Volunteering has many social, emotional and health benefits and could be an option for people with younger/early onset dementia to engage in stage/age-appropriate, personally meaningful activity within their local community. Audio data of people with young onset dementia discussing their volunteering experiences were taken from the Dementia Diaries and co-analysed. This study explored how people with dementia volunteer in the UK, the benefits and barriers, and how we can improve access to volunteering opportunities. The findings suggest that stigma is the overarching concept (or net) which influences people’s experiences of volunteering with dementia. Within the stigma net, three themes were developed that employed a lifespan approach to challenging said stigma: 1) Valuing the past, 2) Valuing the present and 3) Valuing the future, each with additional subthemes. This research contributes to the limited pool of literature that highlights the clear benefits of volunteering for people with young onset dementia, while also considering how dementia stigma can create practical and institutional barriers to accessing volunteering. Guidance is provided for how to deliver meaningful and accessible volunteering opportunities.

The Tisza River is the longest tributary of the Danube, draining the eastern part of the Carpathian Basin (Central Europe). Five countries share its catchment with different waste production and management practices. Large amounts of waste, including macroplastics (MaPs), are washed into the river. Some of the litter is trapped by the riparian vegetation forming litter accumulations. The study aimed to map the amount of litter by a citizen science program and remote sensing data and to compare the MaP data to the amount of microplastic fragments in sediments. Volunteers reported 3216 riverine litter accumulations from five countries along the entire length of the Tisza (2016–2022). The results suggest that low flow conditions (e.g., impoundment by dams) support litter and MaP trapping. The volume of large accumulations registered by the citizens showed a good correlation with the area of drifting litter revealed on Sentinel-2 images (2015–2021) using machine learning algorithms. Though the MaPs probably fragmentate during their fluvial transport, no clear connection was found between the volume of litter accumulations and the mean microplastic fragment content of sediments (2019–2022). The “Clean Tisza Map“ reveals the high degree of stranded pollutants along rivers and supports public cleanup activities.

Citizen science substantially contributes to large-scale biodiversity monitoring and the enhancement of public literacy. While both of the contributions largely depend on the public’s self- regulated learning. In this study, we employed a mix- method approach, incorporating both a questionnaire survey of 133 participants and interviews with 12 volunteers, aiming to explore the feature of self- regulated learning in citizen science, as well as identify the main factors impacting it. The volunteers are all different ages, from different jobs, with varying educational backgrounds. The findings revealed that the educational background of volunteers did not significantly impact their self-regulated learning. However, an increased frequency of participation was linked to higher levels of self-regulated learning. Furthermore, achievement goal orientation mediates the prediction of self-regulation by scientific epistemology. These insights underscore the importance of enhancing citizen science's impact on scientific literacy by fostering self-regulated learning among participants. This can be achieved through explicit instruction in scientific epistemology and by fostering a sense of achievement to boost achievement goal orientations. Additionally, our study advocates for the promotion of social interaction between students and out- of- school citizen scientists in school-based citizen science projects. The main innovation of this study is to consider volunteers as learners, not merely as contributors of data.

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

Participating in collaborative scientific research through citizen science, a component of open science holds significance for both citizen scientists and professional researchers. Yet, the ad-vantages for those orchestrating citizen science initiatives are often overlooked. Organizers en-compass a diverse range, including governmental entities, non-governmental organizations, corporations, universities, and institutions like libraries. For libraries, citizen science holds im-portance by fostering heightened civic and research interests, promoting scientific publishing, and contributing to overall scientific progress. This paper aims to provide a comprehensive understanding of the specific ways in which citizen science can benefit libraries and how libraries can effectively utilize citizen science to achieve their goals. The paper is based on a systematic review of peer-reviewed articles that discuss the direct benefits of citizen science on libraries. A list of the main benefits of citizen science for libraries has been compiled from the literature. Additionally, the reasons why it is crucial for libraries to communicate the benefits of citizen science for their operations have been highlighted, particu-larly in terms of encouraging other libraries to actively engage in citizen science projects.

The question of what generates conscious experience has mesmerized thinkers since the dawn of humanity, yet its origins remain a mystery. The topic of consciousness has gained traction in recent years, thanks to the development of large language models that now arguably pass the Turing test, an operational test for intelligence. However, intelligence and consciousness are not related in obvious ways, as anyone who suffers from a bad toothache can attest - pain generates intense feelings and absorbs all our conscious awareness yet nothing particularly intelligent is going on. Still, in the hard sciences, this topic is frequently met with skepticism because to date no protocol to measure the content or intensity of conscious experiences in an observer-independent manner has been agreed upon. Here we present a novel proposal: Conscious experience arises whenever a quantum mechanical superposition forms. Our proposal has several implications: First, it suggests that the structure of the superposition determines the qualia of the experience. Second, quantum entanglement naturally solves the binding problem, ensuring the unity of phenomenal experience. Finally, a moment of agency may coincide with the formation of a superposition state. We outline a research program to experimentally test our conjecture via a sequence of quantum biology experiments. Applying these ideas opens up the possibility of expanding human experience through brain-quantum computer interfaces.

The goal of the paper is to investigate the expected participation and mentality of smart citizens in smart cities. The key question is the role of the human factor in smart environments globally studied through a research corpus of the mainstream summaries, trend reports, white papers and visions of business – governmental – university research co- operations. Foremost, a short review of the changing scholarly trends is presented as a theoretical framework. Concerning its key ideas, the corpus based findings are recapped and analysed by content networks and the most referred city strategies. Besides, a critical approach reveal further required factors and risks to investigate. The ultimate goal is to understand how the smart city landscape is shaped by citizen-based strategies, open data, empowerment and responsibility. Accordingly, the paper closes with theoretical, practical and metaphor-based recommendations to support the business and political decision making, and also, the emerging scholarly trends in the context of upcoming technological-structural changes.

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

Environmental policy involving citizen science (CS) is of growing interest. In support of this open data stream, validation or quality assessment of the CS data and their appropriate usage for evidence-based policy making, needs a flexible and easily adaptable data curation process ensuring transparency. Addressing these needs, this paper describes an approach for automatic quality assurance as proposed by the Citizen OBservatory WEB (COBWEB) FP7 project. This approach is based upon a workflow composition that combines different quality controls, each belonging to seven categories or ‘pillars’. Each pillar focuses on a specific dimension in the types of reasoning algorithms for CS data qualification. These pillars attribute values to a range of quality elements belonging to three complementary quality models. Additional data from various sources, such as Earth Observation (EO) data, are often included as part of the inputs of quality controls within the pillars. However, qualified CS data can also contribute to the validation of EO data. Therefore, the question of validation can be considered as ‘two sides of the same coin’. Based on an invasive species CS study, concerning Fallopia japonica (Japanese knotweed), the paper discusses the flexibility and usefulness of qualifying CS data, either when using an EO data for the validation within the quality assurance process, or validating an EO data product that describes the risk of occurrence of the plant. Both validation paths are found to be improved by quality assurance of the CS data. Addressing the reliability of CS open data, issues and limitations of the role of quality assurance for validation, due to the quality of secondary data used within the automatic workflow, are described, e.g. error propagation, paving the route to improvements in the approach.

Background/Objectives: Peritoneal dialysis as a form of renal function sub-stitution is not as widespread as hemodialysis. However, it has recognized advantages such as preservation of the residual renal func-tion, no need for vascular access , can be performed at home, but requires a proper in-sertion of a peritoneal dialysis (PD) catheter and maintaining its patency. Methods: We presented a 10-year retrospective study on a group of 133 patients hos-pitalized for peritoneal dialysis catheter insertion/replacement. We routinely implant the catheter laparoscopically, but there were cases in which the insertion was performed open route. We analyzed the patient group by age and gender criteria, number of complications and time when they appeared, duration of surgical intervention and the surgical technique used (126 were performed laparoscopically and 7 were inserted via open route). The open technique was performed mainly in patients with contraindications of general anesthesia. Results: We encountered a number of 23 complications in 18 patients, in only 1 case the patient was switched to permanent hemodialysis (at his own wish). We highlighted in the study the indisputable advantages of laparoscopy, supported by the results obtained: correct placement of the catheter, the possibility of adhesiolysis, preservation of the peritoneal surface through minor op-erative trauma, low number of complications(bleeding, migration, hernia 0,8%, leakage 4%, lower than those found in the literature). Even if infection was the most frequent complication (peritonitis 35%, catheter exit site infection 30.4%), only 1 case appered in the pretraining period. All complications were managed by medical treatment or by temporary cessation of peritoneal lavage, except of two cases that required reimplantation of the catheter. Conclusions: Laparoscopic catheter insertion for PD is a safe method, with reduced post-procedural complications, thus ensuring a long duration of the functionality of the catheter.

Background:Caregiving for individuals with neurological disease involves providing physical, emotional, and social support, which can be a challenging and stressful experience. This study aims to compare the caregivers' burden, including the impact on mental and physical health, social support, and quality of life, in different neurodegenerative disorders. Methods:Fifty-five primary caregivers (F=41;mean age=53.07±12.29) of patients with Parkinson's Disease (PD=26), Multiple System Atrophy (MSA=16), and Amyotrophic Lateral Sclerosis (ALS=13), took part in the study. Standardized screening scales for the quality of life (EQ-5D/EQ-VAS and PQoL), levels of the caregiving burden (CBI and FSQ), and the assessment of the anxiety-depressive axis (HADS) were administered. Results: The mean CBI score was higher for caregivers of MSA patients (28.81±21.90) and ALS (25.15±16.23) than for caregivers of PD patients (16.08±10.34; p=0.036). Critical burden (cut-off>36) was present in the caregivers of MSA (31.3%), ALS (23.1%), and PD (19.2%) patients. Caregivers of patients with ALS had a worse perception of quality of life (EQ-5D total score) than caregivers of patients with MSA and PD (p

Background: The validation of laser usage during laparoscopic procedures, notably by Camran Nezhat in the late 1980s, has been significant. Lasers offer precision and depth control in tissue vaporization without bleeding. Surgical intervention remains central in managing endometrio-sis-associated pain and infertility, especially for patients unresponsive to hormonal therapy. Methods: This retrospective cohort study included 200 patients with SPE who underwent laparo-scopic laser vaporization. Surgery was performed using a CO2 laser, and histological confirma-tion of endometriosis was obtained for all cases. Pain scores and SF-36 questionnaire domains were assessed preoperatively and postoperatively. Fertility outcomes were evaluated among pa-tients desiring pregnancy. Results: Significant improvements in pain score and SF-36 questionnaire domains were ob-served postoperatively (p-value

Monkeypox (mpox) caused by the monkeypox virus (MPXV) is currently the most common orthopoxvirus (OPXV) zoonotic disease. Since 2022, a multi-country outbreak of mpox has been reported with atypically rapid human-to-human transmission. The present work aimed to investigate the frequency of MPXV and OPXV DNA detection in different clinical materials taken at acute and convalescent phases of the infection in Bulgarian patients. A total of 181 clinical samples from 42 Bulgarian patients with possible mpox infections were tested. Screening for MPXV DNA (F3L gene) and OPXV DNA (rpo18 gene) were performed by real-time PCR assays. Of all tested patients six (14%) were confirmed with mpox infection. MPXV DNA was detected in 23/181 (12,71%) and OPXV DNA in 20/181 (11,05%) clinical samples. All confirmed patients were men who have sex with men, aged 23 to 44 (at an average age of 35,17±7,91 years) and two of them were HIV positive. The commonest clinical features of patients were fever (5/6), vesicular-pustular rash: perianal (6/6), penile (4/6), and limbs (4/6). MPXV DNA was found with the greatest frequency in specimens of vesicle contents and nasal/oropharyngeal swabs in 6/6 and 5/6. OPXV DNA mainly was detected in vesicle contents (6/6), nasal/oropharyngeal swabs (4/6), and urine (4/6). In the collected follow-up samples, MPXV DNA was detected in the highest percentage in the specimen's vesicle contents (6/6) and urine (6/6) and not demonstrated in samples of feces and saliva. The laboratory surveillance of MPXV is critical to contain the outbreak and to elucidate the new fast transmission of the virus.

