Water scarcity, particularly in arid and semi-arid regions, poses a significant challenge to crop production, with drought being a prevalent factor limiting grain production globally. Enhancing agricultural water use efficiency is crucial for managing water resources effectively in these areas. Water resource management involves planning, developing, distributing, and optimizing the use of water resources. Water use efficiency management is also essential for crop growth in arid regions. Various agronomic and irrigation strategies can improve crop water use efficiency and drought tolerance. The primary goal of these strategies is to maximize irrigation efficiencies by applying the precise amount of water needed to restore soil moisture to the desired level. These sustainable practices not only reduce the cost of water and labor for farmers through reduced irrigation but also optimize the use of soil moisture storage. This review paper explores practical techniques to improve water use efficiency, highlighting the role of nutrients in enhancing water use efficiency in crop plants.

A low cost, scalable and robust process has been proposed as innovative method for coating solar mirrors with a self-cleaning, transparent in the full solar range and versatile material based on auxetic aluminium nitrides, previously obtained on the laboratory scale. This work presents the scaling-up of fabrication process from laboratory to prototypal scale and pre-liminary results of outdoor self-cleaning solar mirror prototypes testing in the demonstrative CSP plant ENEASHIP located in Casaccia (Rome) ENEA research centre. Prototypes 50x40cm have shown stability in external conditions: no degradation occurs during the test campaign. Their washing restores the initial reflectance affected by soiling and the self-cleaning performance allows the utilization of a reduced quantity of water for cleaning operations with respect to uncoated glass of back surface mirrors. A similar self-cleaning AlN coating could be utilized on other solar components affected by soiling, such as glass envelopes of heat collecting elements, PV panels and everywhere are required self-cleaning performance combined to optical ones.

Complex atypical endometrial hyperplasia (CAH) carries a high probability of cancer. Intraoperative evaluation of endometrial cancer in cases of CAH has not been reliable. The safety and sensitivity of sentinel lymph node (SLN) sampling has been validated. We aim to evaluate the efficacy and safety of SLN sampling in CAH managed by the da Vinci robotic platform. A total of 113 patients with a preoperative diagnosis of CAH were included in this retrospective cohort study. All underwent a robot assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy with 69 patients undergoing SLN sampling. Statistical analysis calculated the probability of cancer, SLN map rate, and surgical complications. Predictors of cancer were evaluated. Forty-seven percent of the entire cohort were diagnosed with endometrial cancer. Median age was 63 years in the SLN cohort (N = 69) and 61 in the No SLN cohort (N = 44) (p= 0.363).  Median BMI was 34 Kg/m2 in the SLN cohort and 40 in the No SLN cohort (p= 0.004). Bilateral SLN map was 92.8% and unilateral SLN map rate was 7.2%. There were no grade 3-4 complications in the SLN cohort, and 4 grade 3-4 complications in the No SLN group (p=0.021). A preoperative diagnosis of CAH bordering on or cannot rule out cancer was the only predictor of cancer.

Phased injection of natural gas into internal combustion marine engines is a promising solution for optimizing performance and reducing harmful emissions, particularly unburned methane, a potent greenhouse gas. This innovative practice distinguishes itself from continuous injection because it allows for more precise control of the combustion process with only a slight increase in system complexity. By synchronizing the injection of natural gas with the intake and exhaust valve opening and closing times while also considering the gas path in the manifolds, methane release into the atmosphere is significantly reduced, making a substantial contribution to efforts to address climate change. Moreover, phased injection improves the efficiency of marine engines, resulting in reduced overall fuel consumption, lower fuel costs, and increased ship autonomy. This technology has been tested on a single-cylinder, large-bore, four-stroke research engine designed for marine applications, operating in dual-fuel mode with diesel and natural gas. Performance was compared with that of the conventional continuous feeding method. Evaluation of the effect on equivalent CO2 emissions indicates a potential reduction of up to approximately 20%. This reduction effectively brings greenhouse gas emissions below those of the diesel baseline case, especially when injection control is combined with supercharging control to optimize the air-fuel ratio.

Abstract: Background: Gender dimorphism and marital status on colorectal cancer mortality have 9 been previously documented, but the relationship between these factors and DNA mismatch repair 10 protein (MMRP) expression status is unknown. Methods: Colectomy specimens were reviewed ret- 11 rospectively for patients between 2018 to 2023 with demographics including race/ethnicity, gender, 12 marital status, faith, body mass index, pathologic staging, and MMRP expression status. Statistical 13 analyses were performed by using baseline characteristics tables and various programs in R-pack- 14 age. Results: A total 1018 colectomies were reviewed, and the tumor stages were significantly higher 15 in right colon (stage 3 and 4) than those in left colon and rectosigmoid colon (p<0.01). Marital status 16 was significantly associated with patients’ gender, age, tumor size and tumor stages (all p<0.01). 17 MMRP status were available in 775 cases, and 139 (17.9%) were MMRP deficient, and 636 (82%) 18 MMRP proficient. MMRP deficiency was significantly associated with older female patients, larger 19 tumor in size, higher tumor stages, higher histologic grade and more common in right colon (all 20 p<0.01). In addition, MMRP deficiency was statistically associated with higher percentage of di- 21 vorced and widowed patients (p<0.01). Multivariate linear regression analysis revealed persistent 22 association of MMRP deficiency with tumor size, tumor grade, tumor stage and nodal metastasis, 23 but the associations with gender and marital status no longer existed. Conclusion: The differences 24 in prevalence of CRC by gender and marital status and tumor MMRP status illustrate the im- 25 portance of these factors on tumor stages and nodal metastasis but these associations were more 26 complex with other confounding factors.

Climate change presents an urgent global challenge, manifesting in rising temperatures and extreme weather events with severe societal impacts. The Eastern Mediterranean, warming faster than the global average, faces immediate repercussions. Climate literacy emerges as pivotal, empowering individuals to comprehend climate science and act accordingly. This study delves into climate literacy, attitudes, and 'greening' behaviours in the Eastern Mediterranean hotspot of Greece, based on a survey of 1,962 citizens. Findings indicate high climate literacy but lower adoption of 'greening' behaviours, especially those involving financial costs. Regression analyses highlight the significant role of climate literacy, concerns about personal impacts, coping appraisal and trust in institutions in promoting 'greening' behaviours. The study underscores the need for multifaceted strategies emphasizing financial motivation, trust-building, and societal norm shifts. Socio-demographic disparities, including gender and occupation, highlight areas for targeted interventions. The emphasis on the mental health impacts of climate-related events underscores the need for holistic disaster management. Policy implications are discussed, highlighting the potential of expanded climate literacy to catalyze collective action toward sustainability.

Poor perinatal mental health can have significant and lasting impacts on a woman’s overall health and the well-being of her children and family. From conception, a baby's behavior, appearance, aversions, and interests can be influenced by the prenatal environment. Thus, the quality of prenatal care is crucial. Factors such as maternal stress, environmental conditions, cravings, mood swings, hormonal changes, and emotional experiences during pregnancy can profoundly affect the baby’s behavior once born. The baby's interaction with the external world begins from conception, not just at birth. For instance, maternal depression can negatively affect both the mental and physical health of the infant. Therefore, fostering a supportive environment for expectant mothers is essential for their health and that of their unborn child. Promoting the mother’s well-being through happiness and comfort is critical.This review paper aims to synthesize current research on maternal-fetal attachment during pregnancy, its evolution, and its postpartum effects on the mother-infant relationship. It will explore how these dynamics change over time, both during pregnancy and after delivery, to provide a comprehensive understanding of the factors influencing attachment and related outcomes. As Alan Soufre, a famous developmental psychologist would state, "Attachment would begin before birth. The mother’s emotional state can shape the child’s development trajectory long before the child is born."

Driven by the growing interest of the scientific community and the proliferation of research in this field, cranial implants have seen significant advancements in recent years regarding design techniques, structural optimisation, appropriate material selection and fixation system method. Custom implants not only enhance aesthetics and functionality but are also crucial for achieving proper biological integration and optimal blood irrigation, critical aspects in bone regeneration and tissue health. This research aims to optimize the properties of implants designed from triply periodic minimal surface structures. The gyroid architecture is employed for its balance between mechanical and biological properties. Experimental samples were designed varying three parameters of the surface model: cell size, isovalue and shape factor. Computational simulation tools were used for determining the relationship between those parameters and the response variables: the surface area, permeability, porosity and Young modulus. These tools include computer aided design, finite element method and computational fluid dynamics. With the simulated values, the corresponding regression models were fitted. Using the NSGA-II, a multi-objective optimisation was carried out, finding the Pareto set which includes surface area and permeability as targets, and fulfil the constraints related with the porosity and Young modulus. From these non-dominated solutions, the most convenient for a given application was chosen, and an optimal implant was designed, from a patient computed tomography scan. An implant prototype was additively manufactured for validating the proposed approach.

The decarbonization of the electricity grid as one among the actions to reduce fossil fuel emissions, and thus their impact on global warming in the future, will be achieved mainly via the integration and widespread diffusion of renewable power sources. This is going to be supported also by the shift from the paradigm production-transmission-distribution, where electricity production oversees large-size power plants, to renewable-based distributed/diffused production, where electricity is generated very close or even by the same (group of) user(s) (or prosumers in the latter case). The number of mid-/small-size installations based on renewable energy technologies will therefore increase substantially, and the related renewable generation will be dominant against that from large-size power plants. Unfortunately, this will reduce the reliability of the grid very likely, unless appropriate countermeasures are taken/implemented, hopefully at the same time the paradigm shift is being achieved. To this aim, it is important to identify the anomalies and main fault causes that might determine in renewable-based power systems. This paper surveys the current state-of-the-art on anomalies and faults affecting wind-PV-storage hybrid power systems, i.e., the main renewable technology ensemble that will establish the future grid, and highlights possible research directions that may help to fill the literature gaps.

Preeclampsia (PE) is a complex and multifaceted obstetric syndrome characterized by several distinct molecular subtypes. It complicates up to 5% of pregnancies and significantly contributes to maternal and newborn morbidity, thereby diminishing the long-term quality of life for affected women. Due to the widespread dissatisfaction with the effectiveness of existing approaches for assessing PE risk, there is a pressing need for ongoing research to identify newer, more accurate predictors. This study aimed to investigate early changes in the maternal serum proteome and associated signaling pathways. The levels of 125 maternal serum proteins at 11-13 weeks of gestation were quantified using liquid chromatography-multiple reaction monitoring mass spectrometry (LC-MRM MS) with the BAK-125 kit. Ten serum proteins emerged as potential early markers for PE: Apolipoprotein M (APOM), Complement C1q subcomponent subunit B (C1QB), Lysozyme (LYZ), Prothrombin (F2), Albumin (ALB), Zinc-alpha-2-glycoprotein (AZGP1), Tenascin-X (TNXB), Alpha-1-antitrypsin (SERPINA1), Attractin (ATRN), and Apolipoprotein A-IV (APOA4). Notably, nine of these proteins have previously been associated with PE in prior research, underscoring the consistency and reliability of our findings. These proteins play key roles in critical molecular processes, including complement and coagulation cascades, platelet activation, and insulin-like growth factor pathways. To improve the early prediction of PE, a highly effective Support Vector Machine (SVM) model was developed, analyzing 19 maternal serum proteins from the first trimester. This model achieved an Area Under the Curve (AUC) of 0.91, with 87% sensitivity and 95% specificity, and a hazard ratio (HR) of 13.5 (4.6 - 40.8) with p&lt;0.001. These findings demonstrate that serum protein-based SVM models possess significantly higher predictive power compared to the routine first-trimester screening test, highlighting their superior utility in the early detection and risk stratification of PE.

Polycystic ovary syndrome (PCOS) is a complex disorder that impacts both the endocrine and metabolic systems. The gut microbiota plays a crucial role in in metabolism regulation and immune responses through its interaction with the external environment. This article explores the intricate interplay between intestinal flora and the pathogenesis of PCOS, focusing on the pivotal role of microbial metabolites, specifically short-chain fatty acids (SCFAs). SCFA levels in fecal and blood samples from women with PCOS (n=69) and healthy controls (n=18) were analyzed using Gas Chromatography-Mass Spectrometry (GC/MS) for precise measurement. The results revealed that women with PCOS exhibited a significant reduction in beneficial bacteria alongside a notable overgrowth of opportunistic microorganisms. An overproduction of acetic acid (AA) and valeric acid (VA) in fecal samples suggests a link between elevated SCFAs and the development of obesity and PCOS. Interestingly, AA in the bloodstream might offer a protective effect against PCOS by ameliorating key symptoms such as high body mass index (BMI), insulin resistance (IR), and chronic inflammation. This finding points to the potential therapeutic value of maintaining optimal AA levels in the blood. Although serum SCFA levels showed non-significant changes following metformin treatment, the normalization of AA in the gut underscores that metformin exerts a more pronounced effect locally within the gastrointestinal tract. This treatment also led to an increase in beneficial gut bacteria and a reduction in opportunistic pathogens, suggesting a restoration of gut microbial balance. Furthermore, the study identified the most effective model for predicting the success of metformin therapy, based on serum concentrations of butyric acid (BA) and VA, achieving a 91% accuracy rate, 100% sensitivity, and 80% specificity. These promising findings highlight the potential for developing targeted interventions and personalized treatments, ultimately improving clinical outcomes for women with PCOS.

Diffuse midline gliomas are among the deadliest human cancers and have had little progress in treatment in the last 50 years. Cell cultures of these tumors have been developed recently, but it is unknown the degree to which such cultures retain the characteristics of the source tumors. DNA methylation profiling offers a powerful tool to look at genome-wide epigenetic changes that are biologically meaningful and can help assess the similarity of cultured tumor cells to their in vivo progenitors. Paraffinized diagnostic tissue from three diffuse intrinsic pontine gliomas with H3 K27M mutations was compared with subsequent passages of neurosphere cell cultures from those tumors. Each cell line was passaged 3-4 times and analyzed with DNA methylation arrays and standard algorithms that provided comparison of diagnostic classification and cluster analysis. All samples tested maintained high classifier scores and clustered within the reference group of H3 K27M-mutant diffuse midline gliomas. There was a gain of 1q in all cell lines, with two cell lines initially manifesting the gain of 1q only during culture. In vitro cell cultures of H3 K27M-mutant gliomas maintain high degrees of similarity in DNA methylation profiles to their source tumor, confirming their fidelity even with some chromosomal changes.

