Children—Dependents in Social Construction Theory—are assessed within democracies regarding their ability to self-direct their behavior concerning their associated society. In this regard, childhood represents a lack of self-direction, a life period when people require the guidance and protection of adults. The assumed necessity of adults supervising children in democracies requires substantial social resources, reducing the self-direction of those charged with overseeing children. Given that self-direction defines the optimal experience of people within democratic society, finding ways to increase the self-direction of children is an individual and a social benefit. In this regard, smartphones have improved self-direction in children. How children have become empowered to self-direct their lives with smartphone use considering Social Construction Theory—as Advantaged, Contenders, or Deviants—is the focus of a scoping review conducted on “children, empowerment, smartphones” of the following databases: OVID, JSTOR, ProQuest, PubMed, Scopus, and Web of Science. The result is that children permitted to self-direct their activities aided by smartphone technology have comparable social behavior to adults positioned as Advantaged, Contenders, or Deviants and, as such they should be encouraged to utilize smartphone technology to improve their self-direction, as doing so will augment individual and caregiver self-direction, providing increased social benefit.

Most of the educational interventions proposed so far in the field of mental well-being in education ‎usually address just students. In this study, we focused on teachers as the Covid-19 pandemic reiterated ‎the importance of their mental well-being during demanding times. We investigated whether ‎neurofeedback (NF) training can increase optimism, self-esteem, life satisfaction, and the ability to ‎cope with stressful events, reflecting on the research literature that emphasizes these four factors, ‎which affect the ability to be confident in dealing with uncertainty and distress. ‎ Forty teachers aged 35-55 participated in the study. The test group took part in 12 NF training sessions, ‎and the control group was not treated. Our findings indicate that compared to the control group, ‎measures of optimism, self-esteem, life satisfaction, and coping with stressful events improved ‎significantly in the test group.‎ To the best of our knowledge, this is the first attempt to test a mental welfare intervention program for ‎teachers through NF. This study responded to a call to develop teacher intervention programs using ‎physiological measurement and technological innovations to improve their mental health and allow ‎them to cope better with stressful teaching conditions.

This paper delves into the critical issue of concrete cracks, a common consequence of environmental factors and external forces, and their potential impact on the structural integrity of buildings. Recognizing the urgency of addressing this issue, the concept of self-healing concrete has emerged, aiming to revolutionize the construction industry by autonomously repairing cracks and minimizing the need for labor-intensive and time-consuming manual interventions. The paper employs a bibliographic analysis methodology to comprehensively explore the most significant technologies associated with self-healing concrete, identifying key research countries/regions and prominent research institutions in this field. Through an examination of scholarly articles, the analysis seeks to uncover key themes, technologies, and contributors within the self-healing concrete domain. Insights into the geographical distribution of research efforts and the roles of influential research institutions are provided, shedding light on collaborative networks and knowledge-sharing dynamics that drive innovation in this evolving field.

Diabetes self-management education helps to improve health outcomes, quality of life and to reduce expenses for diabetic patients. This systematic review aimed to examine the effectiveness of diabetes self-management education used for newly diagnosed patients with type 2 diabetes (T2DM). A review of studies that have researched the use and the impact of health education in newly diabetic patients with T2DM was implemented. A literature search was conducted using the electronic database of Pub MED, Walters Kluwer, Cochrane Library, Elsevier, JSTORE between January 2017 – November 2022. The data on participants and intervention characteristics were extracted by two reviewers independently. We found 789 studies and after selection of PRISMA flow chart we selected 19 studies, including 2512 newly diagnosed adult T2DM. Biomedical results presented the pooled effect of HbA1c -0.64%, FBG -0.32. The evaluation of emotional and social results and behavioral effects has been evaluated respectively in 10 and 9 studies. The education and support of recently diabetic patients help to improve biomedical, psychosocial, and behavioral results. This intervention must be ongoing to maintain healthy behaviors

Currently, the use of medications during pregnancy in Latin America is common; studies with Latin American samples find that nearly 90% of pregnant women use some medication at least once during pregnancy. Furthermore, approximately 21% of the respondents self-medicated. Worldwide, the prevalence of this disease is 32%. The most common medications are nonsteroidal anti-inflammatory drugs and analgesics. Many of these drugs are available over the counter without a prescription. For this reason, a systematic review of the literature on the adverse effects on the woman and the fetus was performed. Objective: To determine the adverse effects associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) on pregnant women and fetuses during pregnancy. Methods: Systematic literature review. The following search strategy was used for the databases: Science Direct, PubMed, Scopus and Web of Science, through September 3, 2022. The population of pregnant women without previous comorbidities was defined. The intervention of interest was the use of NSAIDs during pregnancy. The outcomes of interest were adverse effects for the mother or fetus (weight of the newborn, congenital malformations present in the fetus, systemic effects in the pregnant woman during her gestation period). The types of studies included clinical trials, cohort studies and case‒control studies. Results: 1 study included 2,985 pregnant women without previous comorbidities. The use of aspirin more frequently during pregnancy stands out. The adverse effects on the fetus were preterm birth <37 weeks, low birth weight < 2500 g and increased admission to the neonatal intensive care unit. No adverse effects were found for the mother. Conclusions: There are not enough data indicating that the use of NSAIDs during pregnancy is safe. Some studies show that the use of NSAIDs during pregnancy could be related to problems in the development and growth of the fetus and health effects for the mother during pregnancy, so it is advisable to use these drugs under medical prescription and for the shortest possible time. in the gestation stage.

The prevalence of depression and anxiety among healthcare workers (HCWs) during the Covid-19 pandemics is high. The aim of the study is to identify the importance of self-esteem and occupational factors in association with the incidence of depression and anxiety among HCWs through a longitudinal cohort study during the Covid-19 pandemics in Latvia. Participants were interviewed repeatedly seven times during the Covid-19 pandemics. 322 participants were included in the data analysis for depression and 352 for anxiety. Low self-esteem and working in the general practitioner's office is associated with the incidence of depression and anxiety. Undergraduate education and direct contact with Covid-19 patients are associated with the incidence of depression. The risk of anxiety decreases by 1% each year among HCWs. Our study shows the importance of personality factors of HCWs during the Covid-19 pandemics.

The contemporary landscape of education is witnessing a paradigm shift towards innovative instructional methods, with the flipped learning approach gaining considerable attention. The purpose of this research was to investigate the impact of the flipped learning approach on students' perception and acceptance throughout an entire semester in the 'Introduction to Programming with Java' course, using a research design with a quantitative approach, ultimately aiming to inform educational practice and advance our knowledge of innovative teaching methods in higher education. This study was conducted at a university with 174 students involved, divided into two groups, 87 students in the experimental group and 87 students in the control group. The data collected through the scales were analyzed by using descriptive and inferential statistical analysis techniques in statistical software. At the end of the measurements, the technology acceptance level and self-directed learning perceptions of engineering students who received education with flipped learning were high. The results suggest that educators should consider students' readiness for self-directed learning when implementing the flipped learning approach and focus on creating an environment that supports their autonomy and engagement. This research offers valuable guidance for instructors, curriculum designers, and educational policymakers seeking to enhance the effectiveness of flipped learning in higher education courses.

We used a mixed-method single-case experimental research design to examine the effect of modelling (peer versus non-peer) on exercise self-efficacy in stroke survivors who participated in a community-based exercise program. Quantitative data were obtained using a ABCA design: (A1) no model/baseline 1 (3 weeks); (B) peer model (6 weeks); (C) non-peer model (6 weeks); and (A2) no model/baseline 2 (3 weeks). Four participants completed self-efficacy questionnaires after each weekly session. Qualitative data were obtained using researcher diaries and two semi-structured interviews: after B and A2. Based on quantitative and qualitative results, participants reported higher exercise self-efficacy in the model conditions, with ratings appearing highest for the non-peer model. This finding could be due to a lack of full integration of the peer model and low feelings of similarity. Modelling in general could help people recovering from a stroke increase their exercise self-efficacy, but non-peer models may not be most advantageous.

Traumatic brain injury (TBI) is among the leading causes of mortality and long-term impairment globally. TBI has a dynamic pathology encompassing a variety of metabolic and molecular events that occur in two phases, primary and secondary. An external forceful blow to the brain initiates the primary phase, which is followed by a secondary phase that involves the release of calcium ions (Ca2+) and the initiation of a cascade of inflammatory processes, including mitochondrial dysfunction, rise in oxidative stress, activation of glial cells, and damage to the blood-brain barrier (BBB), resulting in paracellular leakage. There is currently no FDA-approved drug for TBI, but existing approaches rely on delivering small and macromolecular treatments, which are severely constrained by the BBB, poor retention, off-target toxicity, and complex pathology of TBI. Therefore, there is a demand for innovative and alternative therapeutics with effective delivery tactics for diagnosis and treatment of TBI. Tissue engineering and use of biomaterials is one such alternative approach. With this approach, neuronal stem cell therapy is combined with synthetically generated tissue materials such as hydrogels, self-assembling peptides, and electrospun nanofibers, which may induce neurite outgrowth, differentiation of human neural stem cells, and nerve gap bridging in TBI. This review examines tissue engineering and the use of biomaterials as potential treatments for TBI, including their synthesis, mechanisms of action, and limitations. The review also discusses challenges facing tissue engineering and biomaterial technology including survival rate of transplanted stem cells and the development of biodegradable, biocompatible, and mechanically flexible biomaterials. A better understanding of the mechanisms and drawbacks of these novel therapeutic approaches will help guide the design of future TBI therapies.

Biological function depends on the composition as well as structure of the organism, that is the organization of interactions between its parts. In multicellular organisms, the complex communication between cells is crucial for the coordination of cellular functions (growth, differentiation, apoptosis), compartmentalization of cellular processes within the organism, and the integration of cells into functioning higher levels of structural organization. Here we focus on the interaction among cells, as the basic level of biological organization, capable of a remarkable degree of autonomy and self-maintenance. While a wealth of data on putative cell interactions has recently become available, its biological interpretation depends on expectations we have for the structure of these interaction networks. This contribution is an attempt at formulating basic questions we may ask about cell interaction data. We build on the understanding that cells fulfill two general functions: the integrity-maintaining and the organismal service function. We derive the expected patterns of cell interactions considering two intertwined aspects: the immediate functional and the evolutionary. Based on these, we propose several guidelines for analysis and interpretation of transcriptional cell-interactome data.

This article describes the impact of restricting the air intake in industrial 250 m3 WEMCO flotation cells at Los Pelambres concentrator. The influence of this air restriction on the hydrodynamic and metallurgical performance of this type of machine was evaluated. The experiments were conducted in single flotation cells and in entire rougher banks. In all cases, the gas holdup was measured to estimate the effectiveness of the obstruction system to decrease the air concentration. In single cells, axial profiles for solid percentage and particle size were evaluated. In addition, a mass balance was conducted to assess the copper recovery and concentrate features. In individual cells, the air restriction led to a decrease in the gas holdup. However, this slight change was enough to obtain a more stable froth zone and a better solids suspension. The latter was observed as a higher P80 below the pulp-froth interface, a less diluted pulp at this level, a slightly higher Cu recovery, and a coarser concentrate product. A mineralogical analysis of the concentrate sample also showed the presence of coarser liberated Cu-sulfide particles. The results in single cells suggested an improvement in the recovery of coarse particles by a more intense solids suspension. The air intake was also restricted in 3 rougher banks to assess the impact of the air obstruction on the overall performance of the respective circuit. Eleven out of fourteen cells were operated with air restriction, which led to a significant recovery improvement of 0.9%-1.6% (absolute) with a 95% confidence level. Size-by-size mass balances were also conducted for the rougher circuits, which proved that the recovery improvements were justified by the simultaneous increase in the recovery of coarse and fine particles. Thus, a restriction of the air intake showed that the decrease in the gas holdup (and in the bubble surface area flux) was compensated by a better solids suspension and a higher turbulence in the impeller. The former promotes the recovery of coarse particles, whereas the latter improves the interaction between bubbles and fine particles. Further developments are being made to implement a regulatory control strategy to control the air intake in self-aspirated flotation cells, and to use this approach for optimizing industrial flotation banks.

Machinery degradation assessment can offer meaningful prognosis and health management in-formation. Although numerous machine prediction models based on artificial intelligence have emerged in recent years, they still face a series of challenges: (1) Many models continue to rely on manual feature extraction. (2) Deep learning models still struggle with long sequence prediction tasks. (3) Health indicators are inefficient for remaining useful life (RUL) prediction with cross-operational environments when dealing with high-dimensional datasets as inputs. This research proposes a health indicator construction methodology based on a transformer self-attention transfer network (TSTN). This methodology can directly deal with the high-dimensional raw dataset and keep all the information without missing when the signals are taken as the input of the diagnosis and prognosis model. First, we design an encoder with a long-term and short-term self-attention mechanism to capture crucial time-varying information from a high-dimensional dataset. Second, we propose an estimator that can map the embedding from the encoder output to the estimated degradation trends. Then, we present a domain dis-criminator to extract invariant features from different machine operating conditions. The case studies with the FEMTO-ST bearing dataset and the Monte Carlo method for RUL prediction during the degradation process are conducted. The experiment results fully exhibited the signif-icant advantages of the proposed method compared to other state-of-the-art techniques.