The COVID-19 pandemic struck unexpectedly, emergency services and chronic care institutions, including dialysis centers, were overloaded. An important problem was the care of positive COVID patients, but also the care of chronically dialyzed patients who presented emergencies. In our Hospital, which has become a COVID support for dialysis patients with severe forms of the disease, we had to care for PD patients with dialysis-related emergencies. We presented 2 cases of patients managed on an outpatient basis or 1 day hospitalization, treated successfully and without compromising the quality of the care provided. We used remote monitoring, we worked in a multidiscipli-nary team, we shortened the hospitalization of patients (and implicitly the risk of contact). In pandemic conditions, the advantage of PD was represented by the possibility of patient isolation, so that in the first 6 months of the pandemic, we recorded no deaths in this category of patients. In case of hemodialysis patients, in-fection and mortality rates were high. Although we expected an increase in the number of peritoneal dialysis patients in the post-pandemic period, this did not happen. We continue to plead for the popularization of the PD method among patients and doctors, which has proven its advantages under the conditions of the pandemic.

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

The social confinement resulting from the COVID-19 crisis temporarily reduced greenhouse gas emissions. Although experts consider that the decrease in pollution rates was not drastic, some surveys detect a growth in social concern about the climate. In this new climate-conscious environment, municipalities and local governments are promoting a new way of living and caring for cities, even before they can regain national and international freedom of movement. This work analyzes the connection between the new climate awareness arising from the COVID-19 crisis, the proposals of sustainable citizenship around the world, and its communication on Twitter to educate the new eco-conscious audience. The methodology mixes quantitative and qualitative analysis, using the Twitonomy Premium tool and the Twitter research tool, with data extracted at the end of December 2020. Among the top 10 most influential and active accounts, the results show educational institutions, local institutions, companies, neighborhood, associations, and influencers. The impossibility of living the city, has not prevented citizen education and commitment to make real change for when that city and its citizens return to normality. Although this new normality must be different: more ecological, more responsible, more sustainable and practiced from early childhood.

Citizen science has the potential to support the delivery of the United Nations Sustainable Development Goals (SDGs) through its integration into national monitoring schemes. In this study, we explore the opportunities and biases of citizen science (CS) data when used either as a primary or secondary source for SDG 6.3.2 reporting. We use data from waterbodies that have both CS and regulatory monitoring in England and Zambia to explore their biases and complementarity. A comparative analysis of regulatory and CS data provided key information on appropriate sampling frequency, site selection and measurement parameters, necessary for more robust SDG reporting. The results show elevated agreement for pass/fail ratios and indicator scores for English waterbodies (80%) and demonstrate CS data can improve granularity and spatial coverage for SDG indicator scoring, even when extensive statutory monitoring programmes are present. In Zambia, management authorities are actively using citizen science projects to increase spatial and temporal coverage for SDG reporting. Our results indicate that design considerations for SDG focused citizen science can address local needs as well as provide a more representative indicator of the state of a nation’s freshwater ecosystems for international reporting requirements.

We previously reported our initial experience of subxiphoid single-port robotic-assisted thoracic surgery (SRATS) thymectomy using the single-port robotic surgical system (SPS). However, the potential benefits of this technique remain unknown. Thus, this study examined the multi-institutional experience of SRATS thymectomy and compared perioperative outcomes of this technique with those of subxiphoid single-port video-assisted thoracic surgery (SVATS) thymectomy. Data of patients who underwent subxiphoid SRATS and SVATS thymectomy performed by three thoracic surgeons at three institutions between September 2018 and May 2024 were retrospectively collected. In total, 110 patients were included, with 85 and 25 undergoing SRATS and SVATS thymectomy, respectively. No significant differences were noted in the total operative time (154.46±74.06 vs. 146.76±67.07 min, P=0.674) and conversion rate to median sternotomy (0% vs. 4 %, P=0.227) between the two groups. The SRATS group was associated with a lower conversion rate to multi-port surgery (2% vs. 20%, P=0.006), shorter chest tube drainage duration (1.40±0.94 vs. 2.00±1.29 days, P=0.001), and shorter postoperative hospital stay (2.87±1.26 vs. 5.08±5.20 days, P=0.007). Subxiphoid SRATS thymectomy using the SPS is feasible and can be a good alternative to conventional minimally invasive thymectomy. Further large-scale randomized controlled studies are needed to confirm its benefits.

Thalassemia syndromes are common monogenic disorders that represent a significant global health issue. No systematic epidemiological and molecular investigations on thalassemias in Croatian population have been reported to date. This prospective study included 70 children with a presumptive diagnosis of thalassemia, and their 42 first-degree relatives. Molecular characterization was performed using direct sequencing and gap-PCR methods. We identified 46 (30 children and 16 first-degree relatives) β-thalassemia heterozygous carriers from 24 unrelated families, carrying eight different mutations and one hemoglobin variant. Five variants account for approximately 85% of all affected β-globin alleles: Hb Lepore-Boston-Washington (32,6%), HBB: c.93-21G>A (19,6%), HBB:c.315+1G>A (13,1%), HBB:c.92+1G>A (10,9%), and HBB:c.92+6T>C variant (8,7%). A need for more detailed genetic profiling of β-thalassemia carriers is emphasized since genetic modifiers can significantly impact their phenotype. Our study provides important new insights into the relevance of β-thalassemia heterozygosity in the pediatric clinical practice.

This study explores the Experience Economy dimensions within fishing tourism, adopting a data science perspective by employing web crawling for extensive data gathering on reviewer profiles from TripAdvisor. Utilizing Natural Language Processing (NLP) techniques, it scrutinizes the relationship between Experience Economy dimensions and user profiling aspects. Findings reveal "Entertainment" as the predominant dimension in tourist reviews, followed by "Aesthetic," "Educational," and "Escapist." Particularly notable are the frequent co-occurrences of "Entertainment"-"Aesthetic" and "Educational"-"Entertainment" pairs. The practical implications underscore the potential socioeconomic benefits of fishing tourism for local communities and fishermen, emphasizing the necessity for governmental support in terms of infrastructure, leadership, legislation, and financial backing to foster sustainable development in this sector. Notably, this research stands as a pioneering effort in its focus on Experience Economy dimensions and user profiling within the context of fishing tourism, drawing data from business pages and user profiles.

Both the sustainability discourse and the debate on citizen science are strongly focused on the natural and technical sciences. Yet, numerous participatory research activities can be identified in the social sciences and humanities that address sustainability issues of various kinds. These have hardly been studied so far, and their contribution to addressing sustainability challenges is poorly known. The study investigates which sustainability topics are taken up by citizen science in the humanities and social sciences, which factors influence the choice of topics, and its implications. For this purpose, the concept of Citizen Social Science (CSS) is taken up and sustainability is operationalized via the Sustainable Development Goals (SDG) and its specific Targets. Based on a collection of CSS activities in Germany, the addressed sustainability topics are identified accordingly. It is then analyzed how these patterns depend on the main characteristics of CSS projects. The findings indicate a focus on three SDGs related to education, sustainable cities and partnerships for the Goals, while at the same time the project consortia are very heterogeneous. CSS shows particular strengths here through its multi-stakeholder approach. Going forward, the linkage of Citizen Science to the SDGs needs to be further formalized so that its transformative effects can be incorporated into SDG monitoring and the scientific institutions need additional incentives to participate in CSS.

(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.

This paper proposes to study mystical experience by contrasting it with “ordinary” experience, i.e., with standard consciousness. It emphasises the construed nature of standard consciousness and the role that the mutual connectedness of mental contents plays in its construction. It then shows that removal of the factors that are responsible for the “making” of standard consciousness accounts for the principal features of mystical experience; these features are therefore mainly negative. The understanding of mystical experience as the suppression of factors that contribute to the construction of standard consciousness, along with a discussion of the mechanism that makes this possible, permits answers to some frequently asked questions, such as: why is mystical experience ineffable? what is its epistemic status? does it have implications for our understanding of mind, consciousness, and self?

The teaching of mathematics at the Faculty of Military Technology of the University of Defense in the first two years of the five-year Military master’s degree is divided into the teaching of students in four specializations: Military Technologies – Mechanical, Military Technologies – Electrical, Military Geography and Cartography, and Cybersecurity. The article discusses the previous five-year experience in teaching the subjects Mathematics I, Mathematics II, Mathematics III, and Graph theory for the specialization in Cybersecurity, that the author of the paper gained while teaching, as a guarantor of these four subjects. The article provides an overview of the topics that are covered, typical exam assignments, and an evaluation of the results of the semester exams in the five years since the accreditation of the Cybersecurity specialization was granted.

Considering citizens' perceptions of their living environment is very helpful in making the right decisions for city planners who intend to build a sustainable society. Mental map analyses are widely used in understanding the level of perception of individuals regarding the surrounding environment. The present study introduces Aram Mental Map Analyzer (AMMA), an open-source program, which allows researchers to use special features and new analytical methods to receive outputs in numerical data and analytical maps with greater accuracy and speed. AMMA performance is contingent upon two principles of accuracy and complexity, the accuracy of the program is measured by Accuracy Placed Landmarks (APL) and General Orientation (GO), which respectively analyses the landmark placement accuracy and the main route mapping accuracy. Also, the complexity section is examined through two analyses Cell Percentage (CP) and General Structure (GS), which calculates the complexity of citizens’ perception of space based on the criteria derived from previous studies. AMMA examines all the dimensions and features of the graphic maps, and its outputs have a wide range of valid and differentiated information, which is tailored to the research and information subject matter that is required.

In an epoch characterized by the swift pace of digitalization and urbanization, the essence of community well-being hinges on the efficacy of urban management. As cities burgeon and transform, the need for astute strategies to navigate the complexities of urban life becomes in-creasingly paramount. This study employs time series analysis to scrutinize citizen interactions with the coordinate-based problem mapping platform in the Municipality of Patras in Greece. The research explores the temporal dynamics of reported urban issues, with a specific focus on identifying recurring patterns through the lens of seasonality. The analysis, employing the sea-sonal decomposition technique, dissects time series data to expose trends in reported issues and areas of the city that might be obscured in raw big data. It accentuates a distinct seasonal pattern, with concentrations peaking during the summer months. The study extends its approach to forecasting, providing insights into the anticipated evolution of urban issues over time. Projec-tions for the coming years show a consistent upward trend in both overall city issues and those reported in specific areas, with distinct seasonal variations. This comprehensive exploration of time series analysis and seasonality provides valuable insights for city stakeholders, enabling informed decision-making and predictions regarding future urban challenges.

Congenital heart disease (CHD) is the most commonly detected congenital anomaly and affects up to 1 % of all live-born neonates. Current guidelines support the use of Chromosomal Microarray Analysis (CMA) and Next Generation Sequencing (NGS) as diagnostic approaches to identify genetic causes. The aim of our study was to evaluate the diagnostic yield of CMA and NGS in a cohort of neonates with both isolated and syndromic CHD. The present study included 188 infants under 28 days of age with abnormal echocardiography findings hospitalized at the Department of Neonatology, UMC Ljubljana, between January 2014 and December 2023. Phenotypic data were obtained for each infant by retrospective medical chart review. We established the genetic diagnosis of 22 distinct syndromes in 17% of neonates. The most common genetic diagnoses were 22q11.2 microdeletion (22.7%) and CHARGE syndromes (22.7%), Noonan syndrome (9.1%), and Williams syndrome (9.1%). In addition, we detected variants of uncertain significance in 4.8% of neonates. Timely genetic diagnosis is important for the detection of syndrome-related comorbidities, prognosis, reproductive genetic risks and, when appropriate, genetic testing of other family members.

