Beliefs that maintain patriarchal principles may affect individuals’ willingness to avoid conflicts in their intimate partner relationships and eventually are likely to affect chances of intimate partner economic violence. Nonetheless, research has yet to fully explore these associations. This study used a sample of 321 adults in the ultra-Orthodox Jewish community—a patriarchal and traditional culture—to examine associations in beliefs supporting patriarchal principles at the micro (gendered domestic roles), meso, and macro ( institutional power of men and inherent inferiority of women) levels; conflict avoidance and economic violence; and sex differences in these factors. Descriptive statistics were used to explore gender differences in research variables, and path analysis examined the correlations between research variables for men and women. Beliefs in patriarchal ideologies were moderate at all levels, although slightly higher among men. Men tended to avoid conflict with their intimate partner significantly more than women did. Beliefs in support of patriarchal ideologies predicted conflict avoidance, especially among women. Finally, in opposition to prior research findings, this study revealed nonsignificant sex differences in the prevalence of economic violence victimization. These findings, however, do not suggest that economic violence victimization is not rooted in sex issues. We discuss the findings and the meanings assigned to conflict avoidance by men and women while considering gender disparities of power and control. We suggest that the contribution of men’s tendency to avoid conflict likely moderated their chances to perpetrate economic violence.

1) Background: Several studies have shown the benefit of drawing when learning anatomy. Virtual Reality (VR) also appears to be useful to increase the understanding of the location of anatomical structures. This study aims to describe how students in an Operating Room Nursing (OR nursing) master study program perceive the benefit of active learning methods, including drawing and the use of VR. 2) Methods: We combined these two methods in a class of 29 students. 38 half-finished drawings of anatomical structures were made. The students were to complete these during lectures with guidance from the teacher. The students also attended a two-hour VR session where they were to find various anatomical structures. A paper questionnaire was applied to evaluate the teaching program. Data were analyzed statistically. 3) Results: The students highly appreciated these learning methods. They reported that drawing made them work more actively during lectures and increased their learning outcome. They also perceived that the use of VR technology increased their understanding of the location of anatomical structures. 4) Conclusion: The combination of drawing and VR technology may be of benefit to OR Nursing students when learning anatomy by both increasing student activity and 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.

Early childhood may be a stressful period for families with a significant impact on parents’ mental health and the child’s healthy development. The goal of the SKKIPPI cohort study was to assess the occurrence and determinants of psychosocial stress and mental health disorders in parents as well as in their offspring in early childhood in three German regions. Based on random samples from three residents' registration offices, parents with infants up to 12 months of age at the time of sampling, were invited to participate in the study. A screening online questionnaire was newly developed, available in four languages, to assess common psy-chosocial stressors and mental health problems of parents with small children. The study enrolled 4,984 mothers and 962 fathers. The most common potential psychosocial stressors at baseline were professional problems (mothers 22%, fathers 33%), lack of social sup-port (20%, 14%), and severe, negative experiences in childhood (22%, 16%). Obses-sive-compulsive thoughts (21%, 16%), depressive (9%, 9%) and anxiety symptoms (11%, 7%) were the most frequently reported mental health problems by both parents. Regulatory prob-lems of the child were reported by between 1.5% and 5.1% of parents. The SKKIPPI study showed that a substantial proportion of parents are burdened by psychoso-cial problems and suffer from mental health problems in the first years after birth. Early pre-ventive and low-threshold support measures should be available in the health and social care system. The newly developed questionnaire can be used to screen in the relevant populations in order to avoid disturbances in the mother-child attachment.

Objective: To examine the dose-response relationship between average daily temperature and sunlight hours with daily steps across a 35-week period in school-aged children, and to evaluate whether there were differences by sex. Methods: We conducted a follow-up study involving 655 children (50.8% girls, mean age 10.45 ± 0.95) from six public primary schools in Cuenca, Spain. We measured daily steps using Xiaomi Mi Band 3 Smart Bracelets from October 2022 to June 2023 (over 35 weeks). We collected daily average temperature from the local weather station in Cuenca and sunlight hours during the same period. We used ANCOVA models and LOESS regression to examine the dose-response relationship between average daily temperature and daily hours of sunlight with daily steps. Additionally, we performed a multiple linear regression model. Results: Our findings revealed significant variations in daily steps across the 35 weeks. The relationship between environmental factors and daily steps was non-linear, in both girls and boys. The optimal values for higher activity levels were an average temperature of 14°C and 13 hours of sunlight. Furthermore, a 1 ºC increase in temperature was associated with an increase of 74 ± 130 steps/day, while an increase of one hour of sunlight was associated with an increase of 315 ± 237 steps/day. However, sunlight hours may act as a moderating factor. Conclusion: Our study showed a non-linear association between t average daily temperature and sunlight hours with daily steps over a 35-week period. Additional strategies may be necessary to encourage increased physical activity during periods of extreme temperatures or sunlight exposure.

To examine the effect of synchronous dance movements on social bonding and perceived closeness between generations, 168 young (20-45 years) and older (65-90 years) participants were randomly assigned to six dyad conditions. These included dancing synchronously or asynchronously with an in-age-group or an out-age-group unfamiliar partner for 11 minutes. Participants completed social bonding and groups’ closeness questionnaires. To assess variation across individuals’ and dyads’ measurements, a generalized estimating equations modeling analysis was conducted. In line with the first two hypotheses, synchronized dance increased social bonding, and young adults showed enhanced perception of closeness between generations. Hypothesis 3 that synchronous dance with out-age-group members would foster greater perceived closeness compared to in-age-group members was not confirmed. Surprisingly, results indicated that asynchronous movements with the in-age-group led to a higher degree of closeness between generations than asynchronous movements with the out-age-group. The study offers new directions for practitioners in welfare, nursing, and therapy fields, particularly for engaging young adults in intergenerational dance interventions.

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

Views of aging include peoples’ assessment of their own aging process and their subjective age. Positive aging views relate to good psychological well-being which predicts better physical and mental health. While these were substantially studied, the moderating roles of self-aging attitudes and psychological well-being in the subjective age-age discrimination connection have been much less explored. The current study used a convenience sample of 568 participants (mean = 66.21y, SD = 11.95, age range 50-95), 55.8% women, 67.1% employed. In line with the hypotheses, young subjective age and psychological well-being were connected to less age discrimination in the workplace and higher psychological well-being mitigated the subjective age-age discrimination at work connection. When the perception of old age as a period of loss was added to the model, adults who perceived old age as a period of loss and reported lower levels of psychological well-being, demonstrated the strongest relationship between an increase in subjective age and an increase in age-related discrimination at work. The findings emphasize the importance of the psychological well-being of older employees as a resource for improving their attitudes to their last years at work.

This study investigates the effect of perceived discrimination on the mental health of Afghan refugees, and secondly, tests the distress moderating effects of pre-migration traumatic experiences and post-resettlement adjustment factors. In a cross-sectional design, 259 Afghans completed surveys assessing perceived discrimination and a number of other factors using scales developed through inductive techniques. Multivariate analyses consisted of a series of hierarchical regressions testing the effect of perceived discrimination on distress, followed by a sequential analysis of moderator variables. Perceived discrimination was significantly associated with higher distress, and this relationship was stronger among those with a strong intra-ethnic identity, high civic engagement, and high pre-resettlement traumatic experiences. Discrimination is a significant source of stress for Afghan refugees, which may exacerbate stresses associated with other post-migration stressors. Future research is needed to tailor interventions that can help mitigate the stress associated with discrimination among this highly vulnerable group.

Insecurity, corruption, and rising unemployment have resulted in a mass exodus of young adult Afghans seeking asylum in western nations. This has depleted Afghanistan of generations of young people which are critical to rebuild the country. This study aimed to examine the characteristics of young adult Afghans with no immediate intentions of seeking international asylum; that is, individuals who intend to stay in Afghanistan. In a cross-sectional study conducted in Kabul, we surveyed 232 young adults between 18 and 35 years of age. Surveys included measures assessing standard socio-demographic and -economic factors, as well as health and psychological factors. Univariate logistic regression analyses suggest that participants with an intent to stay in Afghanistan are more likely to be financially stable, possess higher health-related quality of life, lower psychological distress, and higher levels of hope and optimism, as well as higher resilience. When controlling for all other variables in the model, only hope, optimism, and higher resilience remained as significant correlates of intending to stay. Our findings suggest that young people who intend to stay in their country look forward to a better future, which provides strong evidence for the need to strengthen the social contract by fostering resilience, hope and optimism in war-affected communities, in order to prevent a generation of talented young people from seeking asylum in western nations.

To assess the community health workers’ (CHWs) knowledge, attitude, and practices (KAP) in type-2 diabetes (T2D) and hypertension (HTN) management. We thus also sought to assess the potential health system barriers for incorporating CHWs in T2D and HTN management. Mixed-method study comprised (1) a survey among 153 active CHWs to assess their KAP of T2D and HTN, and (2) semi-structured interviews with key informants to understand challenges of the health system and proposed solutions in incorporating CHWs in T2D and HTN management. The majority of CHWs correctly answered general knowledge questions on NCDs, risk factors, and prevention; however, only one-quarter correctly answered questions on smoking, family history, or tobacco use as risk factors. Most respondents appeared to have positive attitudes and have been practicing some activities related to T2D and HTN. Both financial and non-financial resource constraints were cited as challenges of the health system; therefore, re-structuring the role definition of CHWs and task of responsibilities, and assessment the need and workload have been proposed as ways forwards to effectively incorporate CHWs in T2D and HTN care. CHWs in Cambodia have shown their potential in T2D and HTN management; however, a well-designed strategy including technical training, clearly defined roles and responsibilities, and strong supporting structure are important to maximize their potential in the health system.

(1) Background: There is insufficient empirical evidence on the correlates of health care utilization of irregular migrants currently living in Turkey. The aim of this study was to identify individual level determinants associated with health service and medication use. (2) Methods: 155 Afghans completed surveys assessing service utilization including encounters with primary care physicians and outpatient specialists in addition to the use of prescription and nonprescription medicines. Multivariate logistic regression analyses were employed to examine associations between service use and a range of predisposing, enabling, and perceived need factors. (3) Results: Health services utilization was lowest for outpatient specialists (20%) and highest for nonprescription medications (37%). Female gender and higher income predicted encounters with primary care physicians. Income, and other enabling factors such as family presence in Turkey predicted encounters with outpatient specialists. Perceived illness-related need factors had little to no influence on use of services; however, asylum difficulties increased the likelihood for encounters with primary care physicians, outpatient services, and the use of prescription medications. 4) Conclusion: This study suggests that health services use among Afghan migrants in Turkey is low considering the extent of their perceived illness-related needs, which may be further exacerbated by the precarious conditions in which they live.

Wastewater genomic surveillance is an efficient and economic approach to track infectious diseases and can help detect unusual epidemiological events. The current study uses this approach for the first time in Morocco to monitor the epidemiology of SARS-CoV-2 and Influenza A, B and RSV virus infections during the third wave of COVID-19 caused by the Omicron variant. The virome was concentrated from wastewater collected from two sewer sheds of two cities, Agadir and Inezgane, using the PEG/NaCl method. The viral copy number was determined using qRT-PCR. All 26 samples in both cities were tested positive for SARS-CoV-2 at various viral loads. For Influenza A virus, two samples were tested positive in Inezgane. The estimated SARS-CoV-2 viral RNA copy numbers observed were then used to estimate the number of infected individuals using the SEIR model. The number of viral copies of SARS-CoV-2 for Agadir and Inezgane varied from 82932 ± 15479 to 507865 ± 58759 copies/L and 61244 ± 8552 to 497506 ± 18061 copies/L, respectively. The estimated number of cases correlates positively with the number of reported cases. Next Generation Sequencing showed that samples contain the following two variants: BA.1 and BA.2 that have been detected in clinical samples. This study demonstrates the effectiveness and feasibility of wastewater genomic surveillance in monitoring pathogens such as SARS-CoV-2 in Morocco.

Healthcare professionals constantly face situations that reflect ecosystems’ degradation. These can negatively affect their mental health. Research suggests that hope and resilience can play an important role in this scenario, since they are related to/predict mental health in highly heterogeneous samples (considering geography, age, profession, health, etc.). In this context, the aims of the present study are: to characterize and explore the relationship between hope, resilient coping and mental health of Portuguese healthcare professionals. Using Google Forms, 276 healthcare professionals answered to the GHQ-28, the (adult) Trait Hope Scale, and the Brief Resilient Coping Scale (cross-sectional study). The minimum and maximum possible scores were reached, with the exception of the maximum score of GHQ-28-Total. Regarding Hope, 19.6% scored below the midpoint (M=43.46, SD=11.97); 29.3% revealed low resilience (M=14.93, SD=4.05); and the average of 4 of the 5 Mental Health scores (exception: Severe Depression) indicates the probability of a psychiatric case. Hope correlated with Social Dysfunction and GHQ-28-Total; resilient coping proved to be a (weak) predictor of 4 of the 5 GHQ-28 indicators (exception: Severe depression). The results support the need to promote the sample's mental health, hope and resilient coping. They also suggest that stimulating resilient coping may contribute to improving healthcare professionals’ mental health.

