Burnout in healthcare affects the quality of patient care. In 2020, Mayo Clinic implemented Advanced Care at Home (ACH), a new hospital-at-home program. We aimed to assess burnout levels among ACH providers, analyzing data from quarterly surveys. Physicians and nurse practitioners registered in ACH completed a 16-question anonymous survey distributed via email. Ten questions from the original survey used the Maslach Burnout Inventory to measure the three domains associated with burnout: depersonalization, emotional exhaustion, and personal achievement. We conducted a descriptive analysis using frequency distribution and percentages. A total of 27 providers participated, with response rates of 38%, 23%, and 66% in the first, second, and third quarters. Over 75% of the participants responded satisfactorily to nine of the ten questions associated with the risk of burnout. Moreover, 77% of providers felt joyful at work "always or most of the time." Of the 74% of participants who responded to the question about feeling burned out from work, 48% of the participants "strongly” or “somewhat” disagreed, while only 26% "strongly” or “somewhat” agreed. Mayo Clinic's ACH has demonstrated low levels of burnout among providers, positively impacting the well-being of healthcare workers and contributing to a high standard of patient care.

This study was conducted to identify the key elements of transitional care for families with pre-term infants in South Korea. We used an integrative review methodology proposed by Whittemore and Knafle in 2005. During the problem identification step, the review question was constructed via the population, intervention, outcome, and timeframe (PIOT) format. During the literature search step, integrative reviews of published literature from nine electronic databases were undertaken and a total of 14 studies were reviewed that met our inclusion criteria. During the data evaluation step, the quality of the literature was assessed using the Mixed Methods Appraisal Tool (MMAT) developed by Hong et al. in 2019. We identified three domains and 10 key attributes of transitional care for families of pre-term infants. The parenting empowerment domain included growth and development, developmental promotion, nutrition, safe environment, general parenting, and parent-infant interaction. The emotional support domain included counseling, advocacy, and community network. The social support domain included professional collaboration. Efforts should continue to further develop programs and policies to enhance transitional care for families of pre-term infants that reflect South Korean nursing practices.

This study examined the effectiveness of virtual delivery of the Strength at Home (SAH) intervention program for intimate partner violence in a sample of 605 military Veterans across 69 Veterans Affairs (VA) Medical Centers through a national implementation of the program. Outcome measures included physical IPV, psychological IPV, coercive control behaviors, posttraumatic stress disorder (PTSD) symptoms, and alcohol misuse. Significant pre-intervention to post-intervention reductions were found for all outcomes, with similar effect size estimates relative to a prior investigation of in-person delivered SAH through the same national VA implementation. Study findings suggest that virtual delivery of SAH may be as effective as in-person delivery which has important implications for program access and impact.

This study investigates why young adults live with their parents in Sweden. As young adults’ living arrangements affect decisions about marriage, education, childbirth, and participation in the workforce, more knowledge for policy makers is crucial to implementing effective policies to support young adults and promote financial independence and well-being. Using a data set from 1998 to 2021 at the municipal level in Sweden, we used a spatial autoregressive panel data model to examine the proportion of young adults living at home and regional disparities. The study uncovers intraregional variations, illustrating how different municipalities within Sweden exhibit different patterns of young adults living at home. Our findings reveal that economic factors, such as unemployment, significantly impact this pattern. The dynamics of the housing market, demographic factors, cultural differences, and location-specific characteristics also play an essential role in explaining this pattern. The findings suggest that the key drivers are the lack of rental housing, high unemployment rates, a high degree of urbanisation, interregional migration, and lack of social capital.

Abstract: Background: The Hospital-at-home (HAH) model is a viable alternative for conven-tional in-hospital stays worldwide. Serum electrolyte abnormalities are common in acute pa-tients, especially in those with many comorbidities. Pathologic changes in cardiac electrophysi-ology pose a potential risk during HAH stay. Periodical Electrocardiogram (ECG) tracing is therefore advised, but few studies evaluated the accuracy and efficiency of compact, self-activated ECG devices in the HAH settings. This study aimed to evaluate the reliability of such a device in comparison to a standard 12-lead ECG. Methods: We prospectively recruited consecu-tive patients admitted to the Sheba Beyond, virtual hospital, in the HAH department, during a 3-month duration. Each patient underwent a 12-lead ECG recording using the legacy device, and a consecutive recording by a compact 6-lead device. Baseline patients’ characteristics during hospi-talization were collected. Level of agreement between devices was measured by Cohen’s Kappa coefficient for inter-rater reliability (Ϗ). Results: Fifty patients were included in the study. 26 (52%) had electrolyte disturbances. Abnormal D-dimer values were observed in 33 (66%) pa-tients, and 12 (24%) patients had elevated troponin values. We found a level of 94.5% raw agreement between devices with regards to nine of the options included in the automatic read-out of the legacy device. The calculated Ϗ was 0.72, classified as substantial consensus. The rate of raw consensus regarding ECG intervals’ measurement (PR, RR, QT) was 78.5% and the calculated Ϗ was 0.42, corresponding to a moderate level of agreement. Conclusion: This is the first report to our knowledge regarding the feasibility of using a compact, 6-Lead ECG device in the setting of HAH to be safe and bearing satisfying agreement level with a legacy, 12-lead ECG device, en-abling quick, accessible arrythmia detection in this setting. Our findings bear a promise to the future development of telemedicine-based hospital at home methodology.

Respiratory therapist(RT)internet-supervised At-Home Telespirometry(AHT)was validated in pilot 22/95=23% ALS Clinic population. Erect, supine Vital Capacity(eFVC, sFVC)were measured longitudinally using ZephyRx smartphone interface and database recording in-clinic-conventional(Viaire-Vyasis-)and at-home-portable(MIR-Spirobank-Smart-)spirometers. Bland-Altman(BA)analysis supported content validity-precision and 7-day-test-re-test-validity [mean difference=0.15L(conventional–portable;95%CI -0.40L, 0.70L); = 2.7% predicted (conventional-portable;95%CI -12.1%, 17.5%) ]meeting ATS-ERS performance standards. RT Internet-supervised AHT measured sFVC was more frequently obtained[35/52=67.3 %]in-home-vs-in-clinic sFVC[9/21=42.9 %](Chi-Square;P=0.0533). Monthly mean eFVC slope decline for the eFVC > 60 % predicted baseline cohort was – 1.24% predicted per month[95% CI -2.15 ,-0.33% predicted]statistically significantly(P=0.015)less compared with the – 5.86% predicted per month[95% CI -9.44, -2.29 % predicted]decline for the eFVC < 60 % predicted baseline cohort and in this cohort was associated with statistically significant decreased survival(P=0.0219). RT Internet-supervised AHT facilitated initiation of non-invasive ventilation(NIV)in 5/22[23%]patients including 3/4[75%] homebound subjects. RT Internet-supervised AHT can be deployed for ALS patients stratified according to baseline eFVC for earlier detection of eFVC and sFVC decreases between clinic visits. A prospective research study[NCT05106569]is ongoing to further define the capability of online deployment of Respiratory therapist(RT)internet-supervised AHT in the timely initiation of NIV use to improve ALS respiratory care in larger numbers of ALS subjects.

Canadians overwhelmingly do not want to live in long-term-care (LTC) facilities when they age; yet many end up there for lack of homecare, because family caregivers burn out, or because they and their professional advisors are unaware of alternatives to institutions. Not only is institutional dementia care problem-driven, it segregates disabled people, thereby abrogating human rights. Because systemic ageism and ableism cloud elder care, institutions remain the default option for Canadians with dementia. Yet, decades of deinstitutionalization enabled younger disabled Canadians to live in the community with supports. Why not elders? We describe a plethora of noninstitutional dementia-care alternatives. We then present a roadmap for considering all relevant care options in service plans, one that incorporates supported decision-making by people with dementia. We propose a paradigm shift in how Canada serves its elder citizens—not just the current generation, but those to come, including ourselves.

Childhood hygiene education has resulted in individuals engaging in hand washing and mask wearing to cope with COVID-19. Individuals can form sustainable development-related habits through childhood education.

Perimenopause, the transitional phase leading up to menopause, affects millions of women worldwide, yet remains poorly understood and under-addressed in healthcare. This report investigates the significant impact of perimenopause symptoms on women's lives, emphasizing the often debilitating effects such as anxiety, depression, weight gain, and hot flashes, which collectively cost an estimated $1.8 billion annually in lost work time. Despite the availability of treatment options like Hormone Replacement Therapy (HRT) and non-hormonal alternatives, awareness and utilization of these options vary significantly among women. The report highlights the historical neglect of women's health issues and the need for improved communication between patients and healthcare providers. A cross-sectional survey conducted with 1,000 adults from the United States and Canada reveals widespread dissatisfaction with the quality of healthcare communication, underscoring the importance of personalized and comprehensive insights for women's health. The findings advocate for more at-home solutions and resources to empower women in managing perimenopause and menopause, promoting informed decision-making and reducing stigma. This study aims to enhance awareness and support for women during this critical life stage.

This study examines the differential impact of proactive and reactive job crafting behaviors on job well-being, drawing from the perspective of boundary theory. The increasing popularity of work connectivity behavior after-hours (WCBA) after work has attracted widespread attention from scholars on the relationship between WCBA and employee well-being. One view suggests that the impact of WCBA is negative, while another view suggests it is positive. Obviously, the impact of (WCBA) on well-being at work is still contradictory. To clarify the complexity of the impact of WCBA on well-being at work, based on boundary theory, we divided WCBA into proactive WCBA (PC) and reactive WCBA (RC), and examined the double-edged sword effect of WCBA on well-being at work, as well as the mediating mechanisms of job control and work-to-home conflict, and the moderated effects of boundary segmentation preferences. This study uses empirical sampling method to collect data from 125 employees for a period of five days for quantitative research. The results show that, first, PC has an inverted U-shaped effect on job control, and job control is negatively related to well-being at work. Thus the mediating effect of job control is significant. Second, RC has a negative impact on job control, and there is also a negative relationship between job control and well-being at work. Therefore, the mediating effect of job control is significant. Third, PC and RC are positively correlated with work-to-home conflict, and work-to-home conflict has a significant positive impact on well-being at work. Therefore, the mediating effect of work-family conflict is significant. Fourth, the study also found that integration preference moderates the relationship between work-to-home conflict and PC on well-being at work, that is, the mediating effect of work-to-home conflict is stronger for employees with low integration preference. This study enriches our understanding of WCBA, PC and RC from the perspective of proactive and passive employee behaviors. The study also provides a new interpretation of the impact of WCBA on well-being at work and offers valuable insights for the sustainable development in digital social transformation and the application of boundary theory and the theory of empowerment-subjugation in achieving the United Nations Sustainable Development Goals. In addition, the study deepens our understanding of the heterogeneous regulatory role played by work-family integration preferences in influencing well-being at work under different types of WCBA.

Background The link between age at marriage and first birth in explaining completed family size is not always direct, due to heterogeneity in circumstances, that compel individual women to marry or initiate childbearing at a particular age. We analyzed data for 1020 women aged 45-49 in 2014 of the 1965-1969 birth cohort from the 2013-14 Zambia Demographic and Health Survey (ZDHS). Methods We fitted a bivariate and multivariate multinomial logistic regression to establish the relationship between a mother’s age at first marriage and at first birth on completed family size (CFS). Chi-square test of proportions measuring differences in proportions and relative risk ratios (RRR) with confidence intervals at 95% are reported. Results Our results show that the average CFS was 6.7 (95% CI: 6.5 – 6.9) among women completing their reproductive span in 2014 with mean age at first marriage and birth being 18.3 years (95% CI: 18.0 – 18.5) and 18.9 years (95% CI: 18.7 – 19.1) respectively. Women marrying at younger ages and having their first birth at younger ages were more likely (RRR: 1.187; 95% CI: 1.138-1.239 and RRR: 0.195; 95% CI: 0.074-0.511 respectively) to have higher CFS than their compatriots that initiated both marriage and childbearing at or after age 22 controlling for covariates as presented in the controlled model. The independent effects model shows that the risk of having 1-3 children compared to 6 or more children was lower (RRR: 0.073; 95% CI: 0.009-0.611; RRR: 0.136; 95% CI: 0,046-0.402 and RRR: 0.421; 05% CI: 0.135-1.312) for women whose ages at first marriage were <15, 15-18 and 19-21 respectively relative to 22+. Women with 1-3 children were 2.5 times more likely to use contraception than women with 6 or more children. Conclusion Having no education, being a rural resident and having a medium household wealth all increase the risk of having higher CFS. Women that marry before age 19 have a higher likelihood of having 6 or more children by the end of their reproductive period. The study concludes that apart from a woman’s age at first marriage and first birth, a complex network of factors interact to determined CFS.