Background: In most cases, intra-labyrinthine schwannoma (ILS) occurs in patients with unilateral hearing deterioration or neurofibromatosis type II (NF II). The pattern of localization of these tumors is various but affects mostly the cochlea. Extirpation of the ILS, if hidden by the cochlea modiolus, is difficult under the aspect of complete removal. Therefore, a tissue removal device (TRD) was designed and tested in temporal bones. The principle of handling the new device is a pushing and pipe cleaner handling inside the cochlea. This present study aimed to describe the first in vivo experience with the newly developed TRD for removing cochlear intra-labyrinthine schwannoma. Methods: In three patients, the TRD was used for the tumor removal of ILS. In two patients with a cochlear schwannoma in combination with a cochlea implantation and one patient suffering from NF II, a cochlear schwannoma was removed with the TRD. The access was performed with a posterior tympanotomy, an enlarged round window approach, and an additional second-turn access. The device was inserted and extracted gradually from the second turn access until the rings were visible in the second turn access. By pushing and pipe cleaner handling, the tumors were removed. An MRI control was performed on the day postoperatively with a T1 GAD sequence. Results: Tumor removal with the TRD was performed in a 15-minute procedure. MRI control confirmed a complete removal on the postoperative day in both cases. Conclusion: In vivo handling of the device confirmed a straightforward handling for tumor removal. MRI scanning showed a complete removal of the tumor by the TRD.

Science is addressing global societal challenges and, due to limitations in research financing, scientists are turning to public at large to jointly tackle specific environmental issues. Citizens are therefore increasingly involved in monitoring programs, appointed as citizen scientists with potential to delivering key data at near no cost to address environmental challenges, so fostering scientific knowledge and advise policy- and decision-makers. One of the first and most successful example of marine citizen science in the Mediterranean is represented by the integrative and collaborative implementation of several jellyfish spotting campaigns in Italy, Spain, Malta, Tunisia started in 2009. Altogether, in terms of time coverage, geographic extent, and number of citizen records, these represent the most effective marine citizen science campaign so far implemented in the Mediterranean Sea. Here we analyzed a collective database merging records over the above four Countries, featuring more than 100,000 records containing almost 25,000 observations of jellyfish specimens, collected over a period of 3 to 7 years (from 2009 to 2015) by citizen scientists participating in any of the national citizen science programs included in this analysis. Such a wide citizen science exercise demonstrates to be one of the so far available most valuable and cost-effective tools to understanding ecological drivers of jellyfish proliferations over the Western and Central Mediterranean basins, and a powerful contribute to develop tailored adaptation and management strategies, mitigate jellyfish impacts on human activities in coastal zones, and support implementation of marine spatial planning, Blue Growth and conservation strategies.

This study aims to identify modern bureaucratic government phenomenon expressed in W.H. Auden’s poem “The Unknown Citizen” (UC). This phenomenon will be revealed through the use of figures of speech, symbols and imagery in the poem. This poem is chosen as the object of the study since phenomenon happened in the poem represents people’s life and government practice in the modern era. Government, in the poem, seems to be very dominant. Its bureaucratic apparatus is powerful. Through its sophisticated technology, the bureau of statistics is able to detect the citizen’s identity. But, ironically, it could have not identified UC’s name as he lived in the world. He, then, was honored by the state by being erected the marble monument. The poem is analyzed by applying phenomenological criticism. The analysis finds that the representation of modern government is expressed through symbols emphasized by dramatic irony and supported by the use of internal sensation imagery. UC is the allegory of the average person with his bravery he sacrifices for the country. The state ought to give him an honor. In this poem Auden, actually, wants to write a parody for establishing monuments in some countries to honor the struggles of their soldiers who died in the World War I. Those monuments are really tombs since the function of a monument is a state’s thanksgiving for their sacrifice.

Design plays a critical role and creates a positive user experience, establishing a solid brand identity and staying competitive in the digital world. This research investigates the impact of user data collecting and analysis in improving user experience. The Data-driven User interface design can create an optimized and relevant UI with individual preferences, which leads to increasing user engagement and usability. The proposal explores methodologies to implement data collection and user research for tailoring digital products.

Recently emerging data-driven citizen sciences need to harness increasing amount of massive data with varying quality. This paper develops essential theoretical frameworks and example models and examine its computational complexity for interactive data-driven citizen science within the context of guided self-organization. We first define a conceptual model that incorporates quality of observation in terms of accuracy and reproducibility, ranging between subjectivity, inter-subjectivity, and objectivity. Next, we examine the database's algebraic and topological structure in relation to informational complexity measures, and evaluate its computational complexities with respect to exhaustive optimization. Conjectures of criticality are obtained on self-organizing processes of observation and dynamical model development. Example analysis is demonstrated with the use of biodiversity assessment database, the process that inevitably involves human subjectivity for the management in open complex systems.

Human activities continue to degrade oceanic, coastal and inland waters. The generational change in the role of society in actively looking after the health of water resources can be achieved through the expansion of ocean and water literacy in schools. The Network of European Blue Schools established under the EU4Ocean Coalition for Ocean Literacy has improved ocean and water literacy; however, this Network needs to grow and be supported. Here we present ProBleu; a recently funded EU project that will expand and support the Network, partly through the use of citizen science. The core of the proposed methodology is facilitating school activities related to ocean and water literacy through funding calls to sustain and enrich current school activities, and kick-start and support new activities. The outcomes of the project are anticipated to have wide and long-term impacts across society, oceanic, coastal and inland water environments.

Objectives: Describe the epidemiology of burns in the pediatric population. Analyze and compare the results obtained from the treatment of burn wounds by using the bio-preserved human epidermis allograft (BHEA) and other types of dressings and determine the need for further need of a skin graft. Methods: A retrospective cross-sectional study of pediatric population with burn injuries was conducted, grouped into categories based on their age group, and the mechanisms of injury into 6 categories: scald, flame, contact, electrical, chemical and friction. Describing the extension and depth of the burn injury. The results of treatment of two groups; the patients who used (BHEA) and the group with “other dressings” were analyzed by inferential statistics to establish the relationship between the use of BHEA and the need for skin grafts compared to the other group. Results: A total of 65 patients were obtained. The average age was 4.5 years (±3.8). Preschoolers (1-5 years old) were the most frequent age group 64% (n=42). Male patients represented 61% (n=40) of cases. Scald was the most reported mechanism 64% (n=42). The average total body surface area burned (TBSAB) was 10.8% (± 9.2). Mixed partial thickness burn (superficial and deep) was the most common with a 55%. The head was the most affected anatomical site; 30%. The face was the most reported “special anatomical site” with a 40% (n=30). 32.2 % of the population (n=21) was treated with BHEA. The average time of epithelialization of the BHEA group was 8 days (±7.2), and their average hospital stay time was 7 days (±5.7). In the “other dressing” group, the average epithelialization time was 18 days (±13.6), and the average hospital stay time was 11 days (±12.6). Fifty percent (n=22) of the “other dressing” group required skin grafts. In the BHEA group only 19% (n=4) required skin grafts. An OR of 0.23 and CI of 95% (0.06 – 0.81) with a p value of (0.017) for the need of skin grafts after de use of BHEA was obtained. Conclusion: The epidemiological results reported are similar to those described in the literature. The use of (BHEA) proved to be a good option for the management of partial thickness burns and burns in transition, promoting timely epithelilization and avoiding deepening of the burns while reducing morbidity, hospital stay and care costs.

Wetland ecosystems provide valuable services to human beings, but they are also among the most threatened ecosystems in the world (1). Sixteen ecosystem services are identified through the South African Water Research Commission's Wet-Health Tool (2). This study sought to establish which of these ecosystem services are highly ranked/rated by the community members living in the Soutpansberg area in South Africa. This area is a strategic water source/watershed. The area is rich in biodiversity and is also experiencing competing administrative jurisdictions: the local traditional leadership and the municipal council. This study also sought to determine the influence of age, education status, employment status, and family income, among other demographic factors, on how people view the importance of services derived from wetlands. It also sought to establish whether people in urban settings view the ecosys-tem services obtained from wetlands similarly to people in rural settings. A literature review was conducted to understand the wetland ecosystem services and how communities benefit from these services. A close-ended questionnaire was used to collect data for the current study, which was circulated among the villagers around the wetlands, particularly those living close to the wetlands. One hundred and sixteen responses from the study were recorded. Food for livestock was ranked the greatest benefit or service derived from the wetlands rated by 82% of the participants, followed by the provision of cultivated foods at 60%, provision of water for human use at 58%, provision of harvestable resources at 42% and erosion control at 38% completes the top 5 ranked ecosystem services in the area. The study concluded that the participants living in rural areas had greater awareness of wetlands' ecosystem services than their urban counterparts.

This work reports 60 marine alien molluscs, collected by two Belgian citizen scientists, from nine countries across the Mediterranean Sea and the Sea of Marmara. Some of their published observations concerning the collecting dates are compared with the year of first publication for these alien molluscs reported in the literature, which enabled to backdate some of these introductions. This underlines the importance of collaboration between volunteers and institutional scientists in tracing variations and changes in the environment and biodiversity.

Keywords: Rhinoplasty - Augmentation rhinoplasty - Open rhinoplasty - Facial rejuvenation – Centrofacial lipofilling.

In considering the question of machine as artist, the art object can be analytically separated from its making, and its making can be dualistically conceptualized as process on one hand and experience on the other. One of the reasons we value art is that there was an experience of its making. To better understand what is meant by the experience of art-making, this paper presents results from a qualitative, phenomenological study of a group of artists. These results appear in three groups: feeling, intention and lifeworld. Machines cannot experience art-making, at least not in the same way as humans, and thus they cannot create art but only art-like objects. Even so, in the present century, we should not be asking whether machines can be artists, but rather how machines can help more people experience art-making for themselves.

The impact of the climate crisis on urban environments and life within them is evident. In the face of challenges like heatwaves, floodings and other extreme events, pollution, and declining quality of life in cities, there is a growing demand for the preservation and expansion of urban green spaces, often driven by citizen-led transformations. This paper examines 100 urban greening projects initiated or supported by citizens globally, categorizing them according to the type of greenery, the stakeholders involved, the mode of implementation and the use of smart technologies incorporated. We notice variations in green endeavors based on the stakeholders spearheading them, however most of entirely citizen-led initiatives aimed at the creation of urban farms and food growing, demonstrating the pressuring needs for food securing and self-determination in communities. More than half of the assessed initiatives that managed to scale up and multiply had public authorities providing a framework or a type of support for their development or an NGO or other organization providing expertise and mobilize citizens at various stages. In terms of technological use, we find mostly websites and social media platforms easing participatory endeavors and knowledge sharing of best practices, accelerating scaling efforts, while there is a low integration of more advanced digital technologies, which if used, could enable real-time monitoring of green spaces, inform evidence-based decision-making, and streamline processes in scaling up green initiatives.