Grand challenges represent wicked problems that affect many people globally. To overcome grand challenges and sustain our existence as human beings, issues have become increasingly central, and in recent years have led to an increase in research and literature on grand challenges affecting both international business areas and multinational enterprises. The aim of this study is to assess the status of literature in all areas connected to multinational corporations and grand challenges, which are global issues with significant implications. From 2013 to 2023, the WoS database was used to investigate eight search terms from literature, and bibliometric and thematic analyses were carried out based on the principles of systematic literature analysis. The most focused areas of the research are performance, multinational enterprises, foreign direct investment, management, firms’ innovation, knowledge, international business, and impact. Asian, African, European, and other countries may emerge together in different clusters depending on whether the major challenges they are struggling with are similar or identical. the terms of grand challenges and innovation (open and social), technology transfer, R&amp;D internalization, digital transformation or technology and artificial intelligence in the literature of multinational enterprises indicates that these themes are used as a tool to solve grand challenges.

HIV early detection (CD4 counts ≥350 cells/μL) is correlated with higher life expectancy among people living with HIV (PLHIV). Several factors including physical, cultural, structural, and financial barriers have contributed to HIV late detection. This is the first-of-its-kind study on the regional differences in early detection of HIV within Tajikistan and any country in the Central Asia region. Utilizing Tajikistan Ministry of Health's national HIV data (N=10,700) spanning 2010 to 2023, we developed median regression models with median CD4 cell count as the outcome and as predictors: time (years), region, age, gender, and area (urban/rural status). Individuals younger than 19 years old are more likely to be detected early for HIV, whereas those older than 39 years are more prone to late detection. Given their active engagement in age-related and sexual activities, those older than 39 years face a higher risk of HIV transmission to others if diagnosed late. Therefore, they require further attention and targeted interventions. Females are detected earlier compared to their male counterparts, regardless of region of residence. Rural populations are detected earlier in most years compared to their urban counterparts. The COVID-19 pandemic accelerated HIV early detection in 2021 but most regions have returned to near pre-pandemic levels of detection in 2022 and 2023. These fluctuations in early detection may signify a shift in attention and resource allocation, potentially affecting efforts to address access gaps during the initial year of the COVID-19 pandemic. There are significant health inequities among different demographic and geographic groups which warrant further attention.

Marijuana is the most used illicit drug among youths in the United States. The objectives of the study were to identify the association between marijuana use and other risk behaviors including suicidality among high school students. The 2021 Mississippi Youth Risk Behavior Survey data sets were combined for this study. Crude odds ratio (OR) and adjusted odds ratio (AOR) with a 95% confidence interval were generated using the survey packages in R to account for weights and the complex sampling design of YRBS data. Tobacco products and alcohol use were significantly associated with marijuana use. Students who responded “Yes” to questions “currently used an electronic vapor product?”, “currently smoked cigarettes or cigars?” or “currently drank alcohol?” were more likely to use marijuana compared to students who responded “No”, after adjusting for other risk factors. Marijuana use is also significantly associated with students who had sex, compared to those who never had sex. The adjusted odds ratio is nearly doubled in those who had sex with the same sex or both sexes, compared to those who had heterosexual sex only. After adjusting for other health risk factors, the association between current marijuana use and attempted suicide was not statistically significant. The impact of students’ not sleeping in their parent's or guardian's home on current marijuana use was not significant after adjusting for other risk factors. Marijuana use is evenly burdened between males and females and between all race categories among Mississippi high school students. The identified associations seem to indicate that electronic vapor, tobacco products, and alcohol use could be the forerunners for drug use and should be treated accordingly in drug use prevention programs.

We assessed the impact of social determinants of health (SDOH) and psychosocial factors on screening behavior in a nationally representative sample of women in the US. A retrospective population-level cross-sectional sample was extracted from the 2022 Health Information National Trends Survey. Descriptive statistics were conducted for demographic characteristics and covariates. Population-based estimates with 95% confidence intervals (95% CI) were produced for Pap testing behaviors across study years. We used logistic regression models to assess Pap testing differences based on SDOH and psychosocial factors, adjusting for covariates, with a significance level of 0.05 for hypothesis testing. Women (n=2,224) with a mean age of 46.96 participated in the study. Our study found that 90% of women were interested in cervical cancer screening, with an 80% actual screening rate. Screening rates differed by age group and rurality. SDOH and psychosocial factors were associated with participants’ interest in screening and in actual screening behavior. The impacts of SDOH and psychosocial factors on screening behavior were 3% and 1%, respectively. The SDOH and psychosocial factors are associated with the uptake of cervical cancer screening among women in the United States. Policies must be directed at bridging the gap created by these SDOHs.

Cellular senescence is the irreversible growth arrest subsequent to oncogenic mutations, DNA damage or metabolic insult. Senescence is associated with aging and chronic age associated diseases such as cardiovascular disease and diabetes. The involvement of cellular senescence in Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD) is not fully understood however, recent studies suggest that such patients have a higher-than-normal level of cellular senescence and accelerated aging. This study aimed to discover key biomarkers of senescence in AKI and CKD patients compared to other chronic ageing diseases as controls. We show that senescence proteins CKAP4 and PTX3 are upregulated in AKI and CKD patients compared with controls with chronic diseases suggesting they may play in a role in overall kidney disease development. Additionally, CKAP4 was found to be differentially expressed in both AKI and CKD when compared to unhealthy controls hence this biomarker could be prognostic senescence biomarker of both AKI and CKD.

In August 4 2011, United Nations Environmental Program (UNEP) submitted an unprecedented, scientific, groundbreaking Environmental Assessment Report (EAR) of Ogoniland, to the Nigerian government. This was the outcome of a 14–month intensive evaluation of the extent of pollution. It was intended that UNEP’s recommendations would be implemented to restore the devastated environment, on the one hand, and on the other, counteract the numerous environmental health issues that have for decades, plagued Ogoniland. However, five years post EAR, and, despite the seriousness of the situation, no significant resolution has occurred, both on the part of the government, and on the part of Shell Petroleum Development Company (SPDC) or Shell. To date, millions of Niger Delta residents, particularly those living in the oil-bearing communities, continue to suffer severe consequences. Although, the assessment was conducted in Ogoniland, other communities in the Niger Delta are also affected. This article explores prevailing issues, using Ogoniland (a microcosm of the Niger Delta) as an example. A multidisciplinary approach for sustainable mitigation of environmental health risks in the Niger Delta is paramount, and Environmental Management tools offer valuable strategies. Adopting UNEP’s recommendations for addressing environmental health problems requires implementing the Environmental Management/Environmental Management System (EM/EMS) model.

Taking due account of users' perspectives is crucial for improving the quality of healthcare services. This study aimed to analyse the representations and evaluation criteria that users of a public health agency express towards care and treatment services and to explore whether and how the content and meaning of their communications varied according to pre-pandemic, pandemic or post-pandemic periods. 501 communications (73.4% complaints, 16% appreciations, 10.6% enquiries) sent to the public relations office of an Italian health agency were collected. An automatic content analysis procedure (ACASM) was applied to the textual corpus. Four main thematic cores were identified concerning the request for care and respect, the value of the doctor-patient relationship and the difficulties in contacting services and accessing care. Two main latent dimensions of meaning were identified, which capture the dialectic between the demand for relationships and the demand for access to care, and between attention to the relational competence of health workers and attention to the needs and rights of users. Communications collected during the pre-pandemic and post-pandemic periods mainly concern the difficulty of access to care; those collected during the pandemic period mainly concern the doctor-patient relationship. Interpersonal aspects and timely access to care appear to be crucial in users' assessment of the quality of care.

In Belgium, sex work was recently decriminalized to enhance street-based sex workers’ (SSWs) health. This qualitative study explores stakeholders' perceptions of the impact of the working environment on street-based sex workers’ occupational safety, health and well-being in Brussels. In-depth interviews with seven stakeholders directly involved with SSWs were conducted with data analyzed using qualitative content analysis. The analysis of study data resulted in one theme: “A power imbalance and a lack of concerted efforts among stakeholders are detrimental to the occupational safety, health, and well-being of street-based sex workers”. In Brussels, the majority of SSWs face various challenges due to structural vulnerabilities, thus limiting their choices regarding their work environment, and further compromising their health. Limited access to resources and severe constraints within their working environment contribute to a lack of safety and adverse health outcomes. A stigma mechanism fueled by ideology and personal interests prevent the enforcement of their rights regarding their working environment, safety and health promotion. The lack of involvement of key stakeholders, especially from the public sector, prevents the majority of SSWs in Brussels from benefiting from a sound working environment and the promotion of their health, safety and well-being.

Sentiment analysis plays a crucial role in understanding customer feedback, guiding product development, and informing business decisions. This paper introduces term sentiment entropy (TSE), a novel weighting method that leverages the distribution of sentiment labels associated with words to enhance text classification accuracy. TSE complements traditional TF-IDF techniques by capturing the nuances of sentiment variation across different contexts. Experiments across diverse public datasets demonstrate TSE's potential to improve sentiment analysis performance, especially in capturing subtle sentiment shifts and adapting to specific domains. While computational cost and label quality pose challenges, TSE offers a promising avenue for refining sentiment analysis and opening new research frontiers.

Mississippi youth are demographically unique compared to that of the nation. The purpose of this study was to determine the trend of drug use among adolescents of the United States and Mississippi, and to estimate the differences of drug use prevalence as a whole, and by gender and by race. National and Mississippi YRBSS data from 2001 to 2021 were obtained for analysis. Summary statistics, prevalence ratio, and survey Chi-squared tests of independence statistics were generated for the comparison for all students, and by gender and race separately. Trend analysis was conducted using logistic regression combined with joinpoint regression. Six survey questions being studied were: have you ever used marijuana, inhalant, heroin, methamphetamines, injected drugs, and were you offered, sold, or given an illegal drug on school property during the last 12 months. Survey packages in R were used to account for the complex sampling design of YRBSS data. On the national level, all six drug related risk behaviors being studied showed significant decrease from 2001 to 2021. In Mississippi however, only “ever used marijuana” showed a trend of decrease, while three remain unchanged, and two increased. 2021 YRBSS data shows that Mississippi adolescents exhibited significantly higher prevalence of drug use, and are more likely to be offered, sold or given an illegal drug on school property. Our study suggests an urgent need for drug use intervention among Mississippi adolescents. More concerted actions at the community, school and government level are needed for reducing youth drug use and controlling the drug traffic on school property.

Recent studies have emphasized the influence of resettlement factors on the mental health of refugees resettling in developed countries. However, little research has addressed gender differences in the nature and influence of resettlement stressors and sources of resilience. We address this gap in knowledge by investigating how gender moderates and mediates the influence of several sources of distress and resilience among 259 Afghan refugees residing in northern California. Gender moderated the effects of four factors on levels of distress. Intimate and extended family ties have little correlation with men’s distress levels, but are strongly associated with lower distress for women. English ability is positively associated with lower distress for women, but not men. In terms of gender ideology, traditionally oriented women and egalitarian men have lower levels of distress. And experiencing greater dissonant acculturation increases distress for men, but not women. The influence of gender interaction terms is substantial and patterns may reflect difficulty adapting to a different gender order. Future studies of similar populations should investigate gender differences in sources of distress and resilience, and efforts to assist new arrivals might inform them of changes in gender roles they may experience, and facilitate opportunities to renegotiate gender roles.

Improving the quality and access to healthcare services in rural areas is fundamental to develop sustainable healthcare systems. This research aims to explore the motivations of healthcare professionals to work and settle in rural island areas of Greece with limited access to secondary and tertiary care. The study suggests practical ways to encourage self-motivation and attract more health workers in rural areas. An exploratory qualitative research approach was employed, involving semi-structured interviews with 16 healthcare professionals working in primary care units that lack direct hospital or hospital-health center access. The research was conducted specifically in the rural islands of Cyclades. Thematic analysis was conducted to identify common themes and unique insights from the participants. The analysis revealed three thematic categories. Τhe «attraction» thematic was influenced by personal factors, random selection, origin, accommodation factors, professional factors and obligatoriness. The «recruitment» thematic was associated with understaffing, special care issues, unstable working environment, educational and organizational aspects, and insular lifestyle. The thematic of «retention» highlighted personal issues, accommodation difficulties, economic and work-related issues, and unique challenges posed by an insular lifestyle. This research provides valuable insights into the motivations that drive healthcare professionals to settle, work, and remain in remote island units, as well as the challenges they encounter in making this decision. The study proposes strategies to motivate and attract more healthcare professionals to rural areas. These findings should be considered when formulating or reviewing primary healthcare empowerment policies to ensure equitable healthcare access for all individuals.

