Chronic pain is a serious health concern and potentially debilitating condition, leading to anxiety, depression, reduced productivity and functionality, and poor quality of life. This condition can be even more detrimental and incapacitating in the pediatric patient population. In low and middle income countries (LMICs), pain services are inadequate or unavailable, leaving most of the world's pediatric population with chronic pain untreated. Many of these children in LMICs are suffering without treatment, and often die in pain. Awareness and advocacy for this population must be prioritized. We reviewed the available literature on the chronic pediatric pain burden in LMICs, barriers to treatments, and current efforts to treat these patients.

Background: Studies on infectious endocarditis (IE) are mostly limited to institutions, which highlights the need for more comprehensive epidemiological studies. Objective: To verify the profile of deaths due IE and the relationship with deaths from other causes and conditions in Brazil and regions. Method: Study in database from the Brazilian Mortality Information System, from 2000 to 2019. Mentions of deaths due to IE, other causes and conditions were identified according to ICD-10. Cluster analysis was performed to verify the relationship between variables. Results: 52,055 deaths from IE were found, with a predominance of males, aged 60 to 79 years, in the Southeast, with deaths from the circulatory system most frequent. Three profiles were identified: 1 - age equal to or greater than 80 years, women, deaths due endocrine, circulatory and metabolic diseases, in the South and Southeast; 2 - also in the South and Southeast, age between 30 and 79 years, men, deaths due infectious and genitourinary diseases; 3 - 0 to 29 years, no genders differences, deaths due diseases of the respiratory system, in the North, Northeast and Central-West. Conclusion: Cluster analysis showed diversity in the profiles of deaths due IE, indicating heterogeneity in regions of the country.

Background: Nephrolithiasis, or kidney stone disease, presents a significant global health burden, with incidence rates and treatment practices varying widely globally. This study aims to discuss the epidemiology, risk factors, treatment modalities, and challenges for nephrolithiasis in the lower half of the World Bank Rank; low and lower-middle-income countries. Methods: A comprehensive literature review was conducted using PubMed for each country on the list, focusing on studies published from January 2000 onwards and reporting data on prevalence, risk factors, treatment practices, and economic implications. Results: Nephrolithiasis represents a significant burden for healthcare systems, with noteworthy geographical variability in prevalence possibly dependent on socioeconomic status and gender. Risk factors include dietary habits, climate, pollution, and infectious diseases. Treatment practices in some regions still rely on open surgery due to limited access to advanced endourological techniques, while other regions demonstrate high proactivity in research. The burden is exacerbated by inadequate healthcare infrastructure and training. Conclusions: Addressing nephrolithiasis in challenging economic circumstances requires targeted interventions, including improved access to modern treatment methods, enhanced training for healthcare professionals, and better socioeconomic and environmental conditions. Future research should focus on region-specific strategies and the development of sustainable healthcare solutions.

Pharmaceutical poisoning is a significant global public health concern, causing approximately 190,000 deaths yearly. This scoping review aims to comprehensively map the available literature on pharmaceutical poisoning and compare patterns between high-income countries (HICs) and low-middle-income countries (LMICs). A systematic search was performed across the following databases: Embase, PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and CINAHL. Studies included were from 1st January 2011 to 31st December 2020, in English, with full text available. Seventy-nine articles were included in the study; 21 were from LMICs and 58 were from HICs. The toxic exposure was largely intentional (77%) in LMICs and accidental (68%) in HICs. Drugs acting on the nervous system were responsible for 95% of toxicities worldwide with analgesics accounting for the largest subtherapeutic group in both LMICs (40%) and HICs (58%). Notable statistics were that HICs accounted for 99% of opioid overdoses, and LMICs accounted for 19% of anti-epileptic-induced toxicities. Overall, the medical outcomes of poisonings were generally worse in LMICs. The review provides possible interventions to target specific geographic locations, based on the trends identified, to reduce the burden worldwide. Many gaps within the literature were recognised, calling for more robust analytical research.

During puberty and emerging sexuality, adolescents experience important physical, mental, and social transformations. In the process of dealing with these changes, adolescents can become potentially vulnerable to mental health problems.The aim was to identify and synthesize published research evidence on sexuality-related mental health stressors among adolescent girls and boys, identify gaps (if any) in current knowledge, and contribute to knowledge about the experiences of emerging sexuality and health among adolescents, to further inform research, practice, and policy initiatives in sexual health.A scoping literature review of peer-reviewed articles published between 1990 and 2018. MEDLINE, CINAHL, EMBASE, PsycINFO, Global health, ERIC, and Sociological Abstracts databases were searched for research studies that reported experiences of sexuality related mental health issues and symptomatology of adolescents. We targeted studies conducted with adolescent populations between ages 11-24 years living in LMICs.Data from 12 published research papers, including 8 qualitative studies, 3 quantitative studies, and 1 mixed method study, were systematically analyzed. Four major themes and 4 sub themes were identified regarding sexual health and mental health of adolescents: 1) Relationship of sexuality and mental health; 2) Social and cultural influences; 3) Challenges in seeking sexuality information and services among adolescents; and 4) Educational needs among adolescents related to sexuality; and 4) Educational needs among adolescents related to sexuality. Lack of social support, Unmet needs for accessible adolescent friendly sexual health services, counseling, and age-appropriate information may be associated with several mental health stressors and symptoms, such as sadness, depressive and anxiety symptomatology, regret, fear, embarrassment, low self-esteem, guilt, shame, and anger. Therefore, tackling sexuality-related stressors could play an important role in addressing the overall wellbeing of young people. Future studies need to generate a deeper understanding of the concept of sexual health and its relation to mental health in diverse contexts. Health care professionals need to be aware of sexuality-related experiences of adolescent girls and boys by offering effective youth-friendly sexual and reproductive health education to support overall mental health and improve the experiences of emerging sexuality in adolescents.

Advanced Hepatocellular carcinoma (HCC) is no longer a terminal illness. This change was mainly attributed to the development of new treatments including tyrosine-kinase inhibitors (TKIs), vascular endothelial growth factor (VEGF) inhibitors and immune checkpoint inhibitors (ICPIs) but the financial toxicity of treating advanced HCC is of a major concern specially in low middle-income countries (LMICs) where the patients are still battling for their most basic rights. Most of advanced HCC patients in LMICs have very limited accessibility to the new treatments including ICPIs. Searching for out of the box solutions to improve access to treatments -mainly ICPIs- is an utmost necessity for LMICs advanced HCC patients.

In response to new developments of work and employment in high-income countries (HICs), psychosocial aspects of work and health received increased attention. In contrast, middle-income countries (MICs) are mainly concerned with severe challenges of noxious and dangerous material work environments, poor employment conditions, and deficient social policies, leaving psychosocial aspects in a marginal role at best. More recently, differences between these two worlds were even aggravated by the COVID-19 pandemic. Yet, with economic globalisation and growing worldwide interconnectivity, the world of work in MICs is being rapidly transformed, sharing several concerns with modern Western societies. In this process, psychosocial occupational health will become an increasingly pressing issue. This contribution explores to what extent psychosocial aspects of work and health are already addressed in research originating from MICs. A selective focus on recent findings from two regions, Asia Pacific and Latin America, reveals a high degree of awareness of, and inquiry into, work-stress related problems within these countries. Importantly, in addition to incorporating research progress from HICs, these analyses identify new aspects within specific cultural and socio-economic environments, thus enriching the international state of art.

Background/Objectives: The burden of hospital-acquired infections (HAIs) is particularly sub-stantial in low- and middle-income countries (LMICs). However, a comprehensive understanding of their prevalence in these regions is lacking. This systematic review aimed to evaluate the prevalence of HAIs in LMICs. Methods: Major databases, including Scopus, PubMed, and Web of Science, were thoroughly searched for published studies between January 1, 2000, and July 15, 2024. The PRISMA guidelines were followed for a comprehensive and systematic approach. The pooled prevalence of HAIs was estimated using a random-effects model and a 95% confidence interval (CI). Results: The literature search identified 87 studies reporting HAI prevalence in LMICs. The overall prevalence of HAIs across LMICs was 22% (95% CI: 17-28), with notable regional variations. The South-East Asian Region (SEAR) presented the highest prevalence at 37% (95% CI: 13-62), followed by the African Region at 25% (95% CI: 16-33). The European Region (EUR) had the lowest preva-lence, at 14% (95% CI: 5-23). In terms of income level, low-income countries had the highest prevalence at 37% (95% CI: 23-52), followed by lower-middle income at 22% (15-30) and up-per-middle income at 13% (95% CI: 6-20). Surgical site infections (SSIs) had the highest prevalence among infection types at 27% (95% CI: 23-31), followed by pneumonia at 23% (95% CI: 18-28) and urinary tract infections (UTIs) at 22% (95% CI: 19-26). Gastrointestinal infections (GIs) were less prevalent at 6% (95% CI: 3-9). Conclusions: This systematic review underscores the high prevalence of HAIs in most LMICs, with variations based on region and income level, emphasizing the need to facilitate the development of targeted prevention and control strategies to mitigate the impact of this critical public health issue, especially in resource-limited settings.

Objectives: Low and Middle Income Countries (LMICs) are experiencing a fast-paced epidemiological rise in clusters of non-communicable diseases (NCDs) such as diabetes and cardiovascular disease, forming an imminent rise in multimorbidity (MMD). However, preventing MMD has received little attention in LMICs, especially in Sub-Saharan African Countries. Design: Narrative review which scoped the most recent evidence in LMICs about MMD determinants and appropriated them for potential MMD prevention strategies. Methods: MMD in LMICs is affected by several determinants including increased age, female gender, environment, lower socio-economic status, obesity, and lifestyle behavious, especially poor nutrition and physical inactivity. Results: MMD public health interventions in LMICs, especially Sub-Saharan are currently impeded by local and regional economic disparity, underdeveloped healthcare systems, and concurrent prevalence of communicable diseases. However, lifestyle interventions that are targeted towards preventing highly prevalent MMD clusters, especially hypertension, diabetes and cardiovascular disease, can provide an early prevention of MMD, especially within Sub-Saharan African countries with emerging economies and socio-economic disparity. Conclusion: Future public health initiatives should consider targeted lifestyle interventions and appropriate policies and guidelines in preventing MMD in LMICs.

In this paper, we draw on recent experiences from the Young Lives study to discuss some of the ethical and practical challenges facing longitudinal cohort studies in low- and middle-income countries in the time of coronavirus. We argue that COVID-19 has instigated an ‘ethics of disruption’ for social researchers across the world, and for longitudinal cohort studies like Young Lives, this requires navigating three core considerations: first, managing research relationships and reciprocity within an observational study design; second, maintaining methodological continuity and consistency across time; and third, balancing an immediate short-term response to COVID-19 against the longer-term perspective. We refer to the study’s plan to implement a new COVID-19 phone survey to illustrate how the team are navigating this altered ethical terrain.

We performed a global analysis with data from 149 countries to test whether temperature can explain the spatial variability of the spread rate and mortality of COVID-19 at the global scale. We performed partial correlation analysis and linear mixed effect modelling to evaluate the association of the spread rate and motility of COVID-19 with maximum, minimum, average temperatures and temperature extreme (difference between maximum and minimum temperature) and other environmental and socioeconomic parameters. After controlling the effect of the duration after the first positive case, partial correlation analysis revealed that temperature was not related with the spatial variability of the spread rate of COVID-19. Mortality was negatively related with temperature in the countries with high-income economies. In contrast, temperature extreme was significantly and positively correlated with mortality in the low-and middle-income countries. Taking the country heterogeneity into account, mixed effect modelling revealed that inclusion of temperature as a fixed effect in the model significantly improved model skill predicting mortality in the low-and middle-income countries. Our analysis suggest that warm climate may reduce the mortality rate in high-income economies but in low and middle-income countries temperature extreme may increase the mortality risk.

Introduction. Self-sampling has the potential to increase cervical cancer screening (CCS) among women living with HIV (WLWH) in low and middle-income countries (LMICs). However, our understanding of how HPV self-collection studies have been conducted in WLWH is limited. The purpose of this scoping review was to examine the extent to which the HPV self-sampling has been applied among WLWH in LMICs. Method: We conducted multiple searches in several databases for articles published between 2000 and January 2022. With the combination of keywords relating to HPV self-sampling, LMICs, and WLWH, we retrieved over 9,000 articles. We used pre-defined inclusion and exclusion criteria to select relevant studies for this review. Once a study met the inclusion criteria, we created a table to extract each study’s characteristics and classified them under common themes. We used a qualitative descriptive approach to summarize the scoping results. Results: A total of 12 articles were included in the final review. Overall, 3,178 women were enrolled in those studies and 2,105 (66%) of them were WLWH. The self-sampling participation rate was 92.6%. The findings of our study show that 43% of the WLWH in 8 of the studies reviewed tested positive for high-risk HPV (hr-HPV) genotypes, indicating 4 out of 10 WLWH in the studies are at risk of cervical cancer. The prevalence of the hr-HPV in WLWH was 18% higher than that of HIV-negative women. Most women in the study found the self-sampling experience acceptable, easy to use, convenient, and comfortable. Self-sampling performance in detecting hr HPV genotypes is comparable to clinician-performed sampling. However, limited access (i.e., affordability, availability, transportation), limited knowledge about self-screening, doubts about the credibility of self-sampling results, and stigma remain barriers to wide acceptance and implementation of self-sampling. In conclusion, the findings of this review highlight that (a) cervical cancer is a threat to every sexually active woman but for WLWH the threat increases, (b) self-sampling laboratory performance is similar to clinician performed sampling, (c) self-sampling is associated with an increase in cervical cancer screening uptake and (d) WLWH reported a positive experience with self-sampling. However, personal, environmental, and structural barriers challenge the application of self-sampling in LMICs, and these need to be addressed. Keywords: keyword 1; keyword 2; keyword 3 (List three to ten pertinent keywords specific to the article yet reasonably common within the subject discipline.)