Since the Paris Agreement in 2016, the goals of limiting climate change and moving toward climate resilience stand. With a share of about \SI{80}{\percent} of global \ce{CO2} emissions, the energy sector is an essential driver for these goals. A shift to low-carbon energy production and a decentralized system for more efficient energy transmission distribution is necessary. In this paper, we present our work on Modeling of Power Exchanges, Algorithms for \ac{LEM}, Competitiveness of \ac{CHP} and Energy Feedback Devices. The study was conducted considering technical, economic, social and regulatory framework. For easy integration into energy simulations or a \ac{DEMS}, a model for power exchanges was created that allows flexible input or deterministic price patterns. The algorithm handles the clearing of an \ac{LEM} by a district aggregator using limit orders with the goal of increasing the share of locally consumed electricity using economic incentives. An investigation was conducted into the operation of flexible \acp{CHP} in low-carbon power systems to balance the volatility of renewable energy. An energy signal light was developed as an energy feedback device, which is integrated into the \ac{DEMS} in a living lab and allows individual configuration. In summary, the results presented should be compared with those of other research approaches in the future and require qualitative and quantitative evaluation.

Physical inactivity, highly dependent on community and environmental conditions, is the fourth leading cause of death worldwide. The objective of Every Walk You Take initiative was to co-design and test a mHealth intervention prototype (mobile app) to promote active living, and to identify barriers and facilitators for active living in individuals older than 55 years. Community stakeholders that included citizen scientists, teachers, researchers, health professionals and policy makers, familiar with the social and economic burden of aging in developed societies, codesigned the prototype. The app functionalities included recommendations on healthy routes in the city (parks, pedestrian lanes and streets) according to environmental variables (air quality and climate) and personal preferences (route difficulty, distance and geolocalization); and the collection of ecological momentary assessments (pictures and voice notes) to identify the barriers and facilitators to perform the routes. The prototype was tested in a pilot study in two deprived neighbourhoods of Barcelona. A total of 21 citizen scientists [mean age=67 (standard deviation=7)], 86% of them female collected, during two 7-day cycles, 112 comments and 48 pictures describing the barriers and facilitators for active living. The negative impact of dirty or damaged roads on citizen scientists’ motivation to engage in physical activity was highly reported as a barrier indicating that city infrastructure directly influences the public's inclination towards adopting active lifestyles. However, citizen scientists highlighted murals and urban green spaces they encountered, which made their walks more enjoyable and stimulating, as facilitators for active living. Every Walk You Take initiative constitutes the foundation for the development of novel models of health surveillance to address gaps in the current research landscape of active living. Moreover, the increased health literacy of the individuals ensures that they are more conscious about the role of physical activity in healthy ageing.

Since its introduction almost 50 years ago, the concept of ‘flow’ has been descriptive of optimal experiences, also in relation to play. However, the explorative nature of play leads to some discrepancies between flow and the optimal experience of play. In this paper the differences between flow and play are explored, leading to proposing the state of ‘wonder’ (directed at exploration) as an alternative to ‘flow’. From this perspective, the study further explores how we may design toys that enable meaningful experiences of play, identifying opportunities in designing for toys as the enablers of immersed experiences of wonder.

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

Mate crime is a specific subset of hate crime in which the perpetrator is known to the victim. To date, there is very little research into the perception and experience of mate crime in autism. The aim of the current study was to examine perceptions of friendship and mate crime in autistic adults, using semi-structured interviews. Five adults were interviewed about their experiences of social interactions, friendships and mate crime. Participants described distancing themselves from the ‘disability’ label whilst growing up to avoid condescension and being perceived as vulnerable, whilst learning to camouflage their social difficulties. Feelings of anxiety were associated with socialising, and participants valued relationships that did not place too many overwhelming demands on their time or energy. Finally, all participants had prior experiences of bullying. They understood the concept of mate crime but were unsure as to whether they would be able to identify it in their own lives if it occurred. However they could identify potential support networks in close friends and family. Results highlight the importance of further research into positive and negative aspects of social relationships in autistic adults, and the need to provide support to those who are socially vulnerable.

In the majority of children with growth hormone (GH) deficiency (GHD), normal GH secretion may occur before the attainment of final height. The aim of the study was to assess the incidence of persistent and transient GHD and the effectiveness of recombined human GH (rhGH) therapy in children with isolated idiopathic GHD, with respect to the moment of therapy withdrawal and according to different diagnostic criteria of GHD. Analysis included 260 patients (173 boys, 87 girls) with isolated idiopathic GHD who completed rhGH therapy and have reassessed GH and IGF-1 secretion. The incidence of transient GHD with respect to different pre- and post-treatment criteria was compared together with assessment of GH therapy effectiveness. Incidence of transient GHD, even with respect to pediatric criteria was very high. Normal GH secretion occurred before the attainment of near-final height. Application of more restricted criteria decreased the number of children diagnosed with GHD but not the incidence of transient GHD among them. Poor response to GH therapy was observed mainly in patients with normal IGF-1 before treatment, suggesting that diagnosis of GHD may be false positive. Further efforts should be made to avoid overdiagnosis GHD and overtreatment of the patients.

IgA nephropathy (IgAN) is a kidney disease that is characterized by the deposition of IgA (immunoglobulin A) in the kidney tissue, leading to inflammation and damage. This disease is a common chronic glomerulopathy that affects people worldwide (1). Therefore, it is crucial to identify factors that worsen the disease, monitor its activity, and predict appropriate treatments. Complement component 4d (C4d) is a protein that is involved in the activation of the complement system, which is a part of the immune system.

This article uses strategy metaphors consisting of a plan, a home and a game to study government programme formation in Finland. The strategy approach both contradicts and complements the traditional political science approach to government formation. The government programme has been strategic in the sense of separating the formulation and implementation parts of the strategy. The most important function of the metaphor of plan is to hold coalition parties together. The adopted austerity policy provides a meagre contribution to the expansion of services and the increase in government spending. Consequently, the home metaphor in the government programme appears in the distant future and in combating external threats. The game metaphor is apparent in the goal of making contracts with social partners. The vocabulary change from politics to strategy alters the government programme’s position in terms of catering to the needs of civil servants, citizens and stakeholders. The strategy perspective might be instrumental in shifting open democratic debates to closed and secretive policy formations.

Background: Infantile hemangiomas (IHs) are the most common benign vascular tumors of infancy. Methods: We report our experience of 248 patients with head and neck IHs. Results: The median age on admission was 4 months, and female/male ratio was 2.17. Among the cases, 45% were followed without treatment. No local complications were observed in any of these patients. Propranolol was given to all patients who received medical treatment. The median duration of treatment was 12 months (1-30 months), and the median follow-up period of all patients was 14 months (0-118 months). The treatment response was 98%. Complication rate was 17% and children aged between 3 and 9 months accounted for 60% of patients who developed complications. Most of the complications were local complications such as bleeding, ulcer, and infection. Conclusion: Although most of them regress spontaneously, complications may occur. Propranolol alone is an effective treatment option, and early treatment initiation increases success rates.

Background and Objectives: The techniques directed to the cranial field in osteopathy are the most questioned due to the lack of scientific evidence. In osteopathic practice, manual palpation is essential and, therefore, measuring reliability is fundamental. The objective of study is to assess the reliability and validity of osteopathic treatment depending on experience. Materials and Methods: A cross-sectional study of reliability and validity was conducted. For measurements, a strain gauge was placed on the sphenobasilar synchondrosis of the skull base, and three maneuvers (lateral compression, anteroposterior compression and compression maneuver of the mastoids) were repeated 25 times each by osteopaths with different time of experience (5-10 years, 1-5 years, <1 year). Measurement averages were computed for each of the three maneuvers to verify the average effect of each group in comparison to that of the Gold Standard (GS) (>10 years of experience). Data were analyzed to check for inter- and intra-observer reliability using intra-class correlation coefficients (ICC). Results: Reliability and validity in 5-10 experience of observer 1 and observer 2 in the tree maneuvers was excellent (p<0.001) against GS. Poor or enough reproducibility and concordance were observed in osteopaths with less experience. Conclusion: Experience of osteopaths determines the efficacy of cranial maneuvers in osteopathic treatment for patients’ rehabilitation.

Background: Infective endocarditis (IE) remains a difficult disease to diagnose and treat, with a persistently high mortality rate. There is a lack of recent data on IE in Bulgaria over the last decades. Methods: The study is retrospective, single centered, includes 270 patients diagnosed with IE, for the period 2005 - 2021. We compared the two periods 2005-2015 (n=119) and 2016-2021 (n=151) to find the characteristics changes. Results: The median age was 65 (23) years and 65.5% (177) were male. In the second period, there is a significant increase in age from 62 (29) to 67 (22), (p=0.023); Charlson comorbidities index (CCI) from 3 (3) to 4 (4), (p=0.000); cases with chronic kidney diseases (CKD) from 12.6% (15) to 36.9% (55), (p=0.001); coronary arterial diseases (CAD) from16.85% (20) to 29.1% (44), (p=0.018); atrial fibrillation (AF) from 10.9% (13) to 23.8% (36), (p=0.006). Injection fraction decreased significantly in the second period from 63 (14) to 59 (15), (p=0.000). Almost half of the patients 45.6% (123) had no known predisposing cardiac condition and 46.3 (125) had an unknown port of entry. IE was community-acquired in 173 (64.1%), healthcare-associated in 26.7% (72), and injection drug use related IE in 9.3% (25).The study population included 67.8% (183) native valve IE, 31.5% (85) prosthetic IE, and 0.74% (2) intracardiac device­related IE. The hemoculture were positive in 59.6%, and the most frequent pathogenic agent was Staphylococcus - 33.3 % ( aureus – 16.5 % and coagulase negative - 16.8 %). Only 20% of patients underwent early surgery. The all­cause 30 days mortality rate was 24.8%. There is no significant difference between the two periods in terms of the characteristics listed above. Conclusion: The profile of IE in Bulgaria has changed with increasing age and comorbidity, changing predisposing cardiac conditions and entry door. The most common pathogen was the Staphylococcus group. The 30 day mortality rate remains high.

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

Despite notable advancements in immunotherapy in the past decades, allogeneic hematopoietic stem cell transplantation (allo-HCT) remains a promising, potentially curative treatment modality. Only a limited number of studies has performed a direct comparison of two prevalent rabbit anti-thymocyte globulin (r-ATG) formulations — specifically, Thymoglobuline (ATG-T, formerly Genzyme) and Grafalon (ATG-G, formerly Fresenius). The primary objective of our retrospective analysis was to compare the outcomes of adult patients undergoing matched or mismatched unrelated donor (MUD/MMUD) allo-HCT, with a graft-versus-host disease (GvHD) prophylaxis based on either ATG-T or ATG-G. A total of 87 patients undergone allo-HCT between 2012 and 2022 were included. We observed no significant differences between ATG-T and ATG-G concerning the occurrence of acute graft-versus-host disease (aGvHD), regardless of its severity. Conversely, chronic graft-versus-host disease (cGvHD) occurred less frequently in the ATG-T group compared to ATG-G (7.5% vs. 38.3%, p=0.001). Patients treated with ATG-T manifested a higher incidence of cytomegalovirus (CMV) reactivations (70% vs. 31.9%, p&lt;0.001), with a shorter time between transplant and CMV (&lt;61 days, 77.8% vs. 33.3%, p=0.008) and a higher median CMV copy number (1000 vs. 0, p=0.004). Notably, despite a higher occurrence of CMV reactivations in the ATG-T cohort, most patients were asymptomatic compared to ATG-G (85.7% vs. 43.8%, p=0.005). Finally, we observed no significant differences in terms of 5-year overall survival (OS) and 3-year probability of relapse while comparing ATG-T and ATG-G (32.0% vs 40.3%, p=0.423; 63.9% vs 55.7%, p=0.438, respectively).

An ambitious citizen-science effort in the city of Indianapolis (Indiana, USA) led to the collection and analysis of a large number of samples at the property scale, facilitating the analysis of differences in soil metal concentrations as a function of property location (i.e., dripline, yard, and street) and location within the city. This effort indicated that dripline soils had substantially higher values of lead and zinc than other soil locations on a given property, and this pattern was heightened in properties nearer the urban core. Soil lead values typically exceeded the levels deemed safe for children’s play areas in the US (<400 ppm), and almost always exceeded safe gardening guidelines (<200 ppm). As a whole, this study identified locations within properties, and cities, that exhibited the highest exposure risk to children, and also exhibited the power of citizen science to produce data at a spatial scale (i.e., within a property boundary) that is usually impossible to feasibly collect in a typical research study.

