Patient engagement is receiving a growing attention in the healthcare context. However, although worldwide healthcare stakeholders agree that patient engagement is a priority for quality and effective care, no shared recommendations on how to promote patient engagement are currently available. Based on these premises, a Consensus Conference (CC) was promoted to address four main issues: What is the definition of Patient Engagement? How measuring Patient Engagement? What are the most recommended methodologies and the tools to promote Patient Engagement? What is the role of new technologies in promoting of Patient Engagement? The consensus was obtained through an iterative process that began with a systematic synthesis of the available literature in each domain followed by plenary expert discussions. This CC - including the systematic analysis of internationals scientific evidences (2749 sources across the major international scientific databases) together with experiences of a multi-disciplinary consortium of investigators and key stakeholders - attempted to provide the first evidence-based Expert Consensus Statement for the promotion of Patient Engagement in chronic care. These recommendations should be envisaged as inspirational principles to promote a real eco-system of engagement and might orient health services research and interventions.

Patient group engagement is increasingly used to inform the design, conduct, and dissemination of clinical trials and other medical research activities. However, the priorities of industry sponsors and patient groups differ, and there is currently no framework to help these groups identify mutually beneficial engagement activities. Methods: We conducted 28 qualitative, semi-structured interviews with representatives from research sponsor organizations (n=14) and patient groups (n=14) to determine: 1) how representatives define benefits and investments of patient group engagement in medical product development and, 2) to refine a list of 31 predefined patient group engagement activities. Results: Patient group and sponsor representatives described similar benefits: engagement activities can enhance the quality and efficiency of clinical trials by improving patient recruitment and retention, reduce costs, and help trials meet expectations of regulators and payers. All representatives indicated that investments include both dedicated staff time and expertise, and financial resources. Factors to consider when evaluating benefits and investments were also identified as were suggestions for clarifying the list of engagement activities. Discussion: Using these findings, we refined the 31 engagement activities to 24 unique activities across the medical product development lifecycle. We also developed a web-based prioritization tool (https://prioritizationtool.ctti-clinicaltrials.org/) to help clinical research sponsors and patient groups identify high priority engagement activities. Use of this tools can help sponsors and patient groups identify the engagement activities that they believe will provide the most benefit for the least investment and may lead to more meaningful and mutually beneficial partnerships in medical product development.

Individuals with low health literacy (HL) are known to have poorer health outcomes and to have higher mortality rates compared to individuals with higher HL: hence, the improvement of HL is a key outcome in modern healthcare systems. Healthcare providers are therefore asked to support patients’ literacy skills by encouraging the implementation of autonomy-supportive patient centered communication (PCC), which in turn requires the enhancement of patient engagement. Our main hypothesis is that the well-known relationship between autonomy-supportive PCC and HL is mediated by patient engagement which is known to play a role in HL promotion and that is related to PCC as well. The purpose of this study was to formulate a hypothetical structural equation model (SEM) linking PCC to patient engagement and HL. A cross-sectional survey design was employed involving 1007 Italian chronic patients. The hypothetical model was tested using SEM to verify the hypothesized mediation of patient engagement between PCC and HL. Results show that the theoretical model has a good fit indexes and that patient engagement fully mediates the relationship between PCC and HL. This finding suggests healthcare systems to implement a new paradigm where patients are supported to play an autonomous role in their own healthcare.

Milk consumption is crucial for a balanced diet, yet recent trends indicate a decline, especially in Italy. A significant factor in this decline is the altered perception of milk quality among consumers, creating a communication gap between them and other stakeholders. This study aimed to explore the discourse on social media and sentiment towards the concept of milk quality among consumers, farmers, and processors. The research adopted a Social Media Analysis to examine online community messages. A sample of 19,906 Italian comments and posts mentioning keywords Milk, Quality, Cow, and Vaccine was collected and categorized using term frequency analysis, correspondence analysis, and sentiment analysis. Results highlighted gaps in the perceptions of milk quality: farmers focused on economic issues, consumers on animal welfare and health, and processors on lactose content. For farmers, almost all comments were negative, while for processors, nearly all comments were positive. Consumers presented a more mixed picture. This work contributes to the literature by expanding research on milk quality using social media as a source of information. The findings suggest that enhancing communication and understanding among these groups could lead to more effective strategies for addressing consumer concerns, potentially reversing the declining of milk consumption.

Monitoring of clients living with HIV encompasses a specific array of activities that routinely check on various aspects of ART following its initiation depending on the availability of resources in that particular state, among other factors as per guidelines from the World Health Organisation. This is a significant practice as it promotes positive health outcomes for patients and efficient utilisation of ART regimens to reduce resistance to the medication – hence it is a measure to guard avoidable costs. It also forms a basis on which decisions are made from. It can be done clinically by assessing for signs e.g., skin rash and symptoms e.g., nausea and vomiting, checking vital organ function and measuring weights across all populations, or can be also be done by assessing specimens for their respective viral loads, white blood cell count, pregnancy status or other infections such as hepatitis B. There have not been any special indications required for one to be eligible for monitoring during ART in developing countries; all qualify for routine monitoring even though some may be more frequent than others in cases of comorbidities such as renal failure where medications can be attributed to exacerbating the condition.

COVID-19 has brought unprecedented challenges and exacerbated existing work-related struggles resulting in heightened occupational stress and impacted work performance among health caregivers. This study utilised the transactional model of stress and coping to explore the coping strategies adopted by radiology health caregivers during the pandemic with the aim to provide baseline data for enhancing preparedness and development of interventions to support staff during future health crises. A qualitative, interpretative phenomenological analysis (IPA) methodology coupled with constructivist and interpretivist philosophical views were utilised in a multi-method context to conduct semi-structured interviews and focus group discussions among 24 radiology health caregivers in the eThekwini district of KwaZulu-Natal, South Africa. Data were transcribed verbatim and manually analysed using the IPA framework. The radiology health caregivers highlighted resilience, adaptability and identified emotion-focused and problem-focused coping as their mostly preferred strategies of dealing with COVID-19 related mental distress. These included accepting professional responsibilities and duties, social coping, spiritual therapy, adaptive behavioural coping, escape-avoidance and solution-oriented approaches. The findings can guide radiology departments in developing bespoke mental health interventions to support radiology health caregivers during any future health crises.

We were tasked by Canada’s COVID-19 Immunity Task Force to describe severe adverse events (SAE) associated with emergency department (ED) visits and/or hospitalizations in immune-mediated inflammatory diseases (IMID). At 8 Canadian centres, data were collected from adults with rheumatoid arthritis (RA), axial spondyloarthritis (AxS), systemic lupus (SLE), psoriatic arthritis (PsA) and inflammatory bowel disease (IBD). We administered questionnaires, analyzing SAEs experienced within 31 days following SARS-CoV-2 vaccination. About two-thirds (63%) of 1556 participants were female; mean age was 52.5 years. BNT162b2 (Pfizer) vaccine was the most common, with mRNA-1273 (Moderna) being second. Forty-nine percent of participants had IBD, 27.4% RA, 14.3% PsA, 5.3% SpA, and 4% SLE. Twelve SAEs leading to ED visit or hospitalization were self-reported, occurring in 11 participants. SAEs included 6 ED visits (including one Bell’s Palsy 31 days after first vaccination) and 6 hospitalizations (including one Guillain-Barré syndrome 15 days after the first vaccination). Two SAEs involved pericarditis, one in SLE (considered a serious disease flare) and one in RA. Thus, in the 31 days after SARS-CoV-2 vaccination in IMID, though several serious AEs occurred, these were relatively few. As SARS-CoV2 continues to be a common cause of death, our findings may help optimize vaccination acceptance.

Management of sarcomas in specialist centers delivers significant benefits. In much of the world specialists are not available and development of expertise is identified as a major need. However the terms ‘specialist’ or ‘expert’ center are rarely defined. Our objective is to offer a definition for patient advocates and a tool for healthcare providers to underpin improving the care of people with sarcoma. SPAGN developed a discussion paper for a workshop at the SPAGN 2023 Conference, attended by 75 delegates. A presentation to the Connective Tissue Oncology Society (CTOS) and further discussion led to this paper. Core Principles were identified that underlie specialist sarcoma care. The primary principle is the multi-disciplinary team discussing every patient, at first diagnosis and during treatment. Principles for optimal sarcoma management include accurate diagnosis followed by safe, high-quality treatment, with curative intent. These Principles are supplemented by Features describing areas of healthcare, professional involvement, and service provision and identifying further research and development needs. These allow for variations because of national or local policies and budgets. We propose the term ‘Sarcoma Intelligent Specialist Network’ to recognize expertise wherever it is found in the world. This provides a base for further discussion and local refinement.

(1) Background: Second Victims are health care workers negatively affected by adverse events and are prone to developing dysfunctional coping strategies compromising not only their own, but also patient safety. An effective way to address this issue is the implementation of peer support programs. This paper reports on the effectiveness of a peer support program at the Austrian Hietzing Clinic (KHI). (2) Methods: Telephone interviews were carried out after peer support sessions using a questionnaire. Descriptive analysis was carried out reporting frequencies and proportions for nominal variables, means with standard deviations for ordinal and interval-scaled variables. (3) Results: So far, 45 peer supporters have completed telephone interviews after a peer support session. The main reasons for the session were bad news from the private sphere and death of a patient. The peer supporters rated the helpfulness of the sessions for their colleagues as very high while not feeling very burdened themselves afterwards. (4) Conclusions: Underutilization of the program is probable. However, the high rating of helpfulness of the carried-out sessions by the peer supporters in combination with them not feeling very burdened, shows that the program is safe for the peer supporters and an upscaling is warranted.

Introduction. Intra-abdominal cystic formations represent heterogeneous pathologies with varied localization and clinical manifestation. The first challenge of a giant intra-abdominal cystic lesion is identifying the organ of origin. The clinical presentation of intra-abdominal cystic lesions varies from acute manifestations to non-specific symptoms or accidental discovery. Case presentation: A 2-year-old girl presents to the emergency unit with a fever of 38.5 Celsius, loss of appetite, and apathy. The investigations showed a gigantic intra-abdominal mass whose organ belonging could not be specified. Postoperatively, a giant mesenteric lymphangioma was evident, which was completely excised. Discussions Giant cystic formations modify the anatomical reports and become space-replacing formations, and the starting point is even more challenging to assess preoperatively. Nevertheless, the careful evaluation of the characteristics of the formation, the effect on the adjacent organs, the age of the patient, and the clinical picture can provide elements of differential diagnosis.

Aim: The aim of the study is to analyze quantitatively the scientific literature covering nursing studies on patient safety. Method: The Web of Science database is queried in this retrospective bibliometric analysis to identify relevant publications. The study themes, contributing journals, countries, institutions, and authors were evaluated quantitatively. Thus, a total of 5470 publications concerning patient safety in nursing were included and analyzed. Findings: The number of studies conducted increased every year from 1992 to 2023. While the country whose articles receive the most citations (31072) is the United States of America (USA), Turkey is ranked as last with the lowest number of citations (581). Journal of Clinical Nursing, with 338 articles, appeared to have the highest number of publications, Chaboyer W. appeared to have the highest number of citations with a total of 1426 and 45 publications. The countries that have the strongest international cooperation for research in this field are the USA, England, Australia and China. Results: After examining the literature in the field of patient safety in nursing through bibliometric analysis, it is seen that themes such as patient safety, medication errors, nursing care, nursing, education, systematic review, quality care and leadership were emphasized as important considerations.

Lichen Amyloidosis (LA) is a type of cutaneous amyloidosis characterized by brownish hyperkeratotic and itchy papules on the lower leg, back, forearm or thigh. It is associated with itching and Atopic Dermatitis (AD) according to an etiopathogenetic mechanism that has not yet been fully elucidated. Currently, available therapies for this condition include oral antihistamines, laser, cyclosporine, topical corticosteroids and phototherapy, but in light of the overlap with AD, Dupilumab may also be indicated. We report the case of a female, 52 years old, suffering from AD and LA for about 27 years. She had lesions attributable to both diseases on the trunk and lower limbs associated with severe itching and had proved resistant to cyclosporine therapy. It was decided to opt for Dupilumab with induction of 2 fl of 300 mg and maintenance with 1 fl every other week. The therapy proved effective, returning a total resolution of both diseases one year after the beginning of the treatment. Dupilumab demonstrated efficacy and safety in LA related to AD and led to clinical and quality of life improvement in this patient. Therefore, Dupilumab should be considered when treating LA. Further studies should be conducted focusing on the efficacy of the drug on LA (whether or not related to AD), changes in skin lesions after discontinuation, and the safety of long-term application.

