainees also reported increased self-efficacy to use common sleep-related assessment instruments and empirically supported interventions to manage sleep and circadian rhythm disturbances, along with increased confidence to manage insomnia disorder in clinical practice (all p<.02). Trainees also endorsed the workshop as an acceptable sleep education program for trainee psychologists via a post-workshop feedback survey, focus group, and six-month follow-up survey. This pilot study provides preliminary evidence for the Sleep Psychology Workshop as an effective and acceptable sleep education program for trainee psychologists.

In ethnobotany, the availability hypothesis predicts that plants that are abundant and easily accessible to people are more likely to be medicinal than not. By protecting species diversity away from people, protected areas (PAs) may act as a limiting factor to a sustainable development of traditional knowledge concerning medicinal uses, and in so doing, PAs provide opportunity to prioritize ex-situ conservation for species that are PAs restricted. In this scenario, ex-situ conservation becomes the only chance for people to develop traditional knowledge on plants which otherwise wouldn’t be documented as traditionally useful to people. To test these expectations, we used data collected for almost 20 years of fieldworks on plant medicinal uses and their abundance inside and outside the Kruger National Park (KNP), South Africa. We fitted four different scenarios of structural equation models (SEMs) to the data collected. We found that total plant abundance (abundance outside + inside KNP) is a significant positive predictor of medicinal status, and so is abundance outside KNP, thus supporting the availability hypothesis. However, not only abundance inside KNP is not a direct significant correlate of medicinal status, but also the relationship between both is negative. The lack of predictive power of inside-abundance is most likely because some species are exclusively found inside KNP, and local communities do not have access to them. It also shows that the positive and direct correlation of total abundance with medicinal status is driven by outside-abundance. In addition, the negative relationships between inside abundance and medicinal status implies that abundant plants inside KNP tend to be not-medicinal, further providing evidence that PAs hinder the development of medicinal knowledge. Furthermore, when inside and outside abundance were included simultaneously in a model as two distinct variables, inside abundance was never a direct significant predictor of medicinal status, but it was so, via an indirect path mediated by outside abundance. This suggests that outside abundance is the key variable driving the development of medicinal plant knowledge. Cumulatively, our findings suggest that anything that promotes the growth of PA-restricted plants beyond the natural realized niches of these plants (ex-situ conservation) such as in botanical gardens, private gardens, in agroforestry systems, etc., is to be promoted so that people-plant interactions may continue for the benefits of ethnobotanical knowledge development.

Hospital-acquired infections (HAIs) contribute to increased length of hospital stay, high mortality and higher health-care costs. Prevention and control of HAIs is a critical public health concern. We conducted a cross-sectional survey of 213 hospital health-care workers in Qassim, Saudi Arabia. We assessed Knowledge, Attitude and Practice (KAP) of standard infection control precautions using a structured questionnaire. Predictors of KAP were investigated using multivaraible logistic regression analyses and independent sample t tests. Prevalence of good (≥80% correct response) knowledge, attitude and practice were 67.6%, 61.5% and 73.2%, respectively. Predictors of good knowledge included age over 34 years (adjusted odds ratio: 30.5, p<0.001), and receiving training (13.3, p<0.001). Predictor of positive attitude was having >6 years of experience (5.5, p<0.001). While, the predictors of good practice were having >6 years of experience (2.9, p<0.01), previous exposure to HAIs (2.5, p<0.05) and training (3.5, p<0.01). However, being female (0.22, p<0.001) and older (>34 years) (0.34, p<0.01) were negatively associated with knowledge. Results indicate that older academic programs might not have adequately covered infection crontrol. Arranging training for HCWs might be useful in improving their knowledge of standard infection control precautions and is also expected to facilitate positive attitude and practice.

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.

Antibiotic resistance (ABR) is an emerging global threat to public health. Substantial evidence has indicated that community pharmacists (CPs) can play a critical role in managing the ever-increasing threat of antibiotic resistance. The study aimed to determine the knowledge, attitude, and practices of CPs (n=180) towards antibiotics and antibiotic resistance as well as to improve the rational use of antibiotics. Two phases of mixed methods (quantitative and qualitative) online study were conducted in Pakistan from August 2019 to March 2020 by using validated questionnaires and semi-structured interview data. Different statistical methods were used to tabulate the quantitative data whereas inductive thematic analysis was conducted to categorize themes from the qualitative data and draw conclusions. Approximately 64.4% were male (mean: 29-33 years old). Overall, CPs had good knowledge of and were familiar with superbugs and their roles in ABR (65.6%, Median=1, IQR=1) although they were poor in differentiating some antibiotic groups with their respective ABR patterns (31.1%, Median=1, IQR=1). Most CPs have a positive attitude towards antibiotics with most (90.0%) having identified ABR as a critical issue in public health (Median=1, IQR=0). Overall, CPs' practices towards antibiotics were reasonable where they tend to educate patients about the rational use of antibiotics (52.8%, Median=1, IQR=1). Two main themes (antibiotics and counseling of patients) were related to self-medication with while educational interventions are the sub-theme. ABR is multifactorial where the subthemes related to budget, time constraints incompetent staff, the absence of CPs, the lack of training, enforcement of laws and regulations are the need of the hour in Pakistan. Effective antibiotic stewardship programs, patient education, and awareness campaigns about antibiotics and ABR along with training of the CPs are important factors that have to be addressed in a timely manner.

This research assessed the level of peer influences among the students of Ebonyi State University, Abakaliki and the existing policy framework in the University to control its negative impact. Objectives: To assess the knowledge, attitude and practice of peer pressure influence control among the students of the institution. Methodology: We used a cross-sectional design, a structured questionnaire of a five-point Likert scale as a veritable instrument for collecting the data from 30 student respondents. The questionnaire was made up of four key sections comprising student’s demographic parameters, knowledge, attitude and practice of students on the subject matter. Data collected was analyzed in a table of descriptive statistics to determine the total, range, mean and median, which were used to ascertain students’ level of knowledge, attitude, practice and countermeasures to overcome negative peer influences emanating from their peers. Results: The mean value outcome of knowledge of students fall between 2.7 to 3.3, the mean value for attitude of student falls between 2.4 to 3.6, while the practice of students falls between mean value 2.7 and 3.2. Most of these outcomes represents poor or weak weight factor which requires several levels of interventions. Conclusion: This study highlights the overriding importance of peer pressure management among the students of Ebonyi State University, Abakaliki to create a safe academic environment and guarantee higher academic performances. This research recommended that the University management should commission research on peer pressure among students, the causes, manifestations and possible remedies to enable them to develop a comprehensive framework for the University.

Arboviruses such as yellow fever virus (YFV), dengue virus (DENV), and chikungunya virus (CHIKV) presenting wide global dissemination and the pathogenic profile developed in infected individuals, which develop from nonspecific clinical conditions to severe forms, characterized by the promotion of significant lesions in different organs of the harborer, culminating in multiple organ dysfunction. To characterize, quantify, and compare the patterns of histopathological alterations in human liver samples from patients with yellow fever (YF), dengue fever (DF), and chikungunya fever (CF). Analytical cross-sectional study by histopathological analysis with 70 samples of liver patients, collected from 2000 to 2017, with confirmed laboratory diagnosis who died due to infection and complications by the YF, DF, and CF. Of the histopathological findings in human liver samples there was a significant difference between the control and infection groups, with a predominance of alterations in the midzonal area of the three cases analyzed, among the arboviruses studied, the hepatic involvement in cases of YF showed greater intensity of histopathological changes. Among the alterations evaluated, cell swelling, microvesicular steatosis and apoptosis were classified as degree of tissue damage from severe to very severe. The pathological abnormalities associated with infection by YFV, DENV, and CHIKV showed predominance of changes in the midzonal area. We also noted that in among of the arboviruses studied, liver involvement in cases of YFV infection was more intense.

The onset of embryonic heart beating may be regarded as the defining feature for the beginning of personal human life. Clarifying the timing of the 1^st human heartbeat, therefore, has religious, philosophical, ethical, and medicolegal implications. This article reviews the historical and contemporary sources of knowledge on the beginning of human heart activity. Special attention is given to the problem of the determination of the true age of human embryos and to the problem of visualization of the human embryonic heart activity. It is shown that historical and current textbook statements about the onset of blood circulation in man do not derive from observations on living human embryos but derive from the extrapolation of observations on animal embryos to the human species. This fact does not preclude the existence of documented observations on human embryonic heart activity: Modern diagnostic (ultrasound) and therapeutic (IVF) procedures facilitate the visualization of early embryonic heart activity in precisely dated pregnancies. Such studies showed that the human heart started its pumping action during the 4^th post-fertilization week. A small number of direct observations on the heart activity of aborted human embryos were reported since the 19^th century but did not receive much recognition by embryologists.

Background: Health-related knowledge is among the essential factors to enable women to be aware of their rights to seek health services. However, little is known about knowledge of safe abortion care services among women of reproductive age in Ethiopia. The main purpose of the study was to assess knowledge of safe abortion care services and associated factors among women of reproductive age in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted from April-June 2019 among 432 respondents. Bivariate statistics including correlation coefficients, student t-test, one-way analysis of variance, and linear regressions, and multiple linear regression analyses were used. A significant statistical test was determined at a 95% confidence interval and p-value <0.05. Results: About 65.5% had heard about safe abortion care services; media being the main source of information for 79.5%. The finding from an independent-sample t-test shows that the place where the respondents grew up (p< 0.006), history of past miscarriage, and previous information of abortion care service were significantly associated with the knowledge about safe abortion care services (p< 0.001). Conclusions: Women without prior health experiences and those with rural origin could be targeted for reproductive health information interventions including safe abortion care provision.

The coronavirus disease (COVID-19), an emerging viral infection, is impacting the social, economic and political patterns of the world. To contain the spread of this pandemic, Nigeria like many countries globally, has imposed drastic preventive measures such as physical distancing and lockdown/curfew. This study assessed the knowledge, attitude and perception (KAP) about COVID-19 among members of staff of a university community in southwest, Nigeria. A cross-sectional survey using an anonymous, self-designed, online KAP questionnaire was conducted from April 18 to May 31, 2020. Purposive and chain referral sampling techniques were used to recruit respondents from the teaching and non-teaching categories of the university. The KAP questionnaire consisted of ten knowledge questions regarding the identification of clinical characteristics, transmission and prevention of COVID-19. The questions on attitude (15) and perception (10) assessed respondents on adherence to policies and their views on government efforts to contain the spread of the infection respectively. A total of 125 (teaching) and 102 (non-teaching) staff responded. The respondents had scientific (78.8 %) and non-scientific (28.2 %) work background. Approximately 59.1 % of the respondents were males. The mean knowledge and positive attitude levels were 70.8 % (SD ± 9.6 %) and 83.1 % (SD ± 13.07 %) respectively. Significant differences in the knowledge mean scores were observed for demographic categories such as educational qualification (p = 0.0006), staff work category (p = <0.0001), work background (p = <0.0001), and type of lockdown (p = 0.0271). Most of the respondents (85.3 %) opined that COVID-19 was a biological weapon and viewed the lockdown as necessary (81.5 %). However, they thought that the Nigerian government was not doing enough to mitigate COVID-19 spread. The perception of COVID-19 in the university community bear implications across public health initiatives, compliance with precautionary behaviour and bilateral relations with foreign nations.