Abstract: Nordic exercises aim to improve physical abilities and prevent injuries; However, it is not clear in what type of sports modalities to use it, so this study arises from the interest of ana-lyzing its effect in different sports modalities. Objective: To analyze Nordic exercises effects on the lower limbs, and their relationship with the explosive and absolute strength inherent to demands of different sports modalities (football, athletics, basketball, sport climbing, cycling and taekwondo). Method: quasi-experimental research, identifying 122 athletes (18±3 years old) from: football (n=24), athletics/speed (n=20), sport climbing (n=20), basketball (n=24), taekwondo (n=14) and cycling (n=20); classified into a control group CG (n=57) and an experimental group EG (n=65). Results: dominant absolute strength of the initial (12.4±0.51) and final (14.5±0.98) EG, in greater proportion in basketball (P= < 0.05); explosive strength of the initial (42.4±1.2) and final (45.8±1.5) EG, with a significant difference in all modalities between before and after (p≤0.05), except in cy-cling and taekwondo; no major changes were found in the GC. Conclusion: Nordic exercises are recommended as part of training to improve levels of explosive strength with emphasis on the modalities of football, basketball, athletics/speed and sport climbing, being applicable to increase absolute strength in basketball.

Introduction: Despite its high prevalence and impact on health, metabolic dysfunction-associated steatotic liver disease (MASLD) is inadequately addressed in European primary care (PC), with a large proportion of cases going undiagnosed or diagnosed too late. A multi-country European re-search consortium led a project to design and evaluate a patient-centered, integrated model for MASLD screening, diagnosis and linkage to specialty care for European PC settings. Aim: Based on the lessons from this project, the latest research evidence and existing guidelines for the management of MASLD, we sought to develop a set of practice recommendations for screening, referral and management of MASLD in PC. Methods: The Rand/UCLA modified Delphi panel method, with two rounds, was used to reach consensus on practice recommendations. The international panel consisted of experts from six countries, representing family medicine, gastroenterology, hepatology, cardiology and public health. Initially, fifteen statements were drafted based on a synthesis of evidence from the literature and earlier findings from our consortium. Prior to the consensus meeting, the statements were rated by the experts in a first round. Then, in a hybrid meeting, the experts discussed findings of round one, adjusted the statements and reassessed the updated recommendations in a second round. Results: In round one, there was already a high level of consensus on 10 out of 15 statements. After round 2, there were fourteen statements with a high agreement (>90%). One statement was not endorsed. The approved recommendations addressed the following practice areas: risk screening and diagnosis, management of MASLD – Lifestyle interventions, pharmacological treatment of MASLD/MASH, pharmacological treatment for co-morbidity, integrated care, surgical management and other referrals to specialists. Conclusion: The final set of 14 recommendations focuses on increasing comprehensive care for MASLD in PC. The recommendations provide practical evidence-based guidance tailored to PC practitioners. We expect that these recommendations will contribute to the ongoing discussion on systematic approaches to tackle MASLD and support European PC providers by integrating the latest evidence into practice.

Throughout the Covid19 period, families were forced to stay indoors, adapting to online school-ing, remote work, and virtual social engagements, inevitably altering the dynamics within households. There is a notable increase in mental health challenges in terms of anxiety and de-pression in children and adolescents. This study intends to explore the psychosocial effects of the Covid-19 pandemic in Italian families adopting self- and proxy-report questionnaires on anxiety, anger, and health-related quality of life. The results showed that approximately 20% obtained a clinical anxiety score and only 10% obtained a clinical anger score. There was found a difference in the perception of the quality of life reported by the child and that perceived by the parent. The stepwise regression model showed that total anxiety scores were predicted by sex, quality of life scores from the parents' self-report version and total anger score. Another stepwise regression model identified physiological and social anxiety as the best predictors that impact the quality of life. Parental well-being actively influences the well-being of children, so it is fundamental to implement preventive programmes and promote child well-being providing parents the most adequate support possible.

Empowering women and promoting gender equality is crucial for accelerating sustainable development in fragile countries, including the Democratic Republic of Congo (DRC). However, there is scarce existing knowledge or understanding of the factors determining women’s empowerment in these contexts. We aimed to assess women's empowerment and determine its associated factors in Kinshasa, DRC. We analyzed data from the 2021 Performance Monitoring Assessment (PMA) survey. A sample of 1,365 women of childbearing age was retained for this study. Twenty empowerment items related to household decision-making, contraception use, and husband/partner influence were considered. We calculated the average women’s empowerment index (aWEI), identified the women empowerment variables using principal component analysis (PCA), and determined the associated factors for the first three principal components through the performance of multivariate binary logistic regression. In Kinshasa, the overall aWEI was estimated at 0.65. It was low for household decision-making (0.34) and high for husband/partner influence domains (0.93), respectively. Three principal components were identified and named, including the absence of threats, control of sexuality, and participation in decision-making. The factors associated with these components were having internet access, being in free union with a partner, being aged 40-49 years, and residing in a non-slum area. Increasing access to information would enable women in Kinshasa to make strategic decisions about their lives, benefiting themselves and others.

Limited understanding exists regarding the intricate dynamics between the levels of social inhi-bition exhibited by both wives and husbands concerning their perceived family support and de-pressive symptoms, particularly within couples who are parents of children diagnosed with au-tism spectrum disorder (ASD). This study used the actor-partner, interdependence mediation model to analyze data collected from 397 pairs of Chinese parents with children diagnosed with ASD. The findings of the study revealed significant indirect actor effects, indicating that the levels of social inhibition exhibited by both wives and husbands were associated with their own de-pressive symptoms through their respective perceptions of family support. In general, the study did not find significant partner effects, except for some indirect effect (IE) of wives on their hus-bands' depressive symptoms through the wives' perceived social support. This observation sug-gests that cultural norms and role expectations within the family context may influence these dy-namics. These results underscore the potential importance of interventions aimed at addressing social inhibition and enhancing perceived family support to alleviate depressive symptoms in this population. Additionally, interventions targeting fathers should emphasize the importance of their involvement in parenting and collaboration with their partners in caring for children with ASD. Such collaborative efforts may contribute to improved outcomes for both parents and chil-dren within families affected by ASD.

Background: Low-level physical activity (PA) among Chronic Low Back Pain (cLBP) is associated with various biopsychosocial factors. This research aimed to study the predictors of PA behavior among cLBP patients. Methods: In the present study 300 eligible patients with cLBP who referred to comprehensive health service centers in the Shahid Beheshti University of Medical Sciences (SBUMS) in Tehran, Iran were random selected.To diagnose the predictors of PA behavior, all the Theory of Reasoned Action (TRA) constructs were examined as risk factors to see if they influence on the probability of PA behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 280 cLBP patients with mean age of 57.07 ±13.09 years old participated in the study. This study showed that motivation to comply significant predictor the cLBP patients for subjective norm OR (%95CI): 2.095(0.116-2.792), p-value<0.001), intention was significant predictor for perform the PA behavior OR (%95CI): 1.431(0.138-1.538), p-value <0.001), behavior beliefs could predictor for attitude OR (%95CI): 1.276(0.106-1.355), p-value= 0.002). attitude, normative beliefs, subjective norm ,and evaluation outcome behavior could predictors the cLBP patients for intention to perform the PA behavior OR (%95CI): 1.188(0.032-1.312), p-value<0.001)., OR (%95CI): 1.158(0.076-2.208), p-value=0.003) ., OR (%95CI): 1.104(0.076-1.128), p-value<0.001) ., OR (%95CI): 0.814(0.301-1.440), p-value=0.007). Conclusions: This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm).

Cardiovascular diseases, which are the leading cause of death in Croatia, are linked to the high prevalence of hypertension. Both are associated with high salt intake which was determined almost two decades ago when Croatian Action on Salt and Health (CRASH) was launched. The main objective of the present study was to evaluate salt, potassium, and iodine intake using 24-hour urine samples in a random sample of adult Croatian population, and to analyse trends in salt consumption after the CRASH has intensively started. Methods: In this national population-based EH-UH 2 study performed in 2018-2021 (participation rate 72 %) in which we analysed a single 24-hour urine sample, 1067 adult participants (mean age 57.12 (SD 13.9), men 35%) were included. Results: Mean salt and potassium intakes were 8.6 g/day (IQR 6.2-11.2) and 2.8 g/day (IQR 2.1-3.5), respectively, with sodium-to-potassium ratio of 2.6 (IQR 1.8-3.3). We detected a decrease of 17.6% (2 g/day less) in salt consumption compared to our previous salt-mapping study. However, only 13.7%, and 8.9 % met the WHO salt and potassium recommended target of 5 g/day, and 3.5 g/day, respectively. Salt intake was higher, and potassium ingestion was lower in rural vs. urban regions, and in continental vs. Mediterranean parts of Croatia. Moderate to severe iodine insufficiency was determined in only 3% adult participants. Conclusion: In the last fifteen years, salt consumption has been significantly reduced in Croatian adult population because of intensive and broad CRASH program led by the Croatian Society of Hypertension and the Croatian Hypertension League. However, salt intake is still too high, and potassium ingestion is too low. With expected more active engagement and help of the government, obtained results could be significantly improved. Salt reduction programs are most cost-effective methods of cardiovascular disease prevention and should be considered more seriously by the government and health policy makers.

This comprehensive review has systematically examined the use of heterogeneous solid acid catalysts in the production of biodiesel from wastewater-derived sludge by using the PRISMA methodology. The manuscript highlighted the composition and characteristics of wastewater-derived sludge, presenting both the opportunities and challenges associated with its use as a feedstock for biodiesel production. Various types of catalysts were dis-cussed, with a detailed exploration of heterogeneous solid acid catalysts, including zeolites, hetero-polyacid (HPA), mixed metal oxides, and sulphonic acid group catalysts. The advantages and limitations of these catalysts were critically analyzed, providing a balanced view of their potential in industrial applications. The application section delved into the catalytic transesterification reaction, mechanisms of biodiesel production, and the effects of catalyst loading on yield. Performance metrics such as catalytic activity, stability, recyclability, cost-effectiveness, and environ-mental impact were thoroughly evaluated, offering a clear understanding of the efficacy of these catalysts. Synthesis and characterization techniques were also reviewed, shedding light on the latest preparation methods and characterization techniques. Recent advances in catalyst development were presented, showcasing the innovative strides made in enhancing catalyst performance. The environmental and economic implications of using solid acid catalysts for bio-diesel production were assessed, emphasizing the importance of sustainability and economic viability.

Background: Annual influenza epidemics are a serious public health problem, causing particularly severe morbidity and mortality in high-risk groups. The study aimed to understand Poles' attitudes and beliefs towards influenza vaccinations in the flu season of 2022–2023, analyze preferences and unmet needs regarding influenza vaccinations, and examine the perception and acceptance of the influenza vaccine among individuals at risk of flu complications. Methods: A cross-sectional survey-based study was carried out on a sample of 1446 respondents. The Google Forms questionnaire was created and disseminated electronically using social media and e-mail. The pre-test was performed at the beginning of the project. Results: The majority of respondents (71%) could identify "high-risk groups" recommended for influenza vaccination. Furthermore, it was observed that individuals aged 21 to 59 demonstrated a higher level of knowledge in this regard compared to those below 20 and above 65 years old, and individuals with higher and medium education levels were much better at identifying risk groups for influenza virus infection. The majority of respondents (52.01%) reported receiving influenza vaccination at some point in the past, with 32.12% receiving it in the 2022–2023 flu season and 41.09% in the 2021–2022 season. The majority of respondents declaring acceptance of the vaccine for the 2022-2023 season were in the high-risk group. Only 17.28% of respondents declared receiving both influenza and SARS-CoV-2 vaccines in the 2022-2023 season, with the vast majority being respondents from the "high-risk group" (p

Family planning (FP) services are crucial interventions for improving maternal and child health outcomes and promoting gender equity. However, ensuring equitable access to these services remains a significant challenge, particularly in countries like Pakistan, where sociocultural norms, economic disparities, and geographic barriers hinder FP uptake. This study utilized spatial analysis techniques, including hotspot analysis, to investigate geographic disparities in FP uptake in Pakistan using data from Pakistan Demographic and Health Surveys (PDHS) conducted between 2006 and 2017. ArcMap 10.1 was used for spatial analysis and Stata 12.0 for statistical analysis. Results revealed significant spatial variations in FP uptake, with urban areas generally exhibiting higher uptake rates than rural regions. Hotspot analysis identified dynamic changes in contraceptive prevalence rates (CPR), with significant clustering in some regions and dispersion in others. It also identified areas with high unmet need and their low intention to use FP services and preference for family size (&gt;3 children), highlighting the need for targeted behavioral change interventions. This innovative spatial approach provides nuanced insights for policymakers and program planners to develop targeted interventions based on localized data to improve FP service delivery, mitigate disparities, and ultimately advance efforts to improve maternal and child health outcomes. The application of geospatial analysis is an effective tool for enhancing program planning, evaluation, and resource allocation in diverse geographical contexts.