Drowning is a serious public health concern. Low middle income countries are mostly affected, as they carry 90% of the global drowning burden. The purpose of this epidemiological study is to provide a comprehensive overview of fatal drownings in South Africa between 2016 and 2021. The data used for the study was obtained from the South African Police Service. Descriptive statistics were used to summarise data. Statistical analysis included a t-test and chi-square test. The results indicate that the average fatal drownings per annum is 1477 in South Africa, with a drowning rate of 2.54 per 100 000 population from 2016 - 2021. The KwaZulu-Natal province had the highest incidence of drowning. The 0 – 4-year category has a high prevalence of drowning amongst all the age categories. More males drowned in South Africa compared to females. The study highlights key areas of concern these include age, sex, race, province, type of water body and time of day. This information is crucial to inform drowning prevention initiatives in South Africa.

Worldwide, 200 million children experience disability, with the vast majority living in low and middle-income countries. The United Nations Convention on the Rights of the Child (CRC) places great importance on the rights of all children for the opportunities for survival, growth, health, and development. A subsequent document, the UN Convention on the Rights of Persons with Disabilities (CRPD) identifies children with disabilities as rights bearers, who should be considered in all policies and programming worldwide. Nigeria, in 1991 and 2010 ratified the CRC and the CRPD respectively. Nonetheless, knowledge of the extent to which their disability and child-directed policies are considered by these two key conventions remains limited. This study examined the extent to which Nigeria’s current disability and childhood policies have integrated the two normative frameworks from the UN. Using a structured search of databases and Nigerian federal and state government websites, we conducted a policy review to identify their disability and child-related disability policies. We also included the CRC and CRPD reports submitted by the Nigerian government to the United Nations Office of the High Commissioner for Human Rights (OHCHR) (2008 & 2010 cyclical year). A thematic analysis, based on the CRC and CRPD report, identified the following six themes: participation, support systems, awareness-raising, factors associated with adherence to the CRC, laws & rights, and services. The review showed that the available Nigerian disability policies were federal, with some state policies which aligned with the CRC and CRPD. Also identified was the lack of disability policies specific to children and their families. We concluded that, to ensure proper inclusion of the rights of all children, including those with disabilities, in Nigeria there is a need for a more optimal uptake of recommendations of the CRC and CRPD as laid out by the UN.

The increasing cancer burden is a major health concern in Arab countries with variations in cancer profiles. Given the limited oncology research output and scarce data on cancer trial participation in the Arab region, this study explored the therapeutic cancer trial landscape in Arab countries over the past 20 years. A bibliometric analysis of the PubMed database was conducted on primary publications of therapeutic trials with a participating Arab center. Arab countries participated in 320 published cancer-related therapeutic trials (2000‒2021). There was a consistent increase in the number of trials, sample size, multiregional site participation, and number of randomized trials. However, most trials were small, did not receive external funding, and included a single Arab site. Compared with Arab-only trials, trials with joint non-Arab sites were larger (p = .003) and more likely to be externally funded (p < .001). Citation numbers and journal impact factors were higher in trial publications with joint non-Arab authorship than those without (p < .001, for both). Despite improving conduct and publication records of oncology trials with Arab centers, cancer trial participation remains limited in Arab countries. Concerted efforts are required to encourage sponsorship and international collaboration in this region.

This paper has examined the effect of economic complexity on poverty in developing countries. The analysis has used a sample of 84 countries over the period 1980-2017. Results indicate that greater economic complexity results in lower poverty headcount rates. This is particularly the case for countries that enjoy higher economic growth rates, lower levels of income inequality and lower degrees of economic growth volatility, including due to lower sizes of export demand and financial flows shocks. These findings have important policy implications for developing countries that are exploring ways and means to recover from the current COVID-19 pandemic crisis, and prepare for future crises.

The transition to sustainable mobility is a recognized socio-economic and environmental challenge, particularly among young adults in low- and middle-income countries (LMICs). This paper addresses the lack of comprehensive research on mobility patterns for LMICs by examining the travel patterns of students, staff, and lecturers at the National Advanced School of Public Works, Yaoundé (NASPW) to understand transport mode choices and barriers to the use of public and active transport modes. Data was collected through online questionnaires from 425 participants. Findings revealed that most students (27.5%) used multiple modes of transport, with moto-taxis being the most common (21%). Lecturers primarily used private cars (50%), while staff relied on taxis or multiple modes (33%). Accessibility, vehicle speed, and flexibility appeared as the most important reasons for the preferred modes of transport. Barriers included long waiting times and traffic congestion for public transport, and distance and inadequate infrastructure for active mobility. The usage of public transportation was encouraged by its affordability and reduced travel time, whilst active options were preferred due to their cost savings and health benefits. To promote sustainable mobility for campus travel, it is crucial to encourage active modes, develop mass transport systems, and raise awareness through symposiums and conferences among students and staff.

Children five years or younger in low- and middle-income countries (LMICs) are severely affected by diarrhoea disease, especially in the sub-Saharan region. Hence, the study aimed at determining the prevalence and determinants of diarrhea disease among children under 5 years in Epworth Township, Zimbabwe. A descriptive cross-sectional study was conducted at a local clinic in Epworth Township, Harare. A convenience sampling strategy was used to recruit study participants for participation and 386 children were enrolled in the study. The majority were male children (n=229; 59.3%), while there were more female caregivers (n=370; 95.9%) than male caregivers (n=16; 4.1%). The prevalence of diarrhea disease in the study was 25.1%. The determinants associated with diarrhea were being partially vaccinated (OR 2.38, CI 95% 2.80–8.22), collecting water more than 1 kilometre from a household (OR 4.55; CI 95% 2.10–9.85) and using untreated water (OR 6.22; CI 95% 2.13–18.20). The age of the caregiver and using a clean water container (OR 0.05; p=0.020) were protective factors. Provision of primary health care, especially prevention of disease through immunization and rendering environmental health services could reduce the prevalence of diarrhea in disadvantaged townships.

Greenhouse Gases (GHGs) emission has considerable impact on global warming and climate change. Since energy systems and their features noticeably influence on the amount of GHGs emission, it can be modeled based on the specifications of energy sources utilized by the countries. In addition, economic activity is another factor which should be considered in GHG emission modeling. In this work, Artificial Neural Network (ANN) is used for estimating carbon dioxide emission, as one of the most abundant GHGs, on the basis of shares of various energy sources used as primary energy supply and GDP as an indicator for economic activities. Five countries including Iran, Kuwait, Qatar, Saudi Arabia and United Arab Emirates (UAE) are considered as case studies. Comparing between the estimated data by the achieved model and actual quantities showed acceptable precision of the ANN model for prediction of carbon dioxide emission. The average absolute relative error and the R-squared values of the GMDH model are approximately 2.28% and 0.9998, respectively. The obtained values for the mentioned statistical criteria show the precision of the model in forecasting the emission of Co2.

This study aimed to assess the prevalence and identify risk factors for schistosomiasis among school-aged children in low- and middle-income communities. A retrospective cross-sectional study was conducted, involving the examination of 24 034 children for Schistosoma haematobium ova. Data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 27. Logistic regression was employed to determine the factors associated with schistosomiasis. The overall prevalence of schistosomiasis in the study population was 75%, with higher rates observed in rural-dominated areas, particularly Bushbuckridge (73%) and Nkomazi (51%). Age, a history of bilharzia, and the presence of blood in urine were significantly associated with schistosomiasis, while being a female child was found to be a protective factor. This study underscores the importance of implementing robust screening procedures and the necessity for health education to mitigate the high prevalence of schistosomiasis and prevent its further spread.

Transitioning to clean cooking fuels is not only part of achieving SDG7, but also makes a significant contribution to mitigating climate change by reducing carbon emissions. The paper contradicts the conventional wisdom that electricity is too expensive to cook with. The paper explores the energy required to cook dishes using different technologies and fuels by analysing data from Cooking Diaries and Controlled Cooking tests conducted under the MECS programme. Electric pressure cookers (EPCs) use least energy when compared with electric hotplates, and a detailed description of how the EPC works explains why this should be. The paper draws out distinctions between African and Asian dishes, notably the impact of energy intensive dishes prepared mostly in Africa. Standard efficiency based approaches to comparing the performance of stoves are not appropriate to modern electric cooking devices so an alternative approach based on specific energy consumptions is proposed e.g. charcoal stoves use 15 times as much energy as EPCs to cook African dishes. Energy ratios provide a basis for estimating carbon emission reductions associated with transitioning to modern cooking fuels. Historical costs show that the cost of cooking with an EPC can be only 20% of the cost of cooking with charcoal, which highlights the potential for modern, energy efficient electric cooking devices to defy the conventional wisdom of the energy ladder.

Methicillin-resistant Staphylococcus aureus (MRSA) constitutes a serious public health concern with a considerable impact on patients' health and substantial healthcare costs. In this study, patients, and healthcare workers (HCWs)from six public hospitals in Benin were screened for MRSA. Strains were identified as MRSA using conventional microbiological methods in Benin and confirmed using Matrix-Assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) mass spectrometry in Belgium. Whole genome sequencing (WGS) was used on confirmed MRSA isolates to characterize their genomic content and study their relatedness. In total,304 and 61 samples were collected from patients and HCWs, respectively. The mecA gene was detected in all isolates. The isolates were assigned to five sequence types (STs), with ST8 (55.6%, n=15), ST152 (18.52%, n=5), and ST121 (18.52%, n=5) being the most common. All isolates carried multiple virulence genes, including genes encoding the Panton-Valentine leukocidin toxin (48.15%, n=13) and the test gene (29.63%, n=8) associated with toxic shock syndrome. The presence of strains carrying numerous genomic features associated with antibiotic resistance and virulence in HCWs is a major public health concern. This study highlights the need to implement a multimodal strategy for reducing the risk of cross-transmission of MRSA in hospitals.

The COVID-19 pandemic halted progress in global vaccine coverage and disrupted routine childhood vaccination practices worldwide. While there is ample evidence of vaccination declines experienced during the pandemic, it is less clear how low-income countries were affected. We executed a systematic review to synthesize the current literature on impacts to routine childhood vaccinations in low-income countries from January 1, 2020 to February 8, 2023. We collected data using an extraction form on Covidence and assessed the quality of studies included in the review using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Effect estimates for changes in vaccination during the pandemic were reported and summarized. Factors that influenced changes were grouped into descriptive themes. Thirteen studies, encompassing 18 low-income countries and evaluating 15 vaccines at varying doses, were included in the final review. We found that routine childhood vaccinations during the COVID-19 pandemic varied considerably by vaccine type, location, and phase of the pandemic. Nine different themes were identified as factors that influenced changes in vaccination. Documenting past experiences and lessons learned is crucial for informing preparedness efforts in anticipation of future public health emergencies. Failure to effectively address these things in the next public health emergency could result in a recurrence of declining routine childhood vaccinations.

Preschoolers with disabilities and their caregivers have been neglected in health and social service provision in most low-income countries and arguably too in low resourced areas of more affluent nations. Yet as this rapid review of published literature identifies, there are low-cost, evidence-based strategies to address their needs that can be implemented in communities by local people. Five key features of the necessary supports are examined. First the leadership functions required to create and implement the support services. Second, the family-centred, home-based support provided to caregivers and the personnel undertaking this form of support. Third, providing opportunities for peer support to flourish and encouraging the formation of advocacy groups across families. Fourth, mobilizing the support of significant groups within the community; notably traditional healers and leaders; health services and poverty alleviation initiatives. Fifth, devising ways in which preschool educational opportunities can be offered to children as a prelude to their inclusion in primary schools. The review serves a further purpose. It provides an example of how public health researchers and academics could achieve more rapid implementation of evidence-based knowledge into existing and new support services through dissemination to community practitioners.