Oxytocin (OXT), a pro-social peptide, is increasingly recognized as a potential protective substance against drug addiction. In the context of ethanol, previous researches have shown OXT properties to reduce self-administration, alleviate motor impairment in rodents, and reduce craving in humans. However, its role in behavioral sensitization, a neuroadaptive response resulting from repeated drug exposure linked to increased drug incentive, remains unexplored. OXT is also associated with modulating the Hypothalamic-Pituitary-Adrenal (HPA) axis, with corticosterone well-known as a significant factor in behavioral sensitization development. This study aimed to investigate the effects of Carbetocin (CBT), an analogue of OXT, on the expression of behavioral sensitization to ethanol and concurrent alterations in plasma corticosterone levels in male and female Swiss mice. We also aimed to confirm previous studies on OXT impact on ethanol consumption in male mice, but with a focus on CBT, using the two-bottle choice model and drinking in the dark (DID) methodology. For the sensitization study, mice received either ethanol (1.8 g/kg, ip) or saline treatments daily for 15 consecutive days, followed by treatment with carbetocin (0.64 mg/kg, ip) or a vehicle for 6 days. Subsequently, on day 22, all animals underwent an ethanol challenge to assess the expression of behavioral sensitization. Plasma corticosterone levels were measured on days 21 and 22. CBT effectively prevented the expression of ethanol-induced behavioral sensitization in both male and female subjects, with no alterations detected in corticosterone levels. In the ethanol consumption study, following an initial phase of ethanol acquisition, mice underwent a 6-day treatment with CBT i.p or saline before being reexposed to ethanol. We also found a reduction in ethanol consumption due to CBT treatment. In conclusion, carbetocin emerges as a promising and effective intervention in mitigating ethanol-induced behavioral sensitization and reducing ethanol intake, highlighting its potential significance in alcohol addiction treatment.

This study uses explainable artificial intelligence to analyze major predictors of poor self-rated health, dementia and their comorbidity, which include various aspects of social support. Data came from the Korean Longitudinal Study of Ageing (2016-2018), with 5527 participants aged 56 or more. The dependent variables were: (1) poor self-rated health (SRH) with 5 categories (very good, good, middle, poor, very poor); (2) dementia (no, yes); and (3) their comorbidity with 4 categories (SRH very good, good or middle, dementia no; SRH very good, good or middle, dementia yes; SRH poor or very poor, dementia no; SRH poor or very poor, dementia yes). The 49 demographic, socioeconomic and health-related predictors were included. The accuracy and area under the receiver operating characteristic curve (AUC) were compared for logistic regression and the random forest. Logistic regression and the random forest registered similar AUCs with the range of 0.80-0.87. Based on random forest variable importance, 18 out of top-20 predictors were identical for SRH, dementia and their comorbidity: previous SRH, life satisfaction - health, age, body mass index, income, chronic diseases, life satisfaction - economic, life satisfaction - overall, grandchildren alive, friendship meeting, brothers/sisters alive, class identity, children alive, social activity - friendship, education, children in weekly contact, religion and drinker. However, some variations were found among the three dependent variables, i.e., previous SRH for comorbidity (1st) and SRH (1st) compared to dementia (11th), grandchildren alive for SRH (6th) and dementia (4th) compared to comorbidity (9th), chronic diseases for comorbidity (6th) compared to SRH (10th) and dementia (10th). In terms of Shapley Additive Explanation (SHAP) values, the probability of dementia is expected to decrease by 5.57% in case a predictor grandchildren alive is included to the model. This study highlights the importance of social support for the prediction of poor self-rated health, dementia and their comorbidity. Specifically, the promotion of family support and friendship activity for elders would be vital for the prevention and management of their self-rated health and dementia.

Previous studies on the mechanisms underlying willed actions reported that the premotor cortex may be involved in the construction of motor awareness. However, its exact role is still under investigation. Here we investigated the role of the dorsal premotor cortex (PMd) in motor awareness by modulating its activity applying inhibitory rTMS to PMd, before a specific motor awareness task (under three conditions: without stimulation, after rTMS and after sham stimulation). During the task, subjects had to trace straight lines to a given target, receiving a visual feedback of the line trajectories on a computer screen. Crucially, in most trials the trajectories on the screen were deviated and to produce straight lines, subjects had to correct their movements towards the opposite direction. After each trial, participants were asked to judge whether the line seen on the computer screen corresponded to the line actually drawn. Results show that participants in the no stimulation condition did not recognize the perturbation until 14 degrees of deviation. Importantly, active, but not sham, rTMS significantly modulated motor awareness, decreasing the amplitude of the angle at which participants became aware of the trajectory correction. These results suggest that PMd plays a crucial role in action self- monitoring.

This paper proposes a Grouped Contrastive Learning of self-supervised Sentence Representation (GCLSR), which can learn an effective and meaningful representation of sentences. Previous works maximize the similarity between two vectors to be the objective of contrastive learning, suffering from the high-dimensionality of the vectors. In addition, most previous works have adopted discrete data augmentation to obtain positive samples and directly employed contrastive framework of computer vision to perform contrastive training, which could hamper contrastive training because text data is discrete and sparse compared with image data. To address those issues, we propose a grouped contrastive learning framework, i.e., GCLSR, which divides the high-dimensional feature vector into several groups and respectively computes the groups’ contrastive losses to make use of more local information, eventually obtaining a more fine-grained sentence representation. In addition, in GCLSR, we design a new self-attention mechanism and a continuous as well as partial word vector augmentation (PWVA). For the discrete and sparse text data, the usage of self-attention could help model focus the informative words by measuring the importance of every word in a sentence. By using the PWVA, GCLSR can obtain high-quality positive samples used for contrastive learning. Experimental results demonstrate that our proposed GCLSR achieves an encouraging result on the challenging datasets of the standard semantic textual similarity (STS) task and transfer task.

The genetic systems of Paspalum species have not been extensively studied. We analysed the ploidy, reproductive mode, mating system, and fertility of four Paspalum species - P. durifolium, P. ionan-thum, P. regnellii, and P. urvillei. An analysis of 378 individuals from 20 populations of north-eastern Argentina was conducted. All populations of the four Paspalum species were pure tetraploid and had a sexual and stable reproductive mode. However, some populations of P. durifolium and P. ionanthum showed low levels of apospory. Populations of P. durifolium and P. ionanthum had low seed sets under self-pollination but were fertile under open pollination, showing that self-incompatibility likely caused self-sterility. In contrast, populations of P. regnellii or P. urvillei showed no evidence of apospory and seed set in both self- and open pollination conditions were high, suggesting that they are self-compatible, due to the absence of pollen-pistil molecular in-compatibility mechanisms. The evolutionary origin of the four Paspalum species could explain these differences. This study supplies valuable insights into the genetic systems of Paspalum species, which could have implications for their conservation and management.

Despite empirical findings that prosociality can prevent children and adolescents from developing psychological maladjustment, little is known about the underlying mechanisms. The goal of the present study was to examine the mediating effects of peer preference and self-perceived social competence on the associations between prosociality and psychological maladjustment (i.e., depressive symptoms and loneliness). Participants were 951 students (Mage = 11 years, 442 girls) in Grades 3~7 from Shanghai, China. They completed peer nominations of prosociality and peer preference, and self-report measures of self-perceived social competence, depressive symptoms, and loneliness. Multiple mediation analyses revealed that: (a) both peer preference and self-perceived social competence mediated the relations between prosociality and psychological maladjustment; and (b) a serial indirect pathway (i.e., prosociality  →  peer preference  →  self-perceived social competence →  psychological maladjustment) emerged when controlling for grade and gender. These findings point to potential targets in the prevention and intervention of adolescent internalizing problems.

Nowadays Air-Source Heat Pumps (ASHP) in combination with a Photovoltaic (PV) installation are a very promising option for a necessary and urgent energy transformation in European Union (EU). It is extremely important to develop solutions that will help maximize the use of energy generated from renewable energy sources (RES). Such issues include the problem of insufficient use of generated electricity in PV on-grid microinstallations in residential buildings. This paper's aim is to analyze the results of one-year-round operation of a PV array grid-connected hybrid installation with ASHP for domestic hot water (DHW) preparation in a residential building in Cracow, Poland in the context of increasing self-consumption (SC) of PV energy. Models of systems are built and simulated in Transient System Simulation Tool 18 (TRNSYS) software. Simulations were carried out for different scenarios involving different building electricity consumption profiles, PV system capacity and specified runtime management of ASHP. The novelty of this study lies in the evaluation of the impact of a certain range of conditions on the energy performance of the system, in particular on SC. The results showed that the use of ASHP, with specified runtime management, results in an increase in monthly SC values from 7 to 18%, and annual SC values up to 13%. Also determining the appropriate size of the used PV system depending on whether it is present ASHP in the installation is crucial to increase the value of the SC parameter. Overall, this study provides valuable insights into the potential benefits of PV panels and ASHP operating together, in particular on SC values.

The dynamic and surface manipulation of the M13 bacteriophage meeting application demands enable a pathway to design efficient applications with high selectivity and responsivity rate. Herein, we report the role of the M13 bacteriophage thin film layer deposited on an optical nanostructure involving gold nanoparticles/SiO2/Si and its influence on optical and geometrical properties. The thickness of the M13 phage layer was either controlled by varying the concentration or humidity exposure levels, and optical studies were conducted. We designed a standard and dynamic model based upon three-dimensional finite-difference time-domain (3D FDTD) simulations distinguishing the necessity of each model under variable conditions. As seen from the experiments, the origin of respective peak wavelength positions is addressed in detail with the help of simulations. The importance of the dynamic model was noted when humidity-based experiments were conducted. Inexpensive, multi-wavelength optical characteristics from a single structure, reproducibility, and reversible properties are significant advantages of involving M13 bacteriophage. We believe this work will provide fundamental insight into understanding and interpreting the geometrical and optical properties of the nanostructures involving M13 bacteriophage.

The objective of this quantitative study was to examine the impact of selected factors on the level and state of public health in local self-government units in 2021, with the consideration of data from 2020 and 2019. This survey included 77 out of 145 local self-government units in the Republic of Serbia and examined six dimensions defined by the Law on Public Health: social care for the public health of the city/municipality in regard to the physical, mental, and social health of the population; health promotion and disease prevention; the environment and health; working environments and population health; the organization and functioning of the health system; and actions in emergency situations. The results of the Pearson correlation showed that there were statistically significant correlations between the effectiveness of the realized program budget and microbiologically defective drinking water samples from the so-called village water supply systems, defective samples of drinking water from public taps, unsatisfactory analyses of wastewater samples, the total number of air samples on an annual level for PM25s, and the number of mandated fines issued. The results of the logistic regression model showed that the local self-government units that received assistance from the Permanent Conference of Cities and Municipalities were 5.6 times more likely to perform analyses of their health status. Furthermore, we determined that the units of local self-governments that appointed a coordinator of the health council identified vulnerable groups in the analysis of the state of health four and a half times more often. In contrast, the units of local self-governments that prepared health status analyses could be used to identify vulnerable groups to a six times greater extent within the framework of the health status analysis. The results showed that in improving the state of public health at the local level, it is necessary to provide systematic institutional support to cities and municipalities in exercising their responsibilities. Based on these results, recommendations were made for the further development of support, i.e., the planning of further activities aimed at strengthening the capacity of the health councils and local self-government units in this area.

Self-conscious emotions, such as shame and guilt, play a fundamental role in regulating moral behavior and in promoting the welfare of the society. Despite their relevance, the neural bases of these emotions are uncertain. In the present meta-analysis, we performed a systematic literature review in order to single out functional neuroimaging studies on healthy individuals specifically investigating the neural substrates of shame, embarrassment and guilt. Seventeen studies investigating the neural correlates of shame/embarrassment, and seventeen studies investigating guilt brain representation met our inclusion criteria. The analyses revealed that both guilt and shame/embarrassment were associated with the activation of the left anterior insula, involved in emotional awareness processing, and arousal. Guilt specific areas were located within the left temporo-parietal junction, which is thought to be involved in social cognitive processes. Moreover, specific activations for shame/embarrassment involved areas related to social pain (dorsal anterior cingulate, insula, thalamus), behavioral inhibition (premotor cortex) networks. This pattern of results might reflect distinct action tendencies associated with the two emotions.

Rapid SARS-CoV-2 self-tests have the potential to expand access to COVID-19 testing and improve community-level case detection, particularly in resource-constrained countries such as Kenya. However, prior to their introduction, their acceptability must be assessed. This qualitative study explored key decision-takers’ values towards SARS-CoV-2 self-testing in Kenya. Healthcare workers, representatives of civil society, and potential implementors from Mombasa and Taita-Taveta were selected as decision-takers. Semi-structured interviews and focus group discussions were used to collect data on their values towards self-testing. A thematic analysis approach was applied. Most informants considered that the Kenyan public is equipped to accept and use self-testing safely as an approach to help to reduce workload at public healthcare facilities, and know one’s COVID-19 status in a private manner. The informants emphasized the need to provide counselling to end-users, to support those needing to self-isolate, and to engage different civil society stakeholders in information provision on self-testing. Fear of stigma and of forced isolation were noted as potential deterrents to self-testing uptake for some individuals. In conclusion, there is high acceptability of self-testing in Kenya among decision-takers. However, enhanced education, counselling, and addressing deterrents to testing would be helpful to ensure effective use of SARS-CoV-2 self-testing in Kenya.

