The Safe Drinking Water Act Amendments of 1996 require community water systems in the United States to send consumers Consumer Confidence Reports (CCRs). CCRs contain information on detected contaminants and required educational information about drinking water. The authors of this study developed a survey to evaluate how utilities track consumer feedback, understanding, and the role of the CCR in shaping consumer perceptions about water quality. Responses from this survey indicate it is common for utilities to indirectly track the effectiveness of their CCRs, but few utilities indicated directly evaluating consumer understanding or the effect of CCRs on consumer perceptions.

To decrease privacy risks, consumers may choose to misrepresent when they are asked to offer personal information. This paper examines the impact of consumer misrepresentation on a monopolistic firm and consumers with an economic model. The results show that consumer misrepresentation may benefit the firm but hurt consumers. In addition, consumers misrepresentation may encourage the firm to provide higher personalized service level in certain scenarios, such as, when the unit cost of personalized service is low. Thirdly, when consumers misrepresent, and the firm only covers part of the market, a greater unit value of consumer’s privacy information will reduce the firm’s profit, but a greater unit cost of personalized service increases the firm’s profit.

Questionnaires for self-report of food-elicited emotions are an established practice in consumer studies. However, most tools are originally developed in English and translated into other languages, which limits their use. The aim of this study was to develop the first Greek emotion lexicon and measurement tool for consumers, using standard methodology and extending it. The lexicon was compiled using linguistic sources and extended using the World Wide Web and a popular social media platform for the collection of authentic language and usage data. Terms were also collected from consumers using questionnaires and a variety of stimuli. Terms collected from consumers only comprise: healthy, distrustful, curious, childish, impressed, tolerant, impatient It was validated by application in various case studies, providing discrimination across and within food categories, and by comparison to the Greek translation of a standard tool in English, the EsSense Profile. The comparison was conducted by measuring emotions elicited by six food categories and demonstrated that it is preferable to use emotion measurement tools developed in the linguistic and cultural context of intended use, as they convey consumers’ emotions naturally and more accurately. This tool can be used as a Check- or Rate- All-That-Apply questionnaire to measure consumer responses to food categories and products. The methodology and validation presented can be applied for the compilation of emotion lexicons in languages less studied than English.

The origin of a product, consumer familiarity, and purchasing identity are factors that affect perception of cheese consumption. The present study aims at identifying consumers’ conceptualizations and attitudes towards local Greek cheeses of the North-Aegean Sea islands, such as Ladotyri, Graviera, Kasseri, Kaskavali, Melichloro, and Kalathaki, some of which have a Protected Designation of Origin (PDO) status, as opposed to cheeses of non-Greek origin, such as Cheddar, Regatto, and Gouda. Sensory and emotional attributes of local, local PDO, and imported cheeses, and drivers associated with consumers’ choice and acceptance above and beyond their sensory attributes were studied, using three methods: a) Flash Profile to gain insight into the sensory positioning of products and description of samples, b) qualitative analysis of focus groups to pinpoint consumer knowledge, preference, and consumption criteria, and c) a new methodology for natural language processing and sentiment analysis of social media posts to determine consumer conceptualizations. Social media posts have proven to be a valuable source of linguistic and cultural data for cheeses. Local cheeses, including PDO products, were found to be linked to village life and family gatherings, home, tradition, and childhood memories, with saltiness and hardness being their main sensory attributes. Imported cheeses were linked to fast food, pizza, and snacking, with elasticity and gumminess as prominent sensory qualities. The main criterion of purchase was intended usage and versatility, taste and texture, price, and familiarity. The findings provide key sensory attributes, information about consumer purchasing criteria, and relevant vocabulary for the promotion of cheeses as agri-food and gastronomic identity key products.

Background: Dental education blends theoretical and practical training to prepare students for independent patient care. This study examines the confidence levels of dental students in Umeå regarding independent performance of general dentistry tasks, and whether this confidence changes after clinical training. Methods: Surveys were conducted before and after a summer clinical internship, with s tudents rating their comfort levels on a scale from 0 to 10 for various procedures. Results: Results from 64 initial surveys and 54 follow-up surveys showed no significant difference in confidence before and after the internship. However, confidence levels varied based on whether students had practiced specific tasks during the internship. Students felt least confident in managing acute dental trauma and treating cavities in young children, while they were most confident in tasks like obtaining radiographic surveys and debriding periodontally compromised dentition. Tooth extraction and dental fillings were the most practiced procedures during the internship. Conclusions: The study concludes that the internship between the ninth and tenth semesters does not notably boost students' confidence in specific dental procedures, possibly due to the short duration of the training. Further exploration, including input from clinical supervisors, is suggested to optimize clinical training in dental education.

ESG (Environmental, Social, and Governance) responsibility fulfillment increasingly affects enterprise valuation. Although researchers debate about the precise effects, the prevailing view suggests a linear relationship between ESG performance and enterprise value. This study introduces a novel ESG responsibility performance metric through the Regulated Intermediary Model to delve into this relationship within the Chinese context. Our findings reveal an inverted U-shaped relationship between ESG performance and enterprise value, with financing constraints having a significant moderating effect. These findings remain robust after employing instrumental variables to mitigate potential endogeneity. Heterogeneity analysis demonstrates that this inverted U-shaped relationship is particularly pronounced in non-polluting and non-state-owned enterprises. Moreover, a comparison between equity and debt financing mechanisms underscores that improved ESG performance is associated with lower cost of equity financing, thereby enhancing enterprise value. Financial institutions are encouraged to leverage innovative financial instruments to diversify enterprise financing channels and alleviate financing constraints of enterprises that fulfill their ESG responsibilities.

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.

The objective was to investigate associations of serum vitamin D concentration with depressive symptoms and assess the impact vitamin D concentration has on the occurrence of depressive symptoms in 20–44-year-old pregnant mothers, postpartum mothers, women (non-pregnant/postpartum women), and men, including a separate subgroup analysis of postpartum breastfeeding and non-breastfeeding mothers. The study populations were selected from 2007-2018 NHANES public data. Subjective interview data and objective laboratory data, including depressive symptoms, serum vitamin D concentration, nutrient intake, and demographic information were utilized. Two diet patterns were created using principal component analysis and a Bayesian multinomial model was fit to predict depression outcomes for each subpopulation. The estimates for the log vitamin D slope parameter were negative for all cohorts; as vitamin D increased, the probability of having no depression increased, while the probability of depression decreased. The pregnant cohort had the steepest vitamin D slope, followed by postpartum, then other women and men. Higher vitamin D concentration had more impact on decreasing depression risk in pregnant and postpartum mothers compared to other women and men. Among postpartum mothers, higher vitamin D concentration had a greater influence on decreasing breastfeeding mothers' depression risk than non-breastfeeding mothers.