Diacylglycerol kinase (DGK) is a lipid kinase that phosphorylates diacylglycerol (DAG) to generate phosphatidic acid (PA). Based on converting one important signaling molecule (DAG) to another (PA), DGK plays an important role in plant responses to abiotic stress including waterlogging stress. However, no studies have been reported on the characterization of the DGK gene family in the waterlogging-tolerant kiwifruit germplasm, Actinidia valvata Dunn. Here, we identified 18 AvDGK genes in the A. valvata genome. The phylogenetic analysis showed that AvDGKs can be classified into three clusters, and members within the same cluster have similar domain distribution, exon-intron structures and conserved motif compositions. Chromosome localization analysis revealed that all the AvDGK genes are located across 18 different chromosomes. There were 29 duplicated gene pairs in kiwifruit and all had undergone purifying selection during evolution. Promoter cis-element analysis revealed that the cis-elements within AvDGK genes are associated with multiple functions, including phytohormone signal transduction, stress response, and plant growth and development. The expression pattern analyses indicated that AvDGK play an important role in the fruit development and plant response to waterlogging stress. AvDGKs gene family in the tetraploid A. valvata genome might promote PA synthesis and subsequent signal transduction both under short-term and long-term waterlogging stress. These results provide information regarding the structural characteristics and potential function of DGK genes within kiwifruit and lay a fundamental basis for further research into breeding for enhancing the kiwifruit’s tolerance to waterlogging stress.

The utilization of Artificial Intelligence (AI) in biotechnology is widespread, addressing challenges such as elucidating disease pathophysiology and novel therapeutic approaches. AI plays a critical role in tasks such as drug manufacturing, chemical analysis, RNA and DNA sequencing, and enzyme studies by automating processes and expediting data collection and analysis. AI has particularly transformed the analysis of omics data for researchers, providing tools to handle complex and multifaceted datasets effectively. Through AI, integrative analysis of multi-omics data can be conducted in efficient ways. This article discusses the application of multi-omics and AI technologies in studying various diseases related to infection (COVID-19), mutation (cancer), and senescence (alopecia) to understand their pathophysiology. The applications of AI were performed as the aspect of the diagnosis, prognosis, and treatment for each disease. We introduce AI-driven analysis of pathophysiology can overcome traditional limitations in pathology, with diverse features showing potential in defining the causes of diseases, and potentially enhancing primary omics data in the distinguish the subtype of diseases. In this context, integrated approaches using multi-omics data and AI technology could provide fresh biological insights by comprehending the molecular mechanism of diseases and is instrumental in advancing precision medicine. We anticipate that the rapidly advancing AI-based multi-omics data analysis will significantly contribute to promoting healthy longevity.

Background: IoT and Big Data are newer technologies that can provide substantial support for healthcare systems and help overcome their shortcomings. The aim of this paper was to analyze literature production descriptively, thematically, and chronologically from an interdisciplinary perspective in a holistic way to identify the most prolific research entities and themes. Methods: The synthetic knowledge synthesis qualitatively and quantitatively analyzes the production of literature through a combination of descriptive bibliometrics, bibliometric mapping and content analysis. For this analysis the Scopus bibliometric database was used. Results: In the Scopus database, 2272 publications were found, which were published between 1985 and June 10, 2024. The first article in this field was published in 1985. Until 2012 the production of literature was steady increasing, after that exponential growth began, which reached its peak in 2023. The most productive countries were the USA, India, China, the United Kingdom, South Korea, Germany and Italy. The content analysis resulted in 8 themes (four from the perspective of computer science and four from the perspective of medicine) and 21 thematic concepts (eight from the perspective of computer science and 13 from the perspective of medicine). Conclusions: The results show that IoT and Big Data have become key technologies in preventive health. The study outcomes might represent a starting point for the further development of research that combines multidisciplinary aspects of healthcare.

The effects of climate change health impacts on urban health care systems and vulnerable populations are a researched topic with foundations on urban risk management, urban health methodologies, and sustainable urbanization. As climate change is a dynamic and transformative global issue the gap between adaptation and mitigation efforts and urban planning relies, among other things, in the limitations of previous studies of risk management structures tailored to the existing strategy to calculate the uncertainties and predict their influence on urban systems and subsystems. Moreover, as climate and health is a well-researched issue, it is also complex as the methodologies and strategic approach to minimize health risks of climate change is intrinsically contingent to risk methodologies and policy-making processes that are efficient with support of knowledge-based information. This paper emphasis the need for focusing on urban health risk management methods that serves to identify potential opportunities, and then manage and take action to prevent adverse health effects. It also emphasizes the probability of events and their consequences, which are measurable both qualitatively and quantitatively.

CAMx-LPiG (Comprehensive Air Quality Model with Extensions – Linear Plume in Grid) is an online hybrid model, based on the Chemistry and Transport Model (CTM) CAMx, that includes a sub-grid scale module to simulate the dispersion of linear road traffic emissions, called LPiG. LPiG is a plume in grid module specifically developed by extending the capabilities of the Lagrangian puff sub-grid model available in CAMx. The online integration of the local scale model within the Eulerian CTM allows for a multiscale simulation of air quality from the regional scale to the urban scale, preserving a coherent description of the chemical state of the atmosphere at all spatial scales and avoiding any double counting of the emissions simulated by the sub-grid module. In this work the model is presented and evaluated against measured NO2 concentrations for the city of Milan for the month of January 2017. The model is able to introduce road traffic induced gradient in NO2 concentration at sub-grid resolution. Moreover, CAMx-LPiG is shown to reduce the bias compared to CAMx stand-alone simulations.

Patients with a psychotic disorder frequently report oral health problems, while mental health nurses (MHNs) seem not to be fully aware of these problems and the risk factors. Therefore, this study aims to develop supportive tools for MHNs regarding oral health to increase sensitization among MHNs and to provide MHNs with knowledge to recognize (potential) oral health problems in patients with a psychotic disorder. We used a human-centered design in which the user, MHNs as well as experts by experience, were placed in the centre of the research process. Problems and needs in MHNs working with patients with a psychotic disorder were addressed. To identify key issues of problem as well as the needs in terms of resources, we started with focus groups (n = 9). We analysed the data thematically based on context of patients and MHNs in practice regarding oral health, preferred oral health tools focused on MHN, and intended outcomes of tools. A Multi Criteria Decision Matrix was developed and analysed (n = 9) to identify the most optimal and viable solution based on established criteria and issues that are prevalent in the work of MHNs. Most promising result was the development of a brochure with an awareness screener. The brochure with awareness screener was developed as a low-fidelity prototype for MHNs regarding oral health in patients with a psychotic disorder, based on the latest scientific evidence. After testing it, the feasibility was tested through semi-structured interviews (n=19). MHNs and experts by experience were satisfied with the tool and provided recommendations for adjustments to the content. Significant augmentations to the brochure include a clinical lesson and a toothbrush with toothpaste for patients. We can conclude that a brochure with an awareness screener is feasible for MHNs. Future steps aiming to further refine and optimize care processes for oral health tools in MHNs, should take refining eligibility criteria for psychiatric populations and the language level of the target group of a tool into account.

Background: The lateral antebrachial cutaneous nerve (LACN) is the terminal sensory branch of musculocutaneous nerve and is rarely entrapped or injured. This study describes the electrodiagnostic (EDX) findings and etiologies of LACN neuropathy. Methods: This is a review of 49 patients with pain and/or paresthesia of the forearm who underwent EDX studies. The diagnosis of LACN neuropathy was based on clinical and sensory conduction abnormalities. Results: The most common etiology of LACN neuropathy was iatrogenic injury in 30 (61.2%) patients, primarily due to biceps tendon repair at the elbow (11 [36.7%]) and phlebotomy (5 [16.7%]. Fifteen (30.6%) patients sustained a non-iatrogenic injury at the proximal forearm/elbow, consisting of 6 (60%) laceration injuries and 5 (33.3%) stretch injuries. Four (8.2%) patients comprised the “other” etiology category, including 2 mass lesions causing LACN compression. Pain, paresthesia, and/or numbness in the LACN distribution were reported in 33 (67.3%), 27 (55.1%), and 23 (46.9%) patients, respectively. Hypoesthesia was detected in 45 (91.8%) patients, and dysesthesia in 7 (14.3%). The sensory nerve action potentials (SNAPs) of the LACN on the symptomatic side were absent in 44 (89.8%) patients. Of the 5 patients whose SNAPs of the LACN were detected, all had a decreased amplitude and 2 had increased sensory latency. Conclusion: The most common etiology for LACN neuropathy in this series was iatrogenic injury; repair of biceps tendon at the elbow was the most frequent provoking cause. Protection of the LACN during surgical procedures at the elbow and forearm is vital to prevent iatrogenic injury.

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

Background: Post COVID-19 syndrome or Long Covid (LC) is a novel fluctuating condition with a protracted course in some patients. Specialist LC services have been operational in the UK since 2020 and deal with a high caseload of patients. Aims: To evaluate long-term outcomes in patients discharged from a community-based LC specialist service. Methods: A service evaluation study that included patients who were well engaged in the services [completed the standard Patient Reported Outcome Measures (PROMs) and received intervention from clinician(s)] and had been discharged for at least 3 months from the service. They consented to the study and completed standard PROMs: COVID-19 Yorkshire Rehabilitation Scale (C19-YRS), EQ-5D-5L, and National Institute for Health and Care Excellence (NICE) criteria for Myalgia Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS). Results: Out of 460 patients contacted, 112 (average of 37.6 months since infection and 9.8 months post-discharge) completed the PROMs. 90.2% patients continued to experience LC symptoms and disability and had not returned to their pre-COVID health status. The average EQ-5D-5L index score was 0.53 (SD 0.29) highlighting a significant disability and that LC had become a long-term condition (LTC) in majority of patients who responded to the survey. 43% patients met the criteria for suspected ME/CFS. Conclusion: A proportion of LC patients develop Persistent Long Covid (PLC) consistent with a LTC and had a significant overlap with ME/CFS.

Long term Precipitation and temperature variations are one of the main determinants of climate variability of one’s area. The aim of this study is to determine trends variation in climatic elements of temperature and precipitation in the southern zone of Tigray regional state, Ethiopia. The station is assumed for the study of climatic records over southern zone of the region in detection for probable trends. The daily, monthly and annual precipitation totals and temperature observed at korem meteorological station were used for the period of 1981-2010 for Precipitation and 1985 – 2010 for minimum and maximum temperature. Summary of descriptive statistics and Mann Kendall test methods were employed for the observed data analysis to demonstrate any existence of possible trends. The main findings of the study indicated that the mean and maximum temperature had a general increasing trend; however, minimum temperature showed decreasing trend. In general annual temperature from 1985 – 2010 of the area showed a warming trend. Moreover analysis of the 30 years (1981-2010) annual precipitation showed a coefficient of variation ranging from 33.77 – 233 %. It indicated that the precipitation dissemination is not normal with large year to year variances.

With buildings accounting for a significant portion of global energy consumption and greenhouse gas emissions, the application of artificial intelligence (AI) holds promise for enhancing sustainability in the building lifecycle. This systematic literature review addresses the current understanding of AI's potential to optimize energy efficiency and minimize environmental impact in building design, construction, and operation. A comprehensive literature review and synthesis were conducted to identify AI technologies applicable to sustainable building practices, examine their influence, and analyze the challenges of implementation. The review was guided by a meticulous search strategy utilizing keywords related to AI application in sustainable building design, construction, and operation. The findings reveal AI's capabilities in optimizing energy efficiency through intelligent control systems, enabling predictive maintenance, and aiding design simulation. Advanced machine learning algorithms facilitate data-driven analysis and prediction, while digital twins provide real-time insights for informed decision-making. Furthermore, the review identifies barriers to AI adoption, including cost concerns, data security risks, and challenges in implementation. AI presents a transformative opportunity to enhance sustainability in the built environment, offering innovative solutions for energy optimization and environmentally conscious practices. However, addressing technical and practical challenges will be crucial for the successful integration of AI in sustainable building practices.

Sustainable manufacturing practices are becoming increasingly necessary due to the growing concerns regarding climate change and resource scarcity. Consequently, material recycling technologies have gradually become preferred over conventional processes. This study aimed to recycle waste polylactic acid (PLA) from household-disposed cups and lids to create 3D-printed parts and promote sustainable manufacturing practices. To achieve this, the current study utilised virgin and post-consumer PLA (sourced from household waste) blends. The PC-PLA wastes were shredded and sorted by size with the aid of a washing step, resulting in a filament with a 1.70 ± 0.5 mm diameter without fragmentation or dissolution. A 50:50 wt.% blend of virgin PLA (vPLA) and PC-PLA was selected as the standard recycling percentage based on previous research and resource conservation goals. The study investigated the impact of three 3D printing parameters (layer height (LH), infill density (I), and nozzle temperature (NT))on the quality of 3D-printed parts using a three-level L9 Taguchi orthogonal array. The findings revealed that blending PC-PLA with vPLA led to significant improvements in the tensile, flexural, and impact strengths by 18.40%, 8%, and 9.15%, respectively, compared to those of recycled PLA. This conclusion was supported by the investigation of the fracture surface area, which revealed fractographic features associated with printing parameters, such as plastic deformation and interfilament debonding. An ANOVA analysis revealed a positive influence of larger layer height and high nozzle temperature on the mechanical properties. Subsequently, the optimal printing parameters (LH: 0.3 mm, I: 100%, and NT: 215 °C) were determined using the S/N ratio, and a confirmation test using the optimum printing parameters exhibited a strong correlation with statistically predicted outcomes. Finally, the study used optimum printing parameters to fabricate 100% post-consumer recycled PLA 3D printed parts, demonstrating their potential for low-strength applications. Based on these findings, it can be concluded that virgin and post-consumer recycled PLA blended filament for fabricating 3D printed components is an effective way to support plastic recycling in the context of a circular economy.