Building on a framework of risk transmission to children of depressed parents, the present study investigated the associations between parents’ self-compassion, parent’s depressive symptoms, and child adjustment. A total 189 Chinese parents (101 mothers) whose children were 2-8 years old were recruited to complete a questionnaire, including measures of self-compassion, depressive symptoms and children’s prosocial behavior, internalizing problems, and externalizing problems. Findings indicated mediation effects, in that parents’ depressive symptoms mediated the associ-ation between their self-compassion and child adjustment outcomes, namely children’s internal-izing and externalizing problems, after controlling the effects of monthly family income, child gender, and parent gender. Competing hypothesis suggested that parents’ self-compassion did not moderate between parents’ depressive symptoms and child adjustment outcomes. Hence, the association between parental depressive symptoms and child adjustment was not dependent on the level of parents’ self-compassion. As an implication, researchers and practitioners should be made aware of the protective role of parents’ self-compassion in the family context.

Tinnitus is an auditory phantom perception in the ears or head in the absence of a corresponding external stimulus. There is currently no effective treatment available that reliably reduces tinnitus. Educative counseling is a treatment approach that aims to educate patients and inform them about possible coping strategies. For this feasability study, we implemented educational material and self-help advice in a smartphone app. Participants used the educational smartphone unsupervised during their daily routine over a period of 4 months. Comparing the tinnitus outcome measures before and after smartphone-guided treatment, we measured changes in the tinnitus-related distress, but not in tinnitus loudness. Improvements on the Tinnitus Severity numeric rating scale reached an effect size of .408, while the improvements on the THI were much smaller with an effect size of .168. Analysis on the user behavior showed that frequent and intensive use of the app is a crucial factor for treatment success: participants that used the app more often and interacted with the app intensively, reported a stronger improvement of the tinnitus. Between study allocation and final assessment, 26 of 52 participants dropped out of the study. Reasons for the dropouts and lessons for future studies are discussed in this paper.

Ordinary computing machines prohibit self-reference because it leads to logical inconsistencies and undecidability. In contrast, the human mind can understand self-referential statements without necessitating physically impossible brain states. Why can the brain make sense of self-reference? Here, we address this question by defining the Strange Loop Model, which features causal feedback between two brain modules, and circumvents the paradoxes of self-reference and negation by unfolding the inconsistency in time. We also argue that the metastable dynamics of the brain inhibit and terminate unhalting inferences. Finally, we show that the representation of logical inconsistencies in the Strange Loop Model leads to causal incongruence between brain subsystems in Integrated Information Theory.

Human papillomavirus (HPV) self-sampling (Self-HPV) is a promising strategy to improve cervical cancer screening coverage in low-income countries. However, issues associated with women who prefer conventional HPV clinical-sampling over HPV self-sampling may affect screening participation. To address this issue, our study assessed factors associated with women’s preferences related to Self-HPV. This study was embedded in a large clinical trial recruiting women aged 30–49 years in a primary HPV-based study termed “3T-Approach” (for Test-Triage-Treatment), launched in 2018 at Dschang District Hospital, West Cameroon. Participants were invited to perform a Self-HPV. After the sampling and before receiving the results, participants completed a questionnaire about cervical cancer screening and their preferences and perceptions around Self-HPV. The median age of the 2201 participants was 40.6 (IQR 35–45) years. Most (1693 (76.9%)) preferred HPV self-sampling or had no preference for either method and 508 (23.1%) preferred clinician-sampling. Factors associated with an increased likelihood of reporting a clinician-sampling preference were tertiary educational level (14.4% CI: 12.8–16.1 vs 29.5% CI: 25.6–33.6) and being an employee with higher grade professional or managerial occupations (5.5% CI: 3.8–7.9 vs 2.6% CI: 2.3–2.8). The main reported reason for women preferring clinician-sampling was a lack of “self-expertise”. Most women (&gt;99%) would agree to repeat HPV self-sampling and would recommend it to their relatives. HPV self-sampling in the cultural context of central Africa was well accepted by participants, but some participants would prefer to undergo clinician sampling. Health systems should support well-educated women to increase self-confidence in using HPV self-sampling.

With the development of science and technology, buying has become much easier. At the same time, however, impulsive buying has many negative consequences for college students, and the causes of impulsive buying should therefore be explored. To explore the relationship between social exclusion and impulsive buying and its underlying mechanism, this study used the Social Exclusion Scale, Self-Esteem Scale, Risk Preference Scale, and Impulsive Buying Scale to investigate the roles of self-esteem and risk preference in the relationship between social exclusion and impulsive buying among 768 college students (387 were female, Mage = 20.25 years). The results were as follows: (1) when controlling for gender, age, family monthly income, and monthly living expenses, social exclusion significantly and positively predicted impulsive buying; (2) self-esteem played a mediating role between social exclusion and impulsive buying; (3) risk preference moderated the relationship between the second half of the mediating path and the direct path. These results reveal the mechanism underlying impulsive buying in college students, that is, social exclusion will predict the decrease of college students' self-esteem, and low self-esteem will further predict college students' impulsive buying which is a way for them to gain a sense of self-worth. Relatively low risk preference can well alleviate the negative impact of social exclusion and low self-esteem on impulsive buying. What’s more, these results have implications for impulsive buying interventions. Schools should aim to create a good peer atmosphere by making certain rules that help to reduce social exclusion and parents and education departments should cultivate students’ risk awareness to avoid risk behaviors in college students, such as impulsive buying behavior.

Smart air filters are beneficial to provide highly efficient particle removal, treat multiple contaminants simultaneously and conserve energy during air filtration processes. Herein, a type of self-supporting smart air filter (SSSAF) was fabricated by sandwiching the VOC-responsive PZT/PVDF electrospun membrane with two metal mesh electrodes. Besides the high filtration efficiency for sub-micron particles, the SSSAF showed good responses to pressure drop in the range of 0 to 500 Pa via the electroactivity of PZT/PVDF membrane. In addition, the SSSAF achieved VOC sensing function via the swelling properties of PZT/PVDF membrane in organic vapors, demonstrated by its signal to 50 to 200 ppm ethanol gases. The SSSAF based nanogenerator was employed to harvest wind energy, which was further applied to inhibit bacterial growth without the need of additional power input. The results provide new insight into development of all-in-one smart air filters.

The field of power harvesting has experienced significant growth over the past few years due to the ever-increasing desire to produce portable and wireless electronics with extended lifespans. The present work aims to introduce an approach to harvesting electrical energy from a mechanically excited piezoelectric element and investigates a power analytical model generated by a smart structure of type polyvinylidene fluoride(PVDF) that can be stuck onto fabrics and flexible substrates, although we report the effects of various substrates and investigates the sticking of these substrates on the characterization of the piezoelectric material.

Learning dental procedures is a complex task involving the development of fine motor skills. The reported use of theories and/ or evidence for designing learning activities to develop the fine motor skills needed for dental practice is limited. The aim of this review is to explore the available body of knowledge related to learning fine motor skills in dentistry. Evidence from studies investigating motor skill learning highlights the negative impact of self-focus and self-regulation on learning outcomes, particularly during the early stages of learning. The development of activities and schedules that enable novices to demonstrate characteristics similar to experts, without the reported long period of ‘deliberate practice’, is clearly of value. Outcomes of learning implicitly are important in dentistry because working under stressful conditions is common, either during undergraduate study or in practice. It is suggested that learning implicitly in the simulation stage can reduce disrupted performance when transitioning to clinical settings. Therefore, further investigation of effective methods for learning dental fine motor skills is indicated, using approaches that result in robust performance, even under stressful conditions.

Afghanistan is overwhelmed with food insecurity that is a large percentage of the population lacks reliable access to food supplies. Grains play a vital role in the country's food security due to their importance in terms of consumption and production quantity. This paper estimates cereal self-sufficiency and then makes a food balance forecast of the three major food crops cultivated in Afghanistan over six-decades. Descriptive statistics and coarse metric techniques were employed to determine cereal self-sufficiency and food balance forecast. The econometric analysis demonstrated that (1) Afghanistan is not yet self-sufficient in meeting grain consumption, and the production and consumption ratio declined from 0.9 to 0.55 from 1979 to 2030. (2) The gap of theoretical food imbalance will increase, and by the year 2030, cereal production will likely be sufficient for only 49.8 percentage of inhabitants, leaving a high shortage equivalent to the amount required by 24.4 million people. By evaluating the quantitative food balance and the growing population change, this study presents an analysis of the emerging threat to Afghanistan's food security and suggests a solution for food security, should increase the size of public agricultural expenditure, improve the level of agriculture infrastructure, and continue to introduce a policy to achieve higher yield.

In this paper, closed and semi-closed form solutions are presented for the self - and mutual inductance of ordinary and Better disk coils which lie concentrically in a plane. The solutions are given as the combination of the elliptic integral of the first kind and a simple integral or only as the second elliptic integral of the second kind. All formulas or obtained in remarkably simple form and give extremely accurate results with significantly neglectable computational time. All cases either regular or singular (disks in contact or overlap) are covered. The formulas for the mutual inductances can be directly used to calculating the self-inductance of the ordinary disk coil or the Bitter disk coil, respectively. Many presented examples show the excellent numerical agreement with previous publish methods.

Quantification of physical activity (PA) depends on the type of measurement and analysis method making it difficult to compare adherence to PA guidelines. Therefore, test-retest reliability, criterion validity, and stability for self-reported (i.e. questionnaire and diary) and device-based measured (i.e. accelerometry with 10/60 second epochs) PA was compared in 32 adults and 32 children from the SMARTFAMILY study to examine if differences in these measurement tools are systematic. PA was collected during two separate measurement weeks and the relationship for each quality criteria was analyzed using Spearman correlation. Results showed the highest PA values for questionnaires followed by 10-second and 60-second epochs measured by accelerometers. Levels of PA were lowest when measured by diary. Only accelerometry demonstrated reliable, valid, and stable results for the two measurement weeks, the questionnaire yielded mixed results and the diary showed only few significant correlations. Overall, higher correlations for the quality criteria were found for moderate than for vigorous PA and the results differed between children and adults. Since the differences were not found to be systematic, the choice of measurement tools should be carefully considered by anyone working with PA outcomes, especially if vigorous PA is the parameter of interest.

Choline and choline metabolites are essential for all cellular functions. They have also been reported to be crucial for neural development. In this work, we studied the functional characteristics of the choline uptake system in human neural stem cells (hNSCs). Additionally, we investigated the effect of extracellular choline uptake inhibition on the cellular activities in hNSCs. We found that the mRNAs and proteins of choline transporter-like protein 1 (CTL1) and CTL2 were expressed at high levels. Immunostaining showed that CTL1 and CTL2 were localized in the cell membrane and partly in the mitochondria, respectively. The uptake of extracellular choline was saturable and performed by a single uptake mechanism, which was Na+-independent and pH-dependent. We conclude that CTL1 is responsible for extracellular choline uptake, and CTL2 may uptake choline in the mitochondria and be involved in DNA methylation via choline oxidation. Extracellular choline uptake inhibition caused intracellular choline deficiency in hNSCs, which suppressed cell proliferation, cell viability, and neurite outgrowth. Our findings contribute to the understanding of the role of choline in neural development as well as the pathogenesis of various neurological diseases caused by choline deficiency or choline uptake impairment.

Background and objectives: Suicide is a topical issue in Lithuania and all around the world. It is the second most common cause of death among young people. There is a lack of research studies on the psychosocial aspects of adolescent suicide in Lithuania. This study aimed to evaluate demographics, life circumstances, and health conditions as factors related to suicide attempt in adolescents. Materials and Methods: A retrospective study was performed at the Children’s Hospital (Vilnius University Santara Clinics). Medical documentation of adolescents treated in this hospital after suicide attempts from January 2011 to April 2018 were analyzed. Results: There were 117 cases of hospitalization due to suicide attempts during this period, and 102 cases were included in the study. There were 83.8% female and 16.2% male patients with an average age of 15.02 ± 1.9 years (p = 0.405); 40.6% of patients lived in divorced families, 17.7% lived in orphanages, 4.2% lived in foster care, 36.4% suffered from parental alcoholism, and 17.2% experienced suicide in their close surroundings. They had comorbidities (girls 72.5%, boys 68.8%), mostly depression (31.3%), were suffering from bullying (54.1%) or violence (26.0%), and 85.4% showed signs of other types of self-harm (girls more often (p < 0.001)). Most of them chose to cut for suicide attempts (86.0% girls, 56.2% boys). In 52.8% of cases, the attempt was spontaneous and 34% relapsed. Thirty-four events occurred in March (18.9%) (p = 0.688). Conclusions: Our study revealed the possible circumstances related to adolescent suicide attempt. Female gender was more common overall and males were more likely to carry out more potentially lethal methods. Other common associated factors were a lack of prosperity in family life, experience of bullying, violence, comorbidities, and the early spring period. Signs of any self-harm could be an indicator of later suicide attempt.