The importance of bio robotics has been increasing day by day. Researchers are trying to mimic nature in a more creative way so that, the system can easily adopt the complex nature and its environment. Hence, bio robotic gripper plays a role in physical connection between the environment and bio robotics system. While handling the physical world in biorobots gripper, the complexity occurs in feedback system where sensor plays a vital role. Therefore, human centered gripper sensor has a good impact on bio robotics field. But categorical classification and their selection process is not very systematic. This review paper follows PRISMA methodology to summarize the previous works on bio robotics gripper sensor and its selection process.. This paper discusses challenges in soft robotics systems, and the importance of sensing systems to facilitate critical control mechanisms along with their selection considerations. Furthermore, a classification of soft actuation based on gripper has been introduced. Moreover, some unique characteristics for soft robotics sensor are explored namely compliance, flexibility, multifunctionality, sensor nature, surface properties, and material requirements. In addition, a categorization of sensors for soft robotic gripper in terms of modalities has been established ranging from the tactile and force sensor to slippage sensor. Various tactile sensors ranging from piezoelectric sensing to optical sensing are explored as it has utmost importance in soft gripper to effectively address the increasing requirements for intelligence and automation. Finally, taking everything into consideration, a flow diagram has been suggested for selecting sensors specific to soft robotics applications.

Academic procrastination, more than merely postponing tasks, represents a significant failure in the self-regulation process of learning. Research on study skills highlights academic time management as one of the crucial elements of learning strategies and sustainable education. These abilities will help achieve the Sustainable Development Goals fourth goal. Therefore, this study aimed to understand how students plan time management in school activities and its influence on study procrastination, analyzing differences between genders and the hours students spend studying. The Time Management Planning Inventory, the Study Procrastination Questionnaire, and a personal and school data sheet were used. A sample of 506 students from elementary schools in northern Portugal was utilized. The results revealed that gender and study hours significantly influence how students plan time management for school tasks in the short and long term. This variable also showed a significant impact on the procrastination of study activities. The practical implications of this study are substantial, as they provide educators and researchers insights into the factors influencing academic procrastination and the role of time management planning and study hours. These insights can be applied to develop effective strategies to reduce academic procrastination and promote sustainable education.

Education plays a key role in human societies and the development of nations. Providing social justice in a country creates educational justice, and educational justice grants equal opportunities for growth and prosperity to the members of the society. In reality, there are differences between urban and rural educational facilities, as well as between girls and boys. Deprived and rural areas are full of losses, from economic problems to intellectual and cultural blockages. Failure to enhance these areas leads to further decline in these environments, and one of its consequences in education is the dropout of students. Girls are especially exposed to this problem due to gender discrimination, traditional and religious views, and living conditions. The purpose of this research was to obtain in-depth information about the experiences and reactions of girls in deprived areas and to identify its factors. This case study was conducted in the Khuzestan province of Iran using the grounded theory, and the results of the interviews were categorized after coding and its paradigm model was presented. In the end, solutions were presented to reduce the dropout rate of girls in deprived areas and prevent this problem.

Over the past decades, overweight and obesity has become a global epidemic and the leading threat for death. To prevent the serious risk, an overweight or obese individual must apply a long-term weight-management strategy to control food intake and physical activities, which is however, not easy. Recently, with the advances of information technology, more and more people can use wearable devices and smartphones to obtain physical activity information, while they can also access various health-related information from Internet online social networks (OSNs). Nevertheless, there is a lack of an integrated approach that can combine these two methods in an efficient way. In this paper, we address this issue and propose a novel mobile-social framework for health recognition and recommendation, namely, H-Rec². The main ideas of H-Rec² include (1) to recognize the individual's health status using smartphone as a general platform, and (2) to recommend physical activity and food intake based on personal health information, life science principles, and health-related information obtained from OSNs. To demonstrate the potentials of the H-Rec² framework, we develop a prototype that consists of four important components: (1) an activity recognition module that senses physical activity using accelerometer, (2) a health status modeling module that applies a novel algorithm to generate personalized health status index, (3) a restaurant information collection module that collects relevant information from OSN, and (4) a restaurant recommendation module that provides personalized and context-aware recommendation. To evaluate the prototype, we conduct both objective and subjective experiments, which confirm the performance and effectiveness of the proposed system.

Population-based data on hematologic malignancies (HM) are rare in Greece regarding adults (≥18 years old). The aim of this study was the assessment of the burden of these malignant neoplasms (MN) for adults in Crete. The study assessed temporal trends of incidence and mortality, depicted their spatial distribution and extracted net-survival curves of patients. Population-data on these MN were obtained from the database of the Cancer Registry of Crete, for a 22 year time period (1/1/1992-31/12/2013). All HM were classified into four main groups of diseases: (1) Hodgkin’s lymphoma (HL); (2) Non-Hodgkin’s lymphomas (NHLs); (3) Multiple myeloma (MM); and (4) All chronic and acute leukemias. Annual, gender-specific, age standardized incidence and mortality rates were estimated (ASIR/100.000/year; ASMR/100.000/year). A total of 3,380 newly diagnosed cases were included in the final analyses; All ASIRs/100,000 increased significantly throughout the study period presenting differences in their geographical distribution of rates among municipalities of Crete. ASIRs for NHLs, HL, MM, leukemias and for all 4 MN were 13.1, 2.6, 4.7, 11.7 and 32.1, respectively, in 2013. Five-year net-survival for patients diagnosed with NHLs, HL, MM and leukemias were: 82%, 85%, 52% and 56%, respectively. This first research article studying a long period of time for adults in Greece generates hypotheses on the existence of risk factors that may partly explain this variation of rates.

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

The health status of Hungary's population is unfavorable, with significant differences in health indicators not only compared to the EU15 but also to the Visegrad countries. Unfavorable health indicators can be disproportionate and particularly affect vulnerable groups, such as people with disabilities. The aim of the present study is to compare the health behaviour and indicators of adolescents with disabilities in Hungary with those of the HBSC survey in the Visegrad countries, and to compare the results of the Hungarian special needs adolescent population with those of the Visegrad countries. Eating habits are unfavourable for both the Visegrad countries and the young people we studied. Children with disabilities have significantly higher rates of schoolwork stress compared to other countries. Significantly higher prevalence of somatic complaints and worse mental well-being parameters higher in Hungary than in the other Visegrad countries. The results suggest that further interventions are needed in Hungary and that differentiated, professionalised health promotion is needed for young people with disabilities. The researchers propose to extend the research to adolescents with disabilities living in the Visegrad countries, on the basis of which a methodology for injury-specific health promotion could be developed, including through interna-tional interprofessional cooperation.

Children on farms face high risks of work and non-work-related fatalities, with tractors being a significant contributor. This study examines children's involvement in fatal tractor-related accidents within agriculture in Iceland in 1950-2024, explores adult reflections on childhood tractor-driving experiences, and analyses Members of Parliament´s arguments against setting a minimum age for off-road tractor driving. Data rests on fatal tractor-related accidents using newspaper archives and supplementary sources, narrative interviews with former summer children who stayed at farms in childhood, and parliamentary debates on tractor-related legislation. Over half of the 81 registered accidents involved children, primarily boys, with 75% occurring between 1958 and 1988 when no minimum age for off-road tractor driving existed. Children's fatality incidence rate was more than four times higher than adults. Arguments against minimum age requirements for off-road driving included the need for child labour, children's superior driving skills, and a denial that children were more often victims than adults. Since 1988, no child has died when driving a tractor. A human-centred approach focusing on working conditions, driver capacity, and adherence to safety procedures and legal frameworks is needed to prevent future accidents.

The aim of this study was to develop a valid and reliable questionnaire to assess vitamin D-related knowledge, attitude and practice (KAP) in Iranian adults who may be at increased risk of vitamin D deficiency. This study was conducted on 527 subjects, aged ≥20 years from Public health care centers in Tehran, Iran. Based on results of literature review and in-depth interviews, the 38-item vitamin D-related KAP questionnaire with four subscale was developed: 1) general knowledge; 2) nutritional knowledge; 3) attitudes; 4) behaviors. Validity of the developed vitamin D-KAP questionnaire was assessed, utilizing face, content, and construct validity methods. Internal consistency was calculated to assess reliability of the current developed questionnaire. A total of 572 (54.1% female) adults, aged 30.2±7.9 years, participated in the study. All items were perceived as relevant and comprehendible by participants. Content validity was confirmed by the panel of experts. The internal consistency, as measured by Cronbach’s alpha coefficients, exceeded the minimum reliability standard of 0.60 for four subscales. The EFA suggested a four-factor construct and the results of the CFA indicated acceptable fit indices for the proposed model. No ceiling effects were observed except for general knowledge (1.2%). Floor effects detected were 0, 1.1, 2.4, and 8.7% for practice, attitude, general knowledge, and nutrition knowledge, respectively. General knowledge had the highest score (79.59±14.52) and nutrition knowledge, the lowest score (42.58±20.40) among the four sub-scales. Results confirm the initial validity and reliability of the vitamin D-related knowledge, attitude and practice questionnaire. Further investigations in different urban and rural population are recommended.

Parental labour migration, either one or both parents, has been associated with various challenges among left-behind children (LBC). However, there is a limited understanding of the LBC’s own views and experiences of social and mental wellbeing and how the new daily life circumstances they encounter following their parents’ migration impact them. This study aimed to understand the influence of parental migration and its aftermath on the social and mental wellbeing of children and adolescents (referred to as LBC) in two rural districts in Indonesia. Employing a qualitative design, data were collected through individual in-depth interviews with LBC (n=24) aged 14 to 18 years, recruited using the snowball sampling technique. Data were thematically analysed, guided by a qualitative data analysis framework. The findings showed that parental migration negatively impacted the social wellbeing of LBC. This impact was reflected in negative labelling from friends and changes in familial roles which influenced their social interactions and activities with peers. Parental migration also caused challenges to the mental wellbeing of LBC. These manifested in the LBC experiencing fractured emotional bonds, leading to negative emotions, including stress, anxiety, sadness, depression, frustration, loss of motivation, and self-imposed isolation, which were associated with their parents’ migration and abrupt disruptions in parent-child communication. The transition to new life situations with caregivers after parental migration and the dynamics within the caregivers’ households were additional factors that detrimentally affected their mental well-being. Unmet basic needs and educational needs due to financial hardships faced by mothers and caregivers, further exacerbated mental health challenges for the children. The findings indicate the importance and improvement of policies and interventions in Indonesia (e.g., counselling services, non-cash food assistance, family hope program, direct cash assistance) that cover and address the diverse needs of mothers or caregivers and the LBC.

Many anti-tumor effects of group-specific component-derived macrophage-activating factors (GcMAFs) have been reported; however, the specific mechanisms remain unclear. Controlling tumor-associated macrophages (TAMs) in the tumor microenvironment is essential for cancer treatment. This study assessed the role of GcMAF in macrophage activation, elucidated the mechanisms by which it exerts its anti-tumor effects, and determined its effects on TAMs in the tumor microenvironment. GcMAF-stimulated RAW264.7 macrophages and EMT6 breast tumor cells were co-cultured in a 0.4-µm pore cell culture insert, and gene and protein expression and cell viability were evaluated. DNA microarray analysis of GcMAF-stimulated RAW264.7 cells was conducted. The induction of M2 RAW264.7 cells by interleukin (IL)-4 and IL-13 was analyzed. GcMAF stimulation increased the tumor necrosis factor-α and inducible nitric oxide synthase mRNA and protein levels in RAW264.7 cells but decreased the viability of co-cultured EMT6 cells. These results were confirmed in the M2 RAW264M2.7 cells, suggesting that GcMAF exerts anti-tumor effects by inducing the differentiation of macrophages into the M1 type and reprogramming M2 macrophages to the M1 type. The anti-tumor activity of GcMAF via M2-to-M1 macrophage reprogramming could aid in developing novel cancer immunotherapies.

This study aims to explain individual engagement in sustainable waste management behaviors (SWMBs) based on the application of protection motivation theory (PMT). SWMBs include waste avoidance, green purchasing behavior, reuse and recycle, and waste disposal behaviors. This study applies PMT to explore how individuals’ SWMBs are influenced by their perceived threats caused by environmental contamination from waste disposal and their perceived coping capability. The Bangkok metropolitan area was selected as a case study because it has faced serious waste management problems caused by massively increasing amounts of solid waste during the last ten years. Questionnaire surveys were conducted with 193 public and private officers residing in the city of Bangkok. The one-way analysis of variance (ANOVA) was performed to justify the effect of individual threat appraisal and coping appraisal on the engagement in SWMBs. The results demonstrated that respondents’ self-efficacy highly influenced all types of SWMBs. The perceived probability of being impacted from pollutants influenced all of the SWMBs except green purchasing behaviors. Response efficacy did not influence all SWMBs; however, the perceived severity of adverse consequences caused by pollutants highly influenced reuse and recycle behaviors. It could be suggested that PMT is well suited for investigating low-cost and simple SWMBs. It could also be suggested that different communication campaigns should be established to enhance citizens’ engagement in each type of SWMB.