Delayed diagnosis and a lack of adequate care for people with autism spectrum disorder (ASD) are related to worse outcomes and quality of life. This study aimed to identify the profile of service use, barriers to access care, and factors related to those barriers in Brazilian families with children with ASD. A total of 927 families with ASD children (3-17 years) from five Brazilian regions completed an online version of the Caregivers Needs Survey. Results showed that the most used services were behavioral interventions and pharmacotherapy, while the most used professionals were neurologists, nutritionists, speech therapists, psychiatrists, psychologists, and pediatricians. The main barriers included waiting lists, costs, and the absence of services or treatment. Service use varied according to age, the region of residence, the type of health care system used, and the parents/caregivers' education. Access to behavioral interventions was more frequent among users of the private system/health insurance and families whose caregivers had higher education. The absence of specialized services/treatments was less frequent among residents of state capitals and families whose caregivers had higher levels of education. This study highlights how families with children/adolescents with ASD in Brazil face significant barriers to access care related to sociodemographic factors.

Continued high rates of both under- and over-nutrition in low- and low-middle-income countries highlight the importance of understanding dietary practices such as early and exclusive breastfeeding, and dietary patterns such as timely, appropriate complementary feeding—these behaviors that are rooted in complex cultural ecologies. A systematic review and synthesis of available qualitative research related to infant and young child dietary patterns and practices from the perspective of parents and families in low income settings is presented, with a focus on barriers and facilitators to achieving international recommendations. Data from both published and grey literature from 2006-2016 was included in the review. Quality assessment consisted of two phases (CASP guidelines and assessment using GRADE-CERQual), followed by synthesis of the studies identified, and subsequent thematic analysis and interpretation. The findings indicated several categories of both barriers and facilitators, spanning individual and system level factors. The review informs efforts aimed at improving child health and nutrition, and represents the first such comprehensive review of the qualitative literature, uniquely suited to understanding complex behaviors leading to infant and young child dietary patterns.

Background: The ongoing COVID-19 pandemic and subsequent lockdown have adversely affected global health care services to varying extent. Emergency Services were also affected along with elective surgeries, which were deferred to accommodate the added burden of COVID 19 affected patients, on the healthcare systems. We aimed to assess the change in delivery of essential and emergency surgeries due to the pandemic. Methodology: A research consortium led by WHO Collaboration Centre (WHOCC) for Research in Surgical Care Delivery in Low- and Middle-Income countries (LMIC), India, conducted this retrospective cross-sectional study with 12 recruited centers. All surgeries performed during the months of April 2020 were compared with those performed in April 2019. These surgeries were stratified into emergency and elective, and further categorized based on NHS surgery prioritization documents. Results: A total of 4396 surgeries were performed at these centers in April 2019 and 1216 surgeries were performed in same month during 2020, yielding a fall of 72.3% (1216 /4396).We found a 54% reduction in emergency surgeries and a 91% reduction in the elective surgeries. Number of cesarean sections reduced by 29.7% and fracture surgeries declined by 85.3% Laparotomies and surgeries for local soft tissue infections with necrotic tissue reduced by 71.7% and 69.5% respectively. Conclusion: Our study quantifies the effects of COVID 19 pandemic on surgical care delivery in India and documents that the overall surgical volume reduced by three fourths in the pandemic period. Emergency surgeries reduced to half when compared with pre-pandemic period. Cesarean section surgeries were affected the least by pandemic, whereas the fracture surgeries and laparotomies were affected the most.

Antimicrobial resistance (AMR) is a global threat associated with high morbidity and mortality, particularly in low- and middle-income countries. Inappropriate use of antimicrobials is one of the major drivers of the AMR pandemic. This study aims to evaluate the rate and quality of antimicrobial prescription and use at the University Teaching Hospital of Kigali, a tertiary referral and teaching hospital. A point prevalence survey (PPS) of antimicrobial prescription was conducted using the Global PPS tool, including the healthcare-acquired infections (HAI)-module. On the day of PPS, 39.3% (145/369) of the patients were prescribed at least one antimicrobial. Out of 259 prescribed antimicrobials, 232 (89.6%) were antibacterials of which 151 (65.1%) belonged to the Watch-group of the WHO AWaRe classification. Top three antibiotics prescribed were cefotaxime (87; 37.5%), parenteral metronidazole (31; 13.4%); and meropenem (23; 9.9%). Stop/review of the prescribed antimicrobials was documented in 27/259 prescriptions (10.4%). Surgical prophylaxis (SP) was prescribed for more than one day in 83.3% of 61. Samples for culture were sent for 27.1% (63/232) of all prescribed antibiotics. This PPS showed a high usage of Watch antibiotics, prolonged surgical prophylaxis and other poor-quality indicators. Therefore, there is an urgent need for antimicrobial stewardship interventions.

Speeding is a significant global issue, with disparities in speed outcome and speed research between low- and middle-income countries (LMICs) and high-income countries (HICs). This study aims to address speed research gaps by examining the prevalence of self-reported speeding and factors influencing drivers' speeding behavior (SB) using the Theory of Planned Behavior (TPB). An online survey involving 387 anonymous drivers was conducted in Yaoundé. Results showed that all drivers reported exceeding speed limits, with 81% exceeding by 5km/h, 12% by 10km/h, and 7% by more than 10km/h in urban areas. On highways, 54% reported exceeded the limit by more than 10km/h. Age, driver's license, and gender showed significant associations with speed limits non-compliance. The study results suggests that the TPB can be useful in assessing speeding behavior, as the inclusion of TPB variables led to a more than 50% proportionate increase in SB variance. Structural equation modeling revealed attitude towards speeding as the strongest predictor of speeding intention (SI), along with certain demographics indirectly influencing SB through SI. Perceived behavioral control (PBC) and SI directly influenced SB. These findings emphasize the potential of interventions targeting attitude, intentions, and perceived behavioral control to modify speeding behavior and improve road safety.

In Low and Lower-Middle-Income countries, the prevalence of anemia in infancy remains high. In early childhood anemia cause irreversible cognitive deficits and represents a higher risk of child mortality. The consequences of anemia in infancy are a major barrier to overcome poverty traps. The aim of this study was to analyze based on a multi-level approach, different factors associated with anemia in children 6–23 m old based on recent available Standard Demographic Health Surveys (S-DHS). We identified 52 S-DHS that had complete information in all covariates of interest in our analysis between 2005 and 2015. We performed traditional logistic regressions and multilevel logistic regression analyses to study the association between hemoglobin concentrations and household, child, maternal, socio-demographic variables. In our sample, 70 % of the 6–23 m old children were anemic. Child anemia was strongly associated with maternal anemia, household wealth, maternal education and low birth weight. Children fed with fortified foods, potatoes and other tubers had significantly lower rates of anemia. Improving overall household living conditions, increasing maternal education, delaying childbearing and introducing iron rich foods at six months of age may reduce the likelihood of anemia at in toddlerhood.

Although numerous articles have been published to address drivers or barriers of corporate social responsibility (CSR), some parts of the world have received less attention. In this study, I reviewed the literature, from 2010 to 2021, to identify drivers and barriers of CSR in the the Middle East and North Africa (MENA) region and compare them with the findings in western countries. (2) Methods: For this study, I used a structured literature review method. By setting the inclusion and exclusion criteria, only 28 articles remained from selected database; (3) Results: The findings revealed some CSR drivers, such as leadership styles, profitability, reputation, moral commitment, and environmental conservation are common in both regions. There are also some differences between CSR drivers, for example religious beliefs, low concentration of ownership, and company characteristics are some of the drivers in the MENA region. Maintaining social license to operate, avoiding the risks of community opposition, pressure from the government, and consumer demand tend to be more important in western countries. Common barriers in both regions are lack of financial resources, cost, lack of CSR knowledge and awareness, and ownership concentration. This review also highlighted that lack of law enforcement, lack of stakeholder communication, lack of management commitment, lack of interests, corruption, and financial debts are some of the addressed barriers of CSR in the MENA region, while cost/benefit ratio, lack of customer interest, and lack of scientific frameworks are the special barriers in western countries. (4) Conclusions: While researchers in western countries have more focus on energy sector, there is a lack of research about drivers and barriers of CSR in the MENA region in several industries, including oil and gas.

The composition and pattern of ecosystems are important factors determining the overall status and spatial differences of ecosystem service functions. However, under the background of differential land policies and ecological protection policies, research on the trend of ecological system pattern changes in the Fenhe River Basin is insufficient. Taking the upper and middle reaches of the Fenhe River Basin as the study area, based on long-term NDVI index and multi-period LUCC remote sensing images, this study used spatial statistics and time trend analysis methods to analyze the spatio-temporal dynamic changes of vegetation, land use, landscape pattern, and explored the impact of major driving factors on ecosystem changes. The results show that: (1) From 2010 to 2020, the vegetation cover in the upper and middle reaches of the Fenhe River Basin increased, with an annual NDVI increment of 0.003 (P<0.001). NDVI showed an increasing trend spatially, with significant statistics (P<0.001) and significant changes (P<0.05) in vegetation in high-altitude mountain areas, and the vegetation cover was mostly forests or grasslands. There was no significant change in vegetation cover in the low-lying urban agglomeration area. (2) From 2010 to 2020, the area of water bodies or wetlands in the study area significantly decreased, with 51.3% converted to arable land and 33.9% transferred to construction land, while only 2.2% remained as water bodies or wetlands. From 2015 to 2020, the trend of water body changes slowed down, with the proportions of conversion to arable land and construction land being 44.0% and 18.4% respectively, while the area of wetlands or water bodies remained at 16.3%. During the period of 2015-2020, the area of water bodies or wetlands converted to other land types increased by more than 14% compared to 2010-2015. This proportion reached more than 30% compared to the 13th Five-year Plan Period. (3) From 2010 to 2020, the spatial changes of landscape diversity (SHDI) and evenness (SHEI) of LUCC showed heterogeneous characteristics. In the high-altitude areas near the river basin boundary, the values of SHDI and SHEI were below 1.0. While in the low-altitude plain areas and urban areas with relatively frequent human activities, the values of SHDI and SHEI were above 1.0, and the values in urban areas could reach above 1.5. The evolution of ecosystem patterns in the upper and middle reaches of the Fenhe River Basin in the past decade has been clarified, providing a scientific basis for the construction and management of ecological environment governance and restoration projects in the Fenhe River Basin, and providing practical references for ecological protection and high-quality development practice in the Yellow River Basin.

Based on data from the Yunnan Province farm household survey, we examine the effect of rural land rights policy on farmers’ income. The regression results show that right significantly raises the total income of farmers, with farm income serving as the primary source of total income. After performing numerous robustness tests, using instrumental variables to handle endogeneity and arriving at the same conclusion, the result is still valid. According to the heterogeneity analysis, in the sample of households with long-term migrant workers, the confirmation of rural land rights significantly increases total and nonfarm income while decreasing farm income. Furthermore, total income includes nonfarm income, which reflects the effect of different farmers' optimal labor allocation based on the external market environment. According to the impact mechanism anal-ysis, right can increase farmers' total income by promoting land transfer, and farmers in less developed areas are more willing to increase their income by land transfer out.

There is a systematic exclusion of gender-based violence, safe abortion, reproductive cancers, infertility services, comprehensive sexuality education, sexuality services, and STI’s other than HIV in essential health packages in LMICs. To accelerate progress on sexual reproductive health (SRH), the Guttmacher–Lancet Commission proposed the adoption of these interventions into an essential health package of SRH services that should be universally available. In this commentary, we use a healthcare priority-setting processes lens to review the importance of these services for universal health coverage. We isolate inherent challenges in social value judgments for terminal, process and content evidence for their healthcare priority-setting. We then advance promising emerging practical examples from low to middle-income countries on evidence-informed decision-making processes. We recommend capacity development through regional support, generating equity and efficiency evidence and strengthening political and publicly acceptable processes to institutionalise and operationalise evidence-informed decision-making.

This study aims to identify the factors determining the income of forestry household in South Korea. We examine an empirical analysis using 3-year panel data conducted by the Korea Forest Service charged with maintaining South Korea's forest lands. The hypothesized factors determining the income of forestry household are classified into four types of assets and three types of livelihood strategies. We divided the income of forestry household (IFH) into three elements: forestry income (FI), non-forestry income (NFI), and transfer income (TI). We assessed the influences of household assets and livelihood strategies on each income. A random effect model was used as a statistical analysis with valid 979 of forestry household for three years. We found that household head's age, labor hours, savings, business category, cultivated land size, and region are significantly associated with IFH. Also, FI is influenced by labor capacity, cultivated size, business category, forestry business portfolio, and region while NFI is determined by household head's age, household head's gender, forestry business portfolio, and savings. TI is affected by household head's age, household head's education level, forestry business portfolios, savings, and region. The effect sizes and directions vary across different types of income (IFH, FI, NFI, and TI). The findings show that forestry in South Korea is highly dependent on sustainable assets and strategies. It is therefore expected that the effectiveness of forest policies to increase the income of forestry household would be differed by the source of each income. The results of this study draw attention to the need for an income support policy that should consider the characteristics of household assets and livelihood strategies in order to enhance IFH in South Korea.

