Background: The effect of velamentous cord insertion (VCI) on perinatal outcomes in twin pregnancies is unclear due to conflicting findings. This retrospective study aimed to examine VCI prevalence and related risk factors in twin pregnancies and its association with adverse perinatal outcomes. Methods: Women with twin pregnancies who delivered between January 2012 and December 2021 in a single tertiary hospital were included. The participants were divided into dichorionic (DC) and monochorionic diamniotic (MCDA) groups, and their maternal and fetal characteristics and VCI rates were compared. Logistic regression models were used to identify risk factors for VCI and VCI-related perinatal outcomes. Results: Among the 694 twin pregnancies included in this study, the VCI rate was significantly higher in MCDA than in DC twins. Body mass index and MCDA twins were significant risk factors for VCI, whereas assisted reproductive technology pregnancy was a significant protective factor against VCI. In DC twins, VCI did not affect perinatal outcomes. Conclusion: In MCDA twins, VCI was a significant risk factor for fetal growth restriction, twin-to-twin transfusion syndrome, and preterm birth at

Background/Objectives: Women with subclinical hypothyroidism (SCH) were reported to be at an increased perinatal risk. We aimed to investigate the relationship between SCH and perinatal outcomes in singleton pregnancies resulting from assisted reproduction technology (ART). Methods: We retrospectively examined the perinatal outcomes of ART singleton pregnancies in women who underwent thyroid function screening before conception and delivered at our hospital from January 2020 to July 2023. We defined SCH as thyroid-stimulating hormone (TSH) levels <2.5 mU/L and normal free T₄ levels. The patients were divided into three groups: normal thyroid function (group A), SCH without levothyroxine therapy (group B), and SCH with levothyroxine therapy (group C). The risks of preterm birth, preeclampsia, fetal growth restriction, manual placental removal, and blood loss at delivery were compared among the three groups. Results: Out of the 650 ART singleton deliveries, 581 were placed in group A, 34 in group B, and 35 in group C. The preterm birth rate at <34 weeks was significantly higher in group B and significantly lower in group C than in group A. The rate of preterm delivery at <34 weeks increased in correlation with TSH levels. Levothyroxine therapy was the significant preventive factor for preterm birth at <34 weeks. Conclusions: The preterm birth rate before 34 weeks was significantly higher in the SCH group. Levothyroxine therapy is a significant protective factor against preterm birth before 34 weeks. Universal screening for thyroid function and appropriate hormone therapy in pregnant women may help reduce perinatal risks, including preterm birth.

Background Community infections of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have increased rapidly since the emergence of the Omicron strain. During the eighth and ninth pandemic waves—when movement restrictions in the community were eased—the all-case registration system was changed, and the actual status of infection became uncertain. Methods We conducted regular rapid antigen tests (R-RAT) once or twice a week to examine the actual state of coronavirus disease (COVID-19) diagnosis among healthcare employees. Results Overall, 320 (1.42/day) and 299 (1.76/day) employees were infected in the eighth and ninth pandemic waves. During both periods, 59/263 doctors (22.4%), 335/806 nurses (41.6%), 92/194 administrative employees (47.4%), and 129/218 clinical laboratory technicians (59.2%) were infected. In the eighth wave, 56 of 195 employees were infected through close contact; in the ninth wave, 26 of 62 employees were infected. No significant difference was observed in the number of vaccinations between infected and non-infected employees. The positivity rate of R-RAT was 0.41% and 0.45% in the eighth and ninth waves. R-RAT detected infection in 212 and 229 employees during the eighth and ninth waves, respectively; the ratio of R-RAT-detected positive employees to those who reported infection was significantly higher during the ninth wave (odds ratio: 1.67, 95% confidence interval: 1.17–2.37, p

Macrophages as a source and target of GDF-15

This systematic review explores the cross-cultural validation of neuropsychological assessments and their clinical applications in cognitive behavioral therapy (CBT), focusing on culturally adapted CBT (CA-CBT) across diverse populations and settings. Methods: Following the PRISMA guidelines, a comprehensive search was conducted in multiple academic databases, including PubMed, PsycINFO, Scopus, and Web of Science. Keywords related to cognitive-behavioral therapy, cultural adaptation, and specific populations were used. Inclusion criteria encompassed randomized controlled trials (RCTs) and pilot studies that assessed CA-CBT for various mental health conditions. Results: The review included studies involving Chinese Americans, Latino caregivers, Syrian refugees, Jordanian children, Malaysian Muslims, Afghan refugees, Iraqi women, Japanese children and adolescents, and Tanzanian and Kenyan children. CA-CBT demonstrated significant effectiveness in reducing symptoms of depression, anxiety, PTSD, and psychosis. For instance, Research has shown that CA-CBT is more effective than standard CBT in reducing depressive symptoms among Chinese Americans and significantly lowering PTSD symptoms in Syrian refugee women. The method has been well-received and feasible in diverse populations, such as Jordanian children and Afghan refugees. Long-term benefits are promising, with sustained improvements reported in various studies. Additionally, digital and remote delivery methods have demonstrated potential for expanding the accessibility of CA-CBT. Conclusions: CA-CBT is a valuable and effective intervention for diverse cultural populations, significantly improving mental health outcomes. However, future research must address limitations such as small sample sizes, short follow-up periods, and variability in assessment tools. Studies should include larger and more diverse sample sizes, longer follow-up periods, rigorous control groups, and comprehensive outcome measures to further validate and enhance the application of CA-CBT across different cultural contexts.

Objective biomarkers have been a critical challenge for the field of psychiatry, where diagnostic, prognostic and theranostics assessments are still based on subjective narratives. Psychopathology operates with idiographic knowledge and subjective evaluations incorporated into clinical as-sessment inventories, but is considered to be a medical discipline and, as such, uses medical in-tervention methods (e.g., pharmacological, ECT; rTMS; tDCS), and therefore is supposed to oper-ate with the language and methods of nomothetic networks. The idiographic assessments are pro-visionally “quantified” into “structured clinical scales” to in some way resemble nomothetic measures. Instead of fostering data merging and integration, this approach further encapsulates the clinical psychiatric methods, as all other, biological tests (molecular, neuroimaging) are per-formed separately, only after the clinical assessment has provided diagnosis. Translational cross-validation of clinical assessment instruments and fMRI is an attempt to address the gap. The aim of this approach is to investigate whether there exist common and specific neural circuits, which underpin differential item responses to clinical self-rating scales during fMRI session in pa-tients suffering from the two main spectra of mental disorders: schizophrenia and major depres-sion. The current status of this research program and future implications to promote the devel-opment of psychiatry as a medical discipline are discussed.

Stroke survivors often face diverse unmet needs, highlighting the significance of identifying and addressing these needs to enhance rehabilitation outcomes and overall quality of life. This study aimed to validate the modified Needs Assessment Questionnaire (mNAQ) as a reliable and valid tool for assessing the needs of stroke patients in the Greek context. Additionally, the research sought to identify potential differences in the assessment of stroke patients' needs based on their stroke phase and National Institutes of Health Stroke Scale (NIHSS) scores. A sample of 71 adult stroke survivors, adhering to World Health Organization guidelines and providing autonomous consent, participated in the study. The mNAQ, comprising 141 items across 12 domains, was uti-lized to evaluate stroke patients' needs. The NIHSS and Barthel Index (BI) were employed for functional independence and mobility assessment. Data analysis incorporated confirmatory fac-tor analysis, exploratory factor analysis, and Cronbach's reliability analysis to establish con-struct validity and internal consistency. Concurrent and known-groups validity analyses were conducted, and Spearman’s rho correlation explored the relationship between mNAQ and BI scores. Non-parametric analyses were applied to identify differences based on stroke phase and NIHSS scores. The study revealed that the mNAQ initially lacked satisfactory psychometric properties in the Greek context. Subsequent modifications, guided by confirmatory and explora-tory factor analyses, resulted in a refined three-factor scale encompassing 31 items in the domains of communication, mobility, and social functioning needs. This adapted measure effectively dif-ferentiated between acute and chronic stroke patients and those with minor and moderate strokes. In conclusion, the validated 31-item Greek mNAQ emerges as a crucial tool for compre-hensively assessing the needs of stroke patients. Its application holds promise for optimizing post-stroke care, improving functional outcomes, and ultimately enhancing the overall well-being and quality of life for stroke survivors.

A Tamoxifen (TAM) response varies significantly among individuals due to genetic variations in cytochrome P450 2D6 (CYP2D6), as well as other TAM pharmacokinetic and/or pharmacodynamic proteins. In this study, 40 ER+ breast cancer patients who received at least 6 months of TAM treatment were prospectively recruited. The study aimed to evaluate, using HPLC-MS/MS, plasma concentrations of TAM and its metabolites, and to study the association with genetic polymorphisms (CYP2D6*4, CYP3A4*1B, CYP3A5*3, UGT2B7*2, UGT2B15*2, SULT1A1*2, and ESR1V364E) and adverse reactions. Bivariable linear regression analyses showed that CYP3A4*1/*1B is significantly associated with an increase of 4-hydroxyTAM plasmatic concentration, a decrease of endoxifen/4-hydroxyTAM ratio and the elimination of 17β estradiol. It was found that the CYP3A4*1/1B genotype alone could explain part of the variability in [4OHTAM], [endoxifen]/[4OHTAM], and 17β-estradiol plasma levels. Similarly, SULT1A1*1/*2 genotype affects the [endoxifen]/[4OHTAM] plasma ratio. Multivariable predictive models, incorporating both polymorphisms and non-genetic variables, are proposed to explain [NdesMeTAM]/[TAM], [4OHTAM]/[TAM], [endoxifen]/[NdesMeTAM], [endoxifen]/[4OHTAM], and 17β-estradiol plasma levels, as well as for predicting hot flashes and cramps. This preliminary study suggests that the genetic variants studied may influence the bioactivation and elimination of TAM, the clinically observed adverse reactions, and potentially the treatment efficacy.

Bartonella species, intracellular parasitic zoonotic pathogens, has drawn increasing attention for their diverse host range and associated human diseases. This study investigates Bartonella infection in small mammals in Yunnan Province, China, focusing on tissue tropism. 333 small mammals were sampled from 13 species, 3 orders, 4 families, and 4 genera in Heqing and Gongshan Counties. Conventional PCR and real-time quantitative PCR (qPCR) were utilized for detection and quantification, followed by bioinformatic analysis of obtained DNA sequences. Results show a 31.5% detection rate, varying across species. Notably, Apodemus chevrieri, Eothenomys eleusis, Niviventer fulvescens, Rattus tanezumi, Episoriculus leucops, Anourosorex squamipes, and Ochotona Thibetana exhibited infection rates of 44.4%, 27.7%, 100.0%, 6.3%, 60.0%, 23.5%, and 22.2%, respectively. Genetic analysis identified 30, 10, and 5 strains based on ssrA, rpoB, and gltA genes, with nucleotide identities ranging from 92.1% to 100.0%. Bartonella strains were assigned to B. grahamii, B. rochalimae, B. sendai, B. koshimizu, B. phoceensis, B. taylorii, and a new species identified in the Episoriculus leucops (GS136). Tissue distribution analysis revealed varied copy numbers across different tissues, with the highest load in spleen. These findings underscore Bartonella's diverse species and host range in Yunnan Province, highlighting its broad tissue tropism in small mammals.

Zanthoxylum armatum is an forest tree with apomixis characteristic, and RWP-RKs are plant-specific transcription factors known to regulate nitrogen response and embryonic development. However, the genome-wide analysis of RWP-RK family genes in Z.armatum is unclear. In this study, 36 ZaRWP-RK transcription factors were identified in the genome of Z.armatum, among which 15 genes were belonged to the RKD subfamily and 21 belonged to the NLP subfamily. Duplication events of ZaRWP-RK genes were mainly segmental duplication, and synteny analysis revealed close phylogenetic relationship between Z.armatum and Arabidopsis. The analysis of cis-elements indicated that ZaRWP-RK genes may be involved in the regulation of embryonic development of Z.armatum by responding to plant hormones such as abscisic acid, auxin, and gibberellin. Real-time PCR showed that the expression levels of most ZaRWP-RK genes were significantly increased from flowers to young fruits. Protein-protein interaction network analysis further revealed the potential roles of the ZaRWP-RK proteins in apomixis. Collectively, this study provide a theoretical basis for future investigations into the ZaRWP-RK genes and their regulatory mechanisms in the apomixis process of Z.armatum.

Lung cancer is known as lung carcinoma. It is a disease which is malignant tumor leading to the uncontrolled cell growth in the lung tissue. Lung Cancer disease is one of the most prominent cause of death in all over world. Early detection of this disease can assist medical care unit as well as physicians to provide counter measures to the patients. The objective of this paper is to approach an automated tool that takes influential causes of lung cancer as input and detect patients with higher probabilities of being affected by this disease. A neural network classifier accompanied by cross-validation technique is proposed in this paper as a predictive tool. Later, this proposed method is compared with another baseline classifier Gradient Boosting Classifier in order to justify the prediction performance.

Although, central venous pressure (CVP) is among the most frequent estimated hemodynamic parameters in the critically ill setting, extremely little is known on how intensive care unit (ICU) nurses use this index in their decision-making process. The purpose of the study was to develop a new questionnaire for accessing how ICU nurses use CVP measurements to address patients’ he-modynamics investigating its validity and reliability. A cross-sectional study was conducted among 120 ICU nurses from four ICUs of Greece. Based on a comprehensive literature review and the evaluation of a five-experts panel a new questionnaire, named “CVP-Score”, was created having 8 items. The construct validity and the reliability of the questionnaire were examined. The half of the study participants’ (51.7%) was working at a specialized ICU, and they had a mean [±Standard Deviation (SD)] ICU experience of 13(±7.1) years. The estimated construct validity of the new-developed tool was acceptable, while the internal consistency reliability as measured by Cronbach alpha was excellent (0.901). CVP Score had acceptable test-retest reliability (r=0.996, p<0.001) and split-half reliability (0.855). CVP Score is a valid and reliable instrument for measuring how critical care nurses use CVP measurements in their decision-making process.

