(1) Background: Ectopic pregnancy (EP) is when fertilized ovum implanted outside of uterine cavity. The incidence was 1.5% to 2.0% of all pregnancies [1, 2]. EP decreases fertility ability [3]. This study focused on the pregnancy rate after EP and various parameters influencing pregnancy. (2) Methods: The data was extracted from National Health Insurance Research Database (NHIRD) during 2000-2013. The study group enrolled women with one EP history. Those who did not have EP was put into the control group. Chi-square/Fisher exact test was performed on category variable and t-test was used on continue variables. (3) Results: The EP group had a higher cumulative rate of conceive, 41.55% than control group, 37.14% and 1.16 times higher risk in developing pregnancy (P<0.001). The conceiving rate was lower than the control group in the first 5 years, but higher than the control group in the 10th to 14th years. (4) Conclusions: The fecundability after EP is lower at the beginning, but regained after long term follow.

Correlations among estrus cycle, pyometra, and canine diabetes mellitus (CDM) have been described since the late 1950s, and substantial progress in understanding mechanisms beyond was achieved nowadays. Progesterone-related diabetes mellitus (PRDM) in dogs is known for its particular potential for diabetes remission. Thus, a deep understanding of the physiopathological aspects involved is crucial to postulate treatment guidelines to improve the PRDM remission rate, as well as to inform preventive measures. This narrative review aims to provide relevant detailed information on 1) canine estrus cycle and its impact on CDM etiology and management, 2) the role of pyometra as a further cause of insulin resistance, and 3) useful individual therapeutic and preventive strategies. Pharmacological annulment of progesterone effects, as well as inflammatory and progesterone-related conditions resolution in association with adequate exogenous insulin therapy, and residual beta cell function, are key aspects to achieve remission, or at least to improve diabetic clinical control. In this way, spaying should be considered mandatory in most PRDM cases. Preventive measures against CDM can include spaying recommendations; however, individual-based recommendations should be considered since castration may be associated with some long-term health issues.

We present a case report of a young patient with pectus carinatum who experienced a small right apex pneumothorax and exhibited Brugada patterns on electrocardiogram tracing. This is the first clinical case reporting Brugada pattern presentation in both a patient with pectus carinatum and a small pneumothorax. We conducted a clinical, anatomical, and electrocardiographic analysis to explore a physiopathological explanation for these findings, considering our patient had no history or clinical signs of Brugada Syndrome. We conclude that: 1. Pectus carinatum may create a window that facilitates the less resistive measurement of cardiac action potentials; 2. Small pneumothoraces can induce modifications in the cardiac electrical signal detected by surface electrodes, and pectus carinatum could unmask these modifications; and 3. Surface electrodes may measure subepicardial potentials that include and are modified by adjacent pericardial tissues, potentially resulting in alterations in transmural potential differences, thus producing fictitious Brugada patterns. Similarly, there is a possibility that the right ventricular outflow tract may be included within the subendocardial potentials.

We document for the first time epsilon waves on the electrocardiogram of a patient with Dravet syndrome (DS) who does not exhibit structural cardiac pathology. DS, a severe form of pediatric epilepsy, involves mutations in the SCN1A gene, which disrupt sodium ion flow and increase the risk of sudden unexpected death in epilepsy. The epsilon waves, typically associated with arrhythmogenic right ventricular dysplasia, may also suggest a link between neuronal and cardiac dysfunctions. In our case, the epsilon waves appear to originate from abnormalities in sodium channels rather than structural changes in the myocardium. This finding underscores the importance of assessing both neurological and cardiac manifestations in patients with severe epilepsy, opening new avenues for the research and treatment of these interactions in DS.

Maintaining sufficient levels of plant nutrients in the soil and controlling certain heavy metals, which can be toxic to the environment, are critical to ensure sustainable agricultural production. The study aimed to assess the linkage of crop-specific agricultural practices established by farmers in the Kvemo Kartli region (Georgia) with metal accumulation in soils of agricultural lands being subject to influence from polluted irrigation water in the past. In particular, we tried to identify the primary sources of micronutrients, including iron (Fe), copper (Cu), manganese (Mn), nickel (Ni), and zinc (Zn), and toxic elements such as cadmium (Cd) and lead (Pb), and share of the contaminated irrigation water and other factors related to agricultural practices under different land uses, such as intensive and extensive arable farming, vineyards, orchards, and permanent pastures having the least disturbed soil. Based on principal component analysis, five primary sources were identified and categorized according to farmers' interviews and previous studies conducted in the region. The results showed that increased concertation of plant-available Cu, Zn, Cd and Pb were mainly associated with irrigation water and intensive use of fungicides; Fe, Mn, and Ni were closely linked to several factors, such as the mineralogical composition of soils, mineral and organic fertilizers inputs, and atmospheric deposition from diffuse sources, where exhausts from transport are probably the primary source. During our study, we attempted to differentiate irrigation water inputs from fungicides using simulation based on irrigation pattern and irrigation water quality on the one hand and fungicide application rate and their metal content on the other. The simulation revealed that the intensive application of fungicides, especially in vineyards, is more significant in enriching soils with Cu and Zn than irrigation water. Identification of factorial dependences was supported by statistical analysis and application of a number of contamination assessment methods: Contamination Factor (CF), Pollution Load Index (PLI), single-factor Pollution Index (PI), Nemerow’s comprehensive pollution index (PIN), Enrichment Factor (EF), and Geo-Accumulation Index (Igeo). Applied environmental indices indicate that the soils under the former and existing vineyards are the most enriched with Cu and Zn, highlighting the significance of agricultural practices on heavy metals accumulation in soils of agricultural lands.

This study evaluated batch fermentation modes, namely, separate hydrolysis and fermentation (SHF), Quasi-simultaneous saccharification and fermentation (Q-SSF), and simultaneous saccharification and fermentation (SSF), and fermentation conditions, i.e., enzyme and yeast loadings, nutrient supplementation and sterilization, on high titer bioethanol production from SPORL-pretreated Douglas-fir forest residue without detoxification. The result indicated Q-SSF and SSF were obviously superior to SHF operation in terms of ethanol yield. The enzyme loading showed a strong positive correlation between enzyme loading and the ethanol yield. The nutrient supplementation and sterility was not necessary for ethanol production from SPORL-pretreated Douglas-fir. The yeast loading showed no significant influence on the ethanol yield for typical SSF conditions. The terminal ethanol titer of 43.2 g/L, or 75.1% theoretical based on glucose, mannose, and xylose theoretical was achieved when SSF was conducted at the condition of following: whole slurry solids loading of 15%, enzyme loading of 20 FPU/g glucan, 1.8 g/kg (wet) yeast loading, without nutrition supplementation and sterilization, at 38°C, on shake flask at 150 rpm for 96h. It is believed that with mechanical mixing, enzyme loading can be substantially reduced with affect ethanol yield by using a long fermentation time.

To improve carbon efficiency for urban logistics service system composed of a third-party logistics service provider (3PLs) and an e-business enterprise, low-carbon operation game between them was studied. Considering low carbon technology investment cost and sales expansion effect of low carbon level, profit functions for both players were constituted. Based on their different bargaining capabilities, totally 5 types of game scenarios were designed. Through analytical solution, Nash Equilibria under varied scenarios were obtained. By analyzing these equilibria, 4 major propositions were given, in which, some key variables and system performance index were compared. Results show that the best system yields could only be achieved under the fully cooperative situation; limited cooperation only for carbon emission reduction would not benefit the system performance improvement; E-business enterprise-leading game’s performance overtook 3PLs-leading ones.

Background/Aim: Baricitinib (BAR) is the first oral selective Janus kinase inhibitor approved in Europe for rheumatoid arthritis (RA). Real-world data are still needed to clarify its long-term benefit/risk profile. This study aimed to evaluate the effectiveness, persistence, adherence, and safety of BAR in a real-world setting. Methods: An ambispective study was conducted between October 2017 and December 2021 in RA patients starting BAR. Effectiveness was evaluated by change from baseline in the Disease Activity Score using 28-joint counts-C reactive protein (DAS28CRP), and achievement of low disease activity/remission. Drug persistence was evaluated by Kaplan-Meier analysis. Adherence was estimated by medication possession ratio (MPR) and the 5-item Compliance Questionnaire for Rheumatology. Safety was assessed by global incidence proportion and adjusted incidence rates of adverse events. Results: 61/64 recruited patients were finally analyzed, 83.6% female, 78.7% seropositive, mean age of 58.1 (15.4) years, and disease duration of 13.9 (8.3) years. 32.8% were naïve to biologics and 16.4% received BAR on monotherapy. After a median exposure to BAR of 12.4 (6.6-31.2) months (range 3.1-51.4), a significant change in DAS28CRP was observed (difference -1.2, p=0.000). A total of 70.5% and 60.7% patients achieved low disease activity or remission, respectively and 50.8% (31/61) patients remained on BAR during follow-up with a median persistence of 31.2 (9.3-53.1) months. The average MPR was 0.96 (0.08) and all patients were “good adherents” by questionnaire. 21.3% patients discontinued baricitinib due to toxicity. Conclusion: In our real-world practice, BAR demonstrated effectiveness, large persistence, high adherence to treatment and acceptable safety profile.

Thunderstorms endager life and infrastructure. Accurate and precise prediction of thunderstorms are therefore helpful to enable protections measures and to reduce the risks. This manuscript presents the latest developments to improve thunderstorm forecasting in the first few hours. This includes the description and discussion of a new Julia-based method (JuliaTSnos) for the temporal extrapolation of thunderstorms and the blending of this method with the numerical weather prediction model (NWP) ICON. The combination of ICON and JuliaTSnow attempts to overcome the limitations associated with the pure extrapolation of observations wit Atmospheric Motion Vectors (AMVs) and thus increase the prediction horizon. For the blending the operational ICON-D2 is used, but also the experimental ICON-RUC, which is performed with a higher data assimilation update cycle. The blended products are evaluated against lightning data. The Critical Success Index (CSI) for the blended RUC product is higher for all forecast time steps. This is mainly due to higher resolution of the AMVs (prediction hours 0-2) and the rapid update cycle of ICON-RUC (prediction hours 2-6). The results demonstrate the potential of the rapid update cycle to improve the short term forecasts of thunderstorms. Also the transition between AMV driven nowcasting to NWP is much smoother in the blended RUC product, which points to the advantages of fast data assimilation for seamless predictions. The CSI is well above the critical value of 0.5 for the 0-2 hour forecasts. However, also with RUC the CSI drops below 0.5 as soon as the last forecast is more than 3 hours away from the last data assimilation, indicating the lack of the model physics to accurately predict thunderstorms. This lack is simply a result of chaos theory. Within this scope the role of NWP in comparison with Artificial Intelligence (AI) is discussed and it is concluded that AI could replace physical short term forecasts in the near future.

Prostate cancer is the second leading cause of death in males in America, with advanced prostate cancers exhibiting a 5-year survival rate of only 32%. Castration-resistance is often developed during the course of treatment, though its influences require further understanding. This study explores the human microbiome for its implications in castration-resistance and metastasis in prostate cancer. RNA sequencing data was downloaded for bone and soft tissue biopsies of patients with metastatic castration-resistant prostate cancer. These sequences were mapped to bacterial sequences to yield species-level abundance approximations. Numerous species were found to correlate to the expression of known markers of castration-resistance, including AR, PI3K, and AKT. Castration-resistance-associated signaling pathways were also enriched with these species, including PI3K-AKT signaling and endocrine resistance. For their implications in cancer aggression and metastasis, cancer stem cell markers were further explored for relation to these species. EGFR and SLC3A2 were widely downregulated with greater abundance of most species. Our results suggest that the microbiome is heavily associated with castration-resistance and stemness in prostate cancer. By considering the microbiome’s importance in these factors, we may better understand the highly aggressive and highly invasive nature of prostate cancer, allowing for needed improvement in the treatment of this disease.

Background: Misconceptions and knowledge gaps about antibiotic use contribute to inappropriate antibiotic use and antimicrobial resistance. Aim: Identifying and prioritizing misconceptions and knowledge gaps about antibiotic use from a healthcare professionals’ perspective. Methods: A modified Delphi study of two rounds with an expert meeting. A literature search was conducted to create statements about misconceptions and knowledge gaps about antibiotic use. These were rated by healthcare professionals from five EU countries representing general practice, out-of-hour services, nursing homes, and pharmacies. Consensus was achieved if ≥80% of the participants rated 4+ on a five-point Likert scale during the second Delphi round. Results. In total, 44 misconceptions were identified through the literature search within four themes: 1) antimicrobial resistance in general, 2) use of antibiotics in general, 3) use of antibiotics for respiratory tract infections, and 4) use of antibiotics for urinary tract infections. Consensus was reached for more than half of the statements within each setting. Conclusions. Experts from different settings and nationalities acknowledge that multiple misconceptions and knowledge gaps can contribute to inappropriate use of antibiotics in the community. These results provide valuable information to use in educational campaigns for patients and healthcare professionals to improve the use of antibiotics.