Abstract: This paper summarises an early and successful piece of citizen science, performed within The University of Queensland Seismograph Stations (UQSS) observatory, in cooperation with colleagues at CSIRO. It was designed to en-courage young STEM students from Brisbane high schools to engage in “real” re-search, back in 1995. Having completed the project report, their (analog) results sat in a cupboard until the report was dusted off and the project was re-analysed in 2022 by an honors student, considering timely climate change applications for the study. This is a time when science is changing considerably from analog to digital medium and operational methods. The original project was called Earthquake generated T phases on BRS Seismograph (Brisbane, Q’ld)- a predictor for Tasman Sea Tsunamis? [1] Fortunately, seismology is a very collaborative field. The research question has since changed. There is a lot of data analysis involved in the science of recording earthquake signals, with auxiliary definitive catalogues, observers logbooks, housing of the recordings themselves (analog and digital) and the software mediums that change over time. In other words, a lot of headaches can be encountered in longitudinal data collection study such as this. The citizen science students used a pre-prepared decadal collection (1980-90) derived from the BRS observatory data catalogue. BRS is part of the global World-Wide Seismograph Station Network (WWSSN). Currently in Australia, university earth science observatories have diminished, and in their place, public seismic networks (PSN) have evolved, either in back-yard sheds or school science labs. The level of expertise required fits the role of advancing citizen science for a real science advantage. This is a topical citizen disaster preparedness action area for today’s climate emergency, which is threatening the globe and all lifeforms. Citizen engagement or mobilisation is an essential preparedness strategy. Keywords: citizen science 1; seismology 2; earth observation 3; climate change 4; education for sustainable development 5; disaster preparedness 6; disaster alerts 7

The pursuit of sustainable wellbeing is one of the research objectives of positive experience design. Driven by this goal, the purpose of this paper is to provide an impact-centered sustainable positive experience design model. Firstly, the literature review method was used to define the research status and concept of impact-centered sustainable design. Secondly, an impact-centered sustainable positive experience design model was constructed, and relevant formulas for concept generation and concept evaluation were proposed. Thirdly, design verification was conducted through a workshop. Finally, the Technology Acceptance Model (TAM) questionnaire was used to evaluate and discuss the design model. An impact-centered sustainable positive design model was proposed, which includes the important impact dimensions of sensory experience and meaningful experience on users’ quality of life at different levels: healthy living (pleasure index, health behavior), harmonious community (social connectivity, social contribution), and livable environment (living environment, environmental contribution). Based on positive experience related theory, this study takes long-term impacts as the starting point for sustainable positive experience design, which helps designers to generate design concepts from a systematic and long-term perspective.

In this brief paper a quantum algorithm to calculate the Hamming distance of two binary strings of equal length (or messages in theory information) is presented. The algorithm calculates the Hamming weight of two binary strings in one query of an oracle. To calculate the hamming distance of these two strings we only have to calculate the Hamming weight of the xor operation of both strings. To test the algorithms the quantum computer prototype that IBM has given open access to on the cloud has been used to test the results.

Abstract: The centrepiece of this analytical review is the metabolism of hydroxyapatite in its natural, bone, and synthetic forms, where the mitochondria-mediated mechanism may serve as the leading mechanism. The possibility that osteoblast mitochondria play an important role in the initial stages of bone mineralisation is discussed. Furthermore, the paper highlights the key role of mitochondria in the metabolism of synthetic hydroxyapatite.Differences between the results of in vivo and in vitro studies using synthetic hydroxyapatite of different morphologies are also detailed. It is noted that long-term infiltration with immune cells and in vivo studies are necessary to adequately evaluate hydroxyapatite as a bone-plastic material.Particular attention is given to the interaction of hydroxyapatite with immune cells and its ability to affect the ribosomes and mitochondria of cells. Due to its mechanical properties, scalability and potential use for the treatment of extensive bone defects of tumor origin, hydroxyapatite is a promising material.This study also highlights the importance of further development of in vitro research methods in the context of their biomimeticity. Overall, this work offers a theoretical direction for future studies of hydroxyapatite as a bone grafting material and emphasises the value of in vivo studies.

Background and objectives: Quality assurance and institutional accreditation in education is becoming of paramount importance. This study aims to assess the impacts of the accreditation process of the National Center for Quality Assurance and Accreditation (NCAAA) on the quality of education in one of private university in Libya. Methods: The research adopts a descriptive study design in University of Tripoli Alahlia (UTA) where an official accreditation process was completed by the NCQAA during 2017-2019. Data were collected using the self-study report that produced by the NCQAA accreditation committee during the accreditation process, and were retrieved in specific data collection sheet by one of the authors. Results: The NCQAA accreditation process that lasted about 4 years brought significant changes in the educational progressions and made the staff members more aware of quality issues in education. Our findings also reported significant improvements in the quality of education in the university. Conclusions: The process of NCQAA accreditation conducted in UTA has been positively improved the quality of education. Data from other institutions would also expressively increase the relevance and rationality of the study.

Introduction: Known for its persistent blood-feeding behavior from dawn to dusk, Aedes albopictus is recognized as one of the most dangerous mosquito species due to its role as a vector for diseases such as dengue. Studies have demonstrated that Aedes albopictus thrives in micro-breeding sites predominantly located on private properties, including abandoned containers and manholes used for rainwater and irrigation. This study investigates an innovative methodology, the TombiniNet, to mitigate the proliferation of Aedes albopictus by engaging citizens in the active management of micro-breeding sites on their properties. Materials and Methods: The study was conducted in Alessandria, a city with approximately 100,000 inhabitants, focusing on a sample of 200 houses and a population of about 5,000 people. Researchers conducted a comprehensive survey and analysis of micro-breeding sites for Aedes albopictus on both private and communal properties. The larval control measures were conducted from April to October, aligning with the peak mosquito breeding season. The study's sample included 51% of houses that allowed researchers access, and within these, 81% had Aedes albopictus larvae, often found in diverse water Containers holes of which basically manholes on villa garden floors. For monitoring the adult populations were used ovitraps that were not placed in private homes but in public areas to monitor and control the mosquito population. Results: The study identified that up to 70% of micro-breeding sites for Aedes albopictus in northern Alessandria were located on private properties. Citizen participation was critical to the success of the intervention, with a marked decrease in the number of adult tiger mosquitoes observed in areas where residents actively managed breeding sites using the TombiniNet. The TombiniNet was particularly effective in private areas, as it could be regularly maintained by residents, preventing debris accumulation that could hinder drainage. Discussion: The findings highlight the importance of engaging citizens in mosquito control programs to effectively manage Aedes albopictus populations in urban areas. The TombiniNet intervention demonstrated that a simple, cost-effective solution could significantly reduce mosquito breeding sites on private properties. By addressing both communal and private breeding sites, a comprehensive and sustainable approach to mosquito management can be achieved, thereby reducing the risk of disease transmission. Future studies should focus on long-term monitoring and the development of additional innovative solutions to enhance citizen participation and control measures. The study's success also pointed out the limitations of applying such interventions in public areas where debris could impede the net's effectiveness.

Bacteriophages, viruses that are widespread throughout the world, are highly specific for bacteria, usually of a single species and often of a particular strain. After being discovered and isolated 100 years ago, their use, called phage therapy, was instituted in medicine two years later and quickly used around the world to treat various bacterial infections. In the West, phage therapy was overshadowed in the second half of the 20th century by antibiotic therapy, which was then thought to be the definitive solution. But because of the increase in bacterial resistance to antibiotics, the idea of using bacteriophages in medicine has been reawakened. The innumerable observations reported over the years in the literature constitute an invaluable experience. We and some of our colleagues have, in the last decade treated some patients compassionately. With the available documentation and our own experience we discuss the potential indications and limitations of phage therapy. The observation of the increasing number of therapeutic failures in the announced perspective of a post-antibiotic era, we believe, that the introduction of bacteriophages into the therapeutic arsenal seems conceivable today to two preconditions: that their production as biologic drug meets current regulatory standards and that the benefit-risk assessment was conducted in a modern setting. Phage therapy could be applied as a substitution or supplement to antibiotic therapy under multiple circumstances in different modes, precise indications and limits.

This paper proposes a product design model for internalising users’ positive experiences through attachment. First, the research commences with a literature review to define the concepts and research status of positive experience design (PED) and product attachment. Subsequently, the design model is constructed, accompanied by relevant formulas for concept generation. Finally, the model’s validity is verified through a workshop, and its effectiveness is evaluated and discussed using the USE questionnaire. This study incorporates the seven factors of product attachment to activate positive states within the user–product relationship and facilitate the cultivation of positive thinking. Grounded in theories of PED and embracing a product attachment perspective, the attachment-driven PED model offers a systematic approach for generating design concepts that are relevant to user experience.

Surgical navigation has evolved as a vital tool in maxillofacial surgery, offering precise and patient-specific data. This study explores the clinical applications and accuracy of intraoperative tool tracking in maxillofacial surgery. The research includes 37 patients with various pathologies who underwent surgery assisted by a surgical navigation system using tracked instruments. The study showcases two representative cases: one involving coronoid hyperplasia with mouth opening deficit and another addressing nose-orbital-ethmoidal-frontal ossifying fibroma resection. The results indicate that surgical navigation with tracked instruments provides high precision (<1.5 mm error), reduced surgical time, and less invasive approaches. The study highlights the potential for reproducible outcomes and increased safety, especially in complex cases. Despite some limitations, the synergy between surgical navigation and tracked instruments offers a promising approach in maxillofacial surgery, expanding its applications beyond current practices.

Abdominal injuries in children caused by guns are a rare clinical entity globally. But, in countries with undefined legal regulations and in the war zones urban violence is a great social problem among older children and adolescents. This manuscript provides details regarding two cases of severe gunshot injuries in young children. The injuries were very complicated and included damage to the parenchymatous and hollow organs as well as major blood vessels. The clinical presentation on admission was very serious and dramatic, but the patients survived. However, one patient developed numerous complications that required repeated surgical interventions and long treatment. The article provides a detailed description of injuries and how to treat them. Patient care requires a multidisciplinary approach, and the initial decision on further treatment depends on the patient's hemodynamic stability.

As we approach the 135th anniversary of the automobile, two industry trends, automation and digitalization, are rapidly revolutionizing the thus far, relatively unchanged automotive user experience. This paper describes the development of the Valeo MyMobius user interface concept. The goal of this project was to explore how to achieve an intuitive driving experience as the automotive industry undergoes transition from primarily analog to primarily digital interfaces and from physical buttons to multimodal interactions. To achieve the perception of intuitiveness, designers must understand their users, find and reduce physical and cognitive friction points, and bridge knowledge gaps with interface designs that facilitate discovery and learnability. The Valeo MyMobius concept featured steering wheel touch displays that supported quick, frequent menu selections using swiping gestures (common in smartphone interactions) and reinforcing icons (to facilitate learnability). Learning algorithms personalized the experience by tailoring suggestions, while more complex interactions were handled with a conversational voice assistant, which also served as a driving copilot, capable of contextually suggesting when Advanced Driving Assistance System (ADAS) features such as ACC could be utilized. The visual design aesthetic embodied Kenya Hara’s design philosophy of “Emptiness,” reducing visual clutter and creating spaces that are ready to receive inspiration and information. Altogether, the Valeo MyMobius concept demonstrated an attainable future where the perception of intuitiveness can be achieved with today’s technologies.