The Dutch PET@home Toolkit was developed to mitigate challenges and foster conversations and planning concerning pets in long-term care at home. This process evaluation study aimed to evaluate the practical application of the toolkit on four topics: 1) satisfaction; 2) relevance; 3) feasibility; and 4) integration of the PET@home Toolkit materials in home care. Outcomes may be used to improve the toolkit materials to better align with the long-term care at home setting. Accounting for data saturation, professional caregivers (N=6), clients (N=2), and family caregivers (N=2) who used toolkit materials participated in semi-structured interviews. Interviews were analysed by two researchers in ATLAS.ti using an inductive-iterative approach. The researchers reached consensus on themes and clustering within interview topics. This led to the identification of the following topics and (themes): satisfaction (general impression, suggestions for improvement), relevance (awareness, planning, pet-related aspects in practice, impact on healthcare quality), feasibility (healthcare practice, competence, quantity), and implementation (digitalisation, task owner, piloting, timing). Several improvements were made to toolkit materials, such as providing clearer instructions for clients in the information booklet. Participants acknowledged the toolkit could lead to better planning while mitigating potential challenges concerning pets which may lead to longer-lasting relationships between clients and their pets.

This article examines older physical education (PE) teachers’ wellbeing over the course of their career in Finland. The study highlights challenges to physical and mental functioning as well as how teachers respond to these challenges. The six interviewees were over 55-year-old PE teachers, whose career had lasted for more than 30 years. Qualitative methods were used in the collection, transcription and analysis of the research data. The qualitative analysis consisted of a series of interpretations that visualised the world described by the interviewees. All the research participants had physical problems that affected their teaching and make teachers consider a potential career change. To be able to teach, teachers adapted their ways of working according to the challenges brought by age and injuries. The research participants found that the challenges caused by musculoskeletal problems and ageing were an inevitable part of the profession. They emphasised the positive sides of the work: the profession permits varied workdays. In addition, the teachers noted that their work provides them with opportunities to remain physically fit. Teaching health education is a means to lighten the workload of older teachers. PE teachers enjoy their profession and are dedicated to it, despite all the challenges. The interviewed participants clearly experienced work engagement. Our development proposal for teacher education is that future PE teachers be informed about the risks involved in the profession. Such activity helps young teachers reflect proactively on the measures taken to maintain their functioning during their career and on perspectives related to the ways of working.

Home-dwelling older people without health services might develop health issues and challenges. To live longer at home and manage well, it is important to promote health-promotion towards this target group. One approach is through health-promotion dialogues conducted by healthcare professionals in the municipality. The aim of this study is to explore healthcare professionals’ experiences who are conducting health-promotion dialogues to older home-dwellers over 75 years without services. Focus-groups were used to collect data, and a total of nine participants formed three focus groups. Thematic analysis was applied to analyse the material, which resulted in one major theme “The challenging dialogues” comprising three sub-themes, “Mobilise coping skills and health awareness”, “Uncover vulnerability”, and “The ambiguity of the dialogues”. The findings were also discussed by using empowerment as a theoretical lens. The health-promotion conversation uses a resource perspective for elderly to remain independent in old age and can reveal vulnerability and underlying needs. The conversation purpose appears ambiguous for the target group, which leads to unclear service expectations and rejections of the offer. Nevertheless, it seems to be important that this health-promotion service to a larger degree addresses a clear purpose in order to meet the needs of the target group in a broader sense in the aging process.

This article contains the theorems concerning the algebraic dependence of polynomial mappings with the constant Jacobian having two zeros at infinity. The work is related to the issues of the classical Jacobian Conjecture. This hypothesis affirm that the polynomial mapping of two complex variables with constant non-zero Jacobian is invertible. The Jacobian Conjecture is equivalent to the fact that polynomial mappings with constant non-zero Jacobian do not have two zeros at infinity, therefore it is equivalent to the two theorems given in the work. The proofs of these theorems proceeds by induction.

Agroforestry homegardens are integrated arrangements of common vegetable plants in areas close to residences, which follow a structure similar to that of tropical forests, with the cultivation of multiple species to meet the basic needs of families, such as the provision of food and medicine, as well as ensuring an environment for other family activities. Considering the importance of these environments, this work aimed to address the composition and use of plant species in agroforestry homegardens, in order to support society initiatives and government policies to strengthen the management of natural resources and individual and collective well-being in the region. For this, 119 homegardens were studied in the municipalities of Belterra, Mojuí dos Campos and Santarém, in the state of Pará, in the Brazilian Amazonia, comprising five different zones (peri-urban, urban, floodplain, indigenous land and tourist land), obtaining the data via questionnaires and guided visitation by the residents. A total of 5,323 vegetal individual plants were surveyed, distributed in 188 species and 62 botanical families. The data showed that 80.5% of the individual plants are concentrated in 18.6% of the species, with no significant difference in the average of species per homegarden in the five zones. The predominance of species for food use, primarily fruit-bearing, stands out, showing a possible direction for incentive actions and/or for the ordering of public policies and programs aimed at these spaces. Most homegardens have up to 17 plant species; less than half of homegardens have species intended for medicinal use; and there is percentage parity between native plant species and those of exotic origin, where native plants stand out for shading. Agroforestry homegardens play a crucial role in the conservation and cultivation of species for food purposes, with the cultivation or maintenance of plants based on their various purposes, showing distinct profiles of distribution and choice of species, evidencing their socioeconomic and environmental importance. Thus, it is important that these land use systems are valued, investing financial resources in actions and projects aimed at maintaining and enhancing their benefits for the region.

As there is lack of understanding about the effect of transitioning between different flooring materials on the gait of older adults, this study investigated the effect of transitioning between a carpeted floor and a vinyl floor on the gait characteristics of older adults. Fourteen older (65 years old and over) and 14 younger (18 to 35 years old) adults walked on different transitional floors by measuring various gait parameters. While the older participants had greater toe clearance than their younger counterparts, the older participants had smaller toe clearance on a carpeted floor than on a vinyl floor, which would increase the probability of a trip-induced fall. Further, the study found the slower transitional acceleration of the whole body COM and the increased friction demand, especially during the toe-off phase, rather than heel contact phase, which will lead to a slip-induced fall on a vinyl floor shortly after transitioning from a carpeted floor to a vinyl floor. Although the increased likelihood of a slip or trip accident was found throughout the changes in gait parameters, the older participants did not perceive of slipping and tripping much. Therefore, older adults are recommended to be made aware of the danger of slipping and tripping while transitioning between different flooring materials.

Insurance companies need to calculate solvency capital requirements in order to ensure that they can meet their future obligations to policyholders and beneficiaries. The solvency capital requirement is a risk management tool essential for, when extreme catastrophic events occur, resulting in a high number of possibly interdependent claims. This paper studies the problem of aggregating the risks coming from several insurance business lines and analyses the effect of reinsurance in the level of risk. Our starting point is to use a Hierarchical Risk Aggregation method, which was initially based on 2-dimensional elliptical copulas. We then propose the use of copulas from the Archimedean family and a mixture of different copulas. Our results show that a mixture of copulas can provide a better fit to the data than an individual copula and consequently avoid over or underestimating of the capital requirement of an insurance company. We also investigate the significance of reinsurance in reducing the insurance company’s business risk and its effect on diversification. The results show that reinsurance does not always reduce the level of risk, but can also reduce the effect of diversification for insurance companies with multiple business lines.

in this paper, the optical channel performance with respect to varying scintillation index parameters is studied. Where different channel effects are studied and analyzed. In free-space optical (FSO) communication, the major drawback of the optical communication system is the atmospheric turbulence (AT). This effect is nonlinear with optical channel altitude being changed. Therefore, the power margenal (PM) required for such a channel is also inconstant respectively. In this thesis, we analyze AT effect on the optical channel with different altitudes. Such that we found the difference in the range of PM required for such optical link distance. In our result, the Bit Error Rate (BER) VS. PM required is measured. The optical channel model is Log-Normal considered and the BER threshold BER^th = 10^-10 is taken.

(1) Background: There is not much research about obesity in nursing homes although knowledge will help us to develop customized treatment plans and prevention strategies, which may help to decrease the burden for all persons involved. The objective of conducting this study was to describe the prevalence of obesity and the association between obesity and care problems in nursing home patients. (2) Methods: This study is a secondary data analysis of data collected in an annually performed cross-sectional study called “Nursing Quality Measurement 2.0”. A standardized and tested questionnaire was used to collect data. (3) Results: 1236 nursing home patients took part and 16.7% of them were obese. The multivariate logistic regression analysis results show that urinary incontinence is significantly associated with the presence of obesity (OR 2.111). The other care problems of pressure injuries, fecal and double incontinence, physical restraints, falls and pain were not associated with obesity. (4) Conclusion: The results indicate that, in the nursing home setting, health care staff should pay special attention to the patients’ nutritional and continence status and help patients maintain a normal, healthy weight. Conducting more studies with larger sample sizes is recommended, as this will allow differentiation among different obesity classes.

The COVID-19 pandemic has been challenging for society, especially for those residing in long-term care facilities (LTCF). This study aimed to describe rates of infection, hospitalization, and death due to COVID-19 among older people and staff of LTCF in a state of Southeastern Brazil and identify strategies to prevent and control the disease spread. This cross-sectional study was conducted with 164 LTCF (6,017 older people). Among the studied LTCF, 48.7% confirmed COVID-19 infection in older people, resulting in 39.6% hospitalization and 32.3% death among infected. Moreover, 68.9% of LTCF confirmed COVID-19 infection in the staff, with 7.3% hospitalization and 1.2% death. Preventive measures were identified and classified as organizational, infrastructure, hygiene items and personal protective equipment, and staff training against COVID-19. These measures showed strategies and barriers experienced in the daily routine of LTCF during the pandemic. LTCF in Brazil experienced challenges similar to observed worldwide.

The Smart Angel connected medical device allows ambulatory surgery patients to monitor their health by taking their own blood pressure and oxygen levels and by answering a health questionnaire from home. This preventive device must necessarily be "usable" by patients with different profiles. The objective of this article is, therefore, to better understand the links between certain characteristics of potential patients and usability. We conducted an experimental study involving thirty-six participants, investigating the effects of four patient characteristics (i.e. age, education, technophilia and health literacy) on usability measured in terms of effectiveness, efficiency, and satisfaction. The results show a moderate correlation between age, health literacy and usability. However, there is a weak correlation between technophilia and usability and no relationship between the level of education and usability. This study provides theoretical insights into the effects of user characteristics by means of personas in usability (ISO 9241-11).

This work considers the existence of heteroclinic solutions for second order differential equations with ϕ-Laplacians and generalized impulsive conditions on the real line. For the construction of the results, it was only imposed that ϕ is a homeomorphism and the Schauder’s fixed point theorem allied with the concepts of L1-Carathéodory functions and sequences together with the equiconvergence on infinity and on each impulsive moments. Finally, a practical part illustrates the main theorem.

As wind turbine power requirements have evolved from the order of kilowatts (kW) to the order of several megawatts (MW), wind turbine components have been subjected to more demanding and critical operating conditions. The wind turbine must cope with higher wind loads due to larger blade sizes, which are also time-varying and ultimately higher power levels. One of the challenges in the manufacture of high-power wind turbines lies in the gearbox and consists of achieving ever greater power density without compromising efficiency, i.e., greater load capacity with lower weight (and production cost) and reduced power losses. In this paper we will analyze the influence that certain design parameters have on the size and weight of the gearbox components and therefore of the gearbox itself. For this purpose, the theoretical model of the gearbox will be planned and the influence of calculation parameters on the gearbox design will be analyzed. The influence of material, modulus and tooth width on the size and weight of the gearbox will be observed. Critical stresses are also calculated. The goal is to prepare the theoretical basis for an optimization process that will result in a gearbox as compact as possible without compromising the service life of the components.

As shown in former papers, the nonadiabatic Heisenberg model presents a novel mechanism of Cooper pair formation generated by the strongly correlated atomic-like motion of the electrons in narrow, roughly half-filled "superconducting bands". These are energy bands represented by optimally localized spin-dependent Wannier functions adapted to the symmetry of the material under consideration. The formation of Cooper pairs is not the result of an attractive electron-electron interaction but can be described in terms of quantum mechanical constraining forces constraining the electrons to form Cooper pairs. There is theoretical and experimental evidence that only this nonadiabatic mechanism operating in superconducting bands may produce eigenstates in which the electrons form Cooper pairs. These constraining forces stabilize the Cooper pairs in any superconductor, whether conventional or unconventional. Here we report evidence that also the experimentally found superconducting state in bismuth at ambient as well as at high pressure is connected with a narrow, roughly half-filled superconducting band in the respective band structure. This observation corroborates once more the significance of constraining forces in the theory of superconductivity.

Medication adherence is a vexing challenge with nonadherence at 50% or greater among US adults. With most medications self-administered by patients in the home, home medication management practices, especially where patients store medication in the home and receptivity to guidance from healthcare providers, need to be better understood to improve adherence. We designed and deployed a survey to investigate home medication management. The 1,673 survey respondents reported that the most common home storage locations for medications were nightstand drawers (28%) and atop nightstands (27%). Kitchen cabinets and bathroom vanities were significantly associated with increased odds of having ever forgotten to take a medication. Desks, dining room tables, and nightstand drawers were associated with the greatest statistically significant decrease in odds of having ever forgotten to take a medication. Almost all (96%) respondents were receptive to guidance on medication storage from a healthcare provider. Patients are largely on their own to devise home medication management practices, yet some home storage locations are significantly associated with decreased odds of having forgotten to take a medication. Knowing which practices are associated with adherence may lead to better guidance for patients from healthcare providers and to innovation in the design of medication adherence interventions.