Neurological involvement following COronaVIrus Disease 19 (COVID-19) is thought to have a neuroinflammatory etiology. Co-ultraPEALut (an antiinflammatory molecule) and luteolin (an antioxidant) yielded promising results as neuroinflammation antagonists. This study aimed at describing cognitive impairment in post-COVID patient treated with co-ultraPEALut. Montreal Cognitive Assessment (MoCA), Prospective-Retrospective Memory Questionnaire (PRMQ), Fatigue Severity Scale (FSS) and a subjective evaluation were administered at baseline and after 10 months. Co-ultraPEALut-treated patients were retrospectively compared with controls. 26 co-ultraPEALut-treated patients showed significant improvement in PRMQ (T0: 51.94±10.55, T1: 39.67±13.02, p

Urban rail transit hub platform is the most important area for passenger flow distribution. In order to calculate passenger flow volume in platform and evaluate platform service level during rush hours, this paper presents a method for modeling and simulation of passenger flow distribution in platform. Passenger flow distribution model (PFDM) is proposed based on the basic analysis and the superposition principle of passenger flow. Simulation design for PFDM is proposed by Anylogic, which contains simulation process and simulation model. Experiment results show that PFDM and simulation design are effective and accordant with the reality scenario, and the simulation precision is comparatively ideal. This research could provide a beneficial reference for train scheduling and operation management under the viewpoint of traffic safety and service level.

Tomato brown rugose fruit virus (ToBRFV) is an emerging tobamovirus infecting tomatoes and peppers. Due to its ability to trigger seed contamination, efficient mechanical transmission, and to break the popular resistance genes (Tm-1, Tm-2 and Tm-22), the virus has resulted in a global pandemic on greenhouse tomato production in recent years despite the implementation of strict hygiene and disinfection measures. The objective of this study was to evaluate whether ToBRFV can be transmissible through recirculating hydroponic systems and search for effective approach to contain its spread under such circumstances. We not only detected the presence of ToBRFV in the runoff water solutions collected from ToBRFV-infected tomato greenhouses, but also demonstrated the infectivity of detected virus through initiating ToBRFV infection on tomato plants using bioassay. We then conducted treatment using cold plasma-generated ozone on ToBRFV-contaminated water reservoir and further assessed the efficacy of the treatment to inac-tivate the virus. Results showed the effectiveness of the cold-plasma ozone treatment was de-pendent on the ozone concentrations (0.1 mg/L to 1.0 mg/L), the periods of exposure (24 min to 72 min), and the relative virus titers (1:100 to 1:10,000 - dilution of virus-infected tissue extract), demonstrating the cold-plasma ozone treatment could offer a promising solution to cope with the potential ToBRFV spread through a recirculating hydroponic system in a greenhouse.

Our goal was to determine the cellular immune response (CIR) among a random sample of the Borriana COVID-19 cohort (Spain) to identify its associated factors and their relationship with infection, reinfection and sequelae. We conducted a nested case-control study using a randomly selected sample of 225 individuals age 18 and older, including 36 individual naïve to SARS-CoV-2 infection, and 189 infected patients. We employed flow cytometry-based immunoassays for intracellular cytokine staining, utilizing Wuhan and BA.2 antigens and chemoluminescence microparticle immunoassay for detection SARS-CoV-2 antibodies. Logistic regression models were used. A total of 215 (95.6%) participants exhibited T-cell response (TCR) to at least one antigen. Positive responses of CD4+ and CD8+ T cells were 89.8% and 85.3% respectively. No difference in CIR was found for naïve and infected patients. Patients who experienced sequelae exhibited higher CIR than those without. A positive correlation was observed between TCR and Anti-Spike IgG levels. Factors positive associated with TCR included A-blood group, number of SARS-CoV-2 vaccine doses received, and Anti-N IgM; factors inversely related were the time elapsed since the last vaccine dose or infection, and B-blood group. These findings contribute valuable insights into the nuance immune landscape shaped by SARS-CoV-2 infection and vaccination.

Climate simulations in West Africa have been attributed with large uncertainties. Global climate projections are not consistent with changes in observations at the regional or local level of the Niger basin, making management of hydrological projects in the basin uncertain. This study evaluates the potential of using the quantile mapping bias correction to improve the Coupled Model Intercomparison Project (CMIP5) outputs for use in hydrology impact studies. Rainfall and temperature projections from 8 CMIP5 Global Climate Models (GCM) were bias corrected using the quantile mapping approach. Impacts of climate change was evaluated with bias corrected rainfall, temperature and potential evapotranspiration (PET). The IHACRES hydrological model was adapted to the Niger basin and used to simulate impacts of climate change on discharge under present and future conditions. Bias correction significantly improved the accuracy of rainfall and temperature simulations compared to observations. Nash coefficient (NSE) for monthly rainfall comparisons of 8 GCMs to the observed was improved by bias correction from 0.69 to 0.84. The standard deviations among the 8 GCM rainfall data were significantly reduced from 0.13 to 0.03. Increasing rainfall, temperature, PET and river discharge were projected for all GCMs used in this study under the RCP8.5 scenario. These results will help improving projections and contribute to the development of sustainable climate change adaptation strategies.

Glycosylation, the most significant modification of proteins, plays an essential role in cellular processes. Congenital disorders of glycosylation (CDG) are multisystemic diseases resulting from mutations affecting glycosylation steps. Diagnosis of CDG relies on biochemical assays, such as isoelectric focusing. Despite its significance, CDG cases remain unreported in Cuba due to the lack of implemented diagnostic methods. This study aimed to evaluate transferrin glycoforms for diagnosing congenital N-glycosylation defects. We conducted a cross-sectional descriptive study using serum samples from 17 patients stored at the National Center for Medical Genetics of Cuba for suspected CDG. Results revealed abnormal glycosylation patterns in 7 patients, suggesting congenital N-glycosylation defects. We conclude that the implementation of transferrin glycoform analysis could pioneer a preliminary diagnosis of CDG in Cuba.

Background: This study aimed to identify the association between occupational stress and depression-well-being by proposing a comprehensive and flexible job burden-capital model with its corresponding hypotheses. Methods: For this research, 1618 valid samples were gathered from the electronic manufacturing service industry in Hunan Province, China; self-rated questionnaires were administered to participants for data collection after obtaining their written consent. The proposed model was fitted and tested through structural equation model analysis. Results: Single-factor correlation analysis results indicated that coefficients between all items and dimensions had statistical significance. The final model demonstrated satisfactory global goodness of fit (CMIN/DF=5.37, AGFI=0.915, NNFI=0.945, IFI=0.952, RMSEA=0.052). Both the measurement and structural models showed acceptable path loadings. Job burden and capital were directly associated with depression and well-being or indirectly related to them through personality. Multi-group structural equation model analyses indicated general applicability of the proposed model to basic features of such a population. Gender, marriage and education led to differences in the relation between occupational stress and health outcomes. Conclusions: The job burden-capital model of occupational stress-depression and well-being was found to be more systematic and comprehensive than previous models.

Wood is poised to become a material of choice for future construction. When appropriately managed, it is a renewable material with unique mechanical properties. Beyond its inherent sustainability, the use of wood has a crucial role in addressing climate change concerns due a significantly lower energy consumption and emissions during manufacturing and transportation, while simultaneously acting as a carbon sink. Thus, there has been a growing demand for hardwoods for structural applications, including Castanea sativa Mill., the focal point of this investigation. Albeit in a limited capacity, Eurocode 5-2 offers friction coefficients for softwoods, but it falls short for hardwoods which it is a gap to bridge with this research. These coefficients play a critical role in numerical simulations involving friction, enabling the optimization of joints and, by extension, the overall structural integrity. Test samples were evaluated at 18% moisture content, which is typical of Service Class 2, for various orientations of timber-to-timber and timber-to-steel friction. Considering previous friction coefficients at 12% moisture content, the linear variation was evaluated at an intermediate value of 15%. The results provide an experimental database for numerical simulations and highlight the influence of moisture content on the coefficients, which increase linearly along moisture percentages.

Despite the clinical significance of partial posttraumatic stress disorder (PTSD), research on its associated cognitive function profiles is notably lacking. This study aimed to identify distinct cognitive function profiles in patients with partial PTSD. Medical records of Vietnamese War Korean Veterans undergoing psychiatric assessments, including the Clinician-Administered PTSD Scale (CAPS) and neurocognitive tests on the same day, were retrospectively reviewed. The participants were divided into partial PTSD (N = 10) and non-PTSD (N = 36) groups based on the CAPS interview. Neurocognitive test score profiles of the partial PTSD and non-PTSD groups were compared. Covariance analysis adjusted for potential confounders in cognitive function. In cognitive profiles, executive function, mental flexibility (measured by Trail Making Test B), and concentration (measured by the Mini-Mental Status Exam) were significantly poorer in the partial PTSD group. When adjusted for age, depressive symptoms, and education level, no significant differences were observed in the cognitive profiles between the partial PTSD and non-PTSD groups. In the current study, executive function and concentration showed deficits in patients with partial PTSD compared with those without PTSD. Partial PTSD cognitive profiles displayed no significant differences from non-PTSD profiles when adjusted for possible confounders such as depressive symptoms.

Abstract. Introduction: BMD study gives partial information on bone health in patients with TSH suppression therapy due to Differentiated Thyroid Cancer (DTC). TBS, a new parameter of bone microarchitecture is propose for bone quality study. This study analyze their long-term use in patients with DTC. Methods: BMD was measured by DXA and TBS with iNsigth software in 145 postmenopausal DTC patients. Vertebral Fractures (VFs) with a semi-quantitative x-ray method. Results: BMD at the end study was not different from initial. TBS decreased from 1.35±0.1 to 1.27±0.1 (p=0.002). PTH, Osteocalcin, and BAP were increased, suggesting increased bone remodeling. There was an increase in osteoporosis and osteopenia (40.6% and 16.5% to 46.6% and 18.6%); 31% had partially degraded and 15.1% degraded TBS changed to 48,9% and 24,8% at the end study. VFs in 30 patients, was not different in age, BMI, calcium and alcohol ingestion, smoking, radioiodine, or thyroid parameters vs. without VFs. Odds ratio for VFs increased with osteopenia (OR 2.63). Combination of TBS plus TBS did not improve discrimination. Conclusions: TBS was lowered while BMD did not differ. Percentage of osteoporosis and osteopenia and of partially degraded and degraded TBS was higher at the end study. Predominant discordance rate was found in partially degraded microarchitecture, in which the proportion of osteopenia was higher than normal or osteoporotic patients. AUC of TBS plus BMD did not improve discrimination. TBS, radioactive iodine, and sedentary lifestyle were the main differential data for patients with DTC and VFs.

The EASY-NET network program (NET-2016-02364191 - Effectiveness of Audit and Feedback (A&F) strategies to improve health practice and equity in various clinical and organizational set-tings), piloted a new and more structured A&F strategy. This study compared the effectiveness of the new strategy versus the periodic publication of indicators alone in improving the appropri-ateness and timeliness of emergency health interventions in patients with Acute Miocardial In-farction (AMI) and ischemic stroke in the Lazio Region. Efficacy was evaluated according to a prospective quasi-experimental design of pre-post (2021-2022) intervention type with control group. The exposed are hospitals in the Lazio Region where professional teams voluntarily par-ticipated in the intervention. The control group is involved only in the usual reporting activities. Effectiveness analysis was conducted at the patient level. Regional health information systems were used to calculate process and outcome indicators. The effectiveness of the intervention was assessed with Difference In Difference models, comparing pre-post intervention periods between exposures and controls. Estimates were calculated in terms of the difference in percentage points (pp) between absolute risks. Sixteen facilities for the IMA pathway and 13 for the stroke pathway joined the intervention. The intervention reduced the proportion of 30-days readmissions after a hospitalization for ischemic stroke by 0.54 pp in the exposed patients with a significant difference of -3.80 pp (IC95% -6.57; -1.03; 5453 patients, 63.7% cases) in the exposed compared to controls. There were no statistically significant differences attributable to the implemented A&F interven-tion in the other indicators considered. The results show, for the first time in Italy, the impact of A&F interventions in an emergency setting using aggregated data from hospitals involved in the Lazio Region emergency network.

