Despite the recognized influence of maximum or acceleration strength on combat techniques and countermovement jump (CMJ) performance, the relationship between body segment weights and combat techniques remains unexplored. This study aimed to examine the impact of body segment weights, including striking arm weight (SAW), kicking leg weight (KLW), and trunk weight (TW), on the dynamics of direct punches (DP), palm strikes (PS), elbow strikes (ES), front kicks (FK), and CMJ performance. Sixteen male military cadets (22.3±1.8 years, 181.4±7.0 cm, 83.0±8.1 kg) performed combat techniques, with performance measured by using a force plate and body segment weights assessed by Dual-energy X-ray absorptiometry. Spearman's correlation analysis was applied. Results indicated a strong correlation between KLW and FK impulse (r = 0.64, p ≤ 0.01) and CMJ impact force (r = 0.80, p ≤ 0.01). SAW showed moderate correlations with DP impulse (r = 0.53, p ≤ 0.05) and ES impulse (r = 0.54, p ≤ 0.05). Additionally, FK peak and impact forces were strongly correlated with CMJ jump height (r = 0.74, p ≤ 0.01; r = 0.77, p ≤ 0.01), and FK peak force moderately correlated with CMJ peak velocity (r = 0.63, p ≤ 0.05). These findings suggest targeted arm strength training could enhance striking abilities, while improvements in leg acceleration strength may directly boost kicking performance and vertical jump capabilities, which are crucial in combat scenarios.

The wealth of data obtained during the past 20 years using Laser-Induced Breakdown Spectroscopy (LIBS) indicates that the technique is very promising to detect small chemical contents of alloying elements. The potential of LIBS was looked more seriously during the past two decades or so as more data were obtained on Aluminum and steel to study the phenomena in the condition of local thermodynamic equilibrium and time-delay between a Q-switch laser and an intensified CCD camera. Since the past decade, some data on compounds were also shown to be useful in determining small concentrations of harmful elements. This manuscript is intended to show that the technique of LIBS performance is very promising in fields such as micro-machining, in alloying element analysis, surface cleaning and environmental applications even with lightweight spectrometers having a relatively low resolution, which can potentially be air-borne.

The emergence of antibiotic-resistant Campylobacter jejuni, a leading cause of gastroenteritis worldwide, presents a significant public health challenge requiring vigilant surveillance and disease control. This study aimed to characterize C. jejuni strains isolated in Romania from 2017-2020, focusing on genetic diversity, virulence, and antibiotic resistance determinants. The isolates underwent phenotypical testing, PCR, and antibiotic resistance assessment using Disc Diffusion Kirby–Bauer for ciprofloxacin, nalidixic acid, erythromycin, and tetracycline. Genetic analysis identified resistance and virulence genes, point mutations, and performed sequence typing (7-gene MLST) to determine genetic relatedness. Results indicated substitutions at position 86 in the amino acid sequence or position 257 in the nucleotide sequence of the gyrA gene in 47 fluoroquinolone-resistant isolates. Additionally, mutations in the rRNA23S gene at positions 2074 and 2075, associated with macrolide resistance, were found in 12 of the 66 isolates. Allelic profiles generated 38 sequence types (STs), including three new STs not present in the reference database. The sequence data analysis revealed a genetically diverse C. jejuni population with a weak clonal structure. This study provides crucial insights into the genetic diversity and antibiotic resistance of C. jejuni strains in Romania, highlighting the need for ongoing surveillance and control measures.

CX3CL1, also named fractalkine or neurotactin, the only known member of the CX3C chemokine family that can chemoattract several immune cells. CX3CL1 exists in both membrane-anchored and soluble forms, each mediating distinct biological activities. CX3CL1 signals are transmitted through its unique receptor, CX3CR1, primarily expressed in microglia of central nervous system (CNS). In the CNS, CX3CL1 acts as a regulator of microglia activation in response to brain disorders or inflammation. Recently, there has been a growing interest in the roles of CX3CL1 in regulating cell adhesion, chemotaxis, and host immune response in viral infection. Here, we provide a comprehensive review of the changes and function of CX3CL1 in various viral infections such as human immunodeficiency virus (HIV), SARS-CoV-2, influenza virus and cytomegalovirus (CMV) infection, to highlight the emerging roles of CX3CL1 in viral infection and the associated diseases.

The mutation in NF2 is the most common alteration associated with meningioma oncogenesis, and it is related to the loss of a suppressing protein called merlin. At the same time, alterations in energy production are visible in cancer cells where increased demand for energy is observed. Fatty acid oxidation could be one of the ways cancer cells obtain energy. This metabolic pathway uses the acylcarnitine shuttle system, which is responsible for the acylation of fatty acids and their transport through mitochondria. Therefore, this study aimed to profile acylcarnitines with short-, medium- and long-acyl chain length in meningiomas to assess their changes in tumors with different NF2 mutation statuses. For the analysis, solid-phase microextraction (SPME) coupled with liquid chromatography high resolution mass spectrometry (LC-HRMS) was used. The presented sampling method enables low invasive and easy collection of the analytes from the studied lesions, which can be crucial for future analysis of potential biomarkers in the surgery room. It was observed that higher levels of these analytes characterized meningiomas with NF2 mutation. Moreover, increased energy consumption and elevated levels of acylcarnitines show that these analytes can be considered as a marker of increased fatty acid oxidation in NF2 mutated cells.

Despite the recognized influence of body mass on combat techniques, the relationship between body segment mass (BSM) and combat moves remains unexplored. This study aimed to examine the relationship between striking arm mass (SAM), kicking leg mass (KLM), and body mass (BM) with the dynamic forces of the direct punches (DP), palm strikes (PS), elbow strikes (ES), front kicks (FK), and countermovement jumps (CMJ) performance. Sixteen male military cadets (22.3 ± 1.8 years, 181.4 ± 7.0 cm, 82.1 ± 8.5 kg) performed combat techniques, with performance measured by using a force plate and body segment mass assessed by Dual-energy X-ray absorptiometry. Spearman's correlation analysis, the Wilcoxon test, and Cohen's d were applied. Results indicated the relationship between KLM or BM and FK impulse (r = 0.64, p = 0.01; r = 0.52, p = 0.04, respectively) and CMJ impact force (r = 0.80, p ≤ 0.01; r = 0.70, p ≤ 0.01, respectively). Moreover, FK peak and impact forces were moderately correlated with CMJ jump height (r = 0.74, p ≤ 0.01; r = 0.77, p ≤ 0.01). The highest relationship was found between KLM and FK impulse; however, the difference in variability explained by KLM versus body mass is only 12%. This suggests that knowledge of BSM did not provide a significantly better estimate of the dynamic forces of the punches and FK than BM.

Background Sarcopenia is a state with progressive and generalized loss of skeletal muscle mass and strength. It is a serious complication occurring in chronic kidney disease (CKD) patients which increases morbidity and mortality rate. Sarcopenia is diagnosed when loss of both compartments - muscle strength and skeletal muscle quality or quantity are present. However, there are still numerous patients, also with CKD, diagnosed as pre-sarcopenic individuals with low muscle strength and normal skeletal muscle quality or quantity and conversely, with correct muscle strength and decreased skeletal muscle mass, who are prone to develop sarcopenia in future life. It is crucial to examine numerous variables possibly associated with changes of skeletal muscle mass and muscle strength in terms of preventing the development of sarcopenia. The aim of the study was to investigate anthropometric and clinical correlates and sources of variation in both skeletal muscle mass and muscle strength in advanced stages of CKD. Methods The study sample consisted of 84 non-dialysis dependent patients of both sexes (including 45.2% of women) with eGFR < 45 ml/min/1.73m²: 26.2% with eGFR 30-44 mL/min/1.73 m², 65.5% with eGFR 15-29 mL/min/1.73 m² and 8.3% with eGFR < 15 mL/min/1.73 m². Muscle strength was estimated by measuring hand grip strength (HGS) with the use of handheld hydraulic dynamometer. Muscle quantity was measured by bioimpedance spectroscopy using Body Composition Monitor. Appendicular skeletal muscle mass (ASM) was calculated according to Lin’s formula. Serum creatinine, urea, uric acid and albumin were measured. Results In bivariate analysis we found that ASM significantly and positively correlated with anthropometric variables such as body mass (r=0.903, p<0.001), NH weight (r=0.882, p<0.001), height (r=0.694, p<0.001), body mass index (BMI) (r=0.701, p<0.001), lean tissue mass (LTM) (r=0.664, p<0.001), lean tissue index (LTI) (r=0.433, p<0.001), fat mass (r=0.614, p<0.001) and fat tissue index (FTI) (r=0.449, p<0.001), and was negatively associated with clinical variable such as hydration status (p<0.001). HGS significantly and positively correlated with anthropometric parameters such as body mass (r=0.319, p=0.003), NH weight (r=0.315, p=0.004), height (r=0.666, p<0.001), LTM (r=0.490, p<0.001), LTI (r=0.238, p=0.029), and ASM (r=0.501, p<0.001), and was negatively associated with clinical variables like uric acid (p=0.039) and urea (p<0.001). After adjustment for age, sex and height, HGS remained significantly and negatively related with uric acid (β=-1.078, p=0.041) and hydration status (β=-0.805, p=0.042). Conclusions In CKD patients, ASM is determined mainly by anthropometric parameters but HGS - both by anthropometric and clinical variables specific for CKD.

To make wind power more competitive, it is necessary to reduce turbine downtime and reduce costs associated with wind turbine Operation and Maintenance (O&amp;M). Incorporating machine learning in developing condition-based predictive maintenance methodologies for wind turbines can enhance their efficiency and reliability. This paper presents a monitoring method that utilizes Base Density for the Support Vector Machine (BDSVM) and the evolutionary Fourier spectra of vibrations. This method allows smart monitoring of the function evolution of the turbine. A complex optimal function (FO) for 5-degree order has been developed that will be the boundary function of the BDSVM to timely determine the magnitude, frequency, and place of the failure occurring in wind turbine drive.

The development of effective vaccines against SARS-CoV-2 remains a critical challenge amidst the ongoing global pandemic. This study introduces a novel approach to enhance mRNA vaccine efficacy by leveraging the untranslated region (UTR) of TMSB10, a gene identified for its significant mRNA abundance in antigen-presenting cells. Utilizing the GEO database, we identified TMSB10 among nine genes with the highest mRNA abundance in dendritic cell subtypes. Subsequent experiments revealed that TMSB10's UTR significantly enhances the expression of a reporter gene in both antigen-presenting and 293T cells, surpassing other candidates and a previously optimized natural UTR. Comparative analysis demonstrated that TMSB10 UTR not only facilitated higher reporter gene expression in vitro but also showed marked superiority in vivo, leading to enhanced specific humoral and cellular immune responses against the SARS-CoV-2 Delta variant RBD antigen. Specifically, vaccines incorporating TMSB10 UTR induced significantly higher levels of specific IgG antibodies and promoted a robust T-cell immune response, characterized by increased secretion of IFN-γ and IL-4 and the proliferation of CD4+ and CD8+ T cells. These findings underscore the potential of TMSB10 UTR as a strategic component in mRNA vaccine design, offering a promising avenue to bolster vaccine-induced immunity against SARS-CoV-2 and potentially other pathogens.

Additive Manufacturing (AM) Direct Laser Fabrication (DLF) of Ti-5Al-5V-5Mo-3Cr (Ti5553) is being developed as a method for producing aircraft components. The additive manufacturing process can produce flaws near the surface, such as porosity and material voids, which act as stress raisers, leading to potential component failure. Eddy current testing was investigated to detect flaws on or near the surface of DLF Ti5553 bar samples. For this application, the objective was to develop an eddy current probe capable of detecting flaws 500 µm in diameter, located 1 mm below the component's surface. Two initial sets of coil parameters were chosen: The first, based on successful experiments that demonstrated detection of a near surface flaw in Ti5553 using a transmit-receive array probe, and the second, derived from simulation by Finite Element Method (FEM). An optimized transmit receive coil design, based on the FEM simulations, was constructed. The probe was evaluated on Ti5553 samples containing sub-surface voids of the target size, as well as samples with side-drilled holes and samples with holes drilled from the opposing inspection surface. The probe was able to effectively detect 80% of the sub-surface voids. Limitations included the probe’s inability to detect sub-surface voids near sample edges and a sensitivity to surface roughness, which produces local changes in lift-off. Multifrequency mixing improved signal-to-noise ratio when surface roughness was present on average by 22%. A probe based on that described in this paper could benefit quality assurance of additively manufactured aircraft components.

A U.S. government health agency conducted epidemiological studies to evaluate whether exposures to drinking water contaminated with volatile organic compounds at U.S. Marine Corps Base Camp Lejeune, North Carolina, were associated with increased health risks to children and adults. These health studies required knowledge of contaminant concentrations in drinking water—at monthly intervals—delivered to family housing, barracks, and other facilities within the study area. Because concentration data were limited or unavailable during much of the period of contamination (1950s–1985), the historical reconstruction process was used to quantify estimates of monthly mean contaminant-specific concentrations. This paper integrates many efforts, reports, and papers into a synthesis of the overall approach to, and results from, a drinking-water historical reconstruction study. Results show that at the Tarawa Terrace water treatment plant (WTP) reconstructed (simulated) tetrachloroethylene (PCE) concentrations reached a maximum monthly average value of 183 micrograms per liter (ug/L) compared to a one-time maximum measured value of 215 ug/L and exceeded the U.S. Environmental Protection Agency’s current maximum contaminant level (MCL) of 5 ug/L during the period November 1957–February 1987. At the Hadnot Point WTP, reconstructed trichloroethylene (TCE) concentrations reached a maximum monthly average value of 783 ug/L compared to a one-time maximum measured value of 1,400 ug/L during the period August 1953–December 1984. The Hadnot Point WTP also provided contaminated drinking water to the Holcomb Boulevard housing area continuously prior to June 1972, when the Holcomb Boulevard WTP came on line (maximum reconstructed TCE concentration of 32 ug/L) and intermittently during the period June 1972–February 1985 (maximum reconstructed TCE concentration of 66 ug/L). Applying the historical reconstruction process to quantify contaminant-specific monthly drinking-water concentrations is advantageous for epidemiological studies when compared to using the classical exposed versus unexposed approach.