Robot-assisted rehabilitation has emerged as a promising approach for enhancing motor function in stroke survivors. However, the feasibility and effectiveness of home-based robotic training in this population are underexplored, especially in low/middle-income countries. This feasibility study aimed to address this gap by examining the feasibility and effectiveness of independent home-based training using PLUTO, a robotic device for hand training. A total of 7 chronic stroke survivors were recruited, with 5 completing the study. The results revealed high engagement and adherence to the home-based training program, with participants averaging 1659.8 minutes of training over 24.8 days. The PLUTO system demonstrated excellent usability and elicited positive user perceptions. Significant improvements were observed in functional outcomes, as evidenced by a noteworthy increase in Fugl-Meyer Assessment scores (mean increase of 6.2 points, exceeding the minimal clinically important difference (MCID) of 5.35 points). Furthermore, participants showed improvements in the ABILHAND measure (mean improvement of 1.24 logits, surpassing the MCID of 0.2 logits) and the Barthel Index (mean increase of 8.8 points). These findings demonstrate the feasibility and effectiveness of home-based robotic rehabilitation for chronic stroke survivors. This has implications for expanding access to rehabilitation services in low- and middle-income countries, enhancing patient engagement and adherence, and improving functional outcomes. Larger controlled studies are warranted to evaluate the effectiveness of home-based robotic rehabilitation programs.

The reef manta ray (Mobula alfredi) is a highly mobile and plankton-feeding species, classified vulnerable to extinction on the IUCN Red List for Threatened Species. Knowledge on their spatial ecology and the extent of their dispersal remain incomplete, especially within island-fragmented habitats as found in New Caledonia. Satellite telemetry was used to investigate the horizontal movement ecology of reef manta rays in New Caledonia. A total of 21 manta rays were tagged with pop-up satellite archival transmitting tags (21 Fastloc and 2 MiniPAT) that remained deployed for a duration ranging from 3 to 180 days (mean ± SE = 76.7 ± 50.3). Rays presented a strong site fidelity and an important affinity for coastal waters. Long-distance migrations (> 300 km) were also observed, mainly through coastal and shallow water paths. Horizontal movements were compared to a home range area and classified into four distinct patterns: Fidelity, Excursion, Fidelity + Relocation and Relocation. The most dominant pattern was Fidelity where manta rays remained within their home range for the whole duration of the tag deployment. Our findings may assist the design of more appropriate management strategies for the species in New Caledonia and other regions worldwide.

The quadruple burden of diseases, early discharge from hospital and hospital at home have resulted in home-based care services becoming a requirement in South Africa. The home-based care services generate a significant amount of health care risk waste that is mismanaged. However, more attention is given to the health care risk waste generated in hospitals and clinics than to health care risk waste generated by home-based caregivers. Therefore, this study investigates the health care risk waste management practices by home-based caregivers. The study adopted a mixed research approach, qualitative and quantitative methods, using a literature review, interviews, and questionnaires as means of data collection. Results show that there are different types of health care risk waste generated as a result of different activities performed by home-based caregivers, but that the waste was found to be managed in an unsafe manner. The majority of households receiving home-based care did not have basic sanitation facilities such as toilets, running water and waste removal services, aggravating the issue of health care risk waste mismanagement. The study recommends a new policy framework that will lead to safe management practices of generated health care risk waste to be adopted by home-based caregivers.

The fact that Thailand’s energy policy has set a new renewable energy target of 30% of total final energy consumption by 2036. It also has the potential of solar energy and community demands in remote areas. However, most of the renewable energy technology will still be able to achieve renewable energy goals, similar to the case of the national policy that promotes Solar Home System (SHS) in remote areas, lack of good handling. Therefore, achieving the goal of the renewable energy policy should be in position using the right strategy. This article presents the result of a case study in the Akha upland community, northern Thailand, where we used the mixing method and factor analysis to analyze strategies for SHS related criteria. The key scopes and challenge included bottom-up planning concepts and subsidies from expert persons, while contributions to factors have an impact on developing sustainable SHS, include the creating approval of SHS technologies, developing of SHS management, promoting of SHS technologies, and supporting of SHS policies, respectively. Mainly, social factors provide positive effects, which thus influence the sustainable development of process SHS in terms of the creation of approval. Furthermore, there should be managed appropriately for each community, for the positive imagery of solar power.

The increasing rearrangement is a rewarding instrument in financial risk management. In practice, risk must be managed in different perspectives. A common example is portfolio risk which often can be seen from at least two perspectives: market value and book value. Different perspectives that is different distributions can be coupled by increasing rearrangement. One distribution is regarded as underlying, and the other distribution can be expressed as increasing rearrangement of the underlying distribution. Then, the risk measure for the latter can be expressed in terms of the underlying distribution. Our first objective is to introduce the increasing rearrangement for application in financial risk management and apply the increasing rearrangement to the class of distortion risk measures. We derive formulas to compute risk measures in terms of the underlying distribution. Afterwards, we apply our results to a series of special distortion risk measures, namely Value at Risk, Expected Shortfall, Range Value at Risk, Conditional Value at Risk, Wang's risk measure. Finally, we present the connection of increasing rearrangement to inverse transform sampling, Monte Carlo simulation, and cost-efficient strategies. Butterfly options serve as illustrative example for the method.

Falls at height are among the major causes of fatal accidents at work, especially in the construction sector. Maintaining balance while performing a tool with both hands generates physical efforts and mental loading that needs to be managed for workers’ safety and health. The purpose of the study is to compare perceived (dis)comfort (overall and localized), the ergonomic risk and the perceived effort through the acquired postures that subjects assumed during the execution of simple and common tasks both on a ladder and on the ground. 26 subjects were asked to perform four tasks in both conditions: top screwing, frontal screwing, object picking from the bottom forward, and object picking from the bottom sideways. Subjective and objective data were gathered for assessing subjective experience (discomfort and effort, perceived) and ergonomic risk. Results highlighted few ergonomic risk differences among “on ladder” and “on ground” tasks, while subjective data reveal significant differences in different scenarios. Main results regard knees and neck areas as the most critical ones.

This article studies examines the relationship of literature, ideology, and reading through a study of language, or la langue, as explored by De Man, Derrida, and Lacan. It attempts to show that structure, assumed to be the given of language, even within deconstruction, is, as structure, that which undoes structure. Literature explores this possibility of language, which is that it be and not be at the same time. The article finishes by studying the connection between this idea of literature as the possibility of language and the possibility of man, an important theme of the above three thinkers.

Tracheotomy as an emergency surgical procedure appeared and developed in ancient times1. The surgical techniques for its performance in our time have reached a level of perfection, and in adults it is one of the most frequent surgical procedures performed in emergency and intensive care units worldwide. Children's tracheotomy, on the other hand, presents far more serious challenges to the medical teams involved in its performance. A number of issues related to it - indications and contraindications, time for performance and protocols for decannulation and others are still subject to clarification. In the past years, the development of medical science, the introduction of vaccination programs, the use of many improved medical materials and technologies, as well as the achievements of neonatal and pediatric intensive care practice, have shifted the emphasis of pediatric tracheotomy from its emergency performance to solve an acute asphyxiation problem, to its implementation in children, representing a complex group of patients, with permanent dependence on tracheostomy and related medical technologies for long-term survival2. There are a growing number of children who have experienced complex therapy, for whom tracheostomy care and mechanical ventilation2, including at home environment, are part of their care. This, in turn, puts new questions on the agenda: who will take care for the child in the early postoperative period and during the days of hospitalization afterwards, who will train the people who will care for the tracheotomized child at home, what precautions should be applied in these children during their daily activities – eating, bathing, playing inside and outside the home and others.

(1) Background: The purpose of this study was to assess the external load demands in futsal, con-sidering both home and away matches and their outcomes, in order to plan microcycles throughout the season based on the external load of each match. (2) Methods: The external load of 10 players from a First Division team in the Spanish Futsal League was recorded. The total dura-tion of player involvement with the clock stopped was 18.15 ±7.04 minutes. The players' external load was monitored using OLIVER devices. To analyse the influence of the match outcome and location on the external load, a univariate general linear model (GLM) analysis was conducted. (3) Results: There are no differences between the variables, except for accelerations of 2 to 3 m/s² (m) per minute and the number of accelerations of 2 to 3 m/s² per minute. Despite not showing significant differences, there is a trend indicating a higher demand for external loads in away matches as well as in matches won. (4) Conclusions: These findings are important for planning microcycles and providing the appropriate dosage to each player to achieve optimal performance in matches.

This study aims to spatially analyze the distribution characteristics of vacant homes in Asan-si, Chungcheongnam-do, and understand the differences in factors causing vacant homes by type. We use a variety of statistical methods to examine these factors and identify key influencing factors such as the number of vacant stores, changes in overall population, land use complexity, and physical characteristics of land and buildings. The findings reveal that the factors contributing to the occurrence of vacant homes vary significantly by region and property type, highlighting the need for region-specific policies. For instance, in old town areas, small lot ratios and land use complexity are significant, while in rural village, the average number of floors and land use complexity play a major role. This study underscores the diversity of factors influencing vacant homes, suggesting that policies should be tailored to the unique characteristics of different regions to effectively address this issue.

Objective: To investigate the feasibility and preliminary effects of a 12-week home-based moderate intensity cycling programme in stroke survivors. Design: Single-blinded, parallel group, Randomised Controlled Trial Setting: Home-based Participants: Participants will be survivors of first-ever stroke and randomly assigned to an Active Cycling Group (ACG) or control group. Intervention: The ACG performed a 12-week home-based cycling programme, three sessions per week. Work intervals were executed at 75% of the maximal heart rate (HR_max), recovery intervals at 50% of HR_max. Work interval duration increased from three ten-minute intervals to 30 minutes continuous cycling. The control group completed a 12-week neurocognitive exercise programme. Main outcome measurements: Primary outcome measures are compliance with training, adherence to protocol and safety as measured by adverse events. Secondary outcome measurements included a: simplified modified Rankin Scale questionnaire (stroke severity), Six-Minute Walking Test (walking ability), Ten-meter Walk Test (walking ability), Rivermead Mobility Index (walking ability), graded submaximal cycling test (exercise capacity), Physical Activity for Individuals with Physical Disability questionnaire (physical activity), EQ-5D-5L (quality of life), Stroke Specific Quality of Life questionnaire (quality of life), Montreal Cognitive Assessment (cognition), General Self-Efficacy Scale (self-efficacy), and Exercise Self-Regulation Questionnaire (self-regulation).

Objectives: To analyze cumulative incidence and mortality by COVID-19 in the different types of nursing homes, in the first and second wave.Methods: Data source: Transparency portal of the Generalitat de Catalunya, official COVID-19 register of all Catalan nursing homes (from March to December 10, 2020). Variables: Affectation of disease and mortality by COVID-19 in geriatric centers in Catalonia, stratified by size of center and type of management. Univariate, bivariate and multivariate linear regression analysis, IBM^TMSPSS^® v.20.Results:N = 1,057 residences (63,682 beds, average = 60.48). 52% have <50 beds, 42.8% between 50-150 beds, and 5%> 150 beds. COVID-19: Cumulative incidence: 21,370 (confirmed + suspicious); mortality: 5,010 (confirmed + suspicious).233 residences did not register COVID-19 patients (22%) and 636 did not register COVID-19 deaths (60.2%).According to the type of supplier, the lowest incidence of COVID-19 was in non-accredited (36.2% without cases), then concerted / collaborators (19.3%) and own of the Generalitat de Catalunya (7.9 %, p = 0.000). The centers with the fewest deaths were the non-accredited (78% without deaths), followed by contracted / collaborators (56.8%) and those of the Generalitat de Catalunya (41.3%, p = 0.000).Depending on the size, no COVID-19 patients were registered: 168 centers <50 beds (30.5%); 64 of the 50-150 beds (14.2%); and 1 of the> 150 beds (1.9%) (p = 0.000). 395 of the <50 beds did not register deaths due to COVID-19 (71.8%), 232 of the 50-150 beds (51.3%), and 9 of the> 150 beds (17%) (p = 0.000).Discussion:Of the 1,057 centers analyzed, 22% did not register cases and in 60% there were no deaths from COVID-19.Residences without concert / collaboration with the Generalitat and with fewer beds showed a lower cumulative incidence and mortality due to COVID-19 during the first wave.