Our study reviews the significance of archaeological parks in the tourism sector, with a specific focus on how digital presence and visitor feedback impact their cultural and touristic appeal. Utilizing statistical analyses such as regression and cluster analysis on data sourced from both Hungarian and Western European parks, the research scrutinizes TripAdvisor and Google ratings, alongside the volume of photographs and reviews. The findings highlight a modest correlation between digital visibility and overall visitor ratings, underscoring the complex relationship between online engagement and the quality of visitor experience. Notably, the cluster analysis identified two distinct groups, signifying diverse levels of visitor engagement and digital visibility across the parks. The conclusions drawn advocate for a comprehensive strategy to enhance visitor experiences, emphasizing the integration of digital engagement with the promotion of the parks cultural and historical values. By exploring the influence of digital presence on the appeal of archaeological parks, our study sheds light on the evolving interface between urban studies and digital heritage, highlighting how digital tools and online platforms are becoming increasingly integral in shaping the perceptions and experiences of urban cultural sites.

This study investigates how customers’ technological readiness affects service quality and the adoption of self-service banking by developing an empirical model. The model was proposed to explore the relationships between technology readiness, self-service quality, and customer satisfaction. The hypotheses and stability of the model were tested using structural equation modeling. The findings revealed that technology readiness, including the optimism, innovation, and insecurity dimensions, had a significant positive impact on self-service quality. In addition, service quality fully mediated the relationship between technological readiness and customer satisfaction. These results suggest that when customers are ready to embrace and use new technology, their evaluation of service quality is high. Thus, bank managers should drive customer perceptions of the quality of self-service banking by improving their technological readiness through various measures. Furthermore, based on the mediating effect of self-service quality, banks must be aware that improving service quality can enhance customer satisfaction and maintain a competitive advantage.

As an emerging model, self-service fitness centers are reshaping the consumer fitness experience globally. Given the crucial role of customer loyalty in the sustainable operation and management of fitness service enterprises, this study constructs a structural model incorporating service quality, service convenience, customer satisfaction, word-of-mouth intentions, and repatronage intentions. The model is designed to elucidate the factors and mechanisms impacting customer loyalty at self-service fitness centers and further investigates how these relationships are affected by service methods, either with staff or without staff. The study employs PLS-SEM to empirically analyze 552 customer questionnaires from four self-service fitness centers in first-tier cities in China. The results reveal positive correlations among the constructs in the structural model, emphasizing the important position of raising service quality standards and reducing the time and effort expended by customers in the management of customer loyalty. Concurrently, service convenience was found to play a significant driving role in customers' perceived service quality. Through the chain-mediating effect of service quality and customer satisfaction, service convenience exerts a considerable positive impact on word-of-mouth intentions and repatronage intentions. Moreover, the study reveals significant differences in these relationships when considering service methods, either with staff or without staff.

Aim: To analyze a single center's experience with Short Bowel Syndrome/ Chronic Intestinal Failure (SBS/CIF) in adult patients treated with Home Parenteral Nutrition (HPN). Materials and methods: In the last thirty years, 13 patients with SBS/CIF were included in an HPN program. Results: Between 1992 and 2023, 13 patients were included in an HPN program. The primary underlying pathology was acute mesenteric ischemia. The median age of the starting HPN was 44 years old. Most are submitted to several surgeries of extensive intestinal resection with posterior intestinal reconstruction. Five of the 13 patients have died while on HPN for a median of 42 months. The causes of death HPN-related were catheter sepsis, endocarditis with cardiac failure, or hepatic failure. One patient died due to underlying pathology: pelvic abscesses and bleeding related to radiotherapy. Eight patients remain alive with a median time of HPN of 173 months. During the HPN support, the most frequent complications were venous catheter infection and venous territory thrombosis. None of the eight patients alive have hepatic failure. Two patients recently started teduglutide, with good tolerance, and need reduction of HPN support. All these eight patients have a satisfactory quality of life (parenteral support needs range between five to two nutrition bags per week). Conclusion: HPN remains the gold standard of SBS/CIF treatment, although Teduglutide may reduce HPN needs and HPN complications and provide a better quality of life. An HPN multidisciplinary healthcare group support is essential to ensure these patients' survival and quality of life. Keywords Short bowel Syndrome, Chronic Intestinal failure, Home Parenteral Nutrition, Teduglutide, Complications of Parenteral Support.

Keywords: Oral health, diabetes, periodontal disease, caries, periodontitis.

Responding to changing value creation processes in the sheet metal working sec-tor, where the complexity and interchangeability of products challenge traditional dif-ferentiation strategies, this empirical analysis explores integrating service-oriented and data-driven business models as new paths to ensure competitiveness, especially for small and medium-sized enterprises (SMEs). This study aims to capture the current state and challenges associated with the implementation of these business models in this sector. The research was conducted through semi-structured interviews with SMEs in the industry. The findings indicate that service-oriented and data-driven business models are not yet widely adopted and that manufacturing companies re-quire support in their implementation. Fields of action were identified for the industry. These are "Creating awareness and understanding", "Recognizing added value", "In-creasing company maturity" and "Understanding the change process". Cooperation between science and industry is essential in tackling these fields of action to ensure the successful integration of such business models in manufacturing companies. This pa-per identifies challenges in the fields of action that companies must address through a structured approach promoting awareness, recognizing value, improving organiza-tional maturity, and understanding the change process to successfully implement ser-vice-oriented and data-driven business models.

The quality of healthcare services is a very important indicator of social welfare in developed and emerging countries. Good quality levels are critical to ensuring patient safety, improving health outcomes, increasing patient satisfaction, optimizing resource utilization, and meeting regulatory requirements. The stable and sustainable operation of medical institutions urgently requires the establishment of a reliable and effective medical quality performance evaluation platform. However, the complexity of the evaluation process, involving numerous evaluators and the consideration of different subjective and objective criteria, poses significant challenges and essentially constitutes a group multi-criteria decision-making problem. This article uses the overall medical environment of the institution, medical service attitude, medical security, administrative service measures, etc. as measurement standards to deal with this challenge. It proposes a medical service quality measurement model suitable for both qualitative and quantitative analysis. In view of the heterogeneity of information, the two-tuple fuzzy language calculation method is introduced to enable evaluators to skillfully manage diverse information and effectively avoid potential information omission problems in the subjective evaluation integration process. The effectiveness and feasibility of the model were demonstrated by applying it to the operational framework of a medical institution in central Taiwan.

Background: The workplace burnout syndrome is often associated with particular aspects of certain job positions, especially those which entail working with people with special needs. The burnout syndrome in healthcare jobs is a serious problem which has grown into an epidemic among healthcare workers and associates. Objectives: The aim of this research is to assess the presence of stress and burnout syndrome at work with healthcare workers, expert workers, professional associates and associates in social service institutions in Belgrade. Material and Methods: This research has been conducted in the form of a cross-sectional study of a representative sample in social institutions in Belgrade. It has been conducted from March to the end of June of 2023. The sample of the study had 491 participants. The questionnaires used were a structured instrument with social-demographic and social-economic characteristics, workplace characteristics, life style characteristics, and the following questionnaires: DASS-21, Copenhagen, Brief Resilience Scale, and Brief Resilient Coping Scale. Results: The end results indicate the following to be significant risk factors for the occurrence of workplace burnout syndrome: overtime (OR=2.62; CI=1.50-4.56), BRS average score (OR=0.28; CI=0.17-0.44), DASS21 D heightened depression (OR=2.09; CI=1.1-4.04), DASS21 A heightened anxiety (OR=2.38; CI=1.34-4.21), DASS21 S heightened stress (OR=2.08; CI=1.11-3.89). The only protective risk factor which stood out was the self-assessment of health levels (OR=0.60; CI=0.42-0.85). Conclusion: Overtime is a significant predictor of workplace burnout. Apart from it, other significant predictors of workplace burnout were heightened depression, anxiety, and stress levels.

In service economy, scholars and practitioners focus on the development and the appliance of innovative services. The importance of service innovation is rising in many sectors and among different organizations. Several disciplines (e.g. marketing, management, operations research, etc.) focus on this innovation, a concept widely used, but with different definitions. In this paper, service innovation has been analyzed according to SD Logic and a service ecosystem perspective. Literature still call for a deeper understanding of how new or renewed resources’ combination affect the shaping of service ecosystems. To contribute to fill this gap, the study explores the practices that different actors, internal and external to a healthcare service ecosystem, enact to co-create value in novel ways that is service innovation. The paper is structured as follows. In the next section, the main academic contributions on service research have been reviewed, focusing on healthcare service innovation. Follows, the research method and the discussion of research findings. Finally, theoretical and managerial implications have been detailed and an agenda for future research suggested. The paper offers interesting insights to develop new or renewed practices that foster the reshaping and maintaining of a healthcare service ecosystem. Some recommendations are included to support managers in the development of service innovation strategies.

Sterol homeostasis in mammalian cells and tissues involves balancing three fundamental processes: de novo sterol biosynthesis; sterol import (e.g., from blood-borne lipoproteins); and sterol export. In complex tissues, composed of multiple different cell types (such as the retina), import and export also may involve intra-tissue, inter-cellular sterol exchange. Disruption of any of these processes can result in pathologies that impact the normal structure and function of the retina. Here, we provide a brief overview of what is known currently about sterol homeostasis in the vertebrate retina and offer a proposed path for future experimental work to further our understanding of these processes, with relevance to the development of novel therapeutic interventions for human diseases involving defective sterol homeostasis.

We investigated the development of a simple and sensitive assay for the identification of minute amounts of animal and human biological material. The suggested system uses isothermal amplification of DNA in a rapid assay format, which returns the results in as little as 40 minutes from sampling. The assay used for the proof of concept employs the novel handheld SaLux19 device (Max-Planck Innovation prototype, Germany). This well-established infield detection system could also be utilized for forensic scenarios. The results presented here demonstrated that the assay is sufficiently specific and sensitive and can detect the presence of Sus scrofa nucleic acids.

With the advances in industry and commerce, passengers have become more accepting of environmental sustainability issues; thus, more people now choose to travel by bus. Government administration constitutes an important part of bus transportation services as the government gives the right-of-way to transportation companies allowing them to provide services. When these services are of poor quality, passengers may lodge complaints. The increase in consumer awareness and developments in wireless communication technologies have made it possible for passengers to easily and immediately submit complaints about transportation companies to government institutions, which has brought drastic changes to the supply-demand chain comprised of the public sector, transportation companies, and passengers. This study proposed the use of big data analysis technology including systematized case assignment and data visualization to improve management processes in the public sector and optimize customer complaint services. Taichung City, Taiwan was selected as the research area. There, the customer complaint management process in public sector was improved, effectively solving such issues as station-skipping, allowing the public sector to fully grasp the service level of transportation companies, improving the sustainability of bus operations, and supporting the sustainable development of the public sector-transportation company-passenger supply chain.

Relay protection service is the most crucial service carried by the electric power communication network, which is directly linked to the safe operation of the power grid. In the route planning of power services, a route planning architecture for the power communication network is constructed in this paper, considering the operation and maintenance requirements, such as relay protection service overload (RPSO) and dual route. To minimize network risk variance, the problem of single-service route allocation is formulated by taking the factors into account such as service delay, link bandwidth utilization, and RPSO constraints. Based on $k$ shortest paths algorithm, a route planning scheme for the power services is proposed, which considers RPSO and risk balance, and a strategy for implementing multi-service route planning of the communication network is studied. The simulation results show that the proposed route planning strategy can effectively avoid relay protection service overload, reduce network risk variance, and balance network risk.

The use of the voice of the customer as a main input to guide decision making towards customer centricity strategies has become a necessity for companies. This research proposes a structured method of textual processing using the KDD (Knowledge Discovery Databases) methodology applied to the tweets of users of Colombian public sector companies, through the analysis of temporal sentiments and topic modeling to identify the areas in which actions should be taken to improve the perception of service. To fulfill such purpose, tweets from January to June 2022 are processed, followed by a temporal analysis of the evolution of the sentiment based on 3 enriched dictionaries; after, the LDA (Linear Discriminant Analysis) algorithm is implemented to find the areas with ailment for the user, in addition to propose a method to homologate the CIER (Comisión de Integración Energética Regional) survey. Finally, metrics are detailed to follow up the perception of the service. It is concluded that for the Acueducto the topic with the highest number of complaints is related to "Water truck request", for Enel "Servide Outages" and for Vanti: " Case solution and request information". Also, the homologation of 3 of the 5 pillars on which the CIER survey is based is presented.