In general, during emergencies, healthcare is provided by tents and temporary structures that do not consider the environmental and social impact of the structure as a first term, in favor of swift response. The resultant construction intended as a temporary solution often persists long-term. This paper aims to analyze an alternative and innovative modular structure designed as a transitory solution in emergency and everyday life. In the first part of the paper, the conceptual framework, and the preliminary design for the new approach to basic non-conventional sanitary spaces are described, by investigating the benefits of a safe space as a generator space for care services and community. In the second part, the technological requirements of the system, its energy efficiency, and environmental impact are analyzed.

In this study, the causal-effect between carbon dioxide emissions and forestry production and trade was investigated in Ghana by employing a data spanning from 1961 to 2014 by using the VECM and ARDL model. Evidence of the long-run equilibrium relationship in the VECM shows that, a 1% increase in veneer sheet production reduces carbon dioxide emissions by 1.47% in the long-run. There was evidence of a bidirectional causality between carbon dioxide emissions and veneer sheet production, carbon dioxide emissions and wood charcoal production, and a unidirectional causality running from carbon dioxide emissions to wood fuel production and plywood production to carbon dioxide emissions. Evidence from the long-run equilibrium relationship in the ARDL model shows that; a 1% increase in plywood production will increase carbon dioxide emissions by 0.17% in the long-run, a 1% increase in sawnwood production will increase carbon dioxide emissions by 0.17% in the long-run, a 1% increase in wood charcoal production will increase carbon dioxide emissions by 0.36% in the long-run and a 1% increase in wood fuel production will increase carbon dioxide emissions by 0.37% in the long-run.

In this study, an attempt was made to investigate the Kenya case of multivariate causality of carbon dioxide emissions by employing a time series data spanning from 1961-2011 using the ARDL method of cointegration analysis. The long-run elasticities show that, a 1% increase in financial development increases carbon dioxide emissions by 0.28%, a 1% increase in GDP per capita increases carbon dioxide emissions by 1.32% and a 1% increase in urbanization decreases carbon dioxide emissions by 1.14%. There was a unidirectional causality running from financial development, food production index, GDP per capita, industrialization and urbanization to carbon dioxide emissions. The innovation accounting shows that 20% of future shocks in carbon dioxide emissions are due to fluctuations in financial development, 9% of future shocks in financial development are due to fluctuations urbanization and 22% of future shocks in food production index are due to fluctuations in carbon dioxide emissions.

The Energy Performance of Buildings Directive 2010 calls for the Nearly Zero Energy Standard for new buildings from 2021 onwards: Buildings using “almost no energy” are powered by renewable sources or energy produced by the building itself. For residential buildings, this ambitious new standard has already been reached. But for other building types this goal is still far away. The potential of these buildings to meet a Nearly Zero Energy Standard was investigated by analyzing ten case studies representing non-residential buildings with different uses. The analysis shows that the primary characteristics common to critical building types are a dense building context with a very high degree of technical installation (such as hospital, research and laboratory buildings). The large primary energy demand of these types of buildings cannot be compensated by building and property-related energy generation including off-site renewables. If the future Nearly Zero Energy Standard were to be defined with lower requirements because of this, the state related properties of Bavaria suggest that the real potential energy savings available in at least 85% of all new buildings would be insufficiently exploited. Therefore, it would be useful to instead individualize the legal energy verification process for new buildings to distinguish critical building types such as laboratories and hospitals.

Increased wildfire activity is the most significant natural disturbance affecting forest ecosystems, with a strong impact on their natural regeneration. This study presents a comprehensive analysis of post-fire forest recovery using Landsat time series data from 2000 to 2023 in the Middle Volga region of the Russian Federation. The analyses utilised the LandTrendr algorithm in Google Earth Engine (GEE) cloud computing platform to examine Normalized Burn Ratio (NBR) spectral metrics and quantify the forest recovery at low, moderate, and high burn severity (BS) levels. To assess the spatio-temporal trends of the recovery, the Mann–Kendall statistical test and Theil–Sen’s slope estimator was applied. The results suggested that the post-fire spectral recovery is significantly influenced by the degree of the BS on affected areas. The higher the class of BS, the faster and more extensive the reforestation of the area occurs. About 91% (40,446 ha) of the first 5-year forest recovery after the wildfire belong to the BS classes of moderate and high severity. A regression model showed that land surface temperature (LST) was more significant to post-fire recovery than the variability in precipitation (Pr), explaining about 65% of the variance in post-fire recovery. This study provides new insights into the post-fire forest recovery dynamics and scientific bases for the cost-effective management strategies under changing climate conditions.

Pulmonary sarcoidosis is a multisystem granulomatous interstitial lung disease (ILD) with a variable presentation and prognosis. Early accurate detection of pulmonary sarcoidosis may prevent progression to pulmonary fibrosis, a serious and potentially life-threatening form of the disease. However, the lack of a gold-standard diagnostic test and specific radiographic findings pose challenges in diagnosing pulmonary sarcoidosis. Chest computed tomography (CT) imaging is commonly used but requires expert, chest-trained radiologists to differentiate pulmonary sarcoidosis from lung malignancies, infections, and other ILDs. In this work, we developed a multichannel, CT and radiomics-guided ensemble network (RadCT-CNNViT) with visual explainability for pulmonary sarcoidosis vs. lung cancer (LCa) classification using chest CT images. We leverage CT and hand-crafted radiomics features as input channels, and a 3D convolutional neural network (CNN) and vision transformer (ViT) ensemble network for feature extraction and fusion before a classification head. The 3D CNN sub-network captures localized spatial information of lesions, while the ViT sub-network captures long-range, global dependencies between features. Through multichannel input and feature fusion, our model achieved the highest performance with accuracy, sensitivity, specificity, and combined AUC of 0.93±0.04, 0.94±0.04, 0.93±0.08 and 0.97 respectively in a 5-fold cross-validation study with pulmonary sarcoidosis (n=126) and LCa (n=93) cases. The model offers promising potential for improving the diagnosis of pulmonary sarcoidosis. A detailed ablation study showing the impact of CNN+ViT compared to CNN or ViT alone, and CT+radiomics input, compared to CT or radiomics alone, is also presented in this work.

Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in adults, characterized by abnormal growth of mature B cells in the blood, bone marrow, and lymphoid tissues. Although CLL primarily affects the hematopoietic system and lymph nodes, renal involvement is exceptionally rare and presents diagnostic and treatment challenges. Potential causes of renal failure in CLL patients include sepsis, dehydration, tumor lysis syndrome (TLS), compression of the ureter by enlarged lymph nodes, and side effects of cancer therapy. This report presents a case of CLL with renal infiltration leading to severe renal failure, discussing the clinical presentation, diagnostic workup, and management of this condition.

The cement industry is a significant contributor (around 8 %) to CO2 global emissions. About 60 % of emissions come from limestone calcination, essential for clinker production, while 40 % result from fuel combustion. Reducing these emissions is challenging due to limestone’s role as the primary raw material for cement. Cement plants are required to achieve carbon neutrality by 2050, as outlined in the 13th United Nations Sustainable Goals. One strategy to achieve this goal, involves Carbon Capture and Utilisation (CCU). Among the options for CO2 utilisation, the Power-to-Liquid (PtL) strategy offers a means to mitigate CO2 emissions. In PtL, CO2 captured from cement industrial flue gas is combined with hydrogen generated by renewable electrolysis (green hydrogen) and catalytically converted into renewable methanol (e-MeOH). In this sense, this review provides a comprehensive overview of the worldwide existing pilot and demonstration units, and projects funded by EU across several industries. It specifically focuses on PtL technology worldwide within cement plants. This work covers 18 locations worldwide, detailing technology existent at plants of different capacities, location, and project partners. Finally, the review analyses techno-economic assessments related to e-MeOH production processes, highlighting the potential impact on achieving carbon neutrality in the cement industry.

An observational cohort study of patients diagnosed with endometrial cancer (EC) stage IA G1, or atypical endometrial hyperplasia (AHE), undergoing organ-preserving treatment, was conducted. Objective of the study: to determine CDO1, PITX2, and CDH13 gene methylation levels in early endometrial cancer and atypical hyperplasia specimens obtained before organ-preserving treatment in the patients with adequate response and with insufficient response to hormonal treatment. Materials and methods: 41 endometrial specimens obtained during diagnostic uterine curettage in women with EC (n=28) and AEH (n=13), willing to preserve reproductive function, were studied; 18 specimens of endometrial cancer IA stage G1 from peri- and early postmenopausal women (comparison group) were included in the study. The control group included 18 endometrial specimens from healthy women obtained by diagnostic curettage for missed abortion and/or intrauterine adhesions. Methylation levels were analyzed using the modified MS-HRM method. Results: All 13 women with AEH had complete response (CR) to medical treatment. In the group undergoing organ-preserving treatment for uterine cancer IA stage G1 (n=28), 14 patients had complete response (EC CR group) and 14 had not (non-CR). It was found that all groups had statistically significant differences in CDO1 gene methylation levels with the control group (p&lt;0.001) except for the EC CR group (p=0.21). The p-value of difference between EC CR and EC non-CR groups was &lt;0.001. The differences in PITX2 gene methylation levels between the control and study groups were also significantly different (p&lt;0.001), except for AEH group (p=0.21). For the difference between EC CR and EC non-CR groups, the p-value was 0.43. For CDH13 gene methylation levels, statistically significant differences were found between the control and EC non-CR groups (p&lt;0.001), and the control and EC comparison groups (p=0.005). When comparing the EC CR group with EC non-CR group, the p-value for this gene was &lt;0.001. Simultaneous assessment of CDO1 and CDH13 genes methylation allowed to accurately distinguish between EC CR and EC non-CR groups (AUC=0.96). Conclusion: Assessment of CDO1 and CDH13 gene methylation in endometrial specimens from patients with endometrial cancer (IA stage G1), planned for medical treatment, can predict the treatment outcome.

This research analyzes the phenomenon of the reduction of urban green spaces in the post-socialist city. Belgrade was selected as a post-socialist city of the former Yugoslavia. The article analyses the views of urban planners on the reasons for the reduction of urban green areas in the post-socialist city based on semi-structured interviews with representative samples for urban areas. This result research confirms the hypothesis that post-socialist city planning reduces urban green areas due to the lack of new mechanisms in documents for the planning of urban green space. The concept of sustainability should connect and balance the skills of urban planners and focus on how urban planners develop and apply standards and protect them in market-democratic systems. In other words, a new mechanism of post-socialist city planning implies a balance between the private and public sectors. In the planning document, urban planners should find a common denominator between the public interest, citizens, investors, and spheres determined by the sustainable principles of the development. City institutions should provide opportunities for the application of those standards. With the new approach, planning would imply work in the service of citizens in the concepts of a sustainable and green city.

Carbon (C) losses due to the conversion of natural forests adversely affect the abiotic components of terrestrial ecosystems. In tropical China, rubber cultivation often extends from its traditional range to elevations of up to 1400 m. However, C storage in rubber plantations across elevation gradients is poorly understood. In this study, we investigated biomass and C storage along elevation gradients in two age groups (8- and 12-year-old) of rubber monoculture plantations in Xishuangbanna, Southwest China. We investigated the C distribution across various tree sections, ranging from aboveground biomass (AGB) to belowground biomass (BGB), including litter, big dead branches, and different soil depths. A significant negative correlation was observed between total ecosystem C stocks and elevation in both age groups of rubber plantations. The highest ecosystem C stock of 197.90 Mg C ha–1 was recorded at 900 m in 8-year-old plantations, whereas in 12-year-old rubber plantations, the highest value of 183.12 Mg C ha–1 was found at 700 m. The total ecosystem C stocks decreased to its lowest level at 1000 m in both the 8-year-old and 12-year-old plantations, ranging between 113.05 Mg C ha–1 and 125.75 Mg C ha–1, respectively. We concluded that the total ecosystem C stocks were negatively correlated with elevation and significantly decreased from 8.05% to 51.55% and 11.46% to 42.96% between 700 m and 1100 m in both 8-year-old and 12-year-old plantations, respectively. However, no correlation was observed between the total soil C stocks and elevation in either age group of rubber plantations. Regardless of elevation gradient, the total ecosystem C stock of 12-year-old rubber plantations was 1.98% greater than that of 8-year-old rubber plantations. Biomass was the second largest contributor, while soil accounted for 82% to 90%, and the other factors contributed less than 2% of the total ecosystem C stock in both age groups. These fluctuations in C stocks along elevation gradients in both 8- and 12-year-old plantations suggested that rubber growth, biomass and C storage capacity decreased above 900 m and that age and elevation are key factors for biomass and C storage in monoculture rubber plantations.