Viruses have established symbiotic relationships with almost every other living organism on Earth and at all levels of biological organisation, from other viruses up to entire ecosystems. In most cases, peacefully coexisting with their hosts, but in most relevant cases, parasitising them and inducing diseases. Viruses are playing an essential role in shaping the eco-evolutionary dynamics of their hosts, and have been also involved in some of the major evolutionary innovations either by working as vectors of genetic information or by being themselves coopted by the host into their genomes. Viruses can be studied at different levels of biological organisation, from the molecular mechanisms of genome replication, gene expression and encapsidation, to global pandemics. All these levels are different and yet connected through the presence of threshold conditions allowing for the formation of a capsid, the loss of genetic information or epidemic spreading. These thresholds, as it occurs with temperatures separating phases in a liquid, define sharp qualitative types of behaviour. These {\em phase transitions} are very well known in Physics. They have been studied by means of simple, but powerful models able to capture their essential properties, allowing to understand them. Can the physics of phase transitions be an inspiration for our understanding of viral dynamics at different scales? Here we review well-known examples of transition phenomena in virology and their simplest mathematical modelling approaches. We suggest that the advantages of abstract, simplified pictures used in Physics are also the key to properly understand the origins and evolution of complexity in viruses. By means of several examples, we explore this multilevel landscape and how minimal models provide deep insights into a diverse array of problems. The relevance of these transitions in connecting dynamical patterns across levels and their evolutionary and clinical implications are outlined.

Modified ammonium polyphosphate (MAPP) as a novel mono-component intumescent flame retardant (IFR) was prepared via the ionic exchange between ammonium polyphosphate (APP) and piperazine sulfonate, which is synthesized by self-assembly using 1-(2-Amioethyl) piperazine (AEP) and p-amino benzene sulfonic acid (ASC) as raw materials. This all-in-one IFR integrating three functional elements (carbon, acid, and gas source) showed more efficient flame retardancy and excellent smoke suppression as well as better mechanical properties than the conventional APP. The incorporation of 22.5 wt.% MAPP into polypropylene (PP) eliminated the melt dripping phenomenon and passed the UL-94 V-0 rating. The results of the cone calorimetry test (CCT) revealed that the release of heat, smoke, and CO is significantly decreased, demonstrating that this novel IFR endows PP with excellent fire safety more effectively. For PP/MAPP composites, a possible IFR mechanism was proposed based on the analysis of the pyrolysis gas and char residues.

For a hierarchy of large scale structures, like galaxies, galaxy clusters, super-clusters, etc. the requirement that their gravitational (binding) self-energy density must at least equal or exceed the background repulsive dark energy density implies a universal mass-radius relation given by M/R² ~ 1g/cm². Here we point out that this mass-radius relation also holds for important individual biological structures, and even various organisms as a whole such as humans, trees, and to behemoths like whales, even though the physics is different. Here we try to understand this universality from two different physical considerations. We also point out the coincidence that the densities of most biological entities are close to that of water, and that the average density of main-sequence stars and giant planets are close to this density. We give a physical basis for the same.

Cortical actomyosin flows, among other mechanisms, scale up spontaneous symmetry breaking and thus play pivotal roles in cell differentiation, division, and motility. According to many model systems, myosin motor-induced local contractions of initially isotropic actomyosin cortices are nucleation points for generating cortical flows. However, the positive feedback mechanisms by which spontaneous contractions can be amplified towards large-scale directed flows remain mostly speculative. To investigate such a process on spherical surfaces, we reconstituted and confined initially isotropic minimal actomyosin cortices to the interfaces of emulsion droplets. The presence of ATP leads to myosin-induced local contractions that self-organize and amplify into directed, large-scale actomyosin flows. By combining our experiments with theory, we found that the feedback mechanism leading to a coordinated, directional motion of actomyosin clusters can be described as asymmetric cluster vibrations, caused by intrinsic non-isotropic ATP consumption, in conjunction with spatial confinement. By tracking individual actomyosin clusters, we identified fingerprints of vibrational states as the basis of directed motions. These vibrations may represent a generic key driver of directed actomyosin flows under spatial confinement in vitro and in living systems.

This review describes major advances in the use of functionalized molecular metal oxides (polyoxometalates, POMs) as water oxidation catalysts under electrochemical conditions. The fundamentals of POM-based water oxidation are described together with a brief overview of general approaches to designing POM water oxidation catalysts. Next, the use of POMs for homogeneous, solution-phase water oxidation is described together with a summary of theoretical studies shedding light on the POM-WOC mechanism. This is followed by a discussion of heterogenization of POMs on electrically conductive substrates for technologically more relevant application studies. Stability of POM water oxidation catalysts are discussed on selected examples where detailed data is already available. The review finishes with an outlook on future perspective and emerging themes in electrocatalytic polyoxometalate-based water oxidation research.

Background and Objectives: Non-cognitive skills (NCS) are vital components of a socially and financially successful life. They are developed through childhood education, family and school environments, and social settings. The aim of this study was to examine the associations between NCS and the parent–child relationship, mental health, and lifestyle at school and at home for adolescents. Materials and Methods: An internet-based survey was conducted with 1,566 mothers and their children (aged 14) in Japan. Survey items for the children included background (i.e., sociodemographic items, school achievements, and lifestyle), NCS (i.e., grit and self-control scales), and mental health, while their mothers provided social, financial, and educational information, and information on parent–child relationships, including descriptions of the fathers and the father–child relationship. Results: Parent–child relationships were mostly good (i.e., 90.9% for mothers and 75.6% for fathers), with bad relationships being less common (1.6% for mothers and 6.7% for fathers). Adolescent lifestyle parameters and mental health were significantly associated with grit and self-control. Adolescents with good parent–child relationships had significantly higher NCS scores regardless of the gender of the parent. Higher NCS scores were significantly associated with better parent–child relationships, more favorable lifestyles, and better mental health among adolescents. Conclusions: These findings imply that good parent–child relationships may aid in the development of adolescents’ NCS, thereby facilitating positive lifestyles at school and home.

The importance of genome organization at the supranucleosomal scale in the control of gene expression is increasingly recognized today. In mammals, Topologically Associating Domains (TADs) and the active / inactive chromosomal compartments are two of the main nuclear structures that contribute to this organization level. However, recent works reviewed here indicate that, at specific loci, chromatin interactions with nuclear bodies could also be crucial to regulate genome functions, in particular transcription. They moreover suggest that these nuclear bodies are membrane-less organelles dynamically self-assembled and disassembled through mechanisms of phase separation. We have recently developed a novel genome-wide experimental method, High-salt Recovered Sequences sequencing (HRS-seq), which allows the identification of chromatin regions associated with large ribonucleoprotein (RNP) complexes and nuclear bodies. We argue that the physical nature of such RNP complexes and nuclear bodies appears to be central in their ability to promote efficient interactions between distant genomic regions. The development of novel experimental approaches, including our HRS-seq method, is opening new avenues to understand how self-assembly of phase separated nuclear bodies possibly contributes to mammalian genome organization and gene expression.

Based on a measuring system to determine levels of spatial organization in 2D polygons (homogeneous or heterogeneous partition of defined areas) lying on principles of regularity, we propose the entropy term linked to the concept of “information”, from the “information theory field”, in order to obtain an information measurement regarding a quantity of or amount of information in the architecture of complex 2D biological organizations. The term “quantity” does not refer to the amount of data (size), but to the probability of a geometrical basic pattern within a set of possible statistical configurations regarding levels of homogeneity and heterogeneity. It is this notion of information that is important in information theory, and measures of information in units of bits, what we propose to use for measuring quantities of organization in the architecture of complex geometrical systems. Two complex systems are tested, biological and non biological in order to obtain experimental results, which are verified with the evaluation criteria “entropy”. Experimental results show that the lowest levels of information and entropy, in addition with low rates of heterogeneity and high rates of homogeneity are particular features of geometrical organizations in biological systems.

This research aims to introduce a new technique, off-site and self-form segmental concrete masonry arches fabrication, without the need of construction formwork or centering. The innovative construction method in the current study encompasses two construction materials forms the self-form masonry arches, wedge-shape plain concrete voussoirs, and Carbon Fibers Reinforced Polymers (CFRP) composites. The employment of CFRP fabrics was for two main reasons; bond the voussoirs and forming the masonry arches. However, CFRP proved to be efficient for strengthening the extrados of the arch rings under service loadings. An experimental test conducted on four sophisticated masonry arch specimens. Research parameters were using thicker keystone as well as the partial strengthening of the self-form arch ring at the intrados. Major test finding was the use of thicker Keystone, alter the behavior of the self-form arch, considerably increased the load carrying capacity by 79%. Partial strengthening of the intrados with CFRP fabrics of typical arch ring Keystone resulted considerable increased the debonding load of fabrication CFRP sheets by 81%, increase the localized crushing load by 13%, and considerably increase voussoir sliding load by 107%.

Changes brought about by the Internet to Scholarly Communication and the spread of Open Access movement, have made it possible to increase the number of potential readers of published research dramatically. This two-phase study aims, at first, to assert the satisfaction of the potential for increased open access to articles published by authors at the University of Coimbra, in a context when there was no stimulus for the openness of published science other than an institutional mandate set by the University policy on Open Access (“Acesso Livre”). The satisfaction of the access openness was measured by observing the actual archiving behavior of researchers (either directly or through their agents). We started by selecting the top journal titles used to publish the STEM research of the University of Coimbra (2004-2013) by using Thomson Reuters’ Science Citation Index (SCI). These titles were available at the University libraries or through online subscriptions, some of them in open access (21%). By checking the journals' policy at the time regarding self-archiving at the SHERPA/RoMEO service, we found that the percentage of articles in Open Access (OA) could rise to 80% if deposited at Estudo Geral, the Institutional Repository of the University of Coimbra, as prescribed by the Open Access Policy of the University. As we concluded by verifying the deposit status of every single paper of researchers of the University that published in those journals, this potential was far from being fulfilled, despite the existence of the institutional mandate and favorable editorial conditions. We concluded, therefore, that an institutional mandate was not sufficient by itself to fully implement an open access policy and to close the gap between publication and access. The second phase of the study, to follow, will rescan the status of published papers in a context where the Portuguese public funding agency, the Fundação para a Ciência e a Tecnologia, introduced in 2014 a new significant stimulus for open access in science. The FCT Open Access Policy stipulates that publicly funded published research must be available as soon as possible in a repository of the Portuguese network of scientific repositories, RCAAP, which integrates the Estudo Geral.

In this study, a parameter of volume stability was proposed for the first time to design polymorph zirconia ceramics used for special components. A series of heterogeneous polymorph zirconia ceramics with various amounts of monoclinic (M) phase were fabricated by two-step sintering. Samples with about 27%, 31%, and 51% M phase content were selected to study the properties. The thermal shock durability was found to be associated with thermal expansion behavior and noncritical micro cracks, which both based on M phase initial content. In good agreement with experimental results, the correlation of normalized K versus M phase initial content was established. It could provide a repeatable reference to prepare special zirconia components without loss of density.

Adipose-derived stem cells (ADSCs) were suggested for treating degenerative osteoarthritis, suppressing inflammatory responses, and repairing damaged soft tissues. Moreover, the ADSCs have the potential to undergo self-renewal and differentiate into bone, tendon, cartilage, and ligament. Recently, investigation of the self-renewal and differentiation of the ADSCs becomes an attractive area. In this work, a pneumatic microdevice has been developed to study the gene expression of the ADSCs after the stimulation of multi-axial tensile strain. The ADSCs were cultured on the microdevice and experienced multi-axial tensile strain during a 3-day culture course. Self-renewal and differentiation abilities were investigated by mRNA expressions of NANOG, SOX2, OCT4, SOX9, PPAR-γ, and RUNX2. The result showed that the genes related self-renewal were significantly up-regulated after the tensile stimulation. Higher proliferation ratio of the ADSCs was also shown by cell viability assay. The microdevice provides a promising platform for cell-based study under mechanical tensile stimulation.

We obtain two generalizations of a known theorem of A. Alam and M. Imdad (Fixed Point Theory Appl. 17 (2015) 693–702) showing that some standard proofs can be obtained involving only Cauchy sequences of the successive approximations instead of the usual successive approximations sequences. Suitable examples prove the effective generalization of our results in metric spaces not necessarily complete.