Pre-Western contact Hawaiʻi stands as a quintessential sustainability example of a large human population that practiced intensive agriculture, yet minimally displaced native habitats that comprised the foundation of its vitality. An explicit geospatial footprint of human-transformed areas across the pre-contact Hawaiian archipelago comprised less than 15% of total land area, yet provided 100% of human needs, supporting a thriving Polynesian society. A post-contact history of disruption of traditional Hawaiian land-use and its supplanting by Western land tenure and agriculture based on ranching, sugarcane, and pineapple, culminated in a landscape, in which over 50% of native habitats have been lost, while self-sufficiency has plummeted to 15% or less. Recapturing the ʻāina momona (productive lands) of ancient times can be accomplished through study of pre-contact agriculture, assessment of biological and ecological changes imposed on Hawaiian social-ecological systems, and conscious planned efforts to increase self-sufficiency and reduce importation. Impediments include the current tourism-based economy, competition from habitat-modifying introduced species, a suite of agricultural pests severely limiting traditional agriculture, and changes in climate rendering some pre-contact agricultural centers suboptimal. Modified agricultural methods will be required to counteract these limitations, and diversified agriculture to broaden the production base, without contributing to further degradation of native habitats.

The objective of the study was to investigate the gap between data and evidence-based decisions among healthcare professionals considering the enormous amount of individual and aggregate data collected. Our study assessed the capacity, skills, and knowledge of the Ministry of Health leadership staff to understand data management, analysis, utilization, and dissemination. Three key components were assessed: 1) Knowledge through true/false questions, 2) Level of Skill (and Competency) using a Likert scale, and 3) Understanding of Key Concepts and Tools based on a Likert scale. The 183 study respondents were diverse healthcare professionals from Kenya, Tanzania, and Rwanda. Majority of respondents had not received any training on data management, analysis, interpretation, and utilization techniques, further there was a significant difference between those who had received training versus those who had not(p=0.005). The respondents were competent in work-related experiences but lacked skills and knowledge on: data concepts and tools, study designs, and types of data analysis. These findings explain the gap between data management, analysis, utilization, and dissemination among health professional’s cadre. To enhance service delivery and optimal provision of health care, it is imperative to have all health care professionals receive a well-designed training on data management, analysis, interpretation, and utilization.

As the automotive industry undergoes a phase of rapid transformation driven by technological advancements, the integration of driving simulators stands out as an important tool for research and development. The usage of such simulators offers a controlled environment for studying driver behavior; the alignment of data, however, remains a complex aspect that warrants a thorough investigation. This research investigates driver state classification using a dataset obtained from real-road and simulated conditions, recorded through JINS MEME ES_R smart glasses. The data set encompasses electrooculography signals, with a focus on standardizing and processing data for subsequent analysis. For this purpose, we used a recurrent neural network model, which yielded a high accuracy on the testing dataset (86.5%). The findings of this study indicate that the proposed methodology could be used in real scenarios and that it could be used for the development of intelligent transportation systems and driver monitoring technology.

Keywords: knowledge; behaviour; ergonomics; posture; musculoskeletal; pain; university; students; survey.

In children, the global burden of vaccines-preventable diseases (VPDs) and deaths can be averted by adopting timely immunization practices. Administering immunization to a child within 28 or 30 days of the designated immunization date is referred to as timely immunization. Delaying or missing vaccinations puts children, especially those in urban slums, at a higher risk of getting sick or dying from different diseases. This study was designed to examine the immunization practices and to measure the determinants of immunization non-compliance in children living in urban slums of Karachi, Pakistan. A community-based retrospective cohort was carried out from October-2018- to August-2019 in six different urban slums of Karachi. Immunization status of children aged less than 2 years was assessed by reviewing their vaccination card. Children from each slum were approached via 30x7 multistage stratified cluster sampling technique. Data of each child was analysed descriptively and inferentially using a statistical software, i.e., Jamovi version 1.2.25. The practice of timely immunization was observed in approximately half of children, i.e., 49.8%(n=457). The immunization rate at birth (first-visit) was 100%, of which 95.7% were timely immunized. Following the second immunization visit, a sharp decline in the immunization rate, including timely immunization rate was observed. Lack of knowledge, childhood illnesses, lack of interest, and vaccines unavailability were the main reasons of immunization non-compliance. However, an increase in paternal education was significantly associated to decrease the odds of immunization non-compliance. A decrease in the practice of timely immunization is replaced by either invalid and/or delayed and/or missed immunization practices. Thus, timely immunization is crucial for preventing the infectious diseases and promoting the health of a child.

Rural women in developing nations are especially vulnerable to higher health risks due to environmental pollution exposure and are more likely to experience poorer health outcomes. Using data from the 2013 China General Social Survey CGSS2013, this study empirically examined the relationship among environmental knowledge (EK), pollution, health investment, and health status of women residing in rural regions in China. We employed a nationally representative sample of 1,930 female individuals for our analysis. Our results showed that the level of EK for women in rural China significantly impacted their self-reported physical and mental health. In order to account for potential endogeneity due to mutual causality, this study employed television usage and network usage as two instrument variables (IVs) of EK. We performed an IV-probit method to correct the estimated errors due to endogeneity. Additionally, to assess the reliability and robustness of our results, we re-estimated our model by replacing health status with the variable Body Mass Index (BMI). The results were consistent, providing evidence of robustness. Additionally, we examined the relationship between health investment (holding and purchasing a public health insurance policy, engaging in frequent physical activity, and acquiring commercial insurance) and health status. Our results indicate that the level of EK had no significant impact on participating in the new rural cooperative medical system. However, the preference of purchasing commercial insurance was positively impacted by EK, though it does not have a direct impact on the health condition. Conversely, an increase in EK and pollution is associated with a greater likelihood of engaging in physical exercise, which could, in turn, improve overall mental health.

Background and Objectives The socioeconomics working group of the European ME/CFS Research Network (EUROMENE) has conducted a review of the literature pertaining to GPs’ knowledge and understanding of ME/CFS. Materials and Methods A MEDLINE search was carried out. The papers identified were reviewed following the Synthesis Without Meta-analysis (SWiM) methodology, and were classified according to the focus of the enquiry (patients, GPs, database and medical record studies, evaluation of a training programme, and overview papers), and whether they were quantitative or qualitative in nature. Results 33 papers were identified in the MEDLINE search. The quantitative surveys of GPs demonstrated that a third to a half of all GPs did not accept ME/CFS as a genuine clinical entity and, even when they did, they lacked confidence in diagnosing or managing it. Patient surveys indicated that a similar proportion of patients was dissatisfied with the primary medical care they had received. These findings were consistent with the findings of the qualitative studies that were examined, and have changed little over several decades. Conclusions Lack of knowledge and understanding of ME/CFS among GPs is widespread, and the resultant diagnostic delays constitute a risk factor for severe and prolonged disease. Failure to diagnose ME/CFS renders problematic attempts to determine its prevalence, and hence its economic impact.

Based upon 30-years of research by the author a new approach to hospital bed planning and international benchmarking is proposed. The number of hospital beds per 1000 population is commonly used to compare international bed numbers. This method is flawed because it does not consider population age structure or the effect of nearness-to-death on hospital utilization. Deaths are also serving as a proxy for wider bed demand arising from undetected outbreaks of 3000 species of human pathogens. To remedy this problem a new approach to bed modelling has been developed which plots beds per 1000 deaths against deaths per 1000 population. Lines of equivalence can be drawn on the plot to delineate countries with higher or lower bed supply. This method is extended to attempt to define the optimum region for bed supply in an effective health care system. England is used as an example of a health system descending into operational chaos due to too few beds and manpower. The former Soviet bloc countries represent a health system overly dependent on hospital beds. Several countries also show evidence for over-utilization of hospital beds. The new method is used to define a potential range for bed supply and manpower where the current most effective health systems currently reside. The method is applied to total curative beds, medical beds, psychiatric beds, critical care, geriatric care, etc., and can also be used to compare different types of healthcare staff, i.e., nurses, physicians, surgeons. Issues surrounding the optimum hospital size and the optimum average occupancy will also be discussed. The role of poor policy in the English NHS is used to show how the NHS has been led into a bed crisis. The method is also extended beyond international benchmarking to illustrate how it can be applied at a local or regional level in the process of long-term bed planning. Issues regarding the volatility in hospital admissions are also addressed to explain the need for surge capacity and why an adequate average bed occupancy margin is required for an optimally functioning hospital.

Hepatitis B virus (HBV) is a major global health challenge. Emerging evidence suggests that poor knowledge and stigma are impacting HBV control efforts in sub-Saharan Africa (SSA), however their role is not well understood. We conducted a cross-sectional study of adults aged ≥ 18 years in a community and pharmacy setting in Freetown, Sierra Leone. A structured questionnaire was used to assess knowledge, stigmatizing attitudes, and health-seeking behaviors regarding HBV. Logistic regression was used to identify predictors of HBV knowledge and related stigma. A total of 306 adult participants were enrolled (50.7% male, 7.5% HBV positive and 11.7% vaccinated). Overall, 52.2% had comprehensive HBV knowledge and 49.3% expressed a stigmatizing attitude towards people with HBV. Notwithstanding, 72.2% stated they would receive the HBV vaccine if offered, 80.4% would take anti-HBV medication and 78.8% would be willing to attend clinic regularly. Comprehensive HBV knowledge was associated with HBV positive status (aOR 4.41; p = 0.029) and being vaccinated against HBV (aOR 3.30; p = 0.034). HBV-related stigma was associated with secondary or higher level of education (aOR 2.36; p &lt; 0.001), good HBV knowledge (aOR 2.05; p = 0.006) and pharmacy setting (aOR 1.74, p = 0.037). These findings suggest that education and stigma reduction may benefit HBV elimination efforts in SSA.

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.

This article uses machine learning analysis of wearable sensor data to explore the topic of driver differentiation. The study focuses on using detailed analyzes of data collected from wearable sensors to identify patterns that differentiate skilled drivers from inexperienced ones. On a predetermined driving route, participants experienced a variety of driving conditions, including parking, navigating cities, driving on highways and driving through residential neighborhoods. The gathered data was analyzed using machine learning techniques, yielding a classification accuracy of 94% overall. The results highlight important differences in sensor data between inexperienced and experienced drivers, providing insight into possible uses for improving safety protocols, driver education, and personalized feedback systems. The article fosters improvements in traffic safety and driver education by offering insightful information on the link between driver behavior analysis and machine learning.

Recent studies have demonstrated a relationship between poor vitamin D status and respiratory infections and diarrhea among young children. Acute lower respiratory infections (ALRI) and diarrhea are among the two most important causes of death in under-5 children. In this analysis, we examine the extent to which vitamin-D deficiency (<10 ng/ml) predicts these outcomes using data from a randomized controlled trial (RCT) of daily folic acid and/ or vitamin B12 supplementation for six months in 6 to 30 months old children conducted in Delhi, India. Of the 960 subjects who had vitamin-D concentrations measured, 331(34.5%) were vitamin-D deficient. We found, after controlling for relevant potential confounders (age, sex, breastfeeding status, wasting, stunting, underweight, anemia status at base line and season), the risk of ALRI was significantly higher among vitamin-D deficient (OR 1.26; 95% CI: 1.03 to 1.55) compared to vitamin-D-replete children in the six months follow-up period. Vitamin-D status was not significantly associated with episodes of diarrhea and clinical pneumonia. The extent of causal relationship of vitamin-D status and ALRI needs to be explored in further studies.