A new model for international bed numbers is applied to local area populations for English Clinical Commissioning Groups (CCGs) where the Age Standardized Mortality Rate (ASMR) is used as a measure of population health and hence for total occupied hospital bed demand (elective plus emergency admission types, including acute, rehabilitation, mental health, and maternity), rather than simple bed availability. A 100-unit increase in ASMR (European Standard population) leads to a 15.3 – 30.7 (feasible range) unit increase in occupied beds per 1,000 deaths. ASMR shows why the Australian states of the Northern Territory and Tasmania have an intrinsic higher bed demand than the other states – although in both cases the bed planning methodologies failed to indicate this need and both states show a large bed deficit. Due to the high volatility in bed demand the average bed demand for 2019 was determined by a linear trend using data for 2014/15 to 2019/20 — as the pre-COVID-19 baseline. The slope of the relationship between occupied beds per 1,000 deaths and deaths per 1,000 population shows a power law function. As is to be expected there is scatter around the trend line which will partly arise from uncertainty in the expected occupied beds in 2019, fluctuations in both ASMR and deaths per 1,000 population from one year to another, changes in the number of persons on the elective, outpatient and diagnostic waiting lists, and local area variation in births and consequently upon maternity, neonatal and pediatric bed demand. Additional variation in bed demand will arise from differences in the level of funding for social care, especially elderly care, and to a lesser extent upon patients using private health care, and charitable hospices for palliative care. However, after including the change in bed demand arising from ASMR the model is sufficiently accurate to identify gross differences in bed demand as a prelude to further investigation. The model requires further extension to cover specialty-level demand, and perhaps segregation between elective and emergency types of inpatient demand. A method for benchmarking the whole hospital’s average bed occupancy is given which enables them to run at optimum efficiency and safety. Using this method English hospitals can be shown to operate at highly disruptive and unsafe levels of bed occupancy leading to deleterious ‘turn-away’. Turn-away implies bed unavailability for the next arriving patient. The problems associated with crafting effective bed planning are illustrated using the English NHS as an example.

The primary therapeutic method for correcting hyperglycemia today is diet therapy. Lipids are not only a source of nutrients but can also act as initiators of adipocyte differentiation in the fetus, which explains the development of fetal macrosomia and future metabolic disorders in children born to mothers with gestational diabetes mellitus (GDM). Changes in the profile of circulating lipids in the maternal bloodstream, depending on adherence to a rational diet among mothers with GDM and the development of fetal macrosomia, is a complex and not fully understood process. The aim of the study was to examine the characteristics of the lipid profile in the blood plasma of pregnant women with GDM in all trimesters of pregnancy based on adherence to diet therapy. The design of the clinical part of the work was carried out within the framework of a 'case-control' study.The study included 110 women, 80 of whom were in the control group, 20 in the group with GDM adhering to the diet, and 10 in the group with GDM not adhering to the diet. The laboratory part was conducted as part of a longitudinal dynamic study with venous blood samples taken at three points: 11-13, 24-26, and 30-32 weeks of pregnancy.A significant impact of diet therapy on the blood lipid composition throughout pregnancy was demonstrated, starting as early as the first trimester. ROC analysis showed high effectiveness of the developed models with an AUC of 0.98 for the "30-32 weeks" model, with sensitivity and specificity of 1 and 0.9, respectively. An association was found between diet, maternal blood lipid composition at 32 weeks of pregnancy, and newborn weight. The direction of changes in the lipid spectrum during the development of macrosomia and diet therapy is diametrically opposed. This confirms at the molecular level that diet therapy can normalize not only carbohydrate but also lipid metabolism in the mother and fetus. Based on the obtained data, it can be suggested that after validation, the developed models could be used to refine the prognosis of macrosomia development based on the lipid profile of blood plasma at different stages of pregnancy.

Background: The Second Victim Phenomenon (SVP) significantly impacts the well-being of healthcare professionals and patient safety. While SVP has been explored in various healthcare settings, there is limited data on its prevalence and associated factors among nurses in Austria. This study investigates the prevalence, symptomatology, and preferred support measures for SVP among Austrian nurses. Methods: A nationwide, cross-sectional, anonymous online survey was conducted using the SeViD questionnaire (Second Victims in German-speaking Countries), which includes the Big Five Inventory-10 (BFI-10). Statistical analyses included binary logistic regression and multiple linear regression using the bootstrapping, bias-corrected and accelerated (BCa) method based on 5000 bootstrap samples. Results: 928 participants responded to the questionnaire. Among the respondents, 81.58% (744/912) identified as Second Victims (SVs). The primary cause of becoming a SV was aggressive behavior from patients or relatives. Females reported a higher symptom load than males, and higher agreeableness was linked to increased symptom severity. Notably, 92.47% of SVs who sought help preferred support from colleagues, and the most pronounced desire among participants was to process the event for better understanding. Conclusions: The prevalence of SVP among Austrian nurses is alarmingly high, with aggressive behavior identified as a significant trigger. The findings emphasize the necessity for tailored support strategies, including peer support and systematic organizational interventions to mitigate the impact of SVP on nurses and to improve overall patient care. Further research should focus on developing and implementing effective prevention and intervention programs for healthcare professionals in similar settings.

In this work, zinc oxide (ZnO)/ granular activated carbon (GAC) composites at different ZnO concentration (0.25M-ZnO@GAC, 0.5M-ZnO@GAC, and 0.75M-ZnO@GAC) were prepared by an in-situ hydrothermal method and demonstrated synergistic photocatalytic degradation and ad-sorption of Rhodamine B (RhB). The thermal stability, morphological structure, elemental com-position, crystallographic structure, and textural properties of developed catalysts were charac-terized by thermal gravimetric analysis (TGA/DTG), scanning electron microscopy equipped with energy dispersive-x-ray (SEM-EDS), x-ray diffraction (XRD), and Brunauer–Emmett–Teller (BET) analysis. Successful loading of ZnO onto GAC was confirmed by SEM-EDS and XRD analysis. The BET surface areas of GAC, 0.25M-ZnO@GAC, 0.5M-ZnO@GAC, and 0.75M-ZnO@GAC were 474 m2/g, 450 m2/g, 453 m2/g, and 421 m2/g, respectively. The decrease in GAC could be attributed to the successful loading of ZnO on the GAC surface. Notably, 0.5M-ZnO@GAC exhibited the best photocatalytic degradation efficiency of 82% and 97% under UV-A and UV-C light over 120 min, attributed to improved crystallinity and visible light absorption. The photocatalytic degradation parameters revealed that lowering the RhB concentration, raising the catalyst dosage and pH be-yond the point of zero charge (PZC) would favor the RhB degradation. Photocatalytic reusability was demonstrated over 5 cycles. Scavenger tests revealed that the hydroxyl radicals (•OH), su-peroxide radicals (O2−•), and photoinduced hole (h+) radicals play a major role during the RhB degradation process. Based on the TOC results, the RhB mineralization efficiency of 79.1% was achieved by 0.5M-ZnO@GAC. Additionally, GAC exhibited a strong adsorptive performance towards RhB with adsorption capacity and RhB removal of 487.1 mg/g and 99.5% achieved within 90 min equilibrium time. The adsorption characteristics were best described by pseu-do-second-order kinetics, suggesting chemical adsorption. This research offers a new strategy for the development of effective photocatalyst materials with potential for wider wastewater treat-ment applications.

The present study analyzes students' weather-related hazard and risk literacy in Greece, a climate change hotspot region in the Eastern Mediterranean. In this context, we examine the students' level in two core literacy variables, namely knowledge and competency. In addition, we explore how knowledge, attitudes and socio-demographic variables influence students' competencies related to weather and climate risk assessment and adaptability. A questionnaire-based survey was conducted on 474 students aged 12-16. The regression results showed that knowledge significantly affects the level of competency. Self-belief and confidence in science were the most influential among the attitudinal variables. We conclude by discussing educational and behavioural issues highlighted as essential to address with targeted policies and measures in formal education complemented by non-formal educational activities.

In the context of healthcare technology management (HTM) in Saudi Arabia and the Gulf region, this study addresses a significant gap by exploring both external and internal risk factors affecting HTM performance. Previous research has primarily focused on modeling or predicting failures in medical devices, mostly examining internal (endogenous) factors that impact device performance and the development of optimal service strategies. However, a comprehensive investigation of external (exogenous) factors has been notably absent. This research introduces a novel hierarchical risk management framework, designed to accommodate the broad array of healthcare technologies, not limited to medical devices. It significantly advances the field by thoroughly investigating and validating a comprehensive set of 53 risk factors and assessing their influence on HTM. Additionally, this study embraces the perspective of enterprise risk management (ERM) and expands it to identify and incorporate a wider range of risk factors, offering a more holistic and strategic approach to risk assessment in healthcare technology management. The findings reveal that several external and internal factors previously underexplored significantly impact HTM performance. Notably, the Fuzzy AHP survey identified “design risk” under facility and environmental risks as the highest risk for HTM in the region. Furthermore, the study reveals that three out of the top ten risks are related to “facility and internal environmental” factors, six are related to technological endogenous factors, and only one is related to managerial factors. This distribution underscores the critical areas for intervention and the need for robust facility and technology management strategies. In conclusion, this research not only fills a critical void by providing a robust framework for healthcare technology risk assessment but also broadens the scope of risk analysis to include a wider array of technologies, thereby enhancing the efficacy and safety of healthcare interventions in the region. Additionally, the proposed hierarchy provides insights into the underlying risk factors for healthcare technology management, with potential applications extending beyond the regional context to a global scale. Moreover, the equation we propose offers a novel perspective on the key risk factors involved in healthcare technology management, presenting insights with far-reaching implications applicable not only regionally but also on a global level. This framework also supports sustainability goals by encouraging the efficient and responsible utilization and management of healthcare technologies, essential for ensuring the long-term economic and environmental sustainability of medical technology use.

Probiotics are becoming more and more popular in the growing of fin and shellfish because these species are consumed worldwide and because different techniques are employed to maximize the productivity and efficiency of fin and shellfish. Probiotic Bacillus is one of the many types of probiotics that are used, but it stands out due to its superior qualities. For instance, because of its ability to sporulate, it can survive in harsh environments, produce antimicrobial substances, and is safe to feed to fish. The different species of Bacillus used in the farming of fin and shell fish were discussed in this review, along with the benefits of using Bacillus spp. as a good substitute in sustainable aquaculture to improve feed utilization, immune system response, stress adaptation, resistance to infectious diseases, tissue preservation integrity, and water quality. Additionally, we discussed the possible risks to safety that Bacillus poses when raising these significant species. For the purpose of future research and development regarding Bacillus application in aquaculture, a summary of the findings of recent studies about the advantages of applying Bacillus to enhance fin and shellfish aquatic animal culture has been provided.

The cement industry has significant environmental impacts, stemming from natural resources extraction and fossil fuels combustion. Notably, carbon dioxide (CO2) emissions are a major concern associated with cement production. The cement industry emits 0.6 tons of CO2 per ton of cement production, which is around 8 % of the total CO2 emissions in the world. Meeting the 13th United Nations Sustainable Goals, cement plants aim to achieve carbon neutrality by 2050, resulting from reduction in CO2 emissions (change in the composition of cementitious materials) and the adoption of carbon capture and utilisation (CCU) technologies. A promising approach involves converting CO₂ into valuable chemicals and fuels, such as methanol (MeOH) through the power-to-liquid (PtL) technologies. In this process, CO2 captured from cement industry flue gas with hydrogen generated from renewable sources through electrolysis of water, catalytically transformed into renewable methanol (e-MeOH), offering a sustainable solution. To achieve this, it is crucial to advance the development of novel, highly efficient catalysts specifically designed for direct CO2 hydrogenation. In this sense, this review discusses recent developments and improvements in CO2 catalytic conversion, emphasizing catalyst performance, selectivity, and stability.

BackgroundIntracranial hemorrhage (ICH) in pregnancy, estimated at 1 in 10,000 cases, presents significant diagnostic challenges prenatally despite advanced imaging techniques such as ultrasound (US) and MRI. Detecting ICH is crucial for pregnancy management and future treatment decisions aimed at improving fetal survival and reducing brain damage. This report presents the diagnosis and outcomes of two cases of prenatal ICH.Cases presentationThe first case involves a 30-year-old pregnant woman with irregular prenatal care diagnosed with ICH at 32 weeks of gestation via US and MRI. She chose to continue the pregnancy, delivering a 3160g male infant at 36 weeks via cesarean section. Following NICU care including resuscitation and ventriculoperitoneal shunt placement, the infant was discharged. Subsequent examinations showed a reduction in ventricle size. In the second case, a 27-year-old woman taking acenocoumarol for a mechanical heart valve developed fetal subdural hemorrhage detected by US and MRI. She opted to terminate the pregnancy, resulting in a stillborn male infant weighing 1530g.ConclusionFetal ICH presents with varying severity and prognostic implications, diagnosed and graded using US. Fetal cranial MRI may help clarify the etiology. Management remains controversial, with termination of pregnancy potentially warranted in severe cases due to poor prognosis. Further research is needed to refine management and improve outcomes in fetal ICH.

The global antibiotic resistance crisis, driven by antibiotic overuse and misuse, is multifaceted. This study aimed to assess the microbiological and genetic characteristics of raw retail pork meat, including the isolation, antibiotic susceptibility testing (AST), whole genome sequencing (WGS) of selected indicator bacteria, antibiotic residue testing, and metagenomic sequencing. Samples were purchased from 10 randomly selected retail stores in Gauteng, South Africa. Samples were aseptically separated, with a portion sent to an external laboratory for isolating indicator bacteria and antibiotic residue testing. Identification of the isolated bacteria was reconfirmed using matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS). AST was performed using the Microscan Walkaway system. WGS and metagenomic sequencing were performed using the Illumina NextSeq 550 instrument. The isolated E. coli and enterococci exhibited little phenotypic resistance, with WGS revealing tetracycline resistance genes. Isolated bacteria and meat samples all harboured tetracycline resistance genes, and the antibiotic residue concentrations were within acceptable limits for human consumption. In the metagenomic context, most identified bacteria were of food/meat spoilage and environmental origin, with the resistome analysis primarily indicating beta-lactam, tetracycline and multidrug resistance genes. Further research is needed to understand the broader implications of these findings on environmental health and antibiotic resistance.

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

Proactive deprescribing is the process of stopping a medicine before harm occurs. This study aimed to specify and validate with an international sample of healthcare professionals, a proactive deprescribing process of steps and constituent activities. We developed a proactive deprescribing process framework of steps which we populated with literature-derived activities required to be undertaken by healthcare professionals. We distributed a survey to healthcare professionals in-ternationally requesting for each activity; the frequency of its occurrence in practice and whether it was important. Extended response questions invited barriers and enablers to deprescribing. The 263 survey respondents were from 25 countries. A proactive deprescribing process was developed comprising four steps: (1) Identify a patient for potential stop of a medicine, (2) Evaluate a patient for potential stop of a medicine, (3) Stop a medicine(s), (4) After a medicine has been stopped, and 17 activities. All activities were considered important by ≥70% respondents. Nine activities re-quired healthcare professionals to undertake in direct partnership with the patient and/or care-giver, of which seven were only sometimes undertaken. Deprescribing interventions should focus on addressing the barriers and enablers of healthcare professionals undertaking the activities that require direct partnership with the patient and/or caregiver.