Northern Nigeria has had historically low antenatal care (ANC) utilization rates with poor health outcomes. Group antenatal care (gANC) improves ANC behavior and pregnancy outcomes. The gANC has been adopted in Kaduna and Kano states, Nigeria. This paper presents baseline findings from the evaluation of the implementation of the gANC program to support scaling in real-world setting. Baseline data were collected from a cohort of 1,269 and 1,200 pregnant women enrolled in gANC at health facilities in Kaduna and Kano states respectively from March to April 2024. Analyses of socio-demographic and pregnancy behavior data were done. Participants were mostly between ages 19-31 years, married or living with a partner, with over 50% having their own businesses. Over 62% and 34% had completed secondary or higher-level education with 60% and 80% living in urban areas in Kaduna and Kano States, respectively. In Kano State, >60% of the women had their last delivery at home with 41.6% not assisted by a skilled birth attendant. In Kaduna, >63% delivered in the hospital and >50% had skilled attendance during labor. Almost half had not used contraceptives previously. Subsequent longitudinal data will examine the impact of gANC utilization on perinatal outcomes.

Results-Based Financing (RBF) in pediatrics, in regions with scarce resources like Northern Uganda, provides an innovative approach to enhancing healthcare delivery. RBF aligns financial incentives with desired health outcomes, boosting service quality, efficiency, and effectiveness by tying compensation to achieving specific, measurable health targets. Lacor and Kalongo hospitals, before the introduction of RBF, faced numerous challenges, including limited resources, staffing shortages, and inconsistent quality of care. RBF adoption requires critical health outcomes to target, such as lowering child mortality rates, enhancing vaccination coverage, and increasing the frequency of timely prenatal care visits. The empirical application of RBF in pediatric services at Lacor and Kalongo Hospital from 2018 to 2024 shows improved healthcare quality and outcomes. Healthcare systems can identify ways to implement RBF models better, ensuring that financial incentives effectively contribute to attaining superior health outcomes.

Vitamin C is an essential nutrient that must be obtained through the diet in adequate amounts to prevent hypovitaminosis C and the potentially fatal deficiency disease scurvy. Global vitamin C status and prevalence of deficiency has not previously been reported, despite vitamin C’s pleiotropic roles in both non-communicable and communicable disease. This review highlights the global literature on vitamin C status and the prevalence of hypovitaminosis C and deficiency. Related dietary intake is reported if assessed in the studies. We also explore if global vitamin C status has changed over time. Overall, the review illustrates the shortage of high quality epidemiological studies of vitamin C status in many countries, particularly low- and middle-income countries. The available evidence indicates that vitamin C deficiency is common in low- and middle-income countries and not uncommon in high income settings. Further high quality studies are required to confirm these findings, including in the countries not yet represented, and to fully understand associations with a range of disease processes. Our findings suggest a need for interventions to prevent deficiency in a range of at risk groups and regions of the world.

In this paper, a seamless connection between sensor technology and machine learning (ML) has been presented which has wide applicability in rehabilitation and physical medicine. The intent is to identify an ML algorithm which has a better performance, easy to deploy, and has less training time and consumes less computational resources. In short, we propose an algorithm which maximizes the synergy between a sensor and ML by maximizing classification performance and easy to do implementation, which is robust in computational power and lower in resource consumption. The premise of the work is to show the important considerations for evaluating ML algorithms for Upper-limb activity recognition for Physical medicine and rehabilitation field.

The United Nations Sustainable Development Goals call for the eradication of poverty, and China has proposed the Rural Revitalization Strategy based on the achievements of its poverty alleviation efforts in 2020. As a vital component of this strategy, the impact of land transfer on farmers' income growth has become a hot topic in both theoretical and practical sectors. This paper utilizes data from the CFPS database for the years 2010-2018 to construct OLS regression models and a Heckman two-stage model to analyze the effects of land transfers on the incomes of different types and sources among farmers. The empirical results show: First, land transfers do promote income growth among farmers, but the effect is primarily positive for those transferring out land, with negligible impact on those acquiring land. Second, the impact of land transfers varies between different types of income for transferees and transferors. Wage income contributes up to 88.26% to the income growth of transferors, a significantly higher rate than the decrease in business income; however, the increase in business income for transferees does not offset the decline in wage income, leading to no significant change in overall income. Further sensitivity analysis using the Heckman two-stage model confirms the robustness of these findings. The conclusions of this study provide theoretical and empirical evidence to optimize land transfer policies, enhance participation in land transfers, and ultimately achieve the mission of rural revitalization.

In post mortem analyses, SARS-CoV-2 was found in the middle ear of some, but not all patients with COVID-19 disease. It is not clear whether SARS-CoV-2 penetrated the ear passively post mortem, or existed in the middle ear of living patients during, and perhaps also after infection. This study investigates whether SARS-CoV-2 can be found in the middle ear of living patients during ear surgery. Swabs from the nasopharynx, the filter connected to the tracheal tube and secretion from the middle ear were collected during middle ear surgery. All samples were tested for the presence of SARS-CoV-2 with PCR. History of vaccination, COVID-19 and contact with SARS-CoV-2-positive individuals were recorded preoperatively. Postoperative SARS-CoV-2 infection was noted at the follow-up visit. Overall 63 participants (62%) were children and 39 (38%) were adults. SARS-CoV-2 was found in the middle ear and in the nasopharynx of two and four CovEar Study participants, respectively. The filter connected to the tracheal tube was sterile in all cases. Cycle threshold (ct) values of the PCR test were between 25.94 and 37.06. SARS-CoV-2 penetrates into the middle ear of living patients and can be found in asymptomatic patients. The presence of SARS-CoV-2 in the middle ear may have implications for ear surgery and can pose a risk of infection for operating room staff. It may also directly affect the audio-vestibular system.

A large proportion of chronic stroke survivors still struggle with upper limb (UL) problems in daily activities. We investigated clinical outcomes and assessed the quality of movement before and after a 5-hour error-enhancement training. The pilot study had a pre-post intervention design, recruiting 22 patients in the chronic phase post-stroke with UL motor impairments. Patients received 1-hour robot treatment for five days. Patients were assessed at baseline and after training, collecting (1) clinical (UL Fugl-Meyer assessment (FMA-UE)), action research arm test (ARAT), motor assessment scale UL and tone), (2) patient-reported (hand subscale of the stroke impact scale, motor activity log (MAL), visual analogue scale of pain and tone) and (3) kinematic (KINARM, BKIN Technologies Ltd., Canada) outcome measures. Our analysis revealed significant improvements (median im-provement (Q1-Q3); p<0.05) in (1) FMA-UE (1.0 (0.8–3.0), p<0.001) and ARAT (2 (0.8–2.0), p<0.001); (2) MAL amount of use (0.1 (0.0–0.3), p<0.001) and MAL quality of use (0.1 (0.1–0.5), p<0.001); (3) KINARM-evaluated position sense ((-0.45 (-0.81–0.09), p=0.030) after training. These findings provide insight into kinematic, clinical, and self-reported improvements in UL functioning after five hours of error-enhancement UL training.

Emerging risk factors for childhood (<5 years) anemia cases in low-income countries have not been limited to COVID-19 and the spread of infectious diseases, hidden hunger, and other economic factors. Yet the effects of climatic factors, such as ambient temperatures, on child anemia have been in its infancy. In this population-based study, we study the region-specific associations between child anemia and ambient temperatures in 43 countries of Africa from 2000-2019. Using generalized linear regression models, we found that after adjusting for key covariates, the risk that temperatures pose on child anemia varies across the four African regions (Western, Eastern, Central, and Southern). This suggests that ambient temperatures have varying effects on child anemia by region. Other studies are needed in other low-income settings to expand our findings.

Disseminated or military tuberculosis (TB) is defined as the presence of at least two non-contiguous sites of Mycobacterium tuberculosis, occurring as a result of progressive primary infection, reactivation and spread of a latent focus or due to iatrogenic origin. Disseminated TB represents a life-threatening condition, especially in at-risk children and when the diagnosis and treatment are delayed. We report on a case of a 3-year old boy who presented with long-lasting unrecognised disseminated TB that was successfully managed in a low-resource setting.

In this paper, based on our previous expertise on ceramic artifacts, several archaeometric methods applied to some samples collected from the Dudești archaeological site (Oltenia region, Romania) are reported for the first time in the literature. The chemical composition and microstructural and morphological characterization of these samples offer important conclusions about the processing conditions. Some specific techniques such as X-ray diffraction (XRD), wave-length-dispersive X-ray fluorescence (WDXRF), Optical microscopy (OM), stereomicroscopy, scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy and Raman spectroscopy, provide composition information about pigments and their decay processes. Additionally, the Brunauer-Emmett-Teller (BET) method helps to estimate pore sizes and specific surface areas. Thermal analysis (TGA) was used to establish details regarding the production technology and the raw materials source used to make the ceramics, too. The obtained results indicated that the ceramics are based on a paste of muscovite, feldspar, with high plasticity, quartz, melanterite, and calcite, the latter in very low concentrations. According to the obtained results, we could assume that non-calcareous clays are present in the investigated samples because calcium exists in low concentrations. Gypsum is present, too, in very low concentration, identified by the presence of sulfate group in WDXRF. In the same context, iron oxides significantly impact the firing atmosphere of iron-rich clay, resulting in blackening under reducing conditions and reddish coloration under oxidative conditions. Using hematite and gypsum as pigments further contributes to the color variations in the pottery. The consistent firing temperature range of 200-600 °C in Dudești pottery implies a standardized production process, the variation in color being dependent on the specific reducing/oxidative regime conditions. This relationship between clay composition and local sources suggests a connection to Neolithic pottery production in the region and their color depending on the reducing/oxidative regime conditions.

Purpose: This study aimed to describe the molecular epidemiology and seasonality of human rhinovirus (HRV) in chronic obstructive pulmonary disease (COPD) and its association with COPD exacerbations in Abu Dhabi, the United Arab Emirates (UAE). Methods: Sputum specimens were collected for analysis from all COPD patients who visited a medical center from November 2021 to October 2022. The real-time quantitative polymerase chain reaction (qPCR) test was used to detect HRV. Results: Of the 78 COPD patients included in the study, 58 (74%) pa-tients presented with one or more exacerbation episodes. The incidence of COPD exacerbation peaked over the winter and substantially decreased during the summer. HRV positivity in pa-tients during exacerbation (E1) was 11/58 (19%) and 15/58 (26%) two weeks after the exacerbation episode (E2). There was no significant difference in the HRV load in these patients. No statistically significant difference was observed in the detection of HRV during exacerbation compared to patients with stable COPD. Conclusion: This is the first study to assess the association between HRV detection by qPCR and COPD exacerbations in the UAE. The high sensitivity of the detec-tion technology helped collect reliable epidemiologic data. Few studies have provided similar Middle East data. This study's pattern of COPD exacerbations and HRV detection parallels that of temperate countries. This information can help with future, more extensive surveillance of res-piratory viruses in the UAE and the Middle East and their association with COPD exacerbations.

An ionospheric response at middle latitudes to geomagnetic storms is not yet very well understood. Total electron content (TEC) variations associated with eight strong geomagnetic storms between 2015 and 2022 obtained from GNSS receivers in the western area of the North Atlantic (Portuguese continental and insular territory) are studied in an attempt to fill this gap. It was found that for most of the studied geomagnetic storms TEC variations are synchronous for the longitudinal ranges from 27ºW and 9ºW. In the southern part of the studied region (around 32ºN) the amplitude of TEC variations is, in general, significantly higher than in the northern part (around 39ºN). Some of the studied geomagnetic storms were associated with TEC variations that we interpret as effects of post-sunset equatorial plasma bubbles that travelled well north from their habitual region. Also, while most of the studied storms were accompanied by reports on different kind of malfunction of GNSS systems (GPS; GALILEO and other), there is no clear pattern in their appearance in dependence on the geomagnetic/ionospheric storms’ strength, commencement time, and its characteristics, in general.

The purpose of this scoping review was to comprehensively clarify the methodology of Mental practice (MP) to date by systematically mapping studies that have performed MP on post-stroke paralytic upper extremity function. Specifically, (1) When is the most common timing of MP in-tervention after stroke onset? (2) What is the MP load (intervention time, number of interven-tion days, and intervention period)? (3) What are the most common methods of Motor Imagery (MI) recall and MI tasks during MP? (4) Is MP often used in conjunction with individual rehabili-tative therapies? (5) What is the paralyzed side's upper limb and cognitive function level at the start of MP intervention? Our scoping review was performed ac-cording to PRISMA-ScR to iden-tify research questions. Then, the PubMed, Scopus, Medline, and Cochrane Library databases were used to screen articles published by July 19, 2022. Eligible articles were selected all study designs were included, including studies involving the use of MP for post-stroke paralytic upper extremity function. Selection of eligible papers was done by two or more independent persons. Data were extracted from the eligible papers for items necessary to identify the research ques-tions. English-language articles identified for this study were 694, of which 62 were accepted. The most common intervention time was 30 minutes or less and the duration of the intervention was 5 times a week in MP. The most common method of recalling MI during MP was using an audio guide. In the future, it will be important to conduct accumulation of research to unify the varied widely MP methodologies identified in this study.