We examine how observations can be used to evaluate an air quality analysis by verifying against passive observations (i.e. cross-validation) that are not used to create the analysis and we compare these verifications to those made against the same set of (active) observations that were used to generate the analysis. The results show that both active and passive observations can be used to evaluate of first moment metrics (e.g. bias) but only passive observations are useful to evaluate second moment metrics such as variance of observed-minus-analysis and correlation between observations and analysis. We derive a set of diagnostics based on passive observation–minus-analysis residuals and we show that the true analysis error variance can be estimated, without relying on any statistical optimality assumption. This diagnostic is used to obtain near optimal analyses that are then used to evaluate the analysis error using several different methods. We compare the estimates according to the method of Hollingsworth Lonnberg, Desroziers, a diagnostic we introduce, and the perceived analysis error computed from the analysis scheme, to conclude that as long as the analysis is optimal, all estimates agrees within a certain error margin. The analysis error variance at passive observation sites is also obtained.

Background: There has been a lack of tools to identify listening difficulties in school settings for both hearing and hearing-impaired Italian students. Thus, the present study aimed to realize cross-cultural adaptation and validation of the Listening Inventory for Education-Revised for Italian students (LIFE-R-ITA). Methods: Following the validation of two forward-backward translations by a multidisciplinary committee, the content validation for the LIFE-R-ITA was performed by pre-testing six implanted children (8-18 years old). After minor cross-cultural adaptations, normative data were collected from a sample of 223 hearing students enrolled in different school settings and educational degrees. Results: For the LIFE-R-ITA, hearing students showed an average score of 72.26% (SD=11.93), reflecting some listening difficulties. The subscales (LIFE total, LIFE class, and LIFE social) indicated good internal consistency. All items were shown to be relevant. Most challenging situations happened when listening in large rooms, especially when other students made noise. LIFE social scores were significantly worse than those of LIFE class (p &lt; 0.001). Conclusions: The LIFE-R-ITA may support teachers and clinicians in assessing students’ self-perception of listening at school. Such understanding may help students overcome their listening difficulties, by planning and selecting the most effective strategies among classroom interventions.

Having valid and reliable tools that help health professionals to assess fear in children undergoing medical procedures is essential to offer humanized and quality of care in the paediatric population. The aim of this study was to develop the cross-cultural adaptation and the evaluation of the psychometric properties of the Spanish version of the “Child Medical Fear Scale” in its shortened version (CMFS-R). The design consisted of two phases, first of cross-cultural adaptation and second of the psychometric validation of the CMFS-R with a sample of 262 children from Spain. Confirmatory factor analysis was conducted to assess construct validity and the Cronbach alpha and the adjusted item-total score correlation coefficients were performed to study reliability. The results confirmed internal consistency and construct validity of the Spanish version of the CMFS-R, indicating that the scale has an acceptable level of validity and reliability. Therefore, this study brings a new version of the scale to assess fear related to medical procedures for use in the Spanish paediatric population.

The unravelling of the human genome created new perceptions on the origin and evolution of diseases and for cancer in particular, it established the notion that neoplasia has been a companion of life since its ap-pearance on earth. It is not surprising that neoplasms, in various forms, develop in numerous species of animals and even in plants. Unmistakable accounts of cancer with clinical features as are understood today, begin in the 5th c. B.C. The principles and practice of the Hippocratic and Galenic tradition dominated cancer care virtually into the 20th century. Advanced sequencing technologies at the dawn of the 21st century, generate new ther-apeutic opportunities with immunotherapy, oncolytic virotherapy and gene transfer, the latter especially in cases of hereditary cancer.

Background: Assessing body image and personalized rehabilitation in lower limb amputation is essential to measure impact on an individual’s quality of life and psychosocial wellbeing. The aim of this study was to develop a Spanish version of the Amputee Body Image Scale (ABIS-E) for Spanish-speaking lower limb amputee. Methods: A cross-sectional study was conducted including amputee patients in local in Madrid, Spain. Clinical outcomes about body image (Amputee Body Image Scale, ABIS), health-related quality of life (EuroQol-5D-5L), depression and anxiety (Hospital Anxiety and Depression Scale, HADS), pain (Brief Pain Inventory-Short Form, BPI-SF) and functional capacity (Prosthesis Evaluation Questionnaire, PEQ) were collected. Results: Seventy-three participants were assessed. Excellent test-retest reliability (ICC=0.847) and good internal consistency (Cronbach's alpha=0.753) were obtained. Three factors were extracted in the factor analyses. Convergent validity with Pearson's and Spearman's correlation coefficients were calculated for the depression and anxiety questionnaires (HADS) (values between .57 and .67), functional capacity (PEQ) (values between -.35 and .71) and quality of life (EQ-5D-5L) (values between -.37 and .61). Conclusions: The ABIS-E is a reliable and valid tool for measuring body image in the Spanish population with a lower limb amputation, potentially useful in primary care to identify psychosocial problems.

We present a general theory of estimation of analysis error covariances based on cross-validation as well as a geometric interpretation of the method. In particular we use the variance of passive observation–minus-analysis residuals and show that the true analysis error variance can be estimated, without relying on the optimality assumption. This approach is used to obtain near optimal analyses that are then used to evaluate the air quality analysis error using several different methods at active and passive observation sites. We compare the estimates according to the method of Hollingsworth-Lönnberg, Desroziers et al., a new diagnostic we developed, and the perceived analysis error computed from the analysis scheme, to conclude that, as long as the analysis is near optimal, all estimates agree within a certain error margin.

Glaucoma is one of the primary causes of blindness worldwide. Canal opening surgery, a type of minimally invasive glaucoma surgery (MIGS) applied in cases of mild to moderate glaucoma, has gained increasing popularity in recent years due to its efficacy in reducing intraocular pressure, its safety profile, the simplicity of its technique, and the reduced likelihood of compromised vision. Nevertheless, the existing body of histopathological studies remains insufficient for a comprehensive understanding of post-surgical wound healing. Consequently, debates persist among researchers regarding the mechanism through which Schlemm’s canal opening surgery reduces intraocular pressure, as well as the surgical techniques that may impact the outcomes and the factors influencing surgical success. As the history of MIGS is relatively short and lacks sufficient systemic reviews or meta-analysis evaluating the influence of individual factors, this review was conducted to illuminate disparities in the researchers’ opinions at the current stage of research.

This paper presents a method for a decentralised peer-to-peer software license validation system using cryptocurrency blockchain technology to ameliorate software piracy, and to provide a mechanism for software developers to protect copyrighted works. Protecting software copyright has been an issue since the late 1970's and software license validation has been a primary method employed in an attempt to minimise software piracy and protect software copyright. The method described creates an ecosystem in which the rights and privileges of participants are observed.

Recently, the Portuguese parliament approved the decriminalisation of euthanasia for incurable illnesses. As the experiences of other countries show us, it will be a matter of time before mental disorders are addressed. Studying the phenomenon, particularly in vulnerable groups, in advance is essential for proper law drafting. Therefore, instruments which allow an objective assessment and comparison between groups must be available. This study aims to explore the validation of Faria's Attitude about Euthanasia scale in Portuguese older adult patients with mixed anxiety-depressive disorder. A sample of 114 older adult patients with mixed anxiety-depressive disorder collected by convenience in the Psychiatry Department of Senhora da Oliveira Hospital in Portugal was included. The pre-final version of the scale was tested in a small group with good results. The validity of the internal structure was analysed using exploratory factorial analysis. The internal consistency study verified reliability. For construct validity, we assessed the correlation with other validated scales measuring attitudes toward euthanasia, cognitive performance, personality and empathy. Attitude about euthanasia scale showed good internal consistency. One factor was retained in the principal component analysis. Significant correlations verified construct validity. The results support the scale's usefulness and validity. This study makes available a unique instrument to assess the overall tendency of the attitudes towards euthanasia in European-Portuguese, which can be used, for example, to compare Portuguese with Brazilian older adult psychiatric patients suffering from the same disorder. Furthermore, the adapted scale paves the way for other cross-cultural translations, adaptations, validations, and comparative analyses.

Natural vegetation restoration can take decades to achieve and requires information on species composition and trend to inform management strategies. Here we demonstrate the potential and portability of drone, dove and Sentinel-2 imagery for species level classification and trajectory monitoring using three study sites with different revegetation histories. Drone imagery (4 cm) was classified using random forests. Dove (3 m) and Sentinel-2 (10 m) images were acquired close to the anniversary of the drone flights and converted into fractional cover maps showing the proportion of exotics, natives and other land covers using ordinary least squares (OLS) and geographically weighted regression (GWR). The time series of fractional cover maps were converted into positive and negative slope and second-order curvature and summarised as one RGB composite to illustrate trend and observe exotic expansion. Drone classification accuracies ranged from 73%-76% when applied to the full plant species list and between 93% and 97% when grouped into natives, exotics, and other land covers. GWR outperformed OLS for all fractional cover mapping and GWR with dove imagery was more accurate than with Sentinel imagery. The combination of very high-resolution drone acquired imagery with the versatility of dove acquired imagery arms land managers with highly accurate species composition and their spatio-temporal dynamics to promote timely intervention.

This study aimed to translate and validate the Genomic Nursing Concept Inventory (GNCI) in Greek, analyze the genomic knowledge of nurses in Crete, Greece, and explore potential factors that could affect it. This cross-sectional study included 324 nurses from public hospitals and primary care units between July and December 2022. The GNCI is a 31-item questionnaire that evaluates genomic nursing concepts, but it has not been translated and validated in Greek. The translation process included independent forward translations, reconciliation, and back-translation. To evaluate internal consistency, Cronbach’s alpha was used, and Confirmatory Factor Analysis (CFA) was conducted to determine the fit of the model. Multiple linear regression analysis was performed to examine the associations between the demographic variables and GNCI scores. The internal consistency of the GNCI was acceptable (Cronbach’s alpha= 0.622). The CFA indicated that the one-factor model had an adequate fit (SRMR = 0.076, CD = 0.677, CFI = 0.744). The mean GNCI score was moderate (0.35±0.14). Regression analysis suggested that only gender could affect GNCI scores, with female nurses scoring higher than male nurses (p&gt;0.001). In conclusion, the Greek version of the GNCI is a reliable tool for assessing genomic knowledge among Greek nurses.

Eustachian Tube Dysfunction is considered a common condition among ENT patients and requires careful history, clinical examination and appropriate investigations to obtain a diagnosis. The ETDQ-7 questionnaire is a useful tool to subjectively score severity of symptoms that are related to this pathology (Appendix A). This study aimed to adapt and validate the ETDQ-7 questionnaire in Greece to ensure correct and efficient use in the outpatient setting (Appendix B). The ETDQ-7 was translated into the Greek language following appropriate methodology. Data for the main study were collected from a sample of 75 Greek patients diagnosed with ETD as well as 25 patients that did not have ETD and who served as a control group. The participants completed the adapted ETDQ-7 questionnaire and underwent a clinical examination that was statistically correlated with their ETDQ-7 answers. Face and content validity were confirmed and the questionnaire was found easy to administer and to be completed by our patients. Test-retest reliability revealed similar internal consistency for the questions and good correlation between individual items and total score. Discriminative validity confirmed statistically significant difference between the two patient groups to ensure that the Greek version of ETDQ-7 is useful to confirm the diagnosis. The Greek version of the ETDQ-7 is safe and efficient to use among a variety of investigation methods for the diagnosis of ETD in the Greek speaking population.

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

The many limitations of implementing anticancer strategies under the term “precision oncology” have been extensively discussed. While some authors propose promising future directions, others are less optimistic and use phrases such as illusion, hype and false hypotheses. The reality is revealed by practicing clinicians and cancer patients in various online publications, one of which has stated that “in the quest for the next cancer cure, few researchers bother to look back at the graveyard of failed medicines to figure out what went wrong.” The message is clear: novel therapeutic strategies with catchy names (e.g., synthetic “lethality”) have not fulfilled their promises despite decades of extensive research and clinical trials. The main purpose of this review is to discuss key challenges in solid tumor therapy that surprisingly continue to be overlooked by the nomenclature committee on cell death and numerous other authors. These challenges include: the impact of chemotherapy-induced genome chaos (e.g., multinucleation) on resistance and relapse, oncogenic function of caspase 3, cancer cell anastasis (recovery from late stages of apoptosis), and pitfalls of ubiquitously used preclinical chemosensitivity assays (e.g., cell “viability” and tumor growth delay studies in live animals) that score such pro-survival responses as “lethal” events. Studies outline herein underscore the need for new direction in the management of solid tumors.

Numerous approaches address over-fitting in neural networks: by imposing a penalty on the parameters of the network (L1, L2, etc); by changing the network stochastically (drop-out, Gaussian noise, etc.); or by transforming the input data (batch normalization, etc.). In contrast, we aim to ensure that a minimum amount of supporting evidence is present when fitting the model parameters to the training data. This, at the single neuron level, is equivalent to ensuring that both sides of the separating hyperplane (for a standard artificial neuron) have a minimum number of data points — noting that these points need not belong to the same class for the inner layers. We firstly benchmark the results of this approach on the standard Fashion-MINST dataset, comparing it to various regularization techniques. Interestingly, we note that by nudging each neuron to divide, at least in part, its input data, the resulting networks make use of each neuron, avoiding a hyperplane completely on one side of its input data (which is equivalent to a constant into the next layers). To illustrate this point, we study the prevalence of saturated nodes throughout training, showing that neurons are activated more frequently and earlier in training when using this regularization approach. A direct consequence of the improved neuron activation is that deep networks are now easier to train. This is crucially important when the network topology is not known a priori and fitting often remains stuck in a suboptimal local minima. We demonstrate this property by training a network of increasing depth (and constant width): most regularization approaches will result in increasingly frequent training failures (over different random seeds) whilst the proposed evidence-based regularization significantly outperforms in its ability to train deep networks.