This paper assessed rice farmers' perceptions of agricultural and irrigation practices through their choices. A survey was carried out among 278 rice farmers on five irrigation schemes in three agro-ecological zones of Togo, viz. the savannah region, the forest region and the coastal region. The sample of random respondents was selected from a list of rice farmers provided by the managers of these irrigated schemes. Data collected through face-to-face interviews using kobocollect software were analyzed with R 4.2 software, and the Pearson test was validated at the 5% level. The results showed that the socio-economic characteristics of the rice growers, such as access to agricultural credit, experience, non-agricultural activities, membership of a rice growers' cooperative, gender, level of education and training in growing irrigated rice, and farm labor, significantly influenced the choice of agronomic practices and irrigation management. Characteristics such as experience, training and hired farm labor enhanced paddy yields, while access to agricultural credit was unproductive. Chemical clearing combined with stump removal, tiller ploughing, transplanting and high plant density are the agricultural practices that increased paddy yields, while tiller mudding and basal mineral fertilization were inefficient. In the same way, water distribution by demand, water depth above the soil of less than 5 cm, use of water-saving technologies and farmer's knowledge of how to improve water and fertilizer use-efficiency also helped to boost paddy yields. For sustainable rice production in the context of labor shortages and the financial resources required, future studies will focus on the effectiveness of motorized mudding and agricultural credits for rice farmers. Furthermore, considering the crucial role of training in the adopting of good agricultural and irrigation practices, future research will study strategies for wide diffusion of knowledge to rice producers.

Endometriosis is a prevalent chronic inflammatory disease characterized by a considerable delay between initial symptoms and diagnosis through surgery. The pressing need for a timely, non-invasive diagnostic solution underscores the focus of current research efforts. This study examines the diagnostic potential of the menstrual blood lipidome. The lipid profile of 39 samples (23 women with endometriosis and 16 patient of control group) was acquired using reverse-phase high-performance liquid chromatography-mass spectrometry with LipidMatch processing and identification. Profiles were normalized based on total ion counts. Significant differences in lipids were determined using the Mann-Whitney test. Lipids for the diagnostic model, based on logistic regression, were selected using a combination of variance importance projection filters and Akaike information criteria. Levels of ceramides, sphingomyelins, cardiolipins, triacylglycerols, acyl- and alkenyl-phosphatidylethanolamines, and alkenyl-phosphatidylcholines increased, while acyl- and alkyl-phosphatidylcholines decreased in cases of endometriosis. PE P-16:0/18:1 and CL 16:0_18:0_22:5_22:6 serve as marker lipids in the diagnostic model, exhibiting a sensitivity of 81% and specificity of 85%. The diagnostic approach based on dried spots of menstrual blood holds promise as an alternative to traditional non-invasive methods for endometriosis screening.

Faba bean is an important legume crop wordwide, grown both for food and feed. As for many legume crops, postemergence weed control is difficult. The aim of this work was to assess potential of intercropping on weed management by assessing the effect of mixing faba bean with different crops (wheat, barley, and pea) on weeds in the South of Spain. Four field trials were conducted over four consecutive seasons, and results found that addition alternate intercropping of faba bean and barley achieved high levels of weed control, both for coverage and biomass (92.7% and 76.6%, respectively). Intercropping with wheat did not reduce weed coverage but did decrease weed biomass by 46.1% as compared to faba bean monocrop. Intercropping with pea did not provide significant reductions for weed coverage neither for weed biomass. The diversity of the weed community was not altered by the different crop combinations tested. Additional experiments under controlled conditions were carried out to determine a possible role of barley allelopathy in weed suppression. A strong allelopathic effect entailing a reduction in the number of plants and biomass was detected for four weeds: Sinapis arvensis, Polypogon monspeliensis, Matricaria camomilla, and Medicago trucatula. It can be concluded that intercropping faba bean with barley is an excellent strategy for weed control in the Southern Spain.

Background: A Morel–Lavallée lesion (MLL) is a traumatic, internal closed degloving injury that results from shearing of subcutaneous tissue away from underlying fascia, usually associated with high-velocity trauma. Case presentation: A 52-year-old man was transported to hospital for further follow-up of a superficial femoral artery injury. Examination on admission showed bruising seen around the left thigh. Contrast-enhanced computed tomography of the left thigh revealed hematoma with extravasation from a branch of the left superficial femoral artery, but no apparent aneurysms or femoral fractures. The patient was treated with compression bandages and discharged on hospital day 6. He left hospital able to walk unaided. He subsequently complained of left thigh pain with swelling and visited the hospital several times. He was treated at another outpatient clinic and was diagnosed with MLL. Single-use disposable portable negative pressure wound therapy (NPWT) was applied for about 2 months, achieving a stable wound site. Conclusion: We encountered a case of MLL successfully treated with single-use portable NPWT. This report presents the case of a patient with isolated MLL without fracture in the left thigh, in which the diagnosis was missed on initial admission. Finally, the patient received minor interventions including drainage along with tissue debridement and portable NPWT. We reviewed the relevant literature and summarize the pathogenesis, clinical manifestations, and treatment strategies for MLL. Emergency physicians require an increased understanding of MLL to avoid misdiagnosis and missed diagnosis.

Background: Physiotherapy and chronic low back pain (CLBP) form a broad and fast developing research area. The aim of the article was to holistically, thematically and chronologically analyze and synthesise literature production and identify most prolific research entities and research themes. Methods: The article quantitatively and quantitatively analyzed research literature production harvested from the Scopus bibliometric database. using a triangulation of bibliometric and thematic analysis. For this, Excell and VOSwiever software were used. Results: In the Scopus database, 2843 data sources were found, which were published between 1974 and February 26, 2024. The growth trend has been linearly positive since the beginning of publication, and after 2018, exponential growth began. A review of the most prolific entities showed that the most literature was published in America, Europe and Australasia. The thematic analysis of the information sources identified six main themes, while the chronological analysis revealed three main areas of developments: assessment tools, CLBP processing and study methodology. Conclusions: The results of the bibliometric study presents a good starting point for further research providing Taxonomy and research landscapes as a holistic framework offering multidisciplinary knowledge about CLBP, while chronological analysis provides a basis for identifying prospective research trends.

High-density olive groves, despite their interesting production potential, have several limitations, also due to the high fruit load and the irrigation requirements.The study aimed to evaluate the effects of fruit load and deficit irrigation on oil yield and fruit quality, and on olive chemical composition in a high-density olive grove (cv Sikitita). Our main hypothesis was that the primary metabolism, as influenced by crop load and stress, could modify the accumulation of different phenolic classes.Different fruit loads were generated through flower thinning (66%, 50%, 33%, 0%) and two deficit irrigation treatments (-60%, -75%) were compared to the well-watered control (920 m3/ha).Thinning treatments had a limited effect on oil yield, on the other hand, deficit irrigation caused considerably less oil accumulation in the fruit on all sampling dates.Thinning 66% and deficit irrigation 75% were considered with the control for untargeted metabolomic analysis, considering three sampling dates. 233 different phenolic compounds were annotated. Multivariate HCA results indicated the impact of harvest time on the phenolic profile of olive fruits, yielding two separate clusters grouping t1 and t2 together and apart from t3. Regarding agronomic techniques, they played a differential role in the phenolic profile (supervised OPLS – DA). Fruit load mostly affected flavonoid glycosides. In contrast, the phenolic response to deficit irrigation is more heterogeneous, with phenolic acids (35%), flavonoids (25%), LMW, and other phenols (25%).

Hybrid power plants have recently emerged as reliable and flexible electricity generation stations by combining multiple renewable energy sources, energy storage systems (ESS), and fossil-based output. However, the effective operation of the hybrid power plants to ensure continuous energy dispatch under challenging conditions is a complex task. This paper proposes a dispatch engine (DE) based on mixed-integer linear programming (MILP) for the planning and management of hybrid power plants. To maintain the committed electricity output, the dispatch engine will provide schedules for operation over extended time periods as well as monitor and reschedule the operation in real-time. Through precise prediction of the PV and wind power output, the proposed approach guarantees optimum scheduling. The precise prediction of the PV and wind power are achieved by employing a predictor of Feed-Forward Neural Network (FFNN) type. With such a dispatch engine, the operational cost of the hybrid power plants, and the use of diesel generators (DGs) are both minimized. A case study is carried out to assess the proposed dispatch engine feasibility. A real-time measurement data pertaining to load, wind, and PV power outputs is obtained from different locations in the Sultanate of Oman. The real-time data is utilized to predict the future output power from PV and the Wind farm over 24 hours. The predicted powers are then used in combination with a PV-Wind-DG-ESS-Grid hybrid plant to evaluate the performance of the proposed dispatch engine. The proposed approach is implemented and simulated using MATLAB. The results of the simulation reveal the proposed Feed-Forward Neural Network’s (FFNN) powerful forecasting abilities. In addition, the results demonstrate that adopting the proposed DE can minimize the use of DG units and reduce plant running expenses.

Air pollution, particularly fine particulate matter (PM2.5), poses a significant threat to public health, especially in rapidly urbanizing areas like Lagos State. Despite the severity of the issue, there is a lack of comprehensive data on PM2.5 levels and the Air Quality Index (AQI) in Lagos. This study leverages data from AirQo, an innovative air quality monitoring network using low-cost sensors, to provide a detailed assessment of PM2.5 concentrations and AQI across eight locations in Lagos State, Nigeria. This approach offers real-time, continuous monitoring, filling a critical data gap in the region's air quality management efforts. This study uses AirQo data to assess the concentration levels and spatial distribution of PM2.5 and AQI across the selected eight locations. Data on PM2.5 concentrations were obtained from AirQo sensors deployed across the eight strategic locations in Lagos. The spatial distribution of PM2.5 levels and AQI were analyzed, and the results were compared with national and international air quality standards. The findings revealed that PM2.5 levels (minimum – 6.28 µg/m3 (Ikeja) and maximum - 204.68 µg/m3 (Banana Island) in many areas of Lagos exceed annual WHO and national air quality guidelines, indicating significant health risks. The spatial analysis identified pollution hotspots, particularly in densely populated and industrial regions. The data suggested vehicular emissions and industrial activities as major contributors to high PM2.5 levels. This study underscores the severe air quality issues in Lagos State, emphasizing the need for immediate and targeted interventions to mitigate PM2.5 pollution. The use of AirQo sensors proved effective in providing accurate and timely data for air quality assessment. It is recommended that Lagos State implements stricter emission controls, promotes cleaner technologies, and enhances public transportation systems to reduce traffic-related pollution. Additionally, expanding the air quality monitoring network and incorporating more environmental data will provide a more comprehensive understanding of air pollution impacts, thereby facilitating better policy and public health decisions.

This bibliographic study addresses key aspects related to fishing, product safety, and climate change in the Adriatic Sea region. The examination of product safety focuses on the assessment of contaminants originating from human activities such as industry, mining, agriculture, and household waste disposal. The contamination of the aquatic environment has emerged as a pressing global concern, extending to the Adriatic subbasin. Aquatic organisms, including fish, are prone to accumulating pollutants directly from polluted water sources and indirectly through the food web. The bio-accumulation of potentially hazardous substances, particularly heavy metals, pesticides, PCBs, PAHs, and antibiotic resistance in aquatic organisms, poses a significant threat to human health. Climate change effects will deplete our seafood supply in terms of quantity and safety owing to negative consequences such as higher levels of pollution, parasites, viruses, infections, acidification, and toxicities such as shellfish poisoning. Global food safety strategies should be developed to reduce greenhouse gas emissions and promote environmentally friendly technology, which indirectly affects seafood quality and microbiological safety, especially for Adriatic Sea, which is part of the Mediterranean Sea, characterized by the most polluted waters in the world.

Functional copy number alterations (fCNAs) are DNA copy number changes with concordant differential gene expression. These are less likely to be bystander genetic lesions and could serve as robust and reproducible tumor biomarkers. To identify candidate fCNAs in neuroendocrine tumors (NETs), we integrated chromosomal microarray (CMA) and RNA-seq differential gene expression data from 31 pancreatic (pNET) and 33 small bowel neuroendocrine tumors (sbNET). Tumors were resected from 47 early disease progression (24 months) patients. Candidate fCNAs that accurately differentiated these groups in this discovery cohort were then replicated using fluorescence in situ hybridization (FISH) on formalin-fixed, paraffin-embedded (FFPE) tissues in a larger validation cohort of 60 pNETs and 82 sbNETs (52 early and 65 late disease progression samples). Logistic regression analysis determined the predictive ability of these biomarkers as well as the assay performance metrics of sensitivity, specificity, and area under the curve. Our results indicate that copy number changes at chromosomal loci 4p16.3, 7q31.2, 9p21.3, 17q12, 18q21.2, and 19q12 may be used as diagnostic and prognostic NET biomarkers. This involves a rapid, cost-effective approach to determine primary tumor site for patients with metastatic liver NETs and to guide risk stratified therapeutic decisions.

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.