Oncology clinical pharmacists are uniquely positioned to make interventions to increase patient activation and engagement. To accomplish this goal, pharmacists can target health system-related, provider-related, and patient-related factors to help enhance patient-centered care and drive behavioral health changes. Interventions that pharmacists must tackle include educating team members and patients on the medication acquisition process, communicating urgency of treatment, optimizing workflows, facilitating guideline recommendations, preventing, and managing treatment toxicities, and promoting patient self-advocacy through education and shared decision-making. As crucial members of the healthcare team, oncology clinical pharmacists can simplify highly complex treatment regimens to facilitate and optimize patients’ ownership of their care. This review will focus on the example of venetoclax treatment in acute myeloid leukemia to demonstrate the impact that pharmacists provide that leads to behavioral change of patients and clinicians.

Academic engagement provides opportunities and resources for students to engage in socio-educational interactions and academic learning. Our study provides an overview of high-impact research in academic engagement and the potential causes of its high valuation in the scientific community based on a bibliometric analysis of 4667 articles indexed in Web of Science, processed mainly by VOSviewer software. In terms of results, the publication of selected articles grows exponentially year by year, presenting concentration levels of 1% in authorship, 49% in a single country, and 5% of the journals. As well as 6% in highly cited articles, which in this case is associated with authors with high levels of publication. The most cited current topics are those relating academic engagement with motivation and emotional aspects.

(1) Background: As part of the Scottish Governments five-year recovery plan to address the backlog in NHS care following the COVID-19 pandemic, community pharmacies in Scotland are planned to provide a Hospital Discharge Medicines Supply and Medicines Reconciliation Service. We aimed to qualitatively explore patients’ experience of this new service; (2) Method: Adult patients (≥18yrs age) who consented to participate in the Community Pharmacy Hospital Dis-charge and Medicines Reconciliation Service were invited for interview within 21 days of dis-charge from hospital. Qualitative, one-to-one, semi-structured, patient interviews were conducted by telephone and audio-recorded using Microsoft Teams®. The interview audio recordings were transcribed verbatim and underwent thematic analysis; (3) Results: 12 patients were inter-viewed, evenly split by sex and with a median age of 62 years (range; 36 to 88 years). Analysis generated main five themes; Patient Engagement, Stakeholder Communication, Practical Factors, Human Factors, and Comparative Experiences. Many of these were interdependent; (4) Con-clusions: Patients appreciated that the service ensured a quicker discharge from hospital. Good stakeholder communication, practical factors (including choice, location, and the realities of ob-taining their medication from the community pharmacy), and a pre-existing and trusted rela-tionship in their usual community pharmacy were the key factors that regulated the patient ex-perience. In the main, patients were positive about the introduction of this new service. However, a lack of previous relationship or trust with a community pharmacy, and previous experiences with medication supply problems were factors which had the potential to negatively impact on patient experiences.

(1) Background: The study of microbiome is being crucial for his role in major systemic diseases, in particular the oral and gut microbiota. In the last years the study of microorganism correlated for example with neurodegenerative disease is increasing the prospective of a possible link between gut microbiota and brain. Here we report a new case report about a patient evaluated genetically firstly for dementia and late-onset dyskinesia, and then tested with 16S metagenomics sequencing. (2) Methods: Starting from buccal swab, we extracted bacterial DNA and then we performed a NGS metagenomics sequencing based on the amplification of hypervariable regions of the 16S in bacteria. (3) Results: The sequencing revealed the presence of Spirochaetes Phylum, a pathogenic bacterium generally known to be able to migrate to the Central Nervous System and not only. (4) Conclusions: Oral infections as our results shows could be possible contributing factors to various neurodegenerative conditions.

The average working person can spend between 35-60 hours a week in the workplace, making it an influential place for mental well-being while also being a place for socio-economic contribution. Workplace incivility can diminish positive mental health outcomes and negatively impact work engagement through increased social anxiety. To investigate this, 118 working adults aged between 19 to 67 years old in Singapore were recruited for a survey comprising of demographics questions, the Workplace Incivility Scale, Brief DSM-5 Social Anxiety Disorder Severity Scale, Utrecht Work Engagement Scale-9 over the period of November 2022 to April 2023. Correlational, regression and mediation analysis showed workplace incivility scale scores to significantly pre-dict social anxiety after controlling for covariates, supporting our hypothesis that employees exposed to work-place incivility would have higher levels of social anxiety that mediated work engagement after controlling for age and gender. The findings here show workplace incivility to be a possible intervention target for social anx-iety to reduce negative impacts on work engagement in order to improve employee experience and retention for organizations.

Organised hiking and trekking tours are promoted by many providers in adventure travel. Such guided tours shall be engaging for the tourists and evoke positive attitudes towards enjoying nature. We present the Trekking Engagement Profile as a tool to evaluate engagement factors of such guided tours, based on engagement research performed in a different domain, namely evaluating engagement in museums and science centres. This tool shall strengthen guides’ soft skills and enable them to increase engagement during an ongoing arrangement. For instance, the Trekking Engagement Profile can be applied when tourists indicate that the quality of a guided tour is not entirely to their liking. We show the viability of using the Trekking Engagement Profile in a small study with guides and participants of trekking tours offered by the Norwegian Trekking Association. Further, we offer guidance and charts to promote its practical use.

The burnout syndrome, which affects so many healthcare workers, has recently awakened wide interest due to the severe repercussions related to its appearance. Even though job factors are determinant to its development, not all individuals exposed to the same work conditions show burnout, which demonstrates the importance of individual variables such as personality. The purpose of this study was to determine personality characteristics of a sample of nursing professionals based on the Big Five model, and then, having determined the personality profiles, analyze the differences in burnout and engagement based on those profiles. The sample was made up of 1236 nurses. An ad hoc questionnaire was prepared to collect the sociodemographic data, and the Brief Burnout Questionnaire, the Utrecht Work Engagement Scale and the Big Five Inventory-10 were used. The results showed that the existence of burnout in this group of workers, is associated negatively with extraversion, agreeableness, conscientiousness and openness to experience, and positively with the neuroticism personality trait. These personality factors showed the opposite pattern with regard to engagement. Three different personality profiles were also found in nursing personnel, in which professionals who had a profile marked by strong neuroticism and low scores on the rest of the personality traits where those who were most affected by burnout.

This research examines sustainable approaches in academic career development by analyzing the interactions between job satisfaction, professional commitment, and research performance among early-career researchers in Romanian institutions. Using a quantitative cross-sectional design, data were collected from 96 individuals classified as R1 and R2 by the European Commission. A detailed questionnaire and Web-Assisted Personal Interviewing (WAPI) identified key relationships. Findings show a significant positive correlation between job satisfaction and research perfor-mance, underscoring the role of professional satisfaction in fostering sustainable academic ex-cellence. Professional commitment is also a crucial predictor of research performance, aligning with existing studies and highlighting the importance of sustainable career practices. Statistical analysis via SPSS version 23.0 validated the initial hypotheses, emphasizing each dimension's significance in a sustainable academic career. Results reflect Romania's research environment, emphasizing the need for sustainable working conditions, effective research evaluation, sup-portive career frameworks, and strong professional commitment to motivate young researchers. This research proposes innovative, sustainable practices for enhancing academic performance and career management, advocating clear objectives, leadership development, continuous competency improvement, and a collaborative, inclusive work environment. Understanding these factors aids individuals and institutions in making informed decisions that support sustainable academic career trajectories and professional growth.

This research explores the behaviors of Generation Z consumers in China, particularly focusing on their interaction with companies through social media for the joint creation of value. Adopting a qualitative methodology, the research initially constructs a scale for assessing co-creation of value on social media platforms. Subsequently, it delves into the motivational aspects of users' engagement in these co-creative activities. The study unveils a range of utilitarian and hedonic motivations that drive Generation Z's value co-creation actions on social media. Insights derived from the findings offer both theoretical and practical implications for the field.

Air corridors are an integral part of the advanced air mobility infrastructure. They are the virtual highways in the sky for transportation of people and cargo in the controlled airspace at an altitude of around 1000 ft. to 2000 ft. above the ground level. This paper presents fundamental insights into the design of air corridors with high operational efficiency as well as zero collisions. It begins with the definitions of air cube, skylane or track, intersection, vertiport, gate, and air corridor. Then, a multi-layered air corridor model is proposed. Traffic at intersections is analyzed in detail with examples of vehicles turning in different directions. The concept of capacity of an air corridor is introduced along with the nature of distribution of locations of vehicles in the air corridor and collision probability inside the corridor are discussed. Finally, the results of simulations of traffic flows are presented.

This study explored father involvement as a social determinant of child health within the context of macro-environmental changes in Mongolia. Using data for children aged 3-4 from UNICEF’s Multiple Indicator Cluster Surveys, this cross-sectional analysis examined the association between father presence and engagement with child health and educational outcomes. Multivariate regression modeling was employed to identify associations between father presence, engagement, and child outcomes including fever, respiratory illness, diarrhea and preschool attendance. In unadjusted analyses, father engagement was associated with higher odds of pre-school attendance (OR=1.12; 95% CI 1.04-1.20) but not with child illness (OR=1.04; 95% CI 0.95-1.14). Father engagement was no longer associated with pre-school attendance after controlling for potentially confounding variables (ORadj = 0.95; 95% CI 0.88-1.03). Unadjusted and adjusted analyses showed that father presence was not associated with acute illness or preschool attendance. Results also suggest that a larger proportion of children were engaged in activities by their mother compared to their father or other adults. Data indicate that father presence and engagement were not associated with child illness or pre-school attendance. Factors such as maternal education, household wealth, and region of residence are stronger predictors of preschool attendance and should continue to be considered for promoting child health and development in Mongolia.

Undernutrition and micronutrient deficiencies such as anemia are considered significant public health challenges in Bangladesh, which enhancing fish consumption is a well-established food-based intervention to address these. This paper documents the establishment of community-based fish chutney production and reports the impact of its consumption on mid-upper arm circumference (MUAC) and hemoglobin (Hb) levels among targeted 150 pregnant and lactating women (PLW) in rural Bangladesh. A fish chutney was developed using locally available ingredients followed by a series of laboratory tests, including nutrient composition, shelf-life and food safety. A community-based fish chutney production process was designed to: 1) supply locally available ingredients for processing; 2) establish two fish drying sites; 3) initiate a community-based production site, and 4) distribute fish chutney to PLW by six women nutrition field facilitators for one year. Then a pre- and post-intervention study was designed for a selected 150 PLW to receive 30g of fish chutney daily for 12 months. Differences in mean mid-upper arm circumference (MUAC) and hemoglobin (Hb) levels pre- and post-consumption were analyzed using one-way analysis of variance. Consumption of 30g of fish-chutney resulted in significant increases of the mean values of Hb levels and MUAC among the targeted PLW.

The process of developing therapies to treat rare diseases is fraught with financial, regulatory, and logistical challenges that have limited our ability to build effective treatments. Recently, a novel type of therapy called antisense therapy has shown immense potential for the treatment of rare diseases, particularly through single-patient N-of-1 trials. Several N-of-1 antisense therapies have been developed recently for rare diseases, including the landmark study of milasen. In response to the success of N-of-1 antisense therapy, the Food and Drug Administration (FDA) has developed unique guidelines specifically for the development of antisense therapy to treat N-of-1 rare diseases. This policy change establishes a strong foundation for future therapy development, and addresses some of the major limitations that previously hindered the development of therapies for rare diseases.

Hemophagocytic lymphohistiocytosis (HLH) is a serious haematologic condition that can be re-lated to various diseases, including tuberculosis (TB). The patient is a previously healthy 26-years-old man, originally from Western Africa, admitted to hospital for fever and weight loss. Given the results of computed tomography (CT) scan, ocular examination and microbiologic tests, a miliary TB with pulmonary, lymph nodal and ocular involvement was diagnosed. Following introduction of antitubercular treatment (ATT) an increase in inflammation indexes and severe pancytopenia were observed; at this point the patient presented six of eight diagnostic criteria for HLH and the diagnosis of HLH secondary to TB was raised. Therefore, HLH treatment with high dose of dexamethasone was started with a good clinical response. We performed a literature re-view of TB-related HLH, which shows a high mortality rate; ATT is necessary to ensure patient survival to remove the antigenic driver. Our patients developed HLH after initiation of ATT as a paradoxical reaction, that may be linked to the release of antigens due to the bactericidal effect of ATT.