The systematic sampling is used as a method to get the quantitative results from the tissues and the radiological images. Systematic sampling on real line (R) is a very attractive method within which the biomedical imaging is consulted by the practitioners. For the systematic sampling on R, the measurement function (MF) is occurred by slicing the three-dimensional object equidistant systematically. The currently used covariogram model in variance approximation proposed by [28,29] is tested for the different measurement functions in a class to see the performance on the variance estimation of systematically sampled R. This study is an extension of [17], and an exact calculation method is proposed to calculate the constant λ(q,N) of confidence interval in the systematic sampling. The exact value of constant λ(q,N) is examined for the different measurement functions as well. As a result, it is observed from the simulation that the proposed MF should be used to check the performances of the variance approximation and the constant λ(q,N). Synthetic data can support the results of real data.

In this paper, we present a multi-task model that predicts disparities and confidence levels in deep stereo matching simultaneously. We do this by combining its successful model for each separate task and obtaining a multitask model that can be trained with a proposed loss function. We show the advantages of this model compared to training and predicting disparity and confidence sequentially. This method enables an improvement of 15% to 30% in the area under the curve (AUC) metric when trained parallel rather than sequential. In addition, the effect of weighting the components in the loss function on the stereo and confidence performance is investigated. By improving the confidence estimate, the practicality of stereo estimators for creating distance images is increased.

This paper formulates a new strategy for participatory forest management consisting of encouraging public participation as long as it increases empathy among participants. The strategy requires the homogeneous representation of the opinion of a participant (i.e. to determine how they assess a forest plan and identify the best one). Utility assessments are prepared for participants through pair-comparisons between meaningful points in the territory and from value functions based on forest indicators. The best plan is designed by applying combinatorial optimization algorithms to the utility of a participant. The calculating of empathy -of one participant relative to another - is based on the equivalence of their respective utilities when the current forest plan is modified. This involves calculating the opinions that are due to systematic changes in the collective plan for those participants that each participant supposes will affect the utility of the other participants. Calculating empathy also requires knowing the interactions among participants, which have been incorporated through agent-based simulation models. Application of the above methodology has confirmed the association between increases in empathy and convergence of opinions in different scenarios: well and medium-informed participants and with and without interaction among them, which verifies the proposed strategy. In addition, this strategy is easily integrated into available information systems and its outcomes show advantages over current participatory applications.

Nocardia is an emerging bacterial disease that often affects patients with compromised immune systems. As survival increases, more and more patients are receiving solid organ transplantations, and more patients are cancer survivors and receiving long-term immune system modifying agents or corticotherapy and immunosuppressive agents, organisms that are not harmful in usual circumstances become a public health problem. Carbapenems are usually a second-line therapy in the setting of Nocardia infections. We present the case of a patient who had an immunocompromised status and was diagnosed with Nocardia farcinica, which showed in vitro resistance to carbapenems. The symptoms were non-specific and had a common presentation, although the infection was disseminated and had severe CNS and ocular involvement. The clinical course was more severe when the carbapenem was withdrawn based on the provided antibiogram and markedly improved when clinical judgment considered it might be beneficial. The first case in our region to describe an „in vitro” carbapenem-resistant Nocardia species, that responded „in vivo” differently and we believe it is important to remind clinicians of this potentially severe disease in difficult cases.

Introduction: Peripheral neuropathies are very common and occur due to multiple causes including diabetes, tuberculosis, vasculitis, thyroid disorders, immune mediated diseases, vitamin B12 deficiency and drugs. Drug induced peripheral neuropathy (DIPN) is potentially irreversible, resulting in sensory deficits and paraesthesia. DIPN due to anti-tubercular drugs is common and can be implicated on linezolid, cycloserine and isoniazid.Case: 40-year-old female, diabetic with MDR-TB presented with severe, sharp, burning pain in her lower limbs. The patient was on all longer acting ATT drug regimen and was suspected with drug induced peripheral neuropathy. Conclusion: Linezolid, is used in treatment of tuberculosis and one of the major side effects includes peripheral neuropathy which is usually quite severe, presenting predominantly with sensory symptoms. Cessation of linezolid and neuropathic pain medications reduced the pain of patient from VCPS 8-10 to 1-2. Treatment of DIPN can be challenging as adverse drug reactions while treating tuberculosis should be kept in mind. It also warrants earliest treatment by identification of the drug in disguise and timely discontinuation of the drug.

The higher-order interactions in complex systems are gaining attention. Extending the classic bounded confidence model where an agent’s opinion update is the average opinion of its peers, this paper proposes a higher-order version of the bounded confidence model. Each agent organizes a group opinion discussion among its peers. Then, the discussion’s result influences all participants’ opinions. Since an agent is also the peer of its peers, the agent actually participates in multiple group discussions. We assume the agent’s opinion update is the average over multiple group discussions. The opinion dynamics rules can be arbitrary in each discussion. In this work, we experiment with two discussion rules: centralized and decentralized. We show that the centralized rule is equivalent to the classic bounded confidence model. The decentralized rule, however, can promote opinion consensus. In need of modeling specific real-life scenarios, the higher-order bounded confidence is convenient to combine with other higher-order dynamics, from the contagion process to evolutionary dynamics.

In an era when medical literature is increasing daily, researchers in biomedical and clinical areas have joined efforts with language engineers to analyze large amount of biomedical and molecular biology literature (such as PubMed), patient data or health records. With such a huge amount of reports, evaluating their impact has long seized to be a trivial task. In this context, this paper intends to introduce a non-scientific factor that represents an important element in the effort of gaining acceptance of claims. Thus, we postulate that the confidence the author is expressing in his work plays an important role in shaping the first impression that influences the reader’s perception of the paper. The results discussed in this paper are based on a series of experiments ran over data from the Open Archives Initiative (OAI) corpus that provides interoperability standards in order to facilitate the effectiveness dissemination of the content. This method can be useful to the direct beneficiaries (authors, who are engaged in medical or academic research), but, also, researchers in the fields of BioNLP and NLP, etc.

