The study aimed to assess the prevalence of the frailty syndrome in older patients hospitalized in the geriatric ward depending on the diagnostic criteria used, the feasibility of particular diagnostic scales in hospitalized patients, and their compatibility. Material and methods: Patients admitted to the Department of Geriatrics of Hospital of the Ministry of the Interior and Administration in Bialystok within eight months were included in the study. Four diagnostic scales were used to identify the frailty syndrome: Fried criteria, 7-point Clinical Frailty Scale (CFS), 40-item Frailty Index (FI), and FRAIL Scale. The compatibility of the scales was determined using Cohen's Kappa statistics. Results: 416 patients (mean age 81.2 ± 6.91 years, 77.4% women) were included in the study. Depending on the scale, the prevalence of frailty syndrome varied from 26.8% ( FRAIL Scale), 52.3% (Clinical Frailty Scale), and 58.1% (Fried criteria) up to 62.9% (Frailty Index). We observed the highest feasibility for CFS (100%), intermediate for Frailty Index (95.2%), FRAIL Scale (89.7%), and the lowest for Fried scale (79.8%). The highest level of agreement was found between the CFS and Fried scale, with 70.2% consistent ratings (Cohen Kappa 0.49). Conclusions: Patients in the geriatric ward are characterized by a high prevalence of frailty, although it differs depending on the criteria. The Frailty Index found the highest prevalence and the lowest in the case of the FRAIL scale. The feasibility of scales and their comparability differed; the most difficult to use in daily practice was the Fried scale, while the Clinical Frailty Scale was determined feasible in all patients. The highest agreement was observed between the Fried criteria and the Clinical Frailty Scale and the lowest between the FRAIL scale and the remaining ones.

The paper proposes an approach to determine the optimal number of medical specialists in the region. According to the author's theoretical model, in order to maximize public welfare, the marginal contribution of the last physician recruited to the growth of the public utility function should be equal to the marginal cost of attracting him and providing conditions for his work. To empirically assess the contribution of physicians to the number of lives saved, the CVD mortality rate is modeled using the instrumental variable method. On average, a 1% increase in the number of cardiologists is associated with a 0.6% decrease in cardiovascular mortality. At the level of provision with cardiologists in the amount of 1 per 100 thousand people, their marginal contribution to the number of lives saved is not less than 129 per 100 thousand people, with a further decrease by 5 people with the increase in the level of provision by 1 unit. The use of the obtained results will increase the validity of managerial decisions and in determining the optimal level of doctors when choosing between alternative possibilities of spending money on hiring doctors of different profiles or other expenses, especially in the case of limited resources.

The nursing home (NH) population becomes increasingly frail, suffering several chronic ill-nesses, high symptom severity, and short remaining lifespan after admission; all this requires skilled, well-organized professional care. Little is known about how NH managers influence the caring and learning environment (CLE) to ensure competencies in meeting NH patients’ needs. The aim of this study is to explore how NH managers influence the CLE to provide basic nursing education for students and apprentices, in order to improve it. This study applies a qualitative design, using multiple methods and focusing on NHs as a context involving complex adaptive systems and on basic nursing as a complex issue. NH managers express a constant struggle to keep workloads manageable, and NHs come across as exhausted organizations with little surplus. Both managers and staff look for ways to execute the work with as little effort as pos-sible and mainly stick to well-established routines. Not participating directly in either daily caring or placement learning, NH managers influence the CLE indirectly through taming and coping strategies, largely using taming strategies that lead to serious unintended outcomes. Coping strategies involve leading collaborative processes in holding environments that are feasible with their workload and roles as managers.

Intensive care unit discharge is an important transition which impacts on patient wellbeing. Nurses can play an essential role in this scenario, potentiating patient empowerment. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement. Embase, PubMed/MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were evaluated in May 2021. Two independent reviewers analyzed the studies, extracted the data, and assessed the quality of evidence. Quality of the studies included was assessed using the Cochrane risk-of-bias tool. Of the 273 articles initially identified, eight randomized controlled trials reported nursing interventions mainly focused on patients’ ICU discharge preparation through information and education. The creation of ICU Nurse-Led and nurses’ involvement in critical care multidisciplinary teams also aimed to support patients during ICU discharge. This systematic review provides an update on clinical practice aimed at improving the patient experience during ICU discharge. The main nursing interventions were based on information and education, as well as the development of new nursing roles. Understanding transitional needs and patient empowerment are key to making the transition easier.

Patients with chronic obstructive pulmonary disease (COPD) often require frequent hospitalization due to worsening symptoms. Preventing prolonged hospital stay and readmission becomes a challenge for healthcare professionals treating patients with COPD. Although the integration of health and social care supports greater collaboration and enhanced patient care, organizational structure and poor leadership may hinder the implementation of patient-oriented goals. This paper presents a case of a 64-year-old chronic smoker with severe COPD who was to be discharged on long-term oxygen therapy (LTOT). It further highlights the healthcare decisions made to ensure the patient’s safety at home and further provides a long-lasting solution to the existing medical and social needs. The goal was accomplished through a discharge plan that reflects multidisciplinary working, efficient leadership, and change management using Havelock’s theory. While COPD is characterized by frequent exacerbation and hospital readmission, it was emphasized that most failed discharges could be attributed to bureaucratic organizational workflow which might not be in the patient’s best interest. It was further demonstrated that healthcare professionals are likely to miss the window of opportunity to apply innovative and long-lasting solutions to the patient’s health condition in an attempt to remedy the immediate symptoms of COPD

Very little is known about laboratory confirmed blood stream infections (LCBIs) in neonatal intensive care units (NICUs) in resource-limited settings. The aim of this cohort study was to determine the incidence, risk factors, and causative agents of LCBIs in a level-2 NICU in India. The diagnosis of LCBIs was established using the Centre for Disease Control, USA criteria. A predesigned questionnaire containing risk factors associated with LCBIs was filled-in. A total of 150 neonates (43% preterm) were included in the study. The overall incidence of LCBIs was 31%. The independent risk factors for LCBIs were: preterm neonates (relative risk (RR) 2.23), duration of NICU stay more than 14 days (RR 1.75), chorioamnionitis in the mother (RR 3.18), premature rupture of membrane in mothers (RR 2.32), neonate born through meconium-stained amniotic fluid (RR 2.32), malpresentation (RR 3.05), endotracheal intubation (RR 3.41), umbilical catheterization (RR 4.18), and ventilator-associated pneumonia (RR 3.17). The initiation of minimal enteral nutrition was protective from LCBIs (RR 0.22). The predominant causative organisms were gram-negative pathogens (58%). The results of the present study can be used to design antibiotic interventions to reduce LCBIs in resource-limited settings.

Genetic testing allows for identification of germline DNA variations which are associated with a significant increase in risk of developing breast and ovarian cancer. Detection of a BRCA1 or BRCA2 pathogenic variant triggers several clinical management actions, which may include increased surveillance and prophylactic surgery for healthy carriers or treatment with PARP inhibitor therapy for carriers diagnosed with cancer. Thus, standardized validated criteria for annotation of BRCA1 and BRCA2 variants according to their pathogenicity are necessary to support clinical decision making and ensure improved outcomes. Upon detection, variants whose pathogenicity can be inferred by the genetic code are typically classified as pathogenic, likely pathogenic, likely benign, or benign. Variants whose impact on function cannot be directly inferred by the genetic code are labeled as Variants of Uncertain Clinical Significance (VUS) and are evaluated by multifactorial likelihood models that use personal and family history of cancer, segregation data, prediction tools, and co-occurrence with a pathogenic BRCA variant. Missense variants, coding alterations that replace a single amino acid residue with another, are a class of variants for which determination of clinical relevance is particularly challenging. Here, we discuss current issues in variant classification by following a typical life cycle of a BRCA1 missense variant through detection, annotation and information dissemination. Advances in massively parallel sequencing have led to a substantial increase in VUS findings. Although comprehensive assessment and classification of missense variants according to their pathogenicity remains the bottle neck, new developments in functional analysis, high throughput assays, data sharing, and statistical models are rapidly changing this scenario.

With the ever-growing geopolitical tensions across borders arising, ultimately from the eternal energy needs, it is the peak time for humanity to put its reliance on a more quasi-perpetuity source of energy, such as the Sun. Even though current photovoltaics are the frontier of solar power harvesting, their efficiencies are reaching a state of stasis sooner or later. The efficiencies of single-junction solar cells are capped by the Shockley-Quiesser limit of 33.7%. Researchers are racing toward a way to beat this limit while keeping the Levelized Cost of Energy (LCE) to its minimum. Amongst all contenders, rectenna (or rectifying antenna), which was invented only a decade after the first practical PV cell by the Bells lab [1], is the most promising technology to take the forefront in quenching the energy needs, not only because of the absence of any such theoretical limit but also a lower cost of production. This report will review three state-of-the-art architectures for optical rectification developed by the leading groups worldwide. The review will compile a concise discussion on Metal-Double-Insulator-Metal diodes, CNT-Insulator-Metal diodes, and Point-contact-Metal-Insulator-Metal diodes, with an elaborative focus on their fabrication methods and results obtained.

Aquaculture is expected to play a vital role in solving the challenge of sustainably providing the growing world population with healthy and nutritious food. Pathogen outbreaks are a major risk for the sector, so early detection and a timely response are crucial. This can be enabled by monitoring of pathogen levels in aquaculture facilities. This paper describes a photonic biosensing platform based on silicon nitride waveguide technology with integrated active components, which could be used for such applications. Compared to the state of the art, the current system presents improvements in terms of miniaturization of the Photonic Integrated Circuit (PIC), and the development of wafer level processes for hybrid integration of active components and for material-selective chemical and biological surface modification. Furthermore, scalable processes for integrating the PIC in a microfluidic cartridge have been developed, as well as a prototype desktop readout instrument. Three bacterial aquaculture pathogens (Aeromonas salmonicida, Vagococcus salmoninarum, and Yersinia ruckeri) were selected for assay development. DNA biomarkers were identified, corresponding primer-probe sets designed, and qPCR assays developed. The biomarker for Aeromonas was also detected using the hybrid PIC platform. This is the first successful demonstration of biosensing on the hybrid PIC platform.

There is little understanding of patients' experiences and perceptions with satisfaction by health professionals such as medical and dental clinicians. Furthermore, patient satisfaction is not well understood. The objective of this article is to better understand patients' satisfaction with their medical and dental care. The methods of the current article are based on a narrative review of the literature strategy. Patient satisfaction's multidimensional nature has been established since the perceived reasons for satisfaction varied widely among patients. Many aspects of the treatment influence participant satisfaction at different stages of the intervention's process. An improved understanding of the basis for managing patients' expectations with information reiteratively and efficiently may ultimately reduce patients' potential for negative feelings toward the medical and dental treatment experience. The consumerist method may misrepresent the concept of satisfaction in health service.

Introduction: The COVID-19 pandemic highlighted the necessity for rapid, efficient testing at large-scale events. Developing rapid and efficient testing methods was critical, especially for events with a high risk of virus spread. The queueing theory offers a powerful tool to manage the flow of people through testing centers. This study uses the M/M/c model to examine how different floor plan configurations impact the efficiency of RADT testing centers. Aim of the study: This research applies queueing theory to optimize the Rapid Antigen Diagnostic Test (RADT) processes at mass gatherings. The study uses the M/M/c queueing model to evaluate the dynamics of RADT centers configured in U-shaped and straight-line layouts. The primary goal is to assess the feasibility of using RADTs efficiently at events and mass gathering entrances, aiming to enhance throughput and minimize wait times. Methodology: The study involved 500 healthy participants, managed by medical staff across a U-shaped and a straight floor plans. Agile management techniques were employed to enhance operational efficiency. The process stages included queue number issuance, registration, sample collection, sample mixing, and results dissemination. Results: Both floor plans enabled the completion of RADT screening in approximately 2 minutes per participant. The U-shaped layout slightly outperformed the straight-line setup in efficiency, demonstrating its effectiveness in optimizing the testing process. Conclusion: This study confirms the feasibility of implementing Rapid Antigen Diagnostic Test (RADT) processes at mass gatherings. It was found that the U-shaped floor plan configuration is particularly effective, indicating its potential suitability for future mass testing scenarios.

We have considered a SEIR-SEI Vector-host mathematical model which captures malaria transmission dynamics, described and built on 7-dimensional nonlinear ordinary differential equations. We compute the basic reproduction number of the model; examine the positivity and boundedness of the model compartments in a region using well established methods viz: Cauchy’s differential theorem, Birkhoff & Rota’s theorem which verifies and reveals the well-posedness, and carrying capacity of the model respectively, the existence of the Disease-Free (DFE) and Endemic (EDE) equilibrium points were determined and examined. Using the Gaussian elimination method and the Routh-hurwitz criterion, we convey stability analyses at DFE and EDE points which indicates that the DFE (malaria-free) and the EDE (epidemic outbreak) point occurs when the basic reproduction number is less than unity (one) and greater than unity (one) respectively. We obtain a solution to the model using the Variational iteration method (VIM) (an unprecedented method) to each population compartments and verify the efficacy, reliability and validity of the proposed method by comparing the respective solutions via tables and combined plots with the computer in-built Runge-kutta-Felhberg of fourth-fifths order (RKF-45). We illustrate the combined plot profiles of each compartment in the model, showing the dynamic behavior of these compartments; then we speculate that VIM is efficient and capable to conduct analysis on Malaria models and other epidemiological models.