Objectives: Female genital mutilation (FGM) is a significant public health problem. It is estimated around 14,700 women affected by FGM live in Switzerland, primarily among women with a history of migration. Our qualitative research investigated the sexual health of immigrant women living with FGM in Switzerland, describing their own perception of health, reproductive life and sexuality. Methods: We conducted semi-structured, in-depth interviews with a group of eight immigrant women of African origin living in Switzerland with Type III FGM (infibulation). Results: Seven of the women were from Somalia and one from Ivory Coast. All of the Somali women were mothers and married (two separated), and the Ivorian woman was a single mother. The women in our study reported a low level of sexual satisfaction and reproductive health. They affirmed their desire to improve, or at least change, their condition. Although they rarely talk with their husbands about sexual subject matter, they would like to include them more and improve dialogue. Conclusions: Specific socio-sexual management is recommended when caring for immigrant women living with FGM in order to respond to their specific health care needs. Multidisciplinary approaches may be able to offer more comprehensive health care, including facilitated communication to improve dialogue between women and health care professionals, and eventually between women and their husbands in discussing sexual matter.

The Ebola virus disease (EVD) is an extremely contagious and fatal illness caused by the Ebola virus. Recently, Uganda witnessed an outbreak of EVD, which generated a lot of attention on various social media platforms. To ensure effective communication and implementation of targeted health interventions, it is crucial for stakeholders to comprehend the sentiments expressed in the posts and discussions on these online platforms. In this study, we used deep learning techniques to analyze the sentiments expressed in Ebola-related tweets during the outbreak. We explored the application of three deep learning techniques to classify the sentiments in 8,395 tweets as positive, neutral, or negative. The techniques examined included a 6-layer convolutional neural network (CNN), a 6-layer long-short-term memory model (LSTM), and an 8-layer Bidirectional Encoder Representations from Transformers (BERT) model. The study found that the BERT model outperformed both the CNN and LSTM-based models across all the evaluation metrics, achieving a remarkable classification accuracy of 95\%. These findings confirm the reported effectiveness of transformer-based architectures in tasks related to natural language processing, such as sentiment analysis.

Intermittent religious fasting increases a risk of hypo- and hyperglycemia in individuals with diabetes, but its impact in those without diabetes is poorly investigated. The study aim was to examine the effects of religious Bahá'í fasting (BF) on glycemic control and variability and compare these effects with time-restricted eating (TRE). In a three-arm randomized controlled trial, 16 subjects without diabetes were assigned to a BF, 16:8 TRE or control group. Continuous glucose monitoring and food intake documentation was conducted before and during the 19 days of intervention, and 24-hour mean glucose, glycemic variability indices, and glucotypes were assessed. BF and TRE groups, but not the control group, markedly reduced the daily eating window while maintaining macronutrient composition. Only the BF group decreased caloric intake (-677.8 ± 357.6 kcal, p=0.013), body weight (-1.92 ± 0.95 kg, p=0.011) and BMI (-0.65 ± 0.28 kg, p=0.006). Higher maximum glucose values were observed during BF in the within-group (+1.41 ± 1.04, p=0.039) and between-group comparison (BF vs. Control: p= 0.010 and TRE vs. BF: p= 0.022). However, there were no alterations of 24-hour mean glucose, intra- and inter-day glycemic variability indices, or glucotypes in any group. Proportions of time above and below range (70-180mg/dl) and HbA1c values remained unchanged. BF and TRE do not exhibit negative effects on glycemic control and variability in subjects without diabetes.

A reduction in population sodium (as salt) consumption is one of the most cost-effective strategies to reduce the burden of cardiovascular disease and it is a global health priority. High potassium intake is also recommended to reduce cardiovascular disease. To establish effective policies for setting targets and monitoring effectiveness within each country, the current level of consumption should be known. Greece lacks data on actual sodium and potassium intakes. The aim of the present study was therefore to assess dietary salt (using sodium as biomarker) and potassium intakes in a sample of healthy adults in northern Greece and to determine whether adherence to a Mediterranean diet is related to different sodium intakes or sodium-to-potassium ratio. A cross-sectional survey was carried out in Thessaloniki greater metropolitan area (northern Greece) (n=252, aged 18-75 years, 45.2% males). Participants’ dietary sodium and potassium intakes were determined by 24h urinary sodium and potassium excretions. In addition, we estimated their adherence to Mediterranean diet by the use of an 11-item MedDietScore (range 0-55). The mean sodium excretion was 175 (SD 72) mmol/day, equivalent to 4,220 (1,745) mg of sodium or 10.7 (4.4) g of salt per day and potassium excretion was 65 (25) mmol/day, equivalent to 3,303 (1,247) mg/day. Men had higher sodium and potassium excretions compared to women. Only 5.6% of the sample had salt intake <5g/d, which is the target intake recommended by the WHO. Mean sodium-to-potassium excretion ratio was 2.82 (1.07). There was no significant difference in salt or potassium intake or their ratio across MedDietScore quartiles. No significant relationships were found between salt intake and adherence to Mediterranean diet, suggesting that the perception of the health benefits of the Mediterranean diet does not hold when referring to salt consumption. These results suggest the need for a larger nation-wide survey on salt intake in Greece and underline the importance of continuation of salt reduction initiatives in Greece.

Context: The global escalation of conflict, violence, and human rights violations sets a pressing backdrop for examining the resilience of forcibly displaced youth (FDY) in Canada. This study aims to unpack the multifaceted challenges and resilience mechanisms of FDY, focusing on their health, well-being, and integration into host communities. It seeks to identify current models of resilience, understand the factors within each model, and highlight gaps and limitations. Methodology: Using a university librarian-supported structured search strategy, this exploratory rapid review searched literature from Ovid Medline and Open Source databases, published in English between January 2019 and January 2024, that fit specific inclusion criteria. The eligible articles (N=12 out of 4,096) were charted and analyzed by two student researchers with the PI. Charted data were analyzed thematically. Results: The selected studies captured diverse geographical perspectives, resilience models (such as Ungar's ecological perspective and Masten's resilience developmental models), as well as protective and promotive frameworks. Key findings indicate the complexity of resilience influenced by individual, familial, societal, and cultural factors. Each model offers insights into the dynamic interplay of these influences on FDY's resilience. However, these models often fall short of addressing the nuances of cultural specificity, the impact of trauma, and the intersectionality of FDY's identities. Conclusion: Recognizing the diverse and evolving nature of FDY's coping mechanisms, this study advocates for a culturally appropriate approach to resilience that integrates an intersectionality framework of individual attributes and culturally sensitive models.

The concept of economic self-reliance, widely known by Thai people as the philosophy of sufficiency economy, has been widely promoted in rural Thai societies. By practicing this philosophy, it is expected that the citizens’ quality of life and local environments could be sustainably improved. This study aims to explore the contribution of the community practices of the sufficiency economy philosophy to rural villagers’ quality of life improvement, and to investigate potential factors that determine the trust of villagers in the philosophy. With the purpose to propose strategies which could enhance trust and promote villagers’ practices of the philosophy, the study investigated influences of three relevant factors on trust towards the philosophy. Those factors included factors related to cognitive-based trust, factors related to emotional-based trust, and factors related to demographic characteristics. Questionnaire surveys and in-depth interviews with community leaders and local villagers were conducted in the Ban Jamrung community, in Thailand’s Rayong province. The results of the statistical analysis revealed that the residents who applied the sufficiency economy philosophy in their daily lives experienced a relatively better quality of life. Additionally, it was found that trust in the philosophy could be predicted more by rational factors than by emotional factors. These findings could be utilized to develop strategies to maintain and enhance the trust of the people in the philosophy of sufficiency economy.

Tennis is an individual sport characterised by high intensity action, including sprints and changes of direction (COD). There is a gap in the knowledge of limb asymmetries in adolescent tennis players and their association with performance. This study aimed to examine the relationship between asymmetry in vertical and horizontal jump tests (CMJ and HJ) and COD with lower limb performance variables in adolescent tennis players. Forty-five adolescent tennis players (age: 13.81 ± 1.08 years; height: 167.64 ± 9.9 cm; body mass: 57.48 ± 10.94 kg; body mass index: 20.27 ± 2.18 kg/m2) performed the CMJ test (unilateral and bilateral), horizontal jumps (unilateral and bilateral), 25 m sprint and 180º COD test. The single-leg countermovement jump showed the greatest asymmetries among the different tests (6.62 ± 9.35%). Significant negative relationships were found between CMJ asymmetry and COD asymmetry with unilateral horizontal jump variables (r = -0.30 to -0.53). In addition, CMJ asymmetry showed significant relationships with CMJR (r=0.49) and COD180R (r=0.29), whereas COD asymmetry showed a significant relationship with COD180L (r=0.40). On the other hand, HJ asymmetry showed no significant relationships with any variable. The main findings of this study indicate that greater imbalances in the CMJ and COD tests are associated with a reduced capacity to perform unilateral horizontal jumps. These results suggest the need to incorporate training protocols that reduce interlimb asymmetries in growing athletes to improve their performance.

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

Recent algorithmic-based research in the stock market has predominantly focused on ultra-high-frequency trading and index estimation. We developed an improved algorithm to address the need for a low-frequency, real-world trading model to build on the existing high hit-ratio and low maximum drawdown. We utilized established price indicators, Stochastic and Williams %R, and introduced a volume factor to increase the model's safety to enhance the model's performance. This improved algorithm demonstrated superior returns while maintaining high hit-ratio and low maximum drawdown. Specifically, we leveraged the existing algorithm to trade using 2X and 3X signals, incorporating volume data, the 52-week average, standard deviation, and other factors. The data set comprised SPY ETF price and volume from 2010 to 2023, covering over 13 years. Our enhanced algorithmic trading model outperformed both the benchmark and previous results, achieving a hit rate of over 90%, a maximum drawdown of less than 1%, an average of 1.5 trades per year, a total return of +519.3%, and an annualized return (AnnR) of +15.1%. The analysis demonstrates that the model's simplicity, ease of application, and comprehensibility can assist investors in making informed investment decisions albeit the past performance does not guarantee future returns.

Previous studies separately addressed the impact of urban expansion on vegetation cover and thermal conditions, as well as its effect on moisture and drought indicators, using geospatial techniques. Some studies, such as those by Malah et al. (2021) and Niu and Li (2020), focused on assessing urban environmental quality using an environmental quality index without considering urban expansion. Meanwhile, other studies, like those conducted by Indrawati et al. (2020), primarily focused on evaluating urban environ-ments using an integrated environmental index consisting of four indicators (greenness, moisture, drought, and cumulative clustering). The study by Zhu et al. (2019) applied the same integrated environmental index (IEI) and, by comparing it with temperature, re-vealed a negative correlation illustrating the effects of the environmental index on land surface temperature (LST). These two studies could be utilized to construct an index assessing the environmental condition in Riyadh. This is the case in the present study, where the addition of a temperature indicator due to the hot desert nature of the study area created the Urban Environmental Thermal Index to evaluate the urban en-vironment and provide results suitable to this region. It is expected that the present study will align with the findings of previous relevant studies, showing a negative im-pact of urban expansion on urban environmental components.

Lymphatic filariasis (LF) is a neglected tropical disease associated with poverty and poor environmental conditions. With the inclusion of vector control activities in LF surveillance actions, there is a need to develop simple methods to identify areas with higher mosquito density and consequent risk of W. bancrofti transmission. An ecological study was conducted in Igarassu, Metropolitan Region of Recife, Pernambuco, Brazil. The mosquitoes were captured in 2,060 houses distributed across 117 census tracts. The vector density index (VDI) was constructed, that measures the average number of lymphatic filariasis transmitting mosquitoes per number of houses collected in the risk stratum. Moreover, the social deprivation indicator (SDI) was constructed and was carried out through principal component factor analysis. The average number of female C. quinquefasciatus found in the high-risk stratum was 242, while the low-risk stratum had an average of 108. The overall VDI was 6.8 mosquitoes per household. The VDI for the high-risk stratum was 13.2 mosquitoes per household, while for the low/medium-risk stratum, it was 5.2. This study offers an SDI for the density of C. quinquefasciatus mosquitoes, which reduces the cost associated with data collection and allows for indicating priority areas for vector control actions.

The permanent protection of groundwater and surface sources of drinking water in the required raw water quality from contamination is the primary foundation of preserving the life of society and the entire engineering infrastructure operability not only in the Czech Republic but also in other countries of the world. One of the basic ways of contamination prevention enhancement and risk mitigation of putting a water source out of operation is the identification of the given risk as well as soil contamination monitoring. The purpose of this study is to understand specific aspects of contamination threats to drinking water sources and determine possible solutions to eliminate the risk, shown in the example case study in the Czech Republic conditions. Based on the findings, a proposal to enhance the prevention of water source contamination has been elaborated in the form of recommendations regarding the ways and means used to monitor the risk areas and to implement technical measures so as to eliminate or terminate the specified risk. A complex approach based on the integration of interdisciplinary factors and methodology is required to minimize the threats of aquatic ecosystems contamination in the Czech Republic.