Abstract: Background: Stunting is primarily a public health concern in LMIC. The involvement of Integrated Service Post cadres is one of the strategies to combat stunting in Indonesia. Objective: This study aimed to determine the effect of a short course on cadres knowledge. Method: A single group pre-post test design was conducted in Yogyakarta, Indonesia, from March to May 2022. Thirty cadres were selected based on the following criteria: willingness to participate, the number of stunted children in their Integrated Service Post (Posyandu), and full attendance at short course. The knowledge scores were measured by a structured questionnaire after short course (post-test 1) and 4 weeks later (post-test 2). We apply STATA 16 to calculate the mean difference (MD) using a t-test and Generalized Estimated Equation (GEE). Furthermore, the adequacy of the short course was evaluated with in-depth interviews. Result: On post-tests 1 and 2, cadres' knowledge of IYCF, children growth monitoring (CGM) and children development monitoring (CDM) significantly improved. The GEE analysis showed that a short course significantly improves cadres' knowledge after age control, education, occupation, and years of experience. Conclusion: Short course in-creased their affection, self-efficacy, and confidence, hence, they are capable of assisting children through home visits.

Background: In long-term care facilities, there are many residents who do not have the ability to seek shelter by themselves in the case of an emergency. Thus, it is extremely important that the staff of nursing homes are equipped with correct disaster prevention concepts, emergency survival responses, and hazard mitigation measures. Purpose: Discuss the intervention effectiveness of different fire prevention and emergency response trainings at nursing homes and the relationship and predictivity of awareness to self-efficacy. Method: Recruit staff from two nursing homes through purposive sampling, using a two-team pre-and post-test design to collect results from 41 individuals in the experiment group and 40 individuals in the control group. The research tool is the “Nursing Home Fire Prevention and Emergency Response Awareness and Self-Efficacy Scale,” to compare the effectiveness of advanced and general fire safety trainings. Result: After receiving improved advanced fire safety training, the total score and the result of the experiment group on fire prevention and emergency response awareness and self-efficacy had both performed better than the control group who received general fire safety training (p < .001); fire prevention and emergency response awareness has significant and positive correlation with self-efficacy (r=.601, p < .001), and awareness is a significant predictor variable to self-efficacy (p < .001). Conclusion/Practical Application: This study finds that the key to improving learning effectiveness includes adding fire science concept chapter when creating fire safety training material in order to strengthen basic awareness; fire safety training should comprehensively introduce all related duty responsibilities of staff fire defense formation, in turn enabling mutual responsive support for the needs of the site; also, to become familiarized with the knowledge requires appropriate frequency of training and enhancing the staff’s awareness to fire prevention and emergency response, which is the most important key of learning effectiveness.

Severe asthma patients are at increased risk of major exacerbations and they need to be monitored regularly. The COVID-19 pandemic has impressively impacted on the health care resources. The telemedicine approach applied to the follow-up of asthmatic patients has been proved to be effective in monitoring their disease and adherence to the therapy. The aim of our study was to investigate the satisfaction of severe asthma patients, before the activation of a telemedicine management complemented by a standard of care. An ad hoc questionnaire was developed and sent by e-mail to 180 severe asthma patients. Most of subjects (82%) were confident with the idea of doing self-measurements and self-managing their disease; 77% of subjects favoured to carry out virtual visit and telemedicine. 93% of patients considered easy the self-injection therapy. 94% of subjects felt safe and 93% were not worried while self-administering. Only mild adverse events were reported in 22% subjects after self-administration. Our results showed an agreement between what is considered necessary and practicable by healthcare personnel and what is perceived by the severe asthma patients, in terms of treatment and monitoring of the disease with Telehealth. Biologics have a safety profile and can be easily self-administred at home

A brain-computer interface for controlling elements commonly used at home is presented in this paper. It includes the electroencephalography device needed to acquire signals associated to the brain activity, the algorithms for artefact reduction and event classification, and the communication protocol.

The present paper offers a reading of three selected novels by two Anglophone Arab writers Diana Abujaber and Fadia Faqir. Our reading is fundamentally based on a philosophical post-humanist perception of other ethnic minorities as being inferior and un-human. In interpreting the three novels, Arabian Jazz (2003), My Name is Salma (2007) and Willow Trees Don’t Weep (2014), a main concern is to bring to light how Arabs –and Muslims –have been zombified and de-humanized in Western mainstream media and culture based on a biased stigmatization and stereotyping of a large heterogeneous ethnic group wherein religions, traditions, languages and cultures are diverse. Also, a pivotal preoccupation is going to be the exiling journey of the protagonists from their homelands to Western countries, and how these journeys contribute to the post-humanization of the self, the identity and the culture of Arab displaced immigrants.

In this work, the author employs the quantum hydrodynamic formalism to achieve the geometrization of spacetime for describing the gravitational interaction within the framework of quantum theory. This approach allows for the development of an equation of gravity that is mathematically connected to the fermion and boson fields. This achievement is accomplished by incorporating two fundamental principles: covariance of the quantum field equations and the principle of least action. By considering these principles, a theory is established that enables the calculation of gravitational corrections to Quantum Electrodynamics, and potentially, to the standard model of particle physics as well. The theory also provides an explanation for two phenomena: the existence of a cosmological pressure density similar to quintessence, that is compatible with the small value of the observed cosmological constant, and the breaking of matter-antimatter symmetry at high energies offering insights into why there is an imbalance between the two in the early universe. In the cosmological modeling of the theory, there exists a proposal to account for the formation of supermassive black holes that are accompanied by their own surrounding galaxies, without relying on the process of mass accretion. The model, in accordance with recent observations conducted by the James Webb Space Telescope, supports the notion that galactic configurations were established relatively early in the history of the universe, shortly after the occurrence of the Big Bang.

We study the Mean-Risk model, where risk is measured by the Modified CoVaR \[ \CoVaR^{\leq}_{\alpha, \beta}(X|Y) = VaR_\beta ( X \;| \; Y + VaR_\alpha (Y) \leq 0).\] We prove that in Gaussian setting, for sufficiently small $\beta$, such model has a solution.

To design properly and optimizate liquid-assisted processes such as reactive infiltration for fabricating light weight and corrosion resistant SiC/TiSi2 composites, the interfacial phenomena taking place when liquid Si-rich Si-Ti alloys are in contact with glassy carbon (GC) were investigated for the first time by wetting tests performed by both the sessile and pendant drop methods at T = 1450°C. Specifically, two different Si-rich Si-Ti alloys were selected, and the obtained results in terms of contact angle values, spreading kinetics, reactivity, and developed interface microstructures were compared with experimental observations previously obtained for the liquid Si-rich Si-Ti eutectics processed under the same operating conditions. The increase of the Si content did not affected the final contact angle values. Contrarily, the final developed microstructure at the interface as well as the spreading kinetics were observed as weakly dependent on the composition. From the practical point of view, Si-Ti alloy compositions with a Si-content falling in the simple eutectic region of the phase diagram might be potentially used as infiltrant materials of C- and SiC-based composites.

ObjectivesIn increasingly stressful times, many people are increasingly turning to fast food, neglecting to drink enough fluids and often forgoing regular exercise. The fast tempo of everyday life leaves little room for healthy habits, such as cooking at home, which means that a conscious and balanced diet takes a back seat.MethodsA descriptive pilot study was conducted to investigate the effects of an eight-week intervention program. This program included the daily intake of breakfast, cooking at home, adequate fluid intake and daily physical activity. The aim of the study was to evaluate the effects of these measures on the participants' body weight and general health.Results During the 56-day intervention, there was a steady trend towards weight reduction, and at the end of the intervention phase, a significant weight reduction in the test person could be observed. At the end of the intervention, the participant was still 45 years old, measured a body weight of 73.4 kg, which represents a BMI of 25.1 and is classified as slightly overweight. ConclusionThe results of the pilot study demonstrate clearly that the health mix of regular cooking at home, a daily breakfast, a daily physical activity session and sufficient fluid intake can be an effective booster for weight loss in adults. This combination has not only led to a significant reduction in body weight, but has also shown that simple, everyday measures can have a profound effect on health.

Brain-Computer Interface (BCI) processes and converts brain signals to provide 20 commands to output devices to carry out certain tasks. The main purpose of BCI is to replace or 21 restore missing or damaged functions of disabled people including neuromuscular disorders like 22 Amyotrophic Lateral Sclerosis (ALS), cerebral palsy, stroke, or spinal cord injury. Hence, BCI does 23 not use neuromuscular output pathways. Scientists have used several techniques like 24 Electroencephalography (EEG), intracortical, and Electrocorticographic (ECoG) to collect brain 25 signals which are used to control robotic arms, prosthetics, wheelchairs, and several other devices. 26 The non-invasive method of EEG is used for collecting and monitoring the signals of the brain. 27 Implementing EEG-based BCI technology in home automation systems may facilitate a wide range 28 of tasks for people with disabilities. It is important to assist and empower individuals with paralysis 29 to engage with existing home automation systems and gadgets in this particular situation. This 30 paper proposed a home security system to control a door and a light using EEG-based BCI. The 31 system prototype consists of the EMOTIV Insight™ headset, Raspberry PI 4, servo motor to 32 open/close the door, and LED. The system can be very helpful for disabled people including arm 33 amputees who cannot close/open doors or use remote control to turn on/turn off doors. The system 34 includes an application made in Flutter to receive notifications on the smartphone related to the 35 status of the door and the LEDs. The disabled person can control the door as well as the LED using 36 his/her brain signals detected by the EMOTIV Insight™ headset.

This paper describes a system that is used to gather data from Smart Home sensors measuring energy consumption, analyze and predict future consumption by using machine learning algorithm for prediction. It focuses on the architecture of the system as well as the need for such system to exist in practice – why the consumption should be measured at all and how that measurement can be put to good use for achieving energy efficiency.

Urinary tract infections (UTIs) are highly prevalent in long-term care facilities, constituting the most common infection in this setting. Our research focuses on analyzing clinical characteristics and antimicrobial prescriptions for UTIs in residents across nursing homes (NH) in Spain. This cross-sectional report is part of a before/after intervention study using a multifaceted approach based on the normalization process theory to improve healthcare quality provided by nursing staff in 34 NHs in Spain. In this study we present the results of the first audit including 719 UTI cases, with an average age of 85.5 years and 74.5% being women. Cystitis and pyelonephritis presented distinct symptom patterns. Notably, 6% of asymptomatic bacteriuria cases were treated. The prevalence of dipstick usage was 83%, raising concerns about overreliance, including in the 46 asymptomatic cases, leading to potential overdiagnosis and antibiotic overtreatment. Improved diagnostic criteria and personalized strategies are crucial for UTI management in NHs, emphasizing the need for personalized guidelines on management of UTIs, to mitigate indiscriminate antibiotic use in asymptomatic cases.

Sociality in animal populations is a continuum, and interactions between conspecifics are meaningful for all vertebrates. Ignorance of social structures can lead to misunderstanding their ecology and, consequently, to unsuccessful species management. Here, we combined genetic and spatial data on radio-collated brown bears (Ursus arctos) to investigate kin-related home range overlap and kin-related centroid distance within central and eastern Finland. We found that the extent of overlap of home ranges was positively linked with relatedness among adult females. A similar positive correlation could be detected between home range centroid distance and relatedness among adult females. Moreover, there were significant differences between the two studied regions: female brown bears in central Finland were more closely related to each other, and the sizes of their home ranges were larger than those in eastern Finland. The smaller home ranges and lower degree of relatedness among bears in eastern Finland might be a result of the substantially higher hunting pressure in the area, combined with immigration of new unrelated individuals from Russia.

This paper proposes the localisation of room occupants in home environments using Unobtrusive Sensing Solutions (USSs). The ability to localise room occupants in home environments can help in the objective monitoring of sedentary behaviour. While wearable sensors can provide tangible information on health and wellness, they have battery life issues and the inability to perform prolonged monitoring. This work uses heterogeneous USSs in the form of an Infrared Thermopile Array (ITA-64) thermal sensor and a Multi-Chirp Frequency Modulated Continuous Wave Mono-pulse (MC-FMCW-M) Radar sensor to monitor room occupants. Digital filters and background subtraction algorithms were used to process the thermal images gleaned from the ITA-64 thermal sensors. The MC-FMCW-M Radar sensor used multi-chirp and Doppler shift principles to estimate the exact location of the targeted room occupants. The estimated distances from the Radar Sensor were compared with ground truth values. Experimental results demonstrated the ability to identify thermal blobs of occupants present in the room at any particular time. Data analyses indicated no significant difference (p = 0.975) and a very strong positive correlation (r = 0.998) between the ground truth distance values and those obtained from the Radar Sensor.

This study investigated mortality discrepancies in Korea, 2000-2020, with a focus on age, gender, and preventable causes of death, and their impact on life expectancy at birth. The study utilized data from Korean Standard Classification of Diseases and OECD/Eurostat lists of preventable and treatable causes of death and employed Arriaga's method. Noteworthy findings revealed gender disparities in life expectancy increases, with male gaining an advantage over females from 2000-2020 (8.142 years for males versus 6.806 years for females). The most significant increase in life expectancy was found to be in males aged 70-74 and females aged 75-79. The gender gap in LEB is narrowing and that the main age group contributing to the gender gap are getting older. Reduced gains in life expectancy at birth resulted from avoidable mortality, contributing 57.3% to the increase. Cerebrovascular disease and transport accidents were positive contributors, whereas suicide and certain cancers were negative contributors. The changes in mortality for individuals aged 65 and over had an impact of 45.44% (males) and 71.01% (females) on life expectancy gains. This study offers a novel approach in evaluating avoidable mortality and life expectancy, having the potential to improve international health indicators and inform health policies.