The West Pomeranian Anti-Crisis Package was an effective tool of the Voivodeship Executive Board of West Pomeranian self-government, which was used to combat and counteract and counteract the social and economic effects of the COVID-19 pandemic. The Anti-Crisis Package was prepared with a view to undertaking systemic, but also point-based measures in order to save and protect regional health care, entrepreneurs, the labour market, but also to use the existing social capital of non-governmental organizations involved in measures reducing the effects of the COVID-19 pandemic. The West Pomeranian Anti-Crisis Package, as evidenced not only by the financial outlays incurred, but also by the outcome of implementing measures achieved in 2020 and their continuation in 2021.

Background: This study assessed the nature of healthcare services offered in the David Umahi Federal University of Health Sciences health clinic and students' disposition to access the facility. Objectives: To assess the knowledge, attitude and practice of students in accessing healthcare services in the David Umahi Federal University of Health Sciences health clinic.Methods: Used cross-sectional design, a structured questionnaire of a five-point Likert scale as a veritable instrument for collecting the data from 50 student respondents. The questionnaire is made up of four key sections comprising student’s demographic parameters, knowledge, attitude and practice of both students and the clinic staff. Data collected was analyzed in a table of descriptive statistics to determine the total, range, mean and median, which were used to ascertain students’ utilization/accessibility disposition, perception of barriers to accessing healthcare service and overall viability of the clinic.Results: The mean value outcome of knowledge of students falls between 3.1 and 3.9, the mean value for attitude of students falls between 2.5 to 3.4 and 4.0, while the practice of students falls between mean values 2.6 and 3.1. Most of these outcomes represent poor or weak weight factor which requires several levels of intervention.Conclusion: This study highlights the overriding importance of the university healthcare clinic in maintaining a healthy study season among students of David Umahi Federal University of Health Sciences and their health-seeking behaviour. This helps to promote health, attract higher intakes and retain them in the institution till graduation.

Background: Nurses are essential members of the healthcare workforce and were among the first line carers for patients in community and hospital settings during the COVID-19 pandemic. As a result, they were at a heightened risk of contracting the disease, resulting in a significant number of reported deaths among them. Several preventive measures were adopted to contain the spread of this potentially lethal virus. This study aims to explore the knowledge, attitudes, and practices (KAP) of nurses regarding hand hygiene, mask wearing, and social distancing measures in healthcare settings in Barbados during the COVID-19 pandemic. Method: An online survey of nurses working in public hospitals and polyclinics (public primary care clinics) of Barbados from December 2020 to July 2021, was conducted. Participants completed a questionnaire capturing socio-demographic information and knowledge and practices related to hand hygiene, using face masks, and social distancing . Each correct response received one mark. Overall knowledge scores were categorized as poor (<60%), average (60-80%), or good (>80-100%). Results: Of 192 participants, the majority were female (82.8%) and had >5 years of experience (82%). Findings revealed that 45.8% had poor knowledge of hand hygiene, and the knowledge of 43.8% of respondents was average. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 2.1 times increased odds (95% CI 1.0, 4.2) of having good knowledge compared to other nursing categories. Regarding mask-wearing, 53.6% of nurses had average and 27.1% had good knowledge. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 3.3 times increased odds (95% CI 1.5, 7.4) of having good knowledge compared to nursing assistants. 68.6% of respondents followed the correct steps of handwashing every time, and 98.3% wore a mask in public places. More than half of the nurses (51.2%) kept a safe distance from others to avoid spreading SARS-CoV-2; one-third were in a crowded place(s) in the past three months, and 55.8% usually followed guidelines for social isolation as recommended by WHO. Conclusion: The study identified knowledge deficiencies related to hand hygiene and wearing masks among nurses. It is imperative to provide additional training on infection control measures.

Objective: Despite increasing interest in understanding factors influencing awareness, knowledge, and acceptability of the human papilloma virus (HPV) vaccine among Latino parents to date, limited information is available specific to Latino fathers living in the United States. Methods: This descriptive qualitative study explored Latino fathers’ awareness, knowledge, and acceptability of the HPV vaccine for their adolescent children. Data were collected through individual, semi-structured interviews and analyzed using a hybrid method of thematic analysis that incorporated deductive and inductive approaches. Results: Nineteen, majority foreign-born Latino fathers (63.2%; n = 12) fathers of male and female adolescents participated in the study. Four main themes and two subthemes emerged from the analyses. Results found fathers’ low awareness and knowledge of HPV and the HPV vaccine. Results also identified fathers’ positive attitude toward vaccines in general. Moreover, results revealed fathers’ trust in healthcare providers. This trust translated into an increased willingness to vaccinate their children against HPV if recommended by their child’s primary healthcare provider. Conclusion: Findings indicate the need for increased efforts to raise awareness and knowledge among Latino fathers of HPV and the HPV vaccine. In addition, findings underscore the critical role of healthcare providers’ recommendation of the HPV vaccine. Given the limited research focused on Latino fathers, this study’s findings are valuable in building a knowledge foundation needed for developing future studies and interventions to promote the HPV vaccine by targeting Latino fathers living in the United States. Future research should quantify Latino fathers' awareness, knowledge, and acceptability of the HPV vaccine for their children, and preferences for educational interventions to promote HPV vaccination.

Abstract: Guanxi, a Chinese term that defines social networks of power and benefits, can be divided into inter-personal and inter-organizational relationships, and guanxi significantly influences construction innovation in China. Many studies have examined the relationship between guanxi and construction innovation at the project or organizational level. However, few of these studies explained how guanxi could affect an individual’s innovative behaviour from a double-level perspective. This paper builds on social capital theory and social exchange theory to examine guanxi’s role in motivating innovative behaviour in a China-specific construction context. It investigates the main effects of inter-personal relationships on innovative behaviour, the mediating effects of knowledge sharing, and the cross-level moderating effects of inter-organizational relationships. These elements were tested using a survey that received 178 responses from 35 different organizations. The results were analysed using Hierarchical Linear Modelling (HLM) and revealed that inter-personal relationships have positive influences on innovative behaviour, thus highlighting the partial mediating effects of knowledge sharing. In addition, the analyses showed that inter-organizational relationships augment inter-personal relationships and knowledge sharing on innovative behaviour by cross-level interaction. The research findings enhance an understanding of guanxi and innovative behaviour in China-specific construction project settings, as well as verifying the significance of guanxi in stimulating innovative behaviour.

Introduction: Oral health knowledge, beliefs and attitudes of parents have a direct influence on their child’s oral health maintenance, dietary habits and encourage healthy behaviors. The aim of this study was to assess the knowledge, and attitude of parents with regards to the oral health practice of their children and its associated factors. Methods: A self -administered structured questionnaire was administered to parents or guardians of learners aged 5 to 12 years at a low socio-economic rural primary school in the uGu district, KwaZulu Natal, South Africa to collect demographic variables, knowledge of dental health, use of toothbrush, use of toothpaste, dietary practices and dental visits; practice with respect to dental care and attitudes towards oral health. The questionnaire was translated from English to IsiZulu was used. Bivariate and multivariate logistic regressions were used to assess the association between parent’s sociodemographic factors with their oral health knowledge and practice scores. Results: One hundred and forty four completed survey instruments were received with an eighty percent (118) representation of mothers. Ninety five percent of the parents (136) had a positive attitude towards oral health with 86% (124) of the children brushed their tongue and 89% (128) of the children brushed their teeth happily. The mean knowledge score was 70% with a median of 72%. Children were significantly more likely to brush their tongues (AOR: 3.20 95% CI: 1.06-9.66) and were more likely to be happier when brushing their teeth (AOR: 4.65 95% CI: 1.41-15.38) when the caregivers were their mothers, and when parents had an above average knowledge score (AOR: 1.86 95% CI: 0.72-4.85) and had positive attitudes (AOR: 3.20 95%CI: 0.46-22.00). Conclusion: To reduce the gaps in knowledge, oral health promotion should be integrated into all point of care contact with parents at health facilities, increased community awareness and advertising campaigns as well as a more focused school health oral program that addresses primary prevention, screening and appropriate referrals to health facilities

Children’s beneficial relationships with animals are well known. Companion animals, particularly dogs have become an integral part of family life and children’s material culture. Aside the proven physiological benefits there is little research about what children say about their relationships with animals and how they describe them. In this paper we bring together both horse-human and dog-human interactions, finding common ground for understanding the complexity of human development, well-being and flourishing. Dogs in schools are fast becoming a trend in helping support and enhance children’s learning as well as their social and emotional well-being. Studies have shown that the very presence of a dog can increase children’s concentration, executive function and behavior. Also, equine therapy is gaining momentum and empirical studies are showing noteworthy benefits to children and young people. However, the lack of children’s voices means that the mechanisms for these benefits are somewhat unknown and unclear. In seeking to explore this, the authors utilize a visual, sensory and diffractive ethnographic approach to illuminate and illustrate, experiment and re-enact, how the children relate, share spaces and multiple subjectivities with their classroom canine, “Ted” and companion horse “Henry”. ”Henry” is part of a programme in which youngsters care for and engage in activities with horses.

AbstractIntroduction: Increasing knowledge of obstetric danger signs (ODS) and encouraging birth preparedness and complication readiness (BPCR) practices are strategies to increase skilled maternal health service utilization in low-income countries. One of the methods to increase mothers' knowledge about ODS and promote BPCR practice is through health education intervention (HEI). However, the effect of context-specific community-based health education led by women's groups on these outcomes has not been comprehensively studied, and the existing evidence is inconclusive. Thus, we aimed to evaluate the effect of a context-specific community-based HEI led by women's groups on mothers' knowledge regarding ODS and BPCR practices in southern Ethiopia.Methods: An open-label, two-arm parallel group cluster-randomized controlled trial was conducted from January to August 2023 on pregnant women from 24 clusters (kebeles) (12 interventions and 12 controls) in the northern zone of the Sidama region. The Open Data Kit smartphone application was utilized to collect data. The intention-to-treat analysis was used to compare outcomes between groups. We fitted multi-level mixed-effects modified Poisson regression with robust standard error to account for between and within cluster effects. Results: One thousand and seventy pregnant women (540 in the intervention and 530 in the control clusters) responded to this study, making the overall response rate 95.02%. Excessive vaginal bleeding (94.3% in the interventional group vs. 88.7% in the control group) was the commonest ODS mentioned during childbirth. Overall, 68.7% of women in the intervention group and 36.2% of mothers in the control group had good knowledge of ODS (P-value < 0.001). Saving money and materials (97.1% in the interventional group vs. 92.7% in the control group) was the most frequently practiced BPCR plan. Overall, 64.3% of women in the intervention group and 38.9% of mothers in the control group practiced BPCR (P-value < 0.001). HEI significantly increased overall knowledge of ODS (adjusted risk ratio [ARR]: 1.71; 99% CI: 1.14-2.57) and improved overall BPCR practice (ARR: 1.55; 99% CI: 1.02-2.39). Conclusions: A community-based HEI led by women's groups improved mothers' knowledge regarding ODS and BPCR practices in a rural setting in southern Ethiopia. Interventions designed to increase women's knowledge of ODS and improve BPCR practice must implement context-specific, community-based HEI that aligns with World Health Organization recommendations. Trial registration: NCT05865873