Abstract: The VSI represents a significant advancement in the assessment of gastrointestinal-specific anxiety among patients with Irritable Bowel Syndrome (IBS) and other Chronic Inflammatory Bowel Diseases (IBD). However, an Italian version of the instrument is not yet available for the reference population. This study utilized a national sample of 500 individuals, including healthy controls and patients with Ulcerative Colitis and Crohn's Disease, to test the validity and reliability of the Italian VSI. Using back-translation methodology to ensure translation fidelity, the research applied a questionnaire and the VSI through an online format to 500 participants. Data analysis revealed that the Italian VSI had excellent psychometric properties, demonstrating high internal consistency (Cronbach’s α = 0.95) and construct validity. The scale proved sensitive in detecting significant differences in visceral sensitivity among groups, highlighting its utility as a clinical and research assessment tool. Specifically, the Italian VSI exhibited a unidimensional factorial structure and maintained a strong correlation with other measures of anxiety and the severity of gastrointestinal symptoms, confirming its role in enhancing the understanding and management of IBS and IBD in Italy.

Purpose. This paper aims to present a unique perspective that emphasizes the intricate interplay between energy, dietary proteins, and amino acid composition, underscoring their mutual dependence for health-related considerations. Energy and protein synthesis are fundamental to biological processes, crucial for the sustenance of life and growth of organisms. Methods and Results. We explore the intricate relationship between energy metabolism, protein synthesis, regulatory mechanisms, protein sources, amino acid availability, and autophagy, in order to elucidate how these elements collectively maintain cellular homeostasis. We underscore the vital role this dynamic interplay has in preserving cell life. Conclusion. A deeper understanding of the link between energy and protein synthesis is essential to comprehend fundamental cellular processes. This insight could have wide-ranging impact in several medical fields, such as nutrition, metabolism, and disease management.

The Atmospheric Dynamics Mission ADM-Aeolus was successfully launched in August 2018 by the European Space Agency (ESA). The Aeolus mission carried a single instrument, the first-ever Doppler Wind Lidar (DWL) in space, called Atmospheric LAser Doppler INstrument (ALADIN). Aeolus circled the Earth in a polar sun-synchronous orbit at about 320 km altitude with a repeat cycle of 7 days, providing vertical profiles of horizontal line-of-sight (HLOS) winds on a global scale. Exceeding scientific expectations, Aeolus, initially designed for a 3-year lifetime, provided global coverage of wind profiles for almost five years. In this long-term validation study, we assessed the accuracy of the Level 2B (L2B) Rayleigh-clear and Mie-cloudy wind products by collecting radiosonde data from three stations in the Brazilian Amazon: Cruzeiro do Sul (7.62° S, 72.67° W), Porto Velho (8.76° S, 63.91° W), and Rio Branco (10.00° S, 67.80° W). Statistical validation was conducted by comparing Aeolus L2B wind products and radiosonde data, launched daily at 12:00 UTC from October 2018 to March 2023. Considering all data collected during the mission period, Pearson’s coefficient (R) of 0.73 was observed in Rayleigh-clear and 0.85 in Mie-cloudy, revealing a strong correlation between Aeolus and radiosonde winds. No significant biases were detected, with values of -0.14 m/s for Rayleigh-clear and -0.40 m/s for Mie-cloud, fulfilling the mission requirement of having absolute biases below 0.7 m/s. However, when analyzed annually, in 2022, the bias for Rayleigh-clear was -0.95 m/s, exceeding the mission requirements.

There is currently no set of instruments or procedures to evaluate the effectiveness of cross-sectoral collaboration in the current CFC program. This study aimed to develop a tool for evaluating the cross-sectoral contributions to the CFC program. A paper-based questionnaire was developed by the research team after a preliminary qualitative procedure, and it was subsequently employed to collect data. This process resulted in 17 indicators (41 items) of cross-sectoral collaboration in the development of the CFC in Makassar. These indicators were categorized into five dimensions: governance, administration, autonomy, mutuality, and norms. There were 32 items remaining after several items that were determined not to correspond with the model were eliminated prior to the CFA analysis. According to the CFA results, the five-domain model corresponded to the data with standardized loading factor (SLF)<0.5, indicating that the convergent validity of SLF was acceptable. In addition, these results suggested that the items employed in the tool were really significant in reflecting these five domains. The developed and validated tool was expected to be beneficial in evaluating cross-sectoral collaboration in the CFC program developed in Makassar City. The findings of this study would serve as a benchmark indicator, enabling the assessment process to gauge the significance with which a city is developing with cross-sectoral restriction measures.

Objectives: This study validated the Japanese version of O’Donovan et al.’s (2020) composite measure of psychological safety scale and examined the associations of psychological safety with mental health and job-related outcomes. Methods: Online surveys were administered twice to Japanese employees with teams of more than three members. Internal consistency and test-retest reliability was tested using Cronbach’s α and intra-class correlation coefficient (ICC). Structural validity was examined using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Convergent validity was tested. Multiple linear regression analyses were conducted to examine the relationship between psychological safety and psychological distress, work engagement, job performance, and job satisfaction. Results: Two hundred healthcare workers and 200 non-healthcare workers were analyzed. The Cronbach’s alpha of the total score was 0.92 - 0.96 and ICC was 0.88 - 0.92. CFA demonstrated poor fit, and EFA yielded a two-factor structure, suggesting one factor combined with peers and team. The scale showed good convergent validity. The total score of the scale showed significant associations with all outcomes in adjusted model in all workers. Conclusions: The Japanese version of the measure of the psychological safety scale presented good reliability and validity. Psychological safety is important for employees’ mental health and performance.

This paper presents a system for identification of wind features, such as gusts and wind shear. These are of particular interest in the context of energy-efficient navigation of Small Unmanned Aerial Systems (UAS). The proposed system generates real-time wind vector estimates and a novel algorithm to generate wind field predictions. Estimations are based on the integration of an off-the-shelf navigation system and airspeed readings in a so-called direct approach. Wind predictions use atmospheric models to characterize the wind field with different statistical analyses. During the prediction stage, the system is able to incorporate, in a big-data approach, wind measurements from previous flights in order to enhance the approximations. Wind estimates are classified and fitted into a Weibull probability density function. A Genetic Algorithm (GA) is utilized to determine the shaping and scale parameters of the distribution, which are employed to determine the most probable wind speed at a certain position. The system uses this information to characterize a wind shear or a discrete gust and also utilizes a Gaussian Process regression to characterize continuous gusts. The knowledge of the wind features is crucial for computing energy-efficient trajectories with low cost and payload. Therefore, the system provides a solution that does not require any additional sensors. The system architecture presents a modular decentralized approach, in which the main parts of the system are separated in modules and the exchange of information is managed by a communication handler to enhance upgradeability and maintainability. Validation is done providing preliminary results of both simulations and Software-In-The-Loop testing. Telemetry data collected from real flights, performed in the Seville Metropolitan Area in Andalusia (Spain), was used for testing. Results show that wind estimation and predictions can be calculated at 1 Hz and a wind map can be updated at 0.4 Hz. Predictions show a convergence time with a 95% confidence interval of approximately 30 s.

Background: Given the extensive translation of the Prolapse Quality of Life Questionnaire (P-QoL) into many languages, it is imperative to develop an Arabic version to facilitate study on Pelvic organ health within the Arabian culture. Objective: To investigate, cross culturally adapt and validate Arabic version of the P-QoL. Study Design: Cross-cultural adaptation and psychometric testing. Methods: A total of 90 participants were included in the study. This cross-sectional study went through two phases; during phase I, the P-QoL was translated and adapted from English into Arabic. The Arabic version was psychometrically validated during phase II using the test-retest reliability internal consistency with Cronbach’s alpha coefficient, convergent construct validity (CC) among the four study tools using Spearman’s coefficient (r) and discriminative validity using Mann-Whitney test to find differences between the means of the two samples. Results: A satisfactory level of semantic, conceptual, idiomatic, and content comparability was reached in the cross-cultural adaptation of the Arabic version of the P-QoL questionnaire. The internal consistency was high in terms of psychometric validation, with a Cronbach’s alpha coefficient of 0.971 for the P-QoL questionnaire. The test-retest results showed a high reliability with interclass correlation coefficient (ICC) of P-QoL = 0.987. The convergent construct validity was highly accepted (moderately strong), reflecting a positive correlation between the Arabic version of the P-QoL and the Australian Pelvic Floor Dysfunction Questionnaire (APFD) r = 0.68 (p &lt; 0.001). Similarly, a significant convergent validity of P-QoL Arabic version and Visual Analogue Scale (VAS) r = 0.47 (p &lt; 0.001) was found, as well as the correlation between the APFD and the VAS r = 0.46 (p &lt; 0.001). However, there were no significant correlation between the SF-12, the P-QoL, the APFD, and the VAS. Conclusion: Based on a significant correlation between the Arabic APFD and the VAS, the results reveal good reliability, internal consistency, and construct validity. It is recommended that Arabic-speaking females with pelvic organ prolapse use the Arabic version of the P-QoL. More research is needed to assess the responsiveness of the P-QoL.

Exosomes are produced by all cell types, their biogenesis is of endosomal origin, originating as a result of cell membrane invagination. Furthermore, physiochemical characteristics are important prerequisites for their commercial application. The representative size range of exosomes is 50-200 nm. Whereas, comparative to animal cell, exosomes from plant cell sources have a relatively larger size range, moreover, exhibit broader therapeutic potential. In this review study, we have briefly discussed the research potential of plant-derived exosomes. Including their earlier studies on biogenesis, characterization, isolation methods, and possible therapeutic applications. Additionally, we have quoted targeted drug delivery for targeted therapies and have provided insights of methods for customizing exosomes produced from plants with various drugs. Most-importantly, here we have embodied exosomes from plant sources are natural nano-inducers possessing the ability for inter-kingdom communication, resulting in cross-kingdom regulations.

Accurately glacier mapping is crucial for understanding climate change impacts, but existing efforts may be biased due to overlooking spatial autocorrelation during map validation. To address this, we compared several widely used machine learning algorithms as gradient boosting machines (GBM), k-nearest neighbor (KNN) and random forest (RF) with parametric logistic regression (GLM) and an unsupervised remote sensing-based method (NDSI) for mapping Peru's glacier regions in a thoughtful experimental setup. Spatial and non-spatial cross-validation methods were used to evaluate model’s performance and compared with a fully independent test set. Performance differences of up to 18% were found between bias-reduced (spatial) and overoptimistic (non-spatial) cross-validation results when compared to independent test set, emphasizing the need to consider spatial autocorrelation when using machine learning for glacier mapping. K-nearest neighbors (KNN) was the overall best model across regions consistently demonstrating the highest performance followed by logistic regression (LR) and gradient boosting machines (GBM). Our novel validation approach, accounting for spatial characteristics, provides valuable insights for glacier mapping studies and future efforts on glacier retreat monitoring. Incorporating this approach improves the reliability of glacier mapping, guiding future national-level initiatives.

Globally, over the past several months millions of persons contracted the coronavirus disease 2019 (COVID-19) resulting in significant mortality. Health care systems are negatively impacted including the care of individuals with cancers and other chronic diseases such as chronic active hepatitis, cirrhosis and hepatocellular carcinoma. There are various probable pathogenic mechanisms that have been presented to account for liver injury in COVID-19 patients such as hepatotoxicity cause by therapeutic drugs, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of the bile duct cells and hepatocytes, hypoxia and systemic inflammatory response. Liver biochemistry tests such as AST, ALT, GGT and ALP are deranged in COVID-19 patients with liver injury. Hepatocellular damage results in the elevation of serum AST and ALT levels in early onset disease while a cholestatic pattern that develops as the disease progress causes higher levels of ALP, GGT, direct and total bilirubin. These liver biochemistry tests are prognostic markers of disease severity and should be carefully monitored in COVID-19 patients. We conducted a systematic review of abnormal liver biochemistry tests in COVID-19 and the possible pathogenesis involved. Significant findings regarding the severity, hepatocellular pattern, incidence and related clinical outcomes in COVID-19 patients are highlighted.

Background: The practice of self-medication is common worldwide and is an important component of medical self-care. However, the practice can be dangerous and is linked to various risks for the patients and the entire community. This study aimed to estimate the prevalence and factors associated with self-medication among Bangladeshi adults. Methods: A cross-sectional survey was conducted between April and June 2021 among Bangladeshi adults (aged &gt;19 years) using convenient sampling. A total of 1320 data were collected through face-to-face interviews using a standardized questionnaire. Multivariable logistic regression analysis was used to identify factors associated with self-medication practice (SMP). Results: Overall, 41% of adults in our survey reported SMP. The most common illnesses that prompted SMP were common cold/flu (66.4%), gastric problems (65%), and headache (64.4%). The most frequent reasons for SMP were to get better services (30.59%), perceive SMP without side effects (23.28%), and save time with effectiveness (14.56%). Potential risk factors included 10 years (AOR = 1.91; 95% CI: 1.04 - 3.50) and &gt;12 years of schooling (AOR = 5.03; 95% CI: 2.27 - 11.15), being a businessman (AOR = 4.64; 95% CI: 1.74 - 12.37), having ≤6 family members (AOR = 2.13; 95% CI: 1.40 - 3.24), being a member of a social group (AOR = 1.53; 95% CI: 1.10 - 2.12), a health status check after every six months (AOR = 1.52; 95% CI: 1.08 - 2.13), and current ill-health (AOR = 1.41; 95% CI: 1.06 - 1.87). Protective factors identified included ≤30 years of age (AOR = 0.40; 95% CI: 0.17 - 0.93), and practice of modern (AOR = 0.39; 95% CI: 0.22- 0.69) and herbal (AOR = 0.45; 95% CI: 0.21- 0.97) healing types. Conclusion: More than one-third of the study participants reported practicing self-medication. Increasing the community’s awareness of the extreme consequences of SMP and not just the average experience might sway individuals away from SMP, and implementing strict jurisdiction could be a way to minimize the SMP.