Community-led initiatives have emerged as powerful drivers of change in the realm of local environmental protection. This qualitative study, conducted in Acmac, Iligan City in 2020, delves into the motivations, strategies, challenges, and outcomes of community-led initiatives, shedding light on their transformative potential. Through interviews, participant observations, and document analysis, the study explores the themes of community empowerment, collaborative decision-making, environmental justice, sustainable practices, and policy advocacy. The findings reveal the significance of bottom-up approaches, emphasizing the role of community engagement in achieving environmental sustainability. The study contributes to the literature by filling gaps in understanding and providing insights into the dynamics and effectiveness of community-led initiatives. The implications of the findings extend beyond the local context, highlighting the need for inclusive environmental practices and policy frameworks. By fostering community empowerment and collaborative action, this research sets the stage for future research and the promotion of community-led initiatives worldwide.

The aerosol optical depth is an important indicator of aerosol particle properties and associated radiative impacts. AOD determination is therefore very important to achieve relevant climate modeling. Most remote sensing techniques to retrieve aerosol optical depth are applicable to daytime given the high level of light available. The night represents half of the time but in such conditions only a few remote sensing techniques are available. Among these techniques, the most reliable are moon photometers and star photometers. In this paper, we attempt to fill gaps in the aerosol detection performed with the aforementioned techniques using night sky brightness measurements during moonless nights with the novel CoSQM: a portable, low cost and open-source multispectral photometer. In this paper, we present an innovative method for estimating the aerosol optical depth by using an empirical relationship between the zenith night sky brightness measured at night with the CoSQM and the aerosol optical depth retrieved at daytime from the AErosol Robotic NETwork. Such a method is especially suited to light-polluted regions with light pollution sources located within a few kilometers of the observation site. A coherent day-to-night aerosol optical depth and Ångström Exponent evolution in a set of 354 days and nights from August 2019 to February 2021 was verified at the location of Santa Cruz de Tenerife on the island of Tenerife, Spain. The preliminary uncertainty of this technique was evaluated using the variance under stable day-to-night conditions, set at 0.02 for aerosol optical depth and 0.75 for Ångström Exponent. These results indicate the set of CoSQM and the proposed methodology appear to be a promising tool to add new information on the aerosol optical properties at night, which could be of key importance to improve climate predictions.

This paper presents the values of several mechanical characteristics for two blends: H (60% PP + 12% PA6 + 8% EPDM + 20% Polybond 3200) and G (20% PP + 42% PA6 + 28% EPDM + 10% Polybond 3200) (%wt), comparing them to those of PP (polypropylene) and PA6 (polyamide 6). The adding of EPDM (ethylene propylene diene monomer rubber) and Polybond 3200 help reducing the disadvantages of simple blends made of PP+PA6, when the PA6 concentration allows for having a PA6 matrix with droplets of PP. SEM analysis helps for understanding the performance of material G as compared to the neat polymers. EDX analysis proved that there was a matrix inversion, material H having a PP matrix and material G a matrix made of PA6 with droplets of PP. Strain at break for PP and material H were proved to be insensitive to test speed, but materials G and PA6 had large value for strain at break and energy at break for v = 10 mm/min. Taking at basis the values for polyamide 6 (PA6), material G has greater values for energy at break: with 97.8% for v = 10 mm/min, with 29.5% for v= 250 mm/min and with 98% for 1000 mm/min, without exhibiting the micro and macro cavitation of PA6. This means that the recipe, the technology and the mechanical characteristics make material G a potential candidate for applications where a low and moderate impact resistant material is required.

With the growing size and use of night lights time series from the Visible Infrared Imaging Radiometer Suite Day/Night Band (DNB), it is important to understand the stability of the dataset. All satellites observe differences in pixel values during repeat observations. In the case of night lights data, these changes can be due to both environmental effects and changes in light emission. Here we examine the stability of individual locations of particular large scale light sources (e.g. airports, prisons) in the monthly composites of DNB data from April 2012 to September 2017. The radiances for individual pixels of most large light emitters are approximately normally distributed, with a standard deviation of typically 15-20% of the mean. We observe geospatial autocorrelation in the monthly variations for nearby sites, while the correlation for sites separated by large distances is small. This suggests that local factors contribute most to the variation in the pixel radiances, and furthermore that averaging radiances over large areas will reduce the total variation. A better understanding of the causes of temporal variation would improve the sensitivity of DNB to lighting changes.

The application of a commonly used computer algorithm based on the group-additivity method for the calculation of the liquid viscosity coefficient at 292.15K and the activity coefficient at infinite dilution in water at 298.15K of organic molecules is presented. The method is based on the complete breakdown of the molecules into their constituting atoms, further subdividing them by their immediate neighbourhood. A fast Gauss-Seidel fitting method using experimental data from literature is applied for the calculation of the atom groups’ contributions. Plausibility tests have been carried out on each of the calculations using a 10-fold cross-validation procedure which confirms the excellent predictive quality of the method. The goodness of fit (Q²) and the standard deviation (σ) of the cross-validation calculations for the viscosity coefficient, expressed as log(η), was 0.9728 and 0.11, respectively, for 413 test molecules, and for the activity coefficient log(γ)^∞ the corresponding values were 0.9736 and 0.31, respectively, for 621 test compounds. The present approach has proven its versatility in that it enabled at once the evaluation of the liquid viscosity of normal organic compounds as well as of ionic liquids.

Ziziphus tree species offer valuable socio-economic and ecological benefits but experience significant damage from insect pests. In Ethiopia, there is limited knowledge on the insects attacking Ziziphus fruits and a study aimed to identify these pests, assess their impact and understand how different land use types (LUTs), affect them were conducted. Sampling involved collecting fifty fruits and ten leaves from ten randomly chosen Ziziphus trees per LUT within each agroecological zone from August to December in 2022 and 2023. Samples were visually assessed for incidence and infestation levels, and the five morphotypes were identified using molecular techniques through phylogenetic analysis. Fruit pest incidence varied during the season yet a positive correlation (r = 0.84) was observed among the assessment months and years. Most fruits showed low to medium infestation levels (5–50%), while severe infestations (&gt;75%) were predominant in the lowland agroecological zone. The insects attributed to the damage were identified as Carpomya incompleta (Becker), Drosophila hydei Sturtevant, D. simulans Sturtevant and Zaprionus indianus Gupta. Fruits showed higher incidence and infestation levels than leaves, indicating significant yield and income losses. Thus, implementing effective management strategies is vital to minimize these losses and achieve sustainable production in Ethiopia.

The COVID-19 pandemic has significantly altered how people work, with an increasing number transitioning to working-from-home (WFH). This paradigm shift has raised various challenges in adapting living spaces to meet the needs of remote work. Dedicated workspaces or home offices need to be customised for creativity and productivity. Thus, this systematic literature review explores the potential challenges and limitations of implementing modern office design features in residential environments. The study synthesises findings from 108 peer-reviewed articles published within the last decade, focusing on ergonomics, productivity, work-life balance, and spatial constraints. The study found several challenges in translating office design features to home settings. Firstly, spatial limitations in residential areas often restrict the implementation of open-plan layouts and collaborative zones, which are hallmarks of modern office designs. Secondly, the integration of ergonomic furniture and adjustable workstations are limited by budget constraints and the dual-purpose nature of many home spaces. Furthermore, the review highlights the psychological challenges of maintaining work-life boundaries when professional and personal spaces overlap. Noise pollution and distractions emerge as significant factors impacting productivity in home offices, which contrasts controlled modern office environments. The review suggests that the complete replication of modern office design in homes may be impractical, a hybrid approach that adapts key features to residential constraints could enhance home office productivity. Potential solutions could include modular furniture designs, the simulation of collaborative spaces, and the development of noise-cancelling technologies specifically for home environments. This study contributes to the growing body of knowledge on remote work environments and provides valuable insights for enhancing work-life balance, environmental sustainability, and economic growth.

Consumer IoT (CIoT) manufacturers seek customer feedback to enhance their products and services, creating a smart ecosystem like a smart home. Due to security and privacy concerns, Blockchain-based federated learning (BCFL) ecosystems can let CIoT manufacturers update their Machine Learning (ML) model using end-user data. FL uses privacy-preserving ML techniques to forecast customers' needs and consumption habits, and blockchain replaces the centralised aggregator to safeguard the ecosystem. However, Blockchain technology (BCT) struggles with scalability and quick ledger expansion. In BCFL, local model generation and secure aggregation are other issues. This research contributes a novel architecture emphasising Gateway Peer (GWP) in blockchain network to resolve scalability, ledger optimisation and secure model transmission issues. In the architecture we replace the centralised aggregator by the blockchain network, while GWP restricts the number of local transactions to execute in BCN. Considering the security and privacy of FL processes, we have added differential privacy and advanced normalisation techniques to ML processes. The approaches strengthen end-users' cyber security and encourage the adoption of technological innovation standards by service providers. The proposed approach has been tested extensively using a well-respected Stanford Cars dataset. We experimentally demonstrate that the proposed architecture makes the network scalable and optimises the ledger significantly. In addition, the normalisation technique outperforms batch normalisation when features are under DP protection.

The propagation of the coronavirus disease 2019 (COVID-19) reshaped the relationship between income and food-away-from-home (FAFH) expenditure in Mexico during 2020. Although the number of households participating in this market fell across income deciles and regions due to the pandemic, the impact on their budget shares is not uniform. Using data from the Encuesta Nacional de Ingresos y Gastos de los Hogares (ENIGH) 2020, we estimated an Engel curve of the Working-Lesser functional form for FAFH. Among the independent variables are the number of family members 65 years of age and older, and dummies to indicate whether the household experienced food insecurity or received remittances. The estimation was carried out following the Heckman two-step method, suitable for censored-response data. The results suggest that the budget share for FAFH drops as income increases. The number of older adults and food insecurity discourage the decision to participate in FAFH expenditure and increase its budget share, whereas remittances encourage participation and reduce its budget share. The corrected conditional elasticity is 0.4609; the sign and the magnitude indicate that FAFH is a necessity good.

Multicomponent training is recommended for people with dementia living in long-term care homes. Nevertheless, evidence is limited and people with severe dementia are often excluded from trials. Hence, the aim of this study was to investigate (1) the feasibility and (2) the requirements regarding a multicomponent training for people with moderate to severe dementia. The study was conducted as an uncontrolled single arm pilot study with a mixed methods approach. 15 nursing home residents with a mean age of 82 years (range: 75-90 years; female: 64%) with moderate to severe dementia received 16 weeks of multicomponent training. Feasibility and requirements of the training were assessed by a standardized observation protocol. Eleven participants regularly attended the intervention. The highest active participation was observed during gait exercises (64%), the lowest during strength exercises (33%). It was supportive if exercises were task-specific or related to everyday life. This study confirms that a multicomponent training for the target group is (1) feasible and well accepted. To enhance active participation (2) individual instructions and the implementation of exercises related to everyday life is required. The effectiveness of the adapted training should be tested in future randomized controlled trials.

As consequence of COVID-19, millions of households suffered mobility restrictions and changes in their lifestyle during several months. The aim of this study was to evaluate the effects of COVID-19 home confinement in food habits, lifestyle and emotional balance of the Spanish population. This cross-sectional study used data collected via an anonymous online questionnaire during the last month before lockdown finished in Spain in a total of 675 participants. 38.8% of the respondents experienced weight gain while 31.1% lost weight during confinement. The increase in body weight was positively correlated with the age (Rs = 0.14, p &lt;0.05) and BMI (Rs = 0.20, p &lt;0.05). We also identified that 39.7% reported poorer quality sleep, it was positively correlated with BMI (Rs = -0.18, p &lt;0.05) and with age (Rs = -0.21, p &lt;0.05). 44.7% of the participants had not performed physical exercise during confinement with differences by sex (p &lt;0.05), by age (p &lt;0.05), by BMI (p &lt;0.05) and sleep quality (p &lt;0.05). According to emotional-eater questionnaire, 21.8% and 11% were classified as emotional eater and very emotional eater, respectively. We emphasize the importance of adopting a healthy lifestyle, as the COVID-19 pandemic nowadays is ongoing.

Restraint use in Australian residential aged care has been highlighted by the media, and investigated by researchers, government and advocacy bodies. In 2018, the Royal Commission into Aged Care selected ‘Restraint’ as a key focus of inquiry. Subsequently, Federal legislation was passed to ensure restraint is only used in residential aged care services as the ‘last resort’. To inform and develop Government educational resources, we conducted qualitative research to gain greater understanding of the experiences and attitudes of aged care stakeholders around restraint practice. Semi-structured interviews were held with 28 participants, comprising nurses, care staff, doctors, physiotherapists, pharmacists and relatives. Two focus groups were also conducted to ascertain the views of residential and community aged care senior management staff. Data were thematically analyzed using a pragmatic approach of inductive and deductive coding and theme development. Five themes were identified during the study: 1. Understanding of restraint; 2. Support for Legislation; 3. Restraint-free environments are not possible; 4. Low-level restraint, and 5. Restraint in the community is uncharted. Although most staff, health practitioners and relatives have a basic understanding of restraint, more education is needed at a conceptual level to enable them to identify and avoid restraint practice, particularly ‘low-level’ forms and chemical restraint. There was strong support for the new restraint regulations, but most interviewees admitted they were unsure what the legislation entailed. With regards to resources, stakeholders wanted recognition that there were times when restraint was necessary and advice on what to do in these situations, as opposed to unrealistic aspirations for restraint-free care. Stakeholders reported greater oversight of restraint in residential aged care but stated that community restraint use was largely unknown. Research is needed to investigate the extent and types of restraint practice in community aged care.