This paper proposes an upper bound for mine productivity and also a simple truck dispatch rule that demonstrates how tight the upper bound can be using simulation. It also proposes a greedy search to approximate the productivity upper bound, which is faster and often exact. Uncertainty is added to the simulation in order to verify how the productivity responds to it. Typically, the productivity upper bound is less tight close to its saturation point as a function of the number of trucks, where adding more trucks only increases queues. Furthermore, more uncertainty in the model typically leads to a less tight upper bound. The results are conducted using real data from an open pit mine in Brazil.

Quantum coherence is an important physical resource in quantum information science, and also as one of the most fundamental and striking features in quantum physics. In this paper, we obtain a symmetry-like relation of relative entropy measure $C_r(\rho)$ of coherence for $n$-partite quantum states $\rho$, which gives lower and upper bounds for $C_r(\rho)$. Meanwhile, we discuss the conjecture about the validity of the inequality $C_r(\rho)\leq C_{\ell_1}(\rho)$ for any state $\rho$. We observe that every mixture $\eta$ of a state $\rho$ satisfying $C_r(\rho)\leq C_{\ell_1}(\rho)$ and any incoherent state $\sigma$ also satisfies the conjecture. We also note that if the von Neumann entropy is defined by the natural logarithm $\ln$ instead of $\log_2$, then the reduced relative entropy measure of coherence $\bar{C}_r(\rho)=-\rho_{\rm{diag}}\ln \rho_{\rm{diag}}+\rho\ln \rho$ satisfies the inequality ${\bar{C}}_r(\rho)\leq C_{\ell_1}(\rho)$ for any mixed state $\rho$.

Background. Upper respiratory infections (URIs) remains as significant cause of morbidity in children. Evidence on efficacy of probiotics to prevent URIs in children is increasing. This systematic review was assembled to analyze evidence about the efficacy of probiotics to reduce duration of upper respiratory infections in ambulatory children. Methods. Randomized controlled trials (RCTs) comparing probiotics vs. placebo to prevent URIs, published between 2001 and 2016 were considered. Quality evaluation was evaluated using CONSORT. Standard mean difference (SMD) or risk ratio (RR) was calculated. Network Meta-Analysis (NMA), using a random effect model was assembled. Results. 31 RCTs were evaluated and 20 studies were included with 3,635 children randomized to probiotics and 3,433 to placebo. Lactobacillus reuteri [SMD -0.56 CI95% (-0.72 to -0.41), p 0.0001] and Lactobacillus acidophillus [SMD -0.33 CI95% (-0.60 to -0.06), p 0.01] were superior to placebo to reduce duration of URIs. L. rhamnosus GG showed tendency [SMD -0.14 CI95% (-0.28 to 0.0), p 0.048]. On the network forest plot L. reuteri showed preventive equivalence when was compared to L. rhamnosus GG, L. casei and BB12. Conclusions. Lactobacillus reuteri, Lactobacillus rhamnosus GG and Bifidobacterium BB12 are evidence-based alternatives to be considered to prevent URIs in children.

Appeals to governments for implementing basic income are contemporary. The theoretical backgrounds of the basic income notion, only prescribe transferring equal amounts to individuals irrespective of their specific attributes. However, the most recent basic income initiatives all around the world are attached to certain rules with regard to the attributes of the households. This approach is facing significant challenges to appropriately recognize the vulnerable groups. A possible alternative for setting rules with regard to the welfare attributes of the households is to employ artificial intelligent algorithms that can process unprecedented amounts of data. Can integrating machine learning change the future of basic income by perdition of vulnerable to future poverty households? In this paper, we utilize a multidimensional and longitudinal welfare data comprising one and a half million individual data and a Bayesian beliefs network approach to examine the feasibility of predicting households’ vulnerability to future poverty based on the existing households’ welfare attributes.

The issue of polarization, as opposed to inequality, has been little explored for European countries. in this paper, using harmonized data produced by Luxembourg Income Study Database, observes income trends for 12 European countries, showing an increase in polarization in many of the countries considered. the drivers that led to this concentration of income are also analyzed, noting heterogeneous factors within countries.

Mangrove ecosystems play an important role in local livelihoods in coastal regions of tropical and subtropical countries. However, in recent years urbanisation has changed the income structure of residents near mangroves. Different landscapes provide different job opportunities; thus, analysis of regional landscape patterns is important for understanding income structures. In this study, surveys on the income structure and landscape patterns of the surrounding areas of three mangrove sites were conducted in the Hau and Hoang Mai River estuaries in Nghe An Province, North-Central Vietnam. The results revealed that both natural and socio-economic landscape components affected income structure. The major occupations in the study area were agriculture, including husbandry, sea fishing, and trading. Land morphology and river type were the major factors influencing the income from agriculture, while coastline morphology primarily affected income from sea fishing. Community-based trading was carried out in the study area; thus, the population inside each administrative unit was a significant factor increasing income, while the retail market size in an area had significant negative effects, potentially due to the increasing number of competitors. Our study aimed to evaluate mangrove ecosystem importance for local livelihoods in relation to landscape patterns, and the results contribute to urban planning based on the conservation and sustainable use of mangrove ecosystems.

Purpose: This study was designed to investigate the ability of telemonitoring involving a secure elec-tronic database called “Alsayed System for Applied Medical-Care Improvement” (ASAMI) to detect at least 95% of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Methods: This prospective observational study, which took place over 16 months in 2022-2023, was based at a medi-cal center in Jordan. The study group participants were patients with COPD (from seven countries) with mixed levels of airflow limitation severity, and every participant was followed for six months. A customized, password-protected version of ASAMI was used to collect data during the study. The implemented diary included questions on daily symptoms such as cough, dyspnea, sputum, and daily physical activities. The detection of AECOPD events was initially based on daily questionnaires com-pleted by patients, followed by the assessment of a healthcare practitioner. Results: 87 participants were monitored for AECOPD. During the study, 78/87 (89.7%) patients presented with one or more exacerbation episodes. The mean (range) age was 59.7 (45-81) years, predominantly male (66%), with moderate airflow limitation (n=42, 48%). Compliance with the provision of daily symptom data was very high, 98% over the entire study period. A total of 189 confirmed AECOPD episodes were reported. Almost all patients and practitioners showed favorable satisfaction with the role of the ASAMI-related service (96% reported a score of 10 satisfaction). The telemonitoring tool was able to detect 99% of AECOPD episodes. Conclusion: The novel ASAMI software was effective as a telemonitoring tool to detect the episodes of AECOPD. The tool was suggested for daily, continuous reporting of respiratory symptoms, with the key benefits being ease of use, patient acceptance, and collation of supplementary data when exacerbations occur. The effects of its widespread use on decision-making can be clarified by evaluating its impact on routine clinical decision-making.

This review provides a comprehensive overview of two major advancements in hearing loss treatment: the middle ear implant (MEI) and bone conduction implants (BCIs). MEI, surgically inserted in the middle ear, directly stimulate the ossicles, and are primarily employed to treat sensorineural, conductive, or mixed hearing losses. BCIs work via bone conduction, bypassing the outer and middle ear to deliver sound vibrations to the inner ear, beneficial especially for conductive or mixed hearing losses and single-sided deafness. The decision to opt for these devices is a multifaceted process, considering audiological criteria, surgical feasibility, and patient expectations. The review also details the portfolio of available devices, their functioning, and audiological usage indications. While both MEI and BCIs prove beneficial for patients, the review emphasizes the need for careful preoperative planning and counselling, considering factors such as potential complications, surgical challenges, and patient suitability. Overall, the two types of implants, despite their individual complexities, provide an effective alternative to traditional hearing aids, offering a path to improved sound clarity and quality for patients with various types of hearing loss.

Diagnostics is believed to drive about 70% of medical interventions, but this may not be true for all demographics. With more than 30% of the African population living in extreme poverty ($1.9 per day - 2022); and healthcare costs competing unfavorably against unbridled access to antibiotics and herbal concoctions, especially in Sub-Saharan Africa, how do you convince such a people to choose diagnostics first? More importantly, how do you design a medical device targeted at meeting the diagnostic needs of this demographic? In developing diagnostic devices for such a market, what is worth sacrificing? How dire is the need for advanced technologies in devices developed for such a demographic? These are questions that remain unaddressed by the technological breakthroughs and current research in medical device development, especially for infectious disease diagnostics. The objective of this paper is to underscore critical concerns which must be considered in the bid to successfully design medical diagnostic devices for Africa and perhaps, other limited-resource settings. It is also written as a suggestive guidance document for researchers whose interest is in the development of infectious disease diagnostic platforms for rural Africa and similar limited-resource environments.

Background: Patients undergoing dual antiplatelet therapy (DAPT) may experience recurrent gastrointestinal bleeding (GIB). We investigated the clinical characteristics and risk factors for recurrent non-variceal upper gastrointestinal bleeding (NVUGIB) in patients who had experienced NVUGIB during receiving DAPT. Methods: We enrolled patients diagnosed with NVUGIB during receiving DAPT between 2006 and 2020. Definite bleeding was confirmed by esophagogastroduodenoscopy in all NVUGIB patients. Results: A total of 124 patients were diagnosed with NVUGIB during receiving DAPT. Male was predominant (n = 103, 83.1%), bleeding mostly from the stomach (n = 94, 75.8%) and peptic ulcers (n = 72, 58.1%). After successful hemostasis of NVUGIB, 36 patients (29.0%) experienced at least one episode of recurrent upper GIB, 19 patients (15.3%) died, and 7 (5.6%) patients had a bleeding-related death. Multivariate analysis showed that age was a significant factor for re-bleeding (odds ratio [OR],1.050; 95% confidence interval [CI]:1.001-1.102, P-value:0.047), all-cause mortality (OR,1.096; 95% CI:1.020-1.178, P=0.013), and re-bleeding related mortality (OR,1.187; 95% CI:1.032-1.364, P-value:0.016). In Kaplan-Meier analysis, the cumulative probabilities of re-bleeding, death, and bleeding-related death were significantly higher in patients aged 70 and older (P=0.008, &lt;0.001, and 0.009, respectively). Conclusion: Clinicians should be cautious about re-bleeding and mortality when elderly patients who experienced NVUGIB during receiving DAPT.Keywords: dual antiplatelet therapy; upper gastrointestinal tract; bleeding; mortality

MAD is the gold standard therapy for mild/moderate OSA and is a second-choice treatment in patients with severe OSA not responding to CPAP. The aim of this study was to analyze the upper airway characteristics of OSA patients and the morphological changes in the upper airway, inducted by four different types of mandibular advancement devices, using CBCT 3D imaging. Twenty-two patients were recruited after OSA diagnosis with polysomnography. Four different customized and titratable MAD were used and an initial CBCT scan was obtained for each patient. After 6 months to the end of the MAD titration phase, all the subjects showed an AHI of &lt; 5 or a decrease of 50% in AHI with MAD when compared with initial AHI and a second CBCT scan with MAD in situ was performed. An important improvement of the airway was observed (+33.76%) and a significant difference in the enlargement ratio between the posterior soft palate (+32.41%) and the posterior tongue (+36.96%) region was also found. The greatest increase in airway volume was achieved in patients treated with the MAD Forward and TAP (respectively +42.77% and + 41.63%). MAD therapy is effective to treat mild/severe OSA with increased upper airway volume. The design of the MAD can influence the effectiveness of the treatment.

The practice of physical activity is an effective non-pharmacological strategy for preventing and treating chronic diseases. A large body of evidence has contributed to establishing a positive correlation between a physically active lifestyle and health benefits, including enhanced vaccination responses, lower numbers of senescent T-cells, increased T-cell proliferative capacity, lower levels of inflammatory cytokines, and improved neutrophil and macrophage function. While females are generally thought to exert more robust immune responses than males in response to a variety of challenges, and both male and female sex hormones have been suggested as mediators of immune function, research on this topic has not always been designed with a sex-specific lens. The goal of this review is to summarize the available experimental and clinical evidence linking exercise and immune function in male and female subjects, with an emphasis on sex differences and sex-specific mechanisms. Overall, the available evidence indicates that moderate exercise and physical activity improves immune function in both sexes, whereas prolonged and high-intensity exercise temporarily impairs immune responses at a higher degree in females. A role of male and female sex hormones in these sex-specific effects is also discussed.

This article presents a methodology for the design of rehabilitation devices that considers factors involved in a clinical environment. This methodology integrates different disciplines that work together. The methodology is composed by 3 phases and 13 stages with specific tasks, the first phase includes the clinical context considering the requirements of the patient and therapist during the rehabilitation, the second phase is focused in engineering based on the philosophy of digital twin, and in the third phase is evaluated the device. This article explains the characteristics of the methodology and how it was applied in the design of an exoskeleton for passive rehabilitation of the upper limb.