The increasing world steel production has contributed to the generation of million tons of mining residues. But, the huge demand of aggregates for the execution of pavements and the lack of raw material for this purpose, the research for new materials to be used in this area has become vital. The sandy residue that was studied was collected at Mariana– MG county, which was the result of the iron ore processing of the company Samarco S.A. This research has as objective the evaluation of the mechanical behaviour of asphalt mixtures utilizing residue from the processing of iron ore in substitution of the fine aggregate in the asphalt mixtures of the Asphaltic Concrete type, aiming its use in the rolling layer of a road pavement. To do so, the Marshall dosage of three asphalt mixtures and the mechanical tests characterized by the resilient modulus and fatigue life at a controlled tension were performed. It was also performed the determination of the optimum content by the Superpave dosage method conducted in two of these mixtures to obtain the Compaction Index and the mechanical behaviour by the Flow Number value. Concluded that the residue is compatible with all current standards for the use in asphalt mixtures, being able to be used in the CBUQ rolling layer, showing an improvement in the behaviour compared to the standard mixture.

Background: Clinical trails have revealed that patients with depression generally accompanied with learning and memory impairment, which critically impact on individual’s health and development. Danggui-Shaoyao-San (DSS), a famous Chinese complex prescription, significantly overcame depression and relieved cognitive disorder based on previous research and publication. However, its effectsand potential mechanism against chronic restraint stress (CRS) remained unknown. Methods: CRS animal model was established and mice were divided to six groups while they were oral administrated with Danggui-Shaoyao-San at doses of 1.25, 2.5 and 5 g/kg for 14 days. Emotional and cognitive performances were detected by behavior tests, meanwhile neural plasticity and its molecular mechanism were examined by Dil staining, western blot and immunofluorescence. Results: DSS treatment dose-dependently improved locomotion ability in open filed test, overcame depression behavior in forced swimming test and elevated plus maze test, enhanced learning and memory ability in Morris water maze test. CRS decreased number of total spines and mushroom spines, while DSS treatment dose-dependently restored these by Dil staining. Expression of BDNF and GluR1 were significantly down-regulated in CRS group, which were significantly normalized by DSS. Conclusions: DSS treatment dose-dependently reversed CRS-induced cognitive impairments by inducing structural remodeling of neurons.

With the increasing use of automatic transmissions in passenger vehicles, there is a growing need for improved gear shifting control strategies that aim to enhance performance and fuel efficiency. This paper introduces a knowledge-based fuzzy control system designed specifically for automatic transmissions in light vehicles. The proposed system utilizes a fuzzy inference system as the controller, enabling the emulation of the driver’s perceptions during the gear shifting process. Consequently, the input signal consists of variables that are either sensitive to or observable by the driver, while the output represents the selected gear. The paper evaluates three distinct control strategies, each based on different inputs. These inputs include the longitudinal velocity of the vehicle, the angular velocity of the engine, or a combination of both, along with the time-derivative of the throttle valve opening. Through the evaluation, it is observed that the combination of inputs yields significantly improved performance. Therefore, the methodology presented in this paper demonstrates that the combined input approach is more effective for gear shifting control.

Although prior research has extensively examined the association of emotional intelligence (EI) with various job attitudes (e.g., job satisfaction), the empirical and systematic investigation of this link within military institutions has captured considerably less research attention. The present research analyzed the relationship between EI, teamwork communication, and job satisfaction among Spanish military cadets. We tested the potential unique contribution of EI to job satisfaction over and above demographics (i.e., gender and age), proactive personality, and resilience. Moreover, we also examined whether EI indirectly affects job satisfaction via its relationship with teamwork communication. A sample of 363 cadet officers of the Spanish General Military Academy completed questionnaires assessing EI, teamwork communication, proactive personality, resilience, and job satisfaction. Our results revealed that EI exhibited incremental variance in predicting job satisfaction even after accounting for demographics, proactive personality, and resilience. Additionally, we found that the effect of EI on job satisfaction was partially driven by enhanced teamwork communication. This research provides empirical evidence suggesting a pathway (i.e., effective teamwork communication) through which EI helps military cadets to experience higher job satisfaction. Implications for future academic programs including EI and teamwork communication to promote positive job attitudes among military personnel are discussed.

Objective: Evaluation of patients with prosthetic valves who developed infective endocarditis by comparing treatment outcomes in both early- and late-onset IE episodes following prosthetic valve replacement surgery. This study sought to conduct a comprehensive assessment of the efficacy of these methodologies. The insights derived from this assessment will be utilized to enhance the quality of care for individuals with infective endocarditis who have received prosthetic valve replacement surgery. Results: During the period of investigation (January 2018 - December 2022), 78 patients diagnosed with infective endocarditis (IE) on prosthetic valve were admitted to the Infectious Diseases Department of the "Dr. Carol Davila" Central Military Emergency University Hospital in Bucharest. In 28 cases (35.8%), the onset of PVE occurred within 12 months of surgery (early onset), whereas in 50 patients (64.2%), the onset occurred more than 12 months after surgery (late onset). The mortality rate was 35.9% (53.6% among the early onset patients and 26% among the late-onset patients). Among patients who received surgical and medical therapy, the mortality rate was 29.6%, whereas among those who underwent only medical therapy, a 39.2% mortality rate was reported. According to the extracted data, antibiotic therapy was successful in 72.6% of patients. In contrast, a combination of surgical and drug-based approaches resulted in a cure in 76.1% of the patients. The most common etiological agent was Staphylococcus aureus (38.5%), followed by Enterococcus faecalis (26.9%), and Streptococcus mitis (10.3%). The mortality rate of patients with S. aureus was 29.2%, indicating the severity of this infectious agent. Conclusions: Prosthetic valve endocarditis (PVE) is a serious condition associated with a high mortality rate both in the short and long term. Regardless of the therapy used, the risk of death remains high. All patients with PVE who survived received effective early treatment, highlighting the need for prophylactic measures.

Bacillus Calmette-Guérin (BCG) immunotherapy has been a cornerstone treatment for non-muscle invasive bladder cancer for decades and still faces challenges, such as severe immune adverse reactions, which reduce its use as a first-line treatment. This review examines BCG therapy’s history, mechanisms, and current status, highlighting how nanotechnology and bioengineering are revitalizing its application. We discuss novel nanocarrier systems aimed at enhancing BCG's efficacy while mitigating specific side effects. These approaches promise improved tumor targeting, better drug loading, and enhanced stimulation of anti-tumor immune responses. Key strategies involve using functional BCG cell wall components and co-delivering BCG with chemotherapeutics to achieve synergistic effects. While most studies remain experimental, this research direction offers hope for overcoming BCG's limitations and advancing bladder cancer immunotherapy. Further elucidation of BCG's mechanisms and rigorous safety evaluations of new delivery systems will be crucial for translating these innovations into clinical practice.

The polysaccharide-based chiral stationary phase (CSP) columns for high-performance liquid chromatography (HPLC) were applied in the separation of liquid crystalline racemic mixtures obtained based on (R,S)-2-octanol and were found to be highly effective in recognizing isomers of minor structural differences. The mobile phase (MP), which consists of acetonitrile (ACN)/water (H2O) at different volume ratios, was used. All measurements were made at room temperature. The order of the elution was also determined. The chromatographic parameters such as resolution - (Rs), selectivity - (α), and the number of theoretical plates, i.e., column efficiency - (N), were determined. The polysaccharide-based CSP columns have unique advantages in separation technology, and this study has shown the potential usefulness of the CSP columns in separating liquid crystalline racemic mixtures belonging to the same homologous series.

The work contains a detailed analysis of the electromagnetic field originating from a point source placed above the layered structure.The surface impedance of the multilayer dielectric structure was determined. Based on the boundary conditions, a method for determining the surface impedance of a layered structure with a perfectly conductive screen and or a magnetic screen is presented. The resonance conditions and the conditions for the excitation of surface waves are derived. The integral expression defining the generalized impedance was analyzed with a view to adapting it to numerical implementation. This allowed the development of a computer program based on which calculations were made of the effect of excitation of waves on multilayer dielectric substrates.

Combining modern thermodynamics theory branches, including finite time thermodynamics or entropy generation minimization, constructal theory and entransy theory, with metallurgical process engineering, this paper provides a new exploration on generalized thermodynamic optimization theory for iron and steel production processes. The theoretical core is to thermodynamically optimize performances of elemental packages, working procedure modules, functional subsystems, and whole process of iron and steel production processes with real finite-resource and/or finite-size constraints with various irreversibilities toward saving energy, decreasing consumption, reducing emission and increasing yield, and to achieve the comprehensive coordination among the material flow, energy flow and environment of the hierarchical process systems. A series of application cases of the theory are reviewed. It can provide a new angle of view for the iron and steel production processes from thermodynamics, and can also provide some guidelines for other process industries.

Bangladesh has adopted some special steps to control the quick spread of the COVID-19 pandemic situation. However, the local residents’ knowledge, attitudes, and practices towards the disease have a direct impact on the success of the controlling measures taken by the state. This article explores knowledge (K) about preventions, attitude (A) to the disease, and practices (P) of preventing COVID-19 situation of the young age groups residing in Bangladesh. Quantitative data were collected online using a KAP questionnaire from 932 participants. Results show the population is generally aware of the symptoms, keeping social distance by staying home and are concerned about re-spreading after the lock-down period. However, they are quite unsure about the possible medicines frequently talked about in the media and the necessity of avoiding animal protein. One of the major limitations is, these findings should not be generalized due to the low number of participants compared to the total population in Bangladesh.

Decompression sickness (DCS) with neurological disorders is the leading cause of diving accidents. Exposure to high levels of CO2 during diving is a safety concern for occupational , groups at risk of DCS. However, the effects of prior exposure to CO2 have never been evaluated. The purpose of this study was to evaluate the effect of CO2 breathing prior to a provocative dive on the occurrence of DCS in mice. 50 mice were exposed to a maximum CO2 concentration of 70 hPa for one hour at atmospheric pressure. Another 50 mice breathing air under similar conditions served as controls. In the AIR group (controls), 22 out of 50 mice showed post-dive symptoms compared to 44 out of 50 in the CO2 group. We found that CO2 breathing is associated with a decrease in body temperature in mice and that CO2 exposure dramatically increases the incidence of DCS. More unexpectedly, it appears that a lower temperature of the animals even before exposure to the accident-prone protocol leads to an unfavorable prognosis. This study also suggests that the composition of the microbiota may influence thermogenesis and thus accidentology. Depending on prior exposure, some bacteria identified in this work could be perceived as protective or pathogenic.

The use of didactic and interactive materials is essential in generating interest among students and teachers in utilizing mathematical models and digital technologies for the educational process. These materials create a dynamic and engaging learning environment that promotes a deeper understanding of complex concepts and fosters a passion for learning. Additionally, integrating interactive materials into pilot courses can assist teachers in better assessing student learning and adjusting the teaching strategies accordingly and the teachers can receive valuable insights into students' strengths and weaknesses, allowing them to provide targeted support and intervention when needed. In this context, the purpose of this paper is to introduce an approach for solving mathematics problems embedded in technical scenarios within the defense and security fields with the aid of digital technology. In this way, students can visualize abstract concepts, experiment with different scenarios, and receive instant feedback on their understanding. This paper helps to reinforce key concepts and enhance problem-solving skills, sparking curiosity, creativity, and encouraging active participation and collaboration. Throughout the development of this proposal, good practices are adopted, and advice for improvement is collected while having a wide range of users, giving feedback, discussions, and testing (pilot) short-term learning/teaching/training activities.

Over the years, Artificial Intelligence (AI) has seen a steady progress in development and evolution that can aid many sectors. Today, AI plays an essential role in the Fourth Industrial Revolution, and it is making its way into the military sector as well. Many countries are actively looking into AI military technology. Some of these innovations include image recognition, text analysis, Self-driving vehicles (SDV), gaming, robotic process automation (RPA) & Robotic and Autonomous Systems (RAS), and Autonomous Weapons Systems (AWS). In this research, we discuss the advantages of each innovation mentioned and analyze the many different cybersecurity threats that awaken due to military artificial intelligence systems. We then discuss the open research areas to better improve the current state of military artificial intelligence applications in terms of ethics, system security, proper strategy plan, accepted responsibility matrix, and introduction of relevant laws.

This article discusses the impact of new financial technologies, such as Non-Fungible Tokens (NFTs) on traditional industries such as art, sports, and game, while focusing on the recently formed "Metaverse" market. As a component of the overall blockchain ecosystem, the history of the establishment of NFT is analyzed. The impact of Web3 and intelligent contracts on Fintech are also investigated. This study examines the general trends in the NFTs market, including their price formation, price-influencing factors, and available patterns. Then the paper provides classifications and examples of NTFs. Besides, the technological application and primary technical path are also described. Later, the paper assesses the market's and marketplaces' accessibility. Finally, this study evaluates the management applications of NFTs and analyzes existing platforms, and demonstrates how they can be implemented effectively in various settings. The concluding portion discusses technological obstacles. The study concludes with a discussion of potential applications for the results and prospects for future research.