For the first time in the world, we provided a phenomenologically verifiable proof for the validation of origin of universe and perceivable reality from the unperceivable information based on Ayurveda. We also provided the axiomatic definitions for the terminologies used to deliver the theoretical framework for the same based on Bharatheeya Knowledge Systems. The presented manuscript provides a corelation between quantum information transport and emergence of gunam “Laghu” and gunam “Guru”. We identified that this point of emergence can be considered as the origin point in the continuous process of generation of Perceivable Reality “Vyaktham” from Unperceivable Information “Avyaktham”. In this context we can consider the unperceivable information in “Avyaktham” as dark matter. So, we must develop methods like gunascopy or informationscopy to understand the types of information imbibed in the quantum matter of a dravyam to understand its original physico-chemical-biological and information state of the constituent matter. This is possible through the assessment of Dravya Guna aspects and panchabhootha tatwas of the dravyas. For the first time in the world, we have developed the method to derive all the gunas from “guru” and “Laghu” and calculated the mass of the finitie components of Nava Dravyas including Mann, Aatma, Kaal, Disha, Aakash, Vaayu, Agni, Jal and Prithvi from the quantum information emergence equation. We strongly believe that this work will open up new avenues to explore the frontiers of reality and universe through natural cognition. The solutions to the Yang-Mill conjecture is achieved by our team using the Quantum Information Emergence and Transport Equations. We proved that the information bounded in the quantum states of the constituent quantum matter of quantum particles will provide them positive masses, even though they travel at the speed of light. Based on the phenomenologically verifiable axioms proposed in this work, we proved that the space on the topologically invarient 2D Poincare Sphere which is equivalent to a 2D space without boundaries can facilitate the never-ending loop of continuous quantum information transport between “Avyaktham” and “Vyaktham”. So the information availabe in the constituent quantum states of “Avyaktham” is equal to the postiive mass of quantum systems travelling at the speed of light. In such condition all the mass of the quantum particles will be converted in to information bounded in the corresponding quantum states of the quantum matter. This complete conversion of mass of the quantumparticles into information will happen only at maximum entropy. Thus at maximum entropy the information which is self information entangled with its own quantum states in “Avyaktham” will have a positive mass equal to the mass gap proposed in the Yang-Mill conjecture.

Let β= (((24!)!)!)!, and let {${\mathcal P}_{n^2+1}$} denote the set of all primes of the form {$n^2+1$}. Let ${\mathcal M}$ denote the set of all positive multiples of elements of the set {${\mathcal P}_{n^2+1} \cap (\beta,\infty)$}. The set {${\mathcal X}=\{0,\ldots,\beta\} \cup {\mathcal M}$} satisfies the following conditions: (1) ${\rm card}({\mathcal X})$ is greater than a huge positive integer and it is conjectured that ${\mathcal X}$ is infinite, (2)} we do not know any algorithm deciding the finiteness of ${\mathcal X}$, (3)~a~known and short algorithm for every {$n \in N$} decides whether or not {$n \in {\mathcal X}$}, (4) a known and short algorithm returns an integer~$n$ such that ${\mathcal X}$ is infinite if and only if ${\mathcal X}$ contains an element greater than $n$. The following problem is open: {\em simply define a set {${\mathcal X} \subseteq N$} such that ${\mathcal X}$ satisfies conditions (1)-(4), and \underline{we do not know any representation of~~${\mathcal X}$~~as a finite union of sets whose definitions are simpler than} \underline{the definition of ${\mathcal X}$}} {\tt (5)}. Let {$f(1)=2$}, {$f(2)=4$}, and let {$f(n+1)=f(n)!$} for every integer {$n \geqslant 2$}. For a positive integer $n$, let {$\Psi_n$} denote the following statement: {\em if a system of equations ${\mathcal S} \subseteq \Bigl\{x_i!=x_k: i,k \in \{1,\ldots,n\}\Bigr\} \cup \Bigl\{x_i \cdot x_j=x_k: i,j,k \in \{1,\ldots,n\}\Bigr\}$ has only finitely many solutions in positive integers \mbox{$x_1,\ldots,x_n$}, then each such solution \mbox{$(x_1,\ldots,x_n)$} satisfies {$x_1,\ldots,x_n \leqslant f(n)$}.} We prove that for every statement $\Psi_n$ the bound {$f(n)$} cannot be decreased. The author's guess is that the statements {$\Psi_1,\ldots,\Psi_9$} are true. We prove that the statement $\Psi_9$ implies that the set ${\mathcal X}$ of all {non-negative} integers $k$ whose number of digits belongs to {${\mathcal P}_{n^2+1}$} satisfies conditions {\tt (1)-(5)}.

Abstract: Giant Cell Arteritis (GCA) is an autoimmune/autoinflammatory disease affecting large vessels in patients over 50 years old. The disease presents as an acute inflammatory response with two phenotypes, cranial-GCA and Large Vessel Vasculitis (LV)-GCA, involving the thoracic aor-ta and its branches. 18F-fluorodeoxyglucose positron emission tomography-computed tomogra-phy (18F-FDG PET-CT) is among the imaging techniques contributing to diagnosis of patients with systemic disease. However, its association with soluble inflammatory markers is still elu-sive. This proof-of-concept study aims to identify novel soluble serum biomarkers in PET/CT pos-itive patients with LV-GCA and associate them with active (0 months) and inactive disease (6 months following treatment), in sequential samples. The Most-Disease-Segment Target-to-Background Ratio (TBRMDS) was calculated for 9 LV-GCA patients, while 12 cranial-GCA and 7 Polymyalgia Rheumatica patients with negative initial PET/CT served as disease controls. Serum macrophage-related cytokines were evaluated by Cytometric Bead Array (CBA). Finally, previously published NMR-metabolomics data acquired at the same blood sampling were associated with PET/CT findings. TBRMDS was significantly increased in active versus inactive disease (3.45 vs. 2.55, p=0.008). The analysis identified 6 serum metabolites, as more sensitive to change from the active to inactive state. Among them, choline levels were exclusively altered in the LV-GCA group, but not the disease controls. Cytokine levels were not associated with PET/CT activity. Combining with CRP, ESR, and TBRMDS a composite index was generated to depict well the differences between active and inactive systemic LV-GCA (25.45 vs 11.45, p=0.0039). These preliminary results could pave the way for more extensive studies integrating serum metabolomic parameters with PET/CT imaging data to extract sensitive composite disease indexes useful for the everyday clinical practice.

The recent mountain pine beetle outbreaks have caused widespread mortality among lodgepole pine trees in western North America, resulting in a reduced population of surviving trees. While previous studies have focused on the cascading impacts of these outbreaks on the physiology and growth of the surviving trees, there remains a need for a comprehensive study into the interactions among various physiological traits and the growth in post-outbreak stands. Specifically, the relationship between chemical (primarily terpenes) and anatomical (mainly resin ducts) defences, as well as the allocation of non-structural carbohydrates (NSCs) to support these defence modalities, is poorly understood. To address these gaps, we conducted a field survey of surviving lodgepole pine trees in post-mountain pine beetle outbreak stands in western Canada. Our retrospective analysis targeted to determine correlations between the post-outbreak concentrations of monoterpenes, diterpenes, and NSCs in the phloem, and the historical resin duct characteristics and growth traits before and after the outbreak. We detected strong correlations between post-outbreak concentrations of monoterpenes and historical resin duct characteristics, suggesting a possible link between these two defence modalities. Additionally, we found a positive relationship between NSCs and the total concentrations of monoterpenes and diterpenes, suggesting that NSCs likely influence the production of these terpenes in lodgepole pine. Furthermore, historical tree growth patterns showed strong positive correlations with many individual monoterpenes and diterpenes. Interestingly, while surviving trees had enhanced anatomical defences after the outbreak, their growth patterns did not vary before and after the outbreak conditions. The complexity of these relationships emphasizes the dynamics of post-outbreak stand dynamics and resource allocation in lodgepole pine forests, highlighting the need for further research. These findings contribute to a broader understanding of conifer defenses and their coordinated responses to forest insect outbreaks, with implications for forest management and conservation strategies.

Tourism Geographers in Anglo-American geographical departments migrate to teach and research tourism in applied schools and departments such as business, resource and environment, and even cultural and creative industry. Under national research assessment and funding pressures, tourism geographers are not encouraged to keep on undertaking serious theoretical researches related to their mother discipline and transferred to research applied researches and publish in hybrid journals. Such changes in tourism geographers` research behavior have not been tested and reported in Asian academic contexts, especially Taiwan while frequently being discussed internationally. This research aims to investigate the differences in the research behavior of tourism geographers between those who are staffed in geography departments and those who migrate to applies departments such as tourism and recreation, resource and environment, and others in terms of publishing journals, paradigmatic approaches, research types(qualitative, quantitative, and mixed), research methods and geographical scales conducted based on content analysis of articles published by tourism geographers in geography and tourism and recreation departments. This study revealed that there are significant differences in the research behavior of tourism geographers between different department. Finally, this paper explains the differences in terms of Taiwan changing social and economic conditions, academic traditions and politics of geography and applied departments, research habits and preferences of tourism geographers among departments and other aspects. This study can help international tourism geography academic circles to understand the complexity and diversity of tourism geography academic landscape of the Chinese language.

We investigate solutions of the classical Mathieu-Hill (MH) equation which describes the dynamics of trapped ions, based on the Floquet theory and the analytical model introduced in \cite{Blu89}. We show the equations of motion are equivalent to those of the harmonic oscillator (HO) and demonstrate methods to determine the solutions of the MH equation. The regions of stability and instability for the MH equation in case of a trapped particle are also discussed. What is more, we address both the damped HO and parametric oscillator (PO) for an ion confined in a Paul trap. The paper is a follow-up of a recently published paper in Photonics, 11 (6) 551.

Cranioplasty (CP) is the main surgical procedure aimed at reproducing a structural or morphological defect of the skull. It has been shown that cranioplasty can be useful for patients with traumatic brain injury (TBI) to achieve functional cognitive and motor improvements. Here, we describe a patient with long-term severe TBI who recovered consciousness following delayed CP. We found that a delayed CP may result in a meaningful functional recovery with emergence from a minimally conscious state and recovery of functional communication, even more than a year after decompressive craniectomy. Delayed intervention is equally successful in promoting functional recovery in long-term TBI patients, as early CP has already shown.