The installation of electric vehicle supply equipment (EVSE) increases demand and peak loads, potentially straining existing energy distribution infrastructure. Dispersed and inadequately planned placement of charging points (CPs) can disrupt the electrical grid, surpass contracted demand thresholds, and require infrastructure upgrades, thereby incurring unfeasible costs for Distribution System Operators (DSOs). In this context, it is necessary to recognize the role of business models in enabling effective electrification of the transportation sector. In response to these challenges, this paper introduces a novel e-mobility hub management strategy, tailored for implementation in the Brazilian context. The proposed strategy revolves around a microgrid configuration encompassing dispatchable and photovoltaic generation, a battery energy storage system (BESS), EVSE infrastructure, and local loads. Moreover, this centralized controller facilitates the implementation of dynamic pricing and demand-response mechanisms, integral to business models seeking to integrate EVSE into the distribution grid. To validate the efficacy of the proposed solution, hardware-in-the-loop (HIL) simulations of the microgrid system are conducted. These simulations, incorporating the centralized controller, serve as a tool for assessing system performance and viability before on-site equipment deployment. Finally, this paper concludes with the insights gleaned from test analysis and its discussion through a selection of the most expressive scenarios, including islanded and connected operation modes.

The hospitality industry is a major segment of Tourism which is in turn a main economic contributor for instance for Small Island Developing States (SIDS). Sustainable tourism practices are promoted worldwide by international organizations like the United Nations World Tourism Organisation (UNWTO) to assist different countries. Varied frameworks such as the Global Reporting Initiative (GRI), the Sustainable Development Goals (SDGs), United Nations Global Compact (UNGC) and environmental indices and management systems such as ISO 14001 are common assessment tools for environmental sustainability. This research reviews the relevance of incorporating environmental and socio-economic factors within hotel operations which may lead to improved transparency, and operational effectiveness while guaranteeing adherence to sustainability within the hotel business. Accordingly, a comprehensive review of environmental sustainability assessment in hotels was carried out. A comprehensive analysis of research articles published between January 2000 and January 2023 by reputed databases ranging from Google Scholar, Scopus, and others, were used to conduct the literature review. A total of 38 papers were examined adhering to the PRISMA standards and it is worth noting that a significant increase in interest emerged from 2018, especially in Europe and Asia. The review reiterated the relevance and need to use relevant assessment methods and tools that aid in implementing sustainable development strategies to promote tourism-dependent economies, particularly in Small Island Developing States (SIDS). It additionally provides valuable knowledge for future directions, whilst improving research methods and incorporating innovative technologies. These advancements are essential as they may guide policy decisions to protect the environment in the hospitality industry.

The efficient and sustainable management of hospitals is an increasingly relevant challenge in the healthcare sector. With limited financial resources, regulatory pressures and increasing demands for quality services, hospitals are faced with the want to approve sound policies to certify financial and operational sustainability. Management accounting is critical in this instance. In Portugal the DL nº 284, of July 26, 1999, allow us to confirm the need to reinforcement of profitability and efficiency in the provision of healthcare. Management accounting is an essential tool for monitoring and controlling costs, making strategic decisions, efficiently allocating resources and evaluating performance in the hospital environment. It allows a comprehensive view of financial and operational aspects, providing valuable information for management and strategic planning. However, the sustainability of hospital management accounting is a critical and complex topic that deserves special attention. Hospitals face several challenges, such as the complexity of hospital costs, the integration of information systems and the measurement of healthcare value. These challenges can compromise the effectiveness of management accounting and its ability to provide relevant and reliable information for decision making. As a result, it is required to address the sustainability of hospital management accounting by identifying the specific challenges faced in this area and exploring opportunities to overcome them. By addressing these challenges and seizing opportunities, hospitals can strengthen their position in the healthcare sector, improve their operational efficiency, optimize resource allocation and ensure the provision of quality services to patients. In this article, the challenges faced by hospital management accounting will be analysed, such as the complexity of costs, the integration of information systems and the measurement of value in healthcare. Additionally, opportunities to improve financial and operational management will be highlighted through the adoption of advanced technologies, an emphasis on value-based management and collaborative partnerships. By exploring these themes, this essay aims to make a contribution. to the advancement of hospital management accounting and the sustainability of hospitals in the current healthcare scenario.

Health services research is a multidisciplinary discipline that aims to improve population health by studying healthcare services' organization, delivery, and financing. Over time, the field has worked to define its boundaries and establish a set of core research topics and methods addressing population wellbeing, access, quality, and cost. Although the influence of health technology is significant, our literature survey on health services research showed that SCs in general—containing their management, cost, and policy—had received little attention. Importantly, our assessment also showed that the system’s readiness to handle supply policy and supply device deficiencies like those encountered during pandemic was hardly ever mentioned. Reduced open areas and water bodies, deteriorating infrastructure, and changes in the biological morphology all affect cities’ uncontrollable and unplanned growth. Urban amenities, facilities, and healthcare services were unevenly distributed due to this unchecked urban population development. In light of this, this research suggests two reliable models for site selection issues for one of Hong Kong’s main hospitals. Levels of uncertainty, infeasibility tolerance, and reliability are taken into consideration. Then, two categories of uncertainty—symmetric and bound-ed—were examined. As a result, the challenge of scheduling in uncertainty has been considered, and potential solutions have been presented using a specified probability distribution function. The paper concludes by introducing the specific justice and health problems and outlining four typical strategies. In order to ensure that medications and other healthcare supplies are produced, distributed, and given to patients, a vast network of systems, components, and procedures must be effectively managed. This research contributes in this regard. Also, its grantee fairness in health systems and the populations health locally, nationally, and globally. It highlights health inequity, advances the measurement of health inequity, and promotes public dialogues on health inequity.

Smart manufacturing encompasses a category of manufacturing that employs computer-integrated capabilities and technologies to enhance supply chain optimization, production efficiency, and recyclability. Yet limited studies have been conducted to optimize these prospects from the perspective of low resource countries where such innovative studies have not been adequately explored. This paper aims to examine the implications of smart manufacturing practices (Smart Procurement, Smart Supply Chain, Smart Production Planning and Control, Automation and Industrial Robot, and Supply Chain Configuration) on pro-environmental behaviour and develop a baseline moderated mediation model to explain the relationship between smart manufacturing and pro-environmental behaviour with a role of green dynamic capability, and environmental orientation. This study is anchored on quantitative research approach, deductive reasoning, and explanatory design. Cross – sectional survey data have been obtained from 382 manufacturing companies in Ghana. Our hypotheses have been tested using Structural Equation Modelling and SMART-PLS version 3.8.9. The study has revealed that smart manufacturing practices significantly and positively relate to pro-environmental behaviour. Moreover, green dynamic capability and environmental orientation moderate the relationship between smart manufacturing and pro-environmental behaviour. The implications of the study include the emergence of a baseline model to guide policymakers, practitioners, and academicians to explain the relationship between smart manufacturing and sustainable manufacturing in the context of developing countries. Again, the social implication of the study includes the realisation of decent job and economic growth, responsible consumption and production as well as actions taken to combat climate change.

Aquaculture contributes to the sustainable development of food security, marine resource conservation, and economy. Shifting aquaculture feed from fish meal and oil to terrestrial plant-derivatives may result in cost savings. However, many carnivorous fish cannot be sustained on plant-derived materials, necessitating the need for the identification of important factors for farmed fish growth and to investigate whether components derived from terrestrial plants can be used in feed. Herein, we focused on the carnivorous fish leopard coral grouper (P. leopardus) to identify the essential growth factors and clarify their intake timing from feeds. Furthermore, we evaluated the functionality of starch, which are easily produced by terrestrial plants. Results reveal that carbohydrates, which are not considered essential for carnivorous fish, can be introduced as a major part of artificial diet. The development of artificial feed using starch offers the possibility of increasing the growth of carnivorous fish in aquaculture.

Thermal camouflage is a highly sought-after technology to increase the survivability of military equipment against infrared (IR) detectors. Recently, two-dimensional (2D) nanomaterials have shown low IR emissivity, widely tunable opto-electronic properties and compatibility with stealth-applications. Among them, graphene and graphene-like materials are the most attractive 2D materials used for thermal camouflage applications. In particular, in multilayer graphene (MLG) charge density can be effectively tuned through sufficiently intense electric fields or through electrolytic gating. Therefore, MLG optical properties, like infrared emissivity and absorbance, can be controlled in a wide range by voltage bias. The large emissivity modulation achievable with this material makes it suitable in the design of thermal dynamic camouflage devices. Generally, the emissivity modulation in the multilayered graphene medium is governed by an intercalation process of non-volatile ionic liquids under a voltage bias. The electrically-driven reduction of emissivity leads to a decrease in the apparent temperature of the surface, which can match that of the background enabling thermal camouflaging. Since this property is common to other graphene-based materials, here we present a review specifically focused on the recent advances in the field of the thermal camouflage properties of graphene in the form of composite film and aerogel structures. A summary of the current understanding of the working principle of thermal camouflage materials, current limitations, and future opportunities is presented and discussed.

During the COVID-19 pandemic, antibody-based vaccines targeting the SARS-CoV-2 spike glycoprotein were the key focus for development because neutralizing antibodies were associated with protection against the SARS-CoV-2 infection in pre-clinical models and human trials. While deploying these spike-based vaccines saved millions of lives worldwide, it has become clear that the immunological mechanisms of protection against severe disease are multifaceted and involve non-neutralizing antibody components. Here, we describe a novel pan-sarbecovirus T-cell vaccine, ChAdOx1.COVconsv12, designed to complement and broaden the protection of spike vaccines. The vaccine immunogen COVconsv12 employs the two regions in the viral proteome most conserved among sarbecoviruses delivered by replication-deficient vector ChAdOx1. It focuses T cells towards epitopes shared among sarbecoviruses including evolving SARS-CoV-2 variants. Here, we show that ChAdOx1.COVconsv12 induced broad T-cell responses in the BALB/c and C57BL/6 mice. In the Syrian hamster challenge model, ChAdOx1.COVconsv12 alone did not protect against the SARS-CoV-2 infection, but when co-administered with 1/50th of the ChAdOx1 nCoV-19 spike vaccine protective dose, faster recovery and lower oral swab viral load were observed. Induction of CD8+ T cells may decrease COVID-19 severity and extend the T-cell response coverage of variants to match the known (and as yet unknown) members of the beta-coronavirus family.

This study aims to investigate the psychological cognitive mechanisms of rural residents amidst the renewal of suburban historical and cultural villages by examining the interplay between nostalgia, collective memory, subjective well-being and place identity in rural tourism destinations. Using Naobao Village as a case study—a suburban historical and cultural village in Hohhot, Inner Mongolia, this research employs a comprehensive approach integrating experimental methods and questionnaire surveys. The findings demonstrate that analyzing the interaction among the four emotions can elucidate the psychological cognitive mechanism of residents. Moreover, it uncovers that tourism effects significantly influence residents' perception of their living environment with positive effects on collective memory, subjective well-being and place identity. In the theoretical model for generating psychological cognition among residents in suburban historical and cultural villages, subjective well-being and collective memory play crucial mediating roles. This study provides a theoretical foundation and practical guidance for spatial reconstruction and cultural evolution of tourist landscapes in suburban rural tourist destinations.

The rapid advancement of large language models (LLMs), such as ChatGPT, has revolutionized natural language processing, enabling these models to generate coherent and contextually relevant text. These capabilities hold significant potential for various applications, particularly in the medical field. LLMs can assist healthcare professionals by providing accurate information, supporting diagnostic processes, and enhancing medical education. However, the implementation of LLMs in clinical settings faces several barriers, including technical limitations, ethical concerns, regulatory constraints, and practical challenges. Ensuring accuracy, reliability, and interpretability is crucial, along with addressing biases, ensuring data privacy, and establishing ethical guidelines. Future research should focus on improving training techniques, developing explainable AI methods, and creating efficient, resource-saving models. Expanding applications through domain-specific models and multi-modal integration can further unlock the potential of LLMs. By addressing these challenges and prioritizing responsible development, LLM technology can be safely and effectively integrated into various domains, driving innovation and improving outcomes. This paper explores the current state of LLM technology, its medical applications, barriers to implementation, and directions for future research and development

In the dynamic arena of healthcare research, where the complexities of data often rival the intricacies of biological systems, the ability to model and analyze such multifaceted datasets is crucial. This comprehensive review delves into the evolution and application of Soft Sets and their extensions, including HyperSoft Sets, SuperHyperSoft Sets, IndetermSoft Sets, IndetermHyperSoft Sets, and TreeSoft Sets, in healthcare claims data analysis. These extensions address intricate challenges in data analysis, offering versatile frameworks for managing uncertainty and indeterminacy inherent in healthcare claims data. By exploring their definitions and applications, this review elucidates how these mathematical tools have evolved and their significance in advancing healthcare research and enhancing data analysis methodologies. Real-world examples underscore the implications of these tools, emphasizing their pivotal role in facilitating informed decision-making and knowledge discovery in healthcare. The review systematically examines various case studies and research findings to illustrate the practical utility of Soft Set extensions. Detailed analyses of real-world scenarios highlight advancements in processing complex healthcare data. The conclusions drawn from this analysis indicate that the adoption of Soft Sets and their extensions can significantly improve the accuracy and efficiency of healthcare data analysis, ultimately contributing to better healthcare outcomes and more informed policy-making. Future research directions are also discussed, suggesting further potential applications and developments in this field.

The healthcare situation in Africa is characterized by limited resources and a high burden of disease, presenting significant challenges to the healthcare systems in the region. The integration of Artificial Intelligence (AI) technologies in African healthcare holds immense potential for addressing these challenges and improving health outcomes. This paper aims to provide a comprehensive understanding of the current healthcare landscape in Africa and the urgent need for AI-driven solutions.In addition to discussing the potential applications of AI in African healthcare, such as disease diagnosis, treatment planning, and medical imaging analysis, this manuscript seeks to shed light on the specific challenges hindering the implementation of AI in the region. By providing detailed examples and case studies, we aim to offer insights into the obstacles that need to be overcome and potential solutions that can be pursued.By leveraging AI technologies, Africa has the opportunity to revolutionize its health systems, bridging the gap in access to quality healthcare across the continent. The objective of this review article is to not only highlight the potential benefits that AI can bring to African healthcare but also to emphasize the urgent need for action and collaboration in implementing and scaling up AI innovations in the region. By doing so, African countries can pave the way for improved health outcomes and ensure that their populations receive the healthcare services they deserve.