Earth is a complex material with a mechanical and physical behavior that differs from modern building materials. The conservation of rammed earth (RE) constructions presents specific difficulties that are challenging to overcome. The lack of knowledge about RE due to its abandonment for decades and attempts to adopt materials and repair methodologies designed for new building products has led to inadequate interventions. In the case of historic defensive constructions, the doubts and technical difficulties are even greater due to the nature of the so called military RE (with physical and mechanical characteristics significantly different from those of civil, more common, RE) and, not least, due to the historical and cultural heritage value of these constructions. Some important interventions have been carried out recently and others are underway or in the planning stage, and there is a constant lack of information and technical data on the best ways to intervene. To fill this gap, the state of conservation of the RE defensive structures and the results of interventions carried out throughout history in the southwest of the Iberian Peninsula are being assessed. This article sets out the framework of the subject, identifies the material and construction techniques, and recognizes the main causes of its deterioration and decay. With special focus on the most frequent damages detected in historic military defensive structures built with RE, it analyses and discuss the most common techniques that have been used for the repair and conservation of these particular structures.

The research question in this article concerns how a competitive environment affects the learner (officer cadet's) personal leadership development and their relationship to their team and with future civilian foundations. More specifically, what are the possible learning effects of the “hidden” curriculum? This article investigates how a more than 250 years of leadership education provides new army officers with new skills and how such an environment may affect the cadets' leadership training. The paper builds on ethnographic data gathered during the three-year education program in most of the relevant practical locations and contexts. Findings regarding trust in their learning environment, cadets have reported scores of (Mean 2.83) on a 1 (low trust) to 5 (high trust) Likert scale, underpinning interviewdata regarding the lack trust in the academy and in their fellow cadets. Cadets also point out that competition has hindered their learning (Mean 2.50). These findings are interpreted in relation to possible negative effects stemming from internal competition and the evaluation system as a whole. The overall output of this system is a zero–sum game, and thus effects evaluative practices and learning processes. This study is of relevance to higher education officers responsible for designing learning environments.

Obesity is related to the establishment of chronic inflammation and metabolic diseases, but it can be positively influenced by the regular practice of physical activity. The study aimed to compare the anthropometric, metabolic, and inflammatory parameters of physically active Military Police Officers (MPOs) with those who are less physically active. Sixty male MPOs, low activity (n=28) and physically active (n=32) participated. The following parameters were measured: plasma cytokine levels, C-reactive protein (CRP) levels, circulating glucose triglyceride (TAG) and high-density lipoprotein cholesterol (HDL-C) levels, and plasma glutamic oxalacetate transaminase (GOT), glutamic-pyruvate transaminase (GPT), and gamma-glutamyl transferase (GGT) activities. The physically active group presented lower body fat and reduced TAG and IL-8 levels compared to the low activity group. Moreover, a negative correlation between SPE and SBP, DBP, BPM was detected for the physically active group (p<0.05) but not in the low activity group. Furthermore, the physically active group's work time (WT) values were not correlated with the important metabolic markers SBP, DBP, BPM, GLU, TAG (p>0.05) but could be in the low activity group (p<0.05). These findings highlight the fundamental protective role of physical activity in controlling body composition, subclinical inflammation, and cardiovascular risk in MPOs.

MicroRNAs (miRNAs) are a kind of conserved small non-coding RNAs that participate in regulating gene expression by targeting multiple molecules. Early studies have shown that the expression of miRNAs changes significantly in different tumor tissues and cancer cell lines. It is well acknowledged that such variation is involved in almost all biological processes, including cell proliferation, mobility, survival and differentiation. Increasing experimental data indicate that miRNA dysregulation is a biomarker of several pathological conditions including cancer, and that miRNA can exert a causal role, as oncogenes or tumor suppressor genes, in different steps of the tumorigenic process. Anticancer therapies based on miRNAs are currently being developed with a goal to improve outcomes of cancer treatment. In our present study, we review the function of miRNAs in tumorigenesis and development, and discuss the latest clinical applications and strategies of therapy targeting miRNAs in cancer.

This paper presents a comprehensive analysis of the financial factors and risk management strategies essential for optimizing disaster resilience within the Serbian defence industry's critical infrastructure. The significance of this sector is multi-faceted, impacting national security, economic stability, and technological advancement. Primarily, the Serbian defence industry ensures the preservation of vital defence interests, maintaining Serbia's independence from foreign sources for weapons and military equipment in both peacetime and wartime. Economically, it is a significant employer of the working-age population, directly affecting local employment rates, fostering economic development, and ensuring the sustainable growth of this crucial sector. This, in turn, stimulates broader economic activity and enhances social cohesion while strengthening the national balance of payments through increased export potential. From a technological perspective, the defence industry drives scientific, technological, and industrial development, reinforcing Serbia's global political and military standing within the Western Balkans and on the international stage. Consequently, the paper aims to examine the risk management and protection of the Serbian defence industry's critical infrastructure, offering concrete and actionable measures to improve and develop these systems with a particular emphasis on security. The research's utility and contribution lie in identifying similarities and differences in the operational performance of defence industry companies, a vital segment of the national economy. The presentation of these findings focuses on the protection of critical infrastructure. The results will form the basis for further investigation into the underlying causes of business performance and the effective management of critical infrastructure security.

Prevalence of overweight and obesity are escalating globally among the general population. However, there are limited evidence on the trends and prevalence of overweight /obesity in the military setting. Increased rates of injuries, low work productivity, incurred higher healthcare costs and prematurely discharge from service are consequences of overweight/obesity among the military. Therefore, we aimed to systematically describe the trends and prevalence of overweight and obesity in the military population, by regions and military service branches. Databases including PubMed, Scopus, Web of Science and Google Scholar were used. Inclusion criteria were military population (inclusive of all service branches) with BMI reported as the overweight/obesity indicator. Population related to military but not exclusively military personnel such as the retirees, the veterans and their dependents were excluded. From the 27 included studies, 13 were published between year 2010 to 2014 and half were conducted in the United States. Overall, studies showed increasing trend in the prevalence of overweight (30% to 50%) and obesity (2% to 30%); only one study showed a decreasing trend of 0.9% and 0.6% for the prevalence of overweight and obesity respectively. However, the rates of increment differed between countries, where Asian countries demonstrated lower overweight prevalence compared to the United States and the European countries. In conclusion, the military population is not protected from overweight and obesity. Interventions should be implemented to prevent overweight / obesity among the military personnel.

Although the dopamine hypothesis of schizophrenia explains the effects of all the available antipsychotics in clinical use, there is an increasing need for developing new drugs for the treatment of positive, negative, and cognitive symptoms of chronic psychoses. Xanomeline-trospium (KarXT) is a drug combination that is based on the essential role played by acetylcholine in the regulation of cognitive processes and the interactions between this neurotransmitter and other signaling pathways in the central nervous system, with a potential role in the onset of schizophrenia, Alzheimer’s disease, and substance use disorders. A systematic literature review that included four electronic databases (PubMed, Cochrane, Clarivate/Web of Science, and Google Scholar) and the US National Library of Medicine database for clinical trials detected 21 sources referring to 14 studies focused on KarXT, out of which only four have published results. Based on the results of these trials, the short-term efficacy and tolerability of xanomeline-trospium are good, but more data is needed before this drug combination may be recommended for clinical use. However, on a theoretical level, the exploration of KarXT is useful for increasing the interest of researchers in finding new, non-dopaminergic, antipsychotics that could be used either as monotherapy or as add-on drugs.

Abstract: The present study seeks to investigate MNOs leadership style and how it influences their compassion competence and their personal level of compassion at work. This is a cross-sectional study carried out from December 2019 to May 2020 using the method of convenience sampling. The study involved 235 MNOs serving in Greek Military Hospitals. A single questionnaire containing Compassion at Work index, Compassion competence scale, and Multifactor Leadership Questionnaire (MLQ-5X), and socio-demographic and professional data, was used for data collection. A total of 400 printed questionnaires were distributed with a response rate of 58.75%. Data analysis was performed using the statistical package SPSS 22.0. The research showed that the transformational and transactional leadership styles coexist in the Nursing Corps of the Armed Forces with an average value of 2.72(SD=0.70)-2.95(SD=0.54) points and 2.47(SD=0.69)-2.74(SD=0.63) points respectively, while the passive style represented a very small percentage with an average subscale value of 0.88(SD=0.61)-0.94(SD=0.63) points. It was also found that both actual compassion at work and compassion ability had improved with the increase of transformational or transactional leadership style characteristics and amelioration of leadership outcome criteria. On the other side, a deterioration of these was observed with the increase of the passive leadership. Specifically, a higher score in the «Intellectual Stimulation» scale was associated with a higher level of compassion at work in the dimension «Experiencing the suffering of others» (p=0.010/SD=0.14), while higher values on the «Laissez-Faire Leadership» scale were associated with less compassion at work in the same dimension (p<0.001/SD=0.13). Also, a higher score on the «Contingent Reward» scale was associated with more compassion at work in the dimension «Takes appropriate action» (p=0.023/SD=0.16). Furthermore, higher values observed in the «Inspirational Motivation», «Individual Consideration» and «Extra Effort» scales were associated with a better communication ability (p=0.035/SD=0.09, p=0.022/SD=0.12, and p=0.042/SD=0.08 accordingly). Finally, a higher score on the «Effectiveness» scale was associated with higher sensitivity (p=0.049/SD=0.08). Teaching appropriate leadership behavior, promoting a culture of compassion, and continuing to train nurses to manage their emotions should be included in the infrastructure of nursing science.

Technology Readiness Levels (TRLs) is a well-established and widely used approach for defining the readiness of new technology. To this extent, it assesses technology maturity against specific benchmarks, ranging from 1 (concept) to 9 (market solution). Although this is a useful classification service, allowing us to establish a common language, there are cases where we find that this conceptual approach fails to adequately highlight the maturity of certain innovative endeavors and effectively steer their development to higher TR levels. We will present an empirical case where the TRL approach presented a critical shortcoming in highlighting the true and effective readiness of a specific technological development and could not suggest the next natural step in ascending the maturity ladder. We will seek to generalize for the case of co-creation at large, analyze why co-creation may be poorly serviced by the current TRL model and suggest an amendment that would allow the observed shortcoming of the traditional TRL approach to be overcome and its use extended also in such co-creative settings.

The main aim of this paper is to explore the issue of big data and to propose a conceptual framework for big data, based on the temporal dimension. The Temporal Big Data Maturity Model (TBDMM) is a means for assessing organization’s readiness to fully profit from big data analysis. It allows the measurement of the current state of the organization’s big data assets and analytical tools, and to plan their future development. The framework explicitly incorporates a time dimension, providing a complete means for assessing also the readiness to process temporal data and/or knowledge that can be found in modern sources, such as big data ones. Temporality in the proposed framework extends and enhances the already existing maturity models for big data. This research paper is based on a critical analysis of literature, as well as creative thinking, and on the case-study approach involving multiple cases. The literature-based research has shown that the existing maturity models for big data do not treat the temporal dimension as the basic one. At the same time, dynamic analytics is crucial for a sustainable competitive advantage. This conceptual framework was well received among practitioners, to whom it has been presented during interviews. The participants in the consultations often expressed their need of temporal big data analytics, and hence the temporal approach of the maturity model was widely welcomed.

The main objective of this paper is to develop a readiness index model that can serve as an analytical tool for exploring the achievements of electrification of transportation systems. We have applied this readiness index model to evaluate the readiness positioning of China, Norway, and Sweden to-wards transport electrification. We have chosen these three countries as they represent diversity among countries that are in the process of adopting electric transport system solutions. Our developed readiness index model has four key dimensions, technological readiness, political readiness, societal readiness, and economic readiness. The embeddedness of all four dimensions in one model provides a multi-perspective way of analyzing and evaluating the readiness levels of countries moving towards transforming the transportation system. Therefore, we named the model a “multidimensional readiness index.” Our main conclusions are that the political processes and political decisiveness involved are the most important factors followed by the societal needs and economic ability, with the current technology available as the fourth. Without the participation of dedicated and determined political decision-makers being involved, the other three factors are challenging to obtain. Political decision-makers need to facilitate the use of economic means to support the transformation in the society and affected industries to balance the initial economic disadvantages of the electrically powered systems until they pass the cost disadvantage turning point. The development of the relevant technology is no longer a great barrier as it was at the beginning of this transformation, about 20 years ago. The technology for electrically powered transportation systems and devices is widely available now, although it is continuously evolving and being improved. Associated industries cannot be expected to initiate, finance, take the risk, and take the lead in this global societal transformation without clear and strong political support.

A fascinating topic that has not been recently revisited by bioethics is the ethics of human experimentation within the military context, in keeping with the pace of modern technology development. Many research innovations stem from military research, where emerging technologies are first applied in the field then eventually repurposed for civilian contexts. This commentary presents an ethical framework for the usage of military personnel as research subjects, within the context of modern military research such as epigenetic technology development in soldiers. Tensions are raised between existing military versus civilian bioethical frameworks for human experimentation and compared to risk-benefit assessments within and beyond the military context. A harmonized ethical framework is proposed for the use of research subjects within the military. The pace of modern scientific research, particularly in genomics, poses new ethical considerations of genetic profiling, consent, risk, and data privacy that urges a timely revisit of military bioethics.

Methylation is a biochemical process involving the addition of a methyl group (-CH3) to various chemical compounds. It plays a crucial role in maintaining the homeostasis of the endothelium, which lines the interior surface of blood vessels and has been linked, among other conditions, to coronary artery disease (CAD). Despite significant progress in CAD diagnosis and treatment, intensive research continues into genotypic and phenotypic CAD biomarkers. This review explores the significance of the methylation pathway and folate metabolism in CAD pathogenesis, with a focus on endothelial dysfunction resulting from deficiency in the active form of folate (5-MTHF). We discuss emerging areas of research into CAD biomarkers and factors influencing the methylation process. By highlighting genetically determined methylation disorders, particularly the MTHFR polymorphism, we propose the potential use of the active form of folic acid (5-MTHF) as a novel CAD biomarker and personalized pharmaceutical for selected patient groups. Our aim is to improve the identification of individuals at high risk of CAD and enhance their prognosis.