Long COVID comprises persistent symptoms which extend beyond four weeks post-SARS-CoV-2 infection. The potential association between long COVID and the endorsement of COVID-19 conspiracy theories has not been explored, particularly in Arab countries where high endorsement of these theories has been reported. This study aimed to explore the association between endorsing COVID-19 conspiracy theories and the prevalence of self-reported long COVID symptoms among adults in Jordan and Kuwait in addition to other Arab countries. The study employed a cross-sectional design using an electronic self-administered survey in Arabic language. Recruitment utilized snowball sampling via social media and the survey was distributed in July 2024. The survey instrument included sections on demographic information, the history of COVID-19 infection, and vaccination status. Long COVID manifestations were assessed using a score reflecting the frequency and intensity of ten recognized long COVID symptoms with subsequent categorization into three categories: low, middle, and high. The beliefs in COVID-19 conspiracy theories were measured via a 5-point Likert scale across five items. The final study sample comprised 756 respondents, the majority of whom self-reported a history of confirmed COVID-19 diagnosis at least once (n = 493, 65.2%). The results indicated a neutral average attitude towards COVID-19 conspiracy theories (mean score = 15.18±4.64 out of 30.00). Participants with high conspiracy theories scores were significantly more likely to report high (aOR = 6.85, 95% CI: 2.90–16.13, p &lt; 0.001) and middle long COVID symptoms (aOR = 2.82, 95% CI: 1.32–6.06, p = 0.008) compared to those with lower scores. Additional predictors of higher long COVID reporting included female sex and lower self-reported household income. Frequent COVID-19 infections and hospitalizations were also associated with higher long COVID symptom reporting. The study results revealed a significant correlation between the endorsement of COVID-19 conspiracy theories and the higher frequency and magnitude of long COVID symptom reporting. The findings also highlighted the influence of sociodemographic factors and COVID-19 infection history on long COVID reporting, which suggests that public health strategies should address these factors to mitigate long COVID challenges effectively.

We investigated the effect of 0.6 MeV proton irradiation on the superconducting and normal state properties of thin-film YBa2Cu3O7−δ superconductors. A thin-film YBCO superconductor (≈ 567 nm thick) was subject to a series of proton irradiations with a total fluence of 7.6×1016p/cm2. Upon irradiation, Tc was drastically decreased from 89.3 K towards zero with a corresponding increase in its normal state resistivity above Tc. This increase in resistivity which indicates the increase of defects inside the thin-film sample can be converted to the dimensionless scattering rate. We found that the relation between Tc and dimensionless scattering rate obtained during proton irradiation approximates the generalized d-wave Abrikosov-Gor’kov theory better than the previous results obtained from electron irradiations. This is an unexpected result since the electron irradiation is known to be most effective to suppress superconductivity over other heavier ion irradiations such as proton irradiation. It suggests that the type of defects created by proton irradiation evolves from cascade defects (in bulk single crystals) to point-like defects (in thin-film single crystals) as the thickness decreases.

In this work, we introduce the TriFusion Network, an innovative deep learning framework designed for the simultaneous analysis of auditory, visual, and textual data to accurately assess emotional states. The architecture of the TriFusion Network is uniquely structured, featuring both independent processing pathways for each modality and integrated layers that harness the combined strengths of these modalities to enhance emotion recognition capabilities. Our approach addresses the complexities inherent in multimodal data integration, with a focus on optimizing the interplay between modality-specific features and their joint representation. Extensive experimental evaluations on the challenging AVEC Sentiment Analysis in the Wild dataset highlight the TriFusion Network's robust performance. It significantly outperforms traditional models that rely on simple feature-level concatenation or complex score-level fusion techniques. Notably, the TriFusion Network achieves Concordance Correlation Coefficients (CCC) of 0.606, 0.534, and 0.170 for the arousal, valence, and liking dimensions respectively, demonstrating substantial improvements over existing methods. These results not only confirm the effectiveness of the TriFusion Network in capturing and interpreting complex emotional cues but also underscore its potential as a versatile tool in real-world applications where accurate emotion recognition is critical.

Previous studies found that corilagin inhibits the growth of many cancer cells. Ovarian cancer is the deadliest gynecological malignancy, but research on the effects of corilagin on ovarian cancer is limited. This experiment aims to explore the impact of corilagin on ovarian cancer A2780 cell apoptosis and its mechanism of action to evaluate the prospects of corilagin in treating ovarian cancer. Corilagin significantly affects the A2780 cell cycle, reducing the proportion of G0/G1 and G2/M phase cells and blocking them in the S phase. Corilagin at low concentrations can cause A2780 cell apoptosis, mitochondrial membrane potential decline, and calcium influx. After the cells were stained with Acridine Orange, autophagosomes were observed under a fluorescence microscope and increased with the increase in concentration. The results of transcriptome sequencing showed that the effect of corilagin could cause differential expression of apoptosis-related genes in A2780 cells and concentrated on the PI3K-AKT pathway. The qPCR results showed that the expression of genes P53 and Bax in cells increased while the expression of BCL-2 decreased. The expressions of apoptotic factors caspase-9, caspase-3, p53-upregulated modulator of apoptosis (PUMA), and cytochrome C increased after the action of corilagin, indicating that corilagin can induce cell apoptosis. Corilagin can effectively inhibit the proliferation of A2780 cells, cause cell cycle arrest, and induce cell apoptosis. Moreover, it can trigger autophagy and has in vitro antitumor effects. It is a promising drug for treating ovarian cancer through the PI3K/P53 pathway.

The fundamental goal of modern medicine is to increase human life expectancy. Currently, most of the patients in hospitals with different clinical profiles are elderly and senile subjects, with a high incidence of comorbidities, as well as concomitant age-related changes in peripheral tissues. One such change is sarcopenia, a progressive loss of muscle mass, strength, and muscle function that is associated with a high risk of adverse outcomes, leading to an increased risk of disability and death among older adults. The mechanisms of development of sarcopenia are currently being actively studied. This narrative review presents the issues of epidemiology, pathophysiology, and diagnostic criteria for sarcopenia. The relationships between sarcopenia and metabolic dysfunction-associated steatotic liver disease (MASLD) with possible promising directions for the treatment of this comorbid pathology are considered.

This study investigated the efficacy and safety of a propolis mangosteen extract complex (PMEC) on gingival health in patients with gingivitis and incipient periodontitis. A multi-centered randomized, double-blind, placebo-controlled trial involving 104 subjects receiving either PMEC or placebo for eight weeks was conducted. The primary focus was on changes in inflammatory biomarkers from gingival crevicular fluid (GCF), with clinical parameters as secondary outcomes. Results revealed that the PMEC group showed significantly reduced expression of all measured GCF biomarkers compared to the placebo group (p&lt;0.0001) at 8 weeks, including substantial reductions in IL-1β, PGE2, MMP-8, and MMP-9 levels compared to baseline. While clinical parameters trended towards improvement in both groups, inter-group differences were not statistically significant. No significant adverse events were reported, indicating a favorable safety profile. These findings suggest that PMEC consumption can attenuate gingival inflammation and mitigate periodontal tissue destruction by modulating key inflammatory mediators in gingival tissue. Although PMEC shows promise as a potential adjunctive therapy for supporting gingival health, the discrepancy between biomarker improvements and clinical outcomes warrants further investigation to fully elucidate its therapeutic potential in periodontal health management.

High-resolution (2 km) high-frequency (hourly) SST data from 2015-2021 provided by the Advanced Himawari Imager (AHI) onboard the Japanese Himawari-8 geostationary satellite were used to study spatial and temporal variability of the China Coastal Front (CCF) in the South China Sea. The hourly SST data were processed with the Belkin and O’Reilly (2009) algorithm to generate long-term mean monthly maps of SST gradient magnitude (GM) and frontal frequency (FM). The horizontal structure of CCF was investigated from cross-frontal distributions of SST along 11 fixed lines that allowed to determine inshore and offshore boundaries of the CCF and calculate the CCF strength defined as the total cross-frontal step dSST = Offshore SST – Inshore SST. Combined with the results of Part1 of this study (Belkin, Lou, Yin, 2023), where the CCF was documented in the East China Sea, the new results reported in this paper allowed the CCF to be reliably traced from the East China Sea via Taiwan Strait into the northern South China Sea and farther west up to the east coast of Hainan Island.

The literature analysis did not indicate any studies on fluorination tests of carbon nanocomposite coatings doped with transition metals of the nc-MeC/a-C type. This was the motivation for undertaking research in this area. As a model coating to investigate the effect of fluorination in a tetrafluoromethane (CF4) atmosphere, a nano-composite carbon coating doped with chromium nc-CrC/a-C produced by magnetron sputtering from graphite targets and the use of a Pulse-DC type medium frequency power supply was chosen [6]. After deposition of the gradient CrCN adhesive sublayer, fluorination of the main coating was conducted in a reactive mode in an (Ar+CF4) atmosphere at various CF4 contents. It was observed that the presence of CF4 in the atmosphere resulted in a reduced amount of chromium carbides formed in favor of chromium fluorides. So far, this is an observation that seems unnoticed by the carbon coatings researchers. Fluorine was assumed to bond much more readily to carbon than to chromium, due to the stability of tetrafluoromethane (CF4). The opposite seems to be true. The mechanical properties (nano-hardness and Young's modulus) and tribological properties in the 'pin-on-disc' friction pair are presented, along with the analysis of bonds occurring between chromium, carbon, and fluorine (XPS).

Since the turn of the millennium, many individuals and groups, including Diane Moore (2007), Stephen Prothero (2007), the American Academy of Religion (2010), and The National Council for the Social Studies (2014, 2017, 2021), have advocated for better religious literacy education (RLE) in K-12 curriculum and public schools. Despite these calls, RLE has yet to make significant inroads in K-12 curriculum and public schools. This paper aims to define religious literacy and RLE, provide current rationales for its inclusion in K-12 curriculum and public schools, identify barriers to RLE, and explore the potential of global competence in promoting RLE.

This paper explores the geometric impossibility of angle trisection within Euclidean geometry, with a particular focus on the 90° angle. It presents a rigorous proof that highlights the fundamental limitations of various approaches to angle trisection, highlighting their failure to achieve universality. The paper critiques modern proofs that allow for the trisection of certain angles while dismissing others, arguing that such methods are inherently flawed due to their lack of geometric consistency. The paper introduces a new perspective through a new property named “inconsistent property”, a concept derived from geometric operations involving proportional magnitudes. This property reveals contradictions within the framework of Euclidean geometry, paralleling the logical challenges faced in proving the impossibility of trisecting an arbitrary angle. By drawing comparisons between traditional and contemporary proofs, the paper demonstrates that inconsistencies arise not only from specific cases but also from broader geometric principles. The findings reaffirm the robustness of Euclidean geometry in addressing the trisection problem and challenge the validity of alternative proofs that do not adhere to universal geometric principles. This paper contributes to a clearer understanding of the limitations of angle trisection methods and encourages further investigation into the technical implications and broader impact of the angle impossibility proof.

The extensions of Boltzmann-Gibbs classical entropic form are presented. The focus is on the thermodynamical entropies which do not obey classical definition of additivity and extensity with main motivation coming from the gravitational systems admitting long-range interactions both in astrophysics (black holes) and in cosmology. Horizon entropies are the main concern. In the paper, the plethora of non-Boltzmann-Gibbs entropies are studied and the comparative analysis of their properties with respect to additivity and extensivity is presented.