The concept of a Social License to Operate (SLO) has become increasingly important in the sustainability literature in recent years. Having its origins in the business discourse of the mining industry with respect to limiting opposition to mining projects, the notion of a social contract above and beyond legal requirements has since become applied across a number of different industries. Despite the concepts adoption confusion exists over the practices and outcomes of SLO, and particularly the nature of engagement. Given this situation it is surprising that not more attention to the role of marketing, and social marketing in particular, in operationalizing the concept. The paper discusses the potential of social marketing to contribute to SLO. Economic, political and social relations are complex in SLO and exchange is intricate in such relational environments. A community-based social marketing orientation is proposed as a means to improve exchange relations and enhance engagement. Seven models of SLO related social marketing models are discussed with community-based social marketing and adaptive co-marketing models being regarded as the most positive for the achievement of an SLO. Potential barriers to adoption of these approaches are noted.

The development of plant-based meat analogues has become a significant challenge for the food industry in recent years due to the increasing demand for sustainable and healthier proteins in the context of a global protein transition. Plant-based meat analogues imitate the visual, textural, and chemical properties of traditional meat products and are required to closely resemble meat to appeal to consumers. In addition, consumers demand natural, clean-label, and nutritional and healthy products. To address these challenges, the food industry must develop highly healthy, nutritious, and E-number-free meat analogue products. Understanding the functionality of each ingredient and its role in the food matrix is crucial to being a key player in the innovation of the meat analogues market. This review provides updated information on the primary ingredients utilized for the development of plant-based burger meat alternatives and their functionality. The key components of meat analogue burgers are outlined, including plant proteins, binding agents, fats and oils, flavorings, colorings, preservatives, fortificants, and clean-label considerations.

In the last few decades, we have witnessed an unprecedented transformation in the way information is created, disseminated, and consumed. The advent of the digital age has revolutionized not only our access to information but also the very fabric of our social, political, and cultural lives. Digital media, a term encompassing everything from online news portals and social media platforms to streaming services and mobile applications, now forms an integral part of the daily lives of billions of individuals worldwide.

Abstract Objectives: Aging may challenge life and even affect individuals' well-being and flourishing. This includes challenges of shrinking social relations and being by yourself in old age while using your personal strengths. The current study examines two important personal resources, i.e., the skill of positive solitude and the 24 character-strengths, that may be associated with flourishing in old age. Methods: A convenience sample of 1085 community-dwelling adults (M = 57.20, SD = 6.24, range = 50-87), completed an online self-report survey with demographic measures and scales measuring personal strengths, the skill of positive solitude, and flourishing. Results: As hypothesized, the 24 character-strengths and positive solitude, were each associated with flourishing, and positive solitude moderated the relationships between the 24 character-strengths and flourishing. The 24 character-strengths and flourishing relationship was stronger among participants with lower levels of positive solitude. Conclusion: These findings highlight that despite the decrease in social relations which often characterizes old age, the skill of positive solitude serves as a valuable resource for flourishing in the later stages of life.

Hybrid methods are a suitable option to extract dietary patterns associated with health outcomes. This study aimed to identify dietary patterns of Brazilian adults (20-59 years old; n=28,153) related to dietary components associated with the risk of obesity. Data from the 2017-2018 Brazilian National Dietary Survey were analyzed. Food consumption was obtained through 24-hour recall. Dietary patterns were extracted using partial least squares regression. The selected response variables were energy density (ED), percentage of total fat (%TF), and fiber density (FD). In addition, 32 food groups were established as predictor variables. The first dietary pattern, named as energy-dense and low-fiber (ED-LF), included with positive factor loadings: solid fats, breads, added-sugar beverages, fast foods, sauces, pasta, and cheeses, and with negative factor loadings: rice, beans, vegetables, water, and fruits. Higher adherence to the ED-LF dietary pattern was observed for individuals >40 years old, from urban areas, in the highest income level, who were not on a diet, reporting away-from-home food consumption, and having ≥1 snack/day. Eating patterns with similar characteristics are often associated with an increased risk of obesity. The results are consistent with recommendations to increase the consumption of fresh foods and to reduce ultra-processed products.

Seaports are critical hubs in global trade, facing increasing pressure to accelerate green transi-tions while navigating evolving economic and environmental landscapes. This research analyses the intricate relationship between port organizational ecosystem resilience and the successful implementation of green transitions, highlighting the challenges and opportunities in moving towards a more sustainable future. The research employed a combined focus group interview and participatory observation methodology to gather insights from experts. Analysis revealed that while technological advancements are a primary driver for greening port operations, a lack of managerial capacity is a significant impediment to the successful integration of these innova-tions. It was identified several challenges, including outdated infrastructure, cybersecurity threats, and the need for ongoing investments in new technologies, along with the need to foster a sustainable behaviour culture. Experts emphasized the importance of developing managerial competencies and continuous learning. The research also highlights the role of strong stake-holder partnerships, including collaboration with government agencies, industry associations, and environmental organizations. This research provides valuable insights for policymakers, port managers, and other stakeholders seeking to navigate the challenges for ensuring a sus-tainable future for the maritime sport organizational ecosystems and maritime industry.

On January 1, 2024, a large earthquake occurred in Japan’s Noto region. Many buildings collapsed as a result of violent shaking. Electricity and water supplies were cut off and communications were disrupted. Immediately after the earthquake, we visited Noto and conducted disaster-relief activities. This report integrates and discusses the results of the site visits, information broadcasts by public institutions, and previous research. Evacuation centers lacked water and proper sanitation, leading to health issues, including infectious diseases. Disaster Medical Assistance Teams (DMAT) were delayed in implementing infection control measures. Isolated evacuation centers faced communication and supply challenges. Infrastructure restoration, power supply, and toilet facilities at evacuation centers were delayed because of geographical challenges. There was a lack of intervention by medical professionals in evacuation centers because the DMATs were forced to invest manpower in rescue operations. It is important to have a team that can determine and carry out the necessary activities on site, even without instructions from the DMAT. It is believed to be effective to decide in advance how volunteer teams and the private sector will conduct their activities, assuming that they will be unable to contact public institutions during a disaster. In large-scale disasters, evacuees must operate evacuation centers autonomously. To achieve this, it is necessary for residents to form healthy communities regularly. A serious disaster is expected to soon occur in Japan. We hope that the experience of this disaster will be useful for preparing for future disasters.

In this paper it is examined how, if at all, logical laws can be normative for human reasoning, wherein the notion of normativity is analysed with respect to approaches to logic given in works of Aristotle, Descartes, Kant, Frege and Wittgenstein. During the ancient and medieval period, logic was being considered in terms of discourse and dialogical practice, but since Descartes and especially Kant it has been treated as a system of laws with which the process of individual human reasoning has been compared. Therefore, normativity can be investigated in private sphere (for thinking and reasoning) and in public sphere (for dialogic practices in a community). Wittgenstein discussed both aspects of normativity: in Tractatus, a focus is on laws of logic that are primarily normative for the state of affairs in the world, while in Philosophical Investigations an emphasis is on a social aspect of normativity (which is closer to Aristotle’s view), which is derived from adopted rules that have been applied in a certain community. Taken that way, logic is certainly normative in the public sphere, but the more difficult issue is whether logic is normative for thinking, regarding to the difference between the logical laws and those of thought.

Vaccines decrease morbidity and mortality. Nevertheless, their benefits depend on public response. During COVID-19, vaccine hesitancy and refusal were rampant, threatening public health. A thorough understand-ing of opponents' arguments is required to address the diffusion of unreliable information on social media and prevent vaccine hesitancy from developing into vaccine refusal. Accordingly, the article examines vac-cine opponents' justifications on social media. Textual content analysis of reader comments on three health-related Israeli Facebook pages was conducted. Data collection encompassed the Israeli COVID-19 vaccination period from October 2020 to May 2022. The comments were analyzed according to the health beliefs model (HBM). We found that vaccine opponents were characterized by low perceptions of the severity of the disease combined with high perceptions of the damages of the vaccine; low perceived benefits of vac-cine compliance; vaccine hesitancy and fear along with public distrust as barriers to change; and call for ac-tion to resist the vaccine and spread related anti-establishment views on the web. As vaccination hesitancy was found to develop into public distrust in the state systems and escalate into conspiracy beliefs and an-ti-vaccination activism, its early detection may prevent future vaccine resistance.

The philosophy of testing statistical hypothesis is a natural consequence and functional extension of mathematical analysis of Probability. Along with the concept of recurrence when applied to random sequences and functions, it leads to the analysis of a priori and posterior which implies testing statistical hypothesis. Testing statistical hypothesis also involves algebraic, functional and dimensional considerations, which are found in the works of Laplace. Aspects of mathematical analysis such as universality of solutions, Laws of Large Numbers, Entropy, Information, and various functional dependencies are the main factors explained in the five properties that lead to implication of testing statistical hypothesis. Various interesting examples with modern scientific significance from genetics, astrophysics, and other areas give methodological access to answers of different problems and phenomena which are involved in the logic of testing statistical hypothesis.

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.

Though Bangladesh is often labelled as "climate change ground zero," the Chittagong Hill Tracts (CHT) were never considered a significant climate change hotspot until heavy rainfall and consequent landslides in 2017. This shift in problem narrative seemingly overlooks myriad environmentally unsustainable 'development' initiatives along with (il)legal deforestation. This paper examines climate change trends and impacts on the lives and livelihoods of diverse local groups in CHT. By analysing changing patterns in meteorological data and qualitative information on changes and challenges in everyday life and the livelihoods of local people, we show a shortfall of captured climate data on CHT to make a strong case for climate change. Yet, this study finds that this region is exposed to a substantial threat of land degradation, flash floods, water scarcity, landslides, and other slow and quick onsets due to a combined effect of deforestation, neoliberalised development, and slight changes in temperature and precipitation patterns. This paper calls for proactive measures to address climate change impacts by endorsing sustainable development strategies prioritizing environmental stewardship, social justice, and economic prosperity.

Social biases may concentrate attention of researchers on a small number of well-known molecules/mechanisms leaving others underexplored. In accordance with this view, central to mechanistic toxicology is a narrow range of molecular pathways that are assumed to be involved in significant part of responses to toxicity. It is unclear, however, if there are other molecular mechanisms which play important role in toxicity events but are overlooked by toxicology. To identify overlooked genes sensitive to chemical exposures we used publicly available databases. First, we used data on published chemical-gene interactions for 17,338 genes to estimate their sensitivity to chemical exposures. Next, we extracted data on publication numbers per gene for 19,243 human genes from Find My Understudied Genes database. Threshold were applied to both datasets using our algorithm to identify chemically sensitive and chemically insensitive genes and well-studied and underexplored genes. 1,110 underexplored genes highly sensitive to chemical exposures were used in GSEA and Shiny GO analyses to identify enriched biological categories. Metabolism of fatty acids, amino acids, and glucose were identified as underexplored molecular mechanisms sensitive to chemical exposures. These findings suggest that future effort is needed to uncover the role of xenobiotics in the current epidemics of metabolic diseases.

(1) Background: The purpose of this study was to assess the external load demands in futsal, con-sidering both home and away matches and their outcomes, in order to plan microcycles throughout the season based on the external load of each match. (2) Methods: The external load of 10 players from a First Division team in the Spanish Futsal League was recorded. The total dura-tion of player involvement with the clock stopped was 18.15 ±7.04 minutes. The players' external load was monitored using OLIVER devices. To analyse the influence of the match outcome and location on the external load, a univariate general linear model (GLM) analysis was conducted. (3) Results: There are no differences between the variables, except for accelerations of 2 to 3 m/s² (m) per minute and the number of accelerations of 2 to 3 m/s² per minute. Despite not showing significant differences, there is a trend indicating a higher demand for external loads in away matches as well as in matches won. (4) Conclusions: These findings are important for planning microcycles and providing the appropriate dosage to each player to achieve optimal performance in matches.

Background: Disparity in adult mortality (AM) with reference to social dynamics and health care has not been sufficiently examined. This study aimed to identify the gap in the understanding of AM in relation to religion, political stability, economic level, and universal health coverage (UHC). Methods: A cross-national study was performed with different sources of data, using the administrative record linkage theory. We created a new data set using data from the 2013 World Bank data catalogue by region, The Economist (Political instability index 2013), Stuckler David et al. (Universal health coverage, 2010), and religious categories of all UN country members. Descriptive statistics, a t-test, an ANOVA followed by a post hoc test, and a linear regression were used where applicable. Result: The average AM rate for males and females was 0.20 ± 0.10 and 0.14 ± 0.10, respectively. AM was significantly higher in economically weak countries, countries with political instability, countries with traditional religion, without achievement of UHC, and Sub-Saharan Africa (p<0.01). There was high disparity of AM between countries with and without UHC (F = male: 61.89, female: 51.85, p<0.001) and between groups with low and high income (F = male: 36.33, female: 42.39, p<0.001). UHC and political stability would significantly reduce AMR by > 0.41 in both sexes and high economic status would reduce male AMR by 0.44, and female AMR by 0.70, in relation to countries without UHC, with political instability, and low economic status. Conclusions: Disparities in AM can be reduced after the achievement of UHC and economically productive activities for those adults affected by conflict and political unrest.