We propose an innovative approach called SMPTC3, designed specifically to enhance security and privacy in cross-chain transaction verification. This approach addresses multi-chain, multi-participant information exchange and large-scale cross-chain transfers, resisting various types of malicious attacks. We leverage the verifiability of cross-chain transactions based on smart contracts and innovatively transform transaction information into confidential sets, organizing them into quadratic secret polynomials. By utilizing secret sharing and random distribution techniques, we construct a secure multiparty computation method, tailored for cross-chain transactions. To enhance the efficiency of cross-chain transactions, we introduce cross-chain batch processing technology, grouping inter-chain transactions into cross-chain transaction sets. Unlike traditional distributed notary technologies, SMPTC3 designates honest participants as a cross-chain notary group, reducing the time required for redundant signature confirmations and significantly lowering the possibility of malicious notaries. Theoretical analysis and empirical experiments demonstrate that SMPTC3 is highly efficient in addressing cross-chain transaction security issues.

The keratinocyte carcinomas, basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), are the most common cancers in humans. Recently, an increasing body of literature has investigated the role of miRNAs in keratinocyte carcinoma pathogenesis, progression and their use as therapeutic agents and targets, or biomarkers. However, there is very little consistency in the literature regarding the identity of and/or role of individual miRNAs in cSCC (and to a lesser extent BCC) biology. miRNA analyses that combine clinical evidence with experimental elucidation of targets and functional impact provide far more compelling evidence than studies purely based on clinical findings or bioinformatic analyses. In this study, we review the clinical evidence associated with miRNA dysregulation in KCs assessing the quality of validation evidence provided, identify gaps, and provide recommendations for future studies based on relevant studies that investigated miRNA levels in human cSCC and BCC. Furthermore, we demonstrate how miRNAs contribute to the regulation of a diverse network of cellular functions, and that large-scale changes in tumor cell biology can be attributed to miRNA dysregulation. We highlight the need for further studies investigating the role of miRNAs as communicators between different cell types in the tumor microenvironment. Finally, we explore the clinical benefits of miRNAs as biomarkers of keratinocyte carcinoma prognosis and treatment.

A power factor correction (PFC) rectifier is compulsory for any electronic circuitry connected to the electrical grid. The majority of PFCs that are utilized are based on a step-up converter that supplies high DC voltage at its output terminal. Electric vehicle battery voltage varies from a few hundred to almost a thousand volts. Thus, an additional conversion step is obligatory when designing an all-brand universal charger. This paper presents a new type of front-end versatile step up / down three voltage level PFC. The rectifier can operate in continuous conduction mode or discontinuous conduction mode. First, the rectifier’s principle of operation is described, and then an innovative rectifier is analyzed for continuous and discontinuous conduction modes. Finally, the proposed theory is experimentally validated in a multiplier-less dual loop mode at discontinuous conduction modes. It was shown that although there is no multiplier use in the control circuitry, the power factor is near unity. It was revealed that the rectifier could swing the output voltage from 50 V to 900 V while the input voltage was 230 Vrms. The innovative topology suits any standard PFC rectifier, three-level voltage supplement, and dual-stage low-voltage power supply.

The rapid and accurate detection of viruses and the discovery of single nucleotide polymorphisms (SNPs) are crucial for disease management and understanding viral evolution. In this study, a pipeline for virus detection, validation, and SNP discovery from next-generation sequencing (NGS) data is presented. By integrating state-of-the-art bioinformatics tools with artificial intelligence, the pipeline processes raw sequencing data to identify viral sequences with high accuracy and sensitivity. Before aligning the reads to the reference genomes, quality control measures and adapter trimming are performed to ensure the integrity of the data. Unmapped reads are subjected to de novo assembly to reveal novel viral sequences and genetic elements. The effectiveness of the pipeline is demonstrated by the identification of virus sequences, illustrating its potential for the detection of known and emerging pathogens. SNP discovery is performed using a custom Python script that compares the entire population of sequenced viral reads to a reference genome. This approach provides a comprehensive overview of viral genetic diversity and identifies dominant variants and a spectrum of genetic variations. The robustness of the pipeline is confirmed by the recovery of complete viral sequences, which improves our understanding of viral genomics. This study highlights the synergy between traditional bioinformatics techniques and modern approaches, providing a robust tool for analyzing viral genomes and contributing to the broader field of viral genomics.

Pd EnCat™ 30 is a palladium catalyst broadly used in several hydrogenation and cross-coupling reactions. It is known for its numerous beneficial features, which include high-yielding performance, easy recovery, and reusability. However, the available data regarding its recyclability in Suzuki coupling reactions are limited to a few reaction cycles and, therefore, fail to explore its full potential. Our work focuses on investigating the extent of Pd EnCat™ 30 reusability in Suzuki cross-coupling reactions by measuring its performance according to isolated yields of product. Our findings demonstrate that Pd EnCat™ 30 can be reused over a minimum of 30 reaction cycles, which is advantageous in terms of cost reduction and more sustainable chemical production.

：Non-Euclidean data, such as social networks, and citation relationships between documents, has node information and structural information. Graph Convolutional Network(GCN) can automatically learn node features and association information between nodes. The core ideology of the graph convolutional network is to aggregate node information by using edge information, thereby generating a new node feature. In the process of updating node features, there are two core influencing factors. One is the number of neighboring nodes of the central node, the other is the contribution of the neighboring nodes to the central node. Due to the previous GCN methods not simultaneously considering the numbers and different contributions of neighboring nodes to the central node, we design the Adaptive Attention Mechanism(AAM). To further enhance the representational capability of the model, we utilize Multi-Head Graph Convolution(MHGC). Finally, we adopt cross-entropy(CE) loss function to describe the difference between the predicted results of node categories and the ground truth (GT). Combined with backpropagation, this ultimately achieves accurate node classification. Based on AAM, MHGC and CE, we contrive the novel Graph Adaptive Attention Network (GAAN). Experiments show that the classification accuracy has achieved outstanding performances on Cora, Citeseer and Pubmed datasets.

Multimodal emotion classification (MEC) involves analyzing and identifying human emotions by integrating data from multiple sources, such as audio, video, and text. This approach leverages the complementary strengths of each modality to enhance the accuracy and robustness of emotion recognition systems. However, one significant challenge is effectively integrating these diverse data sources, each with unique characteristics and levels of noise. Additionally, the scarcity of large, annotated multimodal datasets in Bangla limits the training and evaluation of models. In this work, we unveiled a pioneering multimodal Bangla dataset, MAViT-Bangla (Multimodal Audio Video Text Bangla dataset). This dataset, comprising 1002 samples across audio, video, and text modalities, is a unique resource for emotion recognition studies in the Bangla language. It features emotional categories such as anger, fear, joy, and sadness, providing a comprehensive platform for research. Additionally, we developed a framework for emotion recognition that employs a cross-modal attention mechanism among unimodal features. This mechanism fosters the interaction and fusion of features from different modalities, enhancing the model’s ability to capture nuanced emotional cues. The effectiveness of this approach was demonstrated by achieving an F1-score of 0.64, a significant improvement over unimodal methods.

Structural health monitoring has been studied by a number of researchers as well as various industries to keep up with the increasing demand for preventive maintenance routines. This work presents a novel method for reconstruct prompt, informed strain/stress responses at the hot spots of the structures based on strain measurements at remote locations. The structural responses measured from usage monitoring system at available locations are decomposed into modal responses using empirical mode decomposition. Transformation equations based on finite element modeling are derived to extrapolate the modal responses from the measured locations to critical locations where direct sensor measurements are not available. Then, two numerical examples (a two-span beam and a 19956-degree of freedom simplified airfoil) are used to demonstrate the overall reconstruction method. Finally, the present work investigates the effectiveness and accuracy of the method through a set of experiments conducted on an aluminium alloy cantilever beam commonly used in air vehicle and spacecraft. The experiments collect the vibration strain signals of the beam via optical fiber sensors. Reconstruction results are compared with theoretical solutions and a detailed error analysis is also provided.

Current VAT rules for cross-border e-commerce companies in the EU are not sustainable, because they are extremely complex and often opaque, due to the lack of tax harmonization. The aim of the research is to explore, using a qualitative method, what kind of harmonization would make the current legislation more uniform, simpler, more transparent, and easier to understand, without conflicting with the rules of any Member State. To this end, the aspects of the new platform regulation introduced on 1 July 2021 and its potential for expansion are assessed through information from possible sales models. The research suggests that the rules on platforms do not cover all possible sales models, which in our view imposes an unnecessary extra administrative burden on some businesses and makes their tax activities less transparent. In the light of the results of the research, we propose that the current EU platform regulation should be extended to cover B2B, B2C transactions and services. As a result of this suggested harmonization, a simpler, more transparent, uniform and sustainable tax system would contribute to the whitening of the economy, generating additional tax revenue for Member States.

Safe water is a global public health concern amid increasing scarcity and pollution. Bottled water production and consumption contribute to these problems. This study examines tap water consumption in Italy, assessing associated sociodemographic factors and related health outcomes such as obesity and self-perceived health status. Data from the Italian National Statistics Institute's "Aspects of daily life" survey (N=45,597) were analyzed. Covariates included education, age, gender, economic status, region, concerns about waste and climate change, consumption of carbonated drinks excluding water, alcohol consumption, consumption of vegetables, consumption of snacks, body mass index, and self-perceived health status. Bivariate analyses and mixed-effect logistic regression models explored the associations. People who drink tap water were 19,674 with a higher prevalence in people aged 45 to 59 old, people with a graduate/post-graduate degree diploma, with optimal economic resources, and concerned about waste production and climate change, coming from the North-East regions of Italy. Underweight people showed a higher prevalence of TW assumption as well as those who drink less than occasionally carbonated drinks, drink alcohol, consume vegetables more than once a day, and snacks less than once a week with a satisfying level perceived health status. Regressions showed that all age classes are less likely to drink tap water than people younger than 20 years old. The category with “inadequate” economic resources is more likely to consume tap water. Low educational classes show a low likelihood of consuming tap water as well as Islands. A concern about waste production and climate change is associated with an increased likelihood of assuming tap water. Tap water consumption was negatively associate with obesity but not with a satisfactory Self-perceived health status. Insights from this study can inform public health strategies.

A simple design of an ultrathin six-band polarization-insensitive terahertz perfect metamaterial absorber (PMMA) composed of a metal cross-cave-patch resonator (CCPR) placed over a ground plane was proposed and investigated numerically. The numerical simulation results demonstrate that the average absorption peaks are up to 95% at six resonance frequencies with high quality-factors (>65). In addition, the absorption properties can be kept stability for both normal incident transverse magnetic (TM) and transverse electric (TE) waves. The physical mechanism behind the observed high level absorption is illustrated by the electric and power loss density distributions. The different absorption mainly originates from the higher order multipolar and multipolar plasmon resonance of the structure, which are sharp different to the most previous studies of the PMMAs. Furthermore, the resonance absorption of the PMMA can be tunable by varying the geometric parameters of the unit cell.

A simple design of an ultrathin six-band polarization-insensitive terahertz perfect metamaterial absorber (PMMA) composed of a metal cross-cave-patch resonator (CCPR) placed over a ground plane was proposed and investigated numerically. The numerical simulation results demonstrate that the average absorption peaks are up to 95% at six resonance frequencies with high quality-factors (>65). In addition, the absorption properties can be kept stability for both normal incident transverse magnetic (TM) and transverse electric (TE) waves. The physical mechanism behind the observed high level absorption is illustrated by the electric and power loss density distributions. The different absorption mainly originates from the higher order multipolar and multipolar plasmon resonance of the structure, which are sharp different to the most previous studies of the PMMAs. Furthermore, the resonance absorption of the PMMA can be tunable by varying the geometric parameters of the unit cell.

Breast cancer remains a global health problem requiring effective diagnostic methods for early detection in order to achieve WHO’s ultimate goal of breast self-examination (BSE). A literature review indicates the urgency of improving diagnostic methods and identifies thermography as a promising, cost-effective, and non-invasive and adjunctive and complementary detection method. This research explores the potential of using machine learning (ML) techniques, specifically Bayesian Networks (BN) combined with Convolutional Neural Networks (CNN) to improve breast cancer diagnosis at early stages. Explainable artificial intelligence (XAI) aims to clarify the reasoning behind any output of artificial neural networks based models. The proposed integration adds interpretability of the diagnosis, which is particularly significant for a medical diagnosis. We have constructed two diagnostic expert models. In research model A, combining thermal images after XAI process together with medical records, an accuracy of 84.07% has been achieved, while model B, that includes also CNN prediction, achieved an accuracy of 90.93%. These results demonstrate the potential of XAI to transform breast cancer diagnosis, increasing accuracy and reducing the risk of misdiagnosis.

In the present study, we compare energy transition scenarios from a new set of Integrated Assessment Models, the suite of MEDEAS models, based on a systems dynamic modelling approach, with scenarios from two already well know structurally and conceptually different Integrated Assessment Models, the Integrated MARKAL-EFOM System (TIMES) and the Long-range Energy Alternatives Planning system (LEAP). The investigation was carried out to cross-compare and benchmark the response of MEDEAS models with TIMES and LEAP in depicting the energy transition in two different countries, Austria and Bulgaria. The preliminary results show a good agreement across all the models in representing scenarios projecting historical trends, while a major discrepancy is detectable when the rate of implementation of renewable energy is forced to increase to achieve energy system decarbonization. The discrepancy is mainly traceable to the differences in the models’ conception and structures rather than in a real mismatch in representing the same scenarios. The present study is put forward as a guideline for validating new modelling approaches that link energy policy decision tools to the global biophysical and socioeconomic constraints.