Community-based case managers in health have been compared to glue which holds the dynamic needs of clients to a disjointed range of health and social services. However, case manager roles are difficult to understand due to poorly defined roles, confusing terminology, and low visibility in New Zealand. This review aims to map the landscape of case management work to advance workforce planning by clarifying the jobs, roles, and relationships of case managers in Aotearoa New Zealand (NZ). Our scoping and mapping review includes peer-reviewed articles, grey literature sources, and interview data from 15 case managers. Data was charted iteratively until convergent patterns emerged and distinctive roles identified. A rich and diverse body of literature describing and evaluating case management work in NZ (n=148) is uncovered with at least 38 different job titles recorded. 18 distinctive roles are further analysed with sufficient data to explore the research question. Social ecology maps highlight diverse interprofessional and intersectoral relationships. Significant innovation and adaptations are evident in this field, particularly in the last five years. Case managers also known as health navigators, play a pivotal but often undervalued role in NZ health care, through their interprofessional and intersectoral relationships. Their work is often unrecognised which impedes workforce development and the promotion of person-centred and integrated health care.

Background: Globally, infections are the third leading cause of neonatal mortality. Predominant risk factors for facility-born newborns are poor hygiene practices that span both the facility and home environments. Current improvement interventions focus on only one environment and tar-get limited caregivers, primarily birth attendants and mothers. To inform the design of a hand hygiene behaviour change intervention in rural Cambodia, a formative mixed-methods research study was conducted to investigate the context specific behaviours and determinants of hand-washing among healthcare workers, maternal and non-maternal caregivers along the early new-born care continuum. Methods: Direct observations of hygiene practices of all individuals providing care to 46 newborns across eight facilities and associated communities were completed and hand hygiene compliance assessed in analysis. Semi structured interactive interviews were subsequently conducted with 35 midwives and household members to explore the corresponding cognitive, emotional, and environmental factors influencing the observed key hand hygiene behaviours. Results: Hand hygiene opportunities during newborn care were frequent in both set-tings (n = 1319) and predominantly performed by mothers, fathers and non-parental caregivers. Compliance to hand hygiene protocol across all caregivers, including midwives, was inadequate (0%). Practices were influenced by the lack of accessible physical infrastructure, time, increased workload, low infection risk perception, nurture-related motives, norms and inadequate knowledge. Conclusion: Our findings indicate that an effective intervention in this context should be multi-modal to address the different key behaviour determinants and target a wide range of caregivers.

Harvesting is the collection of mature crops from the field. A harvesting procedure involves cutting, installation, collecting, transferring, and then stacking the cut produce. Mechanization of harvesting operations is critical to lowering harvesting costs, crop production costs, crop loss, turnaround time, weather risk, and increasing benefit through proper technology. To achieve the desired purpose, a manually operated reaper machine is created and developed to assist farmers by lowering the cost of crop cutting and collection in the field while achieving the best efficiency possible within the limits. Research technique is a set of acts or procedures that must be completed in order to do research properly, as well as the intended sequence of these steps. Identify the problem statement. Studying the current design of the reaper machine Review the literature. Product development general design process steps for reaper harvester’s machine include planning, concept development, system-level design, detail design, testing and refining, and product ramp-up. In this step, the material properties are defined based on design. To simulate the reaper machine using Catia software, Prototyping, testing for validation, Interpret and report. Material is chosen based on the strength requirements of the different parts of the Reaper machine. The machine is built with locally accessible materials. This self-propelled reaper moves at a forward speed of 2.54 m/s. The cutting bar measures 120 cm in length and the bundling mechanism is dropped. The field capacity is 0.306 ha/hour, respectively. The needed manpower for harvesting one hectare of wheat and rice reaper harvesting field operation is two man-hours per ha. The amount of fuel required to completely fill the tank after harvesting the plot was measured to determine the amount of fuel consumed for reaping the test plot, which was 1.17 l/h.

This study assesses the effectiveness of HCV self-testing (HCVST) distribution models compared to provider-led HCV testing (PL-HCVT), including the standard of care facility-based HCVT (SOC-HCVT) and community-based organization HCVT (CBO-HCVT) among people who inject drugs (PWID) in Vietnam. A cross-sectional study was conducted as part of a larger implementation science study in Hanoi and Ho Chi Minh City from September 2023 to April 2024. We engaged 8 CBOs and 10 public and private clinics in offering choice of HCVST through community-based and facility-based distribution, and secondary distribution), or PL-HCVT via SOC-HCVT and CBO-HCVT. Among 1,165 PWID, 693 opted for HCVST and 472 for PL-HCVT. The proportion of first-time testers was significantly higher in HIVST community-based and secondary distribution as well as CBO-HCVT compared to SOC-HCVT and facility-based HCVST (87.1%, 93.3% and 82.7% vs. 41.9% and 35.7%, respectively; p < 0.001). Overall, HCV seropositivity rate was lower in HCVST than PL-HCVT, however, higher in HCVST facility-based and community-based distribution compared to HCVST secondary distribution (28.1% and 20.4% vs. 5.7%, respectively). Community-based HCVST was most effective, followed by facility-based HCVST and secondary distribution. Our findings indicate that HCVST effectively reaches first-time testers and results in more people diagnosed and treated among PWID.

In this digital era, laundry applications come as an innovative solution to meet the laundry needs of modern people who often have busy schedules and limited time. This research aims to make a significant contribution to our broader understanding of how digital innovations can revolutionize mundane tasks. This research uses the Waterfall model, which is one of the methods in the Software Development Life Cycle (SDLC). The development process begins with the Requirement Analysis stage, where application requirements and specifications are collected and thoroughly analyzed to ensure that the developed application will meet user expectations. After that, the System Design stage is conducted, where the application architecture, user interface design, and database structure are designed in detail to ensure conformity with the previously identified needs.The next stage is Implementation, where program code is written and application features are developed according to the design that has been made. The final stage is Integration and Testing, where all application components are combined and tested thoroughly to detect and fix any errors or bugs that may exist. The results of this study produced a web-based shuttle laundry service application using the Laravel framework called "All Fresh Laundry". This application can order clothes washing services according to its membership, where there are 3 types of membership based on price and of course have different benefits. In addition, the testing phase of this application using black box testing shows that all menu features function properly according to their functions. Each component of the "All Fresh Laundry" app was thoroughly tested to ensure that no errors or malfunctions occurred. The results of this testing make it clear that every feature, from online ordering to laundry status tracking, works well and meets the specifications that have been set, so that this application can provide an optimal and reliable user experience.

Purpose: To explore how race and residential zip codes' socioeconomic index (SES) influenced COVID-19 testing rates in St. Louis during the early and peak phases of the pandemic. Method: An ecological study was conducted using COVID-19 testing data from March to November 2020 in St. Louis City. The study included 16,915 individual tests from 30 residential zip codes. Results: The overall testing rate in St. Louis was 303.97 per 10,000 population. Testing rates among Blacks, Whites, American Indian/Alaskan Natives, and Asians were 374.26, 247.77, 360.63, and 242.41 per 10,000, respectively. Higher testing rates were observed in low and middle SES zip codes compared to high SES zip codes. Adjusted for SES, testing rates were 1.68% higher among Blacks and 0.43% higher among American Indian/Alaskan Natives compared to Whites, and 0.033% lower among Asians. Geographical mapping showed higher testing rates in the inner core and lower rates in the periphery of St. Louis. Conclusion: Race and SES influence testing rates. Areas with low testing rates should be targeted for intervention in St. Louis.

Conditional Independence (CI) testing is fundamental in statistical analysis. For example, CI testing helps validate causal graphs or longitudinal data analysis with repeated measures in causal inference. CI testing is difficult, especially when testing involves categorical variables conditioned on a mixture of continuous and categorical variables. Current parametric and non-parametric testing methods designed for continuous variables and can quickly fall short in the categorical case. This paper presents a computational approach for CI testing for categorical data types, which we call computational conditional independence (CCI) testing. The test procedure is based on permutation and combines machine learning prediction algorithms and Monte Carlo Cross-Validation. We evaluated the approach through simulation studies and assessed the performance against alternative methods; the generalized covariance measure (GCM) test, the kernel conditional independence (KCI) test, and testing with multinomial regression. We find that the computational approach to testing has utility over the alternative methods, and we can achieve better control over type-I-error rates. We hope this work can expand the toolkit for CI testing for practitioners and researchers.

The field of construction materials is pivotal in developing sustainable and resilient infrastructure. This demands continuous research to understand the properties and behaviors of these materials under diverse conditions. Although advancements in material science and numerical modeling have been significant, experimental testing remains indispensable for a thorough comprehension of material characteristics, particularly under extreme stresses and environmental factors. This need has forced the development of a wide array of testing techniques, each designed to evaluate specific engineering properties, thus creating a complex and varied landscape of experimental methodologies. This study provides a comprehensive overview of both conventional and innovative experimental testing techniques used to characterize construction materials. It explores the related methodologies and identifies potential gaps in their application within the industry. The spectrum of testing covered includes mechanical, chemical, thermal, microstructural, durability, physical, rheological properties, and non-destructive testing methods. Mechanical tests assess strength, hardness, and fatigue, whereas chemical analyses utilize techniques such as spectroscopy and chromatography. Thermal properties are examined using thermogravimetric analysis, and microstructural characteristics are explored through advanced imaging techniques. Durability testing focuses on materials’ resistance to environmental challenges, while physical properties tests evaluate aspects like porosity and water absorption. Rheological and non-destructive tests further examine materials’ behavior and integrity without causing damage. By discussing these methodologies, the study sheds light on various approaches to material evaluation and aims to enhance the selection, application, and development of testing standards. This overview seeks to inform and inspire future research and innovation in the science of construction materials, contributing to the development of more resilient and sustainable construction practices.

A new Mg-Zn-Zr-Ca alloy in powder state was obtained via mechanical alloying method, from pure elemental powder. Further, the obtained powder-alloy was processed by selective laser melting (SLM) procedure to obtain 3D printed samples for small biodegradable implants. A series of microstructural, mechanical and corrosion analysis were performed. The SEM analysis of powder-alloy reveal a good dimensional homogeneity, with uniform colored, no agglutinated and almost rounded particles, suitable for selective laser melting procedure. Further, the SLM samples reveal a robust and unbreakable morphology, with a suitable porosity and without undesirable balling effect. The tested Young’s modulus of the SLM samples, of 42 GPa, is close to cortical bone one, of 30 GPa. The corrosion tests performed in PBS (Phosphate-buffered saline) solution show that the corrosion parameters have a satisfactory evolution.

Modal testing is a common step in aerostructure design, serving to validate the predicted natural frequencies and mode shapes obtained through computational methods. The strategic placement of sensors during testing is crucial to accurately measuring the intended natural frequencies. However, conventional methodologies for sensor placement are often time-consuming and involve iterative processes. This study explores the potential of machine learning techniques to enhance sensor selection methodologies. Three machine learning-based approaches are introduced and assessed, comparing their efficiency with established techniques. The evaluation of these methodologies is conducted using a numerical model of a beam to simulate real-world scenarios. The results offer insights into the efficacy of machine learning in optimizing sensor placement, presenting an innovative perspective on enhancing the efficiency and precision of modal testing procedures in aerostructure design.

The seed industry plays a crucial role in the global food production, but it faces a persistent challenge in ensuring the health and quality of seeds, particularly those of tomato and pepper, which represent key seed commodities on the global market. Seeds can serve as potential pathways for the introduction and dissemination of seed-borne bacteria, which may have devastating effects on crop yield, farmers’ remunerability, and food security. Therefore, fungicides and other anti-microbial compounds are extensively used to disinfect the seeds, thus increasing the input of chemicals in the agri-enviroment. In this review, we address aspects that connect disease epide-miology with seed infection and health, including seed contamination, endophytic colonization, and seed-borne infections. We focused on the main bacterial diseases affecting tomato and pepper by discussing their official seed testing methods as requirements supporting a smooth seed trade. Moreover, we present a survey on the past and recent innovations for seed treatments, focusing on sustainable disinfection methods. Therefore, this review will be a short, but indispensable guide for seed technologists and pathologists involved in the production of high-quality seeds, providing indications and suggestions to contrast seed-borne pathogens dissemination, avoid international controversies and complaints by phytosanitary authorities, extension services and farmers.