Background: Our previous study highlighted important healthcare access and utilization concerns among new immigrants. Hence, in this study, we aimed to explore the role of public and patient involvement (PPI) may have in enhancing the accessibility and their contribution to migration health studies. Method: An open and in-depth interactive consecutive virtual discussion was conducted among volunteer asylum seekers and refugees from Eritrea and Syria in Switzerland. The novel PPI establishment had three phases; inception, training phase, and contribution phase. Result: At the beginning, the concept of PPI was apprehensive to grasp, as it was a new approach. After training and consecutive discussions, volunteers were ardent to engage actively. Hence, among the prime findings were the PPI's role and effect in raising awareness, PPI's role in exploring and communicating the healthcare system accessibilities and utilization among their community, the impact of PPI in echoing the healthcare needs of their fellow migrants, and PPI's contribution in enhancing and strengthening migration health researches. Conclusion: The PPI volunteers in the study were keen to raise their community's awareness through their networks, and bridge the research gap between researchers and the public.

The supply chain has incorporated products by putting them into hair scarfs. This study introduces the use of mini chips in health and beauty products and can reduce fatigue through enhanced sleep patterns. The mini chip could be placed in the scarf and used as a prototype. RFID technology provides the supply chain with specific information that is used to identify products and make communication easier. (Muhammad, et. al. 2013) This paper presents a new tool herein referred to as a scarf prototype which is developed to analyse EMG (electromyogram), ECG (electrocardiography), EEG (electroencephalogram), and EOG (electro-oculogram) signals that focuses in the area of sleep disorders. The mini chips used can be used to determine a solution for sleep disruption by using automated analytics. This could lead to improvement in our understanding of sleep disruption and overall sleep physiology. Automated technology allows repeated measurements, evaluation of sleep patterns, and provide suggestions to improve a person’s quality of sleep. This analysis compares the use of polysomnography and the scarf prototype. The analytics provide models and shows correlation between variables, such as EMG, ECG, EEG, and EOG. This study shows that the results from the scarf prototype is just as reliable as the original method, polysomnography.

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. The Stanford Health Assessment Questionnaire-Disability Index (HAQ) is widely used to measure functional ability in persons with Rheumatoid Arthritis (RA). The instrument was developed with limited involvement from persons with RA, and their perception of the instrument has not been studied in depth. The aim of this study was to explore how persons with RA experience the use of the HAQ in care. Methods. Forty persons with RA were purposefully recruited to participate in semi-structured interviews. The interviews were then analyzed qualitatively using thematic analysis. Results. The participants questioned the relevance of the HAQ but nevertheless experienced that the instrument had a profound effect on their understanding of health and how care is delivered. The analysis resulted in three themes: Problems with individual items, meaning of the summative score, and effects on care and health perceptions. Conclusions. To make the HAQ relevant to persons with RA, it needs to be revised or to include an option to select items most meaningful to the respondent. To ensure relevance, the HAQ update should preferably be co-created by researchers, clinicians and persons with RA.

Background: With the rapid improvement of the healthcare technologies, security and privacy of the most sensitive data, health data is at risk. Protecting patient privacy has many components, even though the data are in electronic format. Although patient privacy is thoroughly discussed in the literature, there is no study presenting all components of patient privacy protection. Methods: In this study, a complete evaluation framework is presented, as an evaluation tool, an inventory is developed, reliability and validity of the inventory is examined. Study is conducted in three phases: Conceptual framework development, inventory development and an evaluation case study. In the evaluation, fuzzy conjoint analysis is employed to handle the subjectivity and am-biguity. As the result of the evaluation, the institution is given a patient privacy protection ma-turity grade, between 1 and 5, where 1 is the worst and 5 is the best grade. Results: In the case study, XXX’s biggest hospital, employing 800 nurses, is evaluated. Half of the nurses, 400, have partici-pated in the study. Literature tells healthcare institutions do not invest enough to protect patient privacy, and the study results support this finding. Institution’s maturity grade resulted as level 2, which is bad. Conclusion: The study measures he privacy maturity with many evaluation com-ponents. Result of the evaluation explains to the patients and the public if their data is safe or not. With this maturity grade, patients have an idea about which institution to choose, public can conclude the institutions’ reliability in terms of patient privacy.

Pulmonary complications are frequently observed in patients with ulcerative colitis (UC), with large airway disease being the most prevalent manifestation. In this case study, we explore the potential for Immunosuppressant, a monoclonal antibody, to induce pulmonary hemorrhage—a side effect not previously documented with its use. The subject, a young male in his twenties with a six-year history of UC, tragically died suddenly. Found in a pool of blood without external injuries, extensive post-mortem examinations were required to determine the cause of death. The patient had been on biologic therapy, receiving Immunosuppressant intermittently over the past two years, including an infusion five days prior to death. External examination revealed bloody, pinkish foamy material expelling from his nose and mouth. An autopsy supported an atypical presentation of UC, while histopathology confirmed diffuse pulmonary hemorrhage, marked by edema and emphysematous changes. Additionally, there was a notable lymphomonocytic infiltration around the arterial walls, and signs of bronchiolitis and focal pleural fibrosis were evident. We concluded that the cause of death was Diffuse Alveolar Hemorrhage (DAH), directly associated with the recent administration of Immunosuppressant. This finding underscores the need for vigilant pulmonary monitoring in patients treated with monoclonal antibodies to promptly identify and manage potential fatal adverse reactions.

Aortic stenosis (AS) is a prevalent valvular disorder that often requires surgical aortic valve replacement (SAVR) to alleviate symptoms and improve survival. However, the selection of an appropriate prosthetic valve size is crucial to avoid patient-prosthesis mismatch (PPM), which can lead to suboptimal hemodynamic outcomes. Von Willebrand factor (VWF), a key component of hemostasis, has been shown to be altered in AS patients and may contribute to the hemostatic imbalance observed following valve replacement. This prospective study aimed to investigate the impact of PPM on postprocedural VWF levels in patients undergoing SAVR for severe AS. The study included 31 consecutive patients diagnosed with severe AS who underwent SAVR. By focusing on the relationship between PPM and VWF dynamics, this study sought to provide valuable insights into the potential role of VWF as a marker for hemostatic changes associated with PPM, ultimately informing strategies for optimal valve selection and perioperative management to minimize complications.

Background: Permanent tracheostomy because of total laryngectomy surgery entails great conse-quences for the patient regarding respiratory physiopathology such as the filtering, humidifying, and heating function of the air by the nose is lost. The use of special stomal filters can determine adequate protection of the trachea-broncho-pulmonary system with a reduction in respiratory pathologies. In fact, in most cases laryngectomee patients are first cigarette smokers who for this reason already have also respiratory diseases such as chronic obstructive pulmonary disease (COPD). Despite the availability of tracheal filters, multiple times, as reported in the literature, the patient tends to limit their use due to reported breathing difficulties, especially in conditions of intense breathing. Methods: The objective of this clinical study was to evaluate the most suitable stomal filter for the laryngectomee patient during physical activity. The filters studied were an INHEALTH device (Blom-Singer SpeakFree HME); two ATOS devices (Provox® Life™ Energy HME and Provox® Life™ Home HME); and an FAHL device (Laryvox HME Sport). Results: For this purpose, the performances of 31 laryngectomee patients, subjected to medi-um-high physical effort, were analyzed through a standardized pneumological test, the Six Minute Walking Test (6MWT) which involves a sustained walk lasting six minutes, with evaluation , every 60 seconds, heart rate, oxygen saturation and meters travelled; furthermore, it examines two sub-jective indices, namely, the basal and final dyspnea index and the initial and final muscular fatigue index.

We report the case of a 61-year-old woman who was referred to the Oral Surgery and Implantology Unit of the University Hospitals of Geneva to take care edentulous sites after dental avulsions of teeth 11 and 21 following traumatic shock due to endotracheal intubation under general anaesthesia. The dental history revealed that the patient had a history of generalized chronic periodontitis that had been treated several years earlier. Treatment consisted, for the first time to our knowledge, of immediate insertion of implants at sites 11 and 21 with simultaneous bone augmentation in a single surgical procedure and immediate restorations.

We present a case report of a 26-years-old female suffering from Coffin Siris Syndrome, who underwent orthodontic treatment and surgery to solve her malocclusion and improve her aes-thetics and functional occlusion. Methods: The presurgical phase involved multibracket self-ligating attachments, Damon prescription. The patient underwent maxillofacial surgery to correct the severe skeletal malocclusion and relocate the bone bases in the right relationship. The post-surgical orthodontic treatment was performed to complete the alignment. Results: The pa-tient improved her aesthetics and functional abilities. Conclusions: Syndromic patients can un-dergo orthodontictreatment if comorbidities and collaboration allow it. Support and collaboration of families and psychotherapists must be considered, but clinical cases of syndromic patients can be faced and solved. Obviously, each syndromic patient is considered unique, and the risk-benefit ratio must be correctly assessed for each one.

Aim/Purpose: This study aims to assess the influence of integrating ChatGPT on enhancing the academic writing performance and engagement of English as a Foreign Language (EFL) undergraduate students at Delhi, India, who are enrolled in Academic Writing during the first semester of the academic year 2024/2025. Given the unique challenges within the Indian undergraduate education system, innovative technological interventions are essential to improve writing skills and increase engagement among EFL learners.

Background: Over the past decades, efforts have been made to improve the nutritional well-being in people with cystic fibrosis (pwCF). Due to the correlation observed between nutritional indices and lung function, prevailing recommendations consistently advocate for BMI percentile goals at or above the 50th percentile in pwCF. Recent global trends show a notable increase in overweight and obese statuses among pwCF. This study aims to explore the nutritional status of Italian pwCF. Methods: Data from the Italian CF Patient’s Registry were analysed to assess the proportion of individuals categorized as underweight, target weight, overweight, and obese from 2010 to 2021. Patient-level comparison data from 2021 were also examined to identify potential determinants of overweight and obesity. Results: Analysis spanning 2010 to 2021 reveals a decrease of approximately 40% in underweight status among adults, while the proportion of malnourished patients 90, and lower prevalence of Pseudomonas aeruginosa colonization. Conclusions: Our study confirms the evolving nutritional status landscape among Italian adult pwCF, with a significant shift towards overweight and obesity over the past decade. These trends highlight the need for proactive measures within CF standards of care to adapt and address the changing needs of patients.

Malawi has developed an excellent, nation-wide system for monitoring people infected with HIV and keeping track of key epidemic markers. Their success lies in two things: the focus on simplicity and the use of data collection not only to track the epidemic and identify problems but also to give regular feedback and support to every clinic in the country. This achievement is the more remarkable given that Malawi is one of the poorest countries in the world, ranking 190 out of 194 countries by GDP, but has one of the most severe epidemics of HIV in the world, ranking 9th out of 168 countries by HIV prevalence. We first discuss the current state and likely future epidemic trends in Malawi: unless we know where we are and where we are going we cannot decide what to do or how to do it to in order to achieve a better outcome. We then discuss the history and development of Malawi’s patient monitoring system, as reported in their Integrated HIV Program Reports,ix which have been published quarterly since the beginning of 2004. We consider the current state of patient monitoring and support as reflected in the most recent report for the third quarter (Q3) of 2016 and comment on some of the questions that this raises. Finally, we consider ways in which the current system could be improved by strengthening Malawi’s analytical capacity and making better use of this unique data set. The focus here is on HIV in adultsv because if ART is initiated early in all adults living with HIV this should include testing all pregnant women for HIV and starting them on treatment immediately. However, PMTCT is especially important and care must be given to reducing MTCT and identifying the long-term child survivors of mother-to-child transmission and this demands a complementary assessment. There is an ongoing debate about the relative merits of treatment and prevention in reducing transmission and it should be made clear that the primary reason for starting people on treatment early is that it is in the best interest of the individual patient to start treatment as soon as possible after becoming infected. Allowing a person’s immune system to deteriorate to any degree is not consistent with the clinician’s commitment to ‘first do no harm’ and even those with the highest CD4⁺ cell count are at a substantially increased risk of death. What matters, therefore, is to get as many people as possible onto ART, ensure that they remain virally suppressed, and consider prevention in this context.