High production and consumption of bananas produce large amounts of banana waste. However, the perception of banana as waste depends on the degree of ripeness, and is therefore subjective, depending on the sensorial perception, emotional reactions, and cultural differences of consumers. Understanding consumer perception of different levels of banana ripeness could contribute to better management of the supply chain, leading thus to a decrease of waste or better utilization of its waste as a byproduct. The aim of this study was to compare European and Chinese consumers’ sensorial and emotional responses to different stages of banana ripeness, using facial expression analysis, liking, and emotion measurement by self-report. One hundred and thirty-five adults of European and Chinese origin watched a video of banana consumption at five different degrees of ripeness. Participants’ facial expressions were analyzed with regard to six emotions (neutral, happy, sad, surprised, angry, disgusted, scared). Emotional responses and consumer acceptance of different degrees of banana ripeness were assessed using pictures of bananas as reference. Liking on a 9-point Likert scale and emotion measurement using PrEmo® followed, to evaluate emotional responses and acceptability of different degrees of banana ripeness. Results showed significant differences in facial reactions between cultures and among ripeness degrees. The European participants were more positively inclined towards all ripeness degrees, compared to the Chinese. Cultural expectations and level of familiarity seem to affect consumer acceptability greatly. Finally, explicit methods can give a more accurate picture of consumer preference and acceptance of different banana ripeness stages. A combination of liking and emotion measurement can be very effective in understanding consumer preference.

Background: The efficacy of sunscreen is evaluated by SPF values, which are quantitatively determined in laboratories on the backs of human subjects according to a standardized procedure. However, SPF cannot be directly translated to sunburn protection under real-life situations because actual efficacy depends on various factors related to human behaviors and environmental conditions. This study clinically evaluated the efficacy of two sunscreen sprays (SPF 30 and SPF 70) under natural sunlight exposure on healthy subjects at the beach. Methods: Twenty subjects were divided into two cells for the two sunscreen sprays (SPF 70 and SPF 30) in a single-center, actual usage test. The primary endpoint of the study was sunburn protection on the dorsal arms and the secondary endpoint was protection on the face and neck. Subjects stayed at the beach for 4 h after application of the sunscreens with normal beach activities. Subjects’ behavior at the beach, the amounts of sunscreen applied and reapplied, and environmental conditions were all recorded. Results: There was no significant sunburn for a majority of the subjects in either cell. However, neither sunscreen completely blocked the sunburn, especially for the face/neck area. We found that the SPF 70 sunscreen was more effective than the SPF 30 sunscreen. Conclusion: Modern sunscreen sprays, applied liberally, are effective in providing sunburn protection for the body in a beach setting.

Background: Complementary and alternative medicines (CAM) are widely used, with pharmacies accounting for a significant share of the distribution market. Despite their popularity, many CAMs lack scientific evidence for effectiveness, and some can cause adverse health effects. Limited research exists on CAM-related adverse events and the effectiveness of CAM labels in conveying crucial information. Methods: This cross-sectional study aimed to investigate CAM utilization, consumer perspectives, and the influence of labels on CAM usage in Melbourne, Australia. Data were collected through an online questionnaire and analysed using descriptive statistics, Pearson's correlation, MANOVA, and regression analyses. Results: The study enrolled 125 current CAM users, primarily recruited from pharmacy and supermarket customers (age: predominantly 31-50; gender: 20.8% male, 79.2% female). Participants' perceptions of effectiveness and safety were positively correlated. Label warnings prompted information-seeking, but consultation with healthcare professionals (HCPs), particularly pharmacists, was infrequent (24%). Adverse reactions were reported by 18.5% of participants, with 8.3% experiencing severe reactions. The analysis revealed relationships between CAM usage and demographics. Ordinal logistic regression showed a significant association between calcium consumption and higher age groups (coefficient = 1.658, p = 0.006), while binary logistic regression identified higher iron consumption among females (coefficient = 2.177, p = 0.007). Conclusions: Label warnings significantly prompted consumers to seek more information about CAMs. However, a limited engagement of HCPs, especially pharmacists, suggests an opportunity for improved consumer education and pharmacist involvement in CAMs-related discussions. The findings highlight demographic influences on CAM usage being essential for developing targeted health interventions and policies. Addressing these aspects may lead to safer CAM practices and informed consumer decision-making.

Promoting organic foods production and consumption contributes to accomplishing United Nations sustainable development goals. Social commerce provides a promising opportunity to develop the organic food industry. However, there is limited knowledge regarding customer behaviors in relation to purchasing organic foods via social commerce platforms. Therefore, this study expanded upon the unified theory of acceptance and use of technology (UTAUT-2) to develop a comprehensive model that explains how customers' social commerce trust and behavioral intentions to purchase organic foods using Instagram social commerce affect their purchasing behaviors. The research model was analyzed by employing partial least squares structural equation modeling (PLS-SEM) for the data collected from a quantitative survey of 410 customers who used Instagram to purchase organic foods in Iran. The results revealed that facilitated purchasing conditions, hedonic motivations, social influence, rating and reviews, and influencers’ endorsements increase customers' purchase intentions. Moreover, Instagram’s recommendations and referrals, influencers’ endorsements, as well as social influence boost customers' trust in the social commerce platform. Eventually, it was determined that influencers’ endorsements, social commerce trust, and purchase intention determine a customer’s organic foods purchasing behaviors. This research provides valuable insights for organic food marketers to optimize their social commerce strategies.

This article conducts a bibliometric analysis focusing on the influence of globalization and technology in the academic context. Previous studies have focused on analyzing the relationship between the number of research citations and international collaboration, but no study has explored it in the scope of consumer behavior and retail. Leveraging the Scopus database, the research analyzes a significant corpus of 2,111 documents from 1971 to 2022. The findings reveal a distinct surge in academic output related to the topic of technology, reflecting a growing interest in understanding the interaction between technological factors and consumer behavior. The study also explores trends in international collaboration in publications as well as its impact on citation counts.