Underreporting is the main limitation of the spontaneous reporting systems. This study aims to reduce underreporting enhancing public participation in vaccinovigilance through an SMS-based reporting system integrated with electronic immunization registries (IRs). Using the VigiVax software, parents of vaccinated children aged 2 years or younger received a single SMS inquiry about adverse events following immunization (AEFI). Responses were collected, validated by health operators and integrated with the information on IRs. AEFI reports were automatically submitted to the Italian Pharmacovigilance system. Among 254,160 SMS messages sent, corre-sponding to 451,656 administered doses (AD), 71,643 responses were collected (28.2% response rate), 21,231of them (8.3%) reporting an AEFI. After seriousness assessment based on clinical criteria, 50 reports (0,24%) were classified as serious. Among these, causality assessment identi-fied 31 reports at least potentially related to the vaccination (RR: 6.86/100,000 AD). Febrile seizures following MMRV vaccination accounted for 11 of these 31 cases, with an incidence of 32 per 100,000 AD. No fatal outcomes were reported. Our findings support the highly favorable risk profile of pediatric vaccinations and the possibility to improve spontaneous reporting through the integration of digital technologies.

Background: Historically, in the United States and globally, women have supported other women before, during, and after childbirth. Birth doulas are considered an important component to eliminating racial disparities in maternal morbidity and mortality. To address disparities in birth outcomes, Healthy Women Healthy Futures (HWHF) provides free birth and postpartum doula services to low-income women and communities of color in New York City. Methods: Secondary analysis of program data (n=364) collected between 2020 and 2021 was conducted. Univariate and multivariable analyses focused on: method of delivery, preterm birth, low-birthweight birth, breastfeeding, maternal-infant skin contact. The key exposure variable was total doula hours. Results: Clients who received prenatal doula support had low rates of preterm birth (8.8%) and low birthweight (7.1%), and high rates of vaginal delivery (69.1%), breastfeeding in the hospital (90.9%), and maternal-infant skin contact (78.2%). Multivariable analysis did not identify an association between number of doula hours and any of the five outcomes examined. Conclusion: While descriptive results point to positive birth outcomes, these effects did not persist in multivariable analyses. Data quality concerns from this intervention likely hindered the ability to detect a program impact, emphasizing the importance of funding to support data collection and management activities.

Introduction: One of the key strategies to achieve sustainable development goal by reduce preventable maternal deaths below 70 per 100,000 is increasing awareness about major obstetrics danger sign. Mother's awareness of obstetric danger signs in developing country is relatively low regardless of attempts trough many local and national program. It is crucial to increase women’s knowledge of obstetric danger signs through education and awareness-raising efforts. Despite its importance to reduce maternal deaths, Studies are limited only to the Northern Ethiopia. Objective: This study aimed to assess prevalence of knowledge of obstetric danger signs and associated factors among women who delivered in the last 12 months in Sidama region, Ethiopia. Methods: We conducted a community-based cross-sectional study from October to November, 2022. A multi-stage sampling procedure was utilized to select study participants. A structured and pretested questionnaire was utilized to collect data. A multilevel mixed-effects negative binomial regression model was used to control effects of clusters and confounders.Results: Out of 1,140 study participants, only 1,130 study participants took part in the study making a response rate of 99.12%. The overall prevalence of knowledge of obstetrics danger sign was estimated as 22.3% (95%CI: 18.7, 25.9). Government employed women (AIRR = 1.37; 95% CI: 1.2, 1.6), women who had access to mass media (AIRR = 1.16; 95% CI: 1.08, 1.25), women who had received model family training (AIRR = 1.15; 95% CI: 1.1, 1.25), autonomous women (AIRR = 1.15; 95% CI: 1.04, 1.25), women who had faced health problems during pregnancy (APR = 1.21; 95% CI: 1.11, 1.32) and urban women (APR = 1.22; 95% CI: 1.09, 1.62) were factors associated positively with knowledge of obstetrics danger sign. Conclusion: The prevalence of knowledge of obstetrics danger sign is found to be lower compared with the national average. Residence, mass-media exposure, model family planning, problem faced during pregnancy and women autonomy are the main predictors of knowledge of obstetrics danger sign. Public health policy makers should enhance health literacy at for focused on rural community. Awareness creation should be improved through mass media. Health providers should educate women during maternity health services to empower women for decision making process.

Objective: The study aimed to characterize the changing landscape of circulating SARS-CoV-2 lineages in the local community of Hong Kong throughout 2022. We examined how adjustments to quarantine arrangements influenced the transmission pattern of Omicron variants in a city with relatively rigorous social distancing measures at that time. Methods: In 2022, a total of 4,684 local SARS-CoV-2 genomes were sequenced using the Oxford Nanopore GridION sequencer. SARS-CoV-2 consensus genomes were generated by MAFFT, and the maximum likelihood phylogeny of these genomes were determined using IQ-TREE. The dynamic changes in lineages were depicted in a time tree created by Nextstrain. Statistical analysis was conducted to assess the correlation between changes in the number of lineages and adjustments to quarantine arrangements. Results: By the end of 2022, a total of 83 SARS-CoV-2 lineages were identified in the community. The increase in the number of new lineages was significantly associated with the relaxation of quarantine arrangements (One-way ANOVA, F(5,47)=18.233, p&lt;0.001)). Over time, Omicron BA.5 sub-lineages replaced BA.2.2 and became the predominant Omicron variants in Hong Kong. The influx of new lineages reshaped the dynamics of Omicron variants in the community without fluctuating the death rate and hospitalization rate (One-way ANOVA, F(5,47)=2.037, p=0.091). Conclusion: The study revealed that even with an extended mandatory quarantine period for incoming travelers, it may not be feasible to completely prevent the introduction and subsequent community spread of highly contagious Omicron variants. Ongoing molecular surveillance of COVID-19 remains essential to monitor the emergence of new recombinant variants.

The EXO+ hip protector was developed to minimize the risk of hip fractures in seniors following falls. This study evaluated its usability in a Singapore nursing home from the perspective of staff, focusing on Learnability, Efficiency, and Satisfaction. A mixed-method design was employed, with nursing home residents wearing the EXO+ daily for 8 weeks. Quantitative data on wear time was collected alongside qualitative insights from four repeated focus group discussions with care staff. In total, 15 residents (including 8 residents with cognitive impairments) and 9 staff participated. The analysis revealed six themes and fourteen subthemes related to EXO+’s usability. Residents wore the device for an average of 1.54 hours per day, with those having cognitive impairments showing increased wear times, especially in the mornings and on weekdays. Findings indicated that the EXO+ was learnable and satisfactory for nursing home use, provided there are adequate supporting features. The efficiency of the EXO+ was not fully measured since no falls were reported during the study period. The study offers valuable insights for potential design modifications and workflow adaptations to enhance the implementation of hip protectors in healthcare settings, highlighting facilitators and barriers to support device uptake.

The antimicrobial resistance to clinically approved antibiotics is rapidly increasing worldwide. Staphylococcus aureus is a critical contributor to deaths associated with antibiotic resistance. In this regard, the search for natural compounds is quite active, that alone or in combination with other agents can be effective as new antibacterial agents. The antibacterial activity of essential oils has presented an increasing interest during the last years and was effective even on multidrug-resistant strains. The present study aims to investigate the interaction effects of oregano essential oil (OEO) with some conventional antibiotics against Staphylococcus aureus tested by agar methods. For this purpose, we selected S. aureus ATCC 29213 and five clinical isolates representative of the species. The essential oil was analyzed using gas chromatography coupled with mass spectrometry (GC-MS). The analysis of the Oregano essential oil revealed the main component to be carvacrol (81,20%). Concentration 2.5% (v/v) OEO was combined with drugs proposed by EUCAST, 2024, specifically penicillin, cefoxitin, erythromycin, gentamycin and tetracycline. The research results showed that the combination of OEO with penicillin, cefoxitin, erythromycin, and tetracycline enhanced the antimicrobial activity of the antibiotics against S. aureus in almost all cases. The area of suppression remained identical (but not smaller) in the unaffected cases. When comparing the effects of the GEN-OEO combination and GEN against most S. aureus strains, a decrease in antimicrobial activity was reported by the diffusion agar method.

Background: In Ethiopia, 8.6% of maternal deaths are attributed to abortion. Despite the legalization of abortion and improved accessibility of safe abortion services, almost six in 10 abortions in Ethiopia are performed outside of the health facility. Abortion considered as an indicator for various aspects of reproductive health and healthcare access within a particular region or country. Despite the significance of the problem, there is a limited understanding of the magnitude of abortion and the contributing factors in the study area. Therefore, this study aimed to assess the prevalence of abortion and determinant factors among reproductive-age women in the Sidama regional state of Ethiopia.Methods: A community-based cross-sectional study was conducted from October to November 11, 2022, among 1,130 women of reproductive age. We utilized a multi-stage sampling method to select eligible women. A structured and pretested questionnaire was utilized to collect the data using Open Data Kit (ODK) mobile application. Due to the hierarchical nature of the data, a multilevel logistic regression model was applied. Variables with p-values < 0.25 on bi-variable analysis were included in a multivariable regression model. In the multivariable regression model, variables with a p-value < 0.05 were declared as statistically significant factors of abortion. Results: Nearly one-fifth (19.5%) of the women had a history of abortion. From the individual level determinates; women with formal education (AOR=0.44; 95% CI: 0.24-0.79), and planned pregnancy (AOR=0.41; 95% CI: 0.28-0.61) had lower odds of abortion. While from the community related factors; urban residence increased the odds of abortion (AOR=2.25; 95% CI: 1.20-4.20) as compared to the rural residence.Conclusion: the prevalence of abortion among reproductive age women of Northern Zone of Sidama Region was high. Education and a planned pregnancy serve as protective factors for abortion, while the risk of abortion increased among women reside in urban area. Therefore, to lower the abortion rate, it is better to implement a comprehensive approach, focusing on education, family planning, and urban-specific intervention.

Brown rice is a familiar whole grain in Japan. We examined national trends in brown rice consumption among Japanese adults aged ≥ 20 years old, using individual-level data from the National Health and Nutrition Surveys conducted between 2012 and 2019. We employed multivariable logistic regression to identify factors associated with brown rice consumption. The 95th percentile of daily brown rice intake remained at 0.0 grams throughout the study period. The percentage of brown rice consumers increased from 1.8% (95% confidence interval: 1.6–2.1) in 2012 to 2.3% (95% confidence interval: 1.8–3.0) in 2019. Compared with individuals who consumed only white rice, brown rice consumers had significantly higher mean intake levels of macronutrients, legumes, vegetables, fruits, and nuts. Brown rice consumption was positively associated with certain sociodemographic characteristics (being female, older age, residing in a major city, living without very young children, and having higher education levels) and health behaviors (lower body mass index, engaging in regular exercise, and being a former or never smoker). Despite its potential nutritional benefits in balanced diets, only a small fraction of adults in Japan consume brown rice, indicating a need for further promotion, particularly among individuals with characteristics associated with brown rice consumption.

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

Developing sustainability competences is an important endeavor for education, as competence development can be complex and requires appropriate approaches. In the case of preparing future educators, this becomes even more important, because of their multiplier role. The current study presents how a project, based on living-lab methodology, helped preservice preschool teachers, attending a course on sustainability issues, develop sustainability-specific professional action competence. Students collaborated with an organization and a school and were trained to deliver to 6-year-old pupils, activities concerning the protection of sea turtles. The process included reflection, based on a given template. After the intervention, the preservice preschool teachers reflected upon their role and professional performance and discussed how they, benefited from this project. They further analyzed through a group interview, how the Living Lab methodology raised their professional confidence and self-efficacy, and helped them develop content knowledge, pedagogical content knowledge, and a sense of purpose and motivation for teaching about sustainability. Outcomes indicate that participants felt confident and efficacious to teach about sustainability, and developed their content knowledge, pedagogy content knowledge, motivation, and volition due to a strong sense of purpose and responsibility. The overall process facilitated the development of critical thinking, systemic thinking, reflection, and collaboration..