Background: Military pilots show high visuo-spatial skills. Previous studies demonstrate that they are better in mental rotating a target, in taking different perspectives, in estimating distances, in travel planning and in topographic memory. Here, we compared navigational cognitive styles between military pilots and people without flight experience. Pilots were expected to be more survey users than non-pilots, showing higher navigational strategies. Method: 106 jet military pilots of Italian Air Force and 92 non-pilots were enrolled in order to investigate group differences in navigational styles. Participants were asked to perform a reduced version of the Spatial Cognitive Style Test – SCST, consisting of six tasks that allow to distinguish individuals in landmark (people orient themselves by using a figurative memory for environmental objects), route (people use an egocentric representation of the space) and survey (people have a map-like representation of the space) users. Results: In line with our hypothesis, military pilots mainly adopt a survey style, whereas non-pilots mainly adopt the route style. In addition, pilots outperformed non pilots in both the 3D-Rotation task and Map Description Task. Conclusion: Military flight expertise influences some aspects of the spatial ability, leading to enhance human navigation. Although, it must be considered that they are a population whose navigational skills were already high at the time of selection at the academy before formal training began.

The rapid development of information and communication technologies has led to the use of new and digital technologies in education which involves combinations of text, graphics, audio, video, animations and other eLearning resources such as authoring tools, Learning Management System (LMS), Mobile learning and others. Arguably, using LMS leaves much to be desired. The inherent problem here is that the future of extensive adoption of ICT via LMS to enhance and promote classroom interaction in Open and Distance Learning (ODL) is bleak. This is worrisome given that the country is lagging far behind in the innovative use of this web 2.0 technology to impart knowledge. Further, the low-level application of LMS in instruction connotes the loss of inherent advantages in its adoption. Also, the online setting which makes students less nervous and interactive, sharing of ideas and viewpoints; and a host of other benefit will be lost. While evidence has shown that LMS is not a new phenomenon, the use of LMS in ODL is still at its infancy, particularly in Nigeria. Research in this area is rare. A quick search on prominent research databases could testify that. It is on this thrust that this study investigates University of Ibadan undergraduate students’ perceived roles and readiness towards integration of learning management system into teaching and learning.

The dynamic landscape of AI adoption and its impact on employment in Malaysia demands a multifaceted approach to navigate the challenges and harness the opportunities presented. While the government's commitment to fostering AI adoption through initiatives like the National AI Framework and the Malaysia Digital Economy Blueprint is commendable, it is imperative to address concerns regarding job displacement and ensure inclusive growth. This study identifies the pressing research problem of workforce readiness for the AI-driven future, emphasizing the need to explore strategies for reskilling and upskilling affected workers. By employing critical lenses such as Marxist, feminist, and postcolonial perspectives, scholars highlight the power dynamics and societal implications inherent in AI deployment, guiding the development of policies and interventions that prioritize workers' interests and address social inequalities. Moving forward, a comprehensive approach combining policy interventions, educational reforms, and inclusive strategies is essential to maximize the benefits of AI adoption while mitigating its potential risks. Longitudinal studies, interdisciplinary research, and comparative analyses will further advance our understanding and inform evidence-based policymaking in this evolving field. Ultimately, by prioritizing workforce preparedness, social equity, and sustainable development, Malaysia can position itself as a leader in the AI-driven global economy, fostering a resilient, inclusive, and prosperous society for all.

Self-administered pre-participation screening for physical activity (PA) requires an instrument that should be easily used and identify individuals at high risk. The Physical Activity Readiness Questionnaire (PAR-Q+) has been used for many years. Its ease of use and ability to identify those not fit to undergo PA has not been assessed. This study was to determine the rates of the PAR-Q+ in identifying adults who may not be fit for moderate or intense PA and obtain feedback on the use of this tool. A public on-line voluntary survey on the PAR-Q+ was carried out obtaining participants’ bio-characteristics, them completing the PAR-Q+ form and providing feedback. With 1019 participants, about 57.8% engaged in at least 150 minutes of PA weekly. This decreased with increasing number of co-morbidities. Increasing age was associated with more co-morbidities. About 33.1% of the participants using the PARQ+ would have required further medical evaluation. Only 3 of the 7 main PAR-Q+ questions were easily understood. Difficulties were encountered with 39 of the 44 follow-up questions, especially amongst those with co-morbidities. The large number of technical terms was also a source of concern. The PAR-Q+ would need extensive simplification before it may be recommended for use.

1) Background: Genomic medicine harbors the real potential to improve the health and healthcare jour-ney of patients, care provider experiences, and improve health system efficiency – even reducing health care costs. There is expected to be an exponential growth in medically necessary new genome- based tests and test approaches in coming years. Testing can also create scientific research and commercial opportu-nities beyond healthcare decision-making. The purpose of this research is to generate a better under-standing of Canada’s state of readiness for genomic medicine, and to provide some insights for other healthcare systems; (2) Methods: a mixed-methodsapproach of literature review and key informant in-terviews with a purposive sample of experts was used. Health system readiness was assessed using a pre-viously published set of conditions. (3) Results: Canada has created some of the established conditions but more needs to be done to improve the state of readiness for genome-based medicine. Important gaps are the need for linked information systems and data integration; evaluative processes that are timely, and transparent; navigational tools for care providers; dedicated funding to facilitate rapid onboarding and supports test development and proficiency testing; and broader engagement with a broader set of inno-vation stakeholders. These findings highlight the known role of organizational context, social influence, and other factors that are known to affect the diffusion of innovation within health systems

AbstractBackground: In digitalization era, health care system was conditioned with the health worker’s ability to adapt media of digital technology. Digital technology media was used to strengthening and fasted the health care for patient and community. Aims: This study aimed to explore the accurate information of health professional utilization digital technology during doing the job at the health facilities in Timor-Leste. Methods: This study was used correctional study with 56 respondents was participated in the study. Was collected the data from 1 to 30 February 2023. Was used questioner of google form based for data collection. Data collection was distributed via online with google form to social media as WhatsApp’s, email and face book and twitter to completed by respondents. The inclusive Criteria are: health professional living in Timor-Leste, to able response the questioner. Was used descriptive analysis in this study. Finding: This study was indicated that majority of health professional was participated in the study as 54,2% man then women have 45,8%. About 100% health professional used hand phone to facilitate their daily activities including related with their work activities. Other side indicated in digital technology tools use are able to use Microsoft word is 78,3%, able to use Microsoft Excel is 76,7% and able to use Power Point is 81,7%. E-mail use about 89,2%, WhatsApp’s use 81,7%, About 74,2% was used zoom/webinars/Google meet application, about 72,5% sad that they were used computer in the work place until now. Around 96.4% need to improve or deepen their knowledge and skills in using ICT in the future to facilitate they are activity. Conclusion: Majority of health professional in Timor-Leste was used the computer, internet, hand phone in daily activities. Majority need to gate the training to improve their knowledge, attitude and psychomotor in the future.

Background: Children's environmental health encompasses a wide range of factors that impact the well-being of children, including physical, chemical, biological, and social elements in their immediate environment. Safeguarding children from harmful substances is the crucial role of nursing students. Nursing students play a vital role as valuable resources for individuals, families, communities, and policymakers. This study aims to assess the knowledge and skills of nursing students concerning children's environmental health at academic institutions delivering nursing program in Nekemte town, Ethiopia. Methods: An institutional-based cross-sectional study design was carried out from August 1–30, 2023, among nursing students in Nekemte Town, and 634 study participants were selected through simple random sampling. Data was entered into Epinfo version 6.4 and exported to STATA version 14 for analysis, and multicollinearity was checked. Finally, from the bivariate analysis, variables of < 0.2 were included in the multivariate analysis; an adjusted odd ratio with a 95% CI was computed; and variables with a P-value <0.05 in the multivariable analysis were taken as significant associated factors. Results: The overall nursing students' level of knowledge about children's environmental health was insufficient (56%). More than one-third (34%) demonstrate their skill towards children's environmental health insufficiently, and one-fourth (25%) and 27% of the learners conduct their craft to prevent children from ecological hazards to a good and better level, respectively. While gender of the participant, age of the participant, year of the study, training history of the participants, and field of study of the students were significantly associated variables with their knowledge of children's environmental health. Conclusion: The study reveals that nursing students' knowledge of children's environmental health is limited, with factors such as gender, age, training history, and field of study significantly influencing their understanding. Therefore, female students should be considered for more tutorials to be effectively knowledgeable regarding children’s environmental health.

Telerehabilitation is an appealing service delivery option for optimising recovering. Internationally, the equity of telerehabilitation services for people from culturally and linguistically diverse (CALD) backgrounds has been questioned. Using a 31-item survey, our study explored the access, readiness, and willingness of 260 patients to use allied health telerehabilitation services for adults receiving interventions from a large tertiary health service located in Sydney, Australia. Overall, 72% patients reported having access to technology, 38% met our readiness criteria, and 53% reported willingness to engage in telerehabilitation. There were no difference in access, readiness and willingness to engage in telerehabilitation between patients from CALD and non-CALD backgrounds. Age was the only factor that influenced access, readiness and willingness to engage in telerehabilitation. Past experience of telerehabilitation was related to willingness, but not access or readiness. Findings highlight the importance of ensuring positive patient experiences to promote ongoing willingness to use telerehabilitation. Efforts are needed to improve patients’ digital health literacy, especially patients from older age groups, to ensure equitable access to telerehabilitation services.

Recently considered modifications to public policy and trends in technology transfer practices have underscored the need for validated instruments to assess the maturity of technologies. This paper details a study that aimed to develop and present a generalized technology readiness level (GTRL) scale that a variety of professionals and researchers could use to assess the maturity of technologies in a range of contexts. Of particular interest is developing and validating an instrument that technology transfer professionals in federal laboratories, universities, and the private sector in the United States of America can use to assess the maturity of technologies to facilitate their technology transfer efforts. The primary goal of the research study was to highlight the need for validated measurement instruments for assessing the maturity of technologies in these contexts, test methods for validating the GTRL scale and other readiness level scales, and fill the knowledge gap regarding methods for properly validating such instruments. This included producing insights to inform future efforts to validate the GTRL scale as well as efforts to develop and validate other instruments to measure technology maturity. The study provides specific recommendations relevant to determining the face validity, content validity, inter-rater reliability, and intra-rater reliability of the GTRL scale and other such instruments for assessing technology maturity.

BackgroundThe novel virus COVID-19, also known as SARS-CoV‑2, is currently rapidly spreading around the globe and pushing healthcare systems to the limits of their capacity. One of the functions of predictive models is to timely act for epidemic preparedness including hospital preparedness. In Egypt, like many other countries in the world, the epidemic situation and forecasting have not yet sufficiently studied. ObjectiveThe study was carried out to develop a short-term forecast scenario for the COVID-19 epidemic situation in Egypt and predict the hospital needs to accommodate the growing number of cases.MethodsSecondary data from the COVID-2019 daily reports and the report issued 8^th of April by the Egyptian Ministry of Health and Population were used. Due to the daily changing level of knowledge and data, the article reflects the status up to 18 April 2020. The prediction was based on the exponential growth rate model. For the depiction of the situation, the full length of the epidemic timeline was analyzed (from February 14^th till April 18^th). The growth rates and their rates of decline during the period from the 22^nd of March till the 18^th of April were calculated and extrapolated in the coming 7 weeks. The predicted hospital needs were assessed against the announced allocated resources.ResultsThe epidemic curve in Egypt is on the ascending arm as of April, 18. The active cases showed exponential growth from the start of the epidemic till April, 18. At the end of this period time, the recovery rate was 23.12% and the case fatality rate (CFR) was7.39. The case fatality rate median level during the last four weeks was 6.64. The active cases are expected to reach more than 20,000 by late May then starts to decline. The allocated regular hospital beds are predicted to show shortage by the time of the release of the paper. The intensive care units (ICU) beds and ventilators are predicted to show insufficiency on May 6.Conclusions: The COVID-19 epidemic in Egypt is expected to continue on the rise for the next few weeks and expected to start to decline late in May, 2020. Our estimates should be useful in preparedness planning. Serious actions should be taken to provide ICU beds and ventilators enough for the predicted number of cases that would need them, not later than the end of April. Mitigation actions have to continue for the coming 6 weeks or until the epidemic situation is more clearly seen.

Retail buildings can provide energy flexibility to the grid with the possibility of load shifting and building automation systems. Demand response is a collective innovation in the smart grid domain. Various stakeholders should be involved in the demand response activities to ensure the success. The owners or senior management of retail buildings need to consider the stakeholders who are directly influenced by the demand response participation, e.g. customers and employees. Meanwhile, demand response activities are influenced by various factors, such as energy market structure, policy, etc. Therefore, this paper investigates the demand response readiness for retail buildings with three aspects: energy control preferences, stakeholder engagement, and cross-national differences. A questionnaire is designed and collected with store managers in Denmark (N=51) and the Philippines (N=36). The result shows that: 1) retail stores are much readier to participate in the implicit demand response by manual energy control compared to the utility control or building automation. Meanwhile, store managers have significant concerns about business activities and indoor lighting compared to other aspects; 2) the statistically significant influential factors for retail stores to participate in the demand response are related to whether the DR participation matches the company goals, influences business operation, and whether retail stores are lack of related knowledge; 3) retail stores believe that stakeholders should be informed about the DR activities but not involved in; 4) there are significant differences regarding the energy control preferences and concerns between retail stores in Denmark and the Philippines, but no significant difference regarding the stakeholder engagement.