A more sustainable society and economy also implies a more sustainable behavior in the consumption of financial products. A possible change in focus can come from the demand side, so that more sustainable consumption of financial products have to go hand to hand with financial literacy. However, financial literacy, potential favoring of this sustainable behavior, is far from reaching an international consensus about its definition, object and scope. Two objectives are analyzed; the different interpretations of financial literacy in the academic literature, as well as its evolution and how, in what context and with what other concepts the term is used in social networks. Scientometric techniques and content analysis have been used to carry out a systematic review of literature and also NLP to analyze the comments on Social Networks. Critical moments are identified in the definition of financial literacy. Also ten sentiments are analyzed in social networks in wich positivity, trust, and anticipation predominate. Greater attention to this issue is necessary both from the private initiative and from public policies, so that financial literacy is an effective tool for a more sustainable behavior by consumers. Finally, a new definition is proposed based on our findings.

Nowadays, considering the growing tendency of companies towards e-commerce as well as green production, and dual-channel green supply chain management has become particularly important. This paper investigates pricing decisions within a dual-channel green supply chain framework while considering the capital constraints faced by risk-averse manufacturer. Simultaneously, the impact of the degree of risk aversion, consumer green preferences, and channel preferences on the optimal decision-making process of green supply chain members is analyzed. We address the issue of financial constraints faced by manufacturer through bank loans and trade credit financing and compare the two cases. Our findings illustrate that trade credit financing outperforms bank loan financing in the dual-channel green supply chain. Moreover, pricing decisions under different models are influenced by consumer preferences and risk aversion. Specifically, the greenness of the product, wholesale price, and sale price exhibit negative correlations with manufacturers' risk aversion but positive correlations with consumer preferences.

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

The capability of large food retail chains to respond quickly to changes in consumer behaviour and their dominant market position affects all food market players and often conflicts with the interests of national food producers, which can reduce the presence of locally sourced products in the food product mix in the country. In Latvia, there have been several proposals to limit retailers' opening hours on weekends and public holidays to increase the viability of small local food producers, retailers, and catering enterprises; however, limiting retailers' opening hours without research-based arguments is unacceptable. The research studies conducted in Europe also do not give a unified conclusion. Household consumer behaviour in the food market is viewed as an essential argument for increasing domestic demand and economic stability. Accordingly, the present research aims to identify the impacts of diversification of opening hours of food supermarkets on consumer shopping habits and the implications for creating an advantage for small and medium agri-food producers in selling their products. The research applied a quantitative approach to identify the main trends in society (n=2738), with a survey including 31 variables to quantify consumer behaviour, values, and opinions and seven socio-demographic variables. If a decision were made in Latvia to close grocery shops on Sundays or reduce their opening hours on weekends, 85% of consumers indicated that they would be unlikely to change their usual shopping location and would plan to shop at a supermarket on other days. The choice between farmers' markets and local food shops on Sundays would be made by 45% of consumers, with more than half (53%) of them shopping at local food shops at least a few times a month. It could, therefore, be argued that reducing the opening hours of supermarkets and closing them on Sundays and public holidays do not provide a competitive advantage and do not divert consumers to small and medium agri-food producers.

Consumer IoT (CIoT) manufacturers seek customer feedback to enhance their products and services, creating a smart ecosystem like a smart home. Due to security and privacy concerns, Blockchain-based federated learning (BCFL) ecosystems can let CIoT manufacturers update their Machine Learning (ML) model using end-user data. FL uses privacy-preserving ML techniques to forecast customers' needs and consumption habits, and blockchain replaces the centralised aggregator to safeguard the ecosystem. However, Blockchain technology (BCT) struggles with scalability and quick ledger expansion. In BCFL, local model generation and secure aggregation are other issues. This research contributes a novel architecture emphasising Gateway Peer (GWP) in blockchain network to resolve scalability, ledger optimisation and secure model transmission issues. In the architecture we replace the centralised aggregator by the blockchain network, while GWP restricts the number of local transactions to execute in BCN. Considering the security and privacy of FL processes, we have added differential privacy and advanced normalisation techniques to ML processes. The approaches strengthen end-users' cyber security and encourage the adoption of technological innovation standards by service providers. The proposed approach has been tested extensively using a well-respected Stanford Cars dataset. We experimentally demonstrate that the proposed architecture makes the network scalable and optimises the ledger significantly. In addition, the normalisation technique outperforms batch normalisation when features are under DP protection.

Consumer, as one of the vital stakeholders of fashion supply chain, has a significant role to play to transition fashion industry into sustainable direction. From purchasing and care practice to donation and disposal, every step of their decision has impact on the environment. Various internal and external variables, including culture, custom, value, belief, norm and assumption, economy, gender, and education etc. influence forming that decision. The result of the decision not only directly impacts he environment and society, but also consumer culture and future business opportunity. This study synthesizes a wide spectrum of consumer behavior related to clothing consumption and associated environmental impact. Building on the synthesis, a holistic discussion is offered which can provide relevant behavioral guideline to consumers as well as other stakeholders.

Infantile Neuroaxonal Dystrophy (INAD) is a rare neurodegenerative disorder, affecting 1:1,000,000 population. It results from pathogenic variants in the PLA2G6 gene located on chromosome (22q13.1). The onset of symptoms usually occurs between 6 to 18 months, causing developmental regression leading to debilitating symptoms such as muscle weakness, dementia, and loss of basic skills. Eventually, it progresses to life-threatening symptoms including breathing difficulties, which limits the life expectancy to 5-10 years. While potential genetic therapy for treatment is are being developed, they are yet to be approved for use, and management remains essentially supportive. This case report is of a 9-year-old Pakistani girl with INAD. She presented with recurrent chest infections, developmental regression, loss of speech, paralysis, hypertension, and eventually breathing difficulties. Brain magnetic resonance imaging and genetic testing con-firmed the diagnosis. This case posed diagnostic challenges in view of its overlapping clinical presentation. Through this report, we aim to raise awareness about the condition among practitioners, outline the importance of genetic counseling in susceptible couples and suggest potential areas of further research.