Despite available global efforts and funding, Tuberculosis (TB) continues to affect a considerable number of patients worldwide. Policy makers and stakeholders set clear goals to reduce TB incidence and mortality, but the emergence of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) complicate the reach of these goals. Drug-resistance TB needs to be diagnosed rapidly and accurately to effectively treat patients, prevent the transmission of MDR-TB, minimise mortality, reduce treatment costs and avoid unnecessary hospitalisations. In this narrative review, we provide a comprehensive overview of laboratory methods for detecting drug resistance in MTB, focusing on phenotypic, molecular and other drug susceptibility testing (DST) techniques. We found a large variety of methods used, with the BACTEC MGIT 960 being the most common phenotypic DST and the Xpert MTB/RIF being the most common molecular DST. We emphasise the importance of integrating phenotypic and molecular DST to address issues like resistance to new drugs, heteroresistance, mixed infections and low-level resistance mutations. Notably, most of the analysed studies adhered to the outdated definition of XDR-TB and did not consider the pre-XDR definition, thus posing challenges in aligning diagnostic methods with the current landscape of TB resistance.

Apple replant disease (ARD) is a complex issue caused by various fungal, oomycetes pathogens and parasites which can differ in their abundance between sites within a geographic region. Knowledge of the specific etiology of ARD at a particular site is required in order to develop commercially viable soil management strategies to combat specific/individual components of the disease. In this study we analyzed the soil from six ARD sites for the presence of fungal, bacterial and oomycetes communities and plant parasitic nematodes. Five fungal, and 17 bacterial classes were differentially represented in the microbiomes from different locations. Mortierellomycetes was the most abundant fungal taxa represented followed by Sordariomycetes. Mortierella exigua a fungal endophyte was the most abundant fungal amplicon sequence variant (ASV) in the core microbiome. Proteobacteria was the most prevalent phylum identified in orchard soils. Several potential phytopathogenic fungi involved in ARD and endophytes including Fusarium oxysporum, F. solani, Nectria ramulariae, Ilyonectria robusta and Nectriaceae were identfied in the orchard soil. Pythium attrantheridium (Globisporangium attrantheridium), P. monospermum and P. ultimum (Globisporangium ultimum) were the most abundant oomycete taxa identified in these soil samples. Six different groups of plant-parasitic nematodes were found across the six orchards soil. Root-lesion nematodes, Pratylenchus spp., which are commonly associated with ARD, were identified in all orchards soil at population densities ranging from 12 to 33/100 cm3 soil. This research contributes valuable understanding of the ARD complex as the apple industry needs alternative approaches to combat the disease.

The present study explained factors influencing citizen satisfaction service in the Investment and One-Stop Service Agency of Tanah Bumbu Regency. In particular, this research analyses the level of citizen satisfaction and the extent to which Awareness, Rules, Organizational, Income, Skill-Ability, and Service Facility Factor influence Citizen Satisfaction. This study uses a mixed methodology with a sequential explanatory strategy. Using the incidental sampling with Slovin's Formula to calculate the number of samples is 93 respondents. The quantitative data were analyzed by the SmartPLS 3.0 program. The findings showed that the level of citizen satisfaction is included in the category "Satisfied". Furthermore, the variable of Citizen Satisfaction is influenced by variables of Awareness, Rules, Organizational, Income, Skill-Ability dan Service Facility Factor for 70,5%. Whereas Awareness, Rules, Organizational, and Skill-Ability Factor has a significant influence on Citizen Satisfaction. Besides, Income and Service Facility Factor do not have a significant influence on Citizen Satisfaction.

Turner syndrome (TS) is caused by a complete or partial absence of an X or Y chromosome, including chromosomal mosaicism, affecting 1 in 2,500 female live births. Sister chromatid exchange (SCE) is used as a sensitive indicator of spontaneous chromosome instability. Cells from mosaic patients constitute useful material for SCE evaluations as they grow under the influence of the same genetic background and endogenous and exogenous factors. We evaluated proliferation dynamics and SCE frequencies of 45,X and 46,XN cells of 17 mosaic TS patients. In two participants, 45,X cells exhibited a proliferative disadvantage in relation to 46,XN cells after 72h of cultivation. The analysis of mean PI showed significant differences between 45,X and 46,XN lineages; however there were no intraindividual differences. On the other hand, mean SCE frequencies showed no differences between the two lineages, but there were intraindividual differences in 5 patients. The absence of mean SCE frequency differences between 45,X and 46,XN lineages may indicate that both were equally unstable, as more than 70% of the 46,XN lineages had an anomalous karyotype. However, 46,XN had a higher mean PI, suggesting that the amount of cells with a karyotype distinct from 45,X may increase with time in mosaic TS women.

In the evolving landscape of cybersecurity threats, the Permanent Denial of Service (PDoS) attacks have emerged as a particularly damaging form of cyber aggression. Unlike the more well-known Denial of Service (DoS) attacks, which disrupt services temporarily, PDoS attacks aim to inflict irreversible damage to systems, often resulting in significant system overhauls and requiring hardware replacement. To enable the development of effective security measures, but also to address the knowledge gaps, this paper offers an in-depth exploration of PDoS attacks, emphasizing their distinguishing characteristics, underlying mechanisms, and potential further development. Through a comprehensive case study, the research highlights diverse tactics and strategies employed by attackers, from targeting IoT devices to manipulating boot processes and exploiting firmware vulnerabilities. A novel classification of PDoS attack vectors is proposed, that also explains the ways in which the systems can be compromised. The findings confirm the pressing need for adaptive and robust defense mechanisms to mitigate the threats posed by PDoS attacks in our interconnected digital world.

1) Background: In service business areas, design enhances the customer experience through the elements which anticipate specific emotional responses of customers. Many service companies are keen to develop and examine design elements from the customer perspective. Furthermore, recently, having considered the significance of customers’ emotional responses by design elements, categorising design elements into manageable dimensions can facilitate the evaluation of design elements. However, design elements and dimensions of design value are not defined in the current service marketing literature, and companies need a measurement tool and managerial guideline to their innovative value creation and compelling service delivery. For these reasons, this research aims to categorise the design value dimensions and propose the managerial implication for the innovative use of design; 2) Methods: This study used the mixed methodology; two stages of interviews and SEM (Structural Equation Modelling); 3) Results: Interview analyses facilitate the identification of design elements in the service delivery process. SEM results underpin the relevance of the categorised design elements and their impact on customer loyalty by comparing different groups (country and time elapsed from experience); and 4) Conclusions: Findings are the fundamentals of developing measuring tool for design and trigger future studies for conceptualising intangible assets.

IntroductionParamedicine is a domain of practice and health profession that specialises in the provision of health and social care across a range of settings including, but not limited to, emergency and primary care. Paramedics work in a variety of clinical settings such as paramedics services, hospitals, and clinics, in the community as well as non-clinical roles, such as education, leadership, policy work, public health and research. A previous competency framework for paramedics in Canada had become increasingly poorly aligned with contemporary practice. We sought to develop a competency framework that represents contemporary paramedic practice in Canada. MethodsThis project was guided by a conceptual framework informed by systems thinking and used a six-step model for developing competency frameworks. We engaged paramedics from across Canada in working groups to explore various contexts of paramedic practice. We gathered data using multiple methods and coded this data into activity statements. We grouped these statements and developed or expanded corresponding professional activities through five drafts of the framework from 2022 to 2024. A technical committee reviewed and edited the draft framework throughout the process, culminating in a public review period from January to March 2024, and a subsequent final version of the National Competency Framework for Paramedics (NCFP). ResultsThe National Competency Framework for Paramedics reflects contemporary paramedic practice in Canada. It describes the professional activities of paramedics organised under five domains - Person-Centred Care; Collaborative Care; Safe Care; Self-Care; and Professional Care. Paramedics perform these activities across multiple contexts of practice by enacting a variety of roles depending on the event. Discussion and conclusion By exploring the variety of practice contexts and the expectations of paramedics across Canada, the NCFP provides a holistic, contemporary description of paramedic practice in Canada, providing a foundation for professional practice in a variety of settings. The five domains provide a comprehensive representation of paramedic practice helping to ensure care is ultimately and sufficiently aligned with the needs of the community and settings in which paramedics can practice. The NCFP can be used to inform education programs to better prepare paramedics for complex, interprofessional health and social care practice now and as practice continues to evolve.

This paper examines the transformation of the Ukrainian stock market by analyzing daily returns from the PFTS stock index spanning 1995-2022. Segmented into sub-periods, it tests the hypothesis that the market's efficiency has grown over time. Various data properties, including persistence, volatility, normality, and resistance to anomalies, are explored using different statistical techniques and methods. Volatility, indicated by standard deviation, exhibits a general decreasing trend, suggesting a shift towards a more efficient market. Returns show no significant differences across sub-periods, except for 2005-2007. R/S analysis indicates the decrease of persistence in the market: a trend towards increased efficiency. Normality tests support a normal distribution of daily returns throughout sub-periods. An analysis of anomalies reveals the market's resilience to day-of-the-week effects, with no specific trends observed. The results suggest the absence of serious changes in data properties in the Ukrainian stock market over the time, means evolutionary processes over 25 years can’t be clearly observed. Reforms and changes have had limited impact, justifying continued reform for the market's evolution.

Background: Fibonacci patterns and tubular forms both arose early in the phylogeny of multicellular organisms. Tubular forms offer the advantage of a regulated internal milieu, and Fibonacci forms may offer packing efficiencies. The underlying mechanisms behind the cellular genesis of Fibonacci and tubular forms remain unknown.

Body Expression (BE) has been defined in the past decades as a discipline within Physical Education (PE) with very particular characteristics and a strong emotional component. In this study, a programme of this discipline was applied to university Physical Activity and Sports Sciences (PASS) students from six consecutive academic years: three prior to and three during the pandemic. A pre-post design was used to determine how the BE programme affected the university students' self-concept (SC). To do so, a questionnaire with a multidimensional approach to this construct was administered, whose dimensions were closely related to the BE programme's characteristics. The results revealed significant improvements in the final SC, compared to the initial SC. Men reported lower SC values than women before the programme implementation, but higher at the end. Therefore, the change was larger in men, so the programme may have had an equalising effect between groups. It was also verified that the pandemic had particularly affected women.

We present a normative methodology, for value-pricing B2B services, using a Nash Equilibrium mechanism. Value is fundamental to any service, yet it has defied a definition. The literature is conspicuously silent on how to define value, but abounds in richly descriptive characterizations. To overcome this deficit, we focus on the financial economics of service-value. We formulate an axiomatic definition and a differential equation that embodies the idea of service-value. We specify a set of value axioms and multidisciplinary postulates that coherently form our service-value constructs. Value-pricing is challenging. It is natural that providers desire a high price and customers want a low price. Realistically, both will agree on a win-win price. To uncover this price, we specify an algorithm to reveal the Nash Equilibrium. Once agreed, it validates providers’ and customers’ commitments, and payment obligations. Service value is cocreated by both provider and customer. For a reciprocal process, its treatment is remarkably asymmetric favoring the customer. We argue that one-sided descriptions of value-in-use and value-proposition are limiting mental models. We propose the additional ideas of value-from-use and value-supposition to strengthen the conceptual symmetry of cocreation. Our work reveals a critical gap in service science, metrology. Metrology, the science of measurements, is absent from service-science. Service-value is silent on the questions of quantities, units, scales, measurement principles and instruments. We argue for a call to action for Service Metrology. We sketch a roadmap of actionable suggestions to get started.

A hybrid fuzzy MADM method is proposed in this paper for evaluating airline service quality. Fuzzy set theory is used since it helps in measuring the ambiguity of concepts associated with human being’s subjective judgment. After reviewing service quality evaluation models especially in airline industry, SSQAI model was adopted as a construct for evaluating airline service quality in Iran. Fuzzy DEMATEL was applied to determine the degree of influence and impact of criteria on each other and extract cause and effect relations between them that helped in ranking criteria based on degree of relationship. Then, ANP network map was constructed based on the relation map generated from Fuzzy DEMATEL analysis. Fuzzy ANP approach assisted in prioritizing criteria based on the need for improvement and enabled in a more accurate measurement in decision making process taking the advantage of using linguistic variables. Fuzzy DEMATEL results demonstrates that expertise, Problem-solving, and conduct has the most influence on other factors and in opposite Valence, Waiting Time, Comfort are the factors which get the most impact from other factors and according to Fuzzy ANP analysis Valence, Convenience, Problem-solving, and Safety&Security are the factors with most priorities that need improvement.