The concepts of accessibility and urban walkability are the cornerstones of urban policies for the contemporary city, called upon to adopt sustainable development models in line with the objectives of the 2030 Agenda and the ambitious objectives of the 'European Green Deal'. These concepts are closely linked to the paradigm of a sustainable city (livable, healthy and inclusive), founded on a system of quality public spaces and on a network of services and infrastructures, both tangible and intangible, capable of strengthening or building new relationships: social, economic and environmental. It is therefore necessary to recognize potential opportunities for connection and permeability in consolidated urban environments, very often fragmented and characterized by enclaves. Within this framework, the city of Cagliari represents an interesting case study as it is characterized by the presence of a series of military complexes, real 'enclaves' which condition the proximity connections and, more generally, the walkability. In this sense, building on previous research and analysis of policies and projects aimed at reintroducing, even partially, this military asset into civilian life (Green Barracks Project - GBP - 2019), this study proposes and applies a methodology to improve urban accessibility in a flexible network logic, where 'walkability' can become not only a moment of possible "choice" but the basis for planning oriented to the '15 min city' model or, more generally, to the renewed, inclusive, safe, resilient and sustainable “City of proximity”.

In 2014, the outbreak of adenoviral pneumonia occurred in Korean military training center. However, there is limited data on characteristics of fever and its response to antipyretics therapy in immunocompetent adults with adenoviral positive community-acquired pneumonia (CAP). Medical records of patients who were admitted to Armed Forces Chuncheon Hospital for treatment of CAP between January 2014 and December 2016 were retrospectively analyzed. We evaluated demographics, clinico-laboratory findings and radiologic findings at admission were compared between adenovirus positive (Adv) group and adenovirus negative (non-Adv) group. Out of 251 military personnel with CAP during the study periods, 67 were classified into Adv group while 184 were Non-Adv group. Patients with Adv group had a longer duration of fever after admission and symptom onset. Adv group patients had a higher mean temperature at admission and more observed over 40 and 39 to 40℃. Adv group patients had more commonly observed no response to antipyretic treatment and adverse events after antipyretics use. Length of hospital stay had no significant difference between two groups and no patient died in both groups. In our study, Adv positive CAP in patients with immunocompetent military personnel had distinct characteristics of fever and response to antipyretic treatment.

The performance of a small reconfigurable unmanned aerial vehicle (UAV) is evaluated, 1 combining a multidisciplinary approach in computational analysis of additive manufactured struc- 2 tures, fluid dynamics, and experiments. Reconfigurable UAVs promise cost savings and efficiency 3 without sacrificing performance, while demonstrating versatility to fulfill different military mission 4 profiles. The use of computational fluid dynamics (CFD) in UAV design produces higher accuracy 5 aerodynamic data, which is particularly important for complex aircraft concepts such as blended 6 wing bodies. To address challenges relating to anisotropic materials, the Tsai-Wu failure criterion is 7 applied to structural analysis, using CFD solutions as load inputs. Aerodynamic performance results 8 show the low-speed variant attains an endurance of 1 hour, 48 minutes, whereas for its high-speed 9 counterpart, it is 29 minutes at 66.7% higher cruise speed. Each variant serves different aspects of 10 small UAS deployment in combat, with low-speed envisioned for close surveillance, and high-speed 11 for incursions. Experimental and simulation results suggest room for design iteration, in wing area 12 and geometry adjustments. Structural simulations demonstrated the need for airframe improvements 13 in the low-speed configuration. This paper highlights the potential of reconfigurable UAVs to disrupt 14 the industry, advocating for further research and design improvements.

The present study aims to evaluate the antibacterial activity of five commercially available essential oils (EOs): Lavender (LEO), Clove (CEO), Oregano (OEO), Eucalyptus (EEO), and Peppermint (PEO) against the most-known MDR Gram-positive and Gram-negative bacteria - Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922) and Pseudomonas aeruginosa (ATCC 27853) - alone and in various combinations. Gas Chromatography-Mass Spectrometry (GC-MS) analysis established their complex composition. Then, the antibacterial activity was investigated in vitro by diffusimetric antibiogram method, using sterile cellulose discs with Ø 6 mm impregnated with 10 µl of sample and sterile borosilicate glass cylinders loaded with 100 µl of sample; MIC (µg/mL) for each EO was calculated from IZD values (mm) measured after 24 hours. The following EO combinations were evaluated: OEO+CEO, CEO+EEO, CEO+PEO, LEO+EEO, and EEO+PEO. Then, the influence of each dual combination on 3 conventional antibacterial drugs – Neomycin (NEO), Tetracycline (TET), and Bacitracin (BAC) - activity was investigated. The most active EOs against S. aureus and E. coli were LEO and OEO (IZD = 40 mm). They were followed by the CEO and EEO (IZD = 20-27 mm); PEO exhibited the lowest antibacterial activity (IZD = 15-20 mm). EEO alone showed the highest inhibitory activity on P. aeruginosa (IZD = 25-35 mm). It was followed by the CEO, LEO, and EEO (IZD = 7-11 mm), while PEO proved no antibacterial action against it (IZD = 0 mm). Only one synergic action was recorded (OEO+CEO against P. aeruginosa); EEO+PEO revealed partial synergism against S. aureus and CEO+PEO additive behavior against E. coli. Two triple associations with TET showed partial synergism against E. coli, and the other 2 ones (with NEO and TET) evidenced the same behavior against S. aureus; all contained EEO+PEO or CEO+PEO. Most combinations reported indifference. However, numerous cases were of antagonism between constituents included in double and triple combinations, and EOs with the strongest antibacterial activities belong to the highest antagonistic combinations. A consistent statistical analysis supports our results, showing that EOs with moderate antibacterial activities could generate combinations with higher inhibitory effects based on synergistic or additive interactions.

In this paper, we study the problem of controllability of impulsive neutral evolution integrodifferential equations with state dependent delay in Banach spaces. The main results are completely new and are obtained by using Sadovskii's fixed point theorem, theory of resolvent operators, and an abstract phase space. An example is given to illustrate the theory.

The International Maritime Organization (IMO) has recently revised its strategy for shipping de-carbonization, deepening the ambition to reduce annual greenhouse gas emissions until 2050. The accomplishment of this strategy requires the large-scale deployment of alternative maritime fuels, whose diversity and technical characteristics impose transition challenges. While several studies address the production of these fuels, a notable gap lies in the analysis of the required adaptations in vessels and ports for their usage. This study aims to fill this gap through a comprehensive re-view of material compatibility, storage in ports/vessels, and bunkering technology. Firstly, we an-alyze key aspects of port/vessel adaptation: physical and chemical properties; energy conversion for propulsion; fuel feeding and storage; bunkering procedures. Then, we perform a maturity as-sessment, placing each studied fuel on the technological readiness scale, revealing the most prom-ising options regarding infrastructure adaptability. Finally, we develop a case study for Brazil, whose economy is grounded on maritime exports. Findings indicate that multi-product ports may have potential to serve as multi-fuel hubs, while the remaining ports are inclined to specific fuels. In terms of vessel categories, we find that oil tankers, chemical ships and gas carriers are the most ready for conversion in the short-term

This research aims to examine the level of readiness of the community to carry out sustainable tourism development, especially community-based tourism on small islands, such as Lombok Island, Indonesia. More specifically, the objectives of this study are as follows: (1) Knowing the level of community readiness in carrying out sustainable tourism development. (2) Knowing the various dimensions that influence sustainable tourism development. (3) Knowing the role of stakeholders in sustainable tourism development. The method applied in this research is mixed methods, a combination of quantitative and qualitative approaches. Quantitative methods are used to determine community readiness for sustainable tourism development. A qualitative approach is used to determine the various factors that influence the development of community-based tourism and to determine the role of stakeholders in the development of community-based tourism. The level of community readiness for sustainable tourism development is high in terms of economic, social, cultural, environmental, and symbolic capital aspects. Aspects that influence the development of sustainable tourism are economic, social, and cultural. Stakeholders who play a role in developing sustainable tourism in the research area are the government, the private sector, universities, non-governmental organizations, and the media.

Modern war is sudden and rapid, and once the battle starts, the demand for equipment maintenance and guarantee will show an outburst situation, which puts equipment maintenance and guarantee capability to a severe test. To accurately grasp the civil-military integration of aviation maintenance and guarantee capabilities, it is necessary to evaluate their capabilities. To this end, the evaluation indicator system is established by using the three-dimensional indicator system construction model of "maintenance task → task demand → capability demand", and the evaluation method based on intuitionistic fuzzy entropy and normal grey cloud model is proposed, using intuitionistic fuzzy entropy theory to determine the expert weights and indicator weights, and the grey cloud model theory to determine the capability evaluation level. Finally, the application process of the evaluation model is demonstrated through specific examples, and the evaluation results are analyzed to verify the effectiveness of the evaluation model.

Modern war is sudden and rapid, and once the battle starts, the demand for equipment maintenance and guarantee will show an outburst situation, which puts equipment maintenance and guarantee capability to a severe test. To accurately grasp the civil-military integration of aviation maintenance and guarantee capabilities, it is necessary to evaluate their capabilities. To this end, the evaluation indicator system is established by using the three-dimensional indicator system construction model of "maintenance task → task demand → capability demand", and the evaluation method based on intuitionistic fuzzy entropy and normal grey cloud model is proposed, using intuitionistic fuzzy entropy theory to determine the expert weights and indicator weights, and the grey cloud model theory to determine the capability evaluation level. Finally, the application process of the evaluation model is demonstrated through specific examples, and the evaluation results are analyzed to verify the effectiveness of the evaluation model.

In this paper, the mechanism of combined process of ion beam sputtering (IBS) and HF acid etching on the chemical structure defects of fused silica and its laser damage resistance perfor-mance were investigated. During the removal process of surface material, the sputtering effect causes lattice atoms to detach from their original positions, forming a large number of unsaturated structures on silica surface, which improves the chemical activity of Si and O atoms, accelerates the chemical reaction process between surface atoms and water molecules, increases the content of hydroxyl (OH-) groups in the shallow layer, and enhances the photothermal weak absorption intensity. However, the presence of OH- groups reduces the bonding strength of Si-O, destroys the spatial network structure of silica bulk, and reduces the mechanical strength of silica surface, resulting in a decrease in its laser damage resistance performance. The paper reveals for the first time the mechanism of IBS to change the structure characteristics of silica material, accelerate the surface hydroxylation process, and thereby reduces the laser damage resistance performance. This work provides technical guidance for effectively suppressing chemical structure defects on silica surface and improving laser damage resistance performance of optical components under high-flux laser irradiation.

Background: The COVID-19 pandemic has sped up digital health transformation across the health sectors to enable innovative health service delivery. Such transformation relies on competent managers with the capacity to lead and manage. However, the health system has not adopted a holistic approach in addressing the health management workforce development needs, with many hurdles to overcome. The objectives of this paper are to present the findings of a three-step approach in understanding the current hurdles in developing a health management workforce that can enable and maximise the benefits of digital health transformation, and to explore ways of overcoming such hurdles. Methods: A three-step, systematic approach was undertaken, including an Australian digital health policy documentary analysis, an Australian health service management postgraduate program analysis, and a scoping review of international literatures. Results: The main findings will guide the formulation of strategies in developing a digitally enabled health management workforce in the digital health era. Conclusions: With the ever-changing landscape of digital health, being able to lead and manage in times of system transformation requires a holistic approach to develop the necessary health management workforce capabilities and system-wide capacity. The evidence would support that this can be achieved with the required system, policy, educational and professional organizational enablers, which drive a digital health focused approach across all the healthcare sectors, in a coordinated and contextual manner.

Injuries from exposure to blasts are of significant concern in military operational settings, including tactical training, and is associated with self-reported concussion-like symptomology and physiological changes as increased intestinal permeability (IP) investigated herein. Timeseries gene expression and IP biomarker data were generated from “breachers” exposed to controlled, low-level explosive blast during training. Samples from 30 male participants at pre, post, follow-up blast exposure the next day were assayed via RNA-seq and ELISA. A battery of symptom data was also collected at each of these time points that acutely showed elevated symptom reporting related to headache, concentration, dizziness, and slowed thinking, dissipating ~16hrs following blast exposure. Evidence for bacterial translocation into circulation following blast exposure was detected by significant stepwise increase in microbial diversity (measured via alpha-diversity p=0.049). Alterations in levels of IP protein biomarkers (i.e., Zonulin, LBP, Claudin-3, I-FABP) assessed in a subset of these participants (n=23) further evidenced blast exposure associates with IP. The observed symptom profile was consistent with mTBI and was further associated with changes in bacterial translocation and intestinal permeability, suggesting that IP may be linked to a decrease in cognitive performance. These preliminary findings show for the first

Postpartum depression (PPD) has serious effects on maternal and infant morbidity and mortality. This study aimed to determine the prevalence of postpartum depression in mothers of under-twos in military barracks in Lagos. The Edinburgh Postnatal Depression Scale (EPDS) and a modified version of the General Help-Seeking questionnaire (GHSQ) were administered to 316 mothers of under-twos in 3 of 12 military barracks in Lagos, Nigeria to determine PPD and major depressive events (MDE). Risk of PPD was established at EPDS scores of >12. Good help-seeking practices were ascribed to scores of 20 or more on the GHSQ. Risk of PPD was found in 15.5% of respondents, and good help-seeking in 3.8% and 11.4% for personal/emotional and harming self/baby respectively. Bivariate analysis using Chi square showed statistically significant positive associations between lower scores for EPDS and higher educational levels of respondents, perception of partner support and being in lower wealth quintiles (p<0.05). Use of the EPDS was accepted among mothers of children aged under two years. Opportunities to educate pregnant women and new mothers about PPD using existing social networks, perinatal and infant screening programmes in the barracks can be leveraged upon to improve mental health delivery as part of maternity care.

This paper investigates the periodic and quasi-periodic orbits in the symmetric collinear four-body problem through a variational approach. In Section 3, we analyze the conditions under which homographic solutions minimize the action functional. We demonstrate that these solutions for four equal masses arranged in a linear configuration are indeed the minimizers of the action functional and compute the minimum value of the action functional for these solutions. Additionally, we employ numerical experiments using Poincaré sections to explore the existence and stability of periodic and quasi-periodic solutions within this dynamical system. Our results provide a deeper understanding of the variational principles in celestial mechanics and reveal complex dynamical behaviors that are crucial for further studies in multi-body problems. The findings have significant implications for theoretical research and practical applications in astrodynamics and space mission planning.