We investigated 328 SARS-CoV-2 cases in Barwon South West Victoria, Australia, in the 2020 pre-vaccination period, comparing infections with symptoms to those that remained asymptomatic. De-identified self-reported data from three sequential questionnaires on case characteristics and symptom progression were examined. Multivariable logistic regression were used to model associations between demographic profile and symptoms. Asymptomatic cases were more than three times as likely to be from ethnic minority groups [OR 3.2, 95% CI 1.5 – 6.7, p&lt;0.01], and approximately seven times more likely to be seniors (≥ 65 years) [OR 7.3, 95% CI 1.0 – 50.1] after adjusting for sex and occupation. The overrepresentation of ethnic minority groups among asymptomatic infections is suggestive of genetic haplotype variability by ethnic group, conferring greater cross protection from other coronaviruses in the early stages of the COVID-19 pandemic. This research should be repeated post-vaccination to reassess symptom expression according to ethnicity, and better comprehend case ascertainment impacts of cultural biases in testing and infection reporting, and the reliance on symptoms to trigger testing. These findings may in part reflect differences in testing patterns by ethnicity and true differences in disease expression, both important for appropriate transmission prevention strategies, and tailoring testing messaging towards ethnic minority communities.

A significant amount of data is available for bench-scale fire assessments. However, there is little surrounding large-scale tests and even less so for bench-to-large scale comparisons. Large-scale tests require more material, time and preparation, making them more expensive than bench-scale assessments. However, large-scale testing is an essential component to bench-scale fire testing. The bench-scale tests must be representative of both large-scale and real fire behaviour to provide an insight into how a material or product will behave in the event of a fire during its end use application. The few existing studies reviewed in this study show more guidance and data is needed, especially on a large-scale. Unfortunately, the data that is presented is done so in an inconsistent manner using various means of presentation, statistical analysis, and modelling that doesn’t show clear comparisons between bench and large scale. Currently, no bench-scale method shows good agreement with large-scale fire behaviour. Overall, there is a need for more large-scale testing and data for direct comparisons to be made.

Since sensor-based perception systems are used in autonomous vehicle applications, validating such systems is imperative to guarantee the robustness of the systems before they are being put to use. In this study, a comprehensive corruption-related simulation-based robustness verification and enhancement process for sensor-based perception systems is proposed. Firstly, we present a methodology and scenario-based corruption generation tools for creating diverse simulated test scenarios that can analogously represent real-world traffic environments, especially considering corruption types related to safety concern. Then, an effective corruption similarity filtering algorithm is proposed to remove corruption types with high similarity and identify the representative corruption types to represent all considered corruption types. As a result, we can generate efficient corruption-related robustness test scenarios with less testing time and good scenario coverage. Subsequently, we perform the vulnerability analysis of object detection models to identify model weaknesses and construct an effective training dataset for model vulnerability enhancement. This enhances the tolerance of object detection models to weather and noise-related corruptions, ultimately improving the robustness of the perception system. We employ case studies to demonstrate the feasibility and effectiveness of the proposed robustness verification and enhancement procedures. Additionally, we explore the impact of different "similarity overlap threshold" parameter settings on scenario coverage, effectiveness, scenario complexity (size of training and testing datasets), and time costs.

Chemical and mechanical properties of plasma-assisted nitrided (PAN), TiN cathodic arc coated, and PAN with TiN coated samples were thoroughly evaluated on tool steel samples of 1.2379. The evaluation involved SEM, nano-indentation, profilometer, micro scratch, and corrosion tests. The results revealed that PAN treatment alters the roughness of the surface, while it has minimal impact on the coefficient of friction. However, it increases the substrate's hardness, making it twice as hard and three times more resilient against scratch tests, along with improved corrosion resistance. TiN-coated samples are four times harder than untreated ones, but they exhibit a higher elastic modulus (E), leading to a lower H/E index. The most promising results were obtained with PAN+TiN treatment, combining high hardness (H) with lower E, resulting in a high H/E index, a crucial criterion for wear resistance. These samples also demonstrated superior scratch hardness and corrosion resistance, despite being thinner and rougher.

In the first part of this article, we discuss and generalize the complete convergence introduced by Hsu and Robbins (1947) to the r-complete convergence introduced by Tartakovsky (1998). We also establish its relation to the r-quick convergence first introduced by Strassen (1967) and extensively studied by Lai (1976). Our work is motivated by various statistical problems, mostly in sequential analysis. As we show in the second part, generalizing and studying these convergence modes is important not only in probability theory but also to solve challenging statistical problems in hypothesis testing and changepoint detection for general stochastic non-i.i.d. models.

This essay is a personal insight based on my own experience in the Iberian Pyrenees, which addresses three situations common in paleoecological research, such as the verification of previously devised hypotheses (anticipation), the finding on unknown events in unstudied sites (discovery) and the finding of unexpected outputs in already known areas (serendipity). The account is concentrated on the value of the coring sites by themselves as generators of paleoecological knowledge, rather than on the actual findings, which are presented and discussed in the corresponding data papers. The main aim is to show that there is still much room for new findings, even in areas that have been surveyed for long time and are supposed to be well known, from a paleoecological perspective. Finally, some general lessons are derived and conceptualized.

Burkina Faso is a sub-Saharan African country with a high poverty rate that has quadruplicated its population in the last half fifty years, that is, from 4.5 to 18 million inhabitants. Such demographic changes together with an intense migration process from rural areas to large cities, among other issues, are contributing to a rapid process of socio-cultural transformation. In this context, changes in both traditional and contemporary housing are analyzed and a complete ther-mo-hygrometric evaluation is carried out by processing significant data from on-site measure-ments to shed new light on the response of the said dwellings to the environmental and local cultural values. Results show that the introduction of land ownership linked to climate change and the increasing scarcity of natural resources are forcing native ethnic groups to modify their traditional ways of life, threatening their subsistence. Consequently, we can prove that the new building typologies are not in the least suitable for the climatic conditions nor the rich cultural heritage of Burkina Faso. This fact, negatively affects the possibility of revitalizing vernacular and environmentally-oriented solutions for the contemporary world and the necessary advance to-wards a more sustainable architecture.

Insecticide testing facilities that evaluate a variety of vector control products may generate large amount of hazardous wastes from routine operations. These wastes originate from degraded technical grade materials, sprayed substrates, redundant stock or working insecticidal solutions. The washing of Long-Lasting Insecticidal Nets (LLINs) during preparation for laboratory and experimental hut trials also contribute to waste water with insecticide content. Human and environmental exposure to insecticidal waste can occur during transport, categorization, storage and disposal in resulting in environmental pollution and potential health effects. Various national and international guidelines have been devised for safe disposal and should be strictly followed to avoid adverse effects on humans or environment. The current paper describes a case study from insecticide test facility in north-eastern Tanzania in management of insecticidal waste.

Electromagnetic sensing has been used for diverse applications of non-destructive testing, including the surface inspection, measurement of properties, object characterization. However, the measurement accuracy could be significantly influenced by the lift-off between sensors and samples. To address the issue caused by lift-offs, various strategies have been proposed for the permeability measurement of ferromagnetic steels, which mainly involves different sensor designs and signal features (e.g., the zero-crossing feature). In this paper, a single high-frequency scenario for the permeability retrieval is introduced. By combining the signal of two sensing pairs, the retrieval of magnetic permeability is less affected by the lift-off of sensors. Unlike the previous strategy on reducing the lift-off effect (directly taking the phase term out of the integration) using the Dodd-Deeds analytical method, the proposed method is based on a high-frequency linear feature of the phase term. Therefore, this method has the merit of high accuracy and fast processing for the permeability retrieval (a simplified version of Dodd-Deeds analytical formulas after the integration). Experimental measurement has been carried out on the impedance measurement of designed sensors interrogating ferromagnetic dual-phase steels. For sensor lift-offs of up to 10 mm, the error of the permeability retrieval is controlled within 4 % under the optimal frequency.

For polymicrobial infections, AtbFinder utilizes a novel paradigm of the population response to antibiotics, enabling bacterial growth in the form of a mixed microbial community and selecting the antibiotics targeting not only the principal pathogen, but also those bacteria that support their growth. TGV medium allowed culturing a more diverse set of bacteria from polymicrobial biospecimens, compared with that achieved with the standard media and enabled, already within 4h, accurate selection of the antibiotics that completely eliminated all cultivatable bacteria from clinical samples. In conclusion, AtbFinder system may be a valuable tool in improving antibiotic selection, enabling targeted empirical therapy and accurate antibiotic replacement, which is especially important in high-risk patients.

(1) Background: the NGS based mutational study of hereditary cancer genes is crucial to design tailored prevention strategies in subjects with different hereditary cancer risk. The ease of amplicon-based NGS library construction protocols contrasts with the greater uniformity of enrichment provided by capture-based protocols and so with greater chances for detecting larger genomic rearrangements and copy-number variations. Capture-based protocols, however, are characterized by a higher level of complexity of sample handling, extremely susceptible to human bias. Robotics platforms may definitely help dealing with these limits, reducing hands-on time, limiting random errors and guaranteeing process standardization. (2) Methods: We implemented and validated the complete automation of the SOPHiA GENETICS’ CE-IVD Hereditary Cancer Solution™ (HCS) libraries preparation workflow on the Hamilton’s STARlet platform. (3) Results: We demonstrate that this automated workflow, used for more than 1000 samples achieved the same performances of manual setup in terms of coverages and reads uniformity, with extremely lower variability of reads mapping rate onto the regions of interest. (4) Conclusions: This automated solution offers same reliable and affordable NGS data, but with the essential advantages of a flexible, automated and integrated framework, minimizing possible human errors and depicting a laboratory’s walk-away scenario.

Diagnosis and prognosis of failures for aircrafts’ integrity are some of the most important regular functionalities in complex and safety-critical aircraft structures. Further, development of failure diagnostic tools such as Non-Destructive Testing (NDT) techniques, in particular, for aircraft composite materials, has been seen as a subject of intensive research over the last decades. The need for diagnostic and prognostic tools for composite materials in aircraft applications rises and draws increasing attention. Yet, there is still an ongoing need for developing new failure diagnostic tools to respond to the rapid industrial development and complex machine design. Such tools will ease the early detection and isolation of developing defects and the prediction of damages propagation; thus allowing for early implementation of preventive maintenance and serve as a countermeasure to the potential of catastrophic failure. In this paper, following a short introductory summary and definitions, this paper provides a brief literature review of recent research on failure diagnosis of composite materials with an emphasis on the use of NDT techniques in aerospace industry. In addition to this, within a some of significant NDT application extents, prognosis of composites is also briefly discussed.

Eddy current sensors can be used to test the characteristics and measure the parameters of the conductive samples. As the main obstacle of the multi-frequency eddy current sensor, the lift-off distance affects the effectiveness and accuracy of the measurement. In this paper, a material-independent algorithm has been proposed for the restoration of the lift-off distance when using the multi-frequency eddy current sensor, which is based on the approximation under the thin-skin effect. Experiment testing on the performance of the proposed method is presented. Results show that from the dual-frequency inductance, the lift-off distance could be restored with a maximum error of 0.24 mm for the distance up to 12 mm. Besides, the derived lift-off distance is used for the inversion of the magnetic permeability. Based on a lift-off insensitive inductance (LII) feature, the magnetic permeability of steels can be inversed in an iterative manner, with an error of less than 0.6 % for the lift-off distance up to 12 mm.

Current oncological developments are based on improved understanding of genetics, and especially the discovery of genes whose alterations affect cell functions with consequences for the whole body. Our work is focused on the one of these genes, the BARD1 and its oncogenic role in breast cancer. Most importantly, the study points to new avenues in the treatment and prevention of the most frequent female cancer based on BARD1 research. The BARD1 and BRCA1 proteins have similar structures and functions, and they combine to form the new molecule BARD1-BRCA1 heterodimer. The BARD1-BRCA1 complex is involved in genetic stabilization at the cellular level. It allows to mark abnormal DNA fragments by attaching ubiquitin to them. In addition, it blocks (by ubiquitination of RNA polymerase II) the transcription of damaged DNA. Ubiquitination, as well as stabilizing chromatin, or regulating the number of centrosomes, confirms the protective cooperation of BARD1 and BRCA1 in the stabilization of the genome. The overexpression of the oncogenic isoforms BARD1β and BARD1δ permit cancer development. The introduction of routine tests, for instance, to identify the presence of the BARD1β isoform, would make it possible to detect patients at high risk of developing cancer. On the other hand, introducing BARD1δ isoform blocking therapy, which would reduce estrogen sensitivity, may be a new line of cancer therapy with potential to modulate responses to existing treatments. It is possible that the BARD 1 gene offers new hope for improving breast cancer therapy.

Current oncological developments are based on improved understanding of genetics, and especially the discovery of genes whose alterations affect cell functions with consequences for the whole body. Our work is focused on the most important of these genes, the BARD1 and its oncogenic role in breast cancer. Most importantly, the study points to new avenues in the treatment and prevention of the most frequent female cancer based on BARD1 research. The BARD1 and BRCA1 proteins have similar structures and functions, and they combine to form the new molecule BARD1-BRCA1 heterodimer. Through ubiquitination, this heterodimer has significant effects on individual proteins, enabling, among others, the destruction of damaged DNA fragments. Ubiquitination, as well as stabilizing chromatin, or regulating the number of centrosomes, confirms the protective cooperation of BARD1 and BRCA1 in the stabilization of the genome. The overexpression of the oncogenic isoforms BARD1β and BARD1δ permit cancer development. The introduction of routine tests, for instance, to identify the presence of the BARD1β isoform, would make it possible to detect patients at high risk of developing cancer. On the other hand, introducing BARD1δ isoform blocking therapy, which would reduce estrogen sensitivity, may be a new line of cancer therapy with potential to modulate responses to existing treatments. It is possible that the BARD 1 gene offers new hope for improving breast cancer therapy.