Burning Man is probably the most famous art festival in the world. What started as a bonfire ritual for a small group of friends held on San Francisco beach in 1986, has evolved into an iconic event. Held annually for one week before the Labor Day weekend, the festival attracts over 60,000 participants each year and yields over $8 million in tickets and contributions.This preprint reveals some preliminary results from the economic analysis of Burning Man that is based on the unique data from over 500 surveys collected during several Burning Man events between 2012 and 2018.The paper’s main findings demonstrate that Burning Man is not some hippie get-together with lots of booze and drugs. Instead, it is a lucrative and exclusive event that is attended by bright, wealthy and well-educated people, both from the United States and abroad. A typical Burner is a 32-old childless male with a college degree and an average annual income above $100,000 who attended Burning Man at least two times before and who spends between $5,000 and $6,000 on tickets, fares, gear, and supplies.

The resonance spectra of neutral silver indicate self-absorption for the studied Ag I lines at the wavelengths of 327.9 nm and 338.2 nm. The center dip is associated with self-reversal due to self-absorption in the plasma. The Q-switched radiation of 355 nm, 532 nm, or 1064 nm from a Nd:YAG laser device generates the plasma at the surface of silver nano-material targets, with experiments conducted in standard ambient temperature and pressure laboratory air. Procedures for recovery of the spectral line shapes confirm that over and above the effects of self-reversal, line shape distortion are important in the analysis. The work discusses parameters describing self-absorption when using fluence levels of 2 to 33 J/cm² to generate the plasma. Furthermore, subsidiary calibration efforts that utilize the hydrogen alpha line of the Balmer series show that the Ag I lines at 827.35 nm and 768.7 nm are optically thin.

Hydrophilic coatings have recently emerged as a new approach to avoid the adhesion of (bio)organisms on surfaces immersed in water. In these coatings the hydrophilic character is crucial for the anti-fouling (AF) performance. However, this property can be rapidly lost due to the inevitable damages which occur at the surface, reducing the long-term effectiveness of the AF functionality. We report hydrophilic polycarbonate-mPEG polyurethane coatings with tunable hydrophilic properties as well as an excellent and long-term stability in water. The coatings exhibit low protein adhesion values and are able to self-replenish their hydrophilicity after damage, due to the existence of a reservoir of hydrophilic dangling chains incorporated in the bulk. The combination of low T_g and sufficient mobility of the mPEG dangling chains (enabled by chains with higher molecular weight) proved to be crucial to ensure autonomous surface hydrophilicity recovery when the coatings were immersed in water. This coatings and design approach offer new possibilities towards high performance AF coatings with an extended service life-time which can be used in several major applications areas, such as marine and biomedical coatings, with major economic and environmental benefits.

In this work, we develop a self-consistent physical model of bubbles in a gas solid two-phase flow. Using the Peng-Robonson state equation and a detailed specific heat ratio equation of bubbles, we obtain the kinetic equations of the bubbles on the basis of the Ergun equation, thermodynamic equations, and kinetic equations. It is found that the specific heat ratio of bubbles in such systems strongly depends on bubble pressures and temperatures, which play an important role in the characteristics of the bubbles. The theoretical studies show that with increasing height in the systems, the gas flow rate shows a downward trend. Moreover, the larger particles in the gas solid flows are, the greater the gas velocity is. The bubble sizes increase with the increasing heights of the gas solid systems, and then decrease. The bubble velocity is affected by the gas velocity and the bubble size, which gradually increase and eventually quasi-stabilize. This shows that gas and solid phases in a gas solid two-phase flow interact with each other and a self-consistent system comes into being. The theoretical results have exhibited important value as a guide for understanding the properties and effects of bubbles in gas solid two-phase flows.

The popularity of handheld devices for point-of-care ultrasound (POCUS) has increased in recent years due to their portability and cost-effectiveness. However, POCUS has the drawback of lower imaging quality compared to conventional ultrasound, because of hardware limitations. Improving the quality of POCUS through post-image processing would therefore be beneficial, with deep learning approaches showing promise in this regard. This review investigates the state-of-the-art progress of image enhancement using deep learning suitable for POCUS applications. A systematic search was conducted from January 2024 to February 2024 on PubMed and Scopus. From the 457 articles that were found, the full text was retrieved for 69 articles. From this selection, 15 articles were identified addressing multiple quality enhancement aspects. A disparity in the baseline performance of the low-quality input images was seen across these studies, ranging between 8.65–29.24 dB for the Peak Signal-to-Noise Ratio (PSNR) and 0.03-0.71 for the Structural Similarity Index Measure (SSIM). In six studies, where both PSNR and the SSIM metrics were reported for the baseline and the generated images a mean difference of 6.60 (SD ± 2.99) and 0.28 (SD ± 0.15) was observed for the PSNR and SSIM, respectively. The reported performances demonstrate the potential of deep-learning-based image enhancement for POCUS. However, variability in the extent of performance gain across datasets and articles was notable, and the heterogeneity across articles makes quantifying the exact improvements challenging.

Purpose of review: This review investigates the oral microbiome's composition, functions, influencing factors, connections to oral and systemic diseases, and personalised oral care strategies. Recent findings: The oral microbiome is a complex ecosystem consisting of bacteria, fungi, archaea, and viruses that contribute to oral health. Various factors, such as diet, smoking, alcohol consumption, lifestyle choices, and medical conditions, can affect the balance of the oral microbiome and lead to dysbiosis, which can result in oral health issues like dental caries, gingivitis, periodontitis, oral candidiasis, and halitosis. Importantly, our review explores novel associations between the oral microbiome and systemic diseases including gastrointestinal, cardiovascular, endocrinal, neurological conditions, autoimmune diseases, and cancer. We comprehensively review the efficacy of interventions like dental probiotics, xylitol, oral rinses, fluoride, essential oils, oil pulling, and peptides in promoting oral health by modulating the oral microbiome. Summary: This review emphasizes the critical functions of the oral microbiota in dental and overall health, providing insights into the effects of microbial imbalances on various diseases. It underlines the significant connection between the oral microbiota and general health. Furthermore, it explores the advantages of probiotics and other dental care ingredients in promoting oral health and addressing common oral issues, offering a comprehensive strategy for personalized oral care.

Carbonaceous materials have gained significant attention in recent years for their various applications in the field of medicine and biotechnology. This comprehensive review explores the synthesis and characterization of carbon-based materials and their potentials in various medical applications. The paper delves into the methods of fabrication of carbon-based nanoparticles, such as carbon nanotubes, biochar, and graphene, while highlighting their unique properties. Characterization techniques, such as microscopy, spectroscopy, and surface analysis, are discussed to provide insights into the chemical and structural properties of these materials. Furthermore, the review examined their wide-ranging medical applications, encompassing tissue engineering, drug delivery, biosensing, and imaging, showcasing the versatility and promising contributions of carbonaceous materials in the healthcare industry. The review outlines the current challenges and prospects in the field, emphasizing the growing significance of carbon-based materials as valuable tools in advancing medical science and technology, as well as public health.

Interoperable multilayer networks are pivotal and transformative in public digital health. They not only enhance the delivery of healthcare services but also contribute significantly to improving public health outcomes. Through better accessibility, efficiency, and data-driven decision-making, these networks are revolutionizing how we approach public health. The seamless data exchange and integration they facilitate across different healthcare systems and providers can lead to substantial cost savings for public healthcare systems. These networks pave the way for a more efficient and effective healthcare system by reducing redundancies, optimizing resource allocation, and minimizing unnecessary procedures. This study combines the pressing issues of public digital health with the innovative interpretation of multilayer network theory, proposing practical solutions that inspire academics and practitioners alike.Public digital health is not just about improving care access and patient engagement. It is also about ensuring the financial sustainability of our healthcare systems. Innovative multilayer network analysis is critical in this game, improving interoperability and reducing spatial and temporal constraints. These networks streamline processes and improve efficiency by easing complex interactions within healthcare systems. This process, in turn, allows healthcare providers to deliver high-quality care at a lower cost, transforming, whenever possible, in-patients and out-patients into home-patients. Networks are a cornerstone and a beacon of hope for transforming public digital health. They are increasing the Value for Money and enhancing a patient-centric approach, making us optimistic about the future of healthcare.This study shows that revolutionizing digital healthcare methodologies has a profound impact on crucial elements like resilience, interoperability, and patient well-being within public health. The enhancement of interoperability facilitates the smooth flow of data exchange across various platforms and healthcare providers, fostering improved collaboration and decision-making processes and elevating the safety of patients.

Emphasis on primary health care (PHC) is the most efficient and economical approach to achieving universal health coverage. The aim of the study is to examine PHC publications from 2011 to 2023 in the Asian Pacific region (APR) using the Web of Science (WoS) database. Academic papers in the WoS PHC subject category published in the APR from 2011 to 2023 were retrieved and analyzed. A total of 4,283 papers were published in the WoS PHC category from APR onwards. The annual number of published papers and their citations increased from 2011 to 2023. Australia led PHC publications in APR with 3,049 publications (71.19% of APR regional output). New Zealand had the highest number of citations per paper (13.76) and the highest mean impact factor (3.23±1.80). Publications in the WoS PHC category also covered a wide range of topics, including Medicine General Internal (64.77%), Health Care Sciences Services (21.88%), Health Policy Services and Public Environmental Occupational Health (21.36%), demonstrating the breadth of PHC research. Australia dominates the output of PHC publications in the APR. Australian Family Physician and Australian Journal of Primary Health are the leading journals publishing PHC papers in the APR.

Mental health in Puerto Rico is a complex and multifaceted issue that has been shaped by the island’s unique history, culture, and political status. Recent challenges, including disasters, economic hardships, and political turmoil, have significantly affected the mental well-being of the population coupled with the limitations in the accessibility of mental health services. Puerto Rico has fewer mental health professionals per capita than any other state or territory in the United States. This comprehensive review examines the impact of disasters on mental health and mental health services in Puerto Rico. Given the exodus of Puerto Ricans from the island, the review also provides an overview of mental health resources available on the island as well as the continental United States. The review identifies efforts to address mental health issues, with the intent of gaining a proper understanding of the available mental health services, key trends, as well as observable challenges and achievements within the mental health landscape of the Puerto Rican population.

The intelligent elderly care model places new demands on the skills of aging caregivers. The identification and development of forward-thinking, high-potential nursing talent is essential for advancing the intelligent elderly care sector. Multi-benchmarking selection and competitive analysis is used to evaluate and identify nursing personnel in the rehabilitation treatment center of a hospital in Hefei City. Using proxy evaluation and democratic evaluation model, three types of benchmarks such as single item benchmark, individual benchmark and group benchmark were identified and selected, and the professional nursing team was constructed based on the evaluation results. Different from the traditional other-directed evaluation, multi-benchmarking selection and competitive analysis is self-directed evaluation, this method is more conducive to the identification of high-potential and digital nursing talents by intelligent elderly service organizations, and facilitates the formation of professional nursing teams with complementary strengths and cross-fertilization, so as to satisfy the diversified and multi-level needs of the elderly for intelligent elderly services.

Thoracic aortopathy encompasses a spectrum of conditions affecting the aorta, ranging from aneurysms to dissections, posing significant challenges in management and care. In recent years, remote care, facilitated by telemedicine and digital health technologies, has emerged as a promising approach to overcome barriers in delivering timely and efficient healthcare services. This paper explores the practical considerations and challenges associated with implementing remote care strategies in the management of thoracic aortopathy in India with the largest population in the world. By evaluating existing literature and drawing upon clinical experiences, we discuss the potential benefits, limitations, and best practices for incorporating remote care into the management of patients with thoracic aortopathy. Additionally, we address important factors such as patient engagement, technology integration, privacy concerns, and regulatory requirements to optimize the delivery of remote care in this specialized field.

Heart failure (HF) affects about 60 million people worldwide, making it one of the chronic conditions with the greatest health and economic impact. The primary objective was to assess the efficacy of lung ultrasound (LUS) in the management of HF in order to intervene early and reduce the rate of hospital readmissions. A systematic search was conducted on PubMed, Embase, Google Scholar, Web of Science, and Scopus, including clinical trials, meta-analysis, systematic reviews, and original articles from 2019/1/1-2023/12/31, about LUS for the assessment of HF, on an outpatient basis, for HF diagnosis or/and decompensation. There may be risk of bias because the effects are dependent on the persons delivering the intervention. The results were synthetized by PRISMA method. A total of 873 articles were identified of which 33 articles were selected: [n=19] focused on prognostic assessment of HF, [n=11] centred on multimodal diagnostic assessments, and [n=2] addressing therapeutic guidance for HF diagnosis. LUS exhibits advantages in the detection of sub-clinical congestion linked to prognostic significance in re-admission and mortality during out-patient follow-up, after hospital discharge, and in complex scenarios as the patients' homes or institutional long-term care facilities. However, there are considerable uncertainties in their interpretation and monitoring changes due to its lack of standardization. The need for an updated international consensus on the use of LUS seems obvious.

Precision medicine (PM), also termed stratified, individualised, targeted or personalised medicine, embraces a rapidly expanding area of research, knowledge, and practice. It brings together two emerging health technologies to deliver better individualised care: the many “-omics” arising from increased capacity to understand the human genome; and “big data” and data analytics including Artificial Intelligence (AI). PM has the potential to transform an individual’s health, moving from population-based disease prevention to more personalised management. There is however a tension between the two, with a real risk that this will exacerbate health inequalities and divert funds and attention from basic healthcare requirements leading to worse health outcomes for many. All areas of medicine should consider how this will affect their practice, with PM now strongly encouraged and supported by government initiatives and research funding. In this review we discuss examples of PM in current practice and its emerging applications in primary care, such as clinical prediction tools that incorporate genomic markers and pharmacogenomic testing. We look towards potential future applications and consider some key questions for PM including evidence of real-world impact, its affordability, the risk of exacerbating health inequalities, and the computational and storage challenges of applying PM technologies at scale.