Access to travel information is crucial for blind and partially sighted (BPS) people in travel planning. However, finding relevant information can be complex and challenging due to the unavailability of appropriate information and accessible information sources. To investigate this issue, a mixed-method study consisting of semi-structured interviews and co-design workshops was conducted to identify the needs of BPS people and the barriers BPS people experience due to the lack of access to such information. The findings provide insights into the information-seeking process and highlight the role of experience-sharing in cultivating a sense of agency, contribution, and interdependence. We contribute an accessible tourism ecosystem based on our findings to motivate research on technologies to support inclusive leisure travel for BPS people and to inform the design of inclusive tourism services.

This comprehensive review digs into the complex landscape of the Metaverse, focusing on user perceptions and the critical roles of usability, social influence, and interoperability. The paper integrates various scholarly insights, underscoring the Metaverse's evolving significance in the digital realm and its implications across diverse sectors. Central to the findings is the importance of usability. The influence of social factors is also prominent, shaping user behavior and decision-making within these virtual spaces. Interoperability becomes a big problem, showing how important it is to have standard protocols and technologies so that experiences on different Metaverse platforms are smooth and seamless. The review further reveals insights into user experience and accessibility, emphasizing the need for inclusive, ergonomic, and user-friendly design to enhance engagement and reduce barriers. Moreover, the paper discusses the ethical and societal implications of the Metaverse, including issues like digital harassment, aggressive marketing, and privacy concerns, which call for responsible development and robust regulatory frameworks. Additionally, the review identifies gaps in current research, particularly in user experience in healthcare applications, the impact of the Metaverse on educational outcomes, and the need for more empirical studies on the long-term effects of Metaverse interactions on user behavior and psychology. This synthesis offers a detailed overview of current user perceptions and challenges within the Metaverse and sets the stage for future research directions, aiming to foster a secure, inclusive, and interoperable Metaverse environment that aligns with ethical standards and societal needs.

Customer satisfaction is the process of reaching a customer's expectations to generate delightful experiences with a product or a brand. Delight involves delivering an unforgettable experience to users by focusing on their requirements, desires, and interests. Delighting Customers is crucial for organizations’ economic growth worldwide, especially in the airline industry. This study aims to determine if safety measures, ticketing policies, and the cost of air travel impact among the airline passengers’ satisfaction post-COVID-19 in Malaysia. A research framework is designed to present an in-depth understanding of the mentioned variables. In this study, a comprehensive survey using online questionnaire was used and 388 valid responses were obtained from airline passengers in Malaysia. Data were analyzed by employing data reduction technique and multivariate data analysis. The results revealed that safety appears to be the most essential aspect of airline customer satisfaction among Malaysians, while cost is perceived as a significant factor. Moreover, as the cost of living rose because of the pandemic, many of the income earners in the lower category are less inclined to take vacations. In a nutshell, the study recommends that airlines implement a conscious practice that contributes to the happiness of passengers, which in turn increases profitability and ensures sustainable growth of the airlines.

(1) Background: Aim was to investigate real-world effectiveness (hypothesizing non-inferiority) and safety profile of risdiplam in paediatric and adult nusinersen-risdiplam spinal muscular atrophy (SMA) switch cohort. (2) Methods: A retrospective and anonymous collection of relevant demographic and clinical data for all Croatian SMA patients switched from nusinersen to risdiplam up to September 2023 (reimbursed by Croatian Health Insurance Fund – CHIF) was performed using CHIF database and associated reimbursement documentation. Patients were included in effectiveness and safety analysis if they met the following inclusion criteria: i) risdiplam reimbursed by CHIF; ii) patient received at least 6 doses of nusinersen before switch to risdiplam; iii) no relevant pause between the latter disease modifying drugs (DMDs); iv) availability of all prespecified studied data and parameters. (3) Results: 17 patients met inclusion criteria [58.9% female; median age 12.75 (3.0-44.5) yr.]. In our ‘switch’ cohort, we have demonstrated a non-inferiority of risdiplam to nusinersen, in SMA 1 (+1.0 in CHOP INTEND; p=0.067), SMA 3p (+0.7 in HFMSE; p=0.897) and SMA 3a (+0.8 in RHS; p=0.463) subpopulations, during a one-year follow-up period. There were no reports on respiratory function worsening, feeding worsening, and no lethal events. No new safety concerns were identified, except of the weight gain that arose as a new potential adverse drug reaction ‘signal’ in two patients. (4) Conclusions: We have reported a pivotal real-world findings on switching SMA patients from nusinersen to risdiplam and demonstrated its effectiveness (non-inferiority), safety and tolerability in a heterogenous paediatric and adult ‘switch’ cohort, which will further increase the quality and standards of care as well as safety of a notable portion of SMA patients; especially for those who demand switch from nusinersen to other DMDs from clinical or personal reasons.

Abstract: Background: Vasoplegic shock syndrome(VSS) after an off-pump coronary artery bypass graft (OPCABG) is an extremely rare condition. Inotropic support is usually the first-line therapy though it can precipitate several complications or be ineffective. We report the first case of severe refractory VSS after OPCABG successfully treated with hydroxycobalamin. Methods: A 77-year-old gentleman underwent OPCABG for three vessels coronary artery disease. Preoperative LV ejection fraction was 28%, and the patient before surgery started sacubi-tril/valsartan titrated, then, to the highest dose. Surgery was uneventful and, by the end of the procedure, TEE showed improved biventricular contractility. Results: The patient was transferred to the ICU without inotropic support but he developed soon hypotension. TEE ruled out pericardial tamponade and confirmed fair contractility. Norepineph-rine was titrated to a medium-high dose, vasopressin was started and a Swan-Ganz catheter was placed. SVR was 480 dyn·s·cm−5. Despite aggressive pharmacologic treatment (including Methylprednisolone and Methylene blue), no improvements were noticed. 10 g of hydroxycobalamin were administered. One hour later hemodynamic status re-assessment showed SVR > 800 dyn·s·cm−5. Afterward, vasopressors were gradually reduced. Conclusions: Our case demonstrated the importance of adequate early treatment in VSS after OPCABG. For the first time, hydroxycobalamin was effectively used to restore homeostasis.

Our lives are comprised of moment-to-moment activity experiences. According to the Model of Human Occupation (MOHO), our occupational experiences can be affected by volition, which consists of personal causation, values, and interests. This study investigated how momentary volition affected occupational satisfaction and mind-wandering while performing occupations. This study also examined the relationship between momentary volition and the overall life perspectives of life satisfaction and life balance. Undergraduate students participated in this cross-sectional study. The experience sampling method (ESM) was used to measure students’ momentary states such as activity, volition, occupational satisfaction, and mind-wandering. After conducting the ESM, the participants’ life satisfaction was measured using the Satisfaction With Life Scale (SWLS), and their life balance was measured by the Life Balance Inventory (LBI). Forty-two participants and 1,092 sampling data were included in the analysis. Momentary personal causation, values, and interests contributed to occupational satisfaction. Mind-wandering was predicted negatively by interests but positively by personal causation. Momentary interests were positively correlated with SWLS and LBI scores. This study demonstrated that momentary volition was associated with occupational satisfaction and engagement, as well as life satisfaction and balance, in undergraduate students.

Oral health surveys are essential to assess the dental caries experience and to influence national policies. This retrospective cross-sectional study aims to analysis dental caries experience who sought dental treatment in a reference university dental hospital at the Lisbon Metropolitan Area between January 2016 and March 2020. Full-mouth examination, sociodemographic, behaviors and medical information were included. Descriptive analyses and logistic regression analysis were applied to ascertain risk indicators associated with dental caries experience. A final sample of 9,349 participants (5,592 females/3,757 males) were included, aged 18 to 99 years old. In this population, caries experience was 91.1%, higher in female participants. Age (OR= 1.01, 95% CI [1.00-1.02], occupation (OR= 2.94, 95% CI [2.37-3.65], OR= 3.35, 95% CI [2.40-4.67], OR= 2.55, 95% CI [1.66-3.91], for employed, unemployed and retired, respectively), overweight (OR= 1.52, 95% CI [1.18-1.96]), reporting to never visited a dentist (OR= 0.38, 95% CI [0.23-0.64] and self-reported week teeth status (OR= 2.14, 95% CI [1.40-3.28]) were identified as risk indicators for the presence of dental caries, according to adjusted multivariable logistic analyses. These results highlight a substantial rate of dental experience in a Portuguese cohort and will pave the way for future tailored oral public health programs in Portugal.

Congenital deafness is a major pediatric problem, affecting about 1.5-3 per 1000 newborns. The early treatment through cochlear implantation and auditory rehabilitation has been a historic milestone. Early diagnosis of congenital deafness is an essential requirement to obtain the best results, which is achieved through neonatal screening, a diagnostic practice that we began systematically at the Hospital Clínico in Valencia (Spain) 30 years ago.

Objective: The causes of vertigo and dizziness in children are diverse and require attention from various specialists. Numerous authors have reported that the commonest type of vertigo in children is migraine-associated vertigo (vestibular migraine and benign paroxysmal vertigo of childhood - BPV). We aimed to check whether this could be applied to our group of patients. Materials and methods: A retrospective case series of 257 consecutive pediatric vertigo and diz-ziness patients referred to the tertiary pediatric ENT clinic from 2015 to 2020. Patients received a complete audiovestibular workup and were referred to pediatric neurologists and other special-ists depending on the signs and symptoms. Results: Of 257 children aged 1-17 years, almost one fifth of them, 49/257 (19.1 %) had a central type of vertigo, 20/257 of them (7.8%) had benign paroxysmal vertigo of childhood and 4/257 (1.6%) had a migrainous type of vertigo. Most of the children, 112/257 (43.6%), remained unclas-sified, without a final diagnosis. Conclusion: Due to the numerous possible causes, a child presenting with dizziness and vertigo requires a multidisciplinary approach. In the majority of cases, vertigo spells are self-limiting. They stop spontaneously and sometimes remain clinically undiagnosed. The most prevalent reasons for pediatric vertigo may be temporary hemodynamic (vaso-vagal) and psychological imbalance.

Empirical evidence is lacking on the nexus between coffee commodity output, climate change and commodity price volatility of Africa’s most populous country, Nigeria and other developing countries. To fill this gap, this study analyzed the reaction of coffee output to climate change and commodity price volatility. We used secondary data from 1961 to 2015 from reliable sources for Nigeria. The study adopted GARCH, ARCH and FMOLS in analysis of coffee output reaction to climate change and commodity price volatility. The findings show that coffee output in Nigeria is influenced by climate change and the international commodity price of coffee. The study demonstrates the potential benefits of improving coffee output and export through climate mitigation and adaptation measures and revival of Agricultural Commodity Marketing in Nigeria and other developing countries.

Indonesia is among the countries developing the concept of smart city. The national government envisions Indonesia 2030 which shall implement the smart city towards sustainable development. Many regions in Indonesia have already implemented the concept of smart city, but still on the level of smart government and smart technology, lacking on the smart citizen component of a smart city. This paper aims to analyze the citizens behavior of using technology on Sleman smart citizen 2021 through the lapor sleman mobile application. This research uses mixed method of quantitative and qualitative approaches in examining the data. The authors distributed 100 questionares and conducted interviews to the government which is department of communication and information, Sleman and the several community that ever use the lapor sleman application. The result of the study reveals the following: firstly, performance expectancy, social influence, and behavioral intention are three independent variables which affect the users’ behavior. Secondly, the behavioral intention has the biggest significant effect on users’ behavior. Thirdly, the citizen behavior of using technology has affect the making a smart citizen. Therefore, using technology in term of lapor sleman mobile application can make the citizens as active participants in public life, in terms of social cooperation, freedom of expression and flexibility. However, there are still many problems in the use of lapor sleman mobile application such as the limited access to only android smartphones, lack of technical know-how, and people’s reluctance to use the lapor sleman mobile application.