Background: Ultraviolet (UV) radiation from the sunlight can harm skin cells, causing short-term effects, such as sunburns and long-term effects, such as pigmentation changes, changes in the skin's immune responses, and increased risk of skin cancer. These conditions can be largely prevented with proper sun protection measures and behavioural changes. This study aims to assess the knowledge on sun protection behaviour and baseline knowledge of medical students from the “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania. Methods: Data in this cross-sectional study were collected through a Google Forms questionnaire, which was distributed from November 2023 to December 2023 via digital communication channels to students across all academic years. STROBE guidelines were consulted for data synthesis; Results: A total of 668 stu-dents responded. The student cohort demonstrated a commendable level of awareness of the risks associated with sun exposure and the advantages of employing sun protection factor (SPF); how-ever, the incidence of sunburns remained notably elevated (72.3%). Further analysis revealed cor-relations among gender, academic year, presence of photosensitizing conditions, and adherence to SPF application. Additionally, there is a need to improve understanding of the appropriate appli-cation techniques for SPF, as only 11.5% of the students exhibited proficiency in this regard; Con-clusions: As future healthcare providers, medical students hold significance in promoting healthy behaviours in the broader community. This study indicates that while their knowledge about sun protection is satisfactory, there is scope for enhancement.

Background: Studies have tried to identify predictors of functional markers of keratoconus progression, whereas structural outcomes of collagen cross-linking have not been properly investigated. Objective: find and set up a combination of diagnostic modalities and measurements to reliably reflect CXL efficiency. Material and methods: We retrospectively reviewed the medical histories of 107 KC patients (131 eyes) who underwent CXL in a medical center from January 2018 to December 2022. The dataset included preoperative examinations and follow-up results, which provided a total of 796 observations. The cases of other corneal diseases, repeated CXL, pregnancy, and observations without follow-up examinations were excluded. Results: The study findings revealed a significant drop in the central and corneal thickness during 14.01±9.98 months of observations. Linear and polynomial equations suggested different trends in pachymetry change after CXL. The linear model showed corneal thinning, and according to the polynomials, pachymetry findings return to baseline values two years after CXL. Conclusion: The most reliable prognosis of postoperative corneal thickness is achieved with the models trained on keratometry readings and topography indices. BAD indices are also reliable predictors of the corneal thickness after CXL. A combination of the aforementioned structural parameters and their derivatives can reliably predict CXL efficiency.

Objectives: Evaluate the performance of diagnostic measures (sensitivity and specificity) of the intrinsic capacity (IC) construct recommended by the WHO ICOPE guidelines by domain and by age group. Study design: This cross-sectional study included 164 community-dwelling elderly (95 women and 69 men). The participants completed the assessment of the 5 domains of IC (cognition, psychological, vitality, locomotion and sensory). In addition, they were assessed for activities of daily living (ADL), instrumental activities of daily living (IADL), frailty and urinary incontinence. Main outcomes measures: Descriptive statistics were used to summarize the intrinsic capacity and identify which domains were compromised. Comparisons between three or more samples were made by 1-way ANOVA with Bonferroni post-test and those with two samples by the t-test or Mann-Whitney test for quantitative variables. Chi-square test was used for qualitative variables. The sensitivity and specificity of each domain and each domain by age group were evaluated using the ROC curve. Results: Participants with a decline in IC were older, worse ADL, IADL and mental function, low gait speed, and higher depression scores. In addition, people with a decline in IC had frailty, urinary incontinence. Other issues related to the decline in CI were self-reported non-practice of physical activities and level of schooling.The evaluation of each domain did not prove to be a good screening tool (sensitivity or specificity &lt; 80%, but both values &gt; 50%). When the analyses were separated by domain and age group, good performance was found in the psychological (69-69 years and ≥80 years), vitality (≥80 years) and sensory (≥80 years) domains. Conclusions: The ICOPE screening tool performed well in terms of diagnostic measures when applied by domain and age group.

Despite the increasing prevalence of pet ownership in Chinese societies, standardized tools to assess grief from pet loss remain lacking. Research predominantly focuses on Western populations, creating a gap in understanding pet bereavement in Chinese cultural settings. This study aimed to adapt and validate the Pet Bereavement Questionnaire (PBQ-C) for a Chinese context to create a culturally appropriate assessment tool. A total of 245 participants with companion animal loss experiences were recruited through the university of the research team. They were invited to complete an online survey including the Chinese PBQ, the Depression subscale of the Depression Anxiety Stress Scales (DASS-21), and the Inventory of Complicated Grief (ICG). Both Exploratory Factor Analysis and Confirmatory Factor Analysis were conducted to examine the psychometric properties of the PBQ-C and the findings supported a three-factor structure—grief, anger, and guilt—aligned with the original PBQ, with three items were reassigned to different factors. Despite these adjustments, the PBQ-C showed strong internal consistency, split-half reliability, and concurrent validity. The validated PBQ-C provides a culturally sensitive tool for assessing pet bereavement in Chinese society that can promote research and counselling support for this under-researched and under-recognized type of loss of human-animal relationships.

Chronic stress, culminating in burnout, evolves gradually and is notoriously difficult to detect due to vague symptoms and individuals' hesitance to acknowledge their struggles. To expedite the identification and recognition of this condition, enabling timely psychological intervention, the integration of Artificial Intelligence (AI) is increasingly considered. This research does not assert the feasibility of an AI system managing all aspects of chronic stress's impact. However, it highlights the capability of current technology to detect stress indicators based on quantifiable data like Heart Rate (HR) and organizational climate dimensions. Although other physiological markers such as oximetry, skin galvanic response, and EKG have been explored, they have not shown reliable differentiation between stress and joy. Focused on the unique context of school principals in the Bedouin regions of Israel, this study investigates the interplay between HR, organizational climate, and stress levels. It introduces a novel application of a fuzzy logic tool that combines HR and organizational climate metrics to aid in stress diagnosis. This tool incorporates the psychologist's expertise to provide real-time data crucial for developing effective coping strategies. While the AI-supported fuzzy system does not replace professional psychological intervention, it significantly enhances the speed of condition identification and intervention planning, thus shortening the response time to stress-related issues in educational leadership within culturally specific settings. The application of such AI-driven tools is pivotal for sustaining the well-being and effectiveness of educational leaders, thereby supporting the broader goal of educational sustainability.

Adjunctive treatment of periodontitis lacks solutions allowing enough time for wound healing in the periodontal pockets by avoiding a fast re-colonization. Such a solution might be an antibiotic containing formulation with a controlled release over weeks. Here, a recently described minocycline containing approach is qualified for further clinical development by focusing on proof-of-concept, systemic burden, resistance development and degradation studies. Animal studies were done in two different (mouse-chamber, rat Porphyromonas gingivalis challenging) models, including effects on inflammation markers, bone loss and bone structure. Also, serum concentrations of minocycline after local application were determined by HPLC-MS/MS. The resistance status of bacterial clinical isolates against minocycline was investigated and the degradation of the formulation was characterized by laser scanning- and scanning electron microscopy. Animal studies clearly demonstrated the applicability of the new formulation in the investigated models. Inflammation markers decreased dosage dependent and reduced bone loss compared to non-treated group was observed. Thereby, the systemic burden of the antibiotic was neglectable. Minocycline is still effective against oral pathogens; resistance development was not seen. The biodegradable thread was first swollen and subsequently degraded over weeks. The results support the continued clinical development of this new formulation. A phase I clinical trial is planned to further evaluate its safety and efficacy.

Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) is a clinical entity characterized by the absence of significant coronary artery obstruction in epicardial arteries (&lt; 50%) on coronary angiography in the setting of acute myocardial infarction (AMI). This article aims to provide a narrative review of the pathophysiological mechanisms, diagnostic challenges, and prognosis associated with MINOCA focusing only on cases associated with myocardial ischemia but of non-atherosclerotic origin. Etiological factors, including thromboembolism, coronary artery spasm, spontaneous coronary artery dissection, coronary microvascular disease, and supply-demand mismatch are addressed. Imaging modalities such as echocardiography, advances in coronary angiography like intravascular ultrasound (IVUS) and optical coherence tomography (OCT), cardiac magnetic resonance (CMR), and coronary computed tomography angiography (CCTA) are also analyzed. MINOCA patients have a better short-term prognosis compared to those with obstructive coronary artery disease but face significant long-term risks, underscoring the need for precise diagnosis and management strategies. Elevated inflammatory markers and specific genetic predispositions are also associated with adverse outcomes in MINOCA. This review focused on MINOCA from the pathophysiological perspective on ischemic, non-atherosclerotic causes, the diverse underlying mechanisms, the challenges in achieving accurate diagnosis, the importance of a tailored therapeutic approach and the necessity for further investigation of clinical outcomes.

This investigation explores the potential of enhancing aqueous zinc-ion batteries (AZIBs) through the introduction of a novel cathode material, NH4V4O10 (NVO), combined with reduced graphene oxide (rGO). Utilizing Density Functional Theory (DFT), it was hypothesized that the incorpora-tion of rGO would increase the interlayer spacing of NVO and diminish the charge transfer in-teractions, thus promoting enhanced diffusion of Zn2+ ions. These theoretical predictions were substantiated by experimental data acquired from hydrothermal synthesis, which indicated a marked increase in interlayer spacing. Significantly, the NVO-rGO composite exhibits remarkable cyclic durability, maintaining 95% of its initial specific capacity of 507 mAh g−1 after 600 cycles at a current density of 5 A g−1. The electrochemical performance of NVO-rGO not only surpasses that of pristine NVO but also outperforms the majority of existing vanadium oxide cathode materials reported in the literature. This study underscores the effective integration of theoretical insights and experimental validation, contributing to the advancement of high-performance energy storage technologies.

Domain generalization has led to remarkable achievements in Hyperspectral Image (HSI) classification. Inspired by contrastive language-image pre-training (CLIP), the language-aware domain generalization method has been explored to learn cross-domain-invariant representation. However, existing methods face some challenges: 1) The weak capacity to extract long-range contextual information and inter-class correlation. 2) Due to the inadequacies of the large-scale pre-training for HSI data, the spatial-spectral features of HSI and linguistic features can not be straightforwardly alignment. To address the above problems, a novel network has been proposed with a CLIP framework, which consists of an image encoder, based on an encoder-only transformer to obtain the global contextual information and inter-class correlation, a frozen text encoder, and a cross-attention mechanism, named Linguistic-Interact-with-Visual Engager (LIVE), enhances the interaction between two modalities. Extensive experiments demonstrating superior performance over state-of-the-art methods in HSI Domain Generalization with a CLIP framework.

Some preterm and sick neonates have altered biochemical profiles and follow-up newborn screening (NBS) collections are recommended. The Victorian NBS program historically recommended recollections for babies with birth weight &lt;1500g (managed by the maternity service provider) and 3 weeks post-transfusion (managed by the laboratory). We aimed to determine adherence to current guidelines and review the guidelines to improve NBS performance. To do this we audited data from 348,584 babies between January 2018 and June 2022. Babies with a recorded birth weight of &lt;1500g were filtered for inclusion. For the overall review and visualization of the protocol, we sourced information from the literature, our professional society and tertiary hospital services. A total of 2647 babies had a birth weight recorded between 200 and 1499g. Of these 2036 (77%) had a second sample collected, indicating that &gt;1 in 5 babies were not receiving a follow-up collection. Our timing of recollections for transfused babies, requiring a 3-week follow-up collection, was longer than in other Australasian jurisdictions. A new combined “sick-prem-protocol” was launched to support recollections and after a one-year review achieve 95% compliance. We recommend NBS laboratories audit preterm and sick neonate recollections to ensure appropriate follow-up. This should be supported with a visual process map to aid education and compliance.

Existing scales assessing family relations are usually quite long. Our aim was to develop and validate the Family Functioning and Cohesion Scale (FFCS), a self-reported short instrument consisting of 14 items. The validation of the FFCS was based on its administration through an online platform to 481 subjects living in 46 different countries around the world. Cronbach's alpha was 0.85 (ranging from 0.83 to 0.86 if any one item was deleted), signifying high internal consistency. The scale can be considered as a sole factor based on its high consistency, while factor analysis produced three factors corresponding to “communication”, “anger/resentment/aggression” and “values and beliefs”. Test-retest reliability correlation coefficient was found to be 0.88 at a 2-week interval. As far as external validity is concerned, the correlation coefficient of the FFCS with the General Functioning subscale of the McMaster Family Assessment Device (FAD) was 0.83. The high measures of consistency, reliability, and validity of the FFCS, combined with its short length, make it an invaluable tool for use in research as well as in any professional dealing with families in the clinical fields of psychiatry, psychology, social work or any other relevant specialty.

This research presents the Cross-Cultural Intelligent Language Learning System (CILS), a novel approach integrating Artificial Intelligence (AI) into language education to enhance cross-cultural communication. CILS utilizes advanced AI technologies to provide adaptive, personalized learning experiences that cater to the unique linguistic and cultural backgrounds of each learner. By dynamically adjusting content and methodology, CILS significantly improves linguistic proficiency and cultural understanding, essential for effective global interactions. The implementation of CILS in platforms such as Busuu and HelloTalk has demonstrated marked improvements in engagement and communication skills among learners. Empirical studies validate the system's effectiveness in real-world settings, showing enhanced learner performance and increased intercultural competence. Additionally, the Technology Acceptance Model (TAM) applied confirms that the usability and perceived usefulness of AI-driven systems strongly influence learner acceptance and sustained use. This study not only underscores the potential of AI in transforming language education but also highlights the critical role of cultural sensitivity in designing educational technologies.

A Partial discharge (PD) occurrence in high-voltage (HV) and medium-voltage (MV) power assets is a warning sign of insulation system degradation or defective manufacturing/assembly, that may cause catastrophic damage and eventually lead to the breakdown of the power equipment. Ultra-high frequency (UHF) PD measurement technology has extensively been used to monitor the insulation health of the HV or MV equipment due to its high immunity against ambient noise and conducted disturbances. This paper presents experimental validation of a new design of a UHF planar rectangular microstrip antenna that can be used for PD monitoring of HV and/or MV power equipment, such as power transformers. The designed planar rectangular microstrip antenna has a compact size of 80mmx70mmx1.6mm. Laboratory experiments were performed to validate the antenna sensitivity to PD activity caused by insulation defects created inside an oil-filled transformer tank model. PD measurement results confirm that the proposed rectangular microstrip antenna has high sensitivity and high signal-to-noise ratio (SNR), thanks to its capability to suppress external noise disturbances, especially during online PD monitoring. Thus, the proposed UHF antenna seems to be a promising and alternative PD sensor that can be employed in UHF PD monitoring systems of HV or MV power equipment.