This paper explores the integration of multiple intelligences and artificial intelligence (AI) in language learning, focusing on its potential to enhance personalization and engagement. Drawing from existing research and studies conducted in various contexts, including the Philippines, this study aims to contribute to the understanding of the benefits, challenges, and effectiveness of this integration. The paper begins with an introduction that highlights the background and significance of integrating multiple intelligences and AI in language learning, identifying research gaps, objectives, research questions, and the theoretical framework. A literature review provides an overview of multiple intelligences theory by Howard Gardner, the role of AI in language learning, and identifies gaps in the existing literature. The methodology section outlines the research design and approach, participant selection, data collection methods, validity and reliability measures, and ethical considerations. Findings and results are presented through the analysis of qualitative data, exploring emergent themes and patterns. The discussion section critically examines the identified research gaps, discusses the validity and reliability of the study, addresses the scope and limitations, and explores the implications of the findings for theory, practice, and future research. The conclusion summarizes the key findings and contributions of the study, reflects on the achievement of research objectives, offers recommendations for further research, and provides final remarks tying together the main points of the study. This paper contributes to the existing body of knowledge by providing insights into the integration of multiple intelligences and AI in language learning and its impact on personalization, engagement, and language learning outcomes.

The nematode Caenorhabditis elegans, with its highly sensitive olfactory system, has emerged as a promising tool for testing chemotaxis. In the field of cancer diagnostics, there is a growing interest in the development of non-invasive screening methods for the detection of volatile organic compounds in a patient's urine. The objective of this study was to contribute to the existing body of knowledge by evaluating the ability of a Caenorhabditis elegans-based chemotaxis assay to discriminate between urine samples from healthy individuals and patients diagnosed with breast or colon cancer. Following synchronization of the developmental stages of C. elegans, nematodes were exposed to the urine of cancer patients and healthy individuals. Subsequently, chemotactic indices were calculated for each urine sample. Our results demonstrated a statistically significant difference in the chemotactic response of C. elegans to urine samples from cancer patients compared to healthy volunteers (p < 0.001). Moreover, the test exhibited promising diagnostic utility, with a sensitivity of 98%, a specificity of 62%, and a detection rate of 78%. Our findings expand on previous observations, confirming the remarkable sensitivity of C. elegans hermaphrodites to discriminating cancer-related volatile organic compounds in urine samples.

This study investigated how different gamification elements in mobile apps influence users' basic psychological needs (autonomy, competence, relatedness) and subsequent engagement outcomes. Survey data was analyzed using PLS-SEM. Social gamification elements enhanced autonomy and competence needs, while immersive elements boosted autonomy and relatedness. Achievement/progression components increased competence and relatedness perceptions. Interestingly, personal traits did not significantly impact psychological needs. Crucially, satisfying autonomy and relatedness predicted higher user satisfaction and continued usage intentions, highlighting their importance for sustained engagement. Competence influenced satisfaction but not continuance intention. The findings demonstrate the motivational roles of distinct gamification features in fostering need-supportive experiences. Designers should incorporate varied social, immersive, and achievement components to address users' psychological requirements holistically. Prioritizing autonomy and relatedness support appears vital for achieving enjoyable, self-motivated, and persistent user engagement across gamified systems and domains. The study provides actionable insights for optimizing motivational affordances through psychologically-informed gamification implementations.

Massification in higher education has made the satisfaction of students’ needs a difficult conundrum among university lecturers. In contrast, the use of innovative design for collaborative learning enhances student engagement in the populous student’s context. Moreover, this paper aims to extensively explore innovative designs for fostering student engagement and collaborative learning among first-year students at the University of Venda. The study employed a qualitative research method with the purposive sampling technique. Subsequently, a group of 200 students was the population of this study. Participant Observation and narrative inquiry were used as data collection instruments. The students in their respective groups were assigned topics from the module content to use their talents to demonstrate their understanding of certain content in the module. The non-surprising findings of this paper elucidated that collaborative learning expedites students’ mastery of key concepts and subject content. The module lecturers introduced students to these innovative designs to ensure collaborative learning and effective student engagement. The key findings elucidated these aspects namely, role-playing exercises, group projects, peer-to-peer learning, use of talents, and peer feedback. The implication of this study is that students learn to work together, delegate responsibilities and communicate effectively to attain a common goal. Using these strategies, the lecturers promote collaboration among students and foster a more engaging and interactive learning experience. This paper further recommends efficient and effective techniques and strategies to foster student engagement and collaboration to track and monitor at-risk students timeously.

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

Pandemic scenario has significantly changed several factors of life, including teaching, and learning at university. The development of suitable teaching materials to support university studies is mandatory to overcome distance learning difficulties and improve traditional teaching methodologies. This work explains a novel method for the preparation of teaching materials for medical sciences, but also plausible for other learning fields. An encephalon was extracted and prepared by using this methodology for teaching purposes. More than 200 students evaluated several factors of the material prepared this way, indicating a better understanding (up to 80%) of theoretical contents related to this human section, together with a high usability and good physical appearance

This study aimed to evaluate the safety and tolerability of STP1, a combination of ibudilast and bumetanide, tailored for the treatment of a specific subgroup of patients with Autism Spectrum Disorder (ASD), namely ASD Phenotype 1 (ASD-Phen1). We conducted a randomized, double-blind, placebo-controlled, parallel-group phase 1b study with two 14-day treatment phases (registered at clinicaltrials.gov as NCT04644003). Nine ASD-Phen1 patients were administered STP1, while three received a placebo. We assessed safety and tolerability, along with electrophysiological markers, such as EEG, Auditory Habituation, and Auditory Chirp Synchronization, to better understand STP1's mechanism of action. Additionally, we used several clinical scales to measure treatment outcomes. The results showed that STP1 was safe and well-tolerated, with electrophysiological markers indicating a significant and dose-related reduction of gamma power in the whole brain and in brain areas associated with executive function and memory. Treatment with STP1 also increased alpha 2 power in frontal and occipital regions and improved habituation and neural synchronization to auditory chirps. Although numerical improvements were observed in several clinical scales, they did not reach statistical significance. Overall, this study suggests that STP1 is safe and well-tolerated in ASD-Phen1 patients and shows indirect target engagement in ASD brain regions of interest.

This study aims to determine the Antecedent of employee engagement among police officers in Tanjung Perak Police Station. The approach used in this research is quantitative with survey and correlation methods. The sampling technique used is purposive sampling which obtained by respondents as many as 146 employees of Police officers in Tanjung Perak Police Station which include all the population. The data analysis technique used in this research is descriptive statistics and inferential statistical analysis. Inferential statistical analysis using Structural Equation Modeling (SEM) approach using Smart PLS application. Furthermore, the measurement of the model (outer model). The test findings suggest that internal and external job transitions improve capital mobility. Movement capital boosts internal employability. Movement capital boosts external employability. Employee engagement and participation are negatively impacted by perceived external employability.

1) Background: Aware that engagement in the healthcare field needs high levels of emotional intelligence, we began this study in to the relationship between engagement and emotional intelligence in nurses. The objective of this study was to determine the explanatory value of the components of emotional intelligence for engagement in a sample of nurses, and to identify which of the emotional intelligence components have the greatest explanatory value for dimensions of engagement, by sex.; 2) Methods: The final study sample was made up of 2126 working nursing professionals with a mean age of 31.66 (SD=6.66). To compile the data, an ad hoc questionnaire was used to collect sociodemographic information, and to collect professional and employment information, the Utrecht Work Engagement Scale, and the Reduced Emotional Intelligence Inventory for Adults.; 3) Results: The results show that nurses with higher levels of emotional intelligence also scored more highly in engagement, with the Interpersonal factor being the greatest predictor of engagement.; and 4) Conclusions: This study have significant practical implications for the creation of intervention programs and activities to improve the performance of nurses in the workplace.

Dysmenorrhea symptoms are frequent and often self-treated using non-prescription medicines. To further characterize women with dysmenorrhea using a combination of hyoscine butylbromide and paracetamol (PLUS) for self-management of their complaints, we performed a secondary analysis of a published pharmacy-based patient survey. 314 women (mean age 32.3 years) with dysmenorrhea reported a pain and cramps intensity of 7.45 ± 2.13 on a 0-10 Likert scale, which was reduced to 2.86 ± 1.81 upon treatment. Associated impairments of work/daily chores, leisure activities, and sleep were improved by 64.6%, 62.2% and 70.4%, respectively. The onset of symptom relief was within 60 min in 84.7%. Tolerability was rated as very good or good by 97.2%. These findings confirm the efficacy and tolerability data on PLUS from randomized controlled trials in a larger group of women conducting self-management of their dysmenorrhea.

Diabetic foot ulcers (DFUs) significantly affect the lives of patients and increase the risk of hospital stay and amputation. We suggest a remote-monitoring platform for better DFU care. This system uses digital health metrics (scaled from 0 to 10, where higher scores indicate a greater risk of slow healing) to provide a comprehensive overview through a visual interface. The platform features smart offloading devices that capture behavioral metrics such as offloading adherence, daily steps, and cadence. Coupled with remotely measurable frailty and phenotypic metrics, it offers an in-depth patient profile. Additional demographic data, wound characteristics, and clinical parameters, such as cognitive function, were integrated, contributing to a comprehensive risk factor profile. We evaluated the feasibility of this platform with 124 DFU patients over 12 weeks; 39% experienced unfavorable outcomes such as dropout, adverse events, or non-healing. Digital biomarkers were benchmarked (0-10), categorized into low, medium, and high risk for unfavorable outcomes, and visually represented using color-coded radar plots. The initial results of case reports illustrate the value of this holistic visualization to pinpoint the underlying risk factors for unfavorable outcomes, including a high number of steps, poor adherence, and cognitive impairment. Although future studies are needed to validate the effectiveness of this visualization in personalizing care and improving wound outcomes, early results in identifying risk factors for unfavorable outcomes are promising.

Citizen science has emerged as a potent approach for environmental monitoring, leveraging the collective efforts of volunteers to gather data at unprecedented scales. Within the framework of the I-CHANGE project, MeteoTracker, a citizen science initiative, was employed to collect and analyze meteorological measurements. This paper presents the results of our analysis, demonstrating the effectiveness of citizen science in generating valuable environmental data. Through MeteoTracker, volunteers contributed to a comprehensive dataset, enabling insights into local weather patterns and trends. Our findings underscore the potential of citizen science to augment traditional monitoring efforts and inform decision-making processes in environmental research and management. The paper discusses the methodology employed, including data collection and statistical analysis techniques. Results highlight the reliability and accuracy of citizen-generated data, as well as the strengths of the MeteoTracker platform. The implications of our findings for environmental research, policy development, and public engagement are discussed, along with recommendations for enhancing the effectiveness of citizen science initiatives in environmental monitoring.

Extending from the current Elaboration likelihood model scholarship, this article proposes a framework for applying ELM to cricket bat purchase. Professional cricketers or fans require comprehensive and adequate pieces of information about cricket bat through the Internet. Buyers simultaneously encourage internet reviews for product impressions, and they experience meaningful associations. ELM and the Internet exemplify the cricket bat buying process by engaging buyers with product specification and create a meaningful relationship between buyers and sellers. At the same time, buyers feel empowered to choose a product of their choice. Describing the Elaboration likelihood model, we have facilitated an approach for cricket bats buying. This article has explored how ELM through the Internet can encourage buyers to be informative about cricket bats while silencing retailers' voices and visions into a unique buyer-seller relationship.

Amidst the transformative backdrop of the post-Covid-19 context, the researcher embarks on a qualitative exploratory study to investigate the intricate interplay of religiosity, educational engagement, and campus life among college students at St. Michael's College, Iligan City. Guided by a theoretical framework integrating Vygotsky's sociocultural theory, Fredricks et al.'s engagement theory, and Pascarella & Terenzini's educational impact theory, this study delves into the dynamic fruition of religiosity in response to the pandemic's impact. Employing purposeful and maximum variation sampling, the investigation unravels narratives from interviews, focus group discussions, and observations. Through thematic analysis, themes of "Adaptive Integration," "Religious Resilience," "Community Nexus," "Challenges of Synchronization," and "Identity Negotiation" emerge. In the discourse of these themes, strategies students employ to navigate challenges arising from this confluence are unearthed. Rooted in a deep understanding of the context, this study presents implications for fostering holistic growth within an inclusive educational environment. As the findings and insights are presented, stakeholders are invited to reimagine the role of religiosity, educational engagement, and campus life in shaping the holistic student experience in a world forever changed.

The COVID-19 pandemic has not only affected public health but has also significantly impacted the economy. Bandung, a bustling city in Indonesia serving as a satellite to the capital, has been hit hard due to its high population density, mobility, and reliance on the tourism, trade, and transportation sectors. Using a Computable General Equilibrium (CGE) model developed at the inter-regional level of Indonesia, this study investigates the microeconomic indicators of several economic activities in Bandung to assess the impact of the pandemic. Additionally, the study examines the role of private sector actors in contributing to the sustainable recovery efforts toward achieving Sustainable Development Goals (SDGs) amidst the pandemic. The findings reveal that Bandung's transportation, accommodation, food and beverage, water supply, and trade sectors experienced a significant decline in economic activity. However, there was a gradual recovery with increased economic activity between 2019 and 2021. Private sector actors and the health sector were the main drivers of economic recovery, with other sectors also contributing to the efforts.