This paper investigates whether optimisation methods with the population made up of one solution can suffer from structural bias just like their multisolution variants. Following recent results highlighting the importance of choice of strategy for handling solutions generated outside the domain, a selection of single solution methods are considered in conjunction with several such strategies. Obtained results are tested for the presence of structural bias by means of a traditional approach from literature and a newly proposed here statistical approach. These two tests are demonstrated to be not fully consistent. All tested methods are found to be structurally biased with at least one of the tested strategies. Confirming results for multisolution methods, it is such strategy that is shown to control the emergence of structural bias in single solution methods. Some of the tested methods exhibit a kind of structural bias that has not been observed before.

Let $\mathcal{M}(\Spin(8,\mathbb{C}))$ be the moduli space of $\Spin(8,\mathbb{C})$-Higgs bundles over a compact Riemann surface $X$ of genus $g\geq 2$. The triality automorphism of $\Spin(8,\mathbb{C})$ acts on $\mathcal{M}(\Spin(8,\mathbb{C}))$ and those Higgs bundles that admit a reduction of structure group to $G_2$ are fixed points of this action. This defines a map of moduli spaces of Higgs bundles $\mathcal{M}(G_2)\rightarrow\mathcal{M}(\Spin(8,\mathbb{C}))$. In this work, the action of the triality automorphism is extended to an action on the Hitchin integrable system associated to $\mathcal{M}(\Spin(8,\mathbb{C}))$. In particular, it is checked that the map $\mathcal{M}(G_2)\rightarrow\mathcal{M}(\Spin(8,\mathbb{C}))$ restricts to a map at the level of Prym varieties. Necessary and sufficient conditions are also provided for the Prym varieties associated with the moduli spaces of $G_2$ and $\Spin(8,\mathbb{C})$-Higgs bundles to be disconnected. Finally, some consequences are drawn from the above results in relation to the geometry of the Prym varieties involved.

The global oil and gas exploration targets are gradually moving towards a new field of oil and gas accumulation with nano pore throats, ranging from millimeter scale to micro nano pore throats.There are difficulties in fluid transport in nano confined pore throats, such as strong adsorption, which greatly increases the difficulty of starting crude oil.Therefore, it is necessary to construct a nanoscale fluid with strong diffusion and dispersion, and improve its permeability, suction, and displacement capabilities.This article develops a carbon dioxide responsive graphene dot type surfactant.By characterizing its structure, physical and chemical properties, and conducting infiltration simulation experiments, its infiltration and drainage ability in nanopore throats is elucidated.Infrared spectrum measurement shows that after functional modification exhibit new characteristic peaks at 1600 cm-1 to 1300 cm-1, considering the N-H plane stretching characteristic peak.The fluorescence spectra showed that the fluorescence intensity of F-GQDs was increased after functional modification, which indicated that F-GQDs was successfully synthesized.Through measurements of interfacial activity and adhesion work calculations, the oil-water interfacial tension can achieve ultra-low values within the range of 10-2 to 10-3 mN/m. Oil sand cleaning experiments and indoor simulations of spontaneous imbibition in tight cores demonstrate that F-GQDs exhibit effective oil washing capabilities and a strong response to carbon dioxide. When combined with carbon dioxide, the system enhances both the rate and efficiency of oil washing.Imbibition recovery can reach more than 50%.The research results provide a certain theoretical basis and data reference for the efficient development of tight reservoirs.

In this paper, the results of a high-precision control survey carried out in the underground mining of the Oyu Tolgoi project using terrestrial laser scanning technology are presented. The purpose of the measurements was to ensure that the direction, total length and volume of the penetration and excavation works were being implemented in accordance with the planned and designed dimensions. The coordinates of the geodetic traverse checkpoints were also assessed. In addition, we checked a traverse network of 18 checkpoints in the tunnel of the selected underground level. These checkpoints were repeatedly measured four times by two using readings of the Trimble S7 1” total station and were processed using the Compass/Bowditch method with Trimble Business Center software. All points except for one were within the tolerance limits. Based on these points, the excavation length and volumes were determined using the terrestrial laser scanners (TLSs) Trimble X7 and Trimble SX12 [25]. The difference between the planned work quantity provided by the Oyu Tolgoi project and the actual values measured using laser scanner was calculated with the comparative method. The TLS partial control measurements in the excavations made through the ore bodies revealed a length of 20285.72m and a volume of 441128.80m3 for the seven underground mine levels, while their project values were 16158.26m length and 422837.50m3 volume.

Submerged aquatic vegetation, also referred to as submerged macrophytes, provides important habitats and serves as a significant ecological indicator for assessing the condition of water bodies and for gaining insights into the impacts of climate change. In this study, we introduce a novel approach for the extensive monitoring of submerged vegetation, validated against established monitoring techniques. Employing full waveform airborne laser scanning, frequently used for topographic mapping and forestry applications on dry land, we extend its application to the detection of underwater vegetation in Lake Constance. The primary focus of this research lies in the automatic classification of LiDAR (Light Detection And Ranging) point clouds, distinguishing the three vegetation classes (i) Low Vegetation, (ii) High Vegetation, and (iii) Vegetation Canopy based on their height. The results reveal detailed three-dimensional representation of submerged vegetation, enabling the identification of vegetation structures and inference of vegetation types with reference to pre-existing knowledge. While the results within training areas demonstrate high precision and alignment with comparative data, the findings in test areas exhibit comprehensible deficiencies that are likely addressable through corrective measures in the future.

Crop phenotyping data collection is the basis for precision agriculture and smart decisionmaking applications. In this study, a dynamic slicing and reconstruction canopy volume (DR) algorithm is proposed to accurately estimate citrus canopy volume. The algorithm dynamically slices nearby slices based on their proportional area change and density difference, subsequently conducting AS reconstruction and volume calculation for each slice using an iterative mean point spacing as the α-value. Compared with six point cloud-based reconstruction algorithms, the DR approach achieved the best results in removing perforations and lacunae (0.84) and exhibited volumetric consistency (1.53) that closely aligned with the growth pattern of citrus trees. The DR algorithm effectively addresses the challenges of adapting the thickness and number of canopy point cloud slices to the shape and size of the canopy in the ASBS and CHBS algorithms, as well as overcoming inaccuracies and incompleteness in reconstructed canopy models caused by limitations in capturing detailed features using the PCH algorithm. It offers improved adaptive ability, finer volume computations, better noise reduction, and anomaly removal. In conclusion, we recommend selecting appropriate operating environments for each algorithm based on their principles, geometric properties, volumetric values, running time, and linear relationships with one another to guide orchard mechanization and intelligent operation.

The research of object classification and part segmentation is a hot topic in computer vision. A considerable number of studies have been carried out about deep learning on 3D point clouds. However,it is challenging to achieve effective feature learning due to sparsity of point clouds. Recently, a variety of Transformers have been adopted to improve point cloud processing and display great potential. Nevertheless, large numbers of Transformer layers tend to incur huge computational and memory costs. PointNet++ is one of the most influential neural architectures for point cloud understanding. Although the accuracy of PointNet++ has been largely surpassed by recent networks, this does not mean that PointNet++ has no potential.Thus, this paper offer two major contributions that significantly improve PointNet++ performance. Firstly, we introduce a novel contextual feature extraction (CFE) block that significantly enhances the feature extraction capabilities of PointNet++ networks. Secondly, to further enhance feature fusion, we seamlessly integrate a mutual learning (ML) block into the network architecture. By embedding these two innovative blocks within each layer of the network, we not only enrich the network's functionality but also impart it with greater robustness and adaptability. The specific experiments were conducted on the S3DIS (6-fold cross-validation) and Modelnet40 datasets with 86.5% and 92.7% accuracy, respectively, which proved that our model is comparable or even better than most existing methods for classification and segmentation tasks.

In this paper, a new full-Newton step feasible interior point method for convex quadratic programming is presented and analyzed. The idea behind this method is to replace the complementarity condition with a non-negative variable weight vector and use the algebraic equivalent transformation for the obtained equation. Under the selection of appropriate parameters, the quadratic rate of convergence of the new algorithm is established. In addition, the iteration complexity of the algorithm is obtained. Finally, some numerical results are presented to demonstrate the practical performance of the proposed algorithm.

This study aimed to investigate the effect of adding Mirror Visual Feedback Therapy (MFT) after Dry Needling (DDN) on sensitivity and motor performance in patients diagnosed with Post-Needling pain from Myofascial Trigger Points (MTrPs) in lateral elbow pain patients. A randomized, controlled, two-arm pilot trial following Consolidated Standards of Reporting Trials (CONSORT) was conducted at the European University of Madrid between February 1, 2023, and June 2, 2023. A total of 49 patients (F=23, M=26) were randomly assigned to the Experimental Group Deep Dry Needling, Ischemic Compression, Cold Spray, Stretching, and Mirror Therapy (n=25), and the others receiving the same interventions without Mirror Therapy (n=24). Pre- and post-treatment assessments encompassed Post-needling pain (VAS), pressure pain threshold (PPT), two-point discrimination threshold (TPDT), and maximum hand grip strength (MHGS). Post-needling pain intensity in the EG showed statistically significant reductions (MD = 0.400, SEM = 0.271, W = 137.00, p = 0.047) following the addition of MT to the DDN protocol. Similarly, PPT exhibited significant improvements (MD = 0.148 Kg/cm2, SEM = 0.271, W = 262.00, p < 0.001). However, TPDT and MHGS did not show significant differences between initial and post-treatment measurements. The addition of MFT to DDN for MTrPS in lateral elbow pain reduced Post-needling pain and influenced on sensory perception in lateral elbow pain patients with Myofascial Trigger Points. Despite observed clinical effects not reaching statistical significance, these findings offer valuable insights for future research considerations.

The paper proposes a new implementation of the PID algorithm in digital hardware. The proposed circuit implements an advanced PID formula, containing a non ideal derivative component, and weighting coefficients, which enable reducing influence of setpoint changes in the proportional and derivative components. The implementation operates on standard single precision (32 bit) floating-point numbers. The proposed circuit structure is optimized for cost. It uses just one arithmetic block, performing the multiply-and-add operation. The calculations are carried out in a sequential manner. The circuit was implemented in a Cyclone V FPGA device from Intel, using the Quartus Prime software. Proper operation of the circuit was verified by simulation. The proposed solution is comparable in terms of speed with other hardware implementations of the PID algorithm operating on standard single precision floating-point numbers, while being significantly cheaper. However, it outperforms by several orders of magnitude the speed of any software-based implementation, including solutions using PLCs, and CPU/MCUs. The proposed circuit structure, together with the overall regulator device concept, suit well the SoC (System on Chip), or SoPC (System on Programmable Chip) idea, i. e. a device, that contains a CPU core immersed in “FPGA fabric” - logic resources characteristic for FPGA devices.

In this paper, a positive answer to the open question of Fabino et al. is given, and the concept of I\c sik type set valued contractions is introduced and fixed point theorem for such contractions is established. Examples to support main theorems are given, and an application to integral inclusion is given.

This study introduces a multilayer perceptron (MLP) error compensation method for real-time camera orientation estimation, leveraging a single vanishing point and road lane lines within a steady-state framework. The research emphasizes cameras with a roll angle of 0°, predominant in autonomous vehicle contexts. The methodology estimates pitch and yaw angles using a single image and integrates two Kalman filter models with inputs from image points (u, v) and derived angles (pitch, yaw). Performance metrics, including AE, MINE, MAXE, SSE, and STDEV, were utilized, testing the system in both simulator and real-vehicle environments. The outcomes indicate that our method notably enhances the accuracy of camera orientation estimations, consistently outpacing competing techniques across varied scenarios. This method’s potency is evident in its adaptability and precision, holding promise for advanced vehicle systems and real-world applications.

In recent years, there has been significant growth in the ubiquity and popularity of three dimensional(3D) point clouds, with an increasing focus on the classification of 3D point clouds. To extract richer features from point clouds, many researchers have turned their attention to various point set regions and channels within irregular point clouds. However, this approach has limited capability in attending to crucial regions of interest in 3D point clouds and may overlook valuable information from neighboring features during feature aggregation. Therefore, this paper proposes a novel 3D point cloud classification method based on global attention and adaptive graph convolution. The method consists of two main branches: the first branch com-putes attention masks for each point, while the second branch employs adaptive graph convolu-tion to extract global features from the point set. It dynamically learns features based on point interactions, generating adaptive kernels to effectively and precisely capture diverse relationships among points from different semantic parts. Experimental results demonstrate that the proposed model achieves 93.8% in overall accuracy and 90.8% in average accuracy on the ModeNet40 dataset.