Recent advancements in neural machine translation (NMT) offer promising potential for generating cross-language clinical natural language processing (NLP) resources. There is a pressing need to be able to foster the development of clinical NLP tools that extract key clinical entities in a comparable way for a multitude of medical application scenarios, hindered by lack of multilingual annotated data. This study explores the efficacy of using NMT and annotation projection techniques with expert in the loop validation to develop named entity recognition (NER) systems for an under resourced target language (Catalan) by leveraging Spanish clinical corpora annotated by domain experts. We employed a state-of-the-art NMT system to translate three clinical case corpora. The translated annotations were then projected onto the target language texts and subsequently validated and corrected by clinical domain experts. The efficacy of the resulting NER systems was evaluated against manually annotated test sets in the target language. Our findings indicate that this approach not only facilitates the generation of high-quality training data for the target language (Catalan) but also demonstrates the potential to extend this methodology to other languages, thereby enhancing multilingual clinical NLP resource development. The generated corpora and components are publicly accessible, providing potentially a valuable resource for further research and application in multilingual clinical settings: https://zenodo.org/doi/10.5281/zenodo.13133124.

Atlas Posterior Arch Deficiency (APAD) is a rare anatomical variation of the atlas vertebra that can be detected using cone-beam computed tomography (CBCT). This study aims to evaluate the prevalence, classification, and clinical implications of APAD in an Italian cohort.

Autoimmune blistering diseases represent a group of chronic severe, disabling, potentially fatal disorders of the skin and/or mucous membranes primarily mediated by pathogenic auto-antibodies. Despite their rarity, these diseases are associated with significant morbidity and mortality, a profound negative impact on the patient’s quality of life and impose a considerable economic burden. Rituximab, an anti CD-20 monoclonal antibody represents the first line of therapy for pemphigus, regardless of its severity as it ensures high rates of rapid, long-lasting complete remission. Nevertheless, disease recurrence is the rule, all patients requiring maintenance therapy with rituximab sooner or later. While innate resistance to rituximab in pemphigus patients is exceptional, acquired resistance is frequent and may develop even in patients with initial complete response to rituximab, representing a real challenge for physicians. We discuss the various resistance mechanisms and their complex interplay, as well as the numerous therapeutic alternatives that may be used to circumvent rituximab resistance. As no therapeutic measure is universally efficient, individualization of rituximab treatment regimen and tailored adjuvant therapies in refractory pemphigus cases are mandatory.

ACL injuries present significant challenges in sports medicine, particularly in restoring knee joint function and preventing further complications like subsequent injuries or post-traumatic osteoarthritis. Traditional rehabilitation techniques, which often rely on pre-planned exercises and standardized assessments, may not adequately prepare athletes for the unpredictable nature of sports. This paper argues for a comprehensive approach that recognizes ACL injuries as failures of complex nonlinear systems rather than merely biomechanical deficiencies. The complexity of ACL injuries involves a dynamic interplay of individual skills, team dynamics, and external conditions. Traditional rehabilitation approaches that focus solely on biomechanical factors overlook the critical role of interpersonal dynamics and sensorimotor control. The brain’s integration of sensory information to form a comprehensive environmental representation is vital for motor actions. Disruptions in this sensorimotor feedback loop can impair motor control, increasing the risk of ACL injuries. Effective rehabilitation should enhance sensory integration and feedback mechanisms, improving motor control and reducing re-injury risk. Addressing proprioceptive deficits and arthrogenic muscle inhibition (AMI) is crucial for successful rehabilitation. Neurocognitive training, focusing on enhancing decision-making and motor responses, is essential for sports performance and injury prevention. Techniques like neurofeedback training can optimize brain activity patterns, leading to better motor responses and adaptation to dynamic environments. Psychological factors such as motivation, anxiety, and fear significantly influence recovery. Integrating psychological support into rehabilitation programs can address these factors, leading to more comprehensive and effective recovery strategies. Innovative rehabilitation approaches, including EMG biofeedback, motor imagery, and virtual reality-based training, can enhance reactive motor planning and adaptability, preparing athletes for the demands of their sport. The future of ACL rehabilitation lies in embracing the complexity of the sensorimotor system and developing multidisciplinary interventions that promote beneficial neuroplasticity. Advances in neuroscience and technology, such as artificial intelligence, can lead to more personalized and effective rehabilitation programs. Recognizing and addressing the multifaceted nature of ACL injuries can significantly improve rehabilitation outcomes, ensuring athletes can safely and effectively return to their sports.

Background: Telemonitoring systems in cardiology have shown potential in improving chronic cardiovascular disease (CVD) management. This study aims to evaluate the impact of telemonitoring, mainly through mobile applications, on patient outcomes such as self-care, blood pressure control, quality of life, and hospitalization. Methods: We systematically reviewed studies assessing telemonitoring methods for patients with chronic CVD. The analysis included studies from various geographic regions and healthcare settings, focusing on qualitative outcomes without performing a meta-analysis. Results: Telemonitoring was found to aid in maintaining blood pressure and significantly enhance self-care abilities. Improvements in quality of life were observed in some studies, though results varied. Most studies indicated telemonitoring could effectively manage blood pressure and reduce hypertension-related complications. However, the heterogeneity of interventions and outcomes measured across trials posed challenges for a comprehensive meta-analysis. Conclusions: Integrating telemonitoring systems into routine care can significantly improve disease management and patient outcomes for chronic CVD patients. Future research should standardize telemonitoring interventions and outcome measures, conduct long-term studies, and evaluate the cost-effectiveness of these systems. Greater blindness in future randomized controlled trials and more studies on atrial fibrillation are also necessary. Significant potential exists for telemonitoring to improve patient outcomes and assist in managing chronic illnesses.

In response to the increasing complexity and sophistication of cyber threats, particularly those enhanced by advancements in artificial intelligence, traditional security methods are proving insufficient. This paper explores the zero-trust cybersecurity framework, which operates on the principle of "never trust, always verify" to mitigate vulnerabilities within organizations. Specifically, it examines the applicability of zero-trust principles in environments where large volumes of information are exchanged, such as schools and libraries, highlighting the importance of continuous authentication, least privilege access, and breach assumption. The findings highlight avenues for future research that may help preserve the security of vulnerable organizations.

The prototype misfit layer compound (SnS)1.17NbS2 consists of alternatively a metallic triatomic NbS2 layer in which Nb atoms are sandwiched by S atoms and an insulating SnS double-layer of NaCl-type structure. Here we investigate the effect of lattice misfit on the stability and chemical bonding in the misfit layer compound using a first-principles density-functional theory approach. The calculations show that for the (SnS)1+xNbS2 approximants, the most stable one has x = 0.167, close to the experimental observations. Charge analysis finds a moderate charge transfer from the SnS to NbS2. Sn or S vacancies in the SnS part affect the electronic properties and interlayer interactions. The obtained information here helps understand the mechanism of formation and stability of the misfit layer compounds and ferecrystals, and further to design of novel multilayer compounds and emerging van der Waals heterostructures.

Carbon capture, utilization, and storage (CCUS) considered a the key strategy for reducing the emissions of anthropogenic carbon dioxide from power generation plants, can be achieved by three main technologies: oxy-fuel combustion, pre-combustion, and post-combustion capture. Post-combustion carbon capture (PCC), where CO2 is removed after the fuel burning, is a crucial solution for reducing greenhouse gas emissions from natural gas power plants (NGPPs). However, high costs and energy penalties associated with PCC technologies hinder their widespread adoption. Recent advancements in hybrid PCC configurations have shown promise in improving efficiency and reducing costs. In effect, six PCC hybrid configurations below were identified as feasible process routes: • 2S-AB +AD: Two-stage Absorption + Adsorption hybrid • 2S-AB +MB: Two-stage Absorption + Membrane hybrid • 2S-AD +AB: Two-stage Adsorption + Absorption hybrid • 2S-AD +MB: Two-stage Adsorption + Membrane hybrid • 2S-MB +AB: Two-stage Membrane + Absorption hybrid • 2S-MB +AD: Two-stage Membrane + Adsorption hybrid Each hybrid has its own technical and economic challenges that need to be investigated in order to identify the best technique for carbon capture. In this paper, we performed Aspen Hysys design simulation of the six hybrids PCC configurations and also their economic evaluations using parameters like investment costs, operating costs, net present value, and rate of return, culminating in the use of three assessment parameters namely, levelized cost of electricity (LCOE), carbon emission intensity (CEI) and cost of carbon avoidance (COA), to evaluate the six hybrids PCC configurations and to determine the most viable option. Overall, it was found by dimensional analysis that the post combustion carbon capture using 2S-MB +AB: Two-stage Membrane + Absorption hybrid is the most viable for capturing CO2 from power generation plants and is hereby recommended. However, the choice of materials (membranes and absorbents) needs to be evaluated so as determined the best optimal configuration for commercialization.

Groundwater flow and transport models are essential tools for assessing and quantifying the mi-gration of organic contaminants at polluted sites. Uncertainties in the hydrodynamic and transport parameters of the aquifer have a significant effect on model predictions. Uncertainties can be quantified with advanced sensitivity methods such as Sobol’s High Dimensional Model Reduction (HDMR) and Variogram Analysis of Response Surfaces (VARS). Here we present the application of VARS and HDMR to assess the global sensitivities of the outputs of a transient groundwater flow model of the Gállego alluvial aquifer which is located downstream the Sardas landfill in Huesca (Spain). The aquifer is subject to the tidal effects caused by the daily oscillations of the water level in the Sabiñánigo reservoir. Global sensitivities are analysed for hydraulic heads, aquifer/reservoir fluxes, groundwater Darcy velocity and hydraulic head calibration metrics. Input parameters in-clude aquifer hydraulic conductivities and specific storage, aquitard vertical hydraulic conductiv-ities, and boundary inflows and conductances. VARS, HDMR and graphical methods agree to identify the most influential parameters which for most of the outputs are the hydraulic conduc-tivities of the zones closest to the landfill, the vertical hydraulic conductivity of the most permeable zones of the aquitard, and the boundary inflow coming from the landfill. The sensitivity of heads and aquifer/reservoir fluxes with respect to specific storage change with time. The aquifer/reservoir flux when the reservoir level is high shows interactions between specific storage and aquitard conductivity. VARS and HDMR parameter rankings are similar for the most influential parameters. However, there are discrepancies for the less relevant parameters. The efficiency of VARS was demonstrated by achieving stable results with a relatively small number of simulations.

One of the most common solutions to access underground is through the construction of circular shafts. At preliminary design stage analytical expressions are often used to estimate the horizontal earth pressure acting on the lining. However, most of these solutions are based on active state conditions and do not consider the restrictions imposed on the shaft lateral displacements by the rigidity of its lining or by the construction method employed. To overcome this limitation a new methodology to account with the shaft lateral displacements in the determination of the horizontal earth pressure acting on circular shafts is developed and validated against the results of relevant physical scale models. The obtained results show good agreement with the measured data, reproducing adequately the reduction of the horizontal earth pressure from its initial value to an active state condition with the increase of the shaft lateral displacement. Following this approach more realistic predictions of the earth pressure acting on the lining of circular shafts can be performed.

Mangroves are critical ecosystems providing essential environmental services, making their conservation crucial. High-resolution remote sensing, particularly through unmanned aerial vehicles (UAVs), offers unprecedented resolution in ecosystem mapping. This study utilizes a multispectral sensor mounted on a UAV to map mangroves at Cardoso Island on Brazil’s southeastern coast and Suape on the northeastern coast. Using Geographic Object-Based Image Analysis (GEOBIA) for segmentation and classification, we employed machine learning algorithms to classify the primary mangrove species: Laguncularia racemosa, Rhizophora mangle, and Avicennia schaueriana. Two flight altitudes were used: a higher altitude for broad-scale mapping and a lower altitude for classification training, supplemented by field measurements for calibration. This method enabled the precise delineation of tree crowns and provided insights into species distribution and zonation, influenced by the distinct estuarine conditions of tides and sediment input. The high-resolution mapping achieved in this study enhances detailed analyses of mangroves, improving ecological models and biophysical estimations such as biomass and blue carbon stocks. This work highlights the potential of UAV-based multispectral imaging in advancing mangrove research and conservation efforts.