The world is progressing towards a more advanced society where end-consumers have access to local renewable-based generation and advanced forms of information and technology. Hence, it is in a current state of transition between the traditional approach to power generation and distribution, where end-consumers of electricity have typically been inactive in their involvement with energy markets and a new approach that integrates their active participation. This new approach includes the use of distributed energy resources (DER) such as renewable-based generations and demand response (DR), which are being rapidly adopted by end-consumers, where incentives are strong. This paper presents the role of DR aggregator to effectively integrate DER technologies as a new source of energy capacity, into the electricity networks using information communication technology and industry knowledge. This framework based on DR aggregators will facilitate renewable energy integration and customer engagement in electricity market efficiently. To this aim, advantages and disadvantages of DR aggregators are discussed in this paper from political, economic, social and technological (PEST) point of views. Based on this analysis, a strengths, weaknesses, opportunities, and threats (SWOT) analysis for a typical DR aggregator is presented.

This research investigates the relationships between occupational health and safety (OHS), staff resilience (SR), staff engagement (SE), and organizational resilience (HOR) within Saudi Arabian hospitals. Employing a quantitative, cross-sectional design, data were collected from 127 administrative staff members working in both public and private hospitals in Saudi Arabia. Using SmartPLS to test the hypothesized relationships and mediation effects, the findings reveal that OHS significantly impacts both SR and SE, and SR significantly influences HOR. Additionally, SE significantly affects HOR. The study also confirms a partial mediation effect of SE and SR in the relationship between OHS and HOR. The model demonstrates substantial explanatory power for HOR, SE, and SR. These results underscore the critical role of OHS in fostering a resilient healthcare environment by enhancing staff engagement and resilience. The study’s implications highlight the importance of targeted interventions to improve OHS practices, promoting overall hospital resilience in alignment with Saudi Arabia’s Vision 2030.

User experience-related challenges play a significant part in user-technology interactions. However, design processes have not always kept up with the evolving needs of users in terms of technology interactions. This paper aims to present the design, structure and evaluation of an integrated mental health intervention platform (AMGR-I), emphasizing the importance of user-centred design and engagement in addressing the evolving needs of users in technology interactions, specifically focusing on individuals with mental health disorders. The AMGR-I pilot platform integrates community, e-learning, and care sub-platforms to provide a holistic approach to mental health intervention. The study utilizes participatory design research with targeted users to gather insights into user preferences and expectations. By involving the targeted audience in the design process, the platform’s user-centered design can be improved effectively. The platform recognizes the changing view of users, who now seek products that deliver pleasure, enjoyment, engagement, and embodiment. This research contributes to the field by highlighting the importance of user-centered design in the development of a comprehensive platform for mental health support.

This study presents a strategic approach to developing applications focused on implementing Large Language Models using the Langchain framework in Python. Three language models are highlighted: GPT-3.5 (turbo mode), LLaMA 2, and Vicuna 7B, each with their distinctive features and capabilities. The methodology used is described in detail, including data extraction from medical reports using zero-shot prompting data extraction techniques, interaction with language models, and structured storage of results. The performance of the models in data extraction is evaluated, presenting metrics such as precision, recall, and F1 score. The results demonstrate high model capability in extracting information, although areas for improvement are identified, particularly in data extraction precision. In conclusion, the efficacy of the models in extracting information from medical histories is not considerably acknowledged, with an emphasis on the importance of improving precision and increasing the volume of trained data for future research in healthcare digitalization.

Background. Malignant pleural mesothelioma (MPM) is still a rather incurable disease. Many classes of compounds with various mechanisms of action have been tested in vivo and ex-vivo, with rather disappointing results. This is partly due to preclinical studies mostly performed in models that fail to recapitulate MPM complexity and do not retain the intra-tumor heterogeneity, a propelling force for tumor progression. Additionally, we and others have shown that, under stress-induced chemotherapy, profound rearrangements take place in MPM cultures to fuel the emergence of chemoresistant cell subpopulations. Thus, finding clinically actionable modulators of MPM resistance is still a very urgent need. Methods. Setup and propagation of patient-derived organoid cultures from MPM pleural effusions; flow cytometry-based validation of organoid cultures, isola-tion and propagation of mesothelioma-associated fibroblasts; co-cultures, Lu-minex-based Cytokine array, ELISA assay to quantitate IL-6 in the conditioned media, qRT-PCR to assess mRNA expression of cancer stem cell markers and fibroblast markers. Results. Organoid cultures were obtained from eight MPM patients by using specific growth media and conditions to propagate pleural effusion-derived cells. We proved that primary MPM specimens and serially passaged (mesothelio-ma-Patient-Derived-Organoids) mPDOs were cytologically similar, with the obtained mPDOs expressing mesothelial markers similarly to the originating specimen. As expected from a clinically relevant model, the size and number of mPDOs were altered, in a patient-specific way, when pharmacologically relevant doses of chemotherapy drugs were added. We derived Mesothelio-ma-Associated-Fibroblasts (MAFs) and the addition of MAFs, to various ratios, altered the response of the mPDOs to pemetrexed + cisplatin, toward a reduced sensitivity to the latter anticancer agents. Additionally, organoid formation and size were altered by MAF-conditioned media, and this correlated with increased expression of cancer stem cell markers. We showed increased levels of IL-6 in the media of the treated cocultures and showed that this latter was derived from the MAFs. Conclusions. Increased secretion of IL-6 by mesothelioma-associated fibroblasts (MAFs) contributes to the resistance of the MPM to therapy.

Thyroidectomy has been post-operatively managed by hormone replacement therapy in order to satisfy the reference ranges of thyroid stimulating hormone (TSH) and thyroxine (T4) levels. While medication and standardized reference ranges have proven to be effective, many patients continue to report unintentional weight gain despite adequate amounts of treatment and levels of TSH and T4. Physicians, over the years, have become complacent to these “normal” ranges, and have ignored the metabolic consequences that are affecting thyroidectomy patients. This paper aims to redefine the approach to post-thyroidectomy clinical care by: challenging the current standardized hormonal range values, exploring the gaps in thyroid hormone conversion, investigating the metabolic pathways of T3, considering the influence of inflammatory markers, and proposing the future for patient-centered management.

To identify factors associated with interstitial lung disease (ILD) in patients with systemic sclerosis (SSc) and build an algorithm to better define this association, for a personalized application in clinical practice. Methods. 78 SSc patients underwent HRCT to assess ILD. Demographic, clinical and laboratory variables were collected, focusing on those associated either directly or indirectly with lung involvement. The discriminant value of each variable was determined using the operating characteristic curves (ROC) and included in a model to estimate the strength of ILD association in SSc. Results. Thirty-three (42.31%) patients showed ILD on HRCT. DLco, M-Borg, GERD-Q, and capillary density were significantly associated with the presence of ILD-SSc. A model including these variables had a coefficient of determination (R2) of 0.697. DLco had an AUC of 0.861 (p&lt;0.001) with a cut-off ≤72.3% (sensitivity 78.8%, specificity 91.1%, +LR 8.86). The m-Borg scale showed an AUC of 0.883 (p&lt;0.001) with a cut-off &gt;2 (sensitivity 84.8%, specificity 82.2%, +LR 4.77), GERD-Q had an AUC of 0.815 (p&lt;0.001) with a cut-off &gt;7 (sensitivity 72.7%, specificity 86.7%, +LR 5.45). The capillary density showed an AUC of 0.815 (p&lt;0.001) with a cut-off ≤4.78 (sensitivity 87.9%, specificity 68.9%, +LR 2.82). Based on the pre-test probability values, these four variables were applied to Fagan's nomogram to calculate the post-test probability of this association. Conclusions. Our study identified four associated clinical factors of ILD in SSc patients. Moreover, their inclusion in an algorithm for the post-test probability, tailored to the specific patients’ characteristics, significantly increases the ability to find out the presence of SSc-ILD.

Sepsis is a serious disease that can lead to mortality. The etiology of the disease is connected to how the body as a host reacts toward microbes such as bacteria, viruses, and fungi invasion. Current research shows that during sepsis, the reaction toward microbe attacks takes two main phases. The first is known as a cytokine storm, while the second is a vicious cycle of pro-inflammatory responses followed by a strict anti-inflammatory response led by CD4+ Tregs. Various immunomodulatory therapies have been proposed to break the cycle of pro- and anti-inflammatory reactions to sepsis. However, clinical trials did not show promising results, indicating further research into the mechanism that Treg uses to inhibit proinflammatory reactions. We used next-generation sequencing (NGS) analysis of bulk RNA-seq and single-cell RNA-seq data to examine the exact molecular pathways used by Treg to inhibit the immune response in sepsis. Our approach identified ACOD1 (Aconitate Decarboxylase 1) as a primary mediator of Treg suppression of immune cells. We identified and validated CD36 as a downstream target of ACOD1. CD36 is a known metabolite regulator in Tregs. Taken together, our results indicate that targeting ACOD1 could prove valuable in regulating Treg function during sepsis.

High systolic blood pressure and increased blood pressure variability after the onset of ischemic stroke are associated with poor clinical outcomes. One of the key determinants of blood pressure is arteriolar size, determined by vascular smooth muscle tone and vasodilatory and vasoconstrictor substances that are released by the endothelium. The aim of this study is to outline alterations in vasomotor function in isolated peripheral arteries following ischemic stroke. The reactivity of thoracic aortic segments from male C57BL/6 mice to dilators and constrictors was quantified using wire myography. Acetylcholine induced endothelium-dependent vasodilation was impaired after ischemic stroke (LogIC50 Sham=-7.499, LogIC50 Stroke=-7.350, P=0.0132, n= 19, 31 respectively). Vasodilatory responses to SNP were identical in isolated aortas in sham and stroke groups. Phenylephrine induced vasoconstriction was impaired in aortas isolated from stroke animals in comparison to sham counterparts (Sham LogEC50= -6.652 vs Stroke LogEC50=-6.475, P< 0.001). Our study demonstrates that 24 hours post-ischemic stroke, peripheral vascular responses are impaired in remote arteries. Aortas from stroke animals exhibited reduced vasoconstrictor and endothelium-dependent vasodilator responses, while endothelium-independent vasodilatory responses were preserved. Since both vasodilatory and vasoconstrictor responses of peripheral arteries are impaired following ischemic stroke, our findings might explain increased blood pressure variability following ischemic stroke.

Today, the world is undergoing a major investment cycle in infrastructure, which is vital for the development and prosperity of countries and society. Management deficiencies in infrastructure projects are well known and some of them concerns weak engagement of project stakeholders. Importance of stakeholder engagement as the key success factors for infrastructure projects is recognized. However, the literature gives very few answers how this process manifests in projects. Some scholars concluded that it is a complex and undertheorized management process which necessitates more empirical research. The research questions seek to identify how practitioners perceive the stakeholder engagement, who implements activities and processes related to engagement and in what way, which organizational aspects influence the process and how success is achieved in infrastructural projects. Interviews were conducted with eight experienced experts who participated in a whole series of (complex) infrastructure projects. The interviews examined all aspects of the engagement of stakeholders in detail, and a thematic analysis was carried out. Based on the analysis, success/failure factors related to the stakeholder engagement process were defined. As a result, a framework model for engaging stakeholders and achieving success in infrastructure projects is presented, which is based on three management levels and three levels of project success.

Abstract: Understanding social media networks and group interactions are crucial to the ad-vancement of linguistic and cultural behaviour. This includes the manner in which people ac-cessed advice on health, especially during the global lockdown periods. Some people turned to social media to access information on health where most activities were curtailed with isolation rules, especially for older generations. Facebook public pages, groups and verified profiles, using "senior citizen health", "older generations", and "healthy living" keywords were analysed over a 12-month period to analyse the engagement promoting good mental health. CrowdTangle was used to source English language status updates, photo and video sharing information which resulted in an initial 116,321 posts and 6,462,065 interactions Data analysis and visualisation were used to explore large datasets, including natural language processing for “Message” content discovery, word frequency and correlational analysis and co-word clustering. Preliminary results indicate strong links to healthy aging information shared on social media which showed correla-tions to global daily confirmed case and daily death totals. The results can be used to identify public concerns early on and address mental health issues in the senior generation on Facebook.

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.