To solve the problem of complex sensor installation and easy damage in contact displacement measurement, a non-contact measurement method of brace displacement in bridge swivel construction based on binocular vision is proposed in this study. Combined with monitoring data in a swivel construction interchange project, binocular vision system was compared and analyzed with the traditional displacement meter and total station. Results showed that force versus displacement variation plots were obtained by binocular visual measurement in the weighing test, the inflection point can be clearly distinguished, and the position of the inflection point was the same as that of the displacement meter; monitoring data of binocular vision measurement and total station were compared and analyzed in the bridge swivel process, the average error was no more than 0.18 mm, the maximum error was no more than 0.42 mm, and the standard deviation was no more than 0.12. The method proposed in this study can be used as an alternative to displacement meter and total station measurement methods in bridge swivel construction, the problem of complex sensor installation and easy damage is solved in brace displacement measurement, equipment and labor costs can be effectively saved.

We develop a quantitative microscopic theory of decaying Turbulence by studying the dimensional reduction of the Navier-Stokes loop equation for the velocity circulation. We have found an infinite dimensional manifold of solutions of the Navier-Stokes loop equation\cite{M93, M23PR} for the Wilson loop in decaying Turbulence in arbitrary dimension $d >2$. This family of solutions corresponds to a fractal curve in complex space $\mathbb C^d$, described by an algebraic equation between consecutive positions plus a nonlinear periodicity condition. We derive the constrained SDE for the evolution of the fractal curve at a fixed moment of physical time as a function of an auxiliary stochastic time. We expect this stochastic process to cover our fixed manifold of the solutions of the decaying Turbulence. The energy density of the fluid decays as $\mathcal E_0/t$, where $\mathcal E_0$ is an initial dissipation rate. Presumably, we have found a new phase of extreme Turbulence yet to be observed in real or numerical experiments.

In this paper, we prove some common fixed point theorems on complex partial metric space. The presented results gener- alize and expand some of the literature well-known results. We also explore some of the application of our key results.

This article has two objectives. Firstly, we will use the vector variational-like inequalities problems to achieve local approximate (weakly) efficient solutions of Vector Optimization Problem within the novel field of the Hadamard manifolds. Previously, we will introduce the concepts of generalized approximate geodesic convex functions and illustrate them with examples. We will see the minimum requirements under which critical points, solutions of Stampacchia and Minty weak variational-like inequalities and local approximate weakly efficient solutions can be identified, extending previous results from the literature for linear Euclidean spaces. Secondly, we will show an economical application, using again solutions of the variational problems to identify with Stackelberg equilibrium points on Hadamard manifolds and under geodesic convexity assumptions.

A run-of-the-mill remote sensor arrange comprises numerous vitality compelled sensor hubs that are arbitrarily sent is the sensor field. Vitality is one of the most significant parts of planning an information dispersal convention for applications, for example, war zone checking, living space observing, and so on. We present EGDD, an Energy-effective Grid-based Data Dissemination plot for arbitrarily conveyed remote sensor systems. The proposed conspire is vitality effective for dealing with both sink and source portability. EGDD depends on a virtual framework-based foundation for information scattering from various versatile sources to different portable sinks. The virtual lattice of square size is built by the main source showing up in the sensor field dependent on the remaining vitality of the sensor hubs. Moreover, we proposed an askew sending calculation for inquiry and information sending which guarantees that just a single spread hub advances the question and information at once. In EGDD, substitute scattering hubs are chosen ahead of time during the lattice development procedure and the least limit vitality level is characterized for spread hubs. When the vitality of a dispersal hub arrives at the base edge esteem, it is supplanted by another spread hub. The reenactment results show that the proposed EGDD conspire is more vitality proficient when contrasted with other information scattering conventions.

In this study, we investigate the form of solutions, stability character and asymptotic behavior of the following four rational difference equations x_{n+1} = (1/(x_{n}(x_{n-1}±1)±1)), x_{n+1} = ((-1)/(x_{n}(x_{n-1}±1)∓1)), such that their solutions are associated with Tribonacci numbers.

In the framework of a multiplicative metric space. We have discuss some Properties of convex structures in pseudo multiplicative metric space and have applied these properties toiobtain alfixed point results in complete pseudo. It would be interesting to prove some further results in such metric spaces with completeness property.

A wealth of Full Waveform (FW) LiDAR data are available to the public from different sources, which is poised to boost the extensive application of FW LiDAR data. However, we lack a handy and open source tool that can be used by potential users for processing and analyzing FW LiDAR data. To this end, we introduce waveformlidar, an R package dedicated to FW LiDAR processing, analysis and visualization as a solution to the constraint. Specifically, this package provides several commonly used waveform processing methods such as Gaussian, adaptive Gaussian and Weibull decompositions, and deconvolution approaches (Gold and Richard-Lucy (RL)) with users’ customized settings. In addition, we also developed functions to derive commonly used waveform metrics for characterizing vegetation structure. Moreover, a new way to directly visualize FW LiDAR data is developed through converting waveforms into points to form the Hyper Point cloud (HPC), which can be easily adopted and subsequently analyzed with existing discrete-return LiDAR processing tools such as LAStools and FUSION. Basic explorations of the HPC such as 3D voxelization of the HPC and conversion from original waveforms to composite waveforms are also available in this package. All of these functions are developed based on small-footprint FW LiDAR data, but they can be easily transplanted to the large footprint FW LiDAR data such as Geoscience Laser Altimeter System (GLAS) and Global Ecosystem Dynamics Investigation (GEDI) data analysis. It is anticipated that these functions will facilitate the widespread use of FW LiDAR and be beneficial for better estimating biomass and characterizing vegetation structure at various scales. The package and code examples can be found at https://github.com/tankwin08/waveformlidar.

To improve the effect of multi-point stretch forming of sheet metal, it is proposed in this paper to replace fixed ball head with swinging ball head. According to the multi-point dies with different arrangements, this research establishes the finite element models of the following stretch forming, i.e. fixed ball heads with conventional arrangement, swinging ball heads with conventional arrangement, swinging ball heads with declining staggered arrangement, and swinging ball heads with parallel staggered arrangement and then numerical simulation is performed. The simulation results show that by replacing fixed ball head with swinging ball head, the surface indentation of the formed part was effectively suppressed, the stress and tension strain distribution of the formed part was improved and the forming quality was improved; that the thickness of the elastic pad was reduced, the springback was reduced and the forming accuracy was improved; and that when the ball head was applied to multi-point die with staggered arrangement, better forming result was achieved, where the best forming result was achieved in combining the swinging ball heads with the multi-point die with parallel staggered arrangement. The forming experiments were carried out, and the experimental results were consistent with the trend of numerical simulation results, which verified the correctness of the numerical simulation.

Despite increased awareness of and attention to the need for sustainable agriculture, fertilizers and compost application in excess of crop requirements remain common agricultural practices in South Korea, causing eutrophication of freshwater and coastal ecosystems. In this study, a phosphorus (P) budget was developed to quantify P inputs, outputs, and retention in a forested- agricultural watershed. The P budget showed that chemical fertilizers and organic compost were the largest source of P (97.6% of the total) followed by atmospheric deposition (2.1% of the total P), whereas forest export (0.2% of the total) and sewage treatment plants (STPs) (0.1% of the total) were negligible. The dominant P outputs were crop harvesting and hydrologic export to surface water. The P balance showed a significant accumulation of P in the watershed; approximately 87% of the total P input was retained in the soils within the watershed. However, P concentrations in drainage water were still high enough to cause eutrophication of downstream reservoirs. The results provide useful information on the proportion of P export and retention in soils and will help support efforts to improve water quality and design better management of agricultural non-point source pollution.

Model-based design has received considerable attention in biological and chemical industries over the last two decades. However, the parameter uncertainties of first-principle models are critical in model-based design and have led to the development of robustification concepts. Various strategies were introduced to solve the robust optimization problem. Most approaches suffer from either unreasonable computational expense or low approximation accuracy. Moreover, they are not rigorous and do not consider robust optimization problems where parameter correlation and equality constraints exist. In this work, we propose a highly efficient framework for solving robust optimization problems with the so-called point estimation method (PEM). The PEM has a fair trade-off between computation expense and approximation accuracy and can be easily extended to problems of parameter correlations. From a statistical point of view, moment-based methods are used to approximate robust inequality and equality constraints. We also suggest employing the information from global sensitivity analysis to further simplify robust optimization problems with a large number of uncertain parameters. We demonstrate the performance of the proposed framework with two case studies where one is to design a heating/cooling profile for the essential part of a continuous production process and the other is to optimize the feeding profile for a fed-batch reactor of the penicillin fermentation process. The results reveal that the proposed approach can be used successfully for complex (bio)chemical problems in model-based design.

In our previous works we have proposed design equations that can predict with reasonable accuracy the transition point from homogeneous to heterogeneous regime as well as the gas holdup and the mean Sauter diameter at the homogeneous regime. The validity of the proposed correlations was checked with data obtained using different geometrical configurations and several Newtonian and non-Newtonian liquids as well as the addition of surfactants. However, in all the experiments the gas phase was atmospheric air. This work investigates the effect of gas phase properties by conducting experiments employing various gases (i.e., air, CO₂, He) that cover a wide range of physical property values. Experiments revealed that only the use of low-density gas (He) has a measurable effect on bubble column performance. More precisely, when the low-density gas (He) is employed, the transition point shifts to higher gas flow rates and the gas holdup decreases, a fact attributed to the lower momentum force exerted by the gas. In view of the new data, the proposed correlations have been slightly modified to include the effect of gas phase properties and it is found that they can predict the aforementioned quantities with an accuracy of ±15%. It has been also proved that CFD simulations are an accurate means for assessing the flow characteristics inside a bubble column.

High-Level Synthesis (HLS) tools have revolutionized FPGA application development by providing a more efficient and streamlined approach, significantly impacting digital design methodologies. Despite the capability of FPGAs to customize numerical representations in data paths, most HLS projects have focused on fixed-point precision, while floating-point representations remain limited to vendor-provided single, double, and half-precision formats. This paper proposes a customized floating-point library compatible with HLS to address these limitations. This library allows programmers to define the number of exponent and mantissa bits at compile time, providing greater flexibility and enabling the use of mixed precision. Moreover, this library includes optimized implementations of common components such as vector summation (VSUM), dot-product (DP), and matrix-vector multiplication (MVM). Results demonstrate that the proposed library reduces latency and resource utilization compared to vendor IP blocks, particularly in VSUM, DP, and MVM operations. For example, the MVM operation involving a 32x32 matrix, using vendor IP requires 22 clock cycles, whereas CuFP completes the same task in just 7 clock cycles, using approximately 60% fewer DSPs, 10% fewer LUTs, and 60% fewer FFs.

We aimed at studying the role technology readiness/acceptance, motivation for exercising, and sensation seeking plays in using or avoiding Smart Sport Watches (SSW). A sample of 315 adolescents, Mage = 29.6 (SD = 11.01) and healthy male (n = 95, 30.2%) and female (n = 179, 56.85%) completed all the measures of these variables’ dimensions via the internet. Multiple followed by univariate analyses of variance (MANOVA, ANOVA) were performed for each of the study’s psychological dimensions and single variables. The two categorical factors (e.g., BS factors) were the use of SSW (yes/no) and walk/run (yes/no). Results revealed that adolescents using SSW rated themselves significantly (p < .05) and substantially higher than their non-SSW users on positive readiness for technology (d = .47), and specifically on optimism (d = .34) and innovation (d = .51). Moreover, users of SSW reported significantly (p < .05) and substantially lower negative readiness for technology than their non-SSW users’ counterparts (d = -0.49), and specifically on discomfort (d = -0.38) and distrust (d = -50), but neither on the overall motivation for exercise dimensions nor on sensation-seeking, accept some trends. Moreover, Adolescents who walk/run reported being more internally motivated (d = 0.38), integrated (d = 0.61), and identified (d = 0.34) than their sedentary counterparts. Discussion centers on the important role of readiness/acceptance in using technological devices and the need to use technology-specific motivation and personality measures to further explore this phenomenon.

Neonatal mortality rates in developing countries are influenced by a complex array of factors. Despite advancements in healthcare, Angola has one of the highest neonatal mortality rates in sub-Saharan Africa, with significant contributors including premature birth, intrapartum events, tetanus, and sepsis. This study aimed to identify the primary causes and contributing factors of neonatal mortality among infants admitted to the Neonatology Service at DBPH in Luanda from May 2022 to June 2023. A retrospective matched case-control design was employed, pairing each neonatal death with two surviving neonates based on age and sex. The analysis included 318 newborns, of whom 106 experienced hospital deaths. A stepwise binary logistic regression model was used to examine associations between variables and neonatal mortality. Variables with p < 0.25 in bivariate analysis were included in the multivariate model. Significant factors associated with neonatal mortality included: a low Apgar score at 1 minute (< 7) (OR 2.172; 95% CI: 1.436–4.731); maternal age under 20 years (OR 3.746; 95% CI: 2.172–6.459); home delivery (OR 1.769; 95% CI: 1.034–3.027); and a short hospital stay of ≤ 48 hours (OR 2.791; 95% CI: 1.183–6.587). Addressing these issues requires urgent interventions, including improving Apgar score management through enhanced training for healthcare professionals, supporting young mothers with intensified maternal education, ensuring deliveries occur in appropriate healthcare settings, and improving universal health coverage and referral systems. These measures could be crucial for enhancing neonatal care and reducing mortality.