Decades ago, when computational was expensive and limited, the structural design was mostly performed by hand calculations using simple mathematical models. For example, it was a common practice to design a structure as complex as the wing of an aircraft by simple beam analysis. However, ever since the classic paper by Turner et al., due to a rapid increase in computational, more complex mathematical models are being used to simulate the physical behavior of complex structural components. To solve intractable problems unsolvable by hand calculations, numerical techniques like Finite Element Analysis (FEA), Computational Fluid Dynamics (CFD), Finite Difference Method etc. are being employed. In fact, the availability of these methods has led to the development of an entirely new area of research known as Multidisciplinary Design Optimization (MDO) where various disciplines are considered in an optimization problem. The most important question while using a mathematical model to represent practical industrial problems is to what extent these models represent the real-life situation. Computational models are always built on upon assumptions. Simply at looking at the simulation outcomes i.e. the graphical and numerical results, it is often very difficult to ensure if the underlying assumption holds and that the results are reliable. This has led to the development of another field of research known as Verification and Validation (called V&V in short).

The comfort of the elderly in hospital settings requires a special attention from the involved health care professionals, particularly nurses, since hospitalization often generates suffering and discomfort. In such contexts, it is essential to take into account the specific characteristics of the elderly, considering their life experiences and their needs, to promote the health, well-being, and comfort of this population. Hence, the present work aimed to explore the nursing interventions that promote comfort among the elderly in hospital settings. A mixed descriptive exploratory study was conducted, through the application of a questionnaire, using intentional non-probabilistic sampling. The study encompassed 55 elderly individuals hospitalized in a medical service of a public hospital located in Lisbon. The results show that the participants perceived a reasonable level of comfort (5.65 ± 6.46). The following categories emerged from the content analysis: 1) Physical interventions; 2) Psycho-spiritual interventions; 3) Socio-cultural interventions; and 4) Environmental interventions. These findings help to understand comfort-promoting nursing interventions in the studied population. It was concluded that, to improve care quality, comforting interventions should focus on the elderly patient’s individuality, through support activities, empowerment, and the preservation/correction of the surrounding environment. Additionally, the provided care should be based on the real needs, expectations, preferences, and values of the elderly individual.

Videogames have been the focus of research since their widespread popularity, with particular emphasis on their effects on cognitive and affective abilities, especially in children and adolescents. Despite numerous correlational studies, robust evidence on the causal relationship between videogames and cognition remains scarce, hindered by the absence of a comprehensive assessment tool for gaming skills across various genres. This study aimed to develop and validate the Gaming Skill Questionnaire (GSQ) and to assess the impact of gaming skills in six different genres (Sport, First-Person Shooters, Role-Playing Games, Action-Adventure, Strategy, and Puzzle Games) on adolescents’ cognitive and affective abilities. The GSQ exhibited strong reliability and validity, highlighting its potential as a valuable tool. Gaming skills positively affected executive function, memory, overall cognition, cognitive flexibility, and emotion recognition, except for empathy. Various game genres had different effects on cognitive and affective abilities, with verbal fluency influenced mainly by sports, executive functions by action, strategy, and puzzle, and emotion recognition positively impacted by action and puzzle but negatively by sports and strategy games. Both age and gaming skills influenced cognitive flexibility, with gaming having a greater effect. These intriguing genre-specific effects on cognitive and affective functioning postulate further research with GSQ's contribution.

This letter presents a dual-frequency terahertz amplitude modulator based on a cross-shaped structure and U-shaped metal patches. Its structural unit is a typical metal-substrate structure. The top metal consists of a cross-shaped structure and U-shaped metal patches, and the bottom substrate layer is made of quartz. Amplitude modulation is achieved by adjusting the temperature of the vanadium dioxide (VO2) patches. The modulation depth can be approximately 75%. The mechanism of the resonance frequency is explained by the equivalent circuit model. The proposed structure shows good amplitude modulation capability at different incidence and azimuth angles by changing the location of the VO2 patches. The dual-frequency terahertz amplitude modulator can be used in terahertz communication, imaging, etc.

This paper proposes a methodology for the development and its Verification and Validation(V&amp;V) of safety-rated software. The development methodology is based on the structured analysis and structured design methodology, which has been proven in the field of safety software development during long period. The suggested the development and the V&amp;V methodology additionally focuses on the quality attributes 3C+T (completeness, Correctness, Consistency and traceability), which are important criteria in IEC international standards. The software development life cycle is compiled from IEC international standardization, which are of the requirements analysis phase, design phase, implementation phase, testing phase, installation/commissioning phase, and operation &amp; maintenance phases. The activities of the development process method were defined from requirements analysis to implementation, and the activities of the verification and validation were defined to include the scope of the developer's activities and then to include the test phase, installation/commissioning phase, and operation phases additionally. In other words, testing phase performed by the developer was defined as informal testing, and testing performed by the verifier according to test criteria, test plans, and test procedures was defined as formal testing. According to proposed methodology, the requirements phase defines the sequence of Entity Relationship Diagram (ERD)-Context Diagram-Data Flow Diagram (DFD), functional decomposition process and defines operational scenario. In the design phase, module design such as task analysis and task allocation were defined. In the implementation phase, we listed the coding guidelines that must be followed for safety-related system. The test phase defined the test criteria, test plan, test procedure, and test result report activities. In the installation/commissioning and operation phases, recommendations for improving reliability, quality, and safety were proposed for deliverables such as user documentation and technical documentation.

Understanding the dynamics of teamwork and communication among healthcare professionals is crucial in the face of evolving healthcare challenges. This study assessed relational coordination among healthcare professionals in the South Tyrolean healthcare system in Italy, focusing on communication and teamwork dynamics in a cross-sectional survey. Using the validated Relational Coordination Survey (RCS) instrument and 525 completed online responses, the questionnaire aimed to understand the implications of different levels of relational coordination ratings by general practitioners, hospital physicians, nurses, and administrative personnel (response rate 26%). The demographics of the participants revealed a predominance of female professionals (64%), with an average age of 50 and 18 years of service. The resulting RCS scores varied significantly across professional groups, with nurses reporting the highest within-group scores, indicating moderate coordination, and administrators reporting the lowest scores, reflecting areas of weak coordination. Between-group relational coordination was generally perceived as weak across professional groups, with the least weakness observed between general practitioners and nurses. German or Italian language and health district affiliation emerged as significant factors influencing relational coordination ratings, highlighting the need for differentiated understanding and strategies in multilingual and diverse regional settings. Assessments of interdisciplinary feedback and referral practices highlight the variation in teamwork and communication weaknesses and underscore the need for targeted interventions to improve relational coordination. This study provides insights into the complexity of relational dynamics in health care settings. It suggests that improving relational coordination through tailored strategies could significantly improve team effectiveness, quality of patient care, and overall system efficiency.

The monitoring of coastal waters using satellite data, from sensors including Sentinel-3 OLCI, has become a vital tool in the management of these water environments; especially when it comes to improving our understanding of the effects of climate change on these regions. In this study, Level-2 water products derived from different OLCI Sentinel-3 processors were validated against a comprehensive in situ dataset from the NW Baltic Sea proper region. The products validated were those of the regionally adapted Case-2 Regional Coast Colour (C2RCC) OLCI processor (v1.0 and v2.1), as well as the latest standard Level-2 OLCI case 2 (Neural Network) products from Sentinel-3’s processing baseline: Baseline Collection 003 (BC003), including “CHL_NN”, “TSM_NN”, and “ADG443_NN”. Furthermore, the effect of the current EUMETSAT system vicarious calibration (SVC) on the Level-2 water products was also validated. Results showed that the system vicarious calibration (SVC) reduces the reliability of the Level-2 OLCI products. For example, the application of these SVC gains to the OLCI data for the regionally adapted v2.1 C2RCC products resulted in RMSD increases of 36% for “conc_tsm”; 118% for “conc_chl”; 33% for “iop_agelb”; 50% for “iop_adg”; and 10% for “kd_z90max” using a ±3h validation window. The findings indicate that the current EUMETSAT SVC gains should be applied and interpreted with caution in the region of study at present. A key outcome of the paper recommends the development of a regionally specific SVC against AERONET-OC data for the region.

The genus Vigna is penta-tropical having more than 200 species with many desirable economically important traits. The aim of study was to validate the in-silico polymorphism of whole genome sequence developed mungbean specific SSR markers and their transferability among the different Vigna species. The present study utilized a set of 200 SSR markers developed from whole genome sequence of mungbean and validated using a diversity panel of 25 accessions which belongs to 13 Vigna species. Out of 200 SSR markers, 130 markers (65%) were polymorphic across the various Vigna species and the number of alleles amplified varied between 7 to24. The SSR markers showed more than 90 percent transferability across the different Vigna species accessions. Based on allelic data, the 25 Vigna accessions grouped into three clusters based upon the unweighted pair group method with arithmetic mean (UPGMA) phylogenetic tree. The principal co-ordinates analysis (PCA) biplot graph and UPGMA based neighbor joining clustering diagram showed similar pattern of Vigna accessions distribution. The population structure assessment has grouped the cultivated and wild species accessions into two sub-population. The estimated marker parameters such as polymorphic information content (0.09 – 0.84), marker index (0.091 – 3.342) and effective multiplex ratio (1.0 – 4.0) suggested their adequacy in several genetic studies such as parental selection, hybrid testing, genetic mapping and marker aided breeding programmes for genetic enhancement of species belonging to the Vigna genus.

Electrifying aircraft, a crucial advancement in the aviation industry, aims to cut pollutive emissions and boost energy efficiency. Traditional aircraft depend on fossil fuels, which contribute significantly to greenhouse gas emissions and environmental pollution. Despite progress in electric propulsion and energy storage technologies, challenges such as low energy density and integration issues persist. This paper provides a comprehensive thematic and bibliometric analysis to map the research landscape in aircraft electrification, identifying key research themes, influential contributors, and emerging trends. The study applies natural language processing to unstructured bibliographic data and cross-sectional statistical methods to analyze publications, citations, and keyword distributions across various categories related to aircraft electrification. The findings reveal significant growth in research output, particularly in energy management and multidisciplinary design analysis. Collaborative networks highlight key international partnerships, with the United States and China being key research hubs, while citation metrics highlight the impact of leading researchers and institutions in these countries. This study provides valuable insights for researchers, policymakers, and industry stakeholders, guiding future research directions and collaborations.

In the context of sustainable development, integrating the work aspect into health promotion systems is essential, ensuring that employees maintain a healthy balance between their professional and personal lives, which respects and amplifies the potential of every individual. Lately, there has been a noticeable shift of medical professionals from the public to the private sector. This trend paints a bleak picture, highlighting the vulnerabilities of a system teetering on the brink of failure, with significant impacts on patient care. Among the myriad reasons behind this shift, burnout stands out prominently. Medical professionals face increasing pressures due to understaffing, limited organizational support, and insufficient resources, leading to feelings of cynicism, exhaustion, and detachment from their roles. Utilizing the Maslach et al. questionnaire, we assessed the risk of burnout among physicians in public hospitals to identify and underscore preventive measures and improvements, correlating our findings with key aspects of organizational empowerment. Our research indicates that enhancing interpersonal relationships and resources—both within teams and between the organization and its physicians—is crucial for the revival of the healthcare system. This approach aims at improving the delivery of healthcare services and offering appropriate recognition to healthcare professionals, aligning with the principles of sustainable employment.

Ketogenic dietary therapies (KDTs) are an effective and safe non-pharmacological treatment for drug-resistant epilepsy, but adherence can be challenging for both patients and caregivers. In Europe, there are no adequate tools to measure it other than monitoring ketosis. This study aimed to adapt and validate the Brazilian adherence questionnaire, Keto-check, into the Italian version: iKetoCheck. Using the Delphi technique, 12 judges validated the contents through agreement rate and the Content Validity Index (CVI). The iKetocheck was self-completed electronically by drug-resistant epilepsy or GLUT1 deficiency patients within an interval of 15 days to measure its reproducibility. Test-retest reliability was evaluated using Pearson correlation and relative significance test. Exploratory and confirmatory factorial analyses were made using Factor software. The final tool, iKetoCheck, consists of 10 questions with 5-point Likert scale answers. It evaluates various aspects such as informing caregivers about the diet, organization of meals, measurement of ketosis, weighing food consumed, diet negligence, use of carbohydrate-free medications, attending follow-up visits, reading food labels, consulting an expert for dietary concerns, and cooking at home. The factorial analysis resulted in three factors: "attention," "organization," and "precision," with satisfactory results for indices in exploratory and confirmatory analyses. Although higher mean values of ketonemia measurement were observed in patients with a higher adherence score, these values were not statistically significant (p=0.284). In conclusion, iKetoCheck is a valid tool for evaluating KDTs' adherence in Italian drug-resistant epilepsy or GLUT1 deficiency patients. It can provide valuable information to improve patient management and optimize the effectiveness of KDTs.

The increase in the frequency of droughts in Africa has increased the interest in crops with drought escape mechanisms like grain Amaranth (Amaranthus hypochondriacus). However, the white-seeded grain Amaranth is easily cross-pollinated by its black seeded wild relatives such as smooth pigweed (Amaranthus hybridus). A study to investigate a minimum isolation distance enough to prevent seed contamination study was carried out at three sites namely Gweru and Bindura (2020/2021 rainy season) and Shamva (2021/2022 rainy season). Smooth pigweed was planted at distances of 3 to 150 m from pure grain Amaranth. Close monitoring of phenology and measurement of meteorological conditions such as temperature, wind speed and direction were done during the anthesis period. Cross-pollination in grain Amaranth was influenced by distance from the pollen source. A maximum of 12.9 % contamination rate was measured within the 10 m radius from the pollen donor plot and a minimum outcrossing rate of 0.45 % was recorded at the widest distance of 150 m. It can be concluded that complete removal of wild relatives of grain Amaranth is important within the field at as far as 150 m from the crop.