As previous study in many countries shown that stroke patient onsets are not distributed randomly, but associate with meteorological factors. However, the relationship between stroke occurence and meteorological factors remain unknown in mountain area in Guizhou China. This paper firstly introduces multi-source fusion data which is integrated by the mountain meteorological factor, geographic mapping elevation information data and stroke population monitoring of Guizhou province. Mainly elaborates from a few aspects, which concludes data collection, data sorting, data extraction, data cleaning and data production in detail. A completed and detailed meteorological stroke data set was successfully established and multi-source data fusion was realized by the use of Gbase and unified data service interface of Guizhou meteorological big data cloud platform. And we report the impact of meteorological variables in Guizhou mountain area climate on stroke. In this study, we performed a statistical fusion data between January 2017 and December 2020 about stroke incidence rate and meteorological factors respectively, for instance, concerning the mean (Mean), maximum (Max), minimum (Min), median (Median), standard deviation (Std) . We calculated stroke rates (date stroke occurence)/(year stroke occurence) and we investigated the distribution of days included in the label. Results: the distribution of the incidence rate basically conforms to the normal distribution with the label Max 0.007399, label Min 0.000204, label Mean 0.002738, label Median 0.002643, label Std 0.00076. We observed a positive significant correlation of stroke incidence rate directly proportional to the daily temperature difference (between 0 and 20 degrees Celsius), as the value of this factor exhibits variation larger, the incidence rate is gradually increasing. And we investigated from the Pearson correlation coefficients that stroke incidence increasing when meteorological factors at low humidity (less than 40% (RH 80%), temperature higher than 31℃); the 24-hour daily temperature difference varies between 6 and 10℃ (6

Alzheimer’s disease (AD) is an irreversible neurodegenerative disease characterized by progressive cognitive decline. The two cardinal neuropathological hallmarks of AD include buildup of cerebral β amyloid (Aβ) plaques and neurofibrillary tangles of hyperphosphorylated tau. The current disease-modifying treatments are still not effective enough to lower the rate of cognitive decline. The paucity of early detection and disease progression biomarkers also seems to present a major obstacle to AD drug development. The current established readouts based on expression levels of amyloid beta, tau and phospho tau have shown many discrepancies in patient samples when linked to disease progression. There is an urgent need to identify diagnostic and disease progression biomarkers from blood, CSF or other biofluids that can facilitate early detection of the disease and provide pharmacodynamic readouts for new drugs being tested in clinical trials. Advances in proteomic approaches using state-of-the-art mass spectrometry, are now being increasingly applied to study AD disease mechanisms, identify drug targets and novel disease biomarkers. In this report, we describe applications of the quantitative proteomic approaches for understanding AD pathophysiology, summarize the current knowledge gained from proteomic investigations of AD and discuss development and validation of new predictive and diagnostic disease biomarkers.

Tumor to stroma ratio is a highly debated prognostic factor in the management of several solid tumors and there is no universal agreement on its practicality. In our study we proposed to confirm or dismiss the hypothesis that a simple measurement of stroma quantity is an easy-to-use and strong prognostic tool. We have included 74 consecutive patients with colorectal cancer who underwent primary curative abdominal surgery. The tumors have been grouped into stroma-poor (stroma &lt;10%), medium-stroma (between 10 and 50%) and stroma-rich (over 50%). The proportion of tumor stroma ranged from 5% to 70% with a median of 25%. Very few, only 6.8% of patients had stroma-rich tumors, 4% stroma-poor tumors and 89.2%tumors with a medium quantity of stroma. The proportion of stroma, at any cut-off, had no statistically significant influence on the disease specific survival. This can be explained by the low proportion of stroma-rich tumors in our patient group and the inverse correlation of stroma proportion with tumor grade. The real-life proportion of stroma-rich tumors and the complex nature of the stroma-tumor interaction has to be further elucidated.

Obstructive sleep apnea (OSA) may be linked to various factors that narrow the upper airways, such as obesity, adenotonsillar hypertrophy and craniofacial abnormalities. Hypothyroidism has also been described as a risk factor for OSA. However, the implication of goiter independently of thyroid function in the occurrence of OSA remains unclear. We present the case of a 66-year-old patient, with a large compressive multinodular goiter for whom total thyroidectomy was indicated. During the preoperative assessment, the patient showed a body mass index (BMI) of 37.8 kg/m2 with symptoms of OSA. Respiratory polygraphy confirmed the diagnosis of severe OSA (apnea hypopnea index: AHI=32) and treatment with continuous positive airway pressure (CPAP) was initiated prior to thyroid surgery. Surprisingly, after total thyroidectomy, OSA symptoms disappeared and the patient abandoned CPAP therapy. Subsequent respiratory polygraphy after thyroidectomy showed a decrease in AHI to a normal value (AHI < 5). Interestingly, there was no change in BMI or other factors explaining the resolution of OSA, except for thyroidectomy. This case report suggests that goiter can be considered a risk factor for OSA. However, prospective studies are needed to accurately assess the effects of goiter on occurrence of OSA according to its dimensions and local extension.

Background: Positive person-centered attributes of inpatient rehabilitation need to be identified from the patient perspective to be further developed and sustained. Purpose: To identify which attributes patients openly evoke as being great care experiences, using an open appreciative inquiry during the inpatient rehabilitation stay. Methods: Qualitative secondary analysis of appreciative patient comments during a bedside patient experience rounding, facilitated by a neutral party. Two independent analysts employed an inductive, summative form of content analysis. Results: Among 150 patients rounded, 122 provided categorizable appreciative accounts. Over two thirds of the patients (67.2%) focused on “staff attributes” in their great-experience accounts. Those attributes were mostly interpersonal such as being “attentive & caring - beyond clinical duty” and being “encouraging (but not too hard) & reassuring”. These interpersonal staff attributes were reported with words showing deep levels of personal significance or patient appreciation. Beyond staff attributes, the perceived quality of the “patient care” (31.1%) and opportunities for “leisure and social activities” (9.0%) were also frequently evoked. Amenities like food or costumer service were the least evoked, rarely so as an exclusive attribute (0.8% for each). Conclusions: The human(e) factor, especially the interpersonal qualities of staff, emerged as greatly appreciated from the patient experience perspective during inpatient rehabilitation. These experiences help identify which person-centered attributes of care might be further developed and sustained.

This study explores the role of stakeholder engagement in enhancing supply chain sustainability within the renewable energy sector. Through a qualitative research approach, including in-depth interviews with key stakeholders such as government agencies, industry associations, renewable energy companies, community groups, and environmental organizations, the research reveals the complexity and significance of effective stakeholder engagement. Stakeholders highlighted diverse motivations, including environmental, social, economic, and regulatory concerns, driving their participation. The study underscores the importance of tailored engagement strategies that recognize stakeholder heterogeneity and address specific needs and expectations. Collaborative approaches, such as public-private partnerships and multi-stakeholder initiatives, were identified as crucial for pooling resources, sharing knowledge, and addressing common challenges. However, challenges related to power imbalances, conflicting interests, and communication barriers were also noted. Government policies and regulatory frameworks were found to play a pivotal role in shaping stakeholder engagement practices and sustainability outcomes. Regulatory uncertainty and inconsistency were cited as significant concerns that could undermine sustainability initiatives. Community engagement emerged as a critical factor, with local communities often directly impacted by renewable energy projects. Meaningful engagement, including consultation and benefit-sharing mechanisms, is essential for building trust and securing social acceptance. Emotional intelligence and marketing strategies were recognized as important tools for effective stakeholder engagement, emphasizing the role of empathy, active listening, and clear communication. The findings of this study highlight the need for a holistic and integrated approach to stakeholder engagement and supply chain sustainability in the renewable energy sector. By addressing diverse stakeholder needs, fostering collaboration, and aligning policies with sustainability goals, stakeholders can work together to accelerate the transition towards a more sustainable energy future.

The Centers for Disease Control and Prevention (CDC) indicates that individuals with prediabetes are significantly less likely to develop type 2 diabetes if they participate in a lifestyle change program that results in at least 5% weight loss and 150 minutes of physical activity per week. The CDC recognizes distance learning as an effective delivery mode for lifestyle change programs to prevent type 2 diabetes. The purpose of this study was to assess enrollment, engagement, and effectiveness of a type 2 diabetes prevention program (DPP) using synchronous distance technology. Eat Smart, Move More, Prevent Diabetes (ESMMPD) is an intensive 12-month DPP delivered using synchronous distance technology. Throughout 26 lessons, participants focused on healthy eating, physical activity, and mindfulness behaviors. Study findings showed a significant decrease in A1C (-0.24 p<.0001). Weight loss averaged 5.66% for those who completed the program. Based on the Wilcoxon signed-rank test, participants demonstrated statistically significant changes in self-reported confidence in their ability to perform all 18 health-promoting behaviors assessed (p<.0001). Participation in the program also resulted in the adoption of health promoting behaviors. A DPP using synchronous distance technology is an effective delivery mode to help participants adopt healthy behaviors, increase physical activity, and achieve the weight loss necessary to prevent or delay the onset of type 2 diabetes.

The aim of this study was to use latent profile analysis to identify specific profiles of burnout syndrome in combination with work engagement and to identify whether job satisfaction, psychological well-being, and other sociodemographic and work variables affect the probability of presenting a profile of burnout syndrome and low work enthusiasm. A total of 355 healthcare professionals completed the Spanish Burnout Inventory, the Utrecht Work Engagement Scale, the Job Satisfaction Scale, and the Psychological Well-Being Scale for Adults. Latent profile analysis identified 4 profiles: 1) burnout with high indolence (BwHIn); 2) burnout with low indolence (BwLIn); 3) high engagement, low burnout (HeLb); and 4) in the process of burning out (IPB). Multivariate logistic regression showed that a second job in a government health care institution; a shift other than the morning shift; being divorced, separated or widowed; and work load are predictors of burnout profiles with respect to the HeLb profile. These data are useful for designing intervention strategies according to the needs and characteristics of each type of burnout profile.

Contradictory reports are available on vaccine-associated hyperstimulation of the immune system, provoking the formation of pathological autoantibodies. Despite being interconnected within the same network, the role of the quieter, yet important non-pathological; natural autoantibodies (nAAbs) is less defined. We hypothesize that upon a prompt immunological trigger, also physiological nAAbs exhibit a moderate plasticity. We investigated their inducibility through aged and recent antigenic triggers. Anti-viral antibodies (anti-MMR; n=1739 and anti-SARS-CoV-2 IgG; n=330) and nAAbs (anti-citrate synthase IgG, IgM; n=1739) were measured by in-house and commercial ELISAs, using Croatian (Osijek) anonymous samples with documented vaccination background. Results were subsequently compared for statistical evaluation. Interestingly, IgM isotype nAAb showed a statistically significant connection with anti-MMR IgG seropositivity (p< 0.001 in all cases), while IgG isotype nAAb levels were elevated in association with anti-SARS CoV-2 specific seropositivity (p= 0.019) and in heterogeneous vaccine regimen recipients (unvaccinated controls; vector/mRNA vaccines p= 0.002). Increasing evidence supports the interplay between immune activation and the dynamic expansion of nAAbs. Consequently, further questions may emerge regarding the ability of nAAbs silently shaping the effectiveness of immunization. We suggest re-evaluating the impact of nAAbs on the complex functioning of the immunological network.

The Textile and Clothing (T\&C) value chain is one of the most polluting in the world and one that produces the most waste. It is, therefore, important to encourage the Circular Economy (CE) model in this sector, to reduce pollution and mitigate the effects of waste production, and consequently increase environmental sustainability. For that, the involvement of the final consumer is essential. And, the final consumer's use of an Eco-gamified application for registering and promoting Consumer-to-Consumer (C2C) and Consumer-to-Business (C2B) activities, which extends the life time of textile products, is of utmost importance. In this article, we survey gamification frameworks for analyzing system design level techniques that enable engaging the final consumer in the CE process. Then, we select and use one of such frameworks, Gameful Design Heuristics (GDH), for defining the gamification structure needed to implement on a Business-to-Consumer-to-Consumer (B2C2C) context of a circular economy. As result, we present a B2C2C circular business process model for the T\&C value chain, and propose the design model of a gamified platform for the final consumers, which allows them to register the C2B and C2C activities, from the circular value chain's business process, and benefit from a game-like experience. All model features have been mapped to GDH framework heuristics, validating that it is possible to support a set of defined heuristics of applied gamification for promoting CE in the T\&C value chain.