Latin America and the Caribbean offer the most favorable natural and social conditions for the emergence of cattle ranching that regenerate and maintains the ecosystem services on which life on Earth depends, that is energy efficient and that contributes to meeting fundamental human food needs. Unlike other major global producers, cattle farming in Latin America and the Caribbean is fundamentally based on pasture. Therein lies both its strength (due to the regenerative potential of well-managed pastures) and its vulnerability (due to the pervasive link between deforestation and pasture formation, especially in the Amazon, where 40% of the Brazilian herd is concentrated). The diversification of pastures (today marked by impressive monotony, with brachiaria accounting for 85% of the species in Brazil), the introduction of legumes and tree plantations within them, and the proper management of herds, open the way to the possibility of drastically reducing the area currently occupied by the activity (especially in the Amazon) while maintaining the supply of its products. Agricultural research has disseminated forms of moderate intensification of cattle ranching, which represent a low opportunity cost of animal feed and, at the same time, regeneration of ecosystem services that have so far been destroyed by the prevailing methods of farming.

Climate change is a major development challenge to Ethiopia. Unless adaptation measures are widely implemented, climate change can set back development efforts and achievements by years. Recognizing this, the Government of Ethiopia (GoE) and civil society organizations have since recently been making considerable efforts to tackle the climate change problem. This paper documents the experience of CARE International in Ethiopia in facilitating bottom-up approaches to promote community-led disaster risk management and climate change adaptation planning through a participator scenario planning (PSP) methodology. PSP is a coordinated approach which leverages a variety of stakeholders' skills and mandates to explore potential climate change risks and their impacts, and then develop locally relevant and shared adaptation action plans that support livelihoods, social capital and ecosystem resilience. The approach has facilitated timely access to and communication of seasonal climate advisories which in turn is empowering communities to take advantage of opportunities that climate presents, which is a key part of adapting to climate change. The institutionalization of the approach by district and regional disaster prevention and food security coordination offices in the southern pastoral regions of Ethiopia encouraged integration of PSP into community livelihood adaptation and local government development planning, hence continuity of the process. Sustainability is expected to be fully achieved when local government planning processes recognize the importance of and provides resources for the participation of meteorological services and community forecasting experts to help refine plans on a seasonal basis, and for systems for dissemination of advisories. Key words: Climate Change, Disaster Risk Reduction, Adaptation, Pastoralism, Ethiopia,

Mortality rates in sub-Saharan Africa remains unacceptably high, and disproportionately affecting economically disadvantaged communities. And healthcare delivery which is considered a major contributor to this is challenged by the limited resources and high service costs, prompting many patients to opt for outpatient department services. This study addresses the need for a data-driven approach to healthcare policy formulation by proposing a model for the implementation of a data warehousing system that integrates outpatients into the national healthcare framework. By leveraging data warehousing, healthcare delivery can be made more efficient through a robust repository that supports decision-making and policy formulation. The research focuses on the outpatient department in resource-scarce settings, proposing a novel multidimensional data model and practical framework implementation. The benefits include improved patient experiences, cost-effective service delivery, and enhanced patient management through electronic health records. Additionally, mobile apps are explored for patient navigation and reminders to enhance treatment adherence. The study’s results indicate that data warehousing can significantly improve healthcare delivery by consolidating critical data and facilitating better planning, resource allocation, and policy formulation. Ultimately, this approach offers valuable insights for optimizing healthcare systems in resource-constrained environments, enabling data-driven policies, and improving health outcomes across sub-Saharan Africa.

Mycoviruses are highly genetically diverse, can significantly change their fungal host’s phenotype, yet, they are generally under-described in genotypic and biological studies. We propose Botrytis cinerea as a model mycovirus system in which to develop a deeper understanding of mycovirus epidemiology including diversity, impact, and the associated cellular biology of the host and virus interaction. Over 100 mycoviruses have been described in this fungal host. B. cinerea is an ideal model fungus for mycovirology as it has highly tractable characteristics – it is easy to culture, has a worldwide distribution, infects a wide range of host plants, can be transformed and gene-edited, and has an existing depth of biological resources including annotated genomes, transcriptomes, and isolates with gene knockouts. Focus on a model system for mycoviruses will enable the research community to address deep research questions that cannot be answered in a non-systematic manner. Since B. cinerea is a major plant pathogen, new insights may have immediate utility as well as creating new knowledge that complements and extends the knowledge of mycovirus interactions in other fungi, alone or with their respective plant hosts. In this review we set out some of the critical steps required to develop B. cinerea as a model mycovirus system and how this may be used in the future.

In modern times, sustainability in supply chain management is one of the keys to boosting the performance of the supply chain, and it enables the accomplishment of SSCM. It has been found in recent years that SSCM with assist of industry 4.0 applications, can benefit splendid productivity and efficiency in the supply chain. The numerous industry 4.0 applications that are involved are Artificial intelligence (AI), Machine Learning (ML), Internet of Things (IoT) Big Data Analytics (BDA), etc. Industry 4.0 with SSCM has gained a lot of interest from various authors and scholars across the world. Healthcare is one of the most critical sectors due to its importance in handling public health. More recently, the COVID-19 pandemic and other viruses (SARS and Ebola) have highlighted supply chain vulnerabilities that are further mitigated by their lean and globalized structures. Covid-19 underlined the need for supply chain visibility problems within the healthcare sector. When the need for medical supplies became urgent and global distribution was disrupted, companies faced the consequences of needing the technology, systems, and plans in place to correctly predict the onslaught. One report shows that about 94 percent of Fortune 1000 companies reported supply chain disruptions due to the COVID-19 global outbreak. Existing studies have discussed supply chain issues and the importance of AI in addressing these challenges. AI, like Industry 4.0 in the healthcare supply chain, is proving to be a game-changer. This paper aims to review and present the various aspects of SSCM and industry 4.0 applications to get a comprehensive literature review, which contains the analysis of multiple articles published from 2010-2020. In addition, the various challenges SSCM and industry 4.0 applications face are identified and discussed. Also, the impact of Industry 4.0 and sustainable practices brings together the healthcare supply chain. This study will help in getting a good understanding of the different industry 4.0 technologies that are important for setting up SSCM.

The seed habit is the most complex and successful method of sexual reproduction in vascular plants. It represents a remarkable moment in the evolution of plants that afterwards spread on land. In particular, seed size had a pivotal role as for evolutionary success and agronomic trait, especially in the field of crop domestication. Given that crop seeds constitute one of the primary products for consumption, it follows that seed size represents a fundamental determinant of crop yield. This adaptative feature is strictly controlled by genetic traits from both maternal and zygotic tissues, although seed development and growth are also affected by environmental cues. Despite being a highly exploited topic for both basic and applied research, there are still many issues to be elucidated as for developmental biology as well as for agronomic science. This review addresses a number of open questions related to cues that influence seed growth and size, and how developmental processes are influenced by them. Besides, new insights on the genetic-molecular control of this adaptive trait are presented.

Numerous studies on evaporative cooling systems have been conducted globally, but there is a scarcity of investigations in eastern Africa. The few studies undertaken in this region have primarily focused on their application in food storage and preservation, rather than for building purpose. The goal of this study is to review the most recent advancements in evaporative cooling technology, which would be relevant in eastern Ethiopia and could provide adequate cooling, give adequate thermal comfort, use less energy, and minimize environmental effect in hot and dry areas. There aren't many studies on evaporative cooling systems for building applications in Eastern Africa as a whole, thus this review has taken into account studies conducted in regions with climates similar to eastern Ethiopia. This study covers the classification, operation, and performance of evaporative cooling systems in hot and dry climate. Evaporative cooling systems work well in hot and dry climates, as revealed by this review study.

Our work is regarding the analysis of land use changes, in the light of “saving soil” against the expansion due to unearned plus value of land: The loss of natural and agricultural surface in front of the expanding urban environment is a critical aspect of unsustainability of urban development, especially in the way it was carried out in the past decades. The measure of the physical transition of land use and characters from a more natural condition of land surface to a new artificial one, joint with a parallel analysis of the increase of land value due to such change is nowadays a major land-policy tool. The interplay of urban economics regulation with planning, reveals new key issues in urban governance and environmental preservation. In this paper it will be shown some experiment about the impact assessment of soil take, related with the seek of valorization of property inside the planning process. Our paper reports as well about the experimental activity carried out inside the MITO Lab of the Polytechnic of Bari, where reports about property values and environmental values have been produced, specially looking at the reality of the Apulia, a southern Italian Region, that is rich of farmlands and coastlines, often invaded by constructions with a severe loss of nature, landscape and ecosystems services.

The West Pomeranian Anti-Crisis Package was an effective tool of the Voivodeship Executive Board of West Pomeranian self-government, which was used to combat and counteract and counteract the social and economic effects of the COVID-19 pandemic. The Anti-Crisis Package was prepared with a view to undertaking systemic, but also point-based measures in order to save and protect regional health care, entrepreneurs, the labour market, but also to use the existing social capital of non-governmental organizations involved in measures reducing the effects of the COVID-19 pandemic. The West Pomeranian Anti-Crisis Package, as evidenced not only by the financial outlays incurred, but also by the outcome of implementing measures achieved in 2020 and their continuation in 2021.

Large Language Models (LLMs) have demonstrated promising capabilities to solve complex tasks in critical sectors such as healthcare. However, LLMs are limited by their training data which is often outdated, the tendency to generate inaccurate ("hallucinated") content and a lack of transparency in the content they generate. To address these limitations, retrieval augmented generation (RAG) grounds the responses of LLMs by exposing them to external knowledge sources. However, in the healthcare domain there is currently a lack of systematic understanding of which datasets, RAG methodologies and evaluation frameworks are available. This review aims to bridge this gap by assessing RAG-based approaches employed by LLMs in healthcare, focusing on the different steps of retrieval, augmentation and generation. Additionally, we identify the limitations, strengths and gaps in the existing literature. Our synthesis shows that proprietary models such as GPT-3.5/4 are the most used for RAG applications in healthcare. Also, there is a lack of standardized evaluation frameworks for RAG-based applications. In addition, the majority of the studies do not assess or address ethical considerations related to RAG in healthcare. It is important to account for ethical challenges that are inherent when AI systems are implemented in the clinical setting. Lastly, we highlight the need for further research and development to ensure responsible and effective adoption of RAG in the medical domain.

Biodiversity loss and nature degradation are pressing issues with huge impacts on our society and economy. Businesses, investors, and regulators focus on corporate efforts to support biodiversity and nature positive actions. This review provides a comprehensive overview about the importance of biodiversity in businesses, the materiality of biodiversity and the role of mandatory and non-mandatory regulations on corporate environmental reporting and sustainability disclosure frameworks. The review also discusses descriptive information on the evolution of sustainability frameworks with a comparison of most prominent sustainability frameworks with a key focus on the materiality approach and biodiversity-related disclosure recommendations. Further, we provide suggestions for more holistic approaches to improve the future sustainability frameworks focusing on the biodiversity impact while showing the necessity of more focus on the decision-making paradigm. Further research on measuring biodiversity impact and innovative trends in sustainability reporting are required to better reflect nature-positive outcomes in corporate sector businesses.

Good health and well-being is one of the essential SDGs that ensure healthy lives and promote well-being for all ages and further entails providing substantial medical services to the public at low cost and with minimal adverse effects on the environment. Information and communication technologies (ICTs) have taken on an increasingly important function as significant facilitators of healthcare reform, with the goals of enhancing access to health services, the quality of treatment provided, and the overall productivity of the healthcare system. However, the integration of ever-increasing ICT technologies into the healthcare systems, also referred to as digital transformation, is not a straightforward process, but it comes with different types of challenges from integration level to application design level and security level. Although several studies have been proposed to address the integration of ICT technologies into healthcare systems, there is still a need for a comprehensive research study on the integration and design challenges, security and privacy challenges, application areas, and possible positive and negative impacts. Therefore, this paper contributes as the research literature study covering an important SDG, "Good health and well-being," and its digital transformation, along with summarising our research findings in a detailed and taxonomical way. To start with, firstly, we present a detailed comparison of existing studies on healthcare and well-being, mainly focusing on integrating ICT technologies in healthcare in terms of sustainable aspects, security and privacy challenges, design and integration challenges, E-health-related applications, and future directions. We also present an overview and the need for digital transformation in healthcare, discuss its significant components, highlight E-health's importance and benefits, explore its integration and design challenges, and categorise the security and privacy challenges. Next, we present an in-depth discussion on the role of Blockchain technology as today's leading technology in E-health, discussing Blockchain technology and its characteristics, highlighting its benefits, and describing the possible types of Blockchain-based E-health use cases. Furthermore, we discuss the positive and negative impact of ICT integration along with identifying open issues and challenges of integrating ICT technologies into the healthcare systems and discuss future research directions, which provide the strength for researchers to address the issues in future solutions.

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.

This study examines the attitudes of healthcare organizations and employees in the Greek Healthcare System towards climate change and the influence of management in promoting environmentally friendly practices. A questionnaire was sent electronically to the 7 Health Districts of Greece and private sector healthcare workers associated with the researchers, while the sample consisted of service (administration, nursing, technical, and medical). The main findings indicate that public sector health organizations are lacking in motivating employees to adopt "green" actions during their work. Communication and information dissemination from administration to healthcare professionals were identified as significant challenges, resulting in participants being unsure of how to respond, in contrast to the private sector which showed slightly more positive results. Moreover, the study highlights a positive association between education level and voluntary green behaviors of employees. This research emphasizes the urgency to confront climate change in conjunction with the principles of Organizational Behavior within the Greek Healthcare System.