Upper confidence bound multi-armed bandit algorithms (UCB) typically rely on concentration in- equalities (such as Hoeffding’s inequality) for the creation of the upper confidence bound. Intu- itively, the tighter the bound is, the more likely the respective arm is or isn’t judged appropriately for selection. Hence we derive and utilise an optimal inequality. Usually the sample mean (and sometimes the sample variance) of previous rewards are the information which are used in the bounds which drive the algorithm, but intuitively the more infor- mation that taken from the previous rewards, the tighter the bound could be. Hence our inequality explicitly considers the values of each and every past reward into the upper bound expression which drives the method. We show how this UCB method fits into the broader scope of other information theoretic UCB algorithms, but unlike them is free from assumptions about the distribution of the data, We conclude by reporting some already established regret information, and give some numerical simulations to demonstrate the method’s effectiveness.

The concept and practice of ’livelihood’ has undergone various stages in the development of Western countries. Its core has always focused on eradicating rural poverty and promoting rural development. This study utilizes the entropy value method to measure the comprehensive development level of the livelihood sustainability of farm households. Additionally, the Theil index is used to measure the presentation income gap, and multiple linear regression is utilized to test the impact of the livelihood capital sustainability of farm households on the presentation income gap. Results showed that the the sustainability of farm households’ livelihood capital has a significant negative impact on the urban-rural income gap. In other words, improving the livelihood capital of farm households can significantly reduce the urban-rural income gap. Accordingly, it is proposed that efforts be made to enhance the sustainability of farm households’ livelihoods, and to increase the contribution of the sustainable enhancement of farm households’ livelihood capital to narrowing the rural-urban income gap.

Excess sedentary behaviour (SB) and insufficient physical activity (PA) have been identified as risk factors for cardiometabolic diseases in adolescents, some factors may affect how much time they spent on these activities. This study sought to compare the SB and PA patterns as well as the compliance with PA recommendations by sex, geographical location, and time of the week in Mexican adolescents. In a cross-sectional design, we objectively assessed SB and PA in 106 adolescents (15 to 18 y) through waist-worn accelerometers for one week. The time spent in SB and in PA at different intensities was compared by sex, geographical location and time of the week with two-way and three-way repeated measures MANOVAs, while the compliance with physical activity recommendations (i.e. ≥60 min/day) was compared using chi-squared and McNemar tests. Male participants spent more time in moderate, vigorous, and moderate to vigorous PA than females both in the whole week and in weekdays (all p < 0.05). There was no significant difference in SB nor PA by geographical location (i.e., metropolitan vs non-metropolitan areas). Moreover, all participants spent more time on moderate, vigorous, and moderate to vigorous PA on weekdays than on weekends (p < 0.05). Compliance with international PA recommendations also showed a sex difference (males > females) and change between weekdays and weekends with no difference by geographical location. While geographical location does not seem to be a relevant factor, sex and time of the week appear to influence the SB and PA patterns in Mexican adolescents.

This study aims to determine the impact of the type of ICT usage on household income from main vegetables, agriculture (including main vegetables), and total income. This study is based on surveys and interviews with vegetable farmers using structured questionnaires conducted in three villages in Indonesia, including Cianjur, Sleman, and Malang in West Java, Yogyakarta, and East Java, respectively. The data were collected from 375 respondents selected in each region from November 2021 to March 2022. An econometric model called the multivariate linear regression (MLR) model is used to assess heterogeneous factors that influence the possibility of increasing the income of vegetable farmers. The study found that variables that use ICT as a primary variable, household, marketing, geographical characteristics, and immediate source information in agriculture have a significant impact on household income (P < 0.01) from primary vegetables, agriculture, and total income, with multiple R squares of 70.5, 72.0, 73.7% and F statistics of 28.48, 30.66, and 33.34, respectively. In summary, this novel study shows that the five categories of information technology used in farming and selling of harvest have a positive impact on household incomes

The purpose of this study was to determine the income, costs and revenue of the Gontor Putri 3 bakery. Want to know the efficiency of the bakery business in Karangbanyu Regency. The method used in this research is analytical descriptive by conducting a survey. The data used in this research is primary data. Data collection techniques use observation, interviews and documentation, while the process of analysis is quantitative descriptive. Using the R/C ratio, a value of 1.72 per month is obtained. This value indicates that the bakery factory in Karangbanyu is efficient because the value is more than one.

The study examined key socio-economic characteristics of smallholder farmers identified for their contribution to market participation. These variables include gender, age, marital status, level of education, household size, additional income, membership of cooperative, herd size and use of ICTs. Using a structured questionnaire, primary data was collected from a total of 129 respondents which was analysed with the Statistical Package for the Social Sciences, and presented using cross-tabulations, percentages and count data. The result indicates that age, additional income, cooperative membership and use of ICTs were important variables which contributed to market participation among respondents. The study also made applicable recommendations as the findings may have relevance for future research, policy and practice for commercializing smallholder farmers.

In the field of agricultural food production, the transition between organic and inorganic farming methods has been an issue of much debate. The debate, on one hand, stresses the urgency for the transition in order to preserve environment and health; and, on the other hand, emphasizes the pressure of maintaining food production for a large growing population. Thus, the dilemma is how to find an agricultural system that would balance between obtaining food security and ensuring a safe sustainably environment-friendly food production system. This article focuses on the debate, in the context of Bangladesh, and questions whether it is the proper time, and stage in the development process, to attempt the transition from inorganic conventional food production methods to organic food production methods. This article contemplates why the organic rice market is not expanding in Bangladesh, and attempts to explain the slow growth of the market through the two main factors of income constraint and lack of awareness among people about the environmental and health detriments of inorganic farming methods. The study is exploratory in nature, and finds that it is not mainly the lack of awareness but the income constraint that can be principally attributed to the slow expansion of the organic rice market in Bangladesh. Through exploring consumers’ awareness about organic farming methods and their demand for organic products, this study shows how income as the major constraint, besides price, affects consumers demand for organic and inorganic rice in Bangladesh. Income being identified as the major barrier reveals the potential of the organic rice market to grow in the future, as Bangladesh continues its journey towards becoming a middle-income country.

Sports are framed within the context of the Olympic spirit and are, therefore, within the vision and mission of the Olympic Committee, aimed at “building a better world”. This is identified as a fundamental value and sustainability is therefore explicitly considered to be a “working principle” of this. In this research an analysis of the performance of professional European football teams publicly listed on stock markets, restating the income statements according to the Value-Added perspective is carried out. This takes into account the effective sustainable contribution in the distribution of added value with reference to the human, structural, debt, infrastructural, and risk capitals of these organisations. The Value-Added Statement is considered as a part of the broader CSR Reporting and can be traced back to the late 1970s. However, it is in widespread contemporary use and is regarded as being both a credible and a tested measure. In this paper, the authors apply a slightly modified and simplified version of this tool to these publicly listed European football clubs as a proxy for wider professional sport. This research demonstrates that, although professional sports clubs are profit-oriented, the distribution of wealth generated by the added value is unbalanced. In most cases, at least in financial terms, shareholders are the most disadvantaged and athletes are the most rewarded.

Doppler findings of persistent reverse end-diastolic flow (PREDF) in a fetal middle cerebral artery (MCA) are a very rare sonographic finding and are a marker of poor fetal condition. This finding often leads to intrauterine fetal death or early neonatal death. The reverse end-diastolic flow in the middle cerebral artery is the terminal hemodynamic event. Fetal cerebral circulation normally has a high impedance; in the event of fetal hypoxemia, impedance decreases, resulting in the central redistribution of blood flow to vital organs, which maintains the oxygen delivery to the brain. Reverse flow in the middle cerebral arteries describes the loss of this autoregulatory process. PREDF is a sequence happening due to increased extracranial or intracranial pressure. Previous case reports mentioned intracranial hemorrhage, intrauterine growth restriction (IUGR), fetal anemia, and fetal hepatic abnormalities as leading problems to PREDF. This condition presumably arises due to cerebral edema associated with severe hypoxemia. We reported Doppler findings of PREDF MCA in a 33-year-old female at 30 weeks gestation who was referred to the hospital with severe preeclampsia accompanied by IUGR and oligohydramnios. A cesarean section was performed due to severe preeclampsia and a low bishop score. Hypotheses on various etiologies and their association with intrauterine/neonatal death as well as the best management still require further investigation.

Research on climacteric syndrome among middle-aged men remains scant than the research among women. Research is also scant on climacteric syndrome among older adults living alone, particularly men, who are more vulnerable than such females. This cross-sectional study investigated whether the prevalence of climacteric syndrome is associated with the type of household middle-aged men live in and identified the determinants of climacteric syndrome based on the household type. Six hundred middle-aged men living in multi-person households and 600 living alone were surveyed about general characteristics, diet-related factors, and climacteric syndrome. Data were analyzed using Pearson’s chi-squared test, Fisher’s exact test, and logistic regression. The risk of climacteric syndrome in single-person households was found to be 1.6 times higher than that among in multi-person households (p = 0.006). In multi-person households, income and breakfast frequency predicted climacteric syndrome (p < 0.05), while age, breakfast frequency, dinner frequency, and weekly eating out frequency predicted climacteric syndrome in single-person households (p < 0.05). Thus, dietary factors are more closely linked to the prevalence of climacteric syndrome in single-person households than in multi-person households. This highlights the need for climacteric syndrome interventions for middle-aged men whose health concerns may persist into older adulthood.

The Süttő 21 site is a fissure fill of the freshwater limestone of the Gazda quarry in Süttő. The material was collected between 2017 and 2019, the results are summarised in this article, with a special focus on the small vertebrate fauna of the site and its stratigraphic and paleoecological significance. The fissure fill can be placed around the early/middle Pleistocene boundary (ca. 1.1 and 0.77 Ma). The paleoecological analysis of the herpeto- and mammal fauna of the sequence indicates the proximity of a permanent water body. The lower part of the sequence is dominated by open habitat indicator taxa indicating a cool, dry climate. Towards the upper part of the sequence, the climate remained cool but became wetter, and the vegetation gradually changed to forest-steppe/open forest. The fauna of the Süttő 21 site can be compared with the material of sites, which are of similar age, thus revealing taxonomic and paleoecological differences between different areas of the country. While a warm, dry climate and open vegetation can be reconstructed in the Villány Hills around the early/middle Pleistocene boundary, the northern Hungarian areas had a cooler, wetter climate, and slightly more closed (grove, forest-steppe) vegetation during this period.

Based on the 2014-2015 China Education Panel Survey (CEPS) and using the propensity score matching method, we studied the causal relationship between physical exercise and prosocial behavior of junior middle school students in China. Ordinary least squares regression and propensity score matching estimation results showed that participation in physical exercise significantly increases students’ prosocial behavior by more than 0.2 standard points. The results of this study were tested and found to be robust.

Background: Our knowledge of prostate cancer (PCa) genomics mainly reflects European (EUR) and Asian (ASN) populations. Our understanding of the influence of Middle Eastern (ME) and African (AFR) ancestry on the mutational profiles of prostate cancer is limited. Design, setting and participants: To characterize genomic differences between ME, EUR, ASN and AFR ancestry, fluorescent in situ hybridization (FISH) studies for NKX3-1 deletions and MYC amplification was carried out on 42 tumors arising in individuals of ME ancestry. These were supplemented by analysis of copy number profiles of 401 tumors of all ancestries. Outcome measurement and statistical analysis: FISH results of NKX3-1 and MYC were assessed in the ME cohort and compared to other ancestries. Gene level copy number aberrations (CNAs) for each sample were statistically compared between ancestry groups. Results and Limitation: NKX3-1 deletions by FISH were observed in 17/42 (17.5%) prostate tumors arising in men of ME ancestry, while MYC amplifications were only observed in 1/42 (0.23%). Using CNAs called from arrays, the incidence of NKX3-1 deletions was significantly lower in ME vs. other ancestries (20% vs. 52%; p = 2.3 x 10-3). No differences in MYC amplifications was noted between the two cohorts using array-based CNAs. Across the genome, tumors arising in men of ME ancestry had fewer CNAs than those of other ancestries (p = 0.014). Additionally, the somatic amplification of 21 specific genes was more frequent in tumors arising in men of ME vs. EUR ancestry (Proportions test; Q < 0.05). Those included amplifications in the glutathione S-transferase family on chromosome 1 (GSTM1, GSTM2, GSTM5) and the IQ Motif Containing family on chromosome 3 (IQCF1, IQCF2, IQCF13, IQCF4, IQCF5, IQCF6). Conclusion: Significant differences in genetic background exists between different ancestries. The lower number of somatic CNAs observed in prostate cancer arising in men of ME ancestry may explain the relatively good prognosis in this population. Larger studies are warranted.