The use of small Unmanned Aircraft Systems (sUAS ) as platforms for data capture has rapidly increased in recent years. However, while there has been significant investment in improving the aircraft, sensors, operations, and legislation infrastructure for such, little attention has been paid to supporting the management of the complex data capture pipeline sUAS involve. This paper reports on the outcomes of a four-year-long community-engagement-based investigation into what tools, practices, and challenges currently exist for particularly researchers using sUAS as data capture platforms. The key results of this effort are: (1) sUAS captured data – as a set that is rapidly growing to include data in a wide range of Physical and Environmental Sciences, Engineering Disciplines, and many civil and commercial use cases – is characterised as both sharing many traits with traditional remote sensing data and also as exhibiting – as common across the spectrum of disciplines and use cases – novel characteristics that require novel data support infrastructure. And (2), given this characterization of sUAS data and its potential value in the identified wide variety of use case, we outline eight challenges that need to be addressed in order for the full value of sUAS captured data to be realized. We then conclude that there would be significant value gained and costs saved across both commercial and academic sectors if the global sUAS user and data management communities were to address these challenges in the immediate to near future, so as to extract the maximal value of sUAS captured data for the lowest long-term effort and monetary cost.

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.

This study delves into the dynamics of relational energy (RE) within organizational context, examining some of its antecedents and decedents. Specifically, it investigates the influence of psychological capital (PsyCap) and humor on RE, and subsequently, the latter’s impact on job performance (JB) mediated by job engagement (JE). A research model based on structural equation modelling carried out with 481 employees in private service industries demonstrates several key relationships. It reveals that both PsyCap and affiliative humor positively affect RE, while aggressive humor exerts a negative influence. Furthermore, RE shows positive association with JE and JP, with JE serving as a mediator. To the authors’ knowledge, this is the first study to present an integrated model encompassing this exact combination of influencers and consequences of RE as well as to be investigated within Western Balkans cultural context. Therefore, it represents a novel approach. Additionally, the research addresses crucial questions regarding the existence and strategic significance of RE within organizational interactions. The findings offer valuable insights for organizations seeking to enhance employee engagement, performance, and wellbeing – even during health crises such as COVID-19 – by fostering RE. The study advances the understanding of RE in organizational settings and provides a foundation for future research in this domain.

Visual Patient technology is a situation awareness–oriented visualization technology that translates numerical and waveform patient monitoring data into a new user-centered visual language. Vital sign values are converted into colors, shapes, and rhythmic movements—a language humans can easily perceive and interpret—on a patient avatar model in real time. In this review, we summarize the current state of the research on the Visual Patient, including the technology, its history, and its scientific context. We also provide a summary of our primary research and a brief overview of research work on similar user-centered visualizations in medicine. In several computer-based studies under various experimental conditions, Visual Patient transferred more information per unit time, increased perceived diagnostic certainty, and lowered perceived workload. Eye tracking showed the technology worked because of the way it synthesizes and transforms vital sign information into new and logical forms corresponding to the real phenomena. The technology could be particularly useful for improving situation awareness in settings with high cognitive demand or when users must make quick decisions. This comprehensive review of Visual Patient research is the foundation for an evaluation of the technology in clinical applications, starting with a high-fidelity simulation study in early 2020.

There is little understanding of patients' experiences and perceptions with satisfaction by health professionals such as medical and dental clinicians. Furthermore, patient satisfaction is not well understood. The objective of this article is to better understand patients' satisfaction with their medical and dental care. The methods of the current article are based on a narrative review of the literature strategy. Patient satisfaction's multidimensional nature has been established since the perceived reasons for satisfaction varied widely among patients. Many aspects of the treatment influence participant satisfaction at different stages of the intervention's process. An improved understanding of the basis for managing patients' expectations with information reiteratively and efficiently may ultimately reduce patients' potential for negative feelings toward the medical and dental treatment experience. The consumerist method may misrepresent the concept of satisfaction in health service.

Combined hepatocellular cholangiocarcinoma (cHCC-ICC) is a rare malignancy that involves a combination of features of hepatocellular carcinoma and intrahepatic cholangiocarcinoma (ICC). cHCC-ICC is generally considered to exhibit a more aggressive clinical course compared to ICC; however, its risk factors and outcomes remain largely undefined. A single-center retrospective study of 82 patients diagnosed with ICC or cHCC-ICC from June 2011 and January 2023, all of whom underwent surgical resection. Our analysis included 70 patients with resected ICC and 12 with resected cHCC-ICC. The overall survival (OS) for the entire cohort was 21.6 months, with a recurrence-free survival (RFS) of 11.8 months. The cHCC-ICC group had significantly higher levels of AST and ALT (AST median 206 vs. 46; ALT median 165.5 vs. 48; p=0.012 and p=0.013, respectively), whereas the ICC group had higher alkaline phosphatase (median 66 vs. 104; p=0.03). CA 19-9 values (p=0.02) were higher in the ICC group, while AFP values were higher in the cHCC-ICC group (p=0.0004). The cHCC-ICC group had a significantly higher rate of recurrence (83% vs. 47%, p=0.028) with a significantly decreased RFS (4.7 months vs. 12.4 months; log-rank p=0.007). cHCC-ICC is a rare entity that needs to be further studied to improve patient outcomes. Our study showed that RFS is lower in the cHCC-ICC group as compared to ICC patients alone. Further studies are warranted and possibly suggest the need for more aggressive initial treatment strategies in patients diagnosed with cHCC-ICC.

This qualitative research explores the integration of digital technologies to enhance supplier engagement in e-commerce, examining the transformative impact of AI, blockchain, and IoT on supplier relationship management (SRM). Through semi-structured interviews and documentary analysis with 15 industry experts, the study reveals that digital technologies enable organizations to optimize supply chain operations, improve transparency, and foster collaborative partnerships with suppliers. Strategic initiatives such as co-development projects and joint innovation efforts are pivotal in accelerating product development cycles and enhancing market competitiveness. Emotional intelligence (EI) emerges as critical in cultivating trust, empathy, and effective communication, underscoring the human dimension of supplier relationships amidst technological advancements. Challenges identified include technological complexity, data privacy concerns, and resistance to change, necessitating robust cybersecurity measures and proactive compliance strategies. Economically, organizations benefit from significant cost savings, improved efficiency, and enhanced profitability through digital transformation initiatives in SRM. By leveraging digital platforms and data-driven insights, organizations can optimize procurement processes, streamline operations, and mitigate risks to achieve sustainable growth and resilience.

Background: South Africa’s public healthcare sector is overburdened, especially its under-resourced primary healthcare delivery system. This burden could be relieved by alleviating the population’s ill-health, focusing on the social determinants of health. These include living conditions and levels of social cohesion. In an attempt to address the aforementioned ‘challenge landscape’, this article considers socio-economic empowerment of those marginalised members of society living at the base of the pyramid (BOP) to improve factors contributing to poor health. We propose that Innovation Platforms (IPs) offer opportunities to achieve this by drawing diverse stakeholders together, which should include marginalised individuals, to pool resources and knowledge and collaborate around a specific set of challenges. Method: A Grounded Theory approach is utilised to develop the framework comprising concept definition from a systemized literature review. It is evaluated through various progressive stages through three phases of evaluation: 1) the initial framework was subjected to scrutiny in a theoretical case study, 2) a first-pass semi-structured interview and later four more semi-structured interviews with subject matter experts, and 3) an instrumental case study to refine the framework and to understand its application in a particular situation (this included four stakeholder interviews and a workshop and feedback session with the project champion). Results: This article contributes to the extant literature by addressing the lack of guidance on stakeholder engagement practices critical to the proper functioning of IPs in the context of overcoming the complex challenges associated with social determinants of health. The final output of the study is a refined management tool for stakeholder engagement in IPs. The tool provides practical recommendations to support policy makers, researchers and practitioners in 1) establishing IPs, 2) identifying areas for improvement and 3) identifying reasons for an IP’s failure and lessons to learn.

Cooperative organizations try to balance economic viability and Corporate Social Responsibility (CSR) management through strategic policies that involve dialogue, participation and engagement with stakeholders. To measure the impact of CSR management, the electricity sector implements monitoring processes and models, such as the Sustainability Reporting Standards of the Global Reporting Initiative (GRI), which measure contributions to the Sustainable Development Goals (SDGs) of the United Nations 2030 Agenda. This research analyses the strategic management of CSR in the 28 electric cooperatives that market electricity in Spain with the aim of determining their level of commitment to CSR and stakeholder participation in their corporate policies. The analysis is based on the descriptive-exploratory study of the whole population of electric cooperatives. The results indicate that the CSR management of most electric cooperatives is still in an emerging stage within the Value Curve. Importantly, there is a significant percentage of cooperatives that have already advanced towards the consolidating and institutionalized stages. However, most of these social-economy organizations are not developing programs that link their CSR strategies with their priority SDGs and sustainability as commitment to their community.

We report on an exploratory study conducted at a graduate school in Sweden with a humanoid robot, Baxter. First, we describe a list of potentially useful capabilities for a robot teaching assistant derived from brainstorming and interviews with faculty members, teachers, and students. These selected capabilities consist of reading, greeting, alerting, remote operation, clarification, and motion. Second, we present feedback on how the robot's capabilities, demonstrated in part with the Wizard of Oz approach, were perceived, and iteratively adapted over the course of several lectures, using the \EP tool. Third, we discuss observations and findings regarding the capabilities and the development process. Our findings suggest that using a social robot as a teaching assistant is promising using the chosen capabilities. We find that personalizing the capabilities and the role of embodiment are important topics to be considered in future work.

Mindful Eating (ME) is an increasingly popular dietary practice that may mediate the sympto-matology of Eating Disorders (EDs). Orthorexia Nervosa (ON) is a recently proposed eating dis-order characterized by excessive concern for healthy eating and calorie control. The purpose of this study is to investigate the relationship between ME and Psychological Distress (PD) with EDs and ON. In a cross-sectional study involving 407 adults, this research explored the interplay between ME, PD, and EDs, notably ON. Utilizing validated scales for ME (MES-16), EDs (EDE-QS), ON (ORTO-R), and PD, subcategorized in depression, anxiety, and stress (DASS-21), alongside inquiries into Instagram usage, significant correlations emerged. ME demonstrated a robust negative asso-ciation with both EDE-QS (r=-0.501, p<0.001) and ORTO-R (r=-0.519, p<0.001), while EDE-Q and ORTO-R showed significant correlations with depression, anxiety, and stress (p<0.001). Variations in ORTO-R mean scores were notably distinct across different ME categories (p<0.001), emphasizing the relationship between ME and ON. Additionally, participants with extensive daily Instagram use displayed significantly higher ON scores compared to minimal users (p<0.05). These findings sug-gest a negative link between ME with EDs and ON, highlighting ME's potential role in reducing ON tendencies. Furthermore, Instagram use seems associated with PD and elevated ON levels.

Family support is offered to Australian parents of young children using a mix of targeted and universal child and family health services. A feature of the universal services is the ability for nurses to work in partnership with families and to offer flexibility depending on need. This model of progressive universalism relies on the voluntary engagement of families, including families with complex needs. In this study, the capacity to engage and retain families, including those at risk for child maltreatment and family violence, was examined. Child and Family Health Nurses (n=129) participated in a pragmatic, multilevel mixed-methods study using the McCurdy and Daro (2001) Integrated Theory of Parent Involvement. A questionnaire was used in the first phase of the study to collect the quantitative data. Focus groups were then held with 27 participants recruited from phase one. Both homogeneous and heterogenous practices identified from the questionnaire were the focus of the discussions. Three phases of practice were identified and described: enrolment, retention and conclusion of the nurse-parent relationship and are presented and discussed in this paper. The retention of families with complex needs relies on flexible, advanced, and multidimensional nursing practices.

One of the major areas of research in a business setting has been the effect of the transformational leadership style on workplace engagement. Much debate has taken place on the definitions of both constructs but in recent years, general agreement appears to have been reached on the Multi-Factor Leadership Questionnaire (MLQ) (Avolio and Bass, 2004) as the measure of transformational leadership, and on workplace engagement measured by the Utrecht Work Engagement Scale (UWES) (Schaufeli et al, 2006). However, in the education setting, there is much less agreement on the definition of transformational leadership. Furthermore, there is less of a focus on workplace engagement than in the business field even though available evidence suggests that workplace engagement worldwide is in crisis. This study sought to address both the lack of agreement on the transformational leadership definition and the lack of focus on workplace engagement in educational research by means of a meta-analysis. The meta-analysis resulted in a significant pooled effect size although due recognition is given to the endogeneity problem in causal studies. The endogeneity issue together with the results of the meta-analysis are discussed with a view to furthering educational leadership research.