Bootstrapping is a flexible, powerful and well-established statistical approach to quantify the uncertainty of virtually any point estimate. While multiple versions of bootstrap confidence intervals are already available in Stata, dbs implements the double (iterated) bootstrap. Instead of relying on parametric assumptions such as the non-parametric resampling bootstrap confidence interval does, it is more flexible and derives critical values directly from that data. To do so, multiple methods are available (analytic approach, double resampling, jackknife estimation). In a comparative simulation study it is empirically demonstrated that the strengths of the double bootstrap are particularly evident for small samples (n < 100) when heteroscedasticity is present. While all other approaches result in undercoverage, only the double bootstrap reaches the target coverage level and hence avoids incorrect statistical conclusions. The computational burden is not even necessarily larger than for other bootstrap approaches.

Groove pancreatitis represents a chronic focal form of pancreatitis affecting the zone between the pancreatic head and the duodenal „C” loop, known as the groove area. This is a rare condition that affects the pancreatic periampullary part, including the duodenum and the common bile duct, associated usually with long-term alcohol and tobacco misuse and being more frequent in men than in women. The most common clinical symptoms of groove pancreatitis include weight loss, acute abdominal pain, nausea, and jaundice. This report is about a 66 year old woman with a history of heavy smoking, presenting with weight loss, nausea, and upper abdominal pain. Contrast enhanced computed tomography revealed the existence of a chronic pancreatitis as well as the dilatation of the main pancreatic duct, a cyst of the pancreatic head and enlargement of the biliary tract. Conservatory treatment was initiated but with no improvement of symptoms. Since there was no indication for endoscopic retrograde cholangiopancreatography, we decided to perform a pancreatoduodenectomy, as surgery appears to be the single effective treatment.

Human milk (HM) feedings are associated with reduced risks of neurodevelopmental and neurocognitive delays and systemic inflammatory diseases in infants born prematurely and/or at a low birth weight. Utilizing a neonatal piglet model, HM feedings were compared to bovine milk-derived infant formula (IF)-feedings with the aim of understanding the underlying mechanisms involved in reducing these risks. Six male piglets at postnatal-day (PD)2 were randomized into two feeding groups: HM-fed (n = 3) or IF-fed (n = 3) for 28 days. At 3- and 4-weeks-old, piglet memory and learning performance were assessed using novel object recognition (NOR). At PD30 piglets were euthanized, and whole brains were excised, weighed, and preserved for further analyses, and brain microglial morphology, and systemic inflammatory cytokines were quantified. During NOR, HM-fed piglets had significantly more non-novel revisits at both 3- and 4-weeks-old compared to IF-fed piglets. Microglia of HM-fed piglets had longer processes, more branch points, more endpoints, and a larger territorial volume compared to IF-fed piglets at PD30. In a neonatal piglet model, HM-feedings may improve cognition and reduce brain inflammatory response compared to IF-feedings.

Malignant lymphoma is an unusual form of gallbladder neoplasm. Almost all of these tumors are diffuse large B-cell lymphomas or mucosa-associated lymphoid tissue-type lymphomas. Herein, we report a rare case of a gallbladder Burkitt’s lymphoma (BL) in a child living with HIV. As far as we are concerned, this is the secondfirst report in the pediatric population and the first one in an individual living with HIV. The patient (a five-year-old black female child) attended the Federal Hospital of Lagoa, Rio de Janeiro, Brazil, underwent cholecystectomy and the postoperative pathological analysis of the gallbladder revealed a diagnosis of BL (EBV-positive). Also, HIV serology was performed and returned positive. She was transferred to the Martagão Gesteira Institute of Pediatrics and Childcare for oncological treatment, dying from sepsis and disease progression about 18 months later. Patient did not undergo ART/cART. Previous cases of gallbladder BL were herein described and analyzed to characterize the clinicopathological features and possible similarities. BL can occur in the gallbladder both in the context of HIV infection and in the pediatric population. Biopsy is mandatory in cases with suggestive findings of lymphoma, and an early diagnosis can change the course of the disease. Furthermore, the case highlights the importance of an early initiation of ART/cART in people living with HIV (PLWH).

The purpose of the current study was the level of the self-confidence among with high musical abilities Student? The randomly selected sample consisted of students (n= 130, M= 65, F= 65) . The analytical descriptive approach was applied in the study and self-confidence Scale developed by the author was administered to participants. Results indicated that: - The self-confidence among the high musical abilities Student students was rated high. There were no statistically significant differences at (α=≤0.05) attributed to effect of sex on the self-confidence overall degree. There were statistically no significant differences at (α≤0.05) attributed to effect of achievement on the self-confidence overall degree,

In a world where physical activity and social participation are fundamental pillars for a full, healthy, and quality life, confidence in walking emerges as a fundamental aspect to be assessed, especially in older adults. The purpose of this study was therefore to develop a Portuguese (Euro-pean) version, linguistically and psychometrically adapted, of the Ambulatory Self-Confidence Questionnaire (ASCQ); A translation method was used followed by an assessment of its validity and reliability. The Portuguese version was completed by 173 older adults. To assess reliability was used Cronbach’s Alpha and Intraclass Correlation Coefficients (ICC). For sociodemographic and clinical characterization, as well as for the questionnaire scoring was used descriptive statistical analysis. Pearson's correlation (r), Student´s t-test and ANOVA were used to analyse the criterion and con-struction validity; The Portuguese interactions of ASCQ was effectively translated and adjusted, revealing exceptional internal consistency and test-retest reliability, as reflected in Cronbach's alpha and ICC values of 0.95. No Floor Effect was observed, however, a Celling Effect was identified (3.5%). Criterion and construct validity were verified because all the correlations established were statistically significant; The adaptation of the ASCQ to Portuguese culture is adequate, making it valid for use within the Portuguese population of Portugal.

Many papers in recent years have been devoted to estimating the per pixel proportions of three broad classes of materials (e.g. photosynthetic vegetation, non-photosynthetic vegetation and bare soil) using data from multispectral sensors. Many of these papers use estimation methods based on the linear mixture model. Very few of these papers assess the accuracy of their estimators. I show how to produce confidence intervals (CIs) and joint confidence regions (JCRs) for the proportions associated with various linear mixture models. There are two main models, both of which assume that the coefficients in the model are non-negative. The first model assumes that the coefficients sum to 1. The second does not, but uses rescaling of the estimated coefficients to produce estimated proportions. Three variants of these two models are also analysed. JCRs are shown to be particularly informative, because they are typically better at localising the information than CIs are. The methodology is illustrated using examples from Landsat Thematic Mapper data at 1169 locations across Australia, each of which has associated field observations. There is also discussion about the extent to which the methodology can be extended to hyperspectral data.