Available water resources in the Middle East, as one of the most water-scarce regions of the world, have undergone extra pressure due to climatic change, population growth, and economic development during the past decades. The objective of this study is to detect the trends and quantify the changes in aridity with respect to precipitation and potential evapotranspiration in 20 countries of the Middle East and the adjacent area. A Pixel-wised trend analysis was conducted on precipitation, potential evapotranspiration, and aridity index for 71 years from 1948 to 2018. A nonparametric Mann-Kendall test was used over 14106 points in the study area to detect the trends at monthly and annual time scales. Results showed statistically significant (|Z| >1.96) upward trends in aridity (a downward trend in aridity index) up to 96 percent from December through September in most parts of the region. Aridity in October and November had a downward tendency in most parts of the study area. At the annual time scale, 62.5 percent of the statistically significant trends in aridity were found to be upward (up to 96 percent increase in aridity) due to the combined effects of the decrease in precipitation and the increase in potential evapotranspiration and 37.5 percent of the detected trends were downward (up to 61 percent decrease in aridity). The highest and the lowest trends in aridity were found in the north of Sudan (96 percent increase in aridity) and Eastern Arabia (61 percent decrease in aridity), respectively.

This article is an anthropology study on how western-style coffee culture influences Indonesian coffee culture and eventually develops a new localized coffee culture. Immense development of such worldwide coffee franchise as Starbucks affects local community's coffee culture, particularly the middle class. This new wave is considered as an alternative lifestyle for those who are consumptive and seeking for leisure, dynamics, and identity. Broader than just the process of domestication or creolization, Indonesian new coffee culture has an element of “soft countering to” western coffee culture even though it still embraces some parts of the western styles. This phenomenon is referred to by the writer as the cultural encapsulation process or the process of substantial cultural resistance by drawing a line between the two coffee cultures with the intention of taking merely compatible elements.

The Middle East spans the transition between temperate Mediterranean climate in the Levant to hyper-arid sub-tropical deserts in the southern part of the Arabian Peninsula, with the complex alpine topography in the northeast feeding the Euphrates and Tigris rivers which support life in the southeastern Fertile Crescent (FC). Climate projections predict severe drying in major parts much of the ME in response to global warming, making it important to understand the controls of hydro-climate perturbations in the region. Here we discuss 23 ME speleothem stable oxygen isotope (δ¹⁸Occ) records from 16 sites from the SISAL_v1 database, which provide a record of past hydro-climatic variability. Sub-millennial changes in ME speleothem δ¹⁸Occ values primarily indicate changes in past precipitation amounts superimposed on variations of the main synoptic pattern in the region, specifically Mediterranean cyclones. The coherency (or lack thereof) between regional records is reviewed from Pleistocene to present, covering the Last Glacial Maximum (LGM), prominent events during deglaciation, and transition into the Holocene. The available speleothem δ¹⁸Occ time-series are investigated by binning and normalizing at 25-year and 200-year time windows over the Holocene. Important Holocene climatic oscillations are discussed, such as the 8.2 ka, 4.2 ka and 0.7 ka (the Little Ice Age) Before Present events. Common trends in the standardized anomalies are tested against different climate archives. Finally, recommendations for future speleothem-based research in the region are given along with comments on the utility and completeness of the SISAL database.

Currently the bimatoprost implant (DURYSTA) is approved for a single administration secondary to concern for progressive corneal endothelial cell (CEC) loss with intracameral administration. In order to better understand the cause of CEC loss and other adverse events (AEs) with intracameral administration, multimodal imaging of the implant utilizing optical coherence topography (OCT), robotic ultrasound and bio microscopy video recording was utilized. Inherently the anterior chamber is a non-confined space. In certain examples the implant assumed a round and spotted structure as it picked up iris pigment as it migrated around the anterior chamber. Accordingly, we explored delivery of the implant in the middle segment behind the iris and in front of the pseudophakic lens. We then evaluated the suitability of various imaging modalities to assess the implant in this location. For middle segment administration, the ArcScan Insight 100 robotic ultrasound provided resolution and repeatability sufficient to monitor the implant behind the iris. This preliminary study hypothesizes that DURYSTA migration in the anterior chamber is the main source of AEs. Through use of a confined location, the middle segment, the implant is unlikely to migrate and cause CEC loss while also delivering drug closer to its site of action, the ciliary body. Further efforts are underway to understand the suitability of the middle segment for serial DURYSTA administration to maximize intraocular pressure lowering while minimizing AEs.

This paper provides the straight proof for the Riemann Hypothesis.The proof has been formulated with the modified version of Riemann Xi function ξ(s) , that shows the relationship with upper incomplete gamma function.

We compare the well known Rayleigh-Ritz variational method (RRVM) with a recently proposed approach based on supersymmetric quantum mechanics and the Gram-Schmidt orthogonalization method (SSQMGS). We apply both procedures to a particular class of double-well harmonic oscillators that had been conveniently chosen for the application of the latter approach. The RRVM eigenvalues converge smoothly from above providing much more accurate results with less computational effort. Present results show that the unproved SSQMGS upper bounds do not hold.

El Olivo Cave (Pruvia de Arriba, Llanera, Asturias, Spain) is a small karst cave located in the Aboño River basin and formed in the Cretaceous limestone of the Mesozoic cover of the Cantabrian Mountains (north of the Iberian Peninsula). It contains an important upper Pleistocene sedimen-tary, archaeological and paleontological record, with abundant technological evidence and faunal remains. The archaeological record shows a first occupation that could correspond to the Middle Paleolithic and a second occupation in the Middle Magdalenian. The stratigraphic sequence inside and outside the cave was studied with geoarchaeological methodology. In this paper, the lithostratigraphic sequence is analyzed and the data from the granulometric, mineralogical, edaphological and radiometric analyses are presented. The results of these analyses enable an accurate interpretation of both the lithostratigraphy of the deposit as well as the processes re-sponsible for its formation and subsequent evolution. The available numerical dates allow us to locate the first sedimentation episode in the cave in OIS 7a, in the Middle Pleistocene, the base of the outer fluvial sedimentation in the cold OIS 3a stage of the Upper Pleistocene and the Magdalenian occupation in the Last Glacial Maximum (OIS 2) at the end of the Late Pleistocene.

Background: The incidence of intravesical recurrence (IVR) following radical nephroureterectomy (RNU) is reported in up to 50% of patients with upper tract urothelial carcinoma (UTUC). It was suggested that preoperative diagnostic ureteroscopy (URS) could increase the IVR rate after RNU, however, the available data are often conflicting. Thus, in this systematic review and meta-analysis we sought to synthesize that available data for the impact of pre-RNU URS for UTUC on IVR and other oncological outcomes; Materials and methods: A systematic literature search of the PubMed, Embase and Cochrane Library databases was performed in June 2020. Cumulative analyses of hazard ratios (HRs) and their corresponding 95% confidence intervals (CI) were conducted. The primary endpoint was intravesical recurrence-free survival (IVRFS), with the secondary endpoints being cancer-specific survival (CSS), overall survival (OS), and metastasis-free survival (MFS); Results: Among a total of 5489 patients included in the sixteen selected papers, 2387 (43.4%) underwent diagnostic URS before RNU and 3102 (56.6%) did not. Pre-RNU diagnostic URS was significantly associated with worse IVRFS after RNU (HR=1.44, 95% CI: 1.29-1.61, p&lt;0.001) than RNU alone. However, subgroup analysis including patients without biopsy during URS revealed no significant impact of diagnostic URS on IVRFS (HR=1.28, 95% CI: 0.90-1.80, p=0.16). The results of other analyses showed no significant differences in CSS (HR=0.94, p=0.63), OS (HR: 0.94, p=0.56), and MFS (HR: 0.91, p=0.37) between patients who underwent URS before RNU and those who did not. Conclusions: The results of this meta-analysis confirm that diagnostic URS prior to RNU is significantly associated with worse IVRFS, albeit with no concurrent impact on the other long-term survival outcomes. Our results indicate that URS has a negative impact on IVRFS only when combined with endoscopic biopsy. Future studies are warranted to assess the role of immediate postoperative intravesical chemotherapy in patients undergoing biopsy during URS for suspected UTUC.

Background: Young adults, particularly university students might be at greater risk of developing psychological distress, and exhibiting symptoms of anxiety and depression during the COVID-19 pandemic. Objective: The primary objective of this study was to explore and compare the determinants and predictors of mental health (anxiety and depression) during and after COVID-19 lockdown among university students. Methods: This was an observational, cross-sectional study with a sample size of 417 students. An online survey utilizing International Physical Activity Questionnaire–Short Form (IPAQ-SF), General Anxiety Disorder–7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) was distributed to Universiti Tunku Abdul Rahman students via Google forms. Results: During lockdown, family income [χ² (1, n=124) = 5.155, p=0.023], and physical activity [χ² (1, n=134) = 6.366, p=0.012] were associated with anxiety, while depression was associated with gender [χ² (1, n=75) = 4.655, p=0.031]. After lockdown, family income was found to be associated with both anxiety [χ2 (1, n=111) = 8.089, p=0.004], and depression [χ2 (1, n=115) =9.305, p=0.002]. During lockdown, family income (OR=1.60, p=0.018), and physical activity (OR=0.59, p=0.011) were predictors for anxiety, and gender (OR=0.65, p=0.046) being the only predictor for depression. After lockdown, family income was a predictor for both anxiety (OR=1.67, p=0.011), and depression (OR=1.70, p=0.009). Conclusion: Significant negative effects attributed to the COVID-19 lockdown, and certain factors predisposed to the worsening of mental health status in university students. Family income, physical activity level, and gender were some of the major determinants that influenced the anxiety and depression.

Based on 2010, 2013 and 2015 CGSS data, the impact of Internet use and social capital on the income gap among farmers in the past five years is assessed at three time points using the OLS method and a quantile regression method. The study finds that (1) the income gap among farmers increases continuously in the five-year period, while Internet use plays a positive impact on farmers’ income growth in all five quartiles; the coefficient differences are all significantly negative, indicating that Internet use plays a positive role in alleviating the income gap between high-income and low-income farmer subgroups, and (2) social capital plays a positive role in moderating the income gap among farmers and that Internet use by farmers expands the boundary of social capital, which in turn increases the income level of and alleviates the income gap among farmers.

Rural households across developing countries rely on diversified sources of income and forest resource play important role in this regard. This study is designed with the objectives of assessing the contribution of forests to annual income of rural households and identifying its determinants with the case of Essera woreda forest in western Ethiopia. It also examined the gender dimensions of forest income and how this income varies with the wealth status of households key informants interview focus group discussion and household based questionnaire survey were used to collect data. On average income from crop production accounted for (40.7%) of the total annual household income. Forest income is second in importance contributing (32.6%), income from livestock off and non-farm activities and woodlots accounted for (13.6%), (11.4%) and (1.7%) of the total household income respectively. Firewood is the most used forest product and constituted the largest proportion (79%) of the total forest income. Forest income is more important for poor households (47.3%) than for medium (30.5%) or rich (20.2%) households. It is also more important for female headed households (58.2%) than for male headed households (29%). The gender dimension of forest income is also important within the household. Female members generated about four times more forest income (77% of the household forest income) than male members (23%). Policy to promote new forest management arrangement such as participatory forest management (PFM) needs to take in to account the major forest users and the types of products they depend on and be accompanied with other poverty reduction measures so that improved forest conservation outcome will not have negative consequences on local livelihoods particularly on poor and women who depend most on the forest.

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

Widespread poverty is the most serious threat and social problem that Bangladesh faces. Regional vulnerability to climate change threatens to escalate the magnitude of this poverty. It is essential that projections of poverty be made while bearing in mind the effects of climate change. The main purpose of this paper is to investigate the agrarian sub-national regional analysis of climate change vulnerability in Bangladesh under various climate change scenarios and its potential impact on poverty. This study is relevant to socio-economic research on climate change vulnerability and agriculture risk management and has the potential to contribute new insights to the complex interactions in household income and climate change risks to agricultural communities in Bangladesh and South Asia. The current study uses analysis of variance, cluster analysis, decomposition of variance and log-normal distribution to estimate the parameters of income variability that ascertain vulnerability levels and help us to understand the poverty levels that climate change could potentially incur. It is found that the income share in income sources revealed that income category shares across the various regions of Bangladesh are far from uniform. The variance decomposition of income showed that agricultural income in Mymensingh and Rangpur is the main cause of income difference. Moreover, large variance of agricultural income in the regions is induced by gross income from rice production. Additionally, constant reduction of rice yield due to climate change in Bangladesh is not such a severe problem for farmers, however, the extreme events like flood, flash flood, drought, sea level rise, and greenhouse gas emission based on RCPs could increase the poverty rates in Mymensingh, Rajshahi, Barisal, and Khulna regions that would be highly affected by unexpected yield loss due to extreme climatic events. Therefore, research and development of adaptation measures to climate change for regions where farmers are largely dependent on agricultural income is important.