Meals on Wheels (MoWs) provide access to daily meals and social contact to adults with care and support needs.MoWs could be essential for the increasing rates of an ageing population and adults living with complex needs in England, yet many do not know that the service exists. This study aimed to explore the perceptions of MoWs service users, and people who refer them to MoWs (‘referrers’), with accessing and setting up the service in England, and what information would be valued when considering accessing MoWs services.Semi-structured interviews were conducted in May-July 2022 with seven service users and 21 referrers, recruited from four MoWs providers across England. Data were analysed using thematic analysis. Participants indicated various pathways into the service, but referrers (family members) were more likely to be the ones enquiring about, and setting up, MoWs for service users. Once an enquiry about MoWs had been made, the service was perceived as straightforward to set up.However, existing preconceptions and stereotypes about the service (e.g. bringing to mind ‘school meals’, aimed solely at older adults) were perceived to act as barriers to accessing MoWs.Information that participants deemed important to have available when deciding on whether to access MoWs related to the meals (e.g. nutritional value, variety, need for any preparation, catering for individual needs), the specific services provided (e.g. wellbeing checks, daily social contact), the reliability and flexibility of delivery, and the cost of services. These findings could inform MoWs providers’ public awareness strategies about MoWs, in order to facilitate referrals to the service for adults with care and support needs.

Glioblastoma multiforme (GBM) is the most frequent and aggressive primary brain tumor. GBM is formed by a very heterogeneous astrocyte population, neurons, neovascularization and infiltrating myeloid cells (microglia and monocyte derived macrophages). The IQGAP1 scaffold protein interacts with components of the cytoskeleton, cell adhesion molecules, and several signaling molecules to regulate cell morphology and motility, cell cycle and other cellular functions. IQGAP1 overexpression and delocalization has been observed in several tumors, suggesting a role for this protein in cell proliferation, transformation and invasion. IQGAP1 has been identified as a marker of amplifying cancer cells in GBMs. To determine the involvement of IQGAP1 in the onco-biology of GBM, we performed immunohistochemical confocal microscopic analysis of the IQGAP1 protein in human GBM tissue samples using cell type-specific markers. IQGAP1 immunostaining and subcellular localization was heterogeneous; the protein was located in the plasma membrane and, at variable levels, in nucleus and/or cytosol. Moreover, IQGAP1 positive staining was found in podosome/invadopodia-like structures. IQGAP1⁺ staining was observed in neurons (Map2⁺ cells), in cancer stem cells (CSC; nestin⁺) and in several macrophages (CD31⁺ or Iba1⁺). Our results indicate that the IQGAP1 protein is involved in normal cell physiology as well as oncologic processes.

Online streaming contents are creating greater service uncertainty, as consumers need to experience such contents before making a decision to continue to purchase them. Few studies have investigated the interaction between eWOM (online word-of-mouth) and online streaming content service characteristics in online streaming contents’ performance and explained the way this interaction can promote service characteristics’ role in service performance or remedy service uncertainty attributable to these characteristics. Thus, this paper examines the interaction between eWOM and service (webtoon) characteristics (i.e., author experience, genre (drama or fantasy), completion, transfer to pay service, and publication time (Wednesday)) on online streaming contents’ service performance measures such as publication period and gamification of contents. Author experience and genre interact with the number of reviews to affect gamification. The transfer to pay service interacts crucially with review ratings and the number of reviews to influence both publication period and gamification. Online streaming contents completion and publication time are interacting factors with review ratings that affected publication period. Service providers need to cope with service uncertainty in furthering online streaming contents service by considering service characteristics as well as customers’ responses through eWOM.

Background. The European Centre for Disease Prevention and Control describes the community pharmacist as gatekeeper to the quality of antibiotic use. The pharmacist has the responsibility to guard safe and effective antibiotic use; however, little is known about how this is implemented in practice. Aims. To assess the feasibility of a method to audit the quality of antibiotic dispensing in community pharmacy practice and to explore antibiotic dispensing practices in Greece, Lithuania, Poland, and Spain. Methods. The Audit Project Odense methodology to audit antibiotic dispensing practice was adapted for use in community pharmacy practice. Community pharmacists registered antibiotic dispensing on a specifically developed registration chart and were asked to provide feedback on the registration method. Results. Altogether twenty pharmacists were recruited in four countries. They registered a total of 409 dispenses of oral antibiotics. Generally, pharmacists were positive about the feasibility of implementing the registration chart in practice. The frequency of checking for allergies, contraindications and interactions differed largely between the four countries. Pharmacists provided little advice to patients. The pharmacists rarely contacted prescribers. Conclusion. This tool seems to make it possible to get a useful picture of antibiotic dispensing patterns in community pharmacies. Dispensing practice does not seem to correspond with EU guidelines according to these preliminary results.

Transportation electrification has been identified as a crucial shift to be made for achieving energy security and emission reduction targets. Electric Vehicles (EVs) play a significant role in achieving these targets; therefore, there is a growing trend to develop new EV technologies and associated infrastructure. Along with these developments, EVs' Quality of Service (QoS) aspects should be enhanced to increase the number of EVs on the road. Various QoS factors are defined to assess the QoS of EVs, and one of the two aims of this paper is to provide a comprehensive review of these factors. The other aim is to review recent developments of associated communication technologies which are essential for exchanging information between EVs and charging stations. This paper serves as a comprehensive review and useful reference for researchers working on QoS aspects of EVs and associated communication systems aiming to enhance the QoS.

Spectacular shifts have been led to by The COVID-19 crisis in consumer behavior. Retailers will have to work hard to meet ever-evolving customer service experience with respect to the ways in which it may be differently affected by offline or online transactions in order to win and stay relevant. We suggest an integrative framework and construct customer service experience hypotheses, based on its antecedents and consequences that will contribute to academic study as well as managerial implications. The hypotheses are tested by a simultaneous equation model employing two data sets of the retail industry's offline and online customers. In this study, 571 samples of these businesses, 319 and 252 respondents from offline and online retail channels, respectively, were collected by means of an online web survey of consumers. The results show that the impact of consequences and antecedents of CSX differs based on the media utilized. The integrative framework of CSX in its online medium is far more effective than its explanatory power offline. The outcomes are reasonably counterintuitive in so far as they demonstrate that while most elements of CSX where a service is selected offline is the same in terms of customer loyalty and value equity, the emotional element related to the service provider is higher when the service is selected offline rather than online. These outcomes indicate that, contrary to popular fears, the online medium enables firms to develop a loyal customer foundation. These findings offer perceptivity into how an online channel could be used to better complement the offline channel, contributing towards new knowledge and understanding on CSX and how it may be utilized for managerial decision-making.

In Differentiated Services (DiffServ) architecture, Priority Service System (PSS) plays a vital responsibility to provide Quality-of-Service (QoS) for the applications based on networks. Priority queuing systems has always been a subject of interest for analytical modelling and evaluating the performance. However, previous works have mainly focused on performing priority queuing under range dependent traffics, namely Short Range Dependent (SRD) or Long Range Dependent (LRD). Recent studies revealed that realistic traffic demonstrates a heterogeneous nature for the modern networks that provide multiple services. In this paper, the results of analytical and simulation models of dynamic priority service systems is reviewed to study the heterogeneous traffic impact on designing and performance of the systems based on networks. In this paper, the results of analytical and simulation models of dynamic priority service systems is reviewed to investigate the impact of heterogeneous traffic on the design and performance of network-based systems. Here, the time of presence of requests in limited and unlimited buffer system is restricted. If the restriction is violated, the requests will be lost. The results of experiments conducted on both models are compared and it is identified that they differ in the allowable limit (2-9) %.

Requirements for cloud services include security and privacy. Although many security patterns, privacy patterns, and non-pattern-based knowledge have been reported, knowing which pattern or combination of patterns to use in a specific scenario is challenging due to the sheer volume of options and the layered cloud stack. To deal with security and privacy in cloud services, this study proposes the Cloud Security and Privacy Metamodel (CSPM). CSPM uses a consistent approach to classify and support existing security and privacy patterns. In addition, CSPM is used to develop a security and privacy awareness process to develop cloud systems. The effectiveness and practicality of CSPM is demonstrated via several case studies.

The present study examines the long-term care service awareness, needs, and usage intention of elderly male homosexuals in Taiwan and their ideal long-term care service model. This study of five elderly male homosexual subjects aged 66 to 73 years was intended as a preliminary exploration. Interviews were used to collect data. The study determined that the five subjects had high awareness of long-term care services, as they had actual experience of long-term care services or even participated in care service staff training to obtain certificates. Some even had experience in applying for home care services and experienced problems during use. The subjects perceived that they were very likely to require long-term care services in the future and tended to use home care services if they required long-term care services. Due to their personal experiences, the subjects had negative awareness of long-term care services and worried that long-term care service staff had poor attitudes toward homosexuals. The subjects considered the most important aspects of long-term care to be basic medical care and lifestyle care. However, they worried that long-term care staff would delay or refuse to provide such services due to the subjects’ sexual orientation or stereotypes, and they were concerned above all about the “friendly attitude” of long-term care staff. They hoped that long-term care staff were friendly toward homosexuals and did not discriminate against them, and they felt that it would be more appropriate for homosexual long-term care staff to provide assistance. In terms of vision, while preferring organizations with homosexual employees, the subjects worried that they would be stigmatized and discriminated against . With regard to ideal long-term care services, while considering institutions with homosexual staff to be ideal, the subjects also worried that these would be labeled as institutions that were dedicated to homosexuals, potentially resulting in discrimination. Therefore, they hoped that the sexuality sensitivity of long-term care staff could be improved and that they would undergo professional continuing education to learn about homosexuals, the situation and care needs of homosexuals, and care techniques for homosexuals.

Ecosystem physical structure, defined by the quantity and spatial distribution of biomass, influences a range of ecosystem functions. Remote sensing tools permit the non-destructive characterization of canopy and root features, potentially providing opportunities to link above- and belowground structure at fine spatial resolution in functionally meaningful ways. To test this possibility, we employed ground-based portable canopy lidar (PCL) and ground penetrating radar (GPR) along co-located transects in forested sites spanning multiple stages of ecosystem development and, consequently, of structural complexity. We examined canopy and root structural data for coherence at multiple spatial scales ≤ 10 m within each site using wavelet analysis. Forest sites varied substantially in vertical canopy and root structure, with leaf area index and root mass more evenly distributed by height and depth, respectively, as forests aged. In all sites, above- and belowground structure, characterized as mean maximum canopy height and root mass, exhibited significant coherence at a scale of 3.5-4 meters, and results suggest that the scale of coherence may increase with stand age. Our findings demonstrate that canopy and root structure are linked at characteristic spatial scales, which provides the basis to optimize scales of observation. Our study highlights the potential, and limitations, for fusing lidar and radar technologies to quantitatively couple above- and belowground ecosystem structure.

Quality of Service (QoS) has a significant role in the provision of resources within service oriented distributed systems. In Quality of Service, cloud computing creates new challenges for improvements using the concept of virtualization. Currently, Cloud Computing is very emerging technology in every field of data storage and resource distribution over the network. Considering this new emerging technology, for the ease of data accessibility, price, resource use, restoration, response time and number of constraints the quality performance measures need to be upgraded. The paper highlights the research gap in providing a solution to achieve a Quality of Services in Cloud Computing. We also review the issues and challenges arising in cloud computing to guarantee quality.

Cancer patients undergoing major interventions face numerous challenges, including the adverse effects of cancer and the side effects of treatment. Cancer rehabilitation is vital in ensuring cancer patients have the support they need to maximise treatment outcomes and minimise treatment-related side effects and symptoms. The Active Together service is a multi-modal rehabilitation service designed to address critical support gaps for cancer patients. The service is located and provided in Sheffield, UK, an area with higher cancer incidence and mortality rates than the national average. The service aligns with local and regional cancer care objectives and aims to improve clinical and quality of life outcomes of cancer patients by using lifestyle behaviour change techniques to address their physical, nutritional, and psychological needs. This paper describes the design and initial implementation of the Active Together service, highlighting its potential to support and benefit cancer patients.