In recent years there has been a clear increase in bottled water consumption, globally which translates to significant health and environmental concerns. This cross-sectional study aims to understand the attitude and preferences of university students in Qatar towards use of bottled and tap water for drinking purposes using an online survey questionnaire. The number of students who responded to the online survey was 14% of the entire student population within the university (n = 688). Overall, majority of the students reported plastic bottled water as the main source of drinking water they preferred to use on campus (n=468; 68.02%), with a higher proportion of females (72.08%) preferring the use of plastic bottled water. Out of the 468 students who preferred plastic bottled water, safety was the most important factor (43.80%) followed by convenience (16.88%) and taste (15.60%). Cost (15.17%), personal/family habits (5.13%), Environmental concerns (2.14%) and minerals (1.28%) were found to be the least important factors. Among the 45 students who preferred tap water over plastic bottled water, cost (46.67%) was the dominant factor followed by convenience (20.00%) and environmental concerns and safety (13.33% each), taste (4.44%), and personal/family habits (2.22%). This study recommends campaigns to focus on attitude and behavior change and not solely emphasize knowledge; 71.7% believed that plastic water bottles are more harmful to the environment, yet the greater majority still resorted to this source. There is an immediate need to further educate students through environmental and health literacy programs on water consumption and quality. Enabling the population to understand the positive and negative aspects of their choices, may be an effective remedy to ensuring a healthy population and healthy environment.

The study aimed to develop a cross-cultural youth violent extremism scale (YVES) that considers the within and between cultural differences and to develop a scale that can be applied and tested in a single or a group of countries and cultures. The future use of the scale can identify the unique practical concerns related to violent extremism. A sample of 6726 young students was selected from 15 Arab states and authorities. Scale generation, scale refinement, and scale validation were the three stages followed in developing violent youth extremism. Using literature review and nomological network to present the scale dimensions and the Correlation to its dimensions and other relevant constructs (LSC, LSE, and criminality scale. A Principal Component Factor analysis with Varimax with Kaiser Normalization produced six factors (29 items). A significant positive relationship was found (r=.651, α = 0.000), a sign of the validity of the scale. The scale reliability was strong and was estimated at 0.98 using Cronbach's Alpha. The construct validity of the scale was estimated by calculating the Correlation between the Youth Violent Extremism scale and Low self-control. A significant positive relationship was found (r=.651, α = 0.000), a sign of the validity of the scale. The scale reliability was also strong and was estimated at 0.98 using Cronbach's Alpha

Pregnant women (PW) are at a higher risk of diseases and hospitalization from viral respiratory infections, specially influenza, due to cardiopulmonary and immunological changes. This study assessed the impact of viral respiratory infections on PW hospitalized with severe acute respiratory infection (SARI). It´s a cross-sectional study with 42 PW and 85 non-pregnant women (NPW) admitted with SARI to two tertiary hospital between January 2015 and December 2019. The rate of virus prevalence, SARI hospitalization, length of hospital stay, oxygen supplementation, intensive care unit (ICU) admission, and death were comparable between PW and NPW. Multivariate analysis showed that PW had a higher rate of viral SARI hospitalizations (OR = 2.37; 95% CI =1.02 - 5.48) compared to NPW, with influenza virus being the most prevalent (aOR =7.58; 95% CI =1.53 - 37.66). Length of hospital stay (aOR = 0.83; 95% CI = 0.73 – 0.95) and admission to the ICU (aOR=0.028; 95% CI=0.004 - 0.25) were lower in PW compared to hospitalized NPW. Respiratory viruses had a greater impact on the frequency of SARI in the group of PW. Although PW had a higher rate of influenza SARI, they had a better outcome than NPW due to the treatment they received.

Despite decades of conflict and political instability, drought has also severely affected Afghanistan’s rural population and agriculture sector. Agriculture is a primary livelihood source in the country, and recurring droughts have put cascading pressures on the agricultural economy and food security. Therefore, understanding the key drivers of all risk components through a comprehensive risk assessment is critical for proactive drought risk management. This study assesses agricultural drought risk from an integrated perspective, emphasizing the combined effects of drought hazard, exposure, and vulnerability. Multi-methods research was conducted, employing remote-sensing-based analysis covering a period from 2001 to 2023. We used the Vegetation Condition Index (VCI) to analyze the drought hazard for the agricultural system during the winter growing season. The vulnerability indicators and exposure levels of the agricultural system were determined through spatial analysis combined with a literature review and expert consultation. An adapted conceptual framework of the Intergovernmental Panel on Climate Change (IPCC) was utilized, which incorporates hazard, exposure, and vulnerability to define risk. The results revealed that droughts occur frequently and in changing patterns throughout the country. All provinces have experienced drought over the past two decades, albeit with varying severities and frequencies. Severe droughts were observed in 2001-2002, 2008, 2011, 2018, and consecutively in 2021-2022-2023. Drought vulnerability and exposure vary widely across the country, particularly in the northern, western, and southern provinces. The final calculated risk shows that most provinces in southern and southwestern zones face a high risk of recurrent droughts, further exacerbating agricultural challenges in these regions. Such analyses under a multimethod approach provide information on spatial patterns of drought risk and drivers of agricultural systems that can support decision-makers and policymakers in formulating strategies to reduce drought risk and adapt to the agricultural sector.

Background: Over the past two decades, the Copenhagen Psychosocial Questionnaire (COPSOQ) has been established as a valid instrument to measure psychosocial stress at work. Currently, the COPSOQ international network is responsible for monitoring and improving COPSOQ. In 2019, a new questionnaire was published, and the Greek version is now being validated. Methods: The measurement qualities of the Greek COPSOQ III have been explored in accordance with the usual requirements of a validation study as defined by DIN EN ISO 10075-3. A sample of observations from 2,189 participants surveyed with the COPSOQ in Greece was used to validate the current version with appropriate statistical analyses. Exploratory factor analysis was used to assess the statistical relationships for many scales. Results: With its 108 items and 40 scales, the Greek COPSOQ III includes all psychosocial work factors that have been internationally validated and remain compatible with approximately 72% of the COPSOQ III German version content. In addition to the primary results, congruence with widely used theoretical approaches such as the demand-control (−support) model (DCM) or the job demands-resources model (JDR) is generally satisfactory. In summary, our validation study for the Greek COPSOQ III version showed adequate reliability and validity, which is in line with the findings of the COPSOQ III questionnaire from other European countries, and it is also compatible with the validation of the German COPSOQ III (Lincke, 2021). Our regression analysis revealed that 34 psychosocial work factors (34 “context” scales) could adequately predict the scores of the satisfactory and health scales (6 “outcome” scales). The analysis also revealed the top five (5) predictors (context variables) for each of the six (6) “effect” scales (outcome variables). Conclusions: With the launch of COPSOQ III in Greece, current and new workplace psychosocial aspects could be explored. COPSOQ III (GR) is a beneficial instrument for enterprise research and risk assessment.

This study examines the association of sociodemographic risk factors and the comorbidities of COVID-19. Most COVID-19-related studies were conducted in inpatient settings among patients with severe infection during the first and second waves of the pandemic. The third wave with less severe Omicron variant presented a unique opportunity to observe the adult patients treated in outpatient settings. We conducted a cross-sectional study (117 patients aged &gt; 40 years presented with symptomatic COVID-19). We employed the Charlson Comorbidity Index (CCI) to compute comorbidity burden, Medical Outcomes Survey Short form (SF-12) to measure general health, and Self-care Self- Efficacy Scale (SCSES) to assess self-care ability. Fisher’s exact test and analysis of variance (ANOVA) were used to compute the relationship between comorbidities and demographics. This study report focuses on the distribution of the comorbidities and its relationship to demographic variables. The top five comorbidities were hypertension (42%), diabetes (31%), pulmonary disease/asthma (19%), depression (14%), and cancer (11%). Depression was significantly higher among younger age groups (p&lt;0.01) and women (p&lt;0.05). Age (p&lt;0.0001) and income (p&lt;0.01) were the most significantly associated demographics with the comorbidity burden. Incidence of pulmonary disease showed a positive association to educational status (p=0.05). This was the first study to report a significant prevalence of depression among adults with symptomatic COVID-19.

The existing segmentation-based scene text detection methods mostly need complicated post-processing, and the post-processing operation is separated from the training process, which greatly reduces the detection performance. The previous method, DBNet successfully simplified post-processing and integrated the post-processing into a segmentation network. However, the training process of the model took a long time for 1200 epochs and the sensitivity to texts of various scales was lacking, leading to some text instances being missed. Considering the above two problems, we design the text detection Network with Binarization of Hyperbolic Tangent(HTBNet). First of all, we propose Binarization of Hyperbolic Tangent (HTB), optimized along with which, the segmentation network can expedite the initial convergent speed by reducing the amount of epochs from 1200 to 600. Because features of different channels in the same scale feature map focus on the information of different regions in the image, to better represent the important features of all objects in the image, we devise the Multi-Scale Channel Attention(MSCA). Meanwhile considering that multi-scale objects in the image cannot be simultaneously detected, we propose a novel module named Fused Module with Channel and Spatial(FMCS), which can fuse the multi-scale feature maps from channel and spatial dimension. Finally we adopt cross entropy as the loss function, which measures the difference between predicted values and ground truths. The experimental results show that HTBNet compared with lightweight models has achieved competitive performance and speed on Total-Text(F-measure:86.0%, FPS:30) and MSRA-TD500 (F-measure:87.5%, FPS:30).

Despite the importance of influenza vaccination for healthcare workers (HCWs), their uptake remains challenging. This study aimed to measure influenza vaccine hesitancy among HCWs in Nakhon Phanom province, Thailand. A representative cross-sectional survey was conducted at six hospitals during August – September 2020 using a self-administered questionnaire. HCWs delaying getting influenza vaccines, accepting but unsure, or refusing with doubts were categorized as hesitant. Those accepting without any doubts were classified as non-hesitant. Vaccine hesitancy determinants were identified by multivariable logistic regression analysis. A total of 338 participants (97%) completed the questionnaires; most were female nurses working at district hospitals without pre-existing chronic medical conditions. Nearly 60% of participants (197/338) exhibited influenza vaccine hesitancy, and significant factors included age above 50 years adjusted odds ratio [aOR] 3.2, 95% CI 1.3-8.5), fair knowledge of influenza/vaccination (aOR 0.4, 95% CI 0.2-0.8), and negative influence of other HCW (High level– aOR 2.3, 95% CI 1.1-4.8; Moderate level- aOR 2.1, 95% CI 1.1-4.4). Imparting updated information to the HCW combined with positive guidance from influential peers may help reduce this hesitancy.

Background/Objectives Bowel endometriosis (BE) is defined as the presence of endometrial-like tissue in the muscular layer of the bowel wall. When BE does not cause severe obstruction to fecal transit, not leading to (sub)occlusive symptoms, the decision to operate becomes challenging as intestinal surgery is associated with higher complication rates and long-term bowel dysfunction. The aim of this cross-sectional study is to evaluate the quality of life (QoL) in patients with BE undergoing medical therapy or expectant management, investigating the impact of characteristics of BE nodules on QoL and intestinal function. Methods A retrospective cross-sectional analysis was conducted on 580 patients with BE who did not undergo surgery but were treated conservatively by medical therapy or expectant management between January 2017 and August 2022. The diagnosis of BE was done by transvaginal ultrasound and confirmed at double contrast barium enema. After at least one year of follow-up, QoL and intestinal function of patients were evaluated by the Endometriosis Health Profile-5 (EHP-5) questionnaire and Bowel Endometriosis Symptom score (BENS), whereas pain symptoms were assessed by the Visual Analogic Scale (VAS 0-10). Statistical analysis was performed to investigate possible associations between QoL and characteristics of bowel nodules (dimension, location, and evidence of stenosis) as well as type and length of eventual medical therapy. Results Patients with BE had a satisfying overall QoL with a mean EHP-5 score of 105.42 ± 99.98 points and VAS lower than 3 for all pain domains; additionally, they did not show a significant impartment of bowel function with mean BENS score of 4.89 ± 5.28 points. Notably, patients under medical therapy had a better QoL than patients without therapy (p

The presence of antibiotic residues in honey has recently become a growing public health concern due to the overuse of these products in beekeeping and their transfer to the food industry. The aim of this study was to develop and validate a simple, selective and sensitive method for the simultaneous identification and quantification of residues of twenty-two sulfonamides, trimethoprim and dapsone in honey using a rapid and reliable liquid chromatography–tandem mass spectrometry (LC–MS/MS) method. The developed method showed good linearity, specificity, precision (repeatability and intra-laboratory reproducibility) and recovery. The decision limit (CCalpha) ranged between 2.16-22.12 µg/kg for CCα, while the detection capability (CCbeta) was between 2.16- 2.67-27.36 µg/kg. The method proved to be rapid, reliable and effective for the determination of sulfonamides, trimethoprim and dapsone from honey samples. The average recoveries were estimated to be between 70 and 106%. The relative standard deviations (RSDs) were between 6-18%. In practice, the method is essential to check the honey sold on the market and ensure its safety before it reaches the consumer.