The socio-economic benefits of globalization cannot be overemphasized. However, the global spread of infectious diseases has so followed a parallel course. The recent wave of pandemics with emerging new diseases has shown that no part of the world is immune from the spread of infectious diseases. COVID-19 like previous pandemics has exposed inadequacies of our healthcare systems and global capacity for prevention, early detection, and response in pandemic outbreaks. Given the highly interconnected global economy and the high potential for passim spread of infections, every nation must not only come up with concerted efforts to prevent and better prepare for pandemics, international solidarity and engagements will also be critical to ensure a long-lasting and sustainable solution. We are only as strong as our weakest health system, global support to strengthen all health systems around the world is the most effective way to be pandemic – ready. ‘All for one and one for all’.

Infertility is affecting around 20 % of couples in the age of procreation but however in some societies as many as one-third of all couples are unable to conceive. Different factors are contributing to male fertility declining such us endocrine disruptors environmental and professional exposures, oxidative stress and life style changes with risks of de novo epigenetics dysregulation. Since the fantastic development of new technologies of Omes and Omics , the contribution of inherited or de novo genomes and epigenome disorders contributions in male infertility are more elucidated and relevant. More than somatic genome investigation of infertile men (from chromosome to single or multiple gene point mutations) many others techniques become available in molecular andrology laboratory to investigate the genome and epigenome integrity, the maturation and the competency of the spermatozoa and its physiological environment. All those new methods of assessment are demonstrating the role of genetics and epigenetics disorders contribution on reproductive pathology and are helping the professional of assisted reproductive technology to propose different management strategy of male infertility to improve the clinical outcomes and minimize the risk of genetics or metabolic disorders at birth.

Background: The incidence of spinal metastatic disease has risen with improved cancer survivorship. Separation surgery, the current standard surgical treatment, does not fully address spinal deformity. Advances in operative management warrant reevaluating maximal tumor resection and anterior column reconstruction with corpectomy. Methods: An IRB-approved retrospective single-center review of 63 patients was performed. Demographics, tumor characteristics, clinical and radiographic data, treatments, and neurological and survival outcomes were analyzed. Results: The mean age at presentation was 63.5 ± 9.6 years (range, 37-84 years) and 28 patients (44.4%) were female. Functional outcomes, measured by KPS, RAND-36 survey scores and Oswestry Disability Index all improved postoperatively (pre- vs postop: 70 to 80 (p=0.0056), 26.5 to 46.4 (p=0.0081), and 28.9 to 16.9 (p=0.0613), respectively). Spinal alignment also improved, with Cobb angle measurements showing a reduction in spinal kyphosis from -5 to 0 (p=0.021). Nine patients (14.5%) had non-fatal postoperative complications. The median OS for this cohort was 14.4 months (range, 0.6-145.0 months) with median follow-up time of 15.5 months. Conclusion: In oligometastatic spinal disease patients with good functional status, corpectomy for decompression of neural elements, deformity correction, and spinal stabilization is associated with improvements in pain and functional outcomes without overwhelming morbidity.

Bowel intussusception is a rare cause of acute or subacute abdomen in adults. The frequency, etiology, symptoms, diagnosis and treatment of the disease differ significantly in comparison to the pediatric population. In adult patients, the cause of the intussusception in the majority of the cases is an underlying intestinal tumor (benign or malign), leading in a complete or incomplete mechanical ileus with corresponding symptoms. Diagnosis via imaging modalities may be challenging and is sometimes set only after exploratory laparotomy. Surgical treatment in adult patients is most of the times mandatory, because it aims not only to reverse the intussusception but also to treat the underlying cause of the disease. We present 4 cases of adult intussusception that were treated surgically and discuss the crucial points in the management of this disease through a review of the literature.

Elaborate sound design, including background music, ambient sounds (sounds describing the game world), and character sounds (sounds generated by the character’s actions), plays a pivotal role in modern videogames. However, the influence of these different types of sound on the player experience has not been extensively researched. This study examines the influence of these sound types on immersion, avatar identification, fun and perceived competence. In two experiments, participants played League of Legends in four different sound conditions. The first experiment revealed a non-significant trend in the effect of character sound on avatar identification. Ambient sounds, however, were limited in this experiment because the task restricted participants’ movement across the game map. Consequently, we adapted the task to allow for a wider variety of ambient sounds in the second experiment. Here, a significant impact of character sounds on immersion, avatar identification, and fun, was observed, as well as an interaction effect of character sounds and ambient sounds on fun. Furthermore, we observed a trend, though not statistically significant, suggesting that ambient sounds may influence the player’s sense of flow. These findings underline the distinct effects of different sound types and we discuss implications for the design of sound in video games.

Globally, the adoption of Solid Organ Transplantation (SOT) as first-line therapy for end-stage organ failure has not come without its share of complications. Enterococcal endocarditis poses a substantial risk to renal transplant patients, and multiple factors must be considered due to the grave nature of this infection. Such factors include addressing multidrug-resistant organisms, antibiotic therapy-related toxicity, and preserving the transplanted organ. Additional considerations include salvaging an affected cardiac valve and avoiding the need for a valve replacement with the attendant complications. Ampicillin and gentamicin have historically been the standard of care as first-line treatment for many years until the aminoglycoside sparing regimen of ampicillin and ceftriaxone showed non-inferiority in clinical studies. We present a second case report with an aminoglycoside sparing regimen of ampicillin and daptomycin in a renal transplant patient who developed Enterococcus faecalis endocarditis. We conclude with a brief review of published research with this combination.

Rhabdomyolysis is a serious clinical condition, which if left untreated can lead to kidney failure and in extreme cases, to death. It has also been reported in association with SARS COV2 infection and can be its initial presentation. COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), which has many variants that change the characteristics of the disease affecting, among other things, the method of transmission or treatment. Some investigators have implicated excessive immune response in the causes of muscle damage during SARS-CoV-2 infection. Others point to direct damage caused by the virus or involving immune factors. In this study we described cases of COVID-19 infection from 1 June 2022 to 15 July 2022 with elevated muscle enzymes in the blood and hospitalized to the first division of Cotugno hospital in Campania. Of 39 patients with SARS-CoV-2 infection, 15 patients presented also rhabdomyolysis. The most common symptoms were: asthenia, fever, arthomyalgia, lipothymia and syncope. No patient had myocardial infarction and 2 patients had atrial fibrillation. All patients were affected by omicron SARS-CoV-2 variants. Of these patients: 4 patients died (2 due to rhabdomyolysis and 2 due to sepsis) and only one patient presented acute kidney injury.

The Dead Sea basin is the lowest terrestrial site on the globe and is internationally recognized as a photoclimatotherapy center. Since the last century, questions raised regarding the possible presence of a unique incident ultraviolet irradiation, allowing successful treatment of psoriasis, atopic dermatitis and other dermatological diseases. Aim: Determine the characteristics of the solar ultraviolet irradiation and understand the mechanism of action of photoclimatotherapy while applying the results to clinical protocols of treatment. Methods: A meteorological station was established at the Dead Sea basin to continuously measure global, UVB and UVA irradiation. The same irradiation parameters are also being monitored continuously by a set of identical ultraviolet irradiation instruments installed on the campus of the Ben-Gurion University of the Negev, in Beer Sheva. Results: This study details the results of these long-term measurements, ae well as their correlation with the success obtained by clinicians treating psoriasis patients. Conclusions: A database of more than 25 years has enabled the medical staff to establish tailor-made protocols for sun-exposure time intervals as a function of particular month and hour of day. The availability of such information has significantly improved the results of photoclimatotherapy for psoriasis and at the same time increasing the safety of sun-exposure at the Dead Sea.

The research theme originates as a design experiment for a sustainable housing system built on-site. The context is Niamey, the capital of Niger. The study takes into account the environmental issues in the construction sector and aims to find a solution capable of meeting housing, environmental, and economic needs. In the field of earthen construction, the most important developments have been achieved in manufacturing methods. In particular, the use of an additive digital manufacturing system, such as large-scale 3D printing, allows the construction of complex shapes derived from structural and thermal studies, maintaining a high degree of automation in the construction process, reducing construction times and labor costs. The research investigates the possibility of responding to housing and environmental needs with a settlement system made entirely of printed earth, maintaining the highest possible degree of automation. Starting from a study on the state of the art of 3D printing in architecture and printable earthen compounds, the design choices of similar cases are analyzed to understand the construction techniques, potentials, and limitations of the medium. Finally, a design proposal is developed based on the definition of a fully printable functional module, which, upon aggregation, determines the characteristics of the final settlement.

Art organizations are increasingly focusing on enhancing the visitor experience to attract a wider audience. The aim objective of this study was to explore the key factors that influence the visitor experience of offline art exhibitions and to use a mixed methods to data collection and analysis. The research process was divided into three stages. In the first stage, we conducted semi-structured interviews with 12 respondents by dividing the exhibition experience into three time periods: pre, during, and post-visit. We extracted seven factors affecting visitor experience through qualitative content analysis including marketing, motivation, physical environment, exhibit quality, participation, technology and service facilities; in the second stage, we developed an assessment scale and pretested it; in the third stage, we collected 725 questionnaires to validate the factors of visitor experience in art exhibitions. The results of linear regression analyses showed that all seven key factors had a significant impact on visitor experience. This study constructed a scale to assess the factors of art exhibition experience, which provides theoretical sup-port for in-depth study of art exhibition experience and useful guidance for planning and design-ing art exhibitions to improve the quality of visitors' experience of art exhibitions.

Background: Glycogen storage diseases (GSDs), known as glycogenoses, belong to inborn metabolic defects in the glycogen metabolism pathway. Several types of GSDs are distinguished, including Ia, Ib, III, VI, and IX. GSDs manifest as excessive glycogen deposition in the liver and muscles, resulting in the dysfunction of these organs. Therefore, the treatment of choice is multitherapy that, due to dietary restrictions, may lead to nutritional deficiencies and organ complications. This study aims to assess anthropometric, body composition, skeletal status, results of selected laboratory tests, dietary, lifestyle and physical capacity analyses in patients with glycogenoses and compare the results between GSD I and GSD III-VI-IX groups. Results: The results indicate that GSD patients were overweight or obese (44% of patients had BMI +1SD or +2SD) with high percentage of fat tissue (50% of patients had above 30% of body fat) and inadequate bone mineralisation (total body less head: median z-score -0.9, L2-L4 segment: median z-score -1.65). GSD I patients had the highest risk of developing obesity (67% of them had above 30% of body fat) and osteoporosis (total body less head: median z-score -1.0, L2-L4 segment: median -1.7). Conclusions: Special attention should be paid to appropriate diet and supplementation in patients with glycogenoses.

The influence of preoperative examination of oral squamous cell carcinoma (OSCC) mucosal surrounding by VELscope (Visually Enhanced Lesion Scope) on the radicality of surgical treatment of OSCC was the goal of this study.It is the first analysis of its kind with a total number of 122 patients suffering from OSCC with homogenous distribution of different tumor stages randomized into a study and a control group and enrolled in our study after meeting the inclusion criteria. The preoperative checkup by VELscope accompanied by the marking of the range of a loss of fluorescence in the study group was performed before the surgery. We have developed a unique mucosal tattoo marking technique for this purpose. The pathohistological results after surgical treatment, i.e. the margin status, were then compared. We achieved the pathological free margin (pFM) in 55 patients, the pathological close margin (pCM) in 6 cases and we encountered no case of the pathological positive margin (pPM) in the mucosal layer in the study group. In comparison, the control group results revealed pPM in 7 cases, pCM in 14 cases and pFM in 40 of all cases in the mucosal layer. This study proved that the preoperative autofluorescence evaluation of a tumor mucosal surrounding can enhance the ability to reach the pFM resection.