Purpose: To identify the impact of dealing with COVID-19 patients in clinical areas on nurses' professional self-concept and self-confidence. Background: Professional self-concept is considered a critical factor in the recruitment/retention process in nursing, nursing shortage, career satisfaction, and academic achievements. Professional self-confidence is also a crucial determinant in staff satisfaction, reducing turnover, and increasing work engagement. Design: Descriptive, comparative study. Methods: The study was conducted between February to May 2021 by utilizing a convenience sampling technique. A total of 170 nurses from two facilities were recruited from two COVID-19 and non-COVID-19 designated facilities. The level of professional self-concept and self-confidence was assessed by utilizing the Nurses' Self-Concept Instrument and Self-Confidence Scale. Results: The professional self-concept level among the exposed group to COVID-19 patients was lower than the comparison group, while the professional self-confidence level among the exposed group to COVID-19 patients was similar to the comparison group. On the other hand, the satisfied staff and those who received professional training in dealing with COVID-19 patients reported a higher level of professional self-concept. Conclusions: Dealing with COVID-19 patients has an impact on professional self-concept; the exposure group was lower than those who did not deal with COVID-19 patients, while the professional self-confidence level among the exposed group was similar to the comparison group. Getting professional training in dealing with COVID-19 patients and being satisfied at work were significant factors in improving the professional self-concept. Policymakers should create strategies that target the improvement of professional training in dealing with COVID-19 patients.

This investigation pioneers an examination of the scarcely explored terrain of social diversity in medical education, assessing the complex impacts of socioeconomic status (SES), prior working experiences, and completed apprenticeships on a spectrum of psychological and academic facets among first-year medical students (n = 336) in an urban university setting. By utilizing a systematic and detailed approach, the study illuminates prior anatomical knowledge and various psycholog-ical constructs, marking a significant stride into a domain where knowledge remains profoundly limited. Analyses indicated that SES significantly affects financial anxiety (F(4, 331) = 17.391, p < .001) and academic behavioral confidence (F(4, 331) = 4.323, p = 0.002). Students with prior working experience reported higher self-perceived clinical experience but lower A-level grades (t(279.459) = -6.690, p < .001), competence in natural sciences (t(321.045) = -3.178, p = 0.002), and online competence (t(319.429) = -2.026, p = 0.044). Those who completed an apprenticeship showed higher resilience, academic confidence, self-efficacy, and greater concerns about balancing studies and work (t values ranging from 2.020 to 3.158, p < 0.05). Correlation analysis revealed a positive relationship between resilience (RQS) and coping with academic stress (CAS) (r = 0.632, p < .001), as well as between resilience and academic behavioral confidence (ABC) (r = 0.608, p < .001). Negative correlations were observed between resilience, coping with academic stress, academic confidence, and cognitive test anxiety (CTA) (r values from -0.235 to -0.404, p < .001). The findings emphasize the need for tailored support for students from diverse SES backgrounds and with varying expe-riences. The study highlights the value of a comprehensive approach in medical education, con-sidering the diverse backgrounds and experiences of students. Future research should explore the long-term impact of these factors on professional competencies and patient care, leveraging the diversity of the student body for a holistic educational experience.

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

Mixed plastic packaging waste sorting residues (MPO323) were treated by thermal pyrolysis to utilize pyrolysis oil and char. The pyrolysis oil was found to contain aromatic and aliphatic hydrocarbons. Chlorine and bromine contents were up to 40,000 mg/kg and 200 mg/kg, respectively. Additionally, other elements like sulfur, phosphorous, iron, aluminum, and lead were detected, which can be interpreted as impurities regarding the utilization of the oils by means of chemical recycling. The pyrolysis char showed high contents of potentially active species like silicon, calcium, aluminum, iron, and others. To enhance the content of aromatic hydrocarbons and to reduce the level of contaminants, the pyrolysis oil was reformed with the corresponding pyrolysis char to act as an active material in a fixed bed. The temperature of the reactor and the flow rate of the pyrolysis oil feed were varied to gain insights on cracking and reforming reactions as well as on the performance with regard to decontamination.

Background - Compared to the da Vinci platform, there is limited experience with the Hugo RAS platform for colorectal surgery in Europe. This difference is especially notable when considering a single complex procedure, such as total colectomy. Aim - To demonstrate the feasibility and safety of using the Hugo RAS for assisted total colectomy. Clinical case- Female patient: eighteen-year-old with Familial Adenomatous Polyposis (FAP). Her IBM was 19. She underwent a total colectomy with ileorectal anastomosis using the Hugo RAS platform. The procedure took 230 minutes and had no complications. The postoperative period was uneventful. She was discharged from the hospital on the third postoperative day. Conclusion - The Hugo RAS platform is one of the emergent minimally invasive robotic platforms that can be used even in total colectomy if the proper patient selection is made. The placement choice of arms and trocars was crucial to obtain a similar operative time of the single laparoscopic approach. The certification of Hugo’s new instruments, such as energy devices and staplers, will make this platform even more competitive.

This case report demonstrates the rare but potentially serious complication of pulmonary vein stenosis (PVS) diagnosed several years after radiofrequency ablation for atrial fibrillation. Pulmonary vein stenosis can remain asymptomatic until significant occlusion occurs, after which it can present with a variety of symptoms, mimicking numerous cardiovascular and pulmonary pathologies. Early diagnosis and treatment rely on consistent follow-up using appropriate diagnostic imaging modalities, which are paramount in preventing severe complications.

Corneal ulcers are a common and potentially vision-threatening condition in horses that can be challenging to treat with conventional therapies alone. This case report describes the successful treatment of a non-healing corneal ulcer in a 28-year-old Hispano-Bretón mare using the secretome derived from adipose tissue-derived mesenchymal stem cells (ASCs). Despite initial treatment with antibiotics, anti-inflammatory drugs, and surgical debridement, the corneal ulcer failed to heal properly, exhibiting persistent epithelial defects and stromal complications. As an alternative regenerative approach, the ASC secretome, a rich source of trophic factors, cytokines, and extracellular vesicles, was topically administered to the affected eye. Remarkably, within one week of secretome treatment, the clinical signs of blepharospasm and epiphora resolved, and the corneal ulcer exhibited complete re-epithelialization, regained transparency, and reduced neovascularization. No recurrence was observed during the 1.5-year follow-up period. This case highlights the potential therapeutic benefits of ASCs secretome in promoting corneal wound healing and suggests its promise as a novel cell-free therapy for treating refractory corneal ulcers in horses.