In recent years, there has been an increasing interest in adopting novel sensing technologies for the continuous monitoring of structural systems. In this respect, Micro-Electro-Mechanical System (MEMS) sensors are widely used in several applications, including Structural Health Monitoring (SHM). Thanks to their significantly lower cost, ease of installation on the structure, and lower power consumption, they enable extensive, pervasive, and battery-less monitoring systems. This paper presents an innovative high-performance device for SHM applications, based on a low-noise triaxial MEMS accelerometer, providing a guideline and insightful results about the opportunities and capabilities of these devices. Sensor nodes have been designed, developed, and calibrated to meet structural vibration monitoring and modal identification requirements. These components include a protocol for reliable command dissemination through the network and data collection, and improvements to software components for data pipelining, jitter control, and high-frequency sampling. Devices were tested in the lab using shaker excitation. Results demonstrate that MEMS-based accelerometers are a feasible solution to replace expensive piezo-based accelerometers. Deploying MEMS is promising to minimize sensor node energy consumption. Time and frequency domain analysis show that MEMS can correctly detect modal frequencies, useful parameters for damage detection. The acquired data from the test bed were used to examine the functioning of the network, data transmission, and data quality. The proposed architecture has been successfully deployed in a real case study to monitor the structural health of the Marcus Aurelius Exedra Hall within the Capitoline Museum of Rome. The performance robustness was demonstrated and the results showed that the wired sensor network provides dense and accurate vibration data for structural continuous monitoring.

Climbing is an Olympic discipline in full development and multidisciplinary in nature, in which the influence of body composition and nutritional status on performance has not yet been clarified despite the quest for low weight in anti-gravity disciplines such as climbing. The present study aimed to do a nutritional (3-day dietary diaries) and body composition (ISAK profile) assessment of sport climbing athletes of different genders and sport levels. The mean age of the forty-six Spanish climbers (22 men and 24 women) was 30 years (SD: 9) with 7.66 years of experience (SD: 6.63). The mean somatotype of the athletes was classified as balanced mesomorph. Negative correlations were observed between fat mass variables and climbing level (p<0.01), and positive correlations with forearm circumference (p<0.05). Mean energy availability (EA) was 33.01 kcal-kg FFM1-d1 (SD: 9.02), with 55.6% of athletes in suboptimal EA status and 35.6% in low energy availability (LEA) status. Carbohydrate and protein intakes were below recommendations in 57.8% and 31.1% of athletes, respectively. There were deficient intakes of all micronutrients except phosphorus in males. These findings suggest that climbing athletes are at high risk of developing low energy availability states and concomitant problems. Optimal nutritional monitoring may be advisable in this type of athlete to try to reduce the risk of LEA.

There are many modern and traditional methods in valuing the performance of the company among them EVA, CVA are modern methods where as EPS, ROI, ROE etc. are some of the traditional methods. modern and traditional methods are not only used to check the performance of a company but it also used in investment decisions by the investors. Stern Stewart, managing partner of M/s Stern Stewart & Co. introduced a modified concept of economic profit in 1990 in the name of Economic Value Added (EVA) as measure of business performance and CVA is only a cash consideration in EVA. In this paper an attempt is made to study which method is used by the investors while taking the investment decisions i.e. traditional methods are modern methods. 100 respondents (Investors) are questioned and collected their views, we are assuming that there is no impact of traditional or modern methods while taking investment decisions by the investors.

This study aimed to conduct a cross-cultural adaptation of the development of the cat-owner/dog-owner relationship scales. The method encompassed several stages: conceptual, item, semantic, operational, measurement, and functional equivalence. Processes included translations, synthesis of translations, back-translations, consensus on the English versions, external evaluation by the original authors, expert committee evaluation, and pre-tests. The study involved surveying 342 pet owners throughout Brazil using a 20-item questionnaire. Data analyses utilized confirmatory factor analysis, covariance-based modeling, and multigroup analysis. The techniques confirmed that the scale preserved its psychometric properties and showed no variance between dog and cat owners, indicating that the measured constructs are universal and unaffected by specific cultural nuances. Hence, the cross-cultural adaptation and validation of the scale facilitate applying and testing concepts and measures in diverse contexts, enriching our understanding of the dynamics between owners and their pets (dogs and cats) in different living situations. In addition, this research holds particular significance in Brazil, given the country’s vast cultural diversity.

(1) Exoskeletons offer potential benefits for overhead working tasks, but gender effects or differences are unclear. This study aimed to compare the performance, strain, and comfort of men and women using an upper-body exoskeleton. (2) n=20 female and n=16 male participants performed an overhead drilling task with and without a passive upper-body exoskeleton in a randomized cross-over study. Task performance of different movement phases, perceived exertion, and ease of use were measured to compare gender differences. One and two-way analyses were used to com-pare genders in the different conditions. (3) Gender differences after controlling for BMI in task performance were found for error integrals (p <.001) with higher values in male participants. Moreover, there was a significant interaction effect for gender x exoskeleton use. While females showed performance decrements in aiming with exoskeleton use, the male's performance increased (p=.025). No other gender differences were observed. (4) Gender differences in task performance using an upper-body industrial exoskeleton were less detectable than expected after controlling for BMI, indicating that body composition and anthropometrics might be valuable indicators for per-formance including assisting devices. Moreover, future studies should also integrate the examina-tion of muscle activity to gain more insights into potential gender movement control patterns.

The essence of cross-modal generation and retrieval modeling for image-text interactions lies in semantic consistency. Among these, cross-modal representation alignment serves as the foundational requirement for achieving cross-modal semantic consistency. The crux of our proposed method entails the collaborative training of an image captioning model(referred to as the ’captioner’) and a pair of contrastive encoders for image-text matching(referred to as the ’concoder’). This synergistic approach yields concurrent enhancements in concoder’s performance, captioner’s proficiency, and cross-modal semantic coherence. We coin the proposed method as ‘ReCap’. To begin, we initialize the concoder through knowledge distillation from a pre-trained model. During the training process, we use the output of the initialized concoder as input to a residual attention network, jointly training it with the captioner to achieve semantic consistency. Subsequently, we iteratively update the concoder during the image-text momentum encoding phase using the residual attention network, creating a closed-loop for semantic consistency resolution. Upon completion of training, the concoder and captioner modules can be used independently to perform tasks related to cross-modal retrieval and cross-modal generation of text and images. In order to substantiate the efficacy of our proposed method, we initially conducted empirical experiments encompassing image-text retrieval and image captioning tasks, employing a widely recognized benchmark dataset, MSCOCO. Subsequently, we assessed the fine-grained cross-modal alignment performance of the concoder through an image classification task on the iNaturalist 2018 dataset. The achieved performance metrics notably surpassed those achieved by several incumbent state-of-the-art models, thus validating the proficiency of our method. Finally, motivated by the practical requirements of handling the nature conservation image data, we performed caption annotation for the iNaturalist 2018 dataset. Subsequently, we trained the ReCap on this annotated data. Experimental results demonstrate that our proposed method can maintain semantic consistency between cross-modal retrieval and image caption generation for species with similar visual features but distinct semantics. This achievement signifies a meaningful exploration in the field of cross-modal semantic consistency representation, holding significant practical value in the domain of biological research.

Background/Objectives: Adolescence represents a period of heightened vulnerability to risky sexual behaviours. In Portugal, adolescents are initiating sexual activity at increasingly younger ages. Yet, there are no studies evaluating their knowledge about sexually transmitted diseases and prevention methods at an earlier stage of their development. Study how middle school ad-olescents define their sexuality and assess their level of information regarding sexuality, STI, and prevention methods. Additionally, it explores adolescents' sources of information on sexuali-ty-related issues. Methods: A cross-sectional observational study was conducted involving the application of a questionnaire to 750 9th-grade students of Vila Nova de Gaia, Porto, Portugal. The questionnaire covered topics such as perceptions of sexuality, knowledge of sexuality and STI, methods of transmission prevention, and sources of information. Results: The mean age was 14.4 years, with 19.9% reporting having already initiated sexual ac-tivity. Overall, the knowledge about sexually transmitted infections is low, pointing to 7.08 out of a maximum score of 18. Condoms and immunisation are well-recognized preventive measures, but many misconceptions persist. Better knowledge is associated with better attitudes in the likelihood of having sexual intercourse. Conclusions: This study reveals adolescents' limited sexually transmitted infections knowledge, misconceptions about prevention, and reliance on peers and the internet over trusted sources, highlighting the need for comprehensive sexual education in middle school.

Until recently, no disease-specific health-related quality of life (HRQoL) instrument existed for pediatric traumatic brain injury (TBI). In this revalidation study, the psychometric properties and the validity of the final German version of the 35-item QOLIBRI-KID/ADO questionnaire were examined in 300 children and adolescents. It is the first self-reported TBI-specific instrument for measuring pediatric HRQoL in individuals aged 8–17 years. The six-factor model fits the data adequately. Internal consistencies were excellent for the total score and satisfactory to excellent for the scale scores. Intraclass correlations indicated good test-retest reliability. Construct validity was supported by overlaps between the QOLBRI-KID/ADO and the PedsQL, which measures generic HRQoL. Discriminant validity indicated that HRQoL was significantly lower in older children and girls, and in those with anxiety, depression, and post-concussion symptoms than in comparison groups, replicating the results of the questionnaire’s first development study. Our results suggest that the QOLIBRI-KID/ADO is a valid and reliable multidimensional instrument for assessing disease-specific HRQoL after pediatric TBI in clinical and research settings, which can additionally be used across the lifespan in combination with the adult version. This may help to improve care, treatment, daily functioning and HRQoL after TBI.

As part of the Copernicus programme of the European Union (EU), the European Space Agency (ESA) has developed and is currently operating the Sentinel-2 mission that is acquiring high spatial resolution optical imagery. This paper provides a description of the calibration activities and the current status of the mission products validation activities. Measured performances, from the validation activities, cover both Top-Of-Atmosphere (TOA) and Bottom-Of-Atmosphere (BOA) products. Results presented in this paper show the good quality of the mission products both in terms of radiometry and geometry and provide an overview on next mission steps related to data quality aspects.

Pakistan relies mostly on fossil fuel for fulfilling its energy demand which is expensive as 11 well as not friendly for the environment. The need of the hour is to shift from fossil fuels to renew-12 able energy resources like geothermal, wind, solar etc. to cater for global warming issues. Pakistan 13 has a lot of potential geothermal sites because of several fault lines and hot springs. A sound 14 knowledge of ground temperature is essential to use geothermal energy, which is obtained by drill-15 ing boreholes and putting sensors making it an expensive procedure. Thus, to avoid huge cost for 16 drilling bore holes, particularly for ground temperature analysis, a numerical approach has been 17 considered for determining ground temperature. Furthermore, correlation charts between air and 18 ground temperatures have been developed as there were no proper studies on the ground temper-19 ature of Pakistan. Then, with the help of a boreholes drilled in National University of Sciences and 20 Technology Islamabad Pakistan, the actual ground and numerically calculated temperatures have 21 been compared which shows an error margin in the range between 0.27% for higher depths to 7.3% 22 near surface. Thus, it is shown that the proposed method is easy to implement and better than large 23 scale testing methods for the depths at which geothermal energy is extracted.

In China, preschool teachers have a significant influence on the development of young children aged 3-6. It is imperative to understand their mental health and the factors associated with it to inform policies, optimize their mental well-being, and support their job performance. This study aimed to investigate the factors contributing to anxiety symptoms among preschool teachers. A sample of 393 Chinese preschool teachers (279 females, 114 males) aged 21-56 completed online questionnaires collecting their socio-demographic and work-related information and assessing anxiety symptoms, interpersonal difficulties, personality traits, perceived stress, resilience, and inner strength. Pearson correlation and multiple linear regression analyses identified significant predictors of anxiety symptoms. The prevalence of anxiety symptoms among the studied cohort was found to be 12.2%. Statistically significant factors positively correlated with anxiety symptoms included objective work-related stress (B=0.149, p<.001), interpersonal difficulties (B=0.921, p<.001), perceived stress (B=0.108, p=.001), and neuroticism (B=0.071, p=.002). The findings highlight the urgent need for measures to reduce work-related stress and anxiety. However, when negative mental health predictors were included, the effect of positive psychological factors became nullified. Positive mental health might have a moderating role in such a negative mental health outcome as anxiety. Therefore, further research is required to understand the impact of positive mental health factors more clearly.

Background: The antisense oligonucleotide against APOC3 mRNA volanesorsen was recently introduced to treat Familial Chylomicronemia Syndrome (FCS). Cases of decreased platelet count are reported among patients treated with volanesorsen. The aim of the study is to evaluate platelet function and thrombin generation (TG) assessment in FCS patients receiving volanesorsen. We performed a cross-sectional study on FCS patients treated with volanesorsen. Methods: changes in PLC were assessed from baseline to Tw12 and Tw36. To assess TG, samples were processed by CAT (with PPP-reagent LOW). The results were expressed by the trombogram graphic (thrombin variation over time); lagTime; Endogenous Thormbin Potential(ETP); peak; time to reach peak(ttpeak), startTail e velocity Index. Platelet aggregation was assessed by testing different agonists using turbidimetry method. Results: Four FCS patients and 4 matched healthy controls were included in the present study. Changes in PLC at Tw12 was 30% and 34% at T36w. Thrombin generation results show values in normal range (for patients and controls respectively lagTime:10,42±4,40 and 9,25±0,99; ttPeak:14,33± 4,01 and 13,10±0,67; startTail:32,13±3,54 and 29,46±1,69; velocityIndex:20,21±3,63 and 33,05±13,21; ETP 599,80±73,47 and 900,2±210,99; peak value 76,84±1,07 and 123,30±39,45) and no significant difference between cases and controls. Platelet aggregation test showed values in range with no significant difference with healthy controls Conclusions: Our study showed for the first time that no significant changes in the general haemostasis assessed by TG and in platelet function have been observed in FCS patients receiving volanesorsen.

In bioprocess engineering the Qualtiy by Design (QbD) initiative encourages the use of models to define design spaces. However, clear guides on how models for QbD are validated are still missing. In this review we provide a comprehensive overview about validation methods, mathematical approaches and metrics currently applied in bioprocess modeling. The methods cover analytics for data used for modeling, model training and selection, measures for predictiveness and model uncertainties. We point out general issues in model validation and calibration for different types of models and put this into context of existing health authority recommendations. This review provides the start-point for developing a guidance for model validation approaches. There is no one-fits-all approach but this review shall help to identify the best fitting validation method or combination of methods for the specific task and type of bioprocess models that is developed.