This research focuses on the customer orientation of insurance brokers, whose activity is regulated by the Law of 26/2006 of July 17 on the mediation of private insurances and reinsurances. The goal is to ascertain whether the intermediation inherent in the insurance broker’s activity, which implies a customer-oriented service, entails a positive behaviour that transcends the immediate environment, reaching society. This study presents a comparative analysis between the insurance brokerage society, characterised by providing a personalised customer service, and banks’ advisory services on insurance. To this end, we study the evolution of the total volume of business and new production, compared for a portfolio of insurance products. The results presented in this research suggest that the customer values the advisory service provided by the broker. However, for a particular business segment in standardised insurance products and products related to banking assets, customers are more likely to resort to the bank’s services. In addition, the results indicate that the commission percentages applied by the entities operating in the banking insurance channel exceed those perceived by the insurance broker. With all this, intermediation in the development of the insurer’s activity can entail an ethical and social behaviour that involves customer-orientation and, possibly, social service, which does not always benefit the insurer.

This paper introduces a new routing and touring service both for outdoor and indoor places of touristic and cultural interest designed to be used in the wider area of ​​Attica, Greece. This service is the result of the work done in OPTORER project and it aspires to offer a range of innovative and thematic routes to several specified points of interest in the selected area of Attica, encouraging the combination of indoors and outdoors routes in a single tour. The aim is to optimize the user experience while promoting specific, user-centric features with safety and social welfare being a priority for every designed tour resulting in enhancing the touristic experience in the area. Using a common smartphone device, as well as common wearable devices (i.e., smartwatches), the OPTORER service will provide an end-to-end solution by developing the algorithms and end-user applications, together with an orchestration platform responsible for managing, operating and executing the service that produces and presents to the end user results derived from solving dynamically complex optimization problems.

The adoption of digital health technologies accelerated during Covid-19, with concerns over the equity of access due to digital exclusion. Using data from a text-based online mental health service for children and young people we explore the impact of the pandemic on service access and presenting concerns and whether differences were observed by sociodemographic characteristics in terms of access (gender, ethnicity and deprivation). We used interrupted time-series models to assess whether there was a change in the level and rate of service use during the Covid-19 pandemic (April 2020-April 2021) compared to pre-pandemic trends (June 2019-March 2020). Routinely collected data from 61221 service users were extracted for observation, those represented half of the service population as only those with consent to share their data were used. The majority of users identified as female (74%) and White (80%), with an age range between 13 and 20 years of age,. There was evidence of a sudden increase (13%) in service access at the start of the pandemic (RR 1.13 95% CI 1.02, 1.25), followed by a reduced rate (from 25% to 21%) of engagement during the pandemic compared to pre-pandemic trends (RR 0.97 95% CI 0.95,0.98). There was a sudden increase in almost all presenting issues apart from physical complaints. There was evidence of a step increase in the number of contacts for Black/African/Caribbean/Black British (38% increase; 95% CI: 1%-90%) and White ethnic groups (14% increase; 95% CI: 2%-27%) ), the sudden increase in service use at the start of the pandemic for the most (58% increase; 95% CI: 1%-247%) and least (47% increase; 95% CI: 6%-204%) deprived areas. During the pandemic, contact rates decreased, and referral sources change at the start. Findings on access and service activity align with other studies observing reduced service utilisation. The lack of differences in deprivation levels and ethnicity at lockdown suggests exploring equity of access to the anonymous service. The study provides unique insights into changes in digital mental health use during Covid-19 in the UK.

Steel structures, such as bridges, must be continuously maintained. Due to increasing trac loads, design and execution shortcomings, many steel bridges are subject to various types of damage, such as cracks. The bridges must be maintained by crack removal and re-welding the cracks. During this work, the bridge is closed for trac in order to suppress the crack ank movement during welding. As a result, trac loads on other routes are higher, which increases further damage on detour routes and subsequently additional welding work and costs on theses structures. Therefore, the aim is to provide a method that allows welding work on steel structures under running trac, respectively under cyclic loads. First, measurements at a representative steel bridge were conducted to derive gap opening parameters of amplitude and frequency for welding tests under cyclic loads. In a test setup for reproducible and comparable welding tests, specimen were welded under cyclic loads. Deep grinding of the root layer allowed defect-free welding within the range of 0.1 mm amplitude at a frequency of 2 Hz loadings. For such welds, the weld quality and the fatigue strength was comparable to the standard requirements.

Plantar flexors (PF) spasticity is known to poorly correlate with active dorsiflexion (DF) impairment throughout the swing phase of hemiparetic gait. Spastic Cocontraction, instead, stemming from descending pathways, potentially misdirect antagonist PF activity opposing DF during swing. Electromyographic (EMG) recordings, while unable to differentiate between reflex-based and descending origins, may offer valuable insights into this distinction by exploring PF EMG activity after tibial nerve neurotomy (which eliminates PF spasticity). Eleven subjects with hemiparesis walking at comfortable velocity and 11 controls walking at comfortable and slow velocity, underwent kinematic and PF/DF EMG analysis. Five of the hemiparetic subjects underwent tibial neurotomy >1 year prior. We evaluated spasticity at rest (Tardieu scale), maximal ankle dorsiflexion, tibialis anterior agonist recruitment and gastrocnemius medialis and soleus cocontraction coefficients during swing. At slow velocity, controls (0.80±0.12 m/s) moved at a similar pace as hemiparetic subjects (0.73±0.37 m/s, NS). Hemiparetic subjects showed: (i) reduced ankle DF across swing (ii) increased PF cocontraction, including before any DF (iii) higher cocontraction despite absent spasticity in tibial neurotomy subjects (iv) higher tibialis anterior recruitment. Increased PF cocontraction occurs in the absence of spasticity or ankle DF despite higher agonist recruitment. Spastic cocontraction is a major factor limiting active DF at swing, unlike spasticity.

The Internet of Things (IoT) generates a large volume of data whenever devices are interconnected and exchange data across a network. As a result, there is a range of services with varying needs, for example, capacity requirements, data quality, and latency demands. These services operate on fog computing devices, which are limited in power and bandwidth compared to the cloud. The main challenge is deciding where to implement services on the fog, the cloud, or the hybrid. This paper proposes an efficient allocation technique that pushes processing closer to the network's fog side. It investigates which devices and services may best allocate while preserving resource usage in the IoT architecture. It also examines the importance of allocating services to devices and optimizing resource use in fog computing. In IoT settings, there is a wide range of services and devices; thus, it is critical to effectively assign the services to the devices. We propose Priority-based Service allocation (PSA) and Sort-based Service Allocation (SSA) techniques, which are used to enable an optimum order to employ devices to perform the various services. The experimental results indicate that our proposed technique minimize the data communication over the network by 82% by allocating most of the services locally in fog. We have maximized the number of distributed services to fog devices by 90% while minimizing the wastage of fog resources.

Whether it’s cellphones, personal computers, or gaming consoles, technology is a part of everyone’s everyday lives, and storage is frequently a problem. One of the solutions we have for this difficulty is the on-demand accessibility of computer framework assets, which enables cloud storage and makes it accessible in any format and from any device. It is a major benefit of cloud computing. Amazon Web Administrations (or basically AWS) may be a secure cloud services stage advertising about everything businesses ought to construct advanced applications with adaptability, versatility, and unwavering quality. Another advantage is that it is significantly less expensive than purchasing items with comparable functionality, such as an SSD storage device. For many enterprises, it is also preferable to host their servers in the cloud using services like Google Cloud and Oracle Cloud. Our main topic of the paper is to compare three different major cloud computing services—AWS, Google, and Azure. Since there are different types of cloud computing services available, we would compare them to determine which is best for usage by individuals or organizations. We can also look at the services’ shared features and unique aspects that they provide to consumers.

The concept of sustainability and sustainable development, especially systemic sustainable development, still raises controversy in literature. The article makes an attempt to re-examine these concepts from a systems perspective, seeking foundations and applications in the selected sector. It is becoming increasingly clear that sustainability and sustainable development are aimed at integrated economic, social, cultural, political, and ecological factors [1[,[2] (pp.641-642). This causes that the constructive approach to the issue is required, taking into account all the actors, areas and dimensions involved in the pursuit of systemic sustainable development. As a result, both local and global dimensions and the way they interact must be explored in a multi-faceted manner in order to offer a perspective more useful than other analytical approaches, because the systems view is a way of thinking in terms of connectedness, relationships, and context [3]. The article aims to review selected publications and studies so as to form the general idea of systemic sustainable development and define the systemic development of sustainable transport, including in particular the perspective of the actors of the sector, transport providers (passenger, urban) and transport development program, implemented both by local governments and on the European scale. An attempt was made to identify elements of the systemic sustainable development model, setting it in the reality of the following subcategories: “Society”, “Economy” and “Environment” in sectoral terms. It is supposed that, systemic sustainable development is a conglomerate of public administration entities, companies operating in the sector, individual and corporate customers, acting in certain conditions for economic, social and environmental well-being, and a number of their initiatives of major or minor significance, grouped in six sub-areas, undertaken to achieve systemic value in the examined sector, with a positive or negative business/economic, social and environmental impact.

To remain competitive in the current market, an enterprise must differentiate itself based on higher value propositions. For this purpose, since improving the product or service performance can reach some limits, one potential solution is to move towards new combinations of products and services. This evolution, called servitization, leads to the generation of Product-Service Systems (PSS). Servitization requires not only a clear understanding of enterprise core business but also a clear vision on the prevailing trends and challenges of PSS development from both business and technological points of view. In addition, the evolution path should be aligned with the enterprise strategy. This paper first highlights the notion of symbiotic PSS where Product Systems and Service Systems, and their stakeholders, interoperate seamlessly based on a win-win approach. Then it proposes a PSS Conceptual Framework (PSS-CF) which can be applied in the early stages of servitization to increase the understating of PSS dimensions and to facilitate the prioritization of the servitization investments. The framework dimensions were discussed in several iterations, from both academic and industrial points of view, in the frame of a European research project. Moreover, the applicability of the framework was studied in four different industrial Use-Cases.

Servitization or productization, indicating evolution from product to service economy or vice-versa, can be considered as a successful strategy to gain competitiveness based on novel combination of products and services. To decrease the risks of servitization and to support the sustainable development of its main outcome, being Product Service System (PSS), it is required not only to have a clear and common understanding of the core business and processes but also to share the same definitions on (PSS) concepts as the main outcome of servitization. For this purpose, managers could be supported by abstract models with a limited number and high ratio of known concepts in the early stages of PSS development. Through an extensive literature review on this subject, followed by a structured conceptualization approach and discussions with domain experts, this paper proposes a Conceptual Model (PSS-CM). To validate the results, PSS-CM and its elements were discussed in several iterations, from both academic and industrial points of view, in the frame of a European research project. In the frame of this project, a case study was also performed to illustrate the instantiation of PSS-CM.

Background: clubfoot is a common congenital deformity. The Ponseti technique, involving early corrective manipulations followed by the application of long leg casts and Achilles tenotomy, is widely accepted as the preferred treatment. Rapid healing of the tendon after surgery has been documented, but the aspect regarding tendon structure and properties is not known. Three cases of Achilles tendon rupture in adolescent previously treated for clubfoot have been described in the literature. Since rupture is a rare event in this age group a possible correlation with previous surgery has been hypothesized. The primary aim of the study was to compare the ultrasound findings of the Achilles tendon, in patients treated for clubfoot, between patients treated with casting alone and the ones who underwent surgery (percutaneous tenotomy or Z-plasty lengthening). Methods: 22 asymptomatic patients, (34 feet) median age 12 years, previously treated for clubfoot, were recruited for this study; the patients underwent an Achilles tendon ultrasound examination during a follow-up outpatient visit. Results: a greater thickness and structural alterations with presence of hypoechoic areas of the operated tendons compared to those treated with plaster alone were observed (p value: 0.0498 and

Based on big data and artificial intelligence technology, the judicial big data intelligent service platform provides users with efficient and accurate legal consulting services. It has many functions such as intelligent question and answer, case analysis, and law inquiry. It also analyzes the application value of the intelligent legal consulting service platform in the field of judicial big data. By building an intelligent service platform, the rapid processing and analysis of massive judicial data has been realized, and the efficiency and quality of judicial work have been significantly improved. In addition, it emphasizes the importance of data management and quality control in the application of judicial big data, and puts forward specific measures to strengthen data management and quality control. With the continuous advancement of technology and the expansion of application fields, the platform is expected to achieve deep integration with other legal services, expand new application fields, and provide users with more comprehensive and efficient legal services. At the same time, it points out the problems that need to be paid attention to in the future development, such as data security, privacy protection and so on. Through in-depth analysis and research on judicial big data, the platform can provide strong support for judicial decision-making and promote the improvement of judicial justice and efficiency.