The late diagnosis of Type 2 Diabetes Mellitus can occur due to lack of access to the primary health care system and the non-manifestation of symptoms. Faced with this problem, this work presents the creation of a mobile application, called DiabetesCheck, for predicting the risk of Type 2 Diabetes Mellitus. A mathematical model is used, which classifies the risk of Type 2 Diabetes Mellitus for a group of patients with intervention and for a comparative group, using Fuzzy Classification and Decision Trees. The proposed application allows the health professional to monitor patients through the history stored in a database, allowing a representation of the evolution of patients and indication of medications. Therefore, this proposal aims to carry out the diagnosis in the initial phase of the disease and help in the prescription of more effective treatments and in the proposition of public policy strategies in epidemiology and screening.

Sexual Violence (SV) can deeply impact victims' physical and psychosocial well-being. Yet many healthcare providers, including registered nurses (RNs), hesitate to screen patients due to a lack of confidence and knowledge. The SATELLITE Sexual Violence Assessment and Care Guide was developed to address this gap; however, the guide’s educational effectiveness remained untested. This pilot study aimed to assess the feasibility, acceptability, and efficacy of an education program based on the SATELLITE guide among RNs in clinical settings, using a pre- and post-test design. Results indicated that the education was not only feasible and acceptable, but also demonstrated the effects as desired with significant increases in RNs' knowledge and confidence in SV screening and care. The program's assessment tool was valid and reliable, and participant recruitment was feasible. Based on these findings, it is recommended that the SATELLITE education program be further tested with a larger RN sample and extended to other healthcare providers. Additionally, exploring different regions, cultural contexts, and healthcare settings would enhance understanding of the program's broader applicability and effectiveness.

Most patients with pancreatic cancer at some point present with symptoms related to exocrine pancreatic insufficiency (EPI). These include diarrhea, abdominal bloating, indigestion, steatorrhea, weight loss, and anorexia. Even though up to 80% of pancreatic cancer patients eventually present with symptoms related to exocrine pancreatic insufficiency, only 21% are prescribed pancreatic enzyme replacement therapy. This treatment is profoundly underutilized in the palliative care of these patients. The objective of this review is to discuss the pharmacology, pharmacokinetics, side effects, available evidence of effectiveness of pancreatic enzyme use for patients with pancreatic cancer, and challenges along with proposed solutions regarding its use. Pancrelipase is an expensive drug, and it is inactive if not taken correctly. The impact of symptoms of EPI can lead to poorer overall well-being. Pharmacists play a crucial role in properly educating patients on the correct use of pancreatic enzyme replacement therapy. Pancreatic enzyme replacement therapy (PERT) is a key strategy in managing symptoms of EPI and can improve quality of life, which is a central focus in palliative care.

(1) Background: To estimate resistance, reactance and phase angle values among moderate preterm infants and their variation according to neonatal and maternal characteristics and nutritional intake. (2) Methods: This was a cohort that evaluated 43 moderate preterm infants using bioelectrical impedance analysis. The study variables included resistance, reactance and PA measurements, in addition to classification of nutritional intake. (3) Results: The mean resistance was 602.0+118.2 Ω, reactance was 57.2 Ω (IIQ = 42.6-65.2) and phase angle was 522° (IIQ = 4.1-6.6). Lower resistance values were found in the presence of risky pregnancy (532.2+111.9 Ω vs 650.9+97.9 Ω, p&lt;0.001) and lower reactance values, in the presence of harmful maternal lifestyle habits at both the first (p=0.01) and second assessments (p=0.01). Eight preterm infants were considered to have insufficient nutritional intake (23.5%); 17, sufficient (50.0%) and 9, partially sufficient (26.5%). There was less reactance among preterm infants with insufficient nutritional intake (p &lt; 0.001). (4) Conclusions: The bioelectrical impedance analysis measurements were within the range of values reported in other studies. There was an association between full diet and adequate nutritional intake with higher resistance values, and a lower reactance value was associated with the presence of risky pregnancy and harmful maternal lifestyle.

Appropriate diagnosis, treatment and care contributes to better service engagement, improvements to wellbeing, cost savings, reductions in morbidity and mortality for people with Alcohol Related Brain Damage. In the North-East of England large amounts of alcohol are consumed, reflected in the number of alcohol-related deaths in the region. However, the pathway for people with Alcohol Related Brain Damage to receipt of diagnosis, treatment and care is unknown and could be unwittingly influenced by stigma. Qualitative in-depth semi-structured interviews were completed with 25 health and social care professionals from organisations involved with people with Alcohol Related Brain Damage recruited via snowball-sampling. Interviews were recorded, transcribed verbatim, coded, and analysed. People with Alcohol Related Brain Damage were stigmatised both by society and professionals which inhibited entry into services therefore Alcohol Related Brain Damage remained underdiagnosed and misdiagnosed. There was no dedicated service but silos with revolving doors and underfunded generic care with long waiting lists typically excluding those with alcohol or neurological problems. Professionals need to be challenged on the assumption that Alcohol Related Brain Damage is self-inflicted via training aimed at challenging unconscious bias. Reducing stigmatising processes associated with Alcohol Related Brain Damage could counteract professionals’ reluctance to provide care.

Background: Retinal diseases such as neovascular age related macular degeneration (nAMD), diabetic macular edema (DME) or branch-/central retinal vein occlusion (B/CRVO) have significant implications for patients' social and psychological well-being. To gain a comprehensive understanding of patients' backgrounds and attitudes, we developed an exploratory questionnaire, the Basic Care and Patient Satisfaction Questionnaire (BPZ-9). Methods: The ALBATROS study aimed to assess the care situation of treatment-naïve patients diagnosed with either nAMD, DME or B/CRVO. The data collection took place at the beginning of treatment and after twelve months of anti-VEGF (vascular endothelial growth factor) therapy. The BPZ-9 instrument comprises nine questions to evaluate patients’ psychological and social situation and their satisfaction with treatment. Results: Data were collected from 1.478 nAMD (mean 78 years), 445 DME (67 years), 233 BRVO (70 years) and 144 CRVO (71 years) patients at 102 study centers throughout Germany. Approximately one third of the patients was living alone and six percent were in organized care. One in four patients had difficulties to walk and one in five needed accompany for treatment. Anxiety to lose vision was present in three out of four patients at the beginning and slightly decreased to two out of three over the 12-month treatment preriod. The distress of having a retinal disease was generally higher than the distress related to treatment. Most patients reported high treatment satisfaction (73%) and felt well informed (81%). Conclusion: Patients receiving anti-VEGF therapy commonly experience impaired mobility, dependency on others, distress and the fear of vision loss.

Many ethical issues arise when robots are introduced into elder-care settings. When ethically charged situations occur, robots ought to be able to handle them appropriately. Some experimental approaches use (top-down) moral generalist approaches, like Deontology and Utilitarianism, to implement ethical decision-making. Others have advocated the use of bottom-up approaches, such as learning algorithms, to learn ethical patterns from human behaviour. Both approaches have their shortcomings when it comes to real-world implementations. Human beings have been observed to use a hybrid form of ethical reasoning called Pro-Social Rule Bending, where top-down rules and constraints broadly apply, but in particular situations, certain rules are temporarily bent. This paper reports on implementing such a hybrid ethical reasoning approach in elder-care robots. We show through simulation studies that it leads to better upholding of human values such as autonomy, whilst not sacrificing beneficence.

: (1) Background: Healthcare workers (HCWs) are a well-known risk group for coronavirus infections with increased working hours in a potentially infectious environment. We evaluated both IgG and Neutralizing antibody levels, with IgG avidity index and persistence among health workers. (2) Methods: 1001 HCWs were tested for both IgG and Neutralizing antibodies. IgG avidity testing and one-year follow-up testing were done on selected HCWSs. (3) Results: COVID-19 IgG antibody levels were high among 299 (94.62%) HCWs with a history of COVID-19 infection (p &lt;0.0001) compared with 479 (69.92%) HCWs who were not infected with COVID-19 during the first and second wave. A total of 899 (89.81%) HCWs had more than 50% neutralizing antibodies while the remaining 102 (10.19%) HCWs had less than 50% of Neutralizing antibodies. The avidity index was maintained at almost 40% (Gray zone). Both antibody levels were found markedly increased after one year when compared to initial results. (4) Conclusions: Healthcare workers are at a 2.29-fold higher risk of infection; Two folds higher IgG levels in HCWs involved in COVID-19 duty and their persistence for a longer time than in other groups signifies IgG antibody role in the prevention of severe disease in HCWs involved in Covid-19 patient care.

The intensive care unit is characterized by the critical care of the infants and children who access it, as well as the high complexity of care. This implies and requires optimal integration among the various professionals working there and their ability to work as a team. The purpose of the study was to describe how nurses perceive clinical risk and how they relate to it and to identify adverse events and related risk factors. Nine nurses, two moderators and one external observer partici-pated in the focus group. In the qualitative analysis, 9 themes describing the perception of clinical risk in PICU were identified, including teamwork, specific training, time management, team communication, management, individual errors, structural criticality, patient fac-tors/characteristics, and standardization. Safety culture can be fostered by hospital management to involve PICU nurses in promoting patient safety, which could improve breaking down barriers that prevent nurses from fulfilling their roles.

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease. The first PREM (Patient Reported Outcome Measure) type questionnaire that has been dedicated to asses experience of care in COPD is the PREM-C9. Aim: To create a Polish version of the PREM-C9 and determine its the psychometric characteristics. Methods: The validation procedure involved forward and back translation and included 42 COPD patients. The psychometric properties were assessed using Cronbach's alpha, Bartlett's test, Kaiser-Meyer-Olkin and Spearman correlation coefficient. The validity of the questionnaire was assessed using Principal Component Analysis for the extracted principal components. The validity of the factor analysis was demonstrated by the Bartlett's sphericity test and the Kaiser-Meyer-Olkin (KMO). Factor analysis was performed using the Oblimin and Varimax rotation. The reliability of the questionnaire was assessed using the Cronbach's alpha. Results: The Polish version of the PREM-C9 questionnaire met all validation criteria: face, translation, psychometric, functional and reconstruction equivalence. The Spearman correlation results between Polish PREM-C9&amp;CAT: rho= 0,44, p=0,003539; HADS-Anxiety: rho= 0.370864, p=0,015612, HADS-Depression: rho= 0,387405, p=0,011253. Conclusion: The developed Polish PREM-C9 questionnaire is a reliable and valid tool that assesses Polish COPD patients' experiences of their disease and the care they receive.

The metaphor of being touched by music is widespread and almost universal. The tactile experience, moreover, has received growing interest in recent years. There is, however, a need to go beyond a mere metaphorical use of the term, by positioning the tactile experience within the broader frame of embodied cognition and the experiential turn in cognitive science. This article explores the possible contribution of a science of touch by defining music as a vibrational art that impinges upon the body and the senses. It takes as a starting point the clinical findings on the psychological and physiological value of tender touch with a special focus on the method of kangaroo mother care, which is a method for holding the baby against the chest of the mother, skin-to-skin. It is seen as one of the most basic affiliative bonding with stimuli that elicit reward. Via an extensive review of the research literature, it is questioned to what extent this rationale can be translated to the realm of music. There are, in fact, many analogies, but a comprehensive theoretical framework is still lacking. This article aims at providing at least some preparatory groundwork to fuel more theorizing about listening and its relation to the sense of touch.

The accelerated pace with which new diagnostic possibilities are produced and the budget re-strictions of the healthcare sector require that the decision-making process of acquiring new technologies becomes systematic in nature. There are some methodologies such as the Health Technology Assessment (HTA) that encompasses technological domains, clinical effectiveness, patient safety, organizational and financial aspects, among others. However, these methods do not contemplate the learning curve (LC) which is a differential factor in operator-dependent technologies. An assessment model was conceived based on the assessment domains of the AdHopHTA project with the addition of LC. The model was validated and calibrated through System Dynamics (SD) and using as case study the assessment of Point-of-care Ultrasound (POCUS) equipment in dengue screening. The model helped identify the influence of the LC and patient demand on the income and costs for the healthcare system regarding dengue screening as well as the cost-benefit indicator. The control charts LC-CUSUM and CUSUM are graphic tools to intuitively assess the learning curve which can be used for real-time monitoring once students reach a certain skill level.