Terrestrial LiDAR becomes more and more popular to estimate leaf and plant area density. Voxel-based approaches account for this vegetation heterogeneity and significant work has been done in this recent research field, but no general theoretical analysis is available. Although estimators have been proposed and several causes of biases have been identified, their consistency and efficiency have not been evaluated. Also, confidence intervals are almost never provided. In the present paper, we solve the transmittance equation and use the Maximum Likelihood Estimation (MLE), to derive unbiased estimators and confidence intervals for the attenuation coefficient, which is proportional to leaf area density. The new estimators and confidence intervals are defined at voxel scale, and account for the number of beams crossing the voxel, the inequality of path lengths in voxel, the size of vegetation elements, as well as for the variability of element positions between vegetation samples. They are completed by numerous numerical simulations for the evaluation of estimator consistency and efficiency, as well as the assessment of the coverage probabilities of confidence intervals. • Although commonly used when the beam number is low, the usual estimators are strongly biased and the 95% confidence intervals can be ≈±100% of the estimate. • Our unbiased estimators are consistent in a wider range of validity than the usual ones, especially for the unbiased MLE, which is consistent when the beam number is as low as 5. The unbiased MLE is efficient, meaning it reaches the lowest residual errors that can be expected (for an unbiased estimator). Also the unbiased MLE does not require any bias correction when path lengths are unequal. • When elements are small (or voxel is large), 103 beams entering the voxel leads to some confidence intervals ≈±10%, but when elements are larger (or voxel smaller), it can remain wider than ±50%, even for a large beam number. This is explained by the variability of element positions between vegetation samples. Such a result shows that a significant part of residual error can be explained by random effects. • Confidence intervals are much smaller (±5 to 10%) when LAD estimates are averaged over several small voxels, typically within a horizontal layer or in the crown of individual plants. In this context, our unbiased estimators show a reduction of 50% of the radius of confidence intervals, in comparison to usual estimators. Our study provides some new ready-to-use estimators and confidence intervals for attenuation coefficients, which are consistent and efficient within a fairly large range of parameter values. The consistency is achieved for a low beam number, which is promising for application to airborne LiDAR data. They entail to raise the level of understanding and confidence on LAD estimation. Among other applications, their usage should help determine the most suitable voxel size, for given vegetation types and scanning density, whereas existing guidelines are highly variable among studies, probably because of differences in vegetation, scanning design and estimators.

In the absence of a treaty protocol or verification regime, the Biological and Toxin Weapons Convention (BWC) instituted Confidence-Building Measures (CBMs) as a mechanism to increase confidence in compliance, by enhancing transparency and mitigating ambiguities regarding states parties’ biological activities. While a promising tool to support treaty compliance, low participation, concerns regarding the completeness and accuracy of CBM submissions, a dearth of analysis, and restricted access to many submissions have limited CBMs’ value. Through interviews with 53 international experts—38 from BWC delegations and 15 independent experts—we identified concrete opportunities to increase CBMs’ value while mitigating the burden on states parties. This study supports states parties’ efforts in the BWC Working Group on the Strengthening of the Convention, as part of a series of research on BWC assurance that aims to characterize challenges around BWC verification and increase certainty in BWC compliance.

Artistic image completion is fundamental for the preservation and restoration of invaluable art paintings and it has experienced significant progress through the implementation of deep learning methodologies. Despite these advancements, challenges persist, even with sophisticated approaches like Generative Adversarial Networks (GANs), particularly in achieving optimal results for high-resolution paintings. Small-scale texture synthesis and the inference of missing information from distant contexts present persistent issues, leading to distortions in lines and unnatural colors, especially in art paintings with complicated structures and textures. Concurrently, patch-based image synthesis has evolved by incorporating global optimization on the image pyramid to enhance structural coherence and details. However, methods relying on gradient-based synthesis encounter obstacles related to directionality, inconsistency, and the heavy computational burdens associated with solving the Poisson equation in non-integrable gradient fields. This paper introduces a groundbreaking approach, integrating Weighted Similarity-Confidence Laplacian Synthesis, to comprehensively address these challenges and advance the field of artistic image completion. This proposal addresses challenges not only in high-resolution artistic image completion but also makes a significant contribution to the broader field of patch-based synthesis by utilizing the Laplacian pyramid for enhanced edge-aware correspondence search. Experimental result confirms the effectiveness of our approach, offering promising outcomes for the preservation and restoration of art paintings with complicated details and irregular missing regions.

Background: Front-of-pack-labels (FOPLs) on packaged foods provide consumers with essential information about the nutritional content of food products, enabling them to make informed choices and align their dietary habits with their health goals. However, evidence on the comprehensibility, use, and effectiveness of FOPLs remains limited, particularly in low- and middle-income countries like Kenya. Objective: In this study, we assessed the effectiveness of three FOPLs in helping consumers identify excess nutrients of concern in packaged food products and their potential influence on food purchases in Kenya. Methods: A total of 2198 shoppers with diverse backgrounds were recruited from selected supermarkets in three Kenyan main cities (Nairobi, Mombasa, Kisumu) and a small town (Garissa). Participants were randomized to three FOPLs: Red and green Octagon label (RG), Red and Green Octagon with icons (RGI) and a black Octagon Warning label (WL). In the control phase, participants were shown unlabeled images of packaged food products and they responded to a set of questions. In the experimental phase, the same product images were presented with one of the three front-of-pack labels they were randomized to, and participants answered the same questions again. Differences in the proportions of participants correctly identifying the nutrients of concern and the changes in intention to purchase unhealthy foods before and after exposure to FOPLs were analyzed using frequency tables and Chi-Square tests. The effectiveness of the three FOPLs was further assessed using a modified Poisson regression. Results: Results showed that exposure to FOPLs significantly improvement participants' ability to correctly identify nutrients of concern across various food categories. Additionally, FOPLs reduced consumers’ intentions to purchase unhealthy foods, with the Warning Labels (WL) emerging as particularly effective in enhancing consumers' understanding of product healthiness and reducing the intention to purchase unhealthy foods compared to the other two FOPLs. Conclusion: These findings underscore the potential role of FOPLs, particularly the WL as an effective regulatory tool for promoting healthier food choices in Kenya.