Understanding the vulnerability of areas and the likelihood of specific disasters, particularly earthquakes, is one of the most important issues in Iran. One of the major concerns in Iran is the resilience of rural communities. The present study is devoted to spatial analysis of risk in rural areas and the evaluation of preparedness in the rural districts of the city of Abhar. In particular, this study evaluates the resilience to earthquakes. The research was conducted in two parts in which the first part has used the VIKOR Multiple criteria decision making model as well as the employment of this model in the ArcGis. The second part of the study used field studies, in the form of questionnaires, to evaluate the readiness of the local population against the risks of earthquakes. Four indicators, individual, physical, economic abilities and access, were assessed. The population included rural districts, where statistical samples were villagers. Results of the spatial analysis indicated that 15 villages are in the high-risk areas, 24 villages were in the medium-risk areas and all other villages were in low-risk areas. In terms of readiness of the locals, the results indicated a lack of planning with regards to the four mentioned indicators.

Athlete’s heart is characterised by structural, functional, and electrical remodelling. During an exercise session, the heart increases the use of oxygen, which is associated with decreased vascular resistance in the lungs’ circulation. Left ventricular hypertrophy is an echocardiographic modification especially met in endurance athlete’s heart. Moreover, left atrial dilatation represents another important characteristic of endurance athletes. Electrical modulation in the athletic heart induces neurological modifications leading to sinus arrhythmia, bradycardia, early repolarisation, and first-grade atrioventricular (AV) blocks. Athletes' nutritional status involves the assimilation of macronutrients such as proteins, carbohydrates, and fats. Depending on the duration of physical exercise, ATP can be obtained in aerobic or anaerobic conditions. This systematic review aims to find correlations between different evaluative methods of cardiac adaptation and present the metabolism in performance athletes.

Immune checkpoint inhibitors (ICI’s) are in the forefront of advanced Non Small Cell Lung Cancer (NSCLC) treatment. Still, only 27- 46% of patients respond to initial therapy with ICI’s and of those, up to 65% develop resistance within four years. After disease progression (PD), treatment options are limited, with 10% Objective Response Rate (ORR) to second or third-line chemotherapy. In this context, ICI rechallenge is an appealing option for NSCLC. Most data on the efficacy of ICI rechallenge are based on retrospective real-world studies of small, heavily pretreated, and heterogeneous patient groups. Despite these limitations, these studies suggest that ICI monotherapy rechallenge in unselected NSCLC patient populations who discontinued initial ICI due to PD is generally ineffective, with a median Progression-Free Survival (PFS) of 1.6-3.1 months and a Disease Control Rate (DCR) of 21.4%-41.6%. However, there is a subpopulation that benefits from this strategy, and further characterization of this subgroup is essential. Furthermore, immunotherapy rechallenge in patients who discontinued initial immunotherapy following treatment protocol completion and progressed after an immunotherapy-free interval showed promising efficacy, with a DCR of 75-81%, according to post-hoc analyses of several clinical trials. Future research of ICI rechallenge for NSCLC should focus on better patient stratification, to reflect the underlying biology of immunotherapy resistance more accurately.

The military areas in Sardinia are around 234 km2, which constitutes 59.97% of the national surface affected by military easements. This situation is due to its geographic centrality in the Mediterranean. This contribution evaluates the performance of the Local Coastline Plan (LCP) and the Site Management Plan of Community Interest (SCI) in conditions of military constraint. The case study is the Municipality of Villaputzu where an important coastal military easement and the use of the coast for recreational tourism purposes coexist together through specific planning, a consequence of institutional agreements between the Municipal Administration of Villaputzu and the Ministry of Defense. The evaluation of the congruence of the specific objectives of the LCP and the SCI shows how their combined action favors the environmental enhancement of Sardinia, contributing to the formation of ecosystem services, even in particular conditions arising from military easements. These are sites that pass from the status of "anti-commons" to "semi-commons". In fact, the military release process in Sardinia, together with the promiscuous military and civil use, activates unique governance policies of their kind that find a significant field of application in Sardinia to guarantee a sustainable renewal of economic development of the ‘semi-commons’ awaiting to become ‘commons’

Current microbiological methods for pneumonia diagnosis require invasive specimen collection and time-consuming analytical procedures. There is a need for less invasive and faster methods to detect lower respiratory tract infection. The analysis of volatile metabolites excreted by pathogenic microorganisms provides the basis for developing such a method. Given the synergistic role of Candida albicans in increasing the virulence of pathogenic bacteria causing pneumonia and the cross-kingdom metabolic interactions between microorganisms, we compare the emission of volatiles from Candida albicans yeasts and the bacteria Staphylococcus aureus using single and mixed co-cultures and apply that knowledge to human in vivo investigations. Gas-chromatography-mass spectrometry (GC-MS) analysis resulted in the identification of sixty-eight volatiles that were found to have significantly different levels in cultures compared to reference medium samples. Certain volatiles found in co-culture originated mainly from C. albicans metabolism (e.g., isobutyl acetate), whereas other volatiles primarily came from S. aureus (e.g., ethyl 2-methylbutyrate). Isopentyl valerate reflects synergic interactions of both microbes, as its level in co-cultures was found to be approximately three times higher than the sum of its amounts in monocultures. Hydrophilic-lipophilic balanced (HLB) coated meshes for thin-film microextraction (TFME) were used to pre-concentrate volatiles directly from bronchoalveolar lavage (BAL) specimens collected from patients suffering from ventilation-associated pneumonia (VAP) that was caused explicitly by C. albicans and S. aureus. GC-MS analyses confirmed the existence of in vitro-elucidated microbial VOCs in human specimens. Significant differences in BAL-extracted amounts respective to the pathogen causing pneumonia were found. The model in vitro experiments provided evidence that cross-kingdom interactions between pathogenic microorganisms affect the synthesis of the volatile compounds. The TFME meshes coated with HLB particles proved to be suitable for extracting VOCs from human material, enabling the translation of in vitro experiments on the microbial volatilome to the in vivo situation involving infected patients. This indicates the direction that should be taken for further clinical studies on VAP diagnosis based on volatile analysis.

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.

Background and Objectives: ARNE score was developed for the prediction of difficult airway for both general and ENT surgery with a universal cut-off value. We tested the accuracy of this score in the case of laryngeal surgery and provided an insight of its combination with flexible laryngoscopy. Materials and Methods: This prospective pilot clinical study included 100 patients who were being scheduled for microscopic laryngeal surgery. We have calculated ARNE score for every patient and flexible laryngoscopy was provided preoperative. Difficult intubation was assessed according to intubation difficulty score (IDS). Results: A total of 33% patients had difficult intubation according to IDS. ARNE score showed to be accurate for prediction of difficult intubation in laryngology with P&lt;0.0001 and AUC 0.784. Flexible laryngoscopy showed to be an independent parameter with P&lt;0.0001 and AUC 0.766. We have defined a new cut-off value of 15.50 for laryngology, according to AUC curve. After the patients were divided in two groups, according to the new cut-off value and provided cut-off value, AUC improved to 0.707 from 0.619 respectively. Flexible laryngoscopy improved the prediction model of ARNE score to AUC 0.882 and of new cut-off value to AUC 0.833. Conclusions: It is recommended to use flexible laryngoscopy together with ARNE score in difficult airway prediction in patients with laryngeal pathology. Also, universally recommended cut-off value of 11 can not be effectively used in laryngology and a new cut-off value of 15.50 is recommended.

Artificial Intelligence innovations, such as chatbots and specialized education suggestion tools, provide potential interactive and on-demand pedagogical engagement between non-Christians and Christians with Christianity. However, there is little empirical research on the readiness, acceptance, and adoption of A.I.'s involvement in religious education in a secular state, such as Vietnam. This research addresses the literature gap by providing an entrepreneurial analysis and customer perspectives on the ideas of A.I.'s involvement in religious education. Specifically, the study explores whether the Vietnamese across different ages and religious orientations accept and have enough skills to adopt A.I.'s religious education innovation. The interview sample is 32 participants, selected based on their religious orientation (Christians & Non-Christians) and age (Generation X, Generation Y & Generation Z). Most respondents are open to A.I. application in religious education except for the Church's personnel. However, only gen Z generations are fully prepared to adopt this innovation. Theoretically, the research customizes the Unified Theory of Acceptance and Use of Technology model into religious innovation context. Practically, this research acts as market research on the demand for A.I.'s religious innovation in Vietnam, an insight for future religious tech entrepreneurs.

Organizational diagnosis (OD) is a comprehensive review of an organization's objectives, re-source allocation, and utilization to achieve those objectives. This study employed OD to en-hance the effectiveness of the Department of Special Education within the Government of Punjab. A questionnaire based on Weisbord's six-box organizational model called the Organ-izational Diagnostic Questionnaire (ODQ), was administered to N=1200 participants, consist-ing of heads of top, middle, and bottom tiers at district and tehsil levels of special education schools, centers, and the main office. Out of these, 506 participants voluntarily completed the ODQ survey. The study findings indicated that the employees of the department possess a good understanding of the organization's objectives. However, there is a lack of opportunities for employee participation in departmental discussions, centralized decision-making, irra-tional task distribution, and unsupportive allocation of human resources. Additionally, there is poor communication, unsatisfactory promotions, incentives, and a lack of knowledge shar-ing among employees, as well as poor inter-relationships, conflicts, and ineffective help-seeking mechanisms. The study also revealed low readiness for change in the organization. Respondents' opinions differed significantly based on their qualifications, job experience, years served, and gender. To improve the department's capacity to absorb change, the study recommends enhancing collaboration and inter-departmental communication, soliciting comprehensive input from all tiers, and promoting employee participation, supportive supervision, and communication. The study contributes to the body of knowledge on OD and highlights the need for improved communication, collaboration, and employee participation, as well as a supportive and supervisory support system to enhance the effectiveness of organizations.

Cardiac autonomic neuropathy (CAN) is a severe complication of diabetes mellitus (DM) strongly linked to a nearly five-fold higher risk of cardiovascular mortality. Patients with Type 2 Diabetes Mellitus (T2DM) are a significant cohort in which these assessments have particular relevance to the increased cardiovascular risk inherent in the condition. This study aimed to explore the subtle correlation between the Ewing test, Sudoscan-cardiovascular autonomic neuropathy score, and cardiovascular risk calculated using SCORE 2 Diabetes in individuals with T2DM. The cohort consisted of 211 patients diagnosed with T2DM with overweight or obesity without established ASCVD, aged between 40 to 69 years. The prevalence of CAN in our group was 67.2%. In the study group, according SCORE2-Diabetes, four patients (1.9%) were classified with moderate cardiovascular risk, thirty-five (16.6%) with high risk, and one hundred seventy-two (81.5%) with very high cardiovascular risk. On multiple linear regression, the SCORE2-Diabetes algorithm remained significantly associated with Sudoscan CAN-score and Sudoscan Nephro-score and Ewing test score. Testing for the diagnosis of CAN in very high-risk patients should be performed because approximately 70% of them associate CAN. Increased cardiovascular risk is associated with sudomotor damage and that Sudoscan is an effective and non-invasive measure of identifying such risk.

Some of the recent large-scale national projects in South Korea are delayed or suspended due to belated responses to risk occurring on site. Currently, the Far East District (FED) project is being implemented to relocate the US Army bases from Yongsan to Pyeongtaek. Because of lack of experience and understanding about the characteristics of such a project, the deadline of taking over to the US Army Korea has been missed. This study identifies problems of each participant in the Yongsan Relocation Plan (YRP) of the US Army Korea with respect to construction project management and establishes a risk management strategy reflecting characteristics of FED project. To derive significant risk factors influencing YRP, various field data like weekly and monthly reports and other reports on construction condition are analyzed, and experts’ advices are collected and a survey is conducted. Mediators and latent variables are ultimately obtained. Furthermore, a structural equation model is used to both analyze and evaluate complex causal relations among many variables of YRP. The impact of risk factors on the schedule, quality and cost of the project is analyzed. In particular, the case of Site A is examined to see how the project is affected by those risk factors.

This study aimed to elucidate the perception gap regarding instructional matters between special education teachers and vocational rehabilitation practitioners involved in transition support in Japan. To this end, 126 vocational support providers affiliated with the Employment and Life Support Centers for persons with disabilities, which are vocational rehabilitation institutions in Japan, and 129 special education teachers from schools for students with intellectual disabilities in Prefecture X, Japan, were surveyed. They were asked to respond on the importance of teaching skills that constitute vocational readiness by means of a questionnaire comprising 25 items across five layers: vocational aptitude, basic work habits, interpersonal skills, daily living management, and health management, both during school and after graduation. The results revealed a perception gap in each of the first layer, vocational aptitude, and second layer, work habits. Additionally, only in the second layer, work habits, did special education teachers recognize the importance of instruction more during the school period than after graduation. Moving forward, it is necessary for both institutions involved in transition support to collaborate, focusing on students with disabilities based on the identified gap.

The Roma population constitutes the largest ethnic minority in Europe, however, data regarding the prevalence of non- communicable diseases are still scarce in the medical literature. The aim of this study was to assess the clinical and metabolic particularities of a Roma population with diabetes, in comparison with a group of Romanian Caucasians. We conducted an observational, transversal study and evaluated 808 adult patients with diabetes mellitus, from a tertiary hospital providing diabetes care, aged between 18 and 89 years old, of whom the majority were men (52.84%). Most of them had type 2 diabetes mellitus (T2DM), reaching 95.1% the Caucasian group and 87.8% among the Roma patients. 81.1% of the Caucasian patients had hypertension, approximately 15% higher than the Roma group, while more than half of the patients in both groups had obesity. There were no differences concerning myocardial infarction, however, the number of patients with history of stroke was 2.1 times higher in the Roma group compared to Caucasians. Chronic kidney disease was present in 22.1% of the Roma patients, 33.25% had retinopathy, and 72.7% presented polyneuropathy. The prevalence of cardiovascular risk factors, cardiovascular disease and microvascular complications among the study Roma population are quite significant, underscoring the importance of ethnic disparities in approaching healthcare management strategies.