Anthropogenic lighting elicits positive phototaxis responses (i.e., attraction) in birds, insects, and many other species across ecosystems. Impacts from lights in marine systems are poorly understood, despite evidence that vessel lighting can cause seabird disorientation and collisions, potentially leading to injury or mortality. The level of attraction generated by different types of lighting, including light-emitting diodes (LEDs), is also not well understood in most seabirds. Using fairy prions (Pachyptila turtur), a species showing strong positive phototaxis particularly to artificial lights on vessels, we investigated the effects of LED colour and lumen output at a colony during the breeding season. We used six random treatment groups (control (dark), red light, amber low lumen, amber high lumen, white low lumen, and white high lumen) and measured attraction and disorientation. Data was analysed using generalised linear mixed-effects models while accounting for environmental variables. Results showed that the control (“dark”) and red light attracted fewest birds, and attraction/disorientation did not differ between these. Medium responses were elicited by amber low/high and white low, while white high lumen induced the highest abundance and attraction/disorientation response. These results agreed with our desktop study, which predicted response rankings based on each light treatment’s colour spectrum and lumen output and a related species’ spectral response. Furthermore, time of night increased bird counts, as did higher humidity, increased moon illumination, and reduced moon visibility. Our data highlight the need to consider LED colour, lumen output, and time of night to reduce anthropogenic lighting impacts on land and at sea.

An online survey assessed the awareness of Nelson region’s residents, comparing responses between those who experienced the installation and those who did not. Findings indicated that eco-art installations can significantly enhance public understanding of ALAN's environmental and health impacts. The installation successfully increased specific knowledge about ALAN, with 92% of visitors reporting learning something new, however overarching knowledge and levels of concern were largely similar between the groups. Emotional engagement was high, with 62% of viewers stating that the installation invoked an emotional response. While the study did not measure behavioural changes, 94% of festival participants found it at least ‘somewhat appropriate’ and 64% ‘very’ or ‘entirely appropriate’ to raise awareness of these issues at such events, suggesting a potential foundation for future action. This research underscores the promise of art-science collaborations in environmental education and public engagement.

The main inhibitory neurotransmitter in the mammalian brain is 4-aminobutyric acid (GABA). Phthalimide acts as a sodium channel antagonist, one of the finest targets for treating epilepsy is the sodium channel and JNK kinase activity is inhibited to treat epilepsy. a novel compound with multiple targets of action for the treatment of epilepsy also anti-oxidant activity has been designed. The compounds are designed in two series aldehydes and aniline. Docking of all the designed compounds has been done with the suitable protein GABA-AT, sodium channel, JNK protein, and anti-oxidant from protein bank. QSAR was done for constructing many linear regression models. In combination with the developed Docking and QSAR outcomes, ADMET has been performed for the active compounds. The result shows that 11 of the compounds have excellent binding energy in docking with all the receptors and also have good QSAR results and follow the ADMET. The structural understanding of human GABA-AT inhibition was obtained from molecular dynamics simulation studies for compound no. 11 at 5 nanoseconds. Synthesis and pharmacological activity also suggest that the designed compound no.11 be considered the best Novel Compound.

In this paper, a class of nonlinear ordinary differential equations with impulses at variable times is considered. The existence and uniqueness of solution are given. At the same time, modifying the classical definitions of continuous dependence and Ga^teaux differentiability, some results on continuous dependence and Ga^teaux differentiable of solution relative to the initial value also are presented in new topology sense. For the autonomous impulsive system, the periodicity of solution is given. As an application, properties of solution for a type of controlled nonlinear ordinary differential equation with impulses at variable times is obtained. These results are foundation to study optimal control problems of systems governed by the differential equations with impulses at variable times.

Mosquito-borne diseases (MBDs) are a group of illnesses transmitted by mosquitoes and can be caused by bacteria, viruses, or parasites. These diseases represent a significant global burden of infectious diseases, including morbidity and mortality. This systematic review delves into the multifaceted factors contributing to the spread of mosquito-borne diseases (MBDs) in the Middle East and North Africa (MENA) region. Following PRISMA guidelines, a thorough analysis of peer-reviewed articles from May 1990 to Jan 2023 was conducted, highlighting the interplay of population, environmental, disease, and mosquito factors in disease transmission and prevalence. The review incorporated 31 studies that revealed a complex relationship between various risk factors and the presence of MBDs. Significant associations were observed with age, certain occupations, environmental conditions such as rainfall and temperature, sanitation practices, specific pathogen variants, clinical symptoms, and Aedes aegypti mosquitoes. Conversely, gender, socioeconomic status, educational status, and certain sanitation-related factors showed inconsistent association with the spread of MBDs. The review underscores the need for targeted interventions, including vector control, improved sanitation, and educational campaigns to mitigate the spread of MBDs in the MENA region. This review could guide research studies to address data gaps and assist in developing effective surveillance programs in the MENA region. This work emphasizes the need for region-specific public health strategies and further research to understand and curb the burden of these diseases effectively.

Research has shown that hands-on projects promote stem education, namely, via problem-solving. CanSat, literally 'satellite in a can', is a stem educational project promoted by the European Space Agency. This paper addresses this issue by researching this STEM project, which demonstrates how problem-solving can be achieved in secondary-level students within the framework of the CanSat. We use qualitative techniques of data collection and analysis. The results showed that students use sophisticated thinking strategies to process information within this interdisciplinary project: (a) cognitive testing, cognitive organization, cognitive regulation, and monitoring, in addition to computer language and physical–mathematical calculations, are cognitive and metacognitive behavior strategies revealed in the CanSat; (b) problem-solving was suggested as a specific model, where students’ higher cognitive and metacognitive ordering processes deepen in project development; (c) computational, lateral, or divergent and convergent thinking were detected as thinking types of students associated with and mobilized in the course of problem-solving, The findings of this research have practical implications for STEM education in space science. Hands-on projects using problem-solving are an essential strategy to promote STEM education. Additionally, they are a starting point to promote meaningful learning and new thinking types.

This paper investigates the dynamic tail dependence risk between BRICS economies and world energy market in the context of the COVID-19 financial crisis of 2020, to determine optimal investment decisions based on risk metrics. For this purpose, the study employs a combination of novel statistical techniques ranging from Markov Switching, GARCH and Vine copula. Using a dataset consisting of daily stock and world crude oil prices; we find high probability of transition between lower and higher volatility regimes. Furthermore, our results based on the C-Vine copula confirm the existence of two types of tail dependence: - symmetric tail dependence between South Africa and China; South Africa and Russia; and lower tail dependence between South Africa and India; South Africa and Brazil; South Africa and Oil. For the purpose of diversification in these markets, we formulate an asset allocation problem using C-vine copula-based returns and optimize it using Particle Swarm algorithm with a rebalancing strategy. The results show an inverse relationship between the risk contribution and asset allocation of South Africa and oil market supporting the existence of lower tail dependence between them. This suggests that when South African stocks are in distress, investors tend to shift their holdings in oil market. Similar results are found between China and oil. In the upper tail, South African asset allocation is found to have an inverse relationship with that of Brazil, Russia and India suggesting that these three markets might be good investment destinations when things are not good in South Africa and vice-versa.

To systematically investigate the epidemiology of breast cancer risk factors in Iran, we performed a systematic search via PubMed, Scopus, Web of Science and Persian databases for identifying studies published on breast cancer risk factors up to March 2019. Meta-analyses were done for risk factors reported in more than one study. We calculated odds ratios (ORs) with corresponding 95% confidence intervals (CIs) using a fixed/random-effects models.Thirty-nine studies entered into the meta-analysis. Pooling of ORs showed a significant harmful effect for risk factors including family history (OR: 1.80, 95%CI 1.47-2.12), HRT (OR: 5.48, 95%CI 0.84-1.74), ER positive (OR: 1.87, 95%CI 1.41-2.33), PR positive (OR: 1.84, 95%CI 1.38-2.29), stress condition (OR: 2.67, 95%CI 1.84-3.50), passive smokers (OR: 1.68, 95%CI 1.34-2.03), full-term pregnancy at age 30 (OR: 3.41, 95%CI 1.19-5.63), abortion (OR: 1.84, 95%CI 1.35-2.33), sweets consumption (OR: 1.71, 95%CI 1.32-2.11) and genotype Arg/Arg (crude OR: 1.59, 95%CI 1.07-2.10), whereas a significant protective effect for late menarche (OR: 0.58, 95%CI 0.32-0.83), nulliparity (OR: 0.68, 95%CI 0.39-0.96), 13 to 24 months of breastfeeding (OR: 0.68, 95%CI 0.46-0.90), daily exercise (OR: 0.59, 95%CI 0.44-0.73) and vegetable consumption (crude OR: 0.28, 95%CI 0.10-0.46).This study suggest that factors such as family history, HRT, ER and PR positive status, stress condition, passive smokers, late full-term pregnancy, abortion, sweets consumption and genotype Arg/Arg might increase risk of breast cancer development, whereas late menarche, nulliparity, 13-24 months breastfeeding, daily exercise and vegetable consumption had an inverse association with breast cancer development.

Plants are an important feature of urban ecosystems which provide numerous environmental and ecosystem benefits such as defenses against noise and air pollution and conservation of biodiversity. The aim of this study was to investigate the structure and composition of urban vegetation in different urban habitats like roadsides, parks, gardens and playgrounds in Dhaka South City area. Stratified random sampling method was used in this study. A total of 221 plant species belonging to 63 families were identified and recorded. Among all plant species Swietenia macrophylla, Polyalthia longifolia, Cocos nucifera, Samanea saman, and Artocarpus heterophyllus are recorded as the most dominant. Most of the tree and shrub population were found between 6-9 m and 1-3m height classes whereas most of tree and shrub population were found in between 10-15cm dbh classes. Highest IVI was found for Swietenia macrophylla (193.22%) followed by Polyalthia longifolia (184.59%), Samanea saman (138.37%), Cocos nucifera (79.9%) and Delonix regia (68.27%) respectively. Average frequency, density, dbh and basal area were found 46.82%, 138.28 tree ha^-1, 458.59 cm ha^-1 and 12.33 m² ha^-1 respectively. Findings of this study reveals that structural attributes of plant represent quite young and still developing vegetation. This research will help to plan for future green infrastructure which will maintain ecosystem function, therefore, providing longer term benefits for the city dwellers.

Vancomycin is one of the ‘last-line’ classes of antibiotics used in the treatment of life-threatening infections caused by Gram-positive bacteria. Even though vancomycin was discovered in 1950s it was widely used after 1980s for the treatment of infections caused by methicillin-resistant Staphylococci as prevalence of such strains were increased. However, currently it is evident that vancomycin resistant Staphylococcusaureusandvancomycin-resistant Enterococci have been developed as a result of various reasons including use of avaparcin, which is an analog of vancomycin, as feed additive in livestock. In present day context, more attention should be paid on prevention of emergence of resistance for the antibiotics in order to keep antibiotics effective. In order to prevent emergence of resistance, proper guidance for the responsible use of antimicrobials is indispensable. Therefore, almost all stakeholders who use antibiotics should have in depth understanding on the antibiotic they use. As such, it is imperative to be aware of the important aspects of vancomycin. In the present review, efforts have been made to discussthe pharmacokinetics and pharmacodynamics, indications, emergence of resistance, control of resistance, adverse effects and alternative therapy for vancomycin.

Activities of daily living (ADLs) are fundamental routine tasks that the majority of physically and mentally healthy people can independently execute. In this paper, we present a Semantic Framework for detecting problems in ADLs execution, monitored through Smart Home sensors. In the context of this work, we conducted a pilot study, gathering raw data from various sensors and devices installed in a smart home environment. The proposed Framework combines multiple Semantic Web technologies (i.e. ontology, RDF, triplestore) to handle and transform these raw data into meaningful representations forming a Knowledge Graph. Subsequently, SPARQL queries are used to define and construct explicit rules to detect problematic behaviours in ADLs execution, a procedure that leads to generating new implicit knowledge. Finally, all available results are visualized in a clinician dashboard. The proposed framework can monitor the deterioration of ADLs performance for people in the spectrum of dementia, by offering a comprehensive way for clinicians to describe problematic behaviors in the every-day life of an individual.