Patients satisfaction with fast and high-quality services is the most important in the healthcare settings and specially in outpatient departments and private clinics. High quality services on health sector are indicated by continuous quality improvement (CQI). CQI is a progressive incremental process focused on safety of all participants, outcomes, systematic process, regulated and improved working environment at the later than earlier stages. Among the various suggested strategies, we adopted the patents feedback to improve the quality of services our clinic. All of the patient visited hospital were sent a massage on mobile and requested to provide their feedback on our services. Roughly around 5% of all visitors responded and filled up questionnaire. Majority of them were satisfied with the services in various department. However, they provided us some suggestions to identify the further gaps and improve the services in improving patients experience at our clinic. We considered their feedback, identified problems, redesigned the policies and implemented. After implementation of new strategies, we preliminary again evaluated the patients’ feedback on our services. Patients feedback explores that optimized methods of services for the has considerably increased the patients’ satisfaction. Taken together, our this shows that patients’ feedback is very important factor to improve patients’ experience at outpatient clinics using continuous quality improvement tools. For that reason, this study would serve as reference for public health stack holders, administrators and researchers.

Quality of Experience (QoE) metrics can be used to assess user perception and satisfaction in data services applications delivered over the Internet. End-to-end metrics are formed because QoE is dependent on both the users’ perception and the service used. Traditionally, network optimization has focused on improving network properties such as the QoS. In this paper we examine the Adaptive streaming over a software defined network environment. We aimed to evaluate and study the media streams, aspects affecting the stream, and network. This was done to eventually reach a stage of analysing the network’s features and their direct relationship with the perceived QoE. We then use machine learning to build a prediction model based on subjective user experiments. This will help to eliminate future physical experiments and automate the process of predicting QoE.

Refinery planning optimization is a challenging problem as regards handling the nonconvex bilinearity mainly due to pooling operations in processes such as crude oil distillation and product blending. This work investigates the performance of several representative piecewise-linear (or piecewise-affine) relaxation schemes (referred to as McCormick, bm, nf5, nf6t, and de (which is a new approach proposed based on eigenvector decomposition) that mainly give rise to mixed-integer optimization programs to convexify a bilinear term using predetermined univariate partitioning for instances of uniform and non-uniform partition sizes. Computational results show that applying these schemes give improved relaxation tightness than only applying convex and concave envelopes as estimators. Uniform partition sizes typically perform better in terms of relaxation solution quality and convergence behavior. It is also seen that there is a limit on the number of partitions that contributes to relaxation tightness, which does not necessarily correspond to a larger number of partitions, while a direct relation between relaxation size and tightness does not always hold for non-uniform partition sizes.

The dynamics involving market competition and the challenges of dealing with empowered customers, means that creating and delivering relevant customer experience (CX) of service, is as important as creating product or services. Several studies have treated customer experience as though a front-desk, sales-point affair with the customer in the retailing environment, negating the critical role of organization-wide efforts in the overall customer experience management sequence. This review, however, adopts customer-centricity, as a theoretical lens to underscore the [re]configuration of organizational-level factors that are critical to adopting a high customer-experienced centred organization. Based on the review, we highlight conditions for adopting high customer experience management organization: (1) developing an integrated CX strategy, (2) CX-based knowledge management, (3) organizational re-design that supports CX-management, (4) top management commitment, (5) integrated CX IT systems, and (6) CX-oriented HR policies. These practices are only necessary conditions, but not sufficient, for creating, delivering, relevant and sustainable customer experience. However, more robust empirical studies are needed to advance the application of organization-wide customer experience management, which vary across industry, products/services, and sector.

Contact with nature is suggested to be as an important resource for human health and well-being. Stress alleviation and reduction of mental fatigue are main instances of improvement of human health and well-being in contact with nature. Although the term restoration experience in contact with nature has been used repeatedly for concepts of stress alleviation and reduction of mental fatigue, these refer to different sets of theories and research studies. In this paper, by reviewing the nature-health related theories of Biophilia, Stress Recovery Theory, Attention Restoration Theory and Supportive Environment Theory (SET), the similarities and differences between these two concepts have been discussed. Moreover, the measurement approach instruments based on different study methodologies and aims are provided. This paper could provide information for future studies with focus on factors to be of benefit for restoration experience in design and planning of natural landscape environments with the aim of health and well-being development.

Good child protection systems and processes require reliable and accurate data. A retrospective study of the case records of 452 children referred to a major UK children’s tertiary centre for suspected child maltreatment was undertaken to determine whether routinely collected data on a child’s journey through the child protection system, together with a study of related multidimensional factors, can be used to develop an enhanced dataset to protect children in the UK and in other countries. Child maltreatment was substantiated in 65% of referred cases, with the vast majority of referrals coming from children living in the most deprived neighbourhoods in the country. Domestic violence and abuse, and the child’s previous involvement with statutory bodies was associated with case substantiation. Physical abuse predominated, with soft tissue injuries, including dog bites, and burns. Burns were related almost exclusively to supervisory neglect. There were also cases of medical neglect. Emotional abuse was associated with exposure to domestic violence and abuse, and to self-harm. The strengths and weaknesses for single centre data systems were explored, concluding with a recommendation to establish an agreed national and international minimum data set to protect children from maltreatment.

Early reporting of the introduction and establishment of exotic species is of paramount importance for successful management. Here we report the introduction and rapid spread of the Bare-eyed Pigeon, Patagioenas corensis, on the binational island of Saint-Martin, West Indies. This range-restricted species naturally occurs in the arid coastal areas of Columbia and Venezuela and nearby islands. Its introduction on Saint-Martin represents an expansion of about 1000 km beyond its established native range. Using observations recorded in e-bird and results from a recent field survey, we show that since its introduction, most probably between late 2012 and early 2013, the species is expanding fast in Saint-Martin and has recently broadened its habitat to include anthropized, built areas. The expansion of Bare-eyed Pigeon on Saint-Martin and the neighbouring Leeward Islands, possibly facilitated by climate change in the future, could be a threat to both native columbid species and other bird species, through competition for resources. We therefore recommend to local authorities and stakeholders to rapidly eradicate the species or at least prevent its further spread on Saint-Martin, possibly though listing it as a game species, while it is still possible to do so.

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

Single-Anastomosis Duodeno-Ileal bypass with Sleeve Gastrectomy (SADI-S) is a modification of the duodenal switch in which only one anastomosis is performed, with a longer common limb and an expected less malabsorptive effect. The present study analyzes presentation and treatment of malnutrition after SADI-S. 258 consecutive patients undergoing SADI-S between May 2007 and September 2017 were included. The common limb length was 200 cm in 50 cases, 250 cm in 156 and 300 in 52. 30 patients were admitted for severe hypoalbuminemia and 16 patients were submitted to revisional surgery and constitute the series of our study. Mean weight before reoperation was 57 kg and mean body mass index (BMI) was 21 kg/m2. Mean number of daily bowel movements was 5,6. Mean time to reoperation was 56 months. Revisional surgery consisted mainly in elongation of the common limb. Mean weight regain was 14 kg and mean final BMI was 26 kg/m2. Daily bowel movements were decreased to 1,3. Factors related to hypoalbuminemia were hypertension, poor controlled diabetes, age over 55 years and a shorter common limb. Although SADI-S is expected to be less malabsorptive than previous biliopancreatic diversions, caution has to be taken with selected patients to avoid postoperative malnutrition.

We describe real-world use of mavacamten in 50 patients with oHCM. Consistent with EXPLORER-HCM and VALOR-HCM, we report significant improvement in wall thickness, mitral regurgitation, left ventricular outflow tract obstruction and NYHA class. Moreover, in our center’s experience, neither arrhythmia burden, nor contractility have worsened in the vast majority of patients: We note a clinically insignificant mean decrease in left ventricular ejection fraction (LVEF), with only two patients requiring temporary mavacamten discontinuance for LVEF < 50%. Adverse events were rare, unrelated to mavacamten itself, and seen solely in patients with disease too advanced to have been represented in clinical trials. Our multidisciplinary pathway enabled us to provide a large number of patients with a novel closely-monitored therapeutic within just a few months of commercial availability. These data lead us to conclude that mavacamten, as a first-in-class cardiac myosin inhibitor, is safe and efficacious in real-world settings.

The number of children diagnosed with autism spectrum disorder (ASD) has increased substantially over the past two decades with current research unable to fully account for this dramatic increase in prevalence. One explanation proposes that both intrinsic (e.g., genetic) and extrinsic (e.g., environmental) risk factors may be involved in the etiology of ASD. The goal of this review paper is to explore modifiable pathways for intervention in children at risk for ASD, specifically examining how early social experience may be correlated with epigenetic change in genes associated with autism. We present an innovative model which proposes that polygenic risk and social experience (via epigenetic mechanisms) may both contribute to the observed ASD phenotype. Previous research on genetic, environmental, and epigenetic mechanisms implicated in the etiology of ASD will be reviewed, with an emphasis on the oxytocin receptor gene, which is epigenetically altered by early social experience, plays a crucial role in mammalian social and cognitive development, and is associated with both genetic and epigenetic risk for ASD. Identifying intrinsic (e.g., genetic) and extrinsic (e.g., social experience) risk markers for ASD, a combination of which has not previously been examined, would transform our understanding of this condition, facilitate earlier identification of ASD risk, and guide early intervention efforts. This may have a far-reaching impact on individuals with ASD, their families, and society.

Our brain continuously interacts with the body as we engage with the world. Although we are mostly unaware of internal bodily processes, such as our heartbeats, they may be influenced by and in turn influence our perception and emotional feelings. While there is a recent focus on understanding cardiac interoceptive activity and interaction with brain activity during emotion processing, the investigation of cardiac-brain interactions with more ecologically valid naturalistic emotional stimuli is still very limited. We also do not understand how an essential aspect of emotions like context familiarity influences affective feelings and is linked to cardiac-brain interactions. Hence to answer these questions, we designed an exploratory study by recording ECG and EEG signals for the emotional events while participants were watching emotional movie clips. Participants also rated their familiarity with the stimulus on the familiarity scale. Linear mixed effect modelling was performed in which the ECG power and familiarity were considered as predictors of EEG power. We focused on three brain regions, including prefrontal (PF), frontocentral (FC) and parietooccipital (PO). The analyses showed that cardiac-brain interaction is dependent on familiarity such that the interaction is stronger with high familiarity. In addition, the results indicate that arousal is predicted by cardiac-brain interaction, which also depends on familiarity. The results support emotional theories that emphasize context dependency and interoception. Multimodal studies with more realistic stimuli would further enable us to understand and predict different aspects of emotional experience.

(1) Background: Existing research has demonstrated the potential of mHealth apps in improving the caregiving outcomes of stroke. Since several apps were published in commercially available app stores without explaining their design and evaluation processes, it is necessary to identify the usability and user experience issues to promote long-term adherence and usage; (2) Methods: User reviews were extracted from the 47 previously identified apps that support stroke caregiving needs using a python-scraper. The reviews were pre-processed and filtered using python scripts. The final corpus was classified based on usability and user experience dimensions to highlight issues within the app; (3) Results: A total of 162,095 were extracted from the two app stores. After filtration, 15,818 reviews were included and classified based on the usability and user experience dimensions. Findings highlight critical issues related to the errors/effectiveness, efficiency and support that contribute to decreased satisfaction, emotion and frustration in using the app; (4) Conclusion: The study identified several usability and user experience issues due to the inability of the app developers to understand the needs of the user. Further, the study describes the inclusion of a participatory design approach to promote an improved understanding of user needs; therefore, limiting any issues and ensuring continued use.