In the last two decades, the application of composite structures in many industrial sectors has been made progressively. For the current major scientific and technological challenge, the energy transition with sustainable and eco-friendly initiatives, the polymer matrix laminated composites have been revealed as an excellent alternative for the renewable energy sector. In this context, the knowledge about mechanical behavior of multiphase materials is required. Then, researches related to macro, mesomechanical and multiscale approaches are very important to improve accuracy of the models to predict effective mechanical properties and to develop a better understanding about complex phenomena such as progressive damage, creep and fatigue. Due to theses needs, this research is a synthesis of fundamentals and advanced topics concerning to global modeling of laminated composite structures, layerwise analyzes and micro-macromechanical models, in which mainly fiber, matrix, interface and damage characteristics are studied and used in the macroscale approach. At the end of this study, some final remarks and a trend analysis are proposed based on literature consulted, in other words, expectations for the future works are made by the authors.

Psychological readiness following Anterior Cruciate ligament Reconstruction (ACLR) correlates with different return to sport outcomes. However, the relationship between strength and power and psychological readiness remains unexplored. The aim of this study was to investigate the relationship between the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) scores and various hamstrings and quadriceps strength and power variables. Twelve participants (20.7±2.5 years old; 174.2±7.5 cm; 70.2±8.5 kg; 18.2±8.3% of body fat) who had an ACLR nine months or more before the study completed the ACL-RSI questionnaire and isokinetic strength testing of the hamstrings and quadriceps (60°.s-1 and 180°.s-1). Based on ACL-RSI scores, they were divided into “cases” and “controls”, deemed not psychologically ready and psychologically ready to return to previous sport performance (PILOS), respectively. The main findings are that quadriceps’ and hamstrings’ rate of torque development (RTD) and time since surgery were determinants of psychological readiness following ACLR. Furthermore, compared to controls cases showed significantly lower angle-specific quadriceps and hamstrings torque close to extension and lower RTD, but no difference in peak torque. These results suggest that physiotherapists should facilitate athletes’ RTS by focusing on the restoration of RTD and strength at angles close to full knee extension.

Background: Coronavirus disease (COVID-19) has caused one of the worst global pandemics in recent decades. It has disrupted education systems worldwide, leading to a forced shift from traditional face-to-face to blended or fully distanced learning, requiring a higher level of student readiness for self-directed learning (SDL) and a more internal locus of control (LOC). Objective: This study explored the relationship between locus of control and level of readiness for SDL among Saudi nursing students and whether the COVID-19 pandemic has impacted this relation-ship. Methods: a cross-sectional correlational descriptive study was conducted to survey 277 Saudi nursing students enrolled in the bachelor program at one of the reputable universities in Saudi Arabia. An E-questionnaire containing two scales, the Self-Directed Learning Readiness Scale for Nursing Education, and the Locus of Control Scale, was used to collect data in addition to the selected participants’ characteristics. Results: Nursing students had a moderate-to-low level of readiness for SDL (mean = 144.0), and the majority had an external LOC. There was a significant association between the locus of control and level of readiness for self-directed learning (r = 0.19*, p = 0.001), and the internal locus of control was more significantly associated with self-directed learning (r = 0.22*, p = 0.0001) than with external locus of control. Conclusion: The study findings indicate a propensity of respondents towards an external locus of control, whereas most of the respondents’ reported levels of readiness ranged between low and moderate across all dimensions of self-directed learning. This study was not registered.

The impacts of climate change are already felt across the globe, and (SIDS) are at the forefront. Small Islands Developing States (SIDS) are extremely vulnerable to climate change and adaptation is crucial, however they often lack funding or the fiscal capacity to make the necessary invest-ments and require support from climate finance instruments. The Green Climate Fund (GCF) was designed with the objective of achieving a “paradigm shift” towards low-carbon and climate resilient country-driven development pathway. Despite the amounts invested, assessing the impacts of climate finance on adaptation and adaptive capacity, particularly at the institutional level remains a challenge. Researchers identified two key components for more efficient adapta-tion policies at the national level: the degree of adaptation mainstreaming and institutional adaptive capacity. In SIDS, institutional capacity at the national level is seen as a key component to achieve the objectives of climate change strategies, and is supported by several programmes, including the Green Climate Fund Readiness Preparatory Support Programmes. However, to date few studies have analysed the linkages between climate finance, adaptation mainstreaming and adaptive institutional capacity. Through the review of the Readiness Grants and semi-structured interviews in three Caribbean SIDS, this research assess how climate finance may promote in-stitutional change through the mainstreaming of adaptation policies at the national level and contribute to more institutional adaptive capacity. It shows that the grants had a positive impact, which can be limited to by the strength of the institutions in place. These results demonstrate that access to climate finance can create a window of opportunity for countries to accelerate institu-tional change and allow to make recommendations on how to maximise the impacts adaptation funds. More in-depth studies would be needed to examine the complementary influence of the different climate finance flows (multilateral or bilateral) and their interplay with national institu-tional mechanisms.

Abstract Background: Occipital neuralgia is a debilitating condition and traditional treatments often provide limited or temporary relief. Recently, ultrasound-guided hydrodissection of the greater occipital nerve (GON) has emerged as a promising minimally invasive approach. Objectives: To describe two novel ultrasound-guided hydrodissection with 5% dextrose for GON and discuss their advantages, disadvantages, and considerations. Methods: Two case reports are presented. Case 1 describes a lateral decubitus approach for hydrodissecting the GON between the semispinalis capitis (SSC) and obliquus capitis inferior (OCI) muscles. Case 2 details a cranial-to-caudal approach for hydrodissecting the GON within the SSC and upper trapezius (UT) muscles when the GON pass through these two muscles. Results: Both patients experienced significant and sustained pain relief with improvements in function and quality of life. Conclusions: Ultrasound-guided GON hydrodissection using 5% dextrose is a promising treatment for occipital neuralgia. The lateral decubitus and cranial to caudal approaches provide additional options to address patient-specific anatomical considerations and preferences.

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.

Paediatric supraventricular tachycardia (SVT) is a common arrhythmia of great clinical significance. If not treated promptly, it can cause heart failure and cardiogenic shock. Depending on the patient’s condition SVT treatment involves vagal manoeuvres, pharmacological or direct current cardioversion. The goal of acute SVT management is to immediately convert SVT to normal sinus rhythm (NSR) and prevent its recurrence. Adenosine is recommended as first-line treatment for stable SVT by the European Resuscitation Council (ERC) and American Heart Association (AHA) guidelines when vagal manoeuvres have proven ineffective. ERC and AHA guidelines recommend the intravenous route of administration. Intraosseous (IO) administration technique is also possible, but still relatively unknown. The aim of this paper is to describe a 3.5-year old child with SVT which was converted to NSR following IO administration of adenosine. Successful conversion was achieved in the second attempt with the adenosine dose. In the described case, there was no recurrence of SVT.

In the paper, a study of the performance of unmanned ground vehicle (UGV), establishes numerical simulation model of the chassis system by three-dimensional software and finite element analysis software. Based on the numerical modelling and analysis, the work focuses on study of the strength and stiffness of the vehicle's chassis and researched the distribution of stress and deformation under the extremal condition. The paper also presents an autopilot design with new cascade control system for an autonomous motion of an unmanned ground vehicle based on Proportional-Integral-Derivative (PID) and Feed-Forward (FF) control. The PID-FF controller is a part of dedicated for presented UGV used in a hybrid control system for precise control and stabilization, necessary to increase the vehicle motion stability and maneuvers precision. The hybrid PID-FF control system proposed for the ground vehicle model gives a satisfactory quality of control, while maintaining the simplicity of the control system. Presented tests performed in area of mechanical design and control analysis gives good results and proves usefulness of designed unmanned device.

The first treatments with dental implants had low success rates (75%). Nowadays, oral rehabilitation with titanium dental implants has a high success rate (95-98%). The success rate significantly increases due to increased scientific knowledge about osseointegration, changes in surgical techniques, and the development of implant surface treatments. Despite the high success rate of implants, no protocol defines the time for the prosthesis to be installed and loaded after surgery. This work compares a new dental implant's primary (mechanical) and secondary (osseointegration) stability. Dental implant with micro- and nano-roughness surface was placed in 24 patients with a minimum of 35 N.cm and a maximum of 60 N.cm. Primary stability was quantified with a torque wrench and Ostell Mentor. The secondary stability 45 and 60 days after surgery was measured with Ostell. The results showed no statistical difference in secondary stability at 45 and 60 days postoperatively among implants. The success rate of dental implants can be associated with the surface morphology with micro and nano-roughness and the shape of the fillets of the implant threads. When the manufacturer's guidelines are followed, it is possible to prosthetically rehabilitate the patient with an implant 45 days after surgery.

As we know, the economy of science is to achieve optimal gains using scarce resources. Similarly, a problem where economies of the world are trying to resolve it is the issue of how to achieve an optimal economic contribution from limited tourism resources. According to the fact that global studies and statistics indicate that good governance is considered as the most important factor in developing countries and is considered as a strong governance of the development and as Information and Communication Technology (ICT) is effective in the interactions and economic and social exchanges of any society, it is the link between the tourism industry and the technology under the form of a robust tool and utilitarian in the tourism process called E-tourism can play a significant role. Therefore, the aim of this study was to investigate the effect of network Readiness Index and good governance on income from tourism industry. In this study, data and information about 14 selected countries were collected from Southwest Asia in the annual period of 2016-2011 in the form of panel data and the proposed model was used and estimated by the generalized torques system method. The estimated results of the model indicate that both hypotheses have a positive and significant impact on the amount of Network Readiness Index in the income of tourism industry, as well as the positive and significant effect of the index the amount of income from the tourism industry is confirmed, and their impact has been positive and significant, as well as exchange rate variables, revenue and commercial openness, also have a positive and significant effect on revenues of the tourism industry.

Endometriosis is known to be a chronic, debilitating disease. The pathophysiological mechanisms of endometriosis development include local chronic inflammation and a certain degree of local immune deficit. We investigated the relationship between the endometriosis severity, IL-8, IL-10, BDNF, VEGF-A serum and tissue levels, patient-related pain, and physical activity in a cohort of 46 patients diagnosed with endometriosis who underwent surgery. The same panel of biomarkers was investigated in a control group of 44 reproductive-aged patients with non-endometriotic gynecological pathology who underwent surgical intervention. Our data show a high statistical significance between tissue expression of IL-8, IL-10, patient-related pain and the severity of endometriosis. No relationship was identified between serum or tissue levels of VEGF-A and BDNF and the severity of endometriosis. These results validate the presence of local chronic inflammation and immune deficit, thereby creating, alongside other studies in the field, an opportunity for the development of innovative and personalized treatment approaches in endometriosis.

Background: Generative artificial intelligence (Gen-AI) has emerged as a transformative tool in research and education. However, there is a mixed perception about its use. This study assessed the use, perception, prospect, and challenges of Gen-AI use in higher education. Methods: This is a prospective, cross-sectional survey of university students in the United Kingdom (UK) distributed online between January and April 2024. Demography and perception of Gen-AI and other AI tools were assessed and statistically analysed to assess the difference in perception between various subgroups. Results: A total of 136 students responded to the survey of which 59% (80) were male. The majority were aware of Gen-AI and other AI use in academia (61%) with 52% having personal experience of the tools. Grammar correction and idea generation were the two most common tasks of use, with 37% being regular users. Fifty-six percent of respondents agreed that AI gives an academic edge with 40% holding a positive overall perception about the use in academia. Comparatively, there was a statistically significant difference in overall perception between different age ranges (I² = 27.39; p = 0.002) and levels of education (I² = 20.07; p < 0.001). Also, 83% of students believe AI use will increase in academia with over half agreeing it should be integrated into learning. Plagiarism (33%), privacy issues (14%), and lack of clarity by the university (13%) remain the top concerns regarding the use of Gen-AI and other AI tools in academia. Conclusions: Gen-AI and other AI tools are being used and their use will continue to grow in higher education. While current use is challenging due mainly to plagiarism fear and lack of clarity by the university, most users believe AI should be integrated into the university curriculum.

Variable and sometimes contrasting effects of using artificial rhizobium inocula to increase grain legume performance have been reported. The objectives of this systematic review and meta-analysis were therefore to (i) estimate the overall effect of rhizobium inocula on grain yield and protein content and (ii) identify potential confounding factors that explain the observed variation. A web of Science database literature search was carried out in 2016. Data from all field experiments, greenhouse and pot experiments that compared grain yields and protein contents in Rhizobium/Bradyrhizobium-inoculated with non-inoculated control crops were extracted and analyzed using previously described unweighted and weighted meta-analysis protocols. GRADE assessments of the strength of evidence of results from the weighted meta-analyses were carried which included an assessment of the risk of publication bias. Results: For unweighted meta-analyses we identified eligible data in 236 and 36 studies for grain yield and protein content respectively. For weighted meta-analyses we identified eligible data in 92 and 8 studies for grain yield and protein content respectively. Rhizobium inoculation was found to (i) significantly increase grain yield in both the unweighted (mean percent difference: 41%, 95%CI 36,46, p&lt;0.0001) and weighted meta-analysis (Standardized mean difference: 1.56, 95%CI 1.26,1.87, p&lt;0.0001) and (ii) significantly increase protein content in the unweighted meta-analysis (mean percent difference: 11%, 95%CI 5,18, p&lt;0.0001), but not the weighed meta-analyses which only detected a trend (0.1&gt;p&gt;0.05) towards higher protein content in inoculated grain legume crops. Multi-level model-based weighted meta-analyses suggest that the (i) type of experiment, (ii) type of fertilizer used in experiments, (iii) grain legume type/species and (iv) the country in which experiments were carried out, were confounding factors. The main limitation of the evidence is that a large number of publications did not report measures of variation and could therefore not be included in the more scientifically sound weighted meta-analyses. However based on the large evidence-base available for grain yield it can be concluded that overall Bradyrhizobium/Rhizobium seed inoculation results can increase grain yield by ~40% compared with non-inoculated grain legume crops.