Better understanding of the quality of life among nursing home residents with dementia is im-portant for developing interventions. The objectives of this cross-sectional study were to examine factors associated with poor health-related quality of life in older adults with dementia living in nursing homes in Hanoi, Vietnam. In-person interviews were conducted with 140 adults 60 years and older with dementia and information about their quality of life was obtained using the Quality of Life in Alzheimer’s Disease scale (QOL-AD). A number of sociodemographic and clinical factors associated with poor health-related quality of life (lowest tertile) were assessed through the results of physical tests, interviews with nursing home staff, and review of medical records. The average age of the study sample was 78.3 years, 65% were women, and their av-erage QOL-AD total score was 27.3 (SD = 4.4). Malnutrition, total dependence in activities of daily living, and urinary incontinence were associated with poor quality of life after controlling for multiple potentially confounding factors. Our findings show that Vietnamese nursing home residents with dementia have a moderate quality of life and interventions based on comprehen-sive geriatric assessment remain needed to modify risk factors associated with poor health-related quality of life.

Home care centers face both an increase in demand and many variations during the execution of routes, compromising the routes initially planned: robust solutions are not effective enough, it is necessary to move on to resilient approaches. We create a close to reality use case supported by interviews of staff at home health care centers, where caregivers are faced with unexpected events that compromise their initial route. We model, analyze and compare three resilient approaches to deal with these disruptions: a baseline approach without any collaboration, a distributed collaborative approach, and a centralized collaborative approach, where we propose a centralization and sharing of information to improve local decision-making. The latter reduces the number of late arrivals by 11% and the total time of late arrival by 21%, and also halves the number of routes exceeding the end of work time (contrary to the distributed collaborative approach, due to the time wasted reaching colleagues). The use of a device, such as a smartphone application, to centralize and share information thus allows better mutual assistance between caregivers. Moreover, we highlight several possible openings like the coupling of simulation and optimization to propose a more resilient approach.

To examine the association of sleep quality and work from home with physical inactivity (PI) in leisure time during Covid-19 pandemic. A population-based household survey was conducted in two Bra-zilian municipalities from October to December 2020. Leisure-time physical activity (PA) was self-reported, and individuals who practiced less than 150 minutes of moderate PA or 75 minutes of vigorous PA weekly were classified as PI. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). WFH was assessed by: "Currently, how is your work routine regarding location? Associations were investigated using logistic regression and directed acyclic graphs (DAG) for the multivariate models. A total of 1,750 adults were interviewed, 69.1% were PI and 51.9% had poor sleep quality. Furthermore, 79.8% were not in WFH. In multivariate analysis, leisure PI was associated with poor sleep quality (OR:1.59: 95% CI: 1.02-2.48), and not being in WFH (OR:1.62: 95% CI: 1.05-2.50). When performing the combined analysis between these two factors, and who were not in WFH were four times more likely to be PI at leisure (OR=4.22;95%CI:2.05-8.65). The results indicate a high prevalence of PI, with poor quality sleep and non-WFH associated with leisure PI. These combined factors exacer-bated the occurrence of PI.

Background: Approximately 75% of all head and neck cancer patients are treated with radiotherapy (RT). RT to the oral cavity results in acute and late adverse events which can be severe and detrimental to a patient’s quality of life and function. The purpose of this study was to explore associations between RT dose to a defined oral cavity organ at risk (OAR) avoidance structure, provider and patient reported outcomes (PROs), opioid use, and hospitalization. Methods: This was a retrospective analysis of prospectively obtained outcomes using multivariable modeling. The study included 196 patients treated with RT involving the oral cavity for a head and neck tumor. A defined oral cavity OAR avoidance structure was used in all patients for RT treatment planning. Validated PROs were collected prospectively. Opioid use and hospitalization were abstracted electronically from medical records. Results: Multivariable modeling revealed the mean dose to the oral cavity OAR was significantly associated with opioid use (p=0.0082) and hospitalization (p=0.0356) during and within 30 days of completing RT. Conclusion: The findings of this study may be valuable in RT treatment planning for patients with tumors of the head and neck region to reduce the need for opioid use and hospitalization during treatment.

The Genji firefly is a key symbol of the conservation and management of rural environments. The species lives underwater as larvae, in the soil when they pupate, and emerges on the ground as adults. Because of the large differences in habitat conditions between larvae and adults, the habitat requirements of the Genji firefly must be clarified over a wide range, from the instream to the surrounding riparian environment. In this study, we built a habitat suitability model for the Genji firefly by relating local landscape features to the number of individuals surveyed in a small river in an agricultural watershed. For habitat suitability modelling, tree-based machine learning methods, namely Random Forests (RF) and classification and regression trees (CART), are used to model species distributions and extract quantitative information on their ecological characteristics. Because the model performance on the test dataset was poor, we removed noisy absences using model outputs from the RF computation using the entire dataset. As a result, we observed improved model performance, in which there seems to be an optimal level for removing noisy absences. Variable importance and partial dependence plots were then used to visualize the relationship between the local landscape features and habitat suitability of the adult firefly. Detailed information on landscape features extracted using RF and CART is useful for a deeper understanding of the ecology of the Genji fireflies.

Multi-level direct networks fueled by the evolving technology of active optical cables and increasing pin-bandwidth achieve reduced diameters and cost, with high-radix switches. These networks, like Dragonfly, are becoming the preferred aspirants for extreme high-performance parallel machines such as exa-scale computing. In this paper, we introduce a Hyper Z-Tree topology, which deploys the Z-Tree, a variant of fat-tree, as a computing node of a Generalized Hypercube (GHC) configuration. The resulting configuration provides higher bisection bandwidth, lower latency for some applications and higher throughput. Furthermore, the levels of the fat tree offer several path diversities across the GHC dimensions, hence conceding a more fault tolerant architecture. To profit from these path diversities, we propose two adaptive routing algorithms, which are extensions to the routing algorithm suggested in HyperX topology. These two algorithms exhibit better latencies and throughput than the HyperX.

Since 2017 Cartagena UNESCO World Heritage has threatened to be categorized as "in Danger" by UNESCO. This research analyzes two main critical aspects, Governance and Current state of the Site. Regarding Governance, the study aims to identify strengths, weaknesses, opportunities and treats in the UNESCO Site. Exemplary heritage management systems are studied to propose an adaptable management approach specifically for Cartagena. On the other hand, a comprehensive analysis is conducted utilizing a photographic report that highlights the major issues arising from inadequate heritage management. Hyperspectral images obtained from a previous study are employed to identify vegetation and asbestos-cement roofs within the cultural heritage Site. The study reveals that the ambiguity surrounding decision-making authority for heritage management, distributed between the Mayor's Office and the Ministry of Culture, is a primary challenge. This fragmentation has resulted in duplicated efforts and a lack of coordinated action, significantly compromising the conservation and protection of the cultural heritage Site. Moreover, twelve current shortcomings of cultural heritage in Cartagena are identified through authors' five-year on-site regular visits, photographic reports and observation. To address the prevailing concerns, a new line of command for cultural heritage management is proposed as the most effective means of tackling these challenges. Additionally, general recommendations are presented to mitigate the existing problems and prevent the classification of Cartagena's heritage as "at risk" by UNESCO in the near future. This research provides a scientific perspective, drawing upon years of experience studying heritage and residing in the city, devoid of political influences or conflicts of interest.

We analyze the upside and downside risk connectedness among international stock markets. We characterize the connectedness among international stock returns using the Diebold and Yilmaz spillover index approach and compute the upside and downside value-at-risk. We document that the connectedness level of the downside risk is higher than that of the upside risk and that stock markets are more sensitive when the stock market declines. We also find that specific periods (e.g., the global financial crisis, the European debt crisis, and the COVID-19 turmoil) intensify the spillover effects across international stock markets. Our results demonstrate that the EU, Ger-many, and the US acted as net transmitters of dynamic connectedness; however, Japan (JP), China (CH), and India (IN) acted as net receivers of dynamic connectedness during the sample period. These findings provide significant new information to policymakers and market participants.

A brief (subjective) description of the state of the art of the many-worlds interpretation of quantum mechanics (MWI) is presented. It is argued that the MWI is the only interpretation which removes action at a distance and randomness from quantum theory. Limitations of the MWI regarding questions of probability which can be legitimately asked are specified. The ontological picture of the MWI as a theory of the universal wave function decomposed in a superposition of world wave functions, the important part of which are defined in three-dimensional space, is viewed from the point of view of our particular branch. Some speculations about misconceptions which apparently prevent the MWI to be in the consensus are mentioned.

In this study, we discuss the properties of absolute vacuum space and how these properties can play a vital role in creating a mechanism in which the very first particle gets created simultaneously everywhere and we find the limit in which when the absolute vacuum volume reaches will lead to the collapse that leads to the creation of the first particle. This discussion is made following to the elementary dimensions theory study that was peer-reviewed at the end of 2020, everything in the universe is made from four elementary dimensions, these dimensions are the three spatial dimensions (X, Y, and Z) and the Vacuum resistant as the factor of change among the four, time itself wasn’t considered as the fourth dimension, rather time corresponds to a factor of change, and during the research it was found out that the Vacuum resistant is the factor of change in the Absolute Vacuum space, where time is a hypothetical concept, that represents changes during certain events compared to a constant change rate event.Therefore, time does exist, but as a factor of change, and as the Vacuum resistant in the absolute vacuum space, Time= factor of change= Vacuum resistant. In the study, the internal and external vacuum resistant volume equivalent is found, External Vacuum resistant=3.2857602*10^15 *mass. This equation is used to identify the amount of Free external vacuum resistant created during nuclear fission and fusion: Initial mass of the excited nucleuses mass of the created new nucleuses+ 3.2857602*10^15 * the lost Mass. In elementary dimensions, the energy created during nuclear reactions is equivalent to the free External vacuum resistant created through nuclear reactions, and mass is equivalent to the internal Vacuum resistant.

A close analysis of the text of Gen. 2:8-15, pertaining to the garden of Eden, shows the structural differences between said text and others from ancient mythologies that mention or describe a paradise. Likewise, that analysis suggests that the data provided by the Bible to locate paradise is merely a narrative device meant to dissipate all doubts as to the existence of the garden where God put human beings. Similarly to other spaces that appear in the Bible, the garden of Eden is but an impossible place. Throughout the centuries, however, recurring proposals have been made that aim to find paradise. As time went by, those proposals were progressively modified by the intellectual ideas dominant at any given era, thus leading the representations of the location of Paradise further and further away from the information provided by the biblical text.

The evaluation was conducted to find out whether the stipulated objectives of the policy are being followed, and at the same time find out whether the envisioned results of implementing such policy system have been achieved so far. The evaluation was expected to provide an opportunity for mending shortfalls of the whole system that would affect its sustainability and usefulness.A total of 33 participants were interviewed in this study and came from the study area (Nkhotakota District Council Office). Purposive sampling was used to select the participants. All study respondents were purposively selected where respondents considered having relevant information and they were interviewed to obtain wide range of perspectives.Seven themes were identified; knowledge on policy, limited stakeholder involvement, poor HIV and AIDS programming, ethical issues, future perspective of the policy, Other Recurrent Transaction (ORT) allocation, and availability of HIV and AIDS Committee. On knowledge on policy, the sub-themes included; objectives well outlined, and poor updates on the policy. On limited stakeholder involvement, the sub-themes were; lack of ownership, ignorance of involvement, and not involved/limited involvement. On the Poor HIV and AIDS programming theme, sub-themes identified were; exclusion of activities in the District Implementation Plan (DIP) and lack of funds. There was one sub-theme on ethical issues and future perspective.We found that the Nkhotakota District Council HIV and AIDS at workplace policy is not functioning properly due to poor coordination and lack of funding. However, there are some positives identified such as existence of the coordinating committee and allocation of funds through ORT. Although the system has been functional for some years in well-established structures, lack of participation by some stakeholders, non-inclusion of HIV and AIDS activities in the DIPs underpin its sustainability

Objectives: COVID-19, a respiratory disease caused by SARS-COV2 and transmitted from person-to-person through viral droplets remains a global pandemic. There is a need to understand the transmission modes, populations at risk, and how to mitigate the spread and case fatality in the United States (US) and globally. The current study aimed to assess the global COVID-19 transmission and case fatality, examine similar parameters by countries and determine evidence-based practice in extreme epidemiology response in epidemic curve flattening and case fatality reduction. Methods: A cross-sectional ecologic design was used to assess the preexisting data on confirmed COVID-19 cases and mortality in March 2020 from the CDC, WHO, Worldodomter, and STATISTA. A rapid assessment between March 23^rd and 31^st, 2020, was utilized for the extreme epidemiology response. The case fatality, termed fatality proportion, was examined using mortality in relation to confirmed cases involving the world, United States of America (USA), United Kingdom (UK), Italy, France, Spain, China, Germany, India and South Korea. Results: The COVID-19 is a global pandemic, with the US as the epicenter for transmission, representing 20.9% of all confirmed cases worldwide, while Italy is the epicenter for case fatality, 30.6% of mortality as at 03/31/ 2020. The fatality proportion (FP) in Italy was 11.4%, Spain (8.8%), France (6.8%) and UK (6.4%). Despite the increased number of confirmed cases, the lowest FP was observed in Germany (0.96%) and South Korea (1.66%). There is increasing linear tends in transmission in the US, R²=0.97 as well as positive daily percentage change, ranging from 1.27% to 20.5%. Conclusions: The USA remains the epicenter for COVID-19 transmission, while Italy is the epicenter for case fatality. The observed relatively low case fatality in Germany and South Korea is due to an “extreme epidemiology” response through the application of Wuhan, China’s early data on COVID-19 transmission control measures and optimized patient care. These data are suggestive of relaxing the clinical guidelines in the United States in COVID-19 testing, application of contact tracing and testing, case isolation and most importantly enhancing resources for case management and social and physical distancing globally, hence epidemic curve flattening and case fatality reduction.