The relationship between antitumor response and tumor marker changes was evaluated in patients with advanced hepatocellular carcinoma treated with durvalumab plus tremelimumab (Dur/Tre). Thirty-two patients were enrolled in this retrospective evaluation of treatment outcomes. According to Response Evaluation Criteria for Solid Tumors at 8 weeks, the objective response rate (OR) was 25% and the disease control rate (DC) was 56.3%. Median alpha-fetoprotein (AFP) ratio at 4 weeks was 0.310 in patients who achieved OR at 8 weeks (8W-OR group), significantly lower than the 1.105 in the non-8W-OR group (p=0.0020), but was 1.210 in patients who did not achieve DC at 8 weeks (non-8W-DC group), significantly higher than the 0.470 in the 8W-DC group (p=0.0006). Similarly, median des-γ-carboxy-prothrombin (DCP) ratio at 4 weeks was 0.125 in the 8W-OR group, significantly lower than the 1.225 in the non-8W-OR group (p=0.0001), but was 1.120 in the non-8W-DC group, significantly higher than the 0.480 in the 8W-DC group (p=0.0255). Early changes in tumor markers after Dur/Tre initiation were associated with antitumor response. In particular, changes in AFP and DCP at 4 weeks may offer useful biomarkers for early prediction of both response and progressive disease following Dur/Tre.

Coronavirus disease-19 (COVID-19) has disproportionately affected certain demographics in England, exacerbating existing health disparities. Effective therapeutics are a critical line of defence against COVID-19, particularly for patients at elevated risk for severe disease. Surveillance systems were established to monitor usage of COVID-19 therapeutics in hospital and community settings and inform stewardship. Three antiviral therapies: nirmatrelvir plus ritonavir (Paxlovid®), remdesivir (Veklury®), and molnupiravir (Lagevrio®); and two neutralising monoclonal antibody therapies (nMAbs): sotrovimab (Xevudy®) and casirivimab with imdevimab (Ronapreve®); were in use in England between July 2020 to April 2023. This paper aims to illuminate trends in the utilisation of COVID-19 therapeutics treatment in both hospital and community settings, stratified by the Index of Multiple Deprivation (IMD) in England. Chapter 3 of the English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) report 2022 to 2023 also discusses the epidemiological surveillance of these five directly-acting antiviral COVID-19 therapeutics use in England between 2022 to 2023.

In this paper, the ratio of gross agricultural production (GAP) and agricultural carbon emission is defined as agricultural carbon emission efficiency (ACEE). Considering rural labor transfer (RLT) increases the agricultural machinery intensity (AMI), the two are substitutes for each other and may interact with agricultural carbon emission efficiency (ACEE), we constructed a Simultaneous Equations Model (SEM) of ACEE, RLT and AMI, and analyzed the interaction mechanism of these three variables by using the Three-Stage Least Squares (3SLS) method to solve the endogeneity of the model. The following conclusions are drawn. First, RLT and AMI significantly promote the improvement of ACEE, while the improvement of ACEE and AMI further promotes RLT. Secondly, the causal relationship and influence mechanism of ACEE, RLT and AMI are interactive and multi-directional. An increase in AMI promotes ACEE, but an increase in ACEE inhibits an increase in AMI, suggesting that the marginal rate of substitution of machinery for labor is decreasing. Finally, China has significant regional heterogeneity. Labor transfer and machinery are only direct factors in increasing ACEE, while factors such as economic base, technology level and farmers' attitudes provide environmental support for the effective improvement of ACEE.

This paper introduces a novel decision-making approach grounded in insights into human visual perception of change. Modern technologies such as internet of things (IoT) provide us with large amounts of sensor data that need to be processed in real time and decisions made with a high degree of accuracy and reliability. Artificial intelligence (AI) methods are welcome in this context and need to be upgraded to meet actual challenges. While modern computing capabilities facilitate rapid data processing, the real-time demands of vast sensor data necessitate swift responses across the cyber chain, often leading to compromises in solution quality to circumvent combinatorial search complexities. Determining the adequacy of a solution entails varied approaches, often relying on heuristic methodologies. We illustrate our original approach with an example of a selected detail of a differential evolution algorithm, where we have to make a decision to adopt the best solution so far. We propose an approach inspired by human perceptual features that exploits the Weber-Fechner law to emulate human judgements, and offers a promising way to improve decision making in AI applications and real-time requirements fulfillment. Our proposed methodology demonstrates applicability across diverse AI scenarios involving numerical data, effectively mirroring human perception abilities.

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

Background: Ventilator-associated pneumonia (VAP) is among the most common healthcare-associated infections in Pediatric Intensive Care Units (PICUs). Because of the lack of a gold-standard diagnostic test, early diagnosis of VAP is challenging. We investigated whether bronchial biomarkers interleukin-4 (IL-4), plasminogen activator inhibitor-1 (PAI-1) and soluble receptor for advanced glycation end products (RAGE) could contribute in early VAP diagnosis through their fluctuation in time in critically ill pediatric patients. Methods: Bronchial secretions were collected from PICU patients with VAP on days 1 and 6. PAI-1, RAGE and IL-4 levels were measured by ELISA. Protein concentrations between high and low VAP suspicion patients were compared using unpaired Student’s t or Mann–Whitney U tests. Results: Twenty PICU patients, with median age 7.75yrs (range 0.5-15.3), mechanically ventilated for ≥48hrs with increased oxygenation requirements and VAP clinical/laboratory signs were enrolled. They were divided in VAP high-suspicion (n=12) or low-suspicion (n=8) groups based on Clinical Pulmonary Infection Score (cutoff:6). ΡΑΙ-1 και RAGE levels did not differ between high- or low-VAP suspicion groups the 1st or 6th days (p-value&gt;0.05). IL-4 was not detected in bronchial secretions. Conclusion: Bronchial concentrations of IL-4, PAI-1 and RAGE in critically ill children are not correlated with high- or low-VAP suspicion.

Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

Background: to analyze the impact of COVID-19 pandemic on characteristics and management of uveal melanoma (UM) in National Referral Center in Poland. Materials and Methods: the retrospective analysis of 1336 patients who were newly diagnosed with UM at Department of Ophthalmology and Ophthalmic Oncology, Jagiellonian University Collegium Medicum Krakow, Poland between January 1, 2018 and December 31, 2021. The demographic and clinical data were compiled including localization, size and treatment methods of tumors. Results: In total, 728 patients with UM were included before COVID-19 pandemic in years 2018-2019 and 608 were included during COVID-19 pandemic in years 2020-2021. Fixed-base dynamics indicators for the incidence of uveal melanoma (base year 2018) in the national referral center in Poland were 80.22% and 86.81% in year 2020 and 2021, respectively. UMs were statistically significantly larger and more frequently localized anterior to the equator of the eye globe in year 2021 than in year 2018 (Chi^2 Pearson test p= 0.0001 and p= 0.0077, respectively). The rate of patients treated with enucleation increased from 15.94% in year 2018 to 26.90% in year 2021 (Chi^2 Pearson test p=0.0005). Conclusions: statistically significant differences were found in the management of uveal melanoma in National Referral Center in Poland during COVID-19 pandemic with tumors being larger, more frequently localized anterior to the equator of the eye globe and more often enucleated.

In this study, we provided an empirical testability of the FF3FM against the co-moment-augmented FF3FM using the Newey–West GMM methods to account for potential endogeneity. The results showed that value risk is not significantly priced, and systematic skewness and systematic kurtosis play more important roles in explaining asset return than market and size factors. We discovered that there is much to gain in moving from the incumbent FF3FM to the co-moment-augmented FF3FM. By extending this study to Nigeria and using out-of-sample data that span across the recent COVID-19 period, the study has contributed to existing knowledge significantly. The study concludes that the co-moment-augmented FF3FM is superior to the incumbent FF3FM in pricing assets, and the anomalies associated with the return-size risk factor relationship are reduced by accounting for systematic skewness and systematic kurtosis in the FF3FM. Therefore, we recommend that investors should take a long position in size-hedged portfolios and hold systematic skewness and kurtosis as constant, and vice visa.

Background: This study was designed to adapt the Delis-Kaplan Executive System (D-KEFS) version of the Color-Word Interference (CWIT) and Trail making Tests (TMT) in Greek adult population from 20 to 49 years old, since it is of research as well as clinical importance to detect executive functions’ impairment in young adults with neurological or/and psychiatric conditions. Aims: Norms for the Greek adult population have been calculated to be available for neuropsychologists and health professionals who work in relevant settings. Methods: The study sample consisted of 101 healthy adults (41% male and 60% female), aged 20 to 49 years (M=32.16, SD=11.57) with education from 12 to 19 years of schooling (M=14.51, SD= .89). Pearson correlation test as well as chi square test were conducted to examine potential associations between gender, age, education, and participants’ performance. Afterwards, we calculated normative data using raw scores and transformed them to percentile scores. Finally, Greek norms were compared to the original raw scores, which were transformed in scaled scores by Delis et al. (2001). Results: The findings showed that age was the only variable which affected CWIT, whereas level of education as well as age were predictive factors for most TMT conditions, except for the visual scanning test (Condition 1). Gender did not affect both tests. Finally, D-KEFS norms for CWIT and TMT are available for Greek adult population to help clinicians detect executive functions’ deficits and therefore adjust tailored therapeutic strategies. Additionally, it is of great importance to use these tests for research purposes. Conclusion: Given that executive functions are assumed as high- level skills, which are highly related to everyday functionality, adapted tests contribute not only to assess the progression of any existing neurological as well as psychiatric disorders, but they can also be used to evaluate patients’ ability to live independently, as well as their access to work.

The authors argue that despite significant numbers of foreign workers present in the Russian labor market Russia remains unattractive for highly skilled foreign workers. The economic crisis the country has faced since 2014 has resulted in a further outflow of foreign nationals from OECD countries. So Russia has to look for employees among newcomers from the former Soviet states, the majority of whom come from Central Asia. Russian politics with regard to immigration is characterized by the collision between “geopolitical” and domestic policy rationales. On one hand, seeking to maximize its influence in the post-Soviet space Russia provides preferential conditions of employment for citizens of partner countries in the framework of the Eurasian Economic Union. On the other hand, the Kremlin is afraid to liberalize its approach to immigration and the integration of immigrants through fear of losing popularity among the electorate. The second substantial feature of Russian immigration politics is an extreme level of securitization of migration issues. The government considers these issues primarily through a policing lens. One cannot claim that the Russian state does not take any steps to liberalize “migratory regulation”; however, the effect of these measures is being vastly reduced by new restrictions. In addition, liberally designed laws do not bring the expected results due to the corrupt practices that pervade the whole of migration regulation.

Background: Delis-Kaplan Executive Function System (D-KEFS) is a neuropsychological tool used in clinical practice to measure executive function in clinical and non-clinical populations, in individuals aged 8-89 years, and consists of nine subtests that can be administered either as a single system or separately. Aims: In the present study, were established norms for the Verbal Fluency Test as well as the Design Fluency Test of the D-KEFS in a Greek population aged 20 to 49 years, since there is no previous study conducted in Greece for these age clusters. Methods: The study sample consisted of 100 healthy adults (44.4% male and 55.6% female), aged 20 to 49 years (M=32.81 SD=11.04) with education from 12 to 18 years (M=14.73, SD= .91). First, Spearman and Pearson tests explored the associations of gender, age and education with D-KEFS subtests’ performance. Afterwards, we calculated normative data using raw scores and transformed to percentile scores. Results: The present study is the first attempt to calculate norms for the two fluency subtests of the D-KEFS in Greek adult population stratified by age and educational level. Conclusion: Future research will promote the use of D-KEFS, in order to introduce a widely used tool which measures all basic executive functions subtypes for Greek adult population. Given that the majority of neuropsychological tools are adapted for older adult population, the current study aims at filling the gap in neuropsychological assessment of young adults as well as those who have co existing neurological or psychiatric disorders.

The study assessed the trapping efficacy of locally-modified 1) Gravid Aedes Trap(GAT) lined with insecticide-treated net (ITN) as a killing agent, 2) Autocidal Gravid Ovitrap(AGO) with sticky board in the semi-field system (SFS) and field setting. Fully-balanced Latin square experiments were conducted to compare GAT lined with ITN vs AGO, both with either yeast or grass infusion. Biogents-Sentinel (BGS) with BG-Lure and no CO2 was used as standard trap for Aedes mosquitoes. In the SFS, GAT outperformed AGO in collecting both nulliparous (65% vs 49%,OR=2.22,[95%CI:1.89-2.60],p

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

Although many physical activity (PA) interventions for older adults have proven ef-fective in controlled research settings, optimal implementation in real life remains challenging. This study identifies determinants perceived by stakeholders when im-plementing community-based PA interventions for older adults. We interviewed 31 stakeholders guided by the Consolidated Framework for Implementation Research (CFIR). Results showed that stakeholders are very specific about the role they can play in implementation making collaboration between stakeholders crucial. Barriers and motivators were identified in the CFIR intervention characteristics domain (relative advantage, complexity and costs, evidence quality and strength, and adaptability and trialability), in the outer setting domain (cosmopolitism, patient needs, and external policy and incentives), in the inner setting domain (implementation climate, relative priority, compatibility and organizational incentives and rewards) and in the individ-ual characteristics domain (knowledge and beliefs, and other personal attributes). An overarching theme was the stakeholders' emphasis on aiming for broad health goals in interventions, as they perceive PA as a means to reach these goals rather than an end in itself. Another overarching theme requiring attention in future implementation ef-forts is the need to tailor implementation efforts to the specific needs of older adults as the end users of the intervention.