Background/Objectives: Disrespectful care during childbirth has been observed as a global issue and a factor influencing maternal morbidity and mortality. While the United States has experienced worsening rates of maternal mortality, perceptions of respectful maternity care have been understudied. Methods A cross-sectional study was conducted Boston from April 2023 to January 2024 among 46 labor and delivery physicians, midwives, and nurses at Massachusetts General Hospital. The survey evaluated their observation of disrespectful care, performance of respectful care, and stress and support factors influencing respectfulness of care. Results: The most reported observed disrespectful behaviors were dismissing patients’ pain (87.0%), discriminatory care based on physical characteristics (67.4%) and race (65.2%), and uncomfortable vaginal examinations (65.2%). Respondents self-reported very high levels of respectful maternity care performance. Reported barriers to respectful care included workload (76.1%) and fatigue (60.9%). Conclusions: Disrespectful care in childbirth is an issue reported by health care providers. Implicit bias and working conditions of health care providers are factors in disrespectful care. This information can be used to strategize future training and other areas of intervention to improve maternity care.

Background: Peloids are therapeutic agents used in thermal and thalasso centers for curative, preventive, and skin care purposes. Marine peloids are those that include seawater and algae, both macro and/or microalgae. The aim of this study is to investigate the suitability of a marine peloid composed by seawater, clay and microalgae for thalasso-wellness and dermocosmetic uses; Methods: the thermophysical properties of the marine peloid were determined and compared with a non-marine peloid using different techniques as densimetry, conductimetry, calorimetry, and viscometry; skin hydration was also measured by means of Corneometry; Results: marine peloid has been shown to be suitable for thermotherapy and thalaso-wellness treatments as its thermophysical properties were similar to other peloids used for this purpose; marine peloids also showed to improve skin hydration after seven days of treatment; Conclusions: this research provides a comprehensive study of the thermophysical properties of a marine peloid composed by clay, seawater and microalgae for thalasso-wellness and cosmetic uses, as well as its moisturizing properties, highlighting its potential as a valuable natural product for skin care applications as well as for wellness treatments in form of cataplasm, poultices and/or wraps.

Microneedle technology is a novel platform technology that revolutionizes ocular drug delivery and addresses critical challenges in the treatment of ocular diseases. Routine treatment methods, such as eye drops and intravitreal injections, suffer from low bioavailability and poor patient compliance. So, novel advanced platform technologies are required to overcome these challenges. Microneedle is a minimally invasive and promising alternative technique that helps precisely control drug delivery to targeted tissues and organs. This review investigates the potential impact of microneedle technology for eye care, underscoring recent advancements, underlying mechanisms, and emerging preclinical and clinical uses. Different types of microneedles, including solid, coated, dissolvable, and hollow, have demonstrated their potential and capability to bypass several barriers in the cornea and sclera. This ensures effective drug penetration and delivery. The current innovations in material science and fabrication methods have enhanced the safety and efficacy of microneedles, reducing discomfort and the chances of infections. These microneedle technologies offer sustained and controlled drug delivery, which could improve therapeutic outcomes for various disease conditions like age-related macular degeneration, glaucoma, diabetic neuropathy, etc. In the current review, recent preclinical and clinical studies emphasize microneedle-based ocular drug delivery's feasibility and potential benefits. These include improved pharmacokinetics, reduced dosing frequency, enhanced patient adherence, and, most importantly, microneedles offer versatile platforms for delivering a wide range of small and large molecules and gene therapies. Despite the exciting progress, obstacles such as regulatory barriers, scalability, and long-term biocompatibility persist. It will be essential to tackle these challenges through interdisciplinary research and partnerships to integrate microneedle technology into standard clinical use effectively. Ultimately, microneedle drug delivery offers a revolutionary method that has the potential to significantly enhance the treatment and results of ocular diseases, marking the dawn of a new era in eye care.

Background: Nowadays vital signs in clinics are electronically monitored excepted for urine output which still requires, manual recording, which is subject to human errors. We, in-vitro, assessed in this study the ability a novel electronic device to measure by a combination of two different methods, the real time flow-output, like urine output. Methods: Flow or urine output was measured by a combination technique of gravimetry using a dynamometer and capacitive sensing to improve precision. Data were obtained in 3 different situations, low, medium, and high flow. Results: Three different situations were tested: full or empty dead space and Pasteur’s chamber. The differences between the injected and measured volume varies from 0 to 5 ml representing a maximal error of 3 % regardless of the volume injected and the flow in ml/hour. The capacitive sensors behave as expected with a parallel curve of the expected and measured flow. Conclusion: We have shown in this in-vitro study that the combination of gravimetry and capacitive sensors analysis allow accurate measurement of volume and flow-output. Clinical trials should be conducted to confirm its usefulness in urine output measurement in the real life.

Introduction: Alzheimer's disease (AD) is the first cause of dementia worldwide without any current curative treatment. Facing an increasing prevalence and its associated costs, AD represents a public health challenge. Usual diagnostic methods still rely on extended interviews and paper tests provided by an exterior examiner. We aim to create a novel, quick cognitive-screening tool on a numerical tablet. Methods: This program, built and edited with Unity®, runs on Android® for the Samsung Galaxy Tab S7 FE®. Composed of seven tasks inspired by the Mini-Mental Status Examination and the Montréal Cognitive Assessment, it browses several cognitive functions. The architectural design of this tablet application is distinguished by its multifaceted capabilities, encompassing not only seamless offline functionality but also a mechanism to ensure the singularity of data amalgamated from diverse sites. Additionally, a paramount emphasis is placed on safeguarding the confidentiality of patient information in the healthcare domain. Furthermore, the application empowers individual site managers to access and peruse specific datasets, enhancing their operational efficacy and decision-making processes. We performed a preliminary usability assessment among healthy subjects. Results: 24 healthy patients were included with a final F-SUS score of "excellent". Participants perceived the tool as simple to use and achieved the test in a mean time of 142 seconds. No technical errors occurred. Conclusion: These preliminary results suggest that our new assessment on a numerical tablet allows a short cognitive screening.

Background: During the stay in the neonatal intensive care unit, parents play a crucial role in the care of their infants. Recent studies reported a decrease in parental participation due to Coronavirus Disease (COVID-19) pandemic that determined restricted access policies in hospitals. The aim of this study is to describe the barriers to a good parents’ participation during the stay in the neonatal intensive care unit in the COVID-19 era. Methods: A quantitative observational study was carried out. Results: 270 parents participated in this study. Mothers’ participation in care seems to be higher as compared to fathers (p = 0.017). Parents who lived the birth of their first child reported a better level of participation in care when compared to those who lived the birth of their second born (p = 0.005). Parents of extremely preterm neonates reported a lower interaction with their infant if compared to parents of term newborns (p &lt; 0.001). Conclusions: Some more disadvantaged categories have reported lower scores: cultural and linguistic minorities, parents of multiple children and fathers. COVID-19 pandemic made several Family Centred Care activities not possible with a higher impact on those who benefited the most of these facilities. This study was prospectively registered by the IRB-CRRM of the University “G. d’Annunzio” Chieti-Pescara on the 23/01/2024 with registration number CRRM;2023_12_07_01.

Abstract: This study aimed to evaluate the long-term impact of paediatric dentistry programmes on children and adolescents to reduce oral health inequalities. It measures and assesses the improvement effects of paediatric dentistry programmes on the oral health of children and adolescents as part of the efforts to decrease oral health disparities in this age group. It included 406 individuals who participated in student and paediatric dentistry programmes between 2013 and 2019 at screening facilities in Gwangjin-gu, Seoul. Frequency analysis was conducted for demographic characteristics, and binary logistic regression analysis was performed to identify factors influencing the prevalence of dental caries as the dependent variable. Data were analysed using PASW Statistics with the statistical significance level set at α=0.05. Regarding oral health indicators based on the frequency of participation in paediatric dentistry programmes for children and adolescents, participants with seven or more sessions had lower prevalence rates of dental caries, malocclusion, and periodontal disease than those with only one session. Second, when comparing oral health indicators in paediatric dentistry programmes between primary and adolescent age groups, individuals under continuous management showed a decrease in permanent teeth affected by dental caries, dental caries prevalence, and malocclusion prevalence (excluding primary school age). Third, binary logistic regression analysis revealed significant influences (p

Background. The SARS-CoV-2pandemic has become the greatest public health challenge worldwide. Intensive research started to develop vaccines and by the late 2020 vaccination campaign started. Objective. Collecting information from European countries, how and in what extent were family physicians/general practitioners/FPs/GPs involved in the vaccinations-campaign in 2021 and how was it organized at national level. Method. A short questionnaire was distributed through the secretariats of WONCA-Europe and the European Forum for Primary Care. Results. In most of the countries participation of FPs/GPs was compulsory. The vaccination was usually centrally organized by governmental authorities. At the beginning (web-based) registration of patients was required, mainly at national level. By the mid of 2021, vaccination on walk in basis became available in almost every country for the first and for the booster injections. The remunerations of GPs/FPs were differed, in some countries without extra payment. The Pfizer’s vaccine was used in all countries; while in 9 countries not EMA approved vaccines were also used in primary care settings and at vaccination centres. In some countries, professional homepages helped the GPs. The involvement of PHC providers did not correlate to the vaccination coverage of the entire population of the respective countries. It was the highest in the more developed countries with higher living standard, where participation of GPs was voluntary and appropriate financial incentives were offered for them. Conclusion. The vaccination campaign was a professional and logistic challenge and an excellent performance of PC providers. Experiences gained could be used in the future to manage similar pandemic challenges.

The violence against women is a theme that extrapolates health issues, since after a victim seek for a health care, there is the notification of the act [1]. In Brazil, many times, these women are first assisted by mobile urgency services (SAMU/SIATE) and, as far as we have concern, there are no other studies with specific data about these assistance. The present paper aimed to analyze SAMU/SIATE assistance to abused women. Qualitative and retrospective epidemiological study of assistance to assaulted women carried out by SIATE and SAMU Maringá/Norte Novo between 2011 and 2020. Women between 20 and 39 years old, non-pregnant, were the main victims, and 19,52% of them have used some kind of drug. The (ex)partner figured as the perpetrator in 17,35%, but there were no information about this variable in 73,75% of the records. The Qui-square test shows a mortality rate superior to 70% among the severe traumatized victims. This is one of the first studies to analyze this kind of care provided by SAMU/SIATE, and reveals some gaps in its “modus-operandi” that can limitate an extrapolation of the results to bigger spheres. More researches in mobile urgency care services, in other provinces also, are needed to propose strategies to fight against this epidemic.

Microbiological control of dental pathologies presents a significant clinical challenge for dental surgeons, particularly considering drug-resistant microorganisms. To address this issue, Antimi-crobial Photodynamic Therapy (PDT) has emerged as an effective and complementary technique for microbial reduction. This therapy involves the application of a photosensitizer dye (PS) either topically or systemically, followed by exposure to low-power lasers with appropriate visible light wavelengths. PDT has found a valuable place in dentistry across various specialties, including surgery, periodontics, endodontics, dentistry, implantology, orthodontics, and pediatrics. In the realm of pediatric dentistry, managing microorganisms during dental treatments has become a major challenge.This article reviews the evidence supporting the potential of photodynamic therapy in combating bacteria, fungi, and viruses, with a particular focus on areas such as endodontics, restoration in deciduous teeth, implantology, and periodontics for bacterial control. Additionally, PDT has shown promise in stomatology, specifically in the treatment of mucositis and herpes. Considering its promising results and ease of application, photodynamic therapy presents an in-teresting alternative for clinical practice. However, it is important to note that specific protocols must be followed for each application, encompassing the type of photosensitizer, concentration, pre-irradiation time, light type, wavelength, energy, power, and mode of light delivery. Researchers have been steadily refining these protocols to facilitate PDT's integration into clinical practice.

Background: The adoption of self-care behaviors among patients with arterial hypertension (AH) plays an important role in the management of their health condition. However, a lack of scales assessing self-care is observed. We aimed to develop and validate the Hippocratic hypertension self-care scale. Methods: From a pool of questions derived from a literature review, 18 items were included in the scale and reviewed by a committee of experts. Participants indicate the frequency at which they follow the self-behavior prescribed in each statement on a five-point Likert scale. Data were collected between April 2019 and December 2019. Re-sults: 202 consecutive adult patients with AH were enrolled in the study. The internal consistency of the scale was found to be 0.807, using Cronbach’s alpha coefficient. An exploratory factor analysis identified two do-mains that accounted for 92.94% of the variance of the scale items; however, each sub-scale could not be used as an independent scale. Finally, the test- retest of the scale showed a significant strong correlation (r=0.0095, p<0.001). Conclusion: Our data indicate that the scale is a reliable and valid tool for assessing self-behaviors in patients with AH. Health professionals can use it in their clinical practice to improve the management of patients’ health condition.

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.