This study employed a deductive research approach and a survey strategy to assess risk perception and its influencing factors among construction workers in Malawi. Three specific construction hazards and their associated risks were selected. The hazards were ‘working at height (WAH) ‘manual handling of loads (MHL)’ and ‘heavy workload or intense pressure to be more productive (HWP)’. The study engaged multistage sampling of 376 subjects. Univariate analysis, factor analysis and multiple linear regressions were performed in order to determine the main influencing factors among the independent variables. The study established that workers were aware of risks posed by their work. They perceived the risk associated with WAH, MHL and HWP as very high (62.7%, = 8.80 ± 1.95); (48.5%, = 8.10 ± 2.38); (57.9%, = 8.49 ± 2.22) respectively. The study identified six factors as variables that showed significant effect on workers’ perception of risk (p < 0.05). These factors were “dreaded factor”, “avoidability and controllability”, “expert knowledge”, “personal knowledge”, education level and age. It is concluded that contractors in the Malawian construction industry should integrate analysis of behaviors and risk perception of the workers and other players to guide the identification of better health and safety interventions at their worksites.

Purpose: Expanded carrier screening (ECS) informs couples of their risk of having offspring affected by certain genetic conditions. Limited data exists assessing the actions and reproductive outcomes of at-risk couples (ARCs). We describe the impact of ECS on planned and actual pregnancy management in the largest sample of ARCs studied to date. Methods: Couples who elected ECS and were found to be at high risk of having a pregnancy affected by at least one of 176 genetic conditions were invited to complete a survey about their actions and pregnancy management. Results: Three hundred ninety-one ARCs completed the survey. Among those screened before becoming pregnant, 77% planned or pursued actions to avoid having affected offspring. Among those screened during pregnancy, 37% elected prenatal diagnostic testing (PNDx) for that pregnancy. In subsequent pregnancies that occurred in both the preconception and prenatal screening groups, PNDx was pursued in 29%. The decision to decline PNDx was most frequently based on the fear of procedure-related miscarriage, as well as the belief that termination would not be pursued in the event of a positive diagnosis. Conclusions: ECS results impacted couples’ reproductive decision-making and led to altered pregnancy management that effectively eliminates the risk of having affected offspring.

We prove: (1) the set of all Diophantine equations which have at most finitely many solutions in non-negative integers is not recursively enumerable, (2) the set of all Diophantine equations which have at most finitely many solutions in positive integers is not recursively enumerable, (3) the set of all Diophantine equations which have at most finitely many integer solutions is not recursively enumerable, (4) analogous theorems hold for Diophantine equations D(x₁, …, x_p) = 0, where p ∈ N\{0} and for every i ∈ {1, …, p} the polynomial D(x₁, …, x_p) involves a monomial M with a non-zero coefficient such that x_i divides M, (5) the set of all Diophantine equations which have at most k variables (where k ≥ 9) and at most finitely many solutions in non-negative integers is not recursively enumerable.

Background/Objectives: Home and community care (HCC) nurses experienced increased occupational challenges during the COVID-19 pandemic including increased workloads, job stressors and occupational risks like virus exposure. The objective was to elucidate what factors influenced nurses’ decisions to stay in their role, take a temporary leave, or exit HCC during the COVID-19 pandemic. Methods: A secondary analysis of data collected using a cross-sectional online open survey distributed among HCC Registered Practical Nurses across Ontario between June and September 2022 was conducted. The factors contributing to nurses’ decision to remain in HCC, temporarily leave, or exit the sector were evaluated using multinomial logistic regression (p < 0.05). Results: Of the 664 participants, 54% (n=357) stayed in the HCC sector, 30% (n=199) temporarily left, and 16% (n=108) exited the sector. Nurses with greater years of experience working in HCC and those who avoided infection were more likely to stay in their role in HCC, which may reflect strong relationships with long-term clients, opportunity and accumulated experience to increase income, and maintained good health. Nurses with higher levels of emotional intelligence were more likely to take leaves and exit HCC, suggesting that stepping away may have been a strategy to safeguard themselves. Conclusions: HCC leadership should prioritize the development of solutions to support nurses in the HCC workforce, including those with fewer years’ experience. This may promote nurses’ participation in the sector, particularly during times of heightened occupational challenges and crises like COVID-19.

The EXO+ hip protector was developed to minimize the risk of hip fractures in seniors following falls. This study evaluated its usability in a Singapore nursing home from the perspective of staff, focusing on Learnability, Efficiency, and Satisfaction. A mixed-method design was employed, with nursing home residents wearing the EXO+ daily for 8 weeks. Quantitative data on wear time was collected alongside qualitative insights from four repeated focus group discussions with care staff. In total, 15 residents (including 8 residents with cognitive impairments) and 9 staff participated. The analysis revealed six themes and fourteen subthemes related to EXO+’s usability. Residents wore the device for an average of 1.54 hours per day, with those having cognitive impairments showing increased wear times, especially in the mornings and on weekdays. Findings indicated that the EXO+ was learnable and satisfactory for nursing home use, provided there are adequate supporting features. The efficiency of the EXO+ was not fully measured since no falls were reported during the study period. The study offers valuable insights for potential design modifications and workflow adaptations to enhance the implementation of hip protectors in healthcare settings, highlighting facilitators and barriers to support device uptake.

This pilot randomized controlled trial (RCT) aimed to explore whether depression and anxiety could be reduced by psychiatric home healthcare supporters offering brief cognitive behavioral therapy for psychosis (CBTp) at home using a workbook for patients with schizophrenia. Eighteen patients with schizophrenia treated in a psychiatric home nursing service were randomly assigned to two groups: one group received CBTp in addition to usual care (CBTp + TAU group; n=8) and the other received only usual care (TAU group; n=8); 2 patients were excluded due to hospitalization or withdrawal of consent. Eight weekly CBTp sessions were conducted; anxiety/depression, quality of life, self-esteem, and overall functioning were assessed at baseline, week 9, and week 13. There was no significant difference in the primary evaluation; however, a significant improvement (p=0.014) was observed in the secondary evaluation of quality of life. The effect size was 0.95 for primary evaluation and 1.33 for the secondary evaluation, indicating a large effect. This study showed that nurses and occupational therapists can provide CBTp in psychiatric home care for patients with schizophrenia to potentially alleviate anxiety and depression compared to standard psychiatric home care alone. Therefore, larger RCTs with larger sample sizes are recommended.

The purpose of this qualitative study was to describe parent perceptions of the home exercise pro-gram (HEP) for their infant with congenital muscular torticollis (CMT), and how these perceptions evolved over a physical therapy (PT) plan of care. Twelve participants were recruited from a pediatric PT clinic, and nine completed interviews at three time points. Qualitative description and an iterative approach for thematic analysis of 27 interviews yielded three themes that corresponded to the research questions. The participants’ responses were categorized into three main themes: 1) parents’ perceptions of three key exercises within the HEP; 2) internal and external sources of stress; and 3) sources of empowerment and disempowerment. Regarding the HEP, parents articulated common sentiments for three frequently prescribed exercises for the management of CMT: 1) Tummy time was the fast favorite, 2) ipsilateral cervical rotation was perceived as stressful, and 3) contralateral cervical lateral flexion felt uncomfortable. Additionally, participants disclosed internal and external sources of stress (guilt, uncertainty, and the demands of returning to work) and sources of disempowerment (inconsistent messaging from providers, feeling overwhelmed) and empowerment (being able to see the bigger picture and clear communication and education about the diagnosis) with respect to managing their infant’s CMT. These themes provide insight into the evolution of parent perceptions over a PT plan of care for CMT. Participants’ insights suggest a need for consistent messaging regarding the diagnosis and evidence-based management of CMT, addressing parent stress, and modifying how exercises are taught. This study contributes updated research on parents’ experience with physical therapy and the HEP for their infant’s CMT.

The growing congestion in delivery rooms and maternity wards in Israeli hospitals is the underlying issue of the current study. The study sought to examine various alternatives for an effective public policy aimed at reducing congestion. The choice of Israel as a case study derives from its conspicuous imbalance between supply and demand in the maternity, resulting from the high demand for prenatal and birthing services on one hand and the low supply, both in absolute terms and relative to OECD countries, of medical resources such as physicians, nurses, and hospital beds. The research findings present fertility and birth data for Israel in the last decade, which are leading to increased congestion and crowding in delivery rooms and maternity wards at local hospitals. At the same time, two possible alternatives are proposed for designing and implementing public policy capable of contributing to the regulation of this congestion. One alternative is the option of home birth and the second is promoting the establishment of private birthing centers outside the hospitals. The research conclusions indicate that policy makers in Israel must anticipate the increasing congestion in hospital delivery rooms and maternity wards and expedite efforts at designing alternative solutions before the emergence of a crisis situation that will make it essential to identify immediate solutions. The study recommends exploring and advancing the adoption of the two alternatives simultaneously as part of public policy, in the assumption that the increasing demand for pregnancy and childbirth services in Israeli society will persist and therefore it is necessary to act to increase the supply of childbirth facilities.

Mental healthcare conditions in India are severely deficient, particularly concerning the living conditions of patients. Post-treatment, numerous individuals with mental illness are abandoned by their families, who may lack the willingness or financial means to care for them. These recovered patients often experience setbacks due to the absence of facilities aimed at developing the skills necessary for reintegrating into society. The lack of separate accommodations for recovered individuals forces them to reside with other patients, worsening their condition. The government is struggling to accommodate and finance the care of recovered patients, affecting those in need of treatment as hospital bed space becomes overwhelmed by the increasing number of cured individuals. Therefore, there is an urgent need for halfway homes. These facilities offer a range of services, including social, medical, psychological, and educational support, alongside housing. The term "halfway houses" reflects their position between fully independent living and highly regulated in-patient or correctional facilities. Following treatment, many patients experience abandonment by their families or encounter difficulties returning home due to memory loss. Recovered patients often live in confined spaces, lacking essential social skills. Therefore, establishing a workspace focused on teaching social and other necessary skills before reintegrating them into society would be a beneficial approach. This would provide a structured environment for individuals who have spent significant time in seclusion, assisting them in developing the skills needed to navigate societal challenges effectively. Recent reports indicate that over 2,000 cured patients are still housed in mental hospitals across the country, according to the NHRC. The NHRC has raised concerns about the situation, noting that all 46 Government Mental Healthcare Institutions in India display very poor and inhumane treatment of patients, leading to the issuance of notices. NHRC visits have revealed deplorable conditions in all 46 mental institutes across the country.

Researchers are always looking to find ways to use energy more efficiently while keeping people comfortable at home. They've tried different methods like fuzzy logic and genetic algorithms to do this. In this paper, we introduce a novel model that combines different techniques like data smoothing, optimization, machine learning, and control algorithms to reach this goal in smart homes. The proposed model is made up of three main parts: smoothing, optimization, and control. The smoothing part uses the Kalman filter to get rid of any unnecessary noise and make sure the data used to predict energy use is clean and smooth. The optimization part uses both genetic with firefly algorithms and artificial neural networks to minimize the gap between the actual environmental conditions and the conditions users find comfortable. It adjusts the comfort settings in real-time using machine learning. The control part uses Mamdani fuzzy logic to make sure energy is delivered in the best way possible to the systems that control temperature, lighting, etc., making the home comfortable and saving energy at the same time. Comparative analyses demonstrate the superiority of the proposed model over existing algorithms, including the Particle Swarm Optimization (PSO) algorithm. Additionally, the paper discusses the importance of adaptive controllers in addressing issues associated with incorrect PID controller selection and highlights the benefits of using the FA-GA in energy optimization and comfort improvement. Overall, the proposed model offers an effective solution for efficient energy consumption optimization and enhanced user comfort in diverse settings through the integration of advanced algorithms and optimization modules.

The common dolphin is the second most bycaught species in Korean waters. To provide key information about their habitat boundaries and hotspots for spatial conservation and management, the spatial use of this species was examined using data obtained from sighting and bycatch surveys of cetacean during the past 20 years. The 95% minimum convex polygon and 95% density contour of fixed kernel suggested that the boundary of home range of common dolphins is limited to the coastal region (Busan-Sokcho) of the East Sea/Sea of Japan. From 50% density contours dawn by kernel density estimation, it was suggested that their hotspots are around the cost of Ulsan-Pohang, Doghae, and Sokcho within the home range. Common dolphins are not at all distributed in the Yellow Sea. Hence, shallow waters, such as the coastal region of the Yellow Sea, are not suitable habitats for common dolphins.