Academics in healthcare grapple with the challenge of efficiently managing time while addressing diverse roles and responsibilities, leading to heightened levels of anxiety and stress within the academic community. The primary objective of this study is to offer a sustainable and systemic solution to the prevalent time-management challenges in healthcare academia, through the development of a predictive model. Employing systemic analysis software and adopting a systemic management approach, we crafted a model to address academic time-management concerns. The dynamics of time allocation for academicians are governed by three fundamental pillars: teaching, research, and administrative tasks. Significantly prioritizing administrative tasks depletes valuable academic time, making time management within academia excessively costly. This occurs as highly skilled individuals find themselves diverted towards administrative duties at the expense of their academic roles diminishing resilience levels. The proposed Timebooster Academic Systemic Model (TASM) advocates for the cultivation of soft skills in academia, en-compassing prioritization, seeking assistance, and addressing tendencies of perfectionism and procrastination. Additionally, TASM recommends the implementation of full automation, delegation of administrative responsibilities, and the mitigation of both overt and covert time-consuming elements. Furthermore, TASM reports on the pivotal role of the academic resilient manager-leaders, who actively contribute to their own satisfaction and academic growth by enhancing collaboration and teamwork. Time-management challenges emerge as a critical determinant of academic well-being and resilience. Systemic models, exemplified by TASM, offer a valuable framework for investigating prioritization concerns, identifying administrative impediments in academic processes, and managing low-value time-consuming elements. The TASM model, along with the systemic philosophy underpinning its design, presents an avenue for advancing the exploration of time-management phenomena within the context of healthcare academia.

One of the industries with the fastest rate of growth is healthcare, and this industry's enormous data requires extensive cloud storage. The cloud may offer some protection, but there is no assurance that data owners can rely on it for refuge and privacy amenities. Therefore, it is essential to offer security and privacy protection. Increased customer satisfaction with security and privacy preservation is crucial since healthcare big data and its sources are stored in the cloud and contain increasingly private and sensitive information. However, maintaining privacy and security in an untrusted green cloud environment is difficult, thus the data owner should have complete data control. A new work SecPri-BGMPOP(security and privacy of Boost graph Convolutional Network -Pinpointing-Optimization Performance) is suggested that can offer a solution that involves several different steps in order to handle the numerous problems relating to security and protecting privacy. Initially Boost Graph Convolutional Network Clustering (BGCNC) algorithm, which reduces computational complexity in terms of time and memory measurements, is first applied to the input dataset to begin the clustering process. Second, enlarge by employing a piece of the magnifying bit string to generate a safe key, pinpointing based encryption avoids amplify leakage even if a rival or attacker decrypts the key or asymmetric encryption. Finally, to determine the accuracy of the method, an optimal key was created using a meta-heuristic algorithmic framework called Hybrid fragment horde bland lobo Optimization (HFHBLO). Our proposed method currently kept in a cloud environment, allowing analytics users to utilize it without risking their privacy or security.

Studies have demonstrated the critical role that safety plays in preserving favourable working conditions in the construction industry, which is necessary to accomplish goals. The aim of this research was to inform stakeholders in the construction industry in developing nations about the value of safety and possible strategies for influencing their opinions regarding safety protocols. The importance of safety to the construction sector, which is crucial to the advancement of the country, has also been emphasized. However, due to a lack of adequate safety understanding among stakeholders in the construction sector, the construction industry is characterized by a great deal of instability and hazard. To determine what factors, affect productive working conditions in the construction production, this study examined safety. A conceptual framework for safe working conditions in the construction sector was developed by considering several aspects, including the person dimension, environment factor, safety behaviour, organization features, technology, and incentives. It is now imperative to bring in these dimensions to improve the safe working conditions in the construction industry, particularly in the developing countries. By putting these safety factors into practice, the construction industry can reduce safety risks, lower the number of accidents and fatalities, cut expenses related to subpar safety performance, safeguard the reputation of construction companies, boost employee morale and satisfaction with their work, enhanced employee retention, reduced absenteeism, and enhanced sustainability goals. Additionally, the proposed conceptual framework is assured to be new and to be widely accepted in the developing nations. Based on this assumption the conceptual framework is designed.

Banks have enormous potential in supporting the achievement of sustainable development goals (SDGs) in accordance with their function as financial intermediaries through sustainable lending. However, the average national financing growth for the sustainable business activity category over the past four years is still 12%. The aim of this research is to identify the conditions of sustainable lending at state-owned conventional banks and analyze the influence of the value chain, economic performance and ESG performance on sustainable lending. The research was conducted at state-owned commercial banks in Indonesia. The research utilized a Structural Equation Modeling (SEM). The SEM results of this study describe value chain, ESG performance (environmental, social and governance) and economic performance have direct and positive influences on sustainable lending, of which ESG performance has the biggest influence. As per individual aspect, social orientation gives the biggest contribution toward sustainable lending.

While digitization can make the health industry faster and more efficient, there are many financial, social and organizational obstacles and barriers to its implementation. This article offers a systematic review of the main troubles detected from the literature review. Also there is a proposal of new kind of restrictions to pay attention. Finally, its offer an heterodox reading about the problem analyzed.

Sustainable water resource management in Bangladesh's Gumti River Basin faces challenges from climate change, urbanization, and population growth. This study aimed to calibrate and validate the HEC-HMS model for the Gumti River to enhance flood prediction and water resource planning. The model was set up using precipitation, temperature, and discharge data from 2019-2021, with SRTM elevation data for catchment delineation. Manual calibration was performed for 2019-2020, followed by validation for 2021, using parameters such as Muskingum routing and SCS Curve Number. Model performance was evaluated using R², Nash-Sutcliffe efficiency (NSE), RSR, and PBIAS metrics. Results showed satisfactory to good performance, with R² values of 0.64 and 0.68 for calibration and validation, respectively. NSE values were within the satisfactory range, while PBIAS indicated very good performance with slight underestimation. The study concludes that the calibrated HEC-HMS model provides a reliable tool for simulating the Gumti River's hydrology, though there's room for improvement. Integration with flood frequency analysis, water quality monitoring, and climate change projections is recommended for comprehensive water resource management, alongside the implementation of Sustainable Water Resource Management principles and community engagement strategies.

This paper presents a co-designed solution aimed at improving community healthcare assistance management. To enhance patients’ self-awareness of their health status, encouraging active participation in care process, and to support nurses in delivering patient-centered care, we have developed an innovative platform with a highly customized app. This platform was designed using a multi-disciplinary bottom-up approach. Patient data collection and processing facilitate the automation of care timeline planning, based on real time patients’ needs and the available resources. To achieve this goal different components have been considered: real-time health data collection and processing, patient care planning, decision support for nurses, secure communication for data transmission, and user-friendly interfaces to ensure easy access to platform functionalities.

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

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.

With the burgeoning growth of online retail, the issue of counterfeit products has become a significant threat to both consumer trust and brand integrity, posing challenges to sustainable market practices. Online retail platforms are promoted to redesign their channel structures and enhance brand traceability to tackle counterfeits using blockchain technology. To investigate the interactions between blockchain technology and the channel structures of online retail platforms, we design a game theory model incorporating a manufacturer with(out) blockchain participation selling products via an online retail platform that operates an agency channel and/or a reselling channel. We show that the critical trade-off of blockchain participation comprises the brand assurance effect of the blockchain, the channel competition intensification effect, and the blockchain adoption cost. The platform is capable of strategically designing the channel structure to encourage (while discouraging) blockchain participation by the manufacturer. Our analysis highlights the complementarity between blockchain participation and the channel structure. Furthermore, the effect of the consumer’s belief in the reselling channel, the commission fee in the agency channel, and the substitutability between channels are investigated in depth. The research provides valuable insights for online retail platforms and policymakers seeking to foster a sustainable and trustworthy e-commerce ecosystem.

The open data market is growing, driven by laws requiring governments to make data publicly available. However, the true value of this market lies in the products and services derived from open data. In Slovenia, the open data market has been growing since 2015, especially in the field of mobility. Platforms such as Avtolog.si facilitate the retrieval of vehicle data via vehicle identification numbers, while tocen.si, ojpp.si, and brezavta.si aggregate mobility data, focusing on sustainable and micromobile public transportation services. These platforms use open government data and private sector open data, and are freely accessible. This study examines the use of open data in the Slovenian mobility applications and similar solutions developed in other countries. By mapping these applications, we gain valuable insights into potential advances in the field, and provide a useful resource for future developers worldwide. By focusing on the socio-economic impact of these innovations, the study identifies methods for evaluating such applications. This approach highlights how transforming open data into user-friendly products and services can deepen our understanding of their broader societal and economic benefits. While open data is valuable in its own right, its full transformative potential is realized through innovative products that support sustainable lifestyles and promote environmentally conscious behavior.

Artificial intelligence (AI) is increasingly being used to improve the quality control of point-of-care diagnostics. This is caused by a number of factors, including the following: 1. AI can accelerate and improve testing accuracy. In comparison to humans, AI technology can review data more quickly and precisely, reducing errors and improving overall quality assurance. 2. When it comes to improving POC test findings on healthcare issues such as infectious diseases or medical crises such as heart attacks, AI can be used for sophisticated predictive analytics and modeling that aid in better decision-making. 3. Artificial intelligence facilitates process automation, increasing productivity and lowering labor costs in labor-intensive tasks such as testing and analyzing samples collected at point-of-care facilities. 4. The use of AI enables organizations implementing these solutions to gain insights from large volumes of raw diagnostic data generated faster and more accurately, allowing them to build solid frameworks around preventive care initiatives and significantly influence public health outcomes.5. Artificial intelligence (AI) has been demonstrated to be a useful tool for real-time monitoring systems that identify any problems with test results early so that they can be corrected before affected patients receive inaccurate diagnoses or treatment plans based on false information provided by diagnostic tests performed at points of care such as clinics or hospitals.Using these technologies would allow healthcare organizations to spend less on labor while still receiving exact diagnoses and rapid treatment delivery at a fraction of the cost that manual approaches required earlier.

Energy poverty in the Global South generally focuses on the lack of basic access to modern fuels and energy carriers. Impoverished people rely primarily on traditional biomass as a source of energy. This situation of basic resource deprivation, in which almost one third of the world's population lives, masks other relevant features of the problem. Current assessments of energy poverty in impoverished areas and the mitigation strategies being implemented derive from the development agenda and, with variations in detail and scope, highlight electricity connections and access to clean cooking fuels as guarantors of progress. However, a comprehensive understanding of energy poverty requires going beyond basic access, building on the interactions between the supply of energy sources and carriers, the provision of energy services and its impact on decent living conditions. Several studies in the last decade have attempted to construct an assessment framework centered on energy services to deal with these interactions. This work discusses the relevant dimensions in the framework (supply, services and impact in wellbeing), reviews the multidisciplinary work available in each aspect, presents a range of proposed taxonomies, and discusses the different issues. A detailed framework is proposed for the integrated assessment of the supply of energy carriers and energy equipment, the provision of relevant energy services, and the improvements obtained in living conditions.

Sorghum (Sorghum bicolor L.) ranks fifth as the most crucial cereal crop globally, yet its seed morphology remains relatively unexplored. This study investigated seed morphology in sorghum based on 115 mini core and 130 Senegalese germplasms. Eight seed morphology traits encompassing size, shape, and color parameters were assessed. Statistical analyses explored potential associations between these traits and resistance to three major sorghum diseases: anthracnose, head smut, and downy mildew. Furthermore, genome-wide association studies (GWAS) were conducted using phenotypic data from over 24,000 seeds and over 290,000 publicly available single nucleotide polymorphisms (SNPs) through the Genome Association and Prediction Integrated Tool (GAPIT) R package. Significant SNPs associated with various seed morphology traits were identified and mapped onto the reference sorghum genome to identify novel candidate defense genes.

Background: Bacterial resistance to several antibiotic classes is seen as a grave threat worldwide. Bacterial resistance to antibiotics was mostly caused by the abuse and overuse of antibiotics, particularly penicillins and first-generation cephalosporins, in Egypt's primary healthcare facilities. Aim of the study: To investigate the main resistant bacteria to a few chosen penicillins and first-generation cephalosporins, as well as the characterization of these antibiotics' resistant genes and their detrimental effects in Egypt's main medical facilities. Methodology: Two hundred respiratory and urinary tract infection (RTI and UTI) specimens were gathered from Egyptian primary medical center patients. The turbidimetric assay at 630 nm wavelength, the broth dilution technique, and the nanopore sequencing homology approach were used to characterize the major resistant pathogenic bacteria and their resistant genes to cefadroxil (first generation cephalosporins) and nafcillin (antipseudomonal penicillin). Moreover, adverse outcomes resulting from antibiotic resistance were noted. Results: Out of 200 specimens with RTI and UTI, 186 samples showed the proliferation of resistant bacteria isolates. Enterococcus faecium strain NFC and Staphylococcus aureus strain CDX were among them. Nanopore sequencing confirmed that the antibiotic-resistant gene in Enterococcus faecium was the NFC gene, whereas the antibiotic-resistant gene in Staphylococcus aureus was the CDX gene. Penicillin-binding proteins with modest affinity were encoded by both genes. These bacterial resistance patterns were linked to a low death rate of 5% and a high morbidity rate of 47%. Conclusion: By expressing low-affinity penicillin-binding proteins through resistant NFC and CDX genes, Enterococcus faecium strain NFC and Staphylococcus aureus strain CDX were found to be the predominant bacterial isolates that cause antibiotic resistance to first-generation cephalosporins and penicillins.

The olive tree (Olea europaea L.) is an evergreen tree that occupies 19% of the woody crop area and is cultivated in 67 countries on five continents. The largest olive production is concentrated in the Mediterranean basin, where the olive tree has had an enormous economic, cultural and environmental impact since the 7th century BC. In the Mediterranean region, salinity stands out as one of the main abiotic stress factors significantly affecting agricultural production. Moreover, climate change is expected to lead to increased salinisation in this region, threatening olive productivity. Salt stress causes combined damage by osmotic stress and ionic toxicity, restricting olive growth and interfering with multiple metabolic processes. A large variability in salinity tolerance among olive cultivars has been described. This paper aims to synthesize information from the published literature on olive adaptations to salt stress and its importance in salinity tolerance. The morphological, physiological, biochemical, and molecular mechanisms of olive tolerance to salt stress are reviewed.