Theoretical physics addresses the fundamental principles of nature and the mysteries of the universe. In the last century, the theory of relativity challenged people's understanding of time and space, while quantum mechanics revealed various forms of energy. However, the concept of gravity remains elusive. All matter in the universe is composed of energy that can be converted into other forms, yet it is always conserved. However, achieving a state of equilibrium, represented by the equal sign, can be challenging to achieve on both macro and quantum scales. A phenomenon that can transition from one state to infinity is called collision and is essential for understanding natural phenomena and physical processes throughout the universe. In the study of general relativity cannot be three-dimensional problems to gain mathematical inspiration, understand the application of new dimensions. Here, we elucidate the nature of gravity, which inspires the solution of the Riemann hypothesis. Our results show that the conduction mode of dimensional energy is defined by Euler's formula. And a special mode of collision is derived which translates into vibration.

Textile wastewater containing dyes pose significant environmental hazards. Advanced oxidative processes, especially the heterogeneous photo-Fenton process, are effective in degrading a wide range of contaminants due to high conversion rates and ease of catalyst recovery. This study evaluates the photocatalytic degradation of azo dyes Acid Red 18 (AR18), Acid Red 66 (AR66) and Orange 2 (OR2) using magnetite as a catalyst. The magnetic catalyst was synthesized via a hydrothermal process at 150°C. Experiments were conducted at room temperature, investigating the effect of catalyst dosage, pH, and initial concentrations of H2O2 and AR18 dye. Kinetic and thermodynamic studies were performed at 25, 40 and 60°C for the three azo dyes (AR18, AR66 and OR2) and the effect of the dye structures on the photocatalytic efficiency was investigated. At 25 °C for 0.33 mmol.L-1 of dyes at pH 3.0, using 1.4 g.L-1 of catalyst and 60 mg.L-1 of H2O2 under a UV radiation of 16.7 mW.cm-2 the catalyst showed a 62,3% degradation for AR18, 79.6% for AR66, and 83.8% for OR2 in 180 minutes of reaction. The oxidation of azo dyes under these conditions is spontaneous and endothermic. The pseudo-first order kinetic constants indicated a strong temperature dependence with an order of reactivity of the type: OR2 &gt; AR66 &gt; AR18, which is associated to the characteristics of molecular complexity (size, steric hindrance, aromatic conjugation), electrostatic repulsion and the nature of the acid-base interactions on the catalytic surface.

As high strength and ultra-high strength steels are widely used in all kinds of modern welded constructions, a lot of research is carried out to investigate the mechanical properties of weldments of these steels but there is a scarce information on such important characteristic as their corrosion behaviour. This research focuses on the corrosion behaviour of weld metal of weldments of S906QL and S700MC steels. Weld metal was tested electrochemically in a 3,5% NaCl aqueous solution via potentiodynamic scan to determine corrosion rate and its dependence on welding gap. No influence of welding gap on corrosion rate was found but the experimental results suggested that corrosion rate depended on the chemical composition of filler material and the microstructure of weld metal.

Hydrogen is in the spotlight in the energy world, and it will remain so for the next years. In Europe, the necessity to integrate ever growing amounts of Renewable Energy Sources (RES) in order to implement the ambitious European decarbonization policy (package Fit-for-55) and to preserve the security of energy supply (package Repower-EU) are feeding the interest in hydrogen. The paper will provide a thorough analysis of prospects and criticalities for the development of hydrogen both as a carrier and as a feedstock and, in definitive, as a key element for the implementation of the European decarbonization policies. First, the present regulatory framework will be highlighted, taking European Union as a main reference since it has presently one of the most advanced hy-drogen legislations in the world. Then, both hydrogen offer (technologies and) and demand (both as a feedstock and as an energy carrier) will be dealt with in detail. Two additional sections will take care to illustrate, respectively, the interactions between hydrogen and the electricity grid and the issues related to the creation of a liquid hydrogen market. Finally, a conclusion section will wrap up and summarize the most urgent issues to be tackled to create a well-functioning hydrogen economy.

Explainable Artificial Intelligence (XAI) plays a vital role in increasing transparency and trust in machine learning models, particularly when applied to tabular data which is used in domains such as finance, healthcare, and marketing. This paper presents an extensive survey of XAI techniques used with tabular data and aims to analyze recent research developments since 2021. The survey classes and describes several XAI techniques pertinent to tabular data, it identifies challenges specific to this domain, and explores potential applications and emerging trends. Future research directions are outlined, concentrating on the need for clear definitions of terminology used, data security, user-centric explanations, enhanced interaction, robust evaluation metrics, and advancements in adversarial example-based analysis. The aim is to contribute to the evolving field of XAI, and provide insights for effective, trustworthy, and transparent decision-making using tabular data.

The neuronal etiology of obesity is centered around diet-induced inflammatory state in the arcuate nucleus of the hypothalamus which impairs the functionality of pro-opiomelanocortine neurons (POMCs) responsible for whole-body energy homeostasis and feeding behavior. Intriguingly, systemic salt inducible kinase 2 (SIK2) knockout mouse demonstrated reduced food intake and energy expenditure along with modestly dysregulated metabolic parameters suggesting a causal link between the absence of SIK2 activity in POMCs and the observed phenotype. To test this hypothesis, we conducted a comparative secretomics study from POMC neurons following pharmacologically induced endoplasmic reticulum (ER) stress induction, a hallmark of metabolic inflammation and POMC dysregulation in diet induced obese (DIO) mice. Our data provide significant in vitro evidence for the POMC specific SIK2 activity in controlling the energy metabolism and feeding in DIO mice by regulating the nature of related POMC secretome. Our data also suggests that under physiological stress conditions SIK2 may act as a gatekeeper for the secreted inflammatory factors and signaling molecules critical for cellular survival and energy homeostasis. On the other hand, in the absence of SIK2 gate opens leading to surge of inflammatory cytokines and apoptotic cues concomitant with the dysregulation of POMC neurons.

Soil formation results from the weathering and alteration of bedrock, influenced by climatic conditions and biotic factors, including living organisms. The mineralogical composition of the parent material, along with plant species and soil microorganisms, forms the foundational elements of an ecosystem's energy cycle. Afforestation in arid-semi arid regions plays a crucial role in preventing erosion and enhancing soil quality, offering significant economic and ecological benefits. This study assessed the impact of parent material diversity on soil physicochemical properties, microbial basal respiration (MR), and microbiological characteristics, as well as their subsequent effects on plant growth, 15 years post-afforestation. For this purpose, various soil physicochemical parameters, MR, soil microbial biomass carbon (Cmic), stoichiometry (microbial quotient= Cmic/Corg = qMic and metabolic quotient = MR/Cmic = qCO2), and tree growth metrics such as height and diameter were measured. The results of the one-way ANOVA indicated that afforested soils on limestone bedrock exhibited significantly better physicochemical and microbiological properties, as well as tree growth parameters, compared to those on andesite. Notably, sensitive microbial properties such as Cmic, MR, and qMic were positively influenced by afforestation. The highest Cmic (323 g C kg−1) and MR (1.3 CO2–C g−1 h−1) values were recorded in limestone-derived soils. Currently, the measured properties of soils can be ranked as LS&gt;AS&gt;LC&gt;AC. Conversely, the highest qCO2 values were observed in the control plots of andesite parent material (7.22). This study highlights the importance of selecting appropriate parent material and understanding soil characteristics to optimize afforestation efforts in bare areas. As a result, the higher plant growth capacity and carbon retention of limestone soil indicate that it has high microbial biomass and microbial activity (qMic).

Lotions with or without 28% ascorbyl glucoside arginine complex (AGAC) were applied twice daily for 24 weeks in a double‐blind half‐face study of 27 Japanese females with solar lentigos (SLs). Pigmentation scores were evaluated using a photo‐scale and skin colors were assessed using a color difference meter and a Mexameter. Treatment with the test lotion elicited a significant decrease in pigment scores at 24 weeks compared to week 0; with a significant decrease in pigment scores at 24 weeks compared to the placebo lotion‐treated SLs. In the test lotion‐treated SLs; the L values and melanin index (MI) significantly (p<0.0001) increased and decreased; respectively; at 12 and 24 weeks of treatment compared to week 0. Comparisons of increased L (△L) values or decreased MI (△MI) values between test and placebo lotion‐treated SLs demonstrated that the test lotion‐treated SLs had significantly higher △L or △MI values than the placebo lotion‐treated SLs both at 12 and 24 weeks of treatment. The sum of our results strongly indicates that AGAC is distinctly effective in ameliorating the hyperpigmentation levels of SLs at a visibly recognizable level by the subjects without any hypo‐pigmenting effects or skin irritation.

We analyzed data of pediatric invasive fungal diseases of the central nervous system (CNS-IFDs) reported by five of total eight Pediatric Hematology-Oncology Departments in Greece for 15 years (2007-2022). A total of twelve patients (11 boys, median age: 9.5yrs range: 2-16) were reported suffering from CNS-IFDs. Underlying malignancy was acute lymphoblastic leukemia in 9/12, and acute myeloid leukemia, Ewing sarcoma and rhabdomyosarcoma in one each. Eleven patients presented with CNS-related symptoms (i.e seizures, headache, cerebral palsy, ataxia, hallucination, seizures, blurred vision, amaurosis). All patients had pathological MRI findings. Multifocal fungal disease was observed in 6/12 patients. Nine proven and three probable CNS-IFD cases were diagnosed. Causative pathogens in proven cases were Aspergillus spp. and Candida albicans (n=2 each), Mucor spp., Rhizopus arrhizus, Absidia spp., Fusarium oxysporum and Cryptococcus neoformans (n=1 each). Causative pathogens in probable cases were Aspergillus spp. (n=2) and Candida spp. (n=1). All patients received appropriate antifungal therapy (median duration: 69.5 days, range 19-364). Two patients underwent additional surgical treatment. Six patients admitted to ICU due to complications. Three patients (25%) died, two due to IFD and one due to underlying disease. Early recognition and prompt intervention of CNS-IFDs may rescue the patients and improve overall survival.

Introduction: Errors are very common in medical practice —and in particular in the healthcare of patients with inflammatory bowel disease (IBD); however, most of them can be prevented. Aim: To address common errors in the management of IBD. Methods: Our approach to the problem will consist in identifying mistakes frequently observed in clinical practice (according to our experience) in the management of patients with IBD, then reviewing the scientific evidence available on the subject, and finally proposing the most appropriate recommendation in each case. Results: The most common mistakes in the management of IBD include those related to diagnosis and differential diagnosis, prevention, nutrition and diet, treatment with different drugs (mainly 5-aminosalicylates, corticosteroids, thiopurines, and anti-TNF agents), extraintestinal manifestations, anemia, the elderly patient, pregnancy, and surgery. Conclusions: Despite the availability of guidelines for both disease management and preventive aspects of IBD care, a considerable variation in clinical practice still remains. In this review, we have identified common mistakes in the management of patients with IBD in clinical practice. There is a clear need for greater dissemination of clinical practice guidelines among gastroenterologists and for the implementation of ongoing training activities supported by scientific societies. Finally, it would be desirable following IBD patients in specialized units, which is undoubtedly associated with higher quality healthcare and a lower likelihood of errors in managing these patients.