The aim of this study was to investigate the work engagement and burnout in healthcare professionals in a private health unit in Greece. A cross-sectional study was conducted with a sample of 151 professionals (doctors, nurses, administrative staff and professionals of other specialties). The questionnaire included demographic and work-related information and the Utrecht Work Engagement Scale and Maslach Burnout Inventory. Analysis was performed by SPSS v.26. With regard to the work engagement, the participants presented a medium score in absorption and a medium to high score in vigor and dedication. In addition, they presented low score in depersonalization, a medium score in emotional exhaustion and a high score in personal accomplishment. Those who had a working contract for an indefinite period had higher score in all the dimensions of burnout. Vigor, dedication and absorption were negatively correlated with emotional exhaustion and depersonalization and positively with personal accomplishment. Healthcare professionals in private health sector in Greece present moderate work engagement and experience moderate levels of burnout. Work engagement is associated with burnout and plays an important role in its prevention. There are some significant differences in work engagement and burnout based on several demographic and work-related characteristics.

Mobility as a Service (MaaS) is an innovative transport concept, anticipated to provide travelers with different kinds of travel services, more sustainable than a private car, in a simpler, packaged way. It combines different transport modes to offer a tailored mobility package, like a monthly mobile phone contract. The rapid development of intelligent transportation system and the shared economy has speeded up the development of MaaS in these years. In this paper, we aim at classifying the existing research on MaaS and the characteristics of MaaS into different categories, in order to answer the following questions after reviewing the existing literature: What is MaaS? Who are the main actors in MaaS? How can MaaS be implemented? Why should it be implemented? Where will MaaS end up in this wave of disruption? When we talk about MaaS, what are we focusing on? What is the future leading frequency of MaaS? Finally, based on the existing literature, we envision the leading future of MaaS.

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

Butyl rubber-based composite (BRC) is one of the most popular materials for the fabrication of protective glove against chemical and mechanical risks. However, in many working places such as metal manufacturing or automotive mechanical services, its mechanical hazards usually appear together with metalworking fluids (MWFs). The presence of these contaminants, particularly at high temperature, could modify its properties due to the scission, the plasticization, the crosslinking of polymer network and thus led to severe modification of mechanical and physicochemical properties of material. This work aims to determine the effect of temperature and a metalworking fluid on mechanical behavior of butyl rubber composite dealing with crosslinking density, cohesion forces and elastic constant of BRC on the based on Mooney-Rivlin’s theory. The effect of temperature with and without MWFs on thermo dynamical properties and morphology of butyl membranes is also investigated. The prediction of service lifetime is then evaluated from extrapolation of Arrhenius plot at different temperatures.

This study investigates the mean annual water temperature trends at the confluence of the Sava and Danube Rivers, along with air temperature trends at the Belgrade meteorological station, spanning from 1956 to 2020. Results reveal a consistent increase in temperature across all three measuring stations, with the Danube experiencing a rise of 0.34°C/10 years, the Sava at 0.44°C/10 years, and Belgrade's air temperature increasing by 0.39°C/10 years. Employing the RAPS method, sharp rises in water temperature were pinpointed in 1989 for the Sava and 1990 for the Danube, while Belgrade's air temperature surge began in 1998. The highest intensity of air temperature increase within the recent period (1998-2020) was observed at the Belgrade observatory, reaching 0.76°C/10 years. Notably, the Sava exhibited a faster increase in water temperature over the last thirty years compared to the Danube. August marked the peak average water temperature for both rivers, while July recorded the highest average air temperature in Belgrade. Despite differing flow rates, both rivers exhibit similar hydrological regimes, with maximum flows occurring in April and minimum flows in August for the Sava, and October for the Danube. Seasonal temperature increases were most pronounced in summer, notably in August, with the smallest rises occurring during cold periods. Additionally, an inverse proportional relationship between mean annual water temperatures and discharges was observed at both river stations.

The need for a relatively quick solution to the problem of providing highways with roadside service facilities necessitates the development of a series of appropriate standard projects. To increase the efficiency of these series, it is advisable to carry out the interconnection of space-planning solutions based on a particular module. Taking into account the variety of planning and landscape characteristics of the sites for the placement of objects of the mainline service, it seems advisable to choose as a module not a square or rectangular, but a triangular configuration, which allows in most cases to harmoniously block the modules. The proposed roof module in the form of a "regular" triangle facing the tetrahedron has a structural basis in the form of a single-tier rod spatial plate. The principal space-planning solutions of all four dozen objects from the approved nomenclature of the mainline service performed in the process of analyzing the possibilities show the real possibility of solving the development tasks on the basis of this system. The use of the proposed modular system makes it possible to successfully solve a number of tasks to reduce the harmful impact on the environment and effectively use renewable energy sources.

Automatic Voice Query Service can extremely reduce the artificial cost, which could improve the response efficiency for users. The automatic speech recognition (ASR) is one of the important component in AVQS. However, many dialect areas in China make the AVQS have to response the multi-accented Mandarin users by single acoustic model in ASR. This problem severely limits the accuracy of ASR for multi-accented speech in the AVQS. In this paper, a new framework for AVQS is proposed to improve the accuracy of response. Firstly, the fusion feature including iVector and filterbank acoustic features is used to train the Transformer-CTC model. Secondly, the transformer-CTC model is used to construct the end-to-end ASR. Finally, key words matching algorithm for AVQS based on fuzzy mathematic theory is proposed to further improve the accuracy of response. The results show that the final accuracy in our proposed framework for AVQS arrives at 91.5%. The proposed framework for AVQS can satisfy the service requirement of different areas in mainland of China. This research has a great significance for exploring the application value of artificial intelligence in the real scene.

The web ecosystem is rapidly evolving with changing business and functional models. Cloud platforms are available in a SaaS, PaaS and IaaS model designed around commoditized Linux based servers. 10 billion users will be online and accessing the web and its various content. The industry has seen a convergence around IP based technology. Additionally, Linux based designs allow for a system wide profiling of application characteristics. The customer is an OEM who provides Linux based servers for telecom solutions. The end customer will develop business applications on the server. Customers are interested in a latency profiling mechanism which helps them to understand how the application behaves at run time. The latency profiler is supposed to find the code path which makes an application block on I/O, and other synchronization primitives. This will allow the customer to understand the performance bottleneck and tune the system and application parameters.

This research was focused on Public Service of departmental auction state officers of Makassar . It aimed to determine the state officers’ performance who passed departmental auction that had been assessed based on competence, and integrity in particular, the ability to provide and develop good service to the community at the 9 Local Government Work Unit (SKPD) Makassar, namely the Regional Revenue Board of Makassar City, the Land Board of Makassar City, the Office of Investment and Integrated One Stop Service of Makassar City and the Department of Population and Civil Registration of Makassar City, Ujung Pandang District Office, Makassar District , Rappocini District , Bontoala District , and Panakkukang District . The 9 SKPD were chosen purposively from 53 SKPD within the Makassar City Administration by considering the representation of SKPD of the Agency and the Department as well as the representation of the district Institution located in the northern, middle and southern part of Makassar City. Interviews and observation data were collected by 3 interviewers and narrated as facts and elaborated by the research team with qualitative and normative studies. The result of the research shown that the state officers’ performance in Makassar city administration area had been able to develop good service to the society at 9 Local Government Work Unit (SKPD) of Makassar City. However, it was necessary to improve the quality of human relations especially for the leading position of all SKPD so that the communication can be better served to the citizens. System reward dan punishment need to be upgraded and enforced as a trigger of employees’ motivation in work.

The popularity of cloud computing is growing owing to its large data storage capacity and high computation power. It provides online, on-demand, scalable application solution, removes hardware and software barriers for non-specialist, rapidly integrates and deploys desired and necessary facilities, supports quick upgrading and addition of features. Users get benefitted with the selection of the appropriate cloud computing platform for their projects. Here, our paper provides a comprehensive overview of the services provided to the users by the most common cloud computing service providers. This paper could be used as a reference while selecting the best service provider based on the requirements of the projects.

The consumption and sale of fresh-cut products and salads have been growing tremendously in the present era. Therefore, the microbial safety of such products is of great concern. In the current study, a survey of general microbiological safety of fresh-cut produce and salads at quick-service restaurants (QSR) was undertaken across the Kingdom of Saudi Arabia. These findings were compared with microbiological criteria for foodstuffs by Saudi standards, metrology, and quality organization SASO-GSO-1016. Of the 82 samples of fresh-cut produce, 7% of samples were found to be unsatisfactory or beyond the acceptable limits. TPC count was unsatisfactory at 22%, coliform at 48%, and Staphylococcus aureus at 4%. For 108 samples for fresh salads, 11% of samples were found to be unsatisfactory or beyond the acceptable limits,13%, 27%, 4%, and 27% of samples showed an unsatisfactory range of TPC, coliforms, S. aureus, and Escherichia coli, respectively. The fresh-cut produce and salads were microbiologically safe in the central region compared to the eastern region followed by the western region. The relatively higher count was found in green pepper, mixed vegetables, and lettuce followed by fresh-cut onions and coleslaw salads. No Salmonella was detected in both fresh-cut produce and salads. The restaurants should be more stringent in their processing to ensure the consumer safety. Washing and sanitization of produce is the only way to reduce the diffusion of food borne pathogens.

Vaccination, particularly against pneumoccus and influenza, is a low-cost primary prevention, useful to avoid hard complications, particularly among frail older people. In this study, we aimed to assess the effect of a strategy for influenza and pneumococcal vaccination for outpatients, never practiced before, evaluating what could stimulate or demotivate vaccination among older people. This study was conducted during the 2023-2024 influenza season at the outpatient clinics of the Geriatrics section, University Hospital of Palermo (Italy). A total of 101 vaccinations were carried out. Half of the patients could be considered as pre-frail and about 20% frail, according to a comprehensive geriatric evaluation. Among participants, 46.3% received only vaccination against Pneumococcus and 26.8% only anti-influenza or the combination of anti-pneumococcus and anti-influenza. Compared with the previous seasons, a 19.5% increase of influenza and 90.2 % of pneumococcal vaccine uptake was observed. Side effects of vaccination were the main reason of the previous rejections, namely 74.8% for influenza and 29.5% for anti-pneumococcal vaccination. In conclusion, our study indicates how a new vaccination strategy in different settings is possible. Proposing influenza and pneumococcal vaccination for outpatients could be an effective instrument to improve immunization coverage that is still low among older people.

Background: We conducted research on the newly developed personalized recommendation service (PRS) of the global network of Korean scientists and engineers (KOSEN) in order to explore the information usage behavior and importance of the PRS used by Korean scientists and engineers. Methods: In order to understand information usage behavior, we gathered data from 513 survey results and analyzed them in terms of information usage behavior and the corresponding importance in each of the service quality areas. Results: We analyzed the 321 outcomes that indicated non-use of the PRS in order to understand the underlying reason(s); we employed 192 results that demonstrated the use of functionality to examine information usage behavior and importance. They found that the predominant motive for non-use of the service resulted from the respondents not knowing how to use it. According to demographic characteristics, the usage behavior of the PRS showed a difference regarding the purpose of using the service in the categories of gender and major field of study. Furthermore, users were concerned with various components of the PRS such as ease of use, design, relevance of content, user support, and interactivity. Conclusions: We suggest reinforcing user education degree and promotion to enhance the PRS. Since users were concerned with ease of use, design, relevance, user support, and interactivity, we recommend these as major points for improvement.

(1) Background: Applied health services research (AHSR) relies upon coordination across multiple organizational boundaries. Our aim was to understand how competing organizational and professional goals enhance or impede the conduct of high quality AHSR. (2) Methods: A qualitative study was conducted in two local health care systems in the UK, linked to a feasibility trial of a clinic-based intervention in secondary care. Data collection involved 24 semi-structured interviews with research managers, clinical research staff, health professionals, and patients. (3) Results: This study required a dynamic network of interactions between heterogeneous health and social care stakeholders, each characterized by differing ways of organizing activities which constitute their core functions; cultures of collaboration and interaction and understanding of what research involves and how it contributes to patient care. These interrelated factors compounded the occupational and organizational boundaries that hindered communication and coordination. (4) Conclusions: Despite the strategic development of multiple organizations to foster inter-professional collaboration, the competing goals of research and clinical practice can impede the conduct of high quality AHSR. To remedy this requires the alignment and streamlining of organizational goals, so that all agencies involved in AHSR develop a shared understanding and mutual respect for the progress of evidence-based medicine and the complex and often nuanced environments in which it is created and practiced.