AbstractIntroduction: Increasing knowledge of obstetric danger signs (ODS) and encouraging birth preparedness and complication readiness (BPCR) practices are strategies to increase skilled maternal health service utilization in low-income countries. One of the methods to increase mothers' knowledge about ODS and promote BPCR practice is through health education intervention (HEI). However, the effect of context-specific community-based health education led by women's groups on these outcomes has not been comprehensively studied, and the existing evidence is inconclusive. Thus, we aimed to evaluate the effect of a context-specific community-based HEI led by women's groups on mothers' knowledge regarding ODS and BPCR practices in southern Ethiopia.Methods: An open-label, two-arm parallel group cluster-randomized controlled trial was conducted from January to August 2023 on pregnant women from 24 clusters (kebeles) (12 interventions and 12 controls) in the northern zone of the Sidama region. The Open Data Kit smartphone application was utilized to collect data. The intention-to-treat analysis was used to compare outcomes between groups. We fitted multi-level mixed-effects modified Poisson regression with robust standard error to account for between and within cluster effects. Results: One thousand and seventy pregnant women (540 in the intervention and 530 in the control clusters) responded to this study, making the overall response rate 95.02%. Excessive vaginal bleeding (94.3% in the interventional group vs. 88.7% in the control group) was the commonest ODS mentioned during childbirth. Overall, 68.7% of women in the intervention group and 36.2% of mothers in the control group had good knowledge of ODS (P-value < 0.001). Saving money and materials (97.1% in the interventional group vs. 92.7% in the control group) was the most frequently practiced BPCR plan. Overall, 64.3% of women in the intervention group and 38.9% of mothers in the control group practiced BPCR (P-value < 0.001). HEI significantly increased overall knowledge of ODS (adjusted risk ratio [ARR]: 1.71; 99% CI: 1.14-2.57) and improved overall BPCR practice (ARR: 1.55; 99% CI: 1.02-2.39). Conclusions: A community-based HEI led by women's groups improved mothers' knowledge regarding ODS and BPCR practices in a rural setting in southern Ethiopia. Interventions designed to increase women's knowledge of ODS and improve BPCR practice must implement context-specific, community-based HEI that aligns with World Health Organization recommendations. Trial registration: NCT05865873

Aiming at the problem of UAV cluster configuration reconstruction, in order to obtain the cluster reconstruction method, the theory and simulation of cluster reconstruction control strategy is studied by simplifying the model，deducing the theoretical formula and analyzing the example. Taking 10 UAVs cluster as an example, the distribution of UAVs in different configurations was analyzed. According to the change of cluster configuration, the principle of formation reconstruction and the execution ability of configuration, the cluster capability was analyzed. The group behavior is modeled by group behavior rules, reconfiguration topology analysis and reconfiguration cost measurement. Based on the cluster parameters and configuration characteristics, simulation experiments were carried out to obtain the change curve of the reconstruction cost and time and the trajectory movement diagram of the UAV in different configurations.

This study is aimed to assess the prevalence of Coxiella burnetii infection among veterinary medicine students from two Bulgarian Universities, located in Sofia and Stara Zagora. A total of 185 veterinary students blood samples were collected and tested for the detection of C. burnetii phase II antibodies and presence of DNA using an enzyme-linked immunosorbent assay (ELISA) and end-point PCR test, respectively. Out of all samples, 29.7% were positive for at least one C. burnetii phase II antibody marker or by PCR test. Veterinary students from Stara Zagora showed significantly seropositive status of Q fever (33.6%), then those who studied in Sofia (23%). The evidence for recent exposition with detection of anti-C. burnetii IgM (+) antibodies had 14.6%. Seroprevalence among students in Stara Zagora was higher (15.3%). Anti-C. burnetii phase II IgG antibodies were detected in 21.6% examined samples. Our study revealed a higher seropositivity among male students (32.8%) as compared to the female ones (16.0%). End-point PCR assay detected as positive 5.9% blood samples. The relative risk (RR) of Q fever exposure for male students was 40.7%, whereas for female (24.6%). Findings from this study indicated that the C. burnetii infection is widely distributed amongst veterinary students from Bulgaria. The study emphasizes the need for improved safety protocols and infection control measures in veterinary training programs.

This study aimed to investigate the knowledge of patients with hypertension about their condition, adherence to antihypertensive medication, and the factors influencing it. A cross-sectional study was conducted in two cardiology outpatient clinics of two tertiary hospitals, in Greece. The study included 188 patients diagnosed with hypertension. The patient’s knowledge about their disease and adherence to medication were assessed by using the HK-LS and A-14 scales, respectively. Patients had sufficient knowledge levels about their disease, but significantly low levels of adherence to medication. Patients with higher knowledge levels were more adherent to medications [r(188) = 0.885, p &lt; 0.001]. By using multivariate analysis, higher age (p = 0.018), residence in a more populous area (p = 0.041), more years with the disease (p = 0.012), and a lower number of medications (p = 0.03) were associated with higher levels of knowledge. Conversely, younger age (p = 0.036), lower educational levels (p = 0.048), fewer years with the disease (p = 0.001), and a higher number of medications (p = 0.003) were associated with lower adherence to medication. The Greek patients' hypertension knowledge was sufficient, however, adherence to medication was significantly low. Healthcare managers could utilize our findings to design targeted interventions for improving adherence to medication for these patients.

Although mammography has been the gold standard for early detection of breast cancer, if a woman has dense breast tissue, a false negative diagnosis may occur. Breast ultrasound, whether hand-held or automated, is a useful adjunct to mammography but adds extra time and cost. The primary aim was to demonstrate that our second-generation Aceso system, which combines full-field digital mammography (FFDM) and automated breast ultrasound (ABUS) in a single platform, is able to produce improved quality images that provide clinically meaningful results. Aceso was first tested using two industry standards: a CDMAM phantom to assess the FFDM images; and the CIRS 054GS phantom to evaluate the ABUS images. In addition, 25 women participated in a clinical trial: 14 were healthy volunteers while 11 were patients referred by the breast clinic at Groote Schuur Hospital. The CDMAM phantom results showed the FFDM results were better than EUREF’s standard of “acceptable” and were approaching “achievable”. The ABUS results showed lateral and axial spatial resolution of 0.5 mm and adequate depth penetration of 80 mm. Our second-generation Aceso system, with its improved quality of clinical FFDM and ABUS images, has demonstrated its potential for early detection of breast cancer in a busy clinic.

Civil construction is one of the oldest known activities in humanity, reports indicate that builders of the Roman Empire already sought the reuse of materials. Currently, considering the depletion of the supply of natural resources, the recycling of solid waste from construction and demolition (CDW), not only provides new products, but also offers ecological and economic alternative. In this context, this research seeks new variables for the disposal of waste from construction and demolition having in the composition of artificial finishing stones an odd possibility to be analyzed. In this research was developed and analyzed a new composite from the construction and demolition waste using as a binder an orthophthalic polyester resin. The residue was sieved and separated by granulometry by the simplex centroid method, the best compacted mixture was determined statically by ANOVA and the Tukey test. The residue was characterized by X-ray fluorescence and the resin by infrared spectroscopy by Fourier transform. Artificial rock plates were produced with 85% residue and 15% resin, by mass, by vibro system, compression and vacuum, later were cut for mechanical, physical and chemical tests. Analysis was performed by scanning electron microscopy of fractured compositions as well as grain sizes. The artificial stone with the best results presented density of 2,256 g/cm3, water absorption of 0.69%, apparent porosity of 1.55%; bending strength of 34.74 MPa and compression of 111.96 MPa; good results in the alterability and thermal tests. In this satisfactory scenario, the use of this waste in the composition of artificial rocks is promising because it directly meets the concept of sustainable development; replacing the concept of end-of-life of the linear economy, by new circular flows of reuse, restoration and renovation, in an integrated process the circular economy; as well as the quality of the final product with properties similar to the artificial rocks already marketed.

Polyphenols and fermentable fibers have shown favorable effects on gut microbiota composition and metabolic function. However, few studies have investigated whether combining multiple fermentable fibers or polyphenols may have additive beneficial effects on gut microbial states. Here, an in vitro fer-mentation model, seeded with human stool combined from 30 healthy volunteers, was supplemented with blends of polyphenols (PP), dietary fibers (FB) or their combination (PPFB) to determine influence on gut bacteria growth dynamics and select metabolite changes. PP and FB blends independently lead to significant increases in the absolute abundance of select beneficial taxa, namely Ruminococcus bromii, Bifidobacterium spp., Lactobacillus spp. and Dorea spp. Total short chain fatty acid concentrations, relative to non-supplemented control (F), increased significantly with PPFB and FB supplementation, but not PP. Indole and ammonia concentrations decreased with FB and PPFB supplementation, but not PP alone while increased antioxidant capacity was only evident with both PP and PPFB. These findings demonstrated that, while the independent blends displayed selective positive impacts on gut states, combination of both blends provided an additive effect. The work outlines the potential of mixed substrate blends to elicit a broader positive influence on gut microbial composition and function to build resiliency toward dysbiosis.

Milk serves as a crucial source of natural bioactive compounds essential for human nutrition and health. The gastrointestinal digestion of milk proteins releases various biologically active peptides that positively impact human health and enhance physiological performance. With the growing production of cheese, Greek yogurt, and other dairy products, the volume of unutilized acid whey is significantly increasing. Acid whey, containing almost all whey proteins and approximately one-quarter of casein, presents a valuable raw material for generating peptides with potential health benefits. These peptides exhibit properties such as antioxidant, antimicrobial, anti-inflammatory, anticarcinogenic, antihypertensive, antithrombotic, opioid, mineral-binding, and growth-stimulating activities, contributing to improved human immunity and the treatment of chronic diseases. Enzymatic hydrolysis of milk proteins has been developed as a method to produce these peptides, facilitating their use in food fortification. To incorporate whey into functional beverages, it undergoes fermentation by lactic acid bacteria with proteolytic activity. To specifically enrich these beverages with peptides exhibiting targeted bioactivities, it is essential to select lactic acid bacteria strains possessing the requisite protease profiles. Additionally, the sensory properties of the final product can be enhanced using starter cultures with diverse metabolic capabilities, even in the absence of added flavoring agents. Given the imperative to develop waste-free technologies and enhance the profitability of the dairy industry, there is a growing need to efficiently utilize and transform acid whey into a broad spectrum of valuable products and food additives. This approach is justified not only by the nutritional benefits of the bioactive components in whey but also by the commercial potential of safe and health-enhancing products.

The paper focuses on the application of a multilevel, integrative and territorial approach to the protection of cultural heritage through planning instruments in Serbia. It points out the problems of the sectoral approach and discusses international recommendations that can be integrated into the planning methodology. The case study is the area of Djerdap National Park, which has an already established international and national importance. The research suggests that the cultural heritage in the area, with the exception of the Roman limes, is still recognized at the level of individual localities. The study emphasizes the importance of aligning all levels of governance to safeguard the whole spatial entity rather than focusing solely on its particular areas. The interna-tional and national importance of the planning area contributes to the strengthening of awareness of heritage and its institutional protection. However, the vitality of the area, which is key to its sustainable development, comes from the local level. Planning documents contribute to the inte-gration of local values and local communities into development programs and projects.

In order to shorten the detection time and improve the average precision on embedded devices, A lightweight and high accuracy model is proposed for passion fruit in complex environments (backlight, occlusion, overlap, sunny, cloudy, rainy). Firstly, replacing the backbone network of YOLOv5 with a lightweight GhostNet model reduces the number of parameters and computation while improving detection speed. Secondly, a new feature branch is added to the GhostNet network, and the feature fusion layer in the neck network is reconstructed to effectively combine the lower-level and higher-level features, which not only improves the accuracy of the model but also maintains its lightweight. Finally, the knowledge distillation methods are used to transfer the knowledge from the more capable teacher model to the less capable student model, which significantly improving the detection accuracy. The improved model is denoted as G-YOLO-NK. The average accuracy of the G-YOLO-NK network is 96.00%, which is 1.00% higher than the original YOLOv5s model. Furthermore, the improved model size is 7.14MB, reduced to half of the original model, and the real-time detection frame rate is 11.25 FPS on the Jetson Nano. Compared to the state-of-the-art model, the proposed model outperforms them in terms of average precision and detection performance. The present work provides an effective model for real-time detection of passion fruits in complex orchard scenes, which can provide valuable technical support for the development of orchard picking robots and greatly improve the intelligence level of orchards.

The impact of interaction SS with MJO on rainfall along Java Island to East Nusa Tenggara has been studied using daily rainfall observation data from 2140 weather observation stations, which are also equipped with GSMaP, OLR, and ERA5 data. There were 61 SS events found, 17 during active MJO and 44 in inactive MJO. Rainfall increases more in the western study area when the active MJO and more in the eastern study area when the inactive MJO is due to SS. SS reduces rainfall in the Jakarta region, regardless of the activity or inactivity of the MJO. SS causes extreme rainfall to only occur in a small part of certain areas, so it tends to significantly reduce the possibility of extreme rainfall. In the southern part of the IMC, SS predominates over MJO in supporting increased water vapor transport. Large-scale synoptic circulations like the monsoon, SS, and MJO can interact with local land-sea wind circulation to produce spatiotemporal variability in rainfall on Java Island. Rainfall mostly increases in the afternoon and decreases in the morning when SS occurs, whether there is MJO or not. Convective instability analysis indicates that SS increases precipitation, most likely by lowering CIN and raising VIMFC.