Background: There are limited evidence-based data to guide treatment recommendations for breast cancer (BC) patients ≥ 80 years (P80+). Identifying and addressing unmet needs are critical. Aims: Advocate-BREAST80+ compared the needs of P80+ vs. patients < 80 years (P80-). Methods: In 12/2021, a REDCap survey was circulated electronically to 6,918 persons enrolled in the Mayo Clinic Breast Disease Registry. The survey asked about concerns and satisfaction with multiple aspects of BC care. Results: 2,437 participants responded (35 % response rate); 202 (8.3%) were P80+. P80+ were less likely to undergo local regional and systemic therapies vs. P80- (p

Pheochromocytoma is a rare neuroendocrine tumor that affects people in the 4th and 5th decades of life. It can be benign or malignant, and present as isolated tumors or along with other neuroendocrine syndromes. We present a case of an elderly man who underwent laparoscopic adrenalectomy for pheochromocytoma when he was 58 years only to have a recurrence of metastatic malignant pheochromocytoma in his seventies. We also conducted a literature review to understand the epidemiology and presentation of the tumor and to emphasize that there should be a low threshold of suspicion for timely diagnosis and management of recurrent pheochromocytoma.

The EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI), EULAR Sjogren’s Syndrome Patient Reported Index (ESSPRI), and other patient-reported outcomes (PROs), such as the visual analog scale (VAS) for symptoms and EULAR sicca score (ESS), are used to assess the disease activity of primary Sjögren’s syndrome (pSS). Recently, Clinical ESSDAI (ClinESSDAI) and Clinical Trials ESSDAI (ClinTrialsESSDAI) were developed for objective clinical disease activity indexes. However, the relationship of ClinESSDAI and ClinTrialsESSDAI with PROs as well as that between ESSPRI and other PROs and the objective parameters of glandular function in pSS have not been established. Herein, we investigated the correlation of ESSPRI and other PROs with the objective parameters of glandular function and the relationship of PROs with ClinESSDAI and ClinTrialsESSDAI in 66 patients with pSS. Correlations were calculated with Spearman’s correlation coefficient. ClinTrialsESSDAI was correlated with ESSPRI, dryness (ESSPRI-Dryness), fatigue, and pain domains of ESSPRI, VAS for oral dryness (oral-VAS), and patient’s global assessment. Although ESSPRI did not correlate with the objective parameters of glandular function, ESSPRI-Dryness, ESS, and oral- and ocular-VAS did. These results suggest that ESSPRI-Dryness, ESS, and VAS for symptoms, but not ESSPRI, reflect the glandular dysfunction and that ClinTrialsESSDAI correlates with PROs for dryness in pSS.

Background: Community-based medical education (CBME) is an essential component of medical education, where primary healthcare physicians (PHPs) play a crucial role. This study explores PHPs' awareness and engagement in CBME and investigates the factors influencing their participation. Methods: This mixed study was conducted in two phases. In the first phase, a qual-itative study was conducted using semi-structured interviews with PHPs, and thematic analysis related to their awareness and engagement in CBME. In the second phase, a quantitative survey was conducted among 72 PHPs pre- and post-training programs. Results: Primary healthcare physicians had a positive attitude toward community-based medical education. The participants have an acceptable level of awareness and engagement, which increased substantially (p-value = 0.03) and (p-value = 0.003), respectively. Logistic analysis indicated that non-Saudi physicians were likelier to participate in the CBME (p-value=0.001). Professions and academic experiences influence their willingness and engagement to participate in CBME (OR= 7.5, p-value=0.001) and (OR=0.21, p-value=0.001), respectively. Conclusion: The study findings highlighted the importance of increased awareness and the factors that enhance PHPs' engagement in CBME. This positive perspective of the PHPs helps build effective partnerships and facilitates the extension of the curriculum to apply CBME.

The World Health Organization(WHO) in 2016 considered mHealth as: “the use of mobile wireless technologies including smart devices such as smartphones and smartwatches for public health” as an important resource for health services delivery and public health given their ease of use, broad reach and acceptance. WHO emphasizes the potential of this technology to increase access to health information, services and skills as well as promoting positive changes in health behaviors and management of diseases. In this regard, the capability of smartphones and smartwatches for m-health monitoring as well as verification of the patient the signal has become an important component of mHealth system. Most of the smartwatches could extract more than one bioelectrical signal therefore, therefore they provide suitable platform for extracting health data for e-monitoring. The existing approaches have not considered the integrity of data obtained from these smart devices. Therefore, it is important that the integrity of the collected data be verified continuously through user authentication. This could be done using any of the bioelectrical signals extracted and transmitted for e-monitoring. In this article, a smartwatch is used for extracting bioelectrical signal before decomposing the signal into sub-bands of Detail and Approximation Coefficient for user authentication. To select suitable features using biorthogonal wavelet decomposition of signal from a non-intrusive extraction, a detailed experiment is conducted extracting suitable statistical features from the bioelectrical signal from 30 subjects using different biorthogonal wavelet family. Ten features are extracted using Biorthogonal wavelet to decompose the signal into three levels of sub-band Detail and Approximation Coefficient and features extracted from each level the decomposed Detail and Approximation Coefficients. Comparison analysis is done after the classification of the extracted features based on the Equal Error Rate (EER). Using Neural Network (NN) classifier, Biorthogonal Wavelet Detail Coefficient Sub-band level 3 of bior1.1 achieved the best result of EER 13.80% with the fusion of the best sub-band three levels of bior1.1 achieving a better result of 12.42% EER.

South Africa is afflicted with the worst epidemic of HIV in the world a legacy of the system of oscillating migrant labour in the region and the consequent social disruption that was the legacy of Apartheid. The initial response from the national government was slow and ineffective but once the magnitude of the epidemic became apparent the government began to respond. The investment in HIV- and TB-related activities in 2013 was R22 Bn or (US$2.5; 2013 exchange rate) of which the South Africa government contributed 80% and the Presidents Emergency Plan for AIDS Relief (PEPFAR) 17%. South Africa now has the more people on anti-retroviral therapy than any other country and treatment is being started much sooner after infection. Much of the best biomedical, virological, immunological, mathematical and social science around the treatment and prevention of HIV and AIDS and the associated epidemic of TB has been done by South African’s and their international collaborators. If the efforts to control the epidemic are maintained South Africa is on track to meet the UNAIDS 90-90-90target by 2020 and to End AIDS by 2030 in spite of the magnitude of the problem. While individual, patient level data are increasingly available, especially in the Western Cape, much greater efforts need to be made to ensure that the information collected in this way is used to give feedback and support to clinic staff, to ensure that health clinics are providing the best possible service, and to individual patients and people living with HIV to ensure that they are receiving the best possible care and support. South Africa needs to make better use of the rich and detailed data that are being collected from individual clinics and their patients to identify problems or difficulties at the clinic level and to ensure that individual patients are retained on treatment, are virally suppressed and receive the best possible care and support.

INTRODUCTION Recently there has been a significant increase in age in the United States. It is necessary to better understand the physiological and surgical needs of these patients in order to optimize outcomes. The vast majority of procedures performed in adult patients are low-risk operations, such as laparoscopic cholecystectomy. Our aim is to investigate the outcomes, including length of stay, morbidity, mortality, re-admission and discharge disposition of the elderly population (>80) undergoing low-risk operations in our tertiary community hospital. METHODS A retrospective chart review was done at a tertiary community hospital. The time frame utilized was 2011-2015. Patients were excluded only on the basis of their age (< 80) at the time of operation. RESULTS There were a total of 30 patients who underwent laparoscopic cholecystectomy from 2011 to 2015. 21 patients (70%) were female and 9 (30%) were male. No patients were converted to an open procedure. The average age was 86.4 years and average ASA classification prior to surgery was 2.88. Higher ASA class, specifically those that were class III/IV were more likely to have an increased length of stay that was statistically significant. Overall age greater than 80 was an independent risk factor for transfer to a higher level of care upon discharge (SNF, LTAC, etc.), a surrogate marker for physical decompensation following surgery. CONCLUSIONS Routine surgery, such as the laparoscopic cholecystectomy, effects the elderly population in a more substantial way, and early recognition coupled with increased education for physicians regarding geriatric patients can help to reduce length of stay, morbidity, and overall physical and mental deconditioning.

A sustainable smart tourism ecosystem relies on building digital networks that link tourists to destinations. This study explores how web and immersive technologies, such as the VRRO platform, can improve tourism by offering interactive experiences to augment traditional travel. The study underscores the role of VRRO's design in enhancing user interaction and engagement, thereby encouraging the generation of user content and the development of a virtual tour network. An empirical analysis investigates user engagement, revealing that the platform is accessible to users regardless of their technological familiarity. It suggests a high likelihood of sustained use and recommendations. In conclusion, VRRO demonstrates how accessible and innovative technologies in tourism modernize travel experiences and significantly contribute to the evolution of the broader tourism ecosystem.

This paper delves into the essential role of local communities in mitigating climate change in the post-pandemic landscape, with a specific focus on Barangay Acmac, Iligan City, Philippines. Employing a qualitative research approach, the study integrates in-depth literature reviews, informal interviews with participants (B-Part 1 to B-Part 20), meticulous observations, and thematic analysis. The research has uncovered crucial insights, including variations in community climate change awareness that emphasize the necessity of comprehensive education and awareness campaigns. It highlights the significance of community-driven initiatives, adaptation, and resilience as key elements in addressing climate change. Collaborative efforts between local government officials and the community are showcased as effective instruments of climate change mitigation, yet challenges persist, including addressing the perceived powerlessness of some community members. The methodology, participants, and theoretical framework offer a robust foundation for exploring community responses to climate change. Drawing from a diverse theoretical framework, this study presents a comprehensive understanding of the climate change and pandemic intersection. The findings firmly establish that local communities are pivotal players in the global endeavor to mitigate climate change, underscoring the need for collective action, extensive education, and shared responsibility. The post-pandemic era presents a unique opportunity for local communities, policymakers, barangay officials, and residents to champion climate education, foster community-driven initiatives, and empower individuals to enact change at the grassroots level. The collaborative spirit observed in Barangay Acmac in 2022 serves as a model for communities worldwide, offering a blueprint for addressing similar challenges. Overall, this paper concludes with a resounding call to action, advocating for the recognition of local communities as the driving force in climate change mitigation, stressing that the power to combat climate change resides within these communities. The time for action is now, and local communities are the catalysts of this essential mission.

The COVID-19 pandemic forced the transition to emergency online learning without prior preparation or guidelines. This transition has been particularly challenging in developing countries and low-resource contexts and hindered student engagement. We aim to identify the engagement strategies which students, engaging in emergency online learning in low-resource contexts, perceive to be effective. We conducted a sequential mixed-methods study based on Moore’s interaction framework for distance education. First, we conducted a literature review and interviewed ten teachers and ten students to identify a list of engagement strategies. Then, we designed a questionnaire that examines student perceptions of these strategies. We administered the questionnaire to 313 students engaging in emergency online learning in low-resource contexts. Our analysis results showed that student-content engagement strategies, e.g. screen sharing, summaries, and class recordings, are perceived as the most effective, closely followed by student-teacher strategies, e.g. Q&A sessions and reminders. Student-student strategies, e.g. group chat and collaborative work, are perceived as the least effective. The perceived effectiveness of engagement strategies depends on the context and the students’ characteristics, e.g. gender, major, and technology access. To support instructors, instructional designers, and researchers we propose a ten-level guide for engaging students during emergency online classes in low-resource contexts.

Online education allows learners to develop knowledge and skills flexibly and conveniently—such observation among students whose characteristics involve student engagement, self-regulation, and self-efficacy. However, studies to characterize Filipino online learners seem lacking. Thus, this study aimed to characterize science education tertiary students in the Philippines concerning their online student engagement (OSE), self-regulated learning (SRL), and online learning self-efficacy (OLSE). The unprecedented events brought by COVID-19 pandemic also urged the implementation of online modalities while there is no available information on students’ online learning profiles. Hence, researchers used a survey research employed through ex post facto approach to determine the effects of the demographic profile on OSE, SRL, and OLSE. The survey was participated by N=373 respondents who answered the questionnaire with informed consent administered via Google Forms. Results revealed that OSE indicators moderately characterized students, while SRL and OLSE indicators are true of them, substantiated by the overall mean M=3.85(SD=0.90), M=3.86(SD=0.92), and M=3.14(SD=0.73), respectively. Also, multivariate tests showed no significant effect among the independent groups (p&gt;0.05), except for gender and OLSE interaction (p&lt;0.05) so, only in OLSE was a significant difference found in gender. In conclusion, Filipino online learners are moderate across aspects of student engagement, self-regulation, and self-efficacy.