In today's intricate media landscape, the resilience and relevance of public service media (PSM) depend on their capacity to align with the diverse and evolving expectations of the public. However, the audience perspective is often overlooked, resulting in a limited understanding of public expectations. This study employs a bottom-up approach that allows for a re-evaluation of the expectations from the audience's viewpoint. It investigates the public's expectations for PSM, drawing on data from 10 focus group discussions (with 60 participants) conducted in the Czech Republic. The findings indicate that expectations can be categorized into four primary dimensions: (1) the expected roles and functions of PSM; (2) the general characteristics of the PSM content (defining the desired nature of PSM content); (3) the principles governing the functioning of PSM (outlining how PSM should operate); and (4) specific requirements concerning PSM news and non-news content. In the latter dimension, objectivity emerged as one of the most critical expectations and a major source of dissatisfaction. While participants collectively value objectivity, they disagree on its definition. A deeper examination revealed that certain public expectations may be unattainable due to the simplistic view of objectivity held by some.

With the rapid development of Earth observation and information technology, people are increasingly able to access geospatial models. Geospatial models, based on principles of geography, utilize mathematical, statistical, as well as computer science methods to interpret and predict geographic phenomena. These models can be applied in the fields such as urban planning, environmental protection, traffic management to help decision-makers solve geography-related problems. However, integrating different geospatial models to collaboratively solve complex geographic problems still faces significant obstacles due to heterogeneity in model structure, dependencies, and running modes. In this study, we propose a containerized service-based integration framework for heterogeneous geospatial models (GeoCSIF). GeoCSIF consists of three main components: (1) Model encapsulation. It breaks down complicated geospatial models into independently manageable model units, and builds as unified service packages with a templated constraint method. (2) Model orchestration. It achieves an optimal combination of large-scale models with complex dependencies using a prioritization-based orchestration method. (3) Model publication. It incorporates heuristics into the model scheduling process, which can provide adaptive deployment for different model runs. Finally, a prototype system was developed to validate the effectiveness and progressiveness of GeoCSIF by the integrating process of heterogeneous flood disaster models.

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

The popularity of online retail is followed by decreasing transactions at shopping centres. Leisure and companionship trips to restaurants and cafés are replacing the frequency of intra-urban shopping trips. Several studies demonstrated a notable trend in urban commercial areas, wherein functionality has shifted from shopping centres to primarily focused on restaurants and cafes. Leisure and companionship places in the urban south have greater diversity than formal restaurants and cafés. This article employs a comprehensive framework to examine the categorization of restaurants and cafés in the urban south, referred to as food services. This study aims to investigate the spatial pattern of food service in Surabaya and ascertain whether there is a concentration of all food service variants around existing shopping centres. This research employs the POI of food service units gathered through web scraping from Google Maps. Applying the k-means cluster analysis demonstrates that the spatial pattern of food services is categorized into several distinct clusters. This article discloses five types of urban spaces characterized by varying compositions of food service variants within them. These spaces include the city centre, sub-city centre, areas along main roads, residential neighbourhoods, and peri-urban areas.

Burden of diseases measured as disability-adjusted life years per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed to allow insightful comparisons with the national average, and to understand differences in trends between the sexes, age groups, time periods, geographic regions and sub-regions. In this illustrative case study, we have analysed the Scottish burden of disease database to understand what ailed the population of the Grampian region before the COVID-19 pandemic. We have identified selected cancers, ischaemic heart disease, Alzheimer’s disease and other dementias amongst the highest contributors to the burden; that drug use disorders and colorectal cancer are showing worsening trends and require health promotion and disease prevention measures from ages 15 and 25 respectively, especially in Aberdeen City; and that males are more vulnerable to atrial fibrillation and flutter, diabetes mellitus and oesophageal cancer, while females are to cerebrovascular disease. We demonstrate the usefulness of our analysis and methodology for the wider health system, allowing targeted medical research investments and coordinated response from public health and health service delivery. We also show the need for up-to-date surveillance data, forecasts and evidence on the impact of interventions to be made available widely.

The employment rate of people who face severe mental health issues is extremely low, while the vast majority expresses their willingness to work. There are various obstacles that impede their work re-integration process. Apart from the illness’ symptoms and the employers’ stigma, these barriers are strongly associated with the effects of long-term unemployment and the lack of positive psychosocial resources, such as career adaptability and resilience. The present study aims at investigating career adaptability and resilience of mental health service users who receive career counseling services. The career counseling approach that was used combines elements from the IPS model and the career construction approach that has been developed to address the contemporary world of work challenges. We investigated how mental health service users view themselves in terms of career adaptability and resilience, and which factors contributed to their development or impeded them. We used a qualitative approach, which allows for an in-depth exploration of the participants’ views. Fifteen mental health users who receive career counseling services were interviewed. Results showed that mental health service users believe that they can overcome any difficulties and setbacks, when they have adequate support from their social network and when they receive career counseling services. They highlighted the importance of counseling services to maintain their work and cope with stressful events. Further implications of the results regarding vocational rehabilitation of mental health users as means for social inclusion are discussed.

The combination of e-commerce and the green economy allows enterprises to distribute their green products directly to consumers through Internet channels. This paper investigates the impact of service spillovers on emission reduction and channel decisions in a two-echelon supply chain,in which the supplier is a Stackelberg leader and the retailer is a follower.By comparing the equilibrium outcomes of the single-channel and dual-channel supply chain in a setting with and without retail services, we observe that the supplier prefers to encroach on the market when services that retail locations provide largely spillover to and benefit the direct sales channel. Contrary to popular belief, a higher degree of service spillovers is beneficial for the retailer to get more returns under the dual-channel structure, whereas supplier encroachment will lead to a decline in the service level if the spillover degree is relatively low. In addition, the emission reduction level of products under supplier encroachment is always higher than that employed in the single-channel structure if consumers have both low-carbon preference and high degree of service sensitivity. Furthermore, we extend the equilibrium decisions under a carbon cap-and-trade (CCT) mechanism; the results fully verify the above conclusions. Interestingly, the implementation of a carbon price not only motivates carbon emission abatement and supplier encroachment, but also helps achieve a win-win outcome for supply chain members when service spillovers happen.

Botswana, Eswatini and Lesotho are three Southern African countries which make use of re-turn-of-service (RoS) schemes to increase human resources for health in their countries. These initiatives bind beneficiaries to a pre-defined period of service upon completion of their studies based on the length of funding support received. We aim to review the history of these policies to understand the conceptualisation, intent and implementation of these schemes. We used a mul-ti-methods research design which consisted of a literature review, policy review and semi-structured interviews with policymakers and implementors. All three governments have a combination of grant-loan schemes and full bursaries or scholarships. The policies have all been operating for over 20-years, with Eswatini’s pre-service being the oldest since it was introduced in 1977 followed by Lesotho’s 1978 policy and Botswana’s 1995 pre-service policy. These policies have never been reviewed or updated. RoS schemes in these countries were introduced to ad-dress critical skills shortages, improve employability prospects for citizens, to have competent public sector employees by global standards, and to aid career progress of government employ-ees. Ministries of Health are passive role players. However, these schemes can only be efficient if there is clear cooperation and coordination between all stakeholders.

Bus services play a significant role as the main public transportation, especially in urban areas throughout the years. Since bus services compete greatly with other types of public transportation, such as e-hailing service and private vehicles, they have recently attracted scholars to conduct many relevant studies. However, most past research studies in the Asian region were not focused on engineering, social science, and Internet of Things (IOT). This present study concentrated on the service quality of bus services in Asia by using systematic literature review of articles. This study conducted a review based on previous studies, specifically on the service quality of performance. Several previous studies were selected by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRIMSA) approach. SCOPUS and Science Direct were chosen as the main journal database. By using this method, 41 articles were selected for further analysis. This study was merely focused on three primary themes, such as study approach, stakeholder, and service quality attributes. Advanced analysis on these primary themes was used to formulate another 18 sub-themes. All themes and sub-themes which reflected the significant impacts of service quality towards bus services were discussed in detail. This study had addressed several qualities of bus services of bus performance towards improvement of urban transportation polices. Lastly, several recommendations that could provide necessary knowledge and information for future research were presented.

This purpose of the study presented in this article is to comparing different service quality measurements between Kano and TRIZ that plays the critical roles in the catering industrial. Data collected from a DINESERV questionnaire comprises service-quality standards to increase customer satisfaction of mobile dining car. Finally, the TRIZ is standardized measure designed to improve the idealization of strategy for selecting the most appropriate service quality model. In addition, the preferences of more than one decision maker are internally aggregated into the TOPSIS procedure. All these things provide several important theoretical and practical implications for developing a successful mobile catering app.

We aimed at developing and validating a scale on the beliefs and attitudes of mental health professionals towards services users’ rights in order to provide a valid evaluation instrument for training activities with heterogeneous mental health professional groups. Items were extracted from a review of previous instruments, as well as from several focus groups which have been conducted with different mental health stakeholders, including mental health service users. The preliminary scale consisted of 44 items and was administered to 480 mental health professionals. After eliminating non-discriminant and low weighting items, a final scale of 25 items was obtained. Exploratory and confirmatory factor analyses produced a four-factor solution consisting of the following four dimensions; system criticism/justifying beliefs, freedom/coercion, empowerment/paternalism, and tolerance/discrimination. The scale shows high concordance with our theoretical model as well as adequate parameters of explained variance, model fit, and internal reliability. Additional work is required to assess the cultural equivalence and psychometrics of this tool in other settings and populations, including health students.

This study investigates the unique morphology and mechanical properties of multi-jet electrospun cashew gum (CG) when combined with high molecular weight polyethylene oxide (PEO) and glycerol. Cashew gum (CG) is an inexpensive, non-toxic polysaccharide derived from Anacardium occidentale trees. Initially, the electrospinnability of aqueous solutions of cashew gum alone or in combination with PEO was evaluated. It was found that cashew gum alone was not suitable for electrospinning; thus, adding a small quantity of PEO was needed to create the necessary molecular entanglements for fiber formation. By using a single emitter with a CG:PEO ratio of 85:15, straight and smooth fibers with some defects were obtained. However, additional purification of the cashew gum solution and the incorporation of glycerol as a plasticizer were necessary to produce defect-free straight and smooth fibers. Interestingly, when the optimized formulation was electrospun using multiple simultaneous emitters, thicker aligned fiber bundles were achieved. Moreover, the resulting oriented fiber mats exhibited unexpectedly high elongation at break at ambient conditions. These findings highlight the potential of this bio-polysaccharide-based formulation for non-direct water contact applications requiring elastic properties.

In an era driven by technology and connectivity, where the sphere of learning goes beyond conventional classrooms, e-Service-Learning (e-SL) merges the possibilities of technology with the principles of experiential education in a powerful blend [1]. Service-learning (SL) is an educational proposal that has been cited by UNESCO [2] as an innovative educational tool through which to address the complex challenges of our society. The Sustainable Development Goals [3] provide a framework around which to structure the SL projects and thus develop the skills needed to act on the full range of goals. Embedding digital means open a debate on the intricate relationship between technology, education, and societal impact [4]. By analyzing two focus groups involving faculty, students and community partners, this contribution aims to explore the potential of combining SL and digital empowerment (DE). The focus group participants discussed the opportunities for innovation, the expected impact on them and the society at large, their needs and the pre-conditions needed to make SL and DE successful, and limitations. The results are presented according to the six principles of sustainability education in the university environment, highlighting the transformative potential of combining these principles within SL and DE.

To scientifically and effectively evaluate the service capacity of expressway service areas (ESAs) and improve the management level of ESAs, we propose a method for the recognition of vehicles entering ESAs (VeESAs) and estimation of vehicle dwell times using ETC data. First, the ETC data and their advantages are described in detail, and then the cleaning rules are designed according to the characteristics of the ETC data. Second, we established feature engineering according to the characteristics of VeESA, and proposed the XGBoost-based VeESA recognition (VR-XGBoost) model. Studied the driving rules in depth, we constructed a kinematics-based vehicle dwell time estimation (K-VDTE) model. The field validation in Part A/B of Yangli ESA using real ETC transaction data demonstrates that the effectiveness of our proposal outperforms the current state of the art. Specifically, in Part A and Part B, the recognition accuracies of VR-XGBoost are 95.9% and 97.4%, respectively, the mean absolute errors (MAEs) of dwell time are 52 s and 14 s, respectively, and the root mean square errors (RMSEs) are 69 s and 22 s, respectively. In addition, the confidence level of controlling the MAE of dwell time within 2 minutes is more than 97%. This work can effectively identify the VeESA, and accurately estimate the dwell time, which can provide a reference idea and theoretical basis for the service capacity evaluation and layout optimization of the ESA.