In diabetic foot injury prevention, no studies relate physical activity with the inflammatory response of the plantar tissues, evaluated by thermography and pressure distribution. These measurements are easy to be implemented in diabetic foot follow-up. The objective of this study was to analyze whether the plantar skin response, evaluated with thermography, after physical activity in healthy or diabetic patients, is a foot ulcer prognostic tool and to asses if there is a correlation between exercise intensity, plantar pressure and plantar thermographic response. A systematic review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format in the PubMed, Scopus and Web of Science databases, with no year limit during the second quarter of 2024. A total of 14 studies have been included in this review. The use of infrared thermography for early inflammatory tissue detection, plantar pressures and the monitoring of controlled physical activity, make possible to monitor changes that allow the identification of patients at risk of developing foot ulcers.

Plug and abandonment (P&amp;A) operations demand valuable time and resources with operational procedures and materials to establish the well barrier element. This study proposes the use of a water-based fluid as a liquid well barrier element for temporary abandonment, based on esti-mates of its lifespan and survival probability on downhole conditions acquired through acceler-ated life tests. For that, the water-based formulation was tested and exposed to 95, 110, 140 and 150°C, for time intervals ranging from 1 to 10 days. After temperature exposure, the fluid prop-erties were verified and failure was detected by accounting for any deterioration in rheological parameters and/or a substantial increase in filtrate volume. Statistical analysis of failure data was performed in R software using Weibull Model, and fluid average lifespan and survival probability were estimated for P&amp;A temperatures. The results obtained demonstrates that the degradation of the fluid only was observed for 140 and 150°C and is mostly related to the CMC deterioration. The reliability metrics shows that until 80°C the fluid is a promising alternative for temporary abandonment, with no need of monitoring. For higher downhole temperatures, theses metrics should be considered to define the maximum time of operation and requirements for monitoring management in the operation design.

Monitoring training load, recovery, and wellness in maturation ages is even more relevant than in adulthood, especially during congested schedules. The objective of this study was to quantify and describe the differences in external and internal load, recovery, and perceived wellness in elite under-16 female players during a period of three competitions in seven days, based on their participation during matches. An observational design was used to quantify external load (total distance, high-speed distance, and PlayerLoad), internal load (differential sRPE), as well as recovery and wellness of 18 international under-16 players during a development tournament. The external load pattern of the starting players was undulating, with matches showing the highest internal load values compared to training sessions and non-starters. Non-starters players (whether training or matches) showed similar external load and differential sRPE values throughout the tournament (p&gt;0.05). Starting players experienced higher internal load than non-starters during matches (p&lt;0.037), without differences between training sessions (p&gt;0.05). No changes were seen in wellness or recovery (all p-values &gt;0.05), except for non-starters in session 3 compared to session 7 (p=0.024). Starting players had more weekly total minutes (p=0.018), differential sRPE (breath: p=0.002; leg: p=0.002; cognitive: p=0.003), total distance (p=0.003), and PlayerLoad (p=0.008) than non-starters. Our results indicate differing load patterns between starters and non-starters, which do not affect wellness and recovery differently. Starters accumulate more weekly total load. Coaches can use these findings to guide decisions and load compensations in high competition contexts for young female soccer players.

I present a personal account of self-organizing systems. As such, it is necessarily biased and partial. Nevertheless, it should be useful to motivate useful discussions. The relevant contribution is not my attempts at answering questions (maybe all my answers are wrong), but the steps towards framing relevant questions to better understand self-organization, information, complexity, and emergence. With this aim, I start with a notion and examples of self-organizing systems (what?), continue with their properties and related concepts (how?), and close with applications (why?).

A major problem of the technological production process of the metallurgical-grade silicon is formation of a large amount of microsilica. However, this material can be a significant source of raw materials for its own production. Hence, this study is aimed to solve the problem of micro-silica utilization, i.e. the technogenic dust-like waste generated during the melting of the technical-grade silicon. Within this study, the technology of the joint briquetting of microsilica was investigated with the carbonaceous reducing agents, i.e. by obtaining of mono-charge and by melting of the technical-grade silicon from the obtained mono-charge in the 200kVA ore-thermal furnace. Results of the study show that the briquettes in the melting process of the technical-grade silicon can be used in the range from 0 to 50%. The using of briquettes may significantly improve the technological parameters. When briquetted charge is applied only, the technological parameters will deteriorate significantly. The material balance of silicon melting showed the recovery rates of the main elements (Si, Al, Ca and Fe). It recorded a decrease in content of aluminum from 1.9-2.1% to 0.5-0.7%, calcium from 0.2-0.3% to 0.07-0.1% and titanium from 0.2-0.23% to 0.11-0.13% during the transition to briquetted monocharge. Phosphorus content increased from 0.004-0.005 to 0.011-0.013%.

This study aimed to evaluate the impact of the built environment (i.e., walk, transit, and bike scores) on the location and transportation or “alternative transportation” credit (LTc1) in Leadership in Energy and Environmental Design for Existing Buildings version 4 (LEED-EB-v4) Platinum (n1 = 24), Gold (n2 = 112), Silver (n3 = 46), and Certified (n4 = 34) office buildings in the USA. Spearman’s test was used to estimate the correlation between built environment scores and LTc1 scores for each certification level. The Wilcoxon–Mann–Whitney test was used to estimate pairwise comparison between unpaired Platinum, Gold, Silver, and Certified groups. The Platinum, Gold, and Silver certification levels showed positive and significant correlations between the built environment and LTc1 (0.44 ≤ r ≤ 0.74, p ≤ 0.0312). By contrast, Certified certification levels showed a non-significant correlation (0.18 ≤ r ≤ 0.33, p ≥ 0.0579). Pairwise comparison showed that Platinum and Gold groups outperformed Certified groups in terms of built environment and LTc1 scores (Cliff’s δ ≥ 0.37, p ≤ 0.0099). Thus, for LEED-EBv4-certified projects located in downtown areas, LTc1 can be seen as a significant lever to achieve high levels of LEED certification.

Long COVID, also referred to as post-COVID-19 condition, describes the lingering after-effects of COVID-19 infection. This complex syndrome encompasses a range of symptoms affecting physical well-being, cognitive function, and mental health. The widespread impact of long COVID extends beyond individual sufferers, placing significant strain on healthcare systems and causing far-reaching socioeconomic consequences. The scale of this multifaceted health crisis is unparalleled in recent history, affecting millions globally and challenging our understanding of post-viral conditions. This study aimed to explore the possibility of targeting G protein-coupled receptors (GPCRs) signaling pathway-related genes as therapeutics for long COVID using computational analysis. Targeting GPCRs and their signaling pathways holds significant promise for long COVID therapeutics, as these receptors are involved in crucial physiological processes including immune regulation, inflammation control, and neurotransmission. All of these are implicated in the diverse and persistent symptoms of long COVID, potentially offering a versatile approach to addressing multiple aspects of the condition simultaneously. This study identified 21 genes associated with GPCRs for further exploration as potential targets. Notably, GPCR genes such as HRAS, KRAS, GNAQ, and GNA11 were determined to be possible therapeutic targets for the pathophysiological mechanisms of long COVID. FDA-approved drugs targeting these genes were identified, including Binimetinib, Cabozantinib, Selumetinib, Panitumumab, Cetuximab, Adagrasib, Tipifarnib, and Sotorasib. Additionally, Naltrexone and Tipifarnib have emerged as potential new treatment options for long COVID. SARS-CoV-2 may hijack GPCR signaling pathways to dysregulate lung ion and fluid transport, contributing to the pathophysiology of pulmonary edema in patients with COVID-19. Further research is required to translate the findings into the development of therapeutics and to investigate the relationship between viral infection and GPCR signalling.

Graph query languages such as Cypher are widely adopted to match and retrieve data in a graph representation, due to their ability of retrieving and transforming information. Despite the most natural way to match and transform information is through rewriting rules, those are scarcely or partially adopted in graph query languages. Their inability of doing so has a major impact on the subsequent way the information is structured, as it might then appear more natural to provide major constraint over the data representation so to consequently constraint the way the information should be represented. On the other hand, recent works are starting to move towards an opposite direction, as the provision of a truly general semistructured model (GSM) allows to both represent all the available data formats (Network-Based, Relational, and Semistructured) as well as support an holistic query language expressing all major queries in such languages. In this paper, we show that the usage of GSM enables the definition of a general rewriting mechanism which can be expressed in current graph query languages only at the cost of adhering the query to the specificity of the underlying data representation. We formalise the proposed query language in terms graph rewriting mechanisms described as a set of production rules $L\to R$ while providing restriction to the characterization of L, while extending it to support structural graph nesting operations, useful to aggregate similar information around an entry-point of interest. We discuss how GSM, by fully supporting index-based data representation, allows for a better physical model implementation leveraging the benefits of columnar database storages. Preliminary benchmarks shows the scalability of this proposed implementation in comparison with state-of-the-art implementations.

Oxidative stress, characterized by an imbalance between the production of reactive oxygen species (ROS) and the body's antioxidant defenses, significantly affects cellular function and viability. It plays a pivotal role in modulating action potentials (APs), essential for properly functioning excitable cells such as neurons, smooth muscles, pancreatic beta cells, and myocytes. The interaction between oxidative stress and AP dynamics is crucial for understanding the pathophysiology of various conditions, including neurodegenerative diseases, cardiac arrhythmias, and ischemia-reperfusion injuries. This review explores how oxidative stress influences APs, focusing on alterations in ion channel functionality, signaling pathways, and membrane properties. By integrating current research, we aim to elucidate how oxidative stress contributes to disease progression and discuss potential therapeutic interventions targeting this interaction.

Treatment of HIV-associated lymphoma (HIV-Ly) with autologous stem cell transplantation (ASCT) has shown a surprisingly low relapse rate in several series. The aim of this study was to compare the clinical outcomes of HIV-Ly and lymphomas of the general population receiving ASCT. We compared two series of consecutive HIV-positive and HIV-negative patients, based on a 1:1 propensity score analysis, matching for age, sex, histology, disease status and prior therapies. We identified 44 patients in both groups. All HIV-positive patients received combination antiretroviral therapy (cART). With a median follow-up of 51 months, PFS was significantly higher in HIV-positive patients (4-years PFS 81% and 51%, in HIV-positive and HIV-negative patients, respectively, p=0.027). Four-year OS was 81% for HIV-positive and 67% in HIV-negative patients (p=0.15). The relapse rate was significantly higher in HIV-negative patients (36% vs 23%) (p=0.04). Our results clearly show that ASCT is an effective curative option for HIV-Ly, with better PFS and lower relapse rate compared to uninfected patients. A favourable effect of ASCT on HIV infection and immune system recovery, potential off-target effects of cART or other yet unknown factors may account for this observation.