Assistance dogs provide significant benefits to older adult owners. However, despite protective legislation, aged care facilities continue to not allow owners to retain their dog on relocation. The purpose of the current study was to explore whether older adults should be allowed to retain their dog on relocation to an aged care facility, and what factors should impact this decision. Further, if allowed to retain their dog, what would be the best practice to allow for this. A deliberative democracy methodology was used, with a range of key stakeholders recruited. Focus groups were held, with follow up questionnaire to establish deliberation for all questions. Results indicated that with sufficient objective measurement, fair decisions can be made to ensure the welfare and wellbeing for owner and dog. Key policy and procedure changes would also be necessary to ensure ongoing support, such as training, care plans, and emergency directives. By ensuring sufficient policies and procedures are in place, training and support could lead to an ideal outcome where facilities could be at the forefront of a better future for aged care.

Family Integrated Care (FICare) is associated with improved developmental outcomes and decreased parental mental health risks in stable preterm infants. However, less is known about its application in critically ill infants who are at greater risk for adverse outcomes. The objective of this study was to assess the safety and feasibility of implementation of FICare in critically ill infants in the first few weeks of life. In this prospective cohort study, 41 critically ill infants were enrolled: 17 in observational group receiving standard care (SC)and 24 in the FICare Plus group. Resources were developed for staff and parents to support earlier engagement in infant care. Outcomes were assessed using standardized questionnaires. The t-test or Wilcoxon Rank-Sum test were used to compare continuous variables, while Chi-square or Fisher exact test were used for categorical variables, respectively. Baseline maternal and infant characteristics were similar in both groups. The tools and procedures developed for FICare Plus successfully supported greater engagement in the care of their infant with no increase in adverse events and no increase in parent stress. Preliminary measures of infant efficacy were similar in both groups. Total anxiety scores were high among all parents at enrolment {83.1 (67-94) vs 77.3 (66-86); p-value 0.4}. However, the scores prior to discharge were lower in FICare Plus group {78 (71-90) vs 63 (52-74.5); p-value 0.02}. This pilot study showed that it is feasible and safe to implement family integrated care in critically ill infants.

Depression and anxiety in cardiovascular disease worsen the prognosis of patients. Treatments for these disorders often provide limited improvement. The present study aimed to test, for the first time, the impact of educational technology on anxiety and depressive symptoms in patients participating in a cardiac rehabilitation program. A 12-month randomized controlled trial was conducted, in which 207 patients were randomly assigned to either the experimental (n=76) or control (n=69) groups. The intervention involved a structured patient education program provided by medical students who had undergone specially designed training in cardiac rehabilitation. The primary outcomes were death, hospitalization, heart failure, and recurrent myocardial infarction. The study also assessed anxiety and depression. A year later, the experimental group showed a statistically significant decrease in anxiety and depression on the HADS scale, with reductions of 2.0 and 1.9 points respectively (p&lt;0.05). The control group showed reductions of 1.5 and 1.2 points (p&lt;0.05). The difference in depression (HRDS) between the groups at 12 months was -1.29 in favor of the main group (95% CI, -0.7 to -1.88), and the standardized effect size (SMD) was 0.36 (95% CI, 0.03 to 0.69). No treatment-related adverse events were observed. The results suggest that educational interventions can have a positive impact on mental health. The study's strengths include a structured intervention, randomization, and long-term follow-up. Limitations include the lack of blinding of study participants and a relatively small sample size.

The Covid 19 pandemic threaten the life of individuals and there was a lack of information in treatment, handling of patients and disposal of waste. The psychological and behavioral impact on Humans due to outbreak of Covid is studied and based on that a person-centered care center is suggested. The research methodology used are surveys, interviews among stake holders and design details of person-centered care center. Based on the surveys and interviews conducted during pandemic, it is found that 94% of the respondents prefer to use private vehicles with at least one member to ac-company them. People prefer to use 3 ply facemasks, followed by cotton masks and N95. Existing literature discusses the physical effects on the individual, but this paper focuses more on pros and cons on human life during the pandemic and lock down period. Based on the study, care center with facilities to treat patients with different levels of infections and counselling center for the persons suffered from Covid and other infectious diseases to overcome their psycho-logical and behavior changes are recommended.

Patients satisfaction with fast and high-quality services is the most important in the healthcare settings and specially in outpatient departments and private clinics. High quality services on health sector are indicated by continuous quality improvement (CQI). CQI is a progressive incremental process focused on safety of all participants, outcomes, systematic process, regulated and improved working environment at the later than earlier stages. Among the various suggested strategies, we adopted the patents feedback to improve the quality of services our clinic. All of the patient visited hospital were sent a massage on mobile and requested to provide their feedback on our services. Roughly around 5% of all visitors responded and filled up questionnaire. Majority of them were satisfied with the services in various department. However, they provided us some suggestions to identify the further gaps and improve the services in improving patients experience at our clinic. We considered their feedback, identified problems, redesigned the policies and implemented. After implementation of new strategies, we preliminary again evaluated the patients’ feedback on our services. Patients feedback explores that optimized methods of services for the has considerably increased the patients’ satisfaction. Taken together, our this shows that patients’ feedback is very important factor to improve patients’ experience at outpatient clinics using continuous quality improvement tools. For that reason, this study would serve as reference for public health stack holders, administrators and researchers.

Given that population COVID-19 vaccination does not appreciably reduce SARS-CoV-2 transmission, instead, the potential to reduce hospitalization has been used to justify coercive vaccine passports. We aim to use a recently published research study as an example in order to demonstrate how data can be misinterpreted and result in deriving misleading ethical and policy implications. Bagshaw et al wrote that unvaccinated patients with COVID-19 in Alberta, Canada “had substantially greater rates of ICU admissions, ICU bed days, and ICU related costs than vaccinated patients did. This increased resource use would have been potentially avoidable had these unvaccinated patients been vaccinated.” The authors in Bagshaw et al then concluded that their findings “have important implications for discourse on the relative balance of increasingly stringent public health protection (restrictions), including mandatory vaccination policies, and the sustainability and function of health system infrastructure and capacity during the ongoing COVID-19 pandemic.” Here we show the following. First, the effect of vaccination on intensive care admissions were grossly over-estimated due to several limitations of this and almost all other vaccine studies. Second, an effect of vaccination on access to acute care and on all-cause excess deaths was grossly over-stated due to several more likely causes being omitted from discussion and from the common narrative. Third, policy implications were overstated and at best unclear due to missing consideration of more relevant aspects required to inform policy. Overall, the data cannot support what Bagshaw et al called “increasingly stringent public health protection (restrictions), including mandatory vaccination policies”.

Cancer-related fatigue is a common, burdensome symptom of cancer and side-effect of chemotherapy. While a Mediterranean Diet (MedDiet) promotes energy metabolism and overall health, its effects on cancer-related fatigue remain unknown. In a randomized controlled trial, we evaluated a rigorous MedDiet intervention for feasibility and safety as well as preliminary effects on cancer-related fatigue and metabolism compared to usual care. Participants had stage I-III cancer and at least 6 weeks of chemotherapy scheduled. After baseline assessments, randomization occurred 2:1, MedDiet:usual care. Measures were collected at baseline, week 4, and week 8 including MedDiet adherence, dietary intake, and blood-based metabolic measures. Mitochondrial respiration from freshly isolated T cells was measured at baseline and 4 weeks. Participants (n=33) were 51.0±14.6 years old, 94% were female, and 91% were being treated for breast cancer. The study was feasible, with 100% completing the study and >70% increasing their MedDiet adherence at 4 and 8 weeks compared to baseline. Overall, the MedDiet intervention vs. usual care had a small-moderate effect on change in fatigue at weeks 4 and 8. For those with a baseline MedDiet score<5 (n=21), the MedDiet intervention had a moderate-large effect of 0.67 and 0.48 at weeks 4 and 8, respectively. The MedDiet did not affect blood-based lipids, though it had a beneficial effect on fructosamine (ES= -0.55). Fatigue was associated with mitochondrial dysfunction including lower basal respiration, maximal respiration, and spare capacity (p<0.05 for FACIT-F fatigue subscale and BFI, usual fatigue). In conclusion, the MedDiet was feasible and attenuated cancer-related fatigue among patients undergoing chemotherapy, especially those with lower MedDiet scores at baseline.

Background: Emergency medical services (EMS) are the first health care contact for the majority of stroke patients. However, there is a lack of data on the current paramedics’ hospital-directed feedback and training needs across different health care settings. We aimed to evaluate paramedics’ prehospital stroke care knowledge, training needs, and current status of feedback on suspected stroke patients. Methods: We surveyed paramedics from the Vilnius region from September to November 2019, and compared the answers between the city and the district agencies. The questionnaire content included questions on paramedics’ demographic characteristics, prehospital stroke care self-assessment, knowledge on stroke mimics, stroke training needs, and the importance of hospital-directed feedback on suspected stroke patients. Results: A total number of 161 paramedics were surveyed, with more district paramedics rating their prehospital stroke care knowledge as inadequate (44.8% (95% confidence interval (CI) 32.8–57.6) vs 28.1% (95% CI 20.1–27.8), p = 0.028). In addition, more district paramedics indicated a need for additional stroke training (83.1% (95% CI 71.5–90.5) vs 69.8% (60.0–78.1), p = 0.043). However, respondents reported being the most confident while dealing with stroke (71.3%, 95% CI 63.8–77.7) compared to other time-critical conditions (p < 0.001). Vertigo (60.8%, 95% CI 53.0–68.0), brain tumours (56.3%, 95% CI 48.5–63.8), and seizures (54.4%, 95% CI 46.7–62.0) were indicated as the most common stroke mimics. Only 6.2% (95% CI 3.4–11.1) of respondents received formal feedback on the outcome of suspected stroke patients brought to the emergency department. Conclusion: A high proportion of paramedics self-perceive having inadequate stroke knowledge and an urgent need for further stroke training. The EMS staff indicate receiving an insufficient amount of feedback on suspected stroke patients, even though the usefulness is perceived to be paramount.

The purpose of this study was to analyse selected psychometric properties of the Polish version of the Spirituality and Spiritual Care Rating Scale (SSCRS), among them the applicability of the dimensions of spiritual care in nursing, i.e. spirituality, spiritual care, religiosity and personalized care, to Polish conditions. Poland-wide multicentre study with a cross-sectional validation design. The study was conducted between March and June 2019. Seven Polish Nursing Faculties accepted the invitation to participate in the study. Representative sample of 853 nurses enrolled in MSc (postgraduate) programs in nursing. After translation and cultural adaption of the SSCRS, the instrument underwent a full psychometric evaluation with theoretical relevance using (exploratory, confirmatory factor analysis), internal consistency (Cronbach's alpha), reliability (test−retest analysis), construct validity (correlation analysis), criterion-related validity (convergent and discriminant validity) analysis. The exploratory and confirmatory factor analysis demonstrated that Polish version of the SSCRS was a three-factor model with “Activity-centred spiritual care” (9 items), “Emotional support-centred spiritual care” (5 items) and “Religiosity” (3 items) domains. The Cronbach’s alpha coefficient for the whole scale was 0.902, and the alpha values for the individual domains were 0.898, 0.873 and 0.563, respectively. The three domains mentioned above seemed to provide the entire picture of spiritual care perceived subjectively by Polish MSc in nursing students. This study demonstrated a substantial degree of similarity in the selected psychometric characteristics of the Polish version of SSCRS and the original scale.

Hospital readmission within 30 days of discharge (30-day readmission) is a high-priority quality measure and cost target. The purpose of this study was to explore the feasibility and efficacy of the Diabetes Transition of Hospital Care (DiaTOHC) Program on readmission risk in high-risk adults with diabetes. This was a non-blinded pilot randomized controlled trial (RCT) that compared usual care (UC) to DiaTOHC at a safety-net hospital. The primary outcome was all-cause 30-day readmission. Between 10/16/2017 and 05/30/2019, 115 patients were randomized. In the intention-to-treat (ITT) population, 14 (31.1%) of 45 DiaTOHC subjects and 15 (32.6%) of 46 UC subjects had a 30-day readmission (p=0.88) while 35.6% DiaTOHC and 39.1% UC subjects had a 30-day readmission or ED visit (p=0.72). The Intervention:UC cost ratio was 0.33 (0.13-0.79)95%CI (p<0.01). Among the 69 subjects with baseline HbA1c >7.0% (53 mmol/mol), 30-day readmission rates were 23.5% (DiaTOHC) and 31.4% (UC, p=0.46) and composite 30-day readmission or ED visit rates were 26.5% (DiaTOHC) and 40.0% (UC, p=0.23). In this subgroup, the Intervention:UC cost ratio was 0.21 (0.08-0.58)95%CI (p=0.002). The DiaTOHC Program is feasible and may decrease combined 30-day readmission/ED visit risk as well as healthcare costs among patients with higher HbA1c levels.