Abstract: Introduction: A retrospective case-controlled study was performed to evaluate the out-comes of shoulder arthroplasty performed as a day case in carefully selected patients, compared to the traditional inpatient approach. Materials & Methods: Patients who had total or hemiarthro-plasty of the shoulder performed as a day case or inpatient procedure were recruited. The primary outcome compared rates of uneventful recovery, defined by the absence of any complications or readmission to hospital within six months of surgery, between Inpatient and Outpatient groups. Secondary outcomes included examiner-determined functional scores and patient-determined pain scores at one, six, twelve, and twenty-four weeks post-surgery. A further assessment of pa-tient determined pain scores was carried out at a minimum of two years post-surgery (5.8 ± 3.2). Results: 73 patients (36 Inpatients and 37 Outpatients) were included in the study. Within this time frame 25/36 inpatients (69%) had uneventful recoveries compared to 24/37 outpatients (65%) (p = 0.17). Outpatients showed significant improvement over pre-operative baseline levels in more of the secondary outcomes (strength and passive range-of-motion) by six months post-operation. Outpatients also performed significantly better than Inpatients in external rotation (p<0.05) and internal rotation (p=0.05) at six-weeks post-surgery. Both groups showed significant improvement compared to pre-operative baselines in all patient-determined secondary outcomes except level of activity at work and sport. Inpatients, however, less severe pain at rest at six weeks (p=0.03), sig-nificantly less frequent pain at night (p=0.03) and extreme pain (p=0.04) at 24 weeks; and less se-vere pain at night at 24 weeks (p<0.01). By minimum two years postoperation, inpatients were more comfortable repeating their treatment setting for future arthroplasty (16/18) compared to outpatients (7/22) (p = 0.0002). Conclusions: At a minimum of two years follow up, there were no significant differences in rates of complications, hospitalisations, or revision surgeries between pa-tients that underwent shoulder arthroplasty as an inpatient versus as an outpatient. Outpatients demonstrated superior functional outcomes but reported more pain at six months post-surgery. Patients in both groups expressed a preference for inpatient shoulder arthroplasty in future. What is Known About This Subject: Shoulder arthroplasty is a complex procedure, and has tradition-ally been performed on an inpatient basis, with patients admitted for six to seven days post-surgery. One of the primary reasons for this is the high level of postoperative pain, usually treated with hospital-based opioid therapy. Two studies demonstrated outpatient TSA to have a similar rate of complications as inpatient TSA, however these studies only examined patients within a shorter term 90 day postoperative period, and did not evaluate functional outcomes between the two groups or in the longer term. What This Study Adds to Existing Knowledge: This study provides evidence supporting the longer-term results of shoulder arthroplasty done as a day case in carefully selected patients, which are comparable to outcomes in patients that are admitted to hospital post-surgery.

Depression is estimated to be a leading contributor to the global mental health-related burden. The determinants of this huge prevalence lie in the fact that depressive symptoms may be comorbid in a wide variety of disorders, thus complicating and exacerbating their clinical pictures. This makes the treatment of depressive symptoms even more difficult since many pharmacological and pharmacokinetic interactions should be considered by physicians approaching the therapy. Hence, depression still represents a challenge for both psychiatrists and the other clinicians, in terms of its high rates of relapse and resistance despite well-established protocols. It is also complicated by the well-known latency in its complete response to current antidepressant treatments. In this context, the search for new strategies in antidepressant treatment is mandatory; even including revising the use of “old” pharmacotherapies by considering their specific features may help to perfecting the treatment of depression, both in its standalone psychiatric manifestation and in the framework of other clinical conditions. The results of a consensus of experts regarding the possible use of trazodone as a valuable strategy for addressing the “real world” unmet needs of depression treatment is herein reported. This is based on the unique characteristics of this drug possibly delivering a rapid antidepressant action as compared to other selective serotonin reuptake inhibitors (SSRIs) as well as on its pharmacodynamic malleability and pharmacokinetic tolerability when used in the milieu of other drugs in treating comorbid depressive symptoms.

Introduction: In the marginalised countries most neglected health issue is Newborn mortality. A study was undertaken to assess the influence of factors and newborn care practices influencing newborn health in the rural area of Bareilly district. Methodology: The Descriptive cross-sectional study was organized in the rural areas of Bareilly. Study participants were selected based on the mothers who gave birth to a baby during the last six months. The mothers who delivered in that area within six months were included, and using the semi-structured questionnaire, data was collected. Data analyzed using Microsoft Excel and SPSS 2021 version for windows. Results: Mothers initiating early breastfeeding were more commonly 78 (52.3%) observed in the younger mothers at 24-29 years, followed by 48(32.3%) at 30-35 years, the difference was statistically significant (p<0.05). Delayed bathing was observed in nearly 125 (70.1%) three fourth in the age of 24-29 years, followed by 29 (16.8%) in the age period 30-35 years. It was observed that unsafe cord care practices were observed more among 8(53.4%) nuclear families than 7(46.6%) joint families, and it was found to be statistically insignificant. Conclusion: The practice of essential newborn care still needs to improve in Bareilly; there is a need to create awareness to the mothers and family members on newborn and early neonatal care aspects, such as promoting exclusive and early initiation of breastfeeding and delayed bathing practices.

Healthcare workers (HCWs) in long-term care (LTC) faced and continue to experience significant emotional and psychological distress throughout the pandemic. Despite this, little is known about the unique experiences of LTC workers. This scoping review synthesizes existing research on the experiences of HCWs in LTC during the COVID-19 pandemic. Following Arksey and O’Malley’s framework, data were extracted from six databases from inception of the pandemic to June 2022. Among 3,808 articles screened, 40 articles were included in the final analysis. Analyses revealed three interrelated themes: carrying the load (moral distress); building pressure and burning out (emotional exhaustion); and working through it (a sense of duty to care). Given the impacts of the pandemic on both HCW wellbeing and patient care, every effort must be made to address the LTC workforce crisis and evaluate best practices for supporting HCWs experiencing mental health concerns during and post-COVID-19.

As of now, anthropogenic habitat injury via dissemination of manufactured chemicals is injuring the world’s ecosystems, but doctors have yet to recognize its consequences to humans. Recognition of overt toxicity due to chronic low-dose exposure will open the door to diagnosis, sequential elimination studies, and prescriptions for preventive cure that represent a first step in preventing escalating chronic diseases. This paper offers a diagnostic construct for such use: chronic ambient poisoning. Incorporating it into clinical practice can reduce misdiagnosis of gastro- and near-toxicity that doctors and patients presently suppress rather than remove, and reduce patient co-dependence with proton-pump inhibitors, anxiolytics, and antidepressants—and the thriving “alternative” health industry. This diagnostic elephant-in-the-room is presently missed for reasons of habit (when an ailment is not recognized, it cannot be included in the differential diagnosis) and of poor conduct and interpretation of non-clinical research studies that are taken to mean an absence of evidence is evidence of absence. Moreover, modern methods fail when: the exposure comprises a “daily cocktail” of poisons acting additively, interactively, and cumulatively over a lifetime; when there is no normal, unexposed comparison group; and when absence of a robust etiopathogenetic model disallows inapt statistics. Only patient-led, consultant-informed sequential elimination studies can “peel the onion” of toxicity and its recognition and “preventive cure”. Clinical use of the chronic ambient poisoning diagnosis can thus open the door to stemming and reversing anthropogenic epidemics.

Background: COVID-19 booster uptake remained poor among healthcare workers (HCW) despite evidence of improved immunity against Delta and Omicron variants. While most studies used a questionnaire to assess hesitancy, this study aimed to identify factors affecting true booster hesitancy by examining actual vaccine uptake across time. Method: COVID-19 vaccination database records among HCW working at 7 Singaporean public primary care clinics between January to December 2021 were extracted, with gender, profession, place of practice, vaccination type and dates. Time to booster was calculated from the date of vaccination minus date of eligibility. Chi-square test was used to compare relationship between 1st dose and booster hesitancy, Kaplan-Meier method and Log-rank test were adopted to evaluate differences in cumulative booster uptake. Multivariate cox regression was used to investigate predictors for timely booster vaccination. Vaccination rate was charted across time and corroborated with media releases pertaining to legislative changes. Results: 877 of 891 (98.9%) primary care HCW were fully vaccinated, 73.8% of eligible HCW had taken the booster. HCW were less booster hesitant [median 16 (5-31.3) days] compared to the 1st dose [median 39 (13-119.3) days]. 1st dose hesitant HCW were more likely to be booster hesitant (OR=3.66, 95%CI 2.61-5.14). Adjusting for sex, workplace and time to 1st dose, ancillary (HR=1.53, 95%CI 1.03-2.28), medical (HR=1.8, 95%CI 1.18-2.74) and nursing (HR=1.8, 95%CI 1.18-2.37) received boosters earlier compared with administrative staff. No temporal relationship was observed between booster uptake, legislative changes and COVID-19 infection numbers. Conclusion: Vaccine hesitancy among HCW had improved from booster to 1st dose, with timely booster vaccination among medical and nursing staff. Tailored education, risk messaging and strategic legislation might help to reduce delayed booster vaccination.

A wide range of research has been developed in the empirical literature regarding income and price elasticities of health care expenditure (HCE). The results are mixed, as researchers employ different methodologies and data sources. The benefits of the panel data method, such as greater data variation, less collinearity, and more degrees of freedom, made it attractive among economists. However, the pooled mean group (PMG) method provides robust estimates compared to conventional methods, such as the mean group estimator and dynamic fixed-effects estimator. As such, this paper applies the PMG method to scrutinize the effect of income and price on U.S. health care consumption using a panel of 46 states. The income and price elasticities were found to be 0.85 and -0.48, respectively, which partially describes the recessionary decline in health care consumption following the Great Recession. In addition, the model reveals that the short-run income elasticity is smaller than the long-run. This confirms that U.S. health care consumption follows the permanent income hypothesis. Consequently, the short-run efficacy of public policies targeting HCE remains limited. The results of this paper suggest reconsidering and adjusting health care policies during a recession so as to avoid probable long-run adverse effects on HCE.

Background: The concept of Quality of Work Life (QWL) has been built multidimensionally through social reproduction; it is impacted by the perceptions of each individual and by the relationship between workers and the work environment. Objective: to analyze the Work Process and QWL of assisting nurses in public health. Methods: Research in a critical paradigm, descriptive, exploratory with a qualitative approach. The population corresponds to Nurses who work in care work. Semi-structured guiding questions were applied and were analyzed with content analysis. Results: seven participants declared female; all Chilean; seven are young adults; six singles; only one has children, and one has a person dependent on her care; six are heads of household, and five receive help with housework. All have a nursing degree, five have a diploma, but none have a postgraduate. Work Process has three subcategories: work object, instrument, organization, and work conditions; the QWL category has six subcategories: definition and perception of QWL, QWL potentiating factors, QWL exhausting factors, QWL improvement strategies, the emotional burden associated with QWL, and Health problems. Conclusions: In this way, the lifestyle built by the assistance in the health area has repercussions on the quality of life and health in general.

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

Type 2 diabetes (T2D) is associated with increased cardiovascular morbidity, mortality, and hospital admissions. There is variability in clinical practice. The objectives are to analyze the variability in the control of Blood Pressure (BP), HbA1c, and LDL-C in T2D patients and its influence on admissions due to cardiovascular events (CVE) Methods: We analyzed the electronic records in Primary Care Health centers in Navarra (Spain) and hospital admission for CVE. We follow 480637 people from 2012 to 2016. We calculated indicators of control of patients with T2D for each year, percentage with: HbA1c &lt; 7%; HbA1c &gt;= 9%; BP &lt;140/90 mmHg; LDL-C &lt;100 mg/dl. We used logistic and Cox regression. Results: Patients in the best control GP practices cluster are 2.5 times more likely to have HbA1c &lt;7% [OR: 2.46 (95% CI: 2.29-3.64)]. Poor HbA1c control ≥ 9% is more likely in the worst control cluster [OR: 1.73 (95% CI:1.63-1.83)]. The probability of admission for CVE increases with age, being male, low income, obesity, history of CVE, having HbA1c ≥ 9%, and belonging to a GP practice in the cluster of HbA1C ≥ 9% worst control. In contrast, it decreases in patients with HbA1c &lt;7%, BP&lt;140/90 mmHg and LDL &lt;100 mg/dl.

COVID-19 pandemic will continue to pose a major public health threat until vaccination-mediated herd immunity is achieved. Most projections predict vaccine will reach a large subset of the population late in 2021 or early 2022. In the meantime, countries are exploring options to remove strict lockdown measures and allow for society and the economy to return to normal function. One possibility is to expand on existing COVID-19 testing strategies by including large-scale rapid point of care diagnostic tests (POCTs). Currently, there is significant variability in performance and features of available POCTs, making selection and procurement of appropriate test for specific use case difficult. In this review, we have used the World Health Organization’s (WHO) recently published Target Product Profiles (TPPs) for specific use cases of COVID-19 diagnostic tests to screen for top-performing POCTs on the market. Several top-performing POCTs, based on clinical sensitivity/specificity, the limit of detection, and time to results, that meet WHO TPP criteria for direct detection of SARS-CoV-2 (acute infection), or indirect diagnosis of past infection (host antibodies) are highlighted here.