Through long-term Rayleigh lidar observations during 2010-2022, atmospheric gravity wave (AGW) activities in the middle atmosphere (30–65 km) are statistically investigated at Haikou (110.3°E, 19.9°N) in China. In total, 827 quasi-monochromatic AGW events are identified from the lidar dataset, and the vertical wavelength, observed wave period, and vertical propagation direction of dominant waves are extracted for each AGW event by analyzing the power spectra of wave-induced temperature perturbations. It is revealed that 81.7% of all AGW events were associated with upward-propagating waves, and the proportion of upward-propagating AGWs reached a maximum in autumn and a minimum in winter. The most common vertical wavelengths and wave periods were 6–11 km and 4–10 hours, respectively. In particular, 68 AGW events associated with simultaneous upward and downward propagating waves were observed by lidar, corresponding to 8.2% of the events. The occurrence of such special AGW phenomena is qualitatively discussed, and multiple formation mechanisms may exist. Comparisons are made with previously reported lidar observation results, and the statistical features of AGW activity in the low-latitude middle atmosphere may vary over a relatively wide range depending on the location and altitude. However, a majority of AGWs propagate upward in the middle atmosphere.

Office workers often experience occupational musculoskeletal disorders. The aim of the current systematic review was to investigate the effectiveness of workplace exercise intervention on the oldest age group of office workers who have been reported in the literature so far, in terms of workability and well-being. Randomized Controlled Trials were used and the methodological guidelines of PRISMA were followed. The keywords used were: office workers, older, exercise intervention, workplace, microbreaks, workability and well-being. The databases searched were: PubMed, PEDro, ResearchGate, CINAHL, PsychINFO and Science Direct. PROSPERO ID: CRD42022329656. Five studies (total number of participants: 1190, mean age: 46,4) met the inclu-sion criteria. Their quality was deemed to be moderate to high, according to PEDro and MPSER scales. Workplace interventions of gradually increased strengthening and moderate stretching exercises, isometric positioning and postural reminders, either with or without supervision, result in decreasing musculoskeletal pain, disability, sick-leave from work and in the improvement of quality of life and physical activity of the middle-aged office workers, without negative impact on their workability. Despite the worldwide aging workforce, there is a knowledge gap due to research absence in the field of microbreak exercise interventions in the group of older office workers.

The increasing prevalence of obesity and sedentary lifestyles has led to an increased incidence of metabolic syndrome (MetS) worldwide. In Taiwan, middle-aged women are at a greater risk of MetS, type 2 diabetes, and cardiovascular disease than men are because they have more subcutaneous fat and larger waist circumferences compared to men with equal visceral fat levels. This study investigated the effects of calorie restriction supplemented with fish oil (CRF) in middle-aged women with MetS. For 12 weeks, 75 eligible participants were randomly assigned either calorie restriction (CR) or CRF. Both dietary intervention groups were further divided into two age groups: ≤45 and >45 years. The changes in MetS severity, inflammatory status, iron status, and red blood cell fatty acid profile were evaluated. Seventy-one participants completed the trial. Both dietary interventions significantly ameliorated MetS and improved the participants’ inflammatory status. CR significantly increased total iron binding capacity, whereas CRF increased hepcidin levels. Furthermore, CRF significantly increased the n-6/n-3 and arachidonic acid/docosahexaenoic acid ratios. In conclusion, CR and CRF improved the anthropometric and MetS characteristics of early-middle aged women, including body weight, blood glucose levels, triglyceride levels, as well as the scores for the homeostasis model assessment of insulin resistance and quantitative insulin sensitivity cheque index. Dietary intervention was more effective in >45-year-old women than ≤45-year-old women.

Optimal upper extremity motor control and range of motion are necessary to achieve even the basic Activities of Daily Living (ADL) function. Stroke, with resulting hemiparesis, can significantly and negatively impact an individual’s ADL function. Functional Independence Measure (FIM) self-care score can provide assessment of what aspects and to what degree ADL functions are impaired. FIM self-care assessment can also track changes in ADL function during stroke recovery and rehabilitation. Recently, sensor-acquired 3D motion analysis of stroke patients’ upper extremity has shown promise as a potential alternative to assess ADL function. This observational study evaluates whether the sensor-acquired upper extremity reachable workspace (RWS) measure correlates with clinician-evaluated FIM self-care score in stroke patients. Seventeen patients with stroke were enrolled in the study. FIM self-care, NeuroQoL upper extremity, and reachable workspace outcome measures (relative surface area, RSA) were collected upon rehabilitation hospital admission, at discharge, and at 3-month visit. Pearson and Spearman’s rank correlation coefficients as well as multiple linear regression analyses were used to determine the relationships between FIM self-care, NeuroQoL, and reachable workspace RSAs. Moderately strong correlation between total reachable workspace RSA and total FIM self-care score at discharge and at 3-month were noted (r=0.619, r=0.661, p&lt;0.05), and similarly strong correlation was also noted with the upper extremity NeuroQoL total score (r=0.690, r=0.815, p&lt;0.05). Multiple linear regression analyses revealed a change in bilateral total RSA of 0.1 unit from admission to 3-month follow up correlated with respective change in FIM self-care score of 2.011 points (95%CI: 0.663-3.360). Longitudinal improvement in ADL function during stroke rehabilitation and recovery process is correlated with improvement in reachable workspace.

This study evaluates the R3THA™ technology-supported assessment protocol for home-based rehabilitation in children with cerebral palsy (CP). It focuses on the reliability and validity of R3THA™ in assessing hand and arm function, comparing kinematic assessments with standard clinical assessments. Conducted during a 4-week summer camp, the study involved children with CP aged 3-18, assessing their functional and impairment levels. The findings suggest that R3THA™ is more reliable for children aged 8 and older, indicating that age significantly influences the protocol's effectiveness. Results also showed that R3THA-AP's kinematic measurements of hand and wrist movements were positively correlated with the Box and Blocks Test Index (BBTI), reflecting hand function and dexterity. Additionally, R3THA-AP's accuracy metrics for hand and wrist activities aligned with the Melbourne Assessment 2's Range of Motion (MA2-ROM) scores, suggesting a meaningful relationship between R3THA-AP data and clinical assessments of motor skills. However, no significant correlations were observed between R3THA-AP and MA2's accuracy and dexterity measures, indicating areas for further research. These findings validate R3THA-AP's utility in assessing motor abilities in CP, supporting its integration into clinical practice.

This study aims to assess trends and significant changes in precipitation and river flow in the Senegal River basin and its upper basin over the period 1982-2021. Eight hydroclimate indicators, namely maximum river discharge (QMAX), standardized flow index, mean daily rainfall intensity index (SDII), maximum 5-day consecutive precipitation (RX5DAY), annual precipitation exceeding the 95th percentile (R95p), annual precipitation exceeding the 99th percentile (R99P), annual flows exceeding the 95th percentile (Q95p), and annual flows exceeding the 99th percentile (Q95p) were considered.. The modified Mann-Kendall test (MMK) was used to analyze trends in extremes while standard normal homogeneity and Pettit’s tests were employed to detect potential breakpoints in these trends. The results indicated an irregular precipitation pattern, with high values of extreme precipitation indices (R95p, R99p, SDII, and RX5DAY) in the southern part, while the northern part exhibits lower values. Inter-annual analysis revealed a significant increase in extreme precipitation events between 1982 and 2021, with a notable breakpoint around the years 2006 and 2007. This breakpoint marks a transition to a much wetter period starting from 2008. Regarding extreme flows, a significant increase was observed between 1982 and 2021. This study provides insights into past hydrological extremes in the study area and can serve as a basis for future research in this field.

The purpose of this study was to quantify characteristics of bimanual movement intensity during 30-hour Hand Arm Bimanual Intensive Therapy (HABIT) and bimanual performance (activities and participation) in real-world using accelerometers in children with unilateral cerebral palsy (UCP). Twenty-five children with UCP participated in a 30-hour HABIT program. Data was collected from bilateral wrist-worn accelerometers during 30-hours HABIT to quantify the movement intensity, and three days pre- and post-HABIT to assess real-world performance gains. Movement intensity and performance gains were measured using six standard accelerometer-derived variables. Bimanual capacity (body function and activities) was assessed using standardized hand function tests. We found that accelerometer variables increased significantly during HABIT, indicating increased bimanual symmetry and intensity. Post-HABIT, children demonstrated significant improvements in all accelerometer metrics, reflecting real-world performance gains. Children also achieved significant and clinically relevant changes in the hand capacity following HABIT. Therefore, our findings suggest that accelerometers can objectively quantify bimanual movement intensity during HABIT. Moreover, HABIT enhances hand function as well as activities and participation in real-world situation in children with UCP.

The importance of performance excellence and operator’s safety is fundamental not only when operators perform repetitive and controlled industrial tasks, but also in case of abrupt gestures due to inattention and unexpected circumstances. Since optical systems work at too low frequencies and they are not able to detect gestures as early as possible, combining the use of wearable magneto-inertial measurement units (MIMUs) with the adoption of deep learning techniques can be useful to instruct the machine about human motion. To improve the initial training phase of neural networks for high classification performance, gestures repeatability over time has to be verified. Since test-retest approach has been poorly applied based on MIMUs signals in a context of human-machine interaction, the aim of this work was to evaluate the repeatability of pick-and-place gestures composed of both normal and abrupt movements. Overall, results demonstrated an excellent test-retest repeatability for normal movements and a fair-to-good test-retest repeatability for abrupt movements. Moreover whereas the reduction of time between test and retest sessions increased repeatability indices.. In detail, results of the test suggested how to improve the reinforcement learning for the identification of gestures onset, whereas results of the retest gave important information about the time necessary to retrain the network.

This paper describes the design and development of an active device that was applied to shoulder rotation rehabilitation. It implements a force control in a similar way to the haptic devices that reflect a force on the user’s hand according to the rehabilitation parameters. This device was tested with patients, combining clinician manipulation and programmed exercises. The results were excellent, given that the range of movement of the shoulder increased in most of the pa-tients. The results of the Usability Scale questionnaire were also promising.

The fluid flow field at the upper airways is highly complex due to the complex structure of the airway. The inhaled particle flow, the air streamline and the interaction of the continuum and discrete phase could significantly affect the transport behaviour of the inhaled particles. A range of analytical, mathematical and computational fluid dynamics (CFD) models analyzed the airflow and particle transport in different idealized and asymmetric airway models. A precise understanding of the continuum and discrete phase interaction in realistic human airways is missing, and this study aims to develop a CFD-DEM model for particle transport in realistic airways. This study uses the CFD model for the continuum phase and the discrete element method (DEM) for the discrete phase. A soft sphere approach is used for the interaction of the discrete phase. Proper validation is performed for particle transport efficiency. The CFD-DEM model analyzed the particle transport in an idealized and realistic airway model, and different methods are used to analyze the transport behaviour. During the particle-particle interaction, a stagnation point and a high-pressure zone are observed at the airway model's carinal angle. The numerical results report higher deposition efficiency (DE) for particle-particle interaction than without interaction. The flow field becomes highly complex with the spring constant values, and higher DE is found for high spring constant values. The spring dashpot friction-dshf method shows higher deposition at the upper part of the airways than other interaction methods. The findings of this study and more case-specific analysis would improve the knowledge of aerosol transport in airways and the health risk assessment of the patient.

In this work we introduce a novel approach to generate lower and upper L2 estimates for solution derivatives of arbitrary order to a general class of dissipative systems in the case that such estimates are available for the solutions themselves. Our method also works in reverse order: from the L2 estimates of solution derivatives of some (arbitrary) order we can derive lower and upper L2 estimates for the solutions and then to their derivatives of any order. This procedure is based on very simple monotonicity properties combined with standard energy estimates in physical space, following previous ideas of Kreiss, Hagstrom, Lorenz and Zingano. For simplicity, it is applied here in the context of algebraic rates, but the method can be used in other contexts as well (exponential, logarithm, and so forth).

The aim of this study was to evaluate the Hapo ms, a passive upper limbs exoskeleton developed to assist workers for tasks with arms in front of the body. Twelve participants had to perform a static task, a manual handling task and a load carrying task two times: with and without the exoskeleton. In all cases subjective (perceived effort in arm and back areas, comfort) and objective (muscular activity, postural balance) criteria were evaluated. Results have shown a decrease in anterior deltoid (-12 to -18% depending of the task) and in biceps brachii (-19% to -33% depending of the task) muscular activity. No significant difference was pointed out in back muscle and postural balance was not significantly perturbed due to the wear of the exoskeleton. Finally, perceived effort reduction was observed during the three tasks (except in back area for task 1). To conclude, the Hapo ms seems well adapted to assist upper arms during tasks with arms in front of the body.

Background: Probiotics can provide health benefits to an individual by regulation of the immune system. Many clinical trials have found that probiotics can prevent upper respiratory tracts infections. Aim: To perform a systematic review and meta-analysis of available trials to investigate the effectiveness of probiotics in the prevention of upper respiratory tract infections in individuals of all ages. Conclusion: Probiotics were found to be better in reducing the number of participants who experienced acute URTI, the average duration per episode of acute URTI, use of antibiotics in URTI related cases and absence due to URTI. Side effects were found to be minor, making probiotics a good candidate for clinical use. This shows that probiotics are effective in preventing acute URTIs. However, due to limited studies and small sample size, the results are subjected to bias and should be interpreted with care.