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

Babies born prematurely are at risk of experiencing visual disturbances, hearing loss, disabilities, the risk of infection and even death. Care for premature babies requires serious attention for both health workers and parents. The role of parents is very important both during hospitalization and at home. Therefore, in order to improve the abilities of parents, it is necessary to make educational efforts with the right method.ObjectivesThis literature review aims to provide an overview of educational methods that nurses can use to improve the ability of parents to care for or care for the development of premature babies. The method used is to search for literature that fits the established theme using 5 data based, namely Scopus, ProQuest, Science Direct, Elsevier Clinicaly for Nursing and Web of Science. The strategy used in finding literature that fits the theme and is used in this literature review uses the PICOS framework. Then conducted a review with the PRISMA method. The literature selection results obtained 572 publications, after going through the selection obtained 11 literatures that match the theme, with 11 educational methods. These methods can be grouped into ideas, namely increasing parental involvement during treatment, using technology, stress management and continuous monitoring. The ability of parents to care for premature babies is needed in order to minimize complications in infants, reduce morbidity, avoid disabilities, increase growth and development of premature babies optimally and reduce parental stress levels, increase parental confidence and good parents' self-efficacy. Choosing the right educational method can improve the ability of parents to properly care for and provide developmental care for premature babies.

Cancer patients and their family caregivers experience various losses when patients become terminally ill, yet little is known about the grief experienced by patients and caregivers and factors that influence grief as patients approach death. Additionally, few, if any, studies have explored associations between advance care planning (ACP) and grief resolution among cancer patients and caregivers. To fill this knowledge gap, the current study examined changes in grief over time in patients and their family caregivers and whether changes in patient grief are associated with changes in caregiver grief. We also sought to determine how grief changed following completion of advance directives. The sample included advanced cancer patients and caregivers (n=98 dyads) from Coping with Cancer III, a federally funded, multi-site prospective longitudinal study of end-stage cancer care. Participants were interviewed at baseline and at follow-up roughly 2 months later. Results suggest synchrony, whereby changes in patient grief were associated with changes in caregiver grief. We also found that patients who completed a living will (LW) experienced increases in grief, while caregivers of patients who completed a do-not-resuscitate (DNR) order experienced reductions in grief, suggesting that ACP may prompt “grief work” in patients while promoting grief resolution in caregivers.

One of the special trends in health care is the increasing availability of data and services to the cloud, especially for convenience (for example, providing a complete patient medical record without interruption) and savings (for example, economic issues). Management of health care data). However, there are limitations to using common cryptographic prototypes and access control models to address security and privacy concerns in an increasingly cloudy environment. In this paper, we explore the potential and capacity of using China's Blockchain technology to protect health care data hosted in the cloud. We also explain the real challenges of such an approach and further research is needed. Health care is a highly data-dependent domain, with large amounts of data being created, published, stored and accessed daily. For example, data are created when a patient undergoes a number of examinations (such as computed tomography or computed tomography scans) and the data need to be sent to the radiologist and then to a physician. The visit results are then stored in the hospital, and then need to be accessed later by another physician at another hospital within the network. It is clear that technology can play an important role in improving the quality of care for patients (for example, using data analytics to make informed medical decisions) and potentially costing more by allocating resources more efficiently in terms of personnel, equipment, etc. , Reduce. For example, paper-based data extraction is difficult to extract into systems (for example, it is costly and may involve data entry errors), archiving them and accessing them as needed is costly. These challenges may cause medical decisions to be incomplete, requiring repeated tests for missing information or missing data stored in another hospital in another state or country (at the expense of increased costs and no convenience). (For patients) and so on. Because of the nature of the industry, it is important to ensure the security, privacy and integrity of health care data. As a result, there is definitely a need for a secure and secure data management system.

The aim of this study was to analyze the level of specific back-health-related physical activity and exercise knowledge. This is a cross-sectional study. A representative sample of 1500 students were recruited with a confidence level of 95% and an accepted standard error of ±2.53%. Individuals were aged between 13 and 18 years old (mean age= 15.18; SD = ±1.446). Self-reported questionnaires were used to record back-health-related physical activity and exercise knowledge concerning back care in adolescents. The level of specific knowledge of back health education related to physical activity and exercise in adolescents was low (X = 2.05, SD = ±2.264). Only 10.9% of the students passed the specific knowledge test, achieving a grade equal or superior to 5. The boys average score was higher (X = 2.17, SD = ±2.312) than the girls (X = 1.94, SD = ±2.212) with statistically significant differences (p = .048). The level of specific knowledge increased with age (F = 11.531; p &lt; .001). High school students have a low level of specific knowledge. Physical Education teachers should apply the conceptual content properly. Knowledge is the first step towards changing behavioral habits. Back care education in the school curriculum is recommended.

Watching the international COVID-19 epidemics unfold during February and early March 2020, we began to highlight how outbreaks in care homes were inevitable, given the vulnerable patients in close proximity, and pressures on social care to help relieve pressure on the NHS. We suggested public health measures would significantly impact on care homes. Specifically we felt all homes would have multiple individuals isolated within days of introduction of guidance requiring isolation of new cough (or fever), and that a clear definition of an outbreak would be needed that differentiated COVID19 from influenza. We share the experiences of a GP practice looking after 900 nursing or dual registration care homes in the London Borough of Ealing in the early stages of the COVID19 Pandemic 2020. We believe that the altered presentation of cases of COVID19 in care homes contributed to the size of outbreaks, and that keeping COVID19 out of homes is the only way to manage this disease, with early isolation and complete segregation of positive and negative cases. We have seen over 300 suspected cases resulting in four fold (n=175) average monthly death rates, three fold usual issue of anticipatory medications, and approximately 32% mortality rate (up to 43% in over 90’s). Discharge pathways from hospital and admissions to care homes must be clear and robust. COVID19 naïve patients should not be admitted to units with outbreaks and COVID19 positive patients should not be admitted to anything other than a designated “hot” home until risk of contagion is passed. Some patients are testing positive at over 30 days since initial mild symptoms.

Background: the primary care service in Catalonia has operated an asynchronous teleconsulting service between GPs and patients since 2015 (eConsulta), which has generated some 500,000 messages. New developments in big data analysis tools, particularly those involving natural language, can be used to accurately and systematically evaluate the impact of the service. Objective: the study was intended to examine the predictive potential of eConsulta messages through different combinations of vector representation of text and machine learning algorithms and to evaluate their performance. Methodology: 20 machine learning algorithms (based on 5 types of algorithms and 4 text representation techniques)were trained using a sample of 3,559 messages (169,102 words) corresponding to 2,268 teleconsultations (1.57 messages per teleconsultation) in order to predict the three variables of interest (avoiding the need for a face-to-face visit, increased demand and type of use of the teleconsultation). The performance of the various combinations was measured in terms of precision, sensitivity, F-value and the ROC curve. Results: the best-trained algorithms are generally effective, proving themselves to be more robust when approximating the two binary variables "avoiding the need of a face-to-face visit" and "increased demand" (precision = 0.98 and 0.97, respectively) rather than the variable "type of query"(precision = 0.48). Conclusion: to the best of our knowledge, this study is the first to investigate a machine learning strategy for text classification using primary care teleconsultation datasets. The study illustrates the possible capacities of text analysis using artificial intelligence. The development of a robust text classification tool could be feasible by validating it with more data, making it potentially more useful for decision support for health professionals.

This paper investigates the role of English language proficiency (ELP) as a measure of cultural integration on U.S. immigrant families’ economic integration, as measured by annual earnings, and health care market integration, as captured by annual medical care spending. Bayesian Markov Chain Monte Carlo (MCMC) estimation of a mixed bivariate ordered probit (MBOP) model of annual earnings and medical care spending is conducted using a nationally representative pooled cross-sectional sample data from the U.S. National Health Interview Surveys (NHIS). The results reveal that limited English proficiency is associated with lower marginal earnings propensities (-$44.83, -$50.66, and -$56.97), and higher marginal medical care spending propensities ($8.09, $6.09, and $4.32) for each of the three decreasing levels of ELP. Furthermore, we find a small yet statistically significant positive 7.2% correlation between immigrant families’ annual earnings and medical care spending propensities. Therefore investing to raise immigrants’ families ELP in the U.S. would not only contribute to more effective socio-economic integration, but also strengthen the U.S. workforce and economy for decades to come.

Background User fee exemption for maternal and child health care service policy was introduced with a focus on providing free caesarean sections (CS) in Nigeria from 2011 to 2015. This policy had a positive impact on access to facility-based delivery, but its effect on socioeconomic and geographical inequality remains unclear. This study’s main objective is to examine access to birth by CS in the context of free maternal health care. Specifically, the study examines socio-demographic and geographical inequality in access to birth by CS among women who gave birth between 2011 and 2015 under the free maternal health care policy using a population-based survey data obtained from two of the six main regions of the country. Methods Data were obtained from 1227 women who gave birth during the period the policy was in operation selected using cluster random sampling between May and August 2016. Adjusted and unadjusted binary logistic regression models were used to examine whether there is socio-demographic and geographical inequality in access to birth by caesarean section. Results The overall caesarean section rate of 6.1% was found but varies by income (14.1% in monthly income of over $150 versus 4.9% in income of $150 and below), education (11.8% in women with higher education versus 3.9% among women with secondary education and less) and place of residence (7.8% in urban areas versus 3.6% in rural areas). Women who earn a monthly income of $150 or less were 48% less likely to have a birth by CS compared to those who earn more. Compared to women who were educated to tertiary level, women who had secondary education or less were 54% less likely to have birth by caesarean section. Conclusion This study shows that inequality in access to CS persists despite the implementation of free maternal health care services. Given the poor access to facilities with capabilities to offer CS in most rural areas, free maternal healthcare policy is not enough to make birth by CS universally accessible to all pregnant women in Nigeria.

This study evaluates inequalities in the use of dental services according to place of birth before and after the economic crisis in Spain. A cross-sectional study was performed in the population aged 18 to 65 years in Spain. We used data from three Spanish National Health Surveys for years 2006 (before the crisis), 2014 and 2017 (after the crisis). Log-binomial regression was used to quantify the association between region of origin and use of dental care services before and after controlling for the selected covariates. In 2006, we found a greater probability of not using dental care services in immigrants from Asia (PR:1.36, 95% CI:1.10–1.67) and Africa (PR:1.16; 95% CI:1.05–1.28) compared to the natives. For 2014, the probability of not using dental care services was greater for all immigrants compared to the natives, with the greatest odds for those from Africa (PR:1.71; 95% CI:1.46–2.01) and Asia (PR:1.3; 95% CI:1.23–1. 47). The associations for 2017 were weaker in magnitude than the ones observed for 2014, although stronger than for 2006. This study suggests that the economic recovery did not have the same impact for natives and immigrants regardless of regions of origin, given the observed inequalities in use of dental services.

Background: This study aims to compare the impact of early and late post-discharge cardiopulmonary rehabilitation on the outcomes of intensive care unit (ICU) survivors. Methods: The retrospective, cohort study used a sub-database of the Taiwan National Health Insurance Research Database (NHIRD) that contains information of all patients had ICU admission between 2000 and 2012. Early group was defined if patients had received cardiopulmonary rehabilitation within 30 days after ICU discharge, and late group was define as if patients had received cardiopulmonary rehabilitation between 30 days and one year after ICU discharge. The end points were mortality and re-admission during the 3-year follow-up. Results: Among 2136 patients received cardiopulmonary rehabilitation after ICU discharge, 994 was classified early group and other 1142 patients were classified as late group. Overall, early group had a lower mortality rate (6.64% vs 10.86%, p = 0.0006), and a lower ICU readmission rate (47.8% vs 57.97%, p < 0.0001) than late group after 3-year follow-up. Kaplan-Meier analysis showed that early group had significantly lower mortality (p=0.0009) and readmission rate (p<0.0001) than late group. In multivariate analysis, the risk of ICU readmission was found to be independently associated with late group (HR, 1.28; 95% CI, 1.13-1.47). Conclusions: Early post-discharge cardiopulmonary rehabilitation among ICU survivors has the long-term survival benefit and significantly decreases the readmission rate.

The complex progression, specialized care, and comorbidities of chronic diseases place a financial and health burden on society. In some instances, the high hospital readmission rate is also a result of chronic diseases. The readmission rates can be decreased if the quality of life for patients is increased and healthcare costs are reduced through effective management and preventive measures. As a result, healthcare professionals, service providers, and policy-makers are looking for innovative approaches to reduce healthcare costs while enhancing the quality of care. There is an emerging trend in deploying technological advancements like artificial intelligence (AI), the Internet of Things (IoT), sensors, wearables, social media, mobile apps, and genomics to decrease hospital readmissions. In some instances, predictive analytics, early warning systems, personal-ized care management, remote monitoring and Telehealth, decision support systems, patient education and engagement, and other areas of artificial intelligence and machine learning have outperformed traditional approaches in lowering hospital readmissions. Although AI effectively reduces readmission, there are potential risks if it is not combined with efficient interventions. Therefore, real-time monitoring and intervention are required for AI systems to increase patient safety and decrease hospital readmissions. To achieve autonomy, prevent harm, achieve fairness, and achieve explicability, the ethical principles relating to AI systems should be taken into ac-count. This study examines the significant impact on health and the economy of hospital read-missions for chronic diseases and the role of AI in reducing readmissions.