The process of international migration causes a situation of vulnerability in people's health and greater difficulty in coping with disease. Furthermore, the adversities suffered during migration can trigger reactive signs of stress and cause anxious, depressive, confusional and somatic symptoms. This article studies the relationships between psychosocial risk, psychological distress and somatization in immigrants from 4 communities: Maghrebis, Sub-Saharans, South Americans and South Asian. A cross-sectional study was carried out with questionnaires on 602 immigrants who were surveyed in the Primary Care Centres of an urban area of Catalonia. The instruments used were the Demographic Psychosocial Inventory (DPSI), the Brief Symptom Inventory (BSI) and the Somatic Symptom Inventory (SSI). The average psychosocial risk obtained was 0.35, with the highest values in the sub-Saharan community. Psychological distress showed a mean value of 0.66, with the sub-Saharan community scoring the lowest in all dimensions except depression. The average somatization values were 1.65, with the sub-Saharan community scoring the least. The female gender is a risk factor for somatization and psychological distress. Perceived psychosocial risk is a predictor of psychological distress, but not somatization, suggesting that the use of more adaptive coping strategies could minimize the effect of the migration process on somatizations.

Critically the paper argues that a truly people-centered technology supported chronic care system can only be designed by understanding and responding to the needs, attributes and capabilities of the most vulnerable in society. The paper suggests innovative ways of supporting interactions with these ‘end-users’ and highlights how reflection on these approaches can contribute to emancipating both the health system to move towards more socially inclusive e-health solutions.

Human infection caused by the SARS-CoV-2 virus, called COVID-19, is a new pandemic with devastating effects worldwide. Science seeks the rational and systematic explanation of phenomena. In pandemics, decisions on prevention and treatment of people should be consistently taken, supported by scientific knowledge and ethical principles to produce more good than harm. At first, prospective observational studies to systematically collect patient data, correlating protective or therapeutic interventions with outcomes to assess effectiveness and safety, should be prioritized as the most appropriate type of study. The proposed protocol in this article aims to provide doctors with information on the reduction of harm in early COVID-19 patients by applying individualized interventionist or expectant therapeutic strategies, respecting the autonomy and preferences of physicians and patients in clinical decision-making. The evaluation of the clinical status, besides laboratory confirmation of COVID-19, comprises an individualized symptom score for each patient, a global self-perception scale of the severity of the disease, a clinical progression scale developed by the WHO for clinical studies in COVID-19 and, at the first consultation, doctors´ overall impression on the clinical prognosis. The analysis of anonymized data should preferably use descriptive and inferential statistical resources. The case report form is available for free use in the protocol, along with examples of patient informed consent forms for the prescription of off-label medications and authorization to use the data. Their results may be useful to indicate interventions that are candidates for efficacy trials, in randomized controlled trials, with a higher chance of success. It respects the autonomy and preferences of doctors and patients to decide the best options for treatment in uncertain situations. It also allows the gathering of useful information for future more rigorous clinical trials, trying to link science, ethics, and personal clinical experience.

Non-pharmacological interventions in the fight against COVID 19 include: a) suppression, which facilitates its extinction; and b) mitigation, which reduces its speed of spread. Left unmitigated, the intensive care unit bed capacity (ICU) is exceeded over its maximum supply, resulting in increased deaths. Suppression has shown in simulation models the potential for decreasing ICU occupation below its surge limit, effectively decreasing mortality. However, for avoiding a rebound in transmission, suppression must be maintained intermittently until a vaccine is available (which may take up to 2 years). The objective of this paper was to describe the mortality patterns observed in Spain, Italy and South Korea for discussing a hypothetical combined public health policy and socioeconomic model that could potentially reduce mortality while reducing the economic impact of this pandemic in Spain. The plan is based on a progressive-voluntary reinstatement to work of the population exposed to the lowest risks (healthy non-immune family units <50 y/o and immune population) and it depends on having sufficiently available ICU beds for providing adequate support. This model, if proven correct for Spain, could eventually be followed by other countries facing a similar impact of the present pandemic.

The aim of this article is to understand the symbolic representations of the assistance strategies aimed at disabled children, expressed in two newspapers published on the island of Faial, in the Azores, in the second half of the 19th and early 20th centuries (covering the time horizon between the end of the monarchic period and the implementation of the First Republic). The technique of documentary analysis and a subsequent qualitative thematic content analysis of childcare news collected in two local newspapers was used. The discursive records produced by the press on the assistance strategies value, on the one hand, an axiological dimension and forms of charitable intervention and, on the other hand, aggregate and reconcile the discourses and techniques inherent to charitable and philanthropic models. This mutual assimilation underlies the achievement of the same objective: the moralisation and integration of invalid childhood and, above all, the protection of the existing social order. We conclude that, perhaps contrary to what would be expected, the charitable logic articulated in a concomitant way with the philanthropic logic survived even with the stabilization of the republican period (result of a revolution that deposed the regime of the constitutional monarchy and implemented the republican regime in 1910 in Portugal whose political elites mobilized an official discourse that advocated the separation between the State and Religion, assigning the State the function of social assistance for children and youth). This demonstrates a certain dissociation, as well as a relative autonomy of conceptions about child and youth care between republican political ideology and current social practices at least in this specific context.

The livestock sector can be a major contributor to the mitigation of greenhouse (GHG) emissions. Within the sector, beef production produces the largest proportion of the livestock sector’s direct emissions. The objective of this study was to assess the on-farm GHG emissions in semi-arid rangelands in Argentina and to identify the relationships between emissions and current farm management practices. A survey recorded detailed information on farm management and characteristics. Assessments of GHG emissions were based on the IPCC Tier 2 protocols [1]. The relationships between farm management and GHG emissions were identified using General Linear Models. Cluster analysis was used to identify groups of farms that differed from others in emissions and farm characteristics. Emissions per product sold were low on farms that had improved livestock care management, rotational grazing, received technical advice, and had high animal and land productivities. Emissions per hectare of farmland were low on farms that had low stocking rates, low number of grazing paddocks, little or no land dedicated to improved pastures and forage crops, and low land productivity. Our results suggest that the implementation of realistic, relatively easy-to-adopt farming management practices has considerable potential for mitigating GHG emissions in semi-arid rangelands of central Argentina.

Motivated by the theoretical model of health insurance choice with Flexible Spending Accounts (FSAs) presented in Cardon 2012, this study investigates the determinants of optional coverage (SSP) and flexible spending accounts (FSA) enrollment, among the privately insured in post-affordable-care-act (ACA) USA. To this end, we rely on semi-parametric bi-variate probit methods, along with a pooled cross-section of the 2015-2016 National Health Interview Surveys. As predicted by the theoretical model, we find that SSP and FSA are complement health solutions with a positive correlation. Our results emphasize that the most important trigger factors influencing the joint probability of SSP and FSA adoption include not only insurance premium cost, but also age, education, marital status, number of work hours, region of residency, citizenship status, and annual health expenditure level. We find that controlling for these latter factors, health status is not significant especially for FSA adoption. In addition, despite the fact that the relative frequency of individuals with FSA rises with increasing levels of medical expenditure, ACA restrictions on FSA tax exclusion to an annual adjusted maximum of $2600 (in 2017 $s) seems to adversely burden individuals with greater medical expenditure, thereby reducing their likelihood of FSA enrollment in post-ACA USA. Understanding these factors is very crucial to US health care market's stakeholders, including insurance companies, firms looking to design their health insurance offerings, but also policy-makers interested in providing new tailored health solutions for reducing health risks.

This study uses data from the pilot project "Community Monitoring for Better Health and Education Services Delivery Project'' in Burkina Faso, to model the joint impact of generic essential drugs and nursing staff supplies constraints on access to primary health care in the country. The results show that statistical endogeneity of supply side constraints are present in the standard univariate probit specification of access to care. However, when accounted for, the resulting Trivariate Probit model shows that although shortages of generic essential drugs supply do not seem to constitute a significant barrier to access in Burkina Faso, shortages in nursing staff supply do. In fact, the likelihood of primary care access is reduced by 85.5% among those that reported having experienced a shortage in nursing staff, while paradoxically increasing by 60.3% among those that reported having experienced a shortage in generic essential drugs. A potential explanation for these findings is that overall the health care needs in the three surveyed regions in the country were more linked to primary health care services consumption from nurses, although further research would be important to clearly elucidate the position of health goods such as generic essential drugs.

The consequences of a fall on an elderly person can be reduced if the accident is attended by medical personnel within the first hour. Independent elderly people use to stay alone for long periods of time, being in more risk if they suffer a fall. The literature offers several approaches for detecting falls with embedded devices or smartphones using a triaxial accelerometer. Most of these approaches were not tested with the target population, or are not feasible to be implemented in real-life conditions. In this work, we propose a fall detection methodology based on a non-linear classification feature and a Kalman filter with a periodicity detector to reduce the false positive rate. This methodology requires a sampling rate of only 25 Hz; it does not require large computations or memory and it is robust among devices. We test our approach with the SisFall dataset achieving 99.4% of accuracy. Then, we validate it with a new round of simulated activities with young adults and an elderly person. Finally, we give the devices to three elderly persons for full-day validations. They continued with their normal life and the devices behaved as expected.

This paper presents the design and measurement of an IEEE 802.11ad standard compatible RF transceiver for 60GHz wireless communication system. In addition to the traditional half-duplex (HD) mode, this work supports full-duplex (FD) operation to deliver better channel utilization and faster response time for the system. The isolation between the transmitter and receiver from the architecture design to system integration for FD operation has been fully considered. A digital self-interference cancellation (DSIC) is implemented in MATLAB to verify the FD performance. The super-heterodyne architecture with an intermediate frequency (IF) of 12GHz is designed to suppress the image frequencies without using extra filters. A flexible phase-locked loop (PLL) synthesizer provides a local oscillator (LO) frequency with a 2kHz resolution. Other than the time division duplex (TDD) mode used in the conventional 60GHz system, a wide bandwidth baseband digital variable gain amplifier (DVGA) with a 3dB bandwidth of more than 4GHz also supports frequency division duplex (FDD) operation. The transceiver chip is fabricated in Tower Jazz 0.18µm SiGe BiCMOS process. With on-board antenna, the transceiver covers all four channels in 802.11ad standard with MCS-12 (7.04Gbps under 1.76GSym/s and 16-QAM) under 1.5m. In the proposed system design, the RF frontend based self-interference (SI) suppression from the local transmitter to receiver LNA is around 54dB. To achieve a practical FD application, the SI is further suppressed with the help of digital SI compensation. The measured power consumption for transmitter and receiver configuration is 194mW and 231mW, respectively, in HD mode and 398mW for FDD or FD operation mode.

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.

A low cost, scalable and robust process has been proposed as innovative method for coating solar mirrors with a self-cleaning, transparent in the full solar range and versatile material based on auxetic aluminium nitrides, previously obtained on the laboratory scale. This work presents the scaling-up of fabrication process from laboratory to prototypal scale and pre-liminary results of outdoor self-cleaning solar mirror prototypes testing in the demonstrative CSP plant ENEASHIP located in Casaccia (Rome) ENEA research centre. Prototypes 50x40cm have shown stability in external conditions: no degradation occurs during the test campaign. Their washing restores the initial reflectance affected by soiling and the self-cleaning performance allows the utilization of a reduced quantity of water for cleaning operations with respect to uncoated glass of back surface mirrors. A similar self-cleaning AlN coating could be utilized on other solar components affected by soiling, such as glass envelopes of heat collecting elements, PV panels and everywhere are required self-cleaning performance combined to optical ones.

The paper examines the evolution and crucial role of energy communities in the context of the transition to renewable energy sources. Such communities are presented as an innovative and resilient response to the challenges posed by climate change. Their importance emerges from their ability to decentralise energy production, increasing local security and reducing dependence on non-renewable energy sources and external suppliers. However, despite the obvious benefits, the contribution highlights several challenges, such as the need for significant upfront investment and the presence of regulatory barriers that may hinder the integration of these solutions into existing energy systems. A detailed bibliometric analysis is used, focusing on specific research areas and using tools to map the most relevant keywords and emerging trends. The results of the bibliometric analysis highlight how energy communities are emerging as key players in the sustainability landscape, capable of addressing and overcoming contemporary environmental challenges. The research reaffirms the transformative potential of energy communities in promoting a more sustainable and resilient future.

This study aims to broaden the current understanding of the antecedents and consequences of green purchase intention within the realm of perceived green value (PGV) A mixed-method approach is deployed, integrating PLS-SEM and Necessary Condition Analysis (NCA) to examine the role of influence and interaction as key precursors to perceived responsibility and perceived self-efficacy, and explores how perceived responsibility and perceived self-efficacy impacts green purchasing intention, mainly through the mediation of perceived responsibility (PER) and perceived self-efficacy (PSE) using survey data gathered from consumers participating. The results indicate that PGV positively influences green purchase intention (GPI). Moreover, PER and PSE exhibit significant chain mediation effects, with the mediation effect of perceived environmental responsibility being particularly strong. It is recommended that the government intensify green disseminate and education, promote the establishment of certification and evaluation systems for electric vehicle products, and that electric vehicle factories emphasize the environmental attributes and economic interest of their products to encourage green purchasing behavior.