Cervical mesonephric ductal adenocarcinoma (MA) is a HPV-independent adenocarcinoma that originates from remnants of the wolffian duct in the male reproductive system during fetal development and occurs in middle-aged women. MA is a rare disease that accounts for less than 1% of all cervical adenocarcinomas. We report a case of MA in which abdominal radical hysterectomy(ARH) was performed after neoadjuvant chemotherapy (NAC). The patient was a 66-year-old woman with abnormal genital bleeding. A colposcopy examination revealed macroscopic invasive cancer. A pelvic MRI scan revealed a 53 × 26 mm tumor in the cervix, and the histological diagnosis of the cervix was endometrioid carcinoma, with the diagnosis being cervical adenocarcinoma cT1b3N0M0. One course of NAC with paclitaxel-carboplatin (PC) was administered to shrink the tumor and stop the bleeding, and ARH was performed. Postoperative histopathological diagnosis was MA. The surgical margins of the resected specimen were negative, and NAC had been effective, so the patient underwent five courses of PC therapy after surgery. There has been no recurrence 12 months after surgery. There is no established standard treatment, but there are reports that PC therapy is effective. It is necessary to search for effective treatments by following up and accumulating further cases.

Background: Gender stereotypes and biases can influence perceptions of competence and suitability for certain medical specialties. Empathy is an important component of an optimal doctor-patient relationship. The scope of our study is to verify the correlation between “empathetic" behavioral style with attention and sensibility to the gender differences of patients of the medical students. Methods: An online survey was conducted using the Jefferson Scale for Empathy (JSE), to measure empathy in the context of health professions education and patient care; and the Nijmegen Gender Awareness in Medicine Scale (N-GAMS), which measures attitudes and assumptions about gender. A total of 234 students (52.1% M; mean age: 22.68±2.48) from Medicine and Surgery at the University of Salerno (Italy) participated, of whom n° 175 were third-year students and n° 59 were fifth-year students. Results: The JSE score shows that male students have higher scores (77.29±12.38) than females (75.91±10.39). Conversely, female students have higher perspective-taking (JSE Factor 1: Male= 51.26±11.84; Female= 52.72±11.88). In addition, third-year students are much more empathetic than their fifth-year colleagues (JSE Score: 3°ys= 77.35±11.46; 5°ys= 74.49±11.33). With reference to the GS, we found that male students have greater sensitivity than their female colleagues (GS: Male= 2.67±0.68; Female= 2.37±0.48); conversely, they have higher scores of gender stereotype towards patients (GRIP: Male= 2±0.88; Female= 1.59±0.61) and doctors (GRID: Male= 1.88±0.89; Female= 1.64±0.63). Also, the third-year students compared to their fifth-year colleagues are characterized by greater gender sensitivity (GS: 3°ys= 2.57±0.62; 5°ys= 2.42±0.57), less bias with respect to patients (GRIP: 3°ys= 1.77±0.79; 5°ys= 1.90±0.78) but, on the other hand, show more stereotypes and prejudices towards doctors (GRID: 3°ys= 1.77±0.81; 5°ys= 1.75±0.74). Conclusions: Humanistic attitudes, including empathy, should be instilled, and evaluated among trainees as an essential part of their postgraduate medical education.

Elizabethkingia anophelis is an opportunistic pathogen causing lifethreatening infections in humans, particularly in immunocompromised patients, neonates and elderly. Infections caused by this species are exceptionally challenging to treat due to its multiresistance to antimicrobials. We report a case of central line-associated bloodstream infection by E. anophelis in a 2.5-year-old girl with acute lymphoblastic leukemia successfully treated with a combination of piperacillin/tazobactam and amikacin. The literature was also reviewed on paediatric infections caused by E. anophelis. Accurate identification with MALDI-TOF, or using molecular techniques, is crucial because of varying susceptibilities among species. Early, accurate diagnosis and prompt effective treatment optimize outcomes.

In this study, Caciocavallo Ragusano, a typical cheese produced in Sicily Island (Italy), was ob-tained from milk of dairy cows fed with and without enriched olive cake (ECO and CTR, respec-tively) in order to evaluate nutritional, microbiological, volatile, and sensory differences in cheeses. ECO cheese showed greater (p < 0.05) MUFA and PUFA and polyphenols content, and lower SFA content than CTR cheese. Microbiological analyses revealed the absence of Salmonella, Listeria monocytogenes, Escherichia coli, and E. coli O157, and no significant differences in the vi-able counts of the remaining microbial groups analyzed, between samples. Thermophilic lacto-cocci were more prevalent in ECO cheese. The implementation of culture-independent method, such as PCR-DGGE analyses, revealed the presence of a more diverse microbial population in both cheeses. Regarding the volatile compounds profile, long-chain free fatty acids were more abundant in the ECO cheese resulting in a healthier free fatty acid profile. This study also showed that, especially for their appearance and taste, the consumers mostly appreciated the ECO cheese. Results showed that using enriched olive cake could enhance the sustainability and the quality of Ragusano cheese, improving not only the health of the consumers but also positively influencing tastes and acceptability.

Plastic surgery is a diverse speciality, relevant to non-plastic doctors, as plastic surgeons frequently collaborate with other specialities and its’ basic principles are transferable across multiple specialities. Foundation year (FY) doctors are the most junior doctors in the workforce and may need to apply plastic surgery knowledge and principles during their clinical duties. Despite this, formal plastic surgery education for junior doctors is limited, resulting in an educational gap. This study gains insight into the perceived confidence, knowledge gaps, skills, educational activities and needs related to plastic surgery. This qualitative study uses phenomenology through semi-structured individual interviews with 8 FY doctors. Data was analysed using reflexive thematic analysis. This study revealed that plastic surgery features diversely in the work life of FYs, who often manage patients with a lack of knowledge and confidence, influencing patient care and FY wellbeing. FYs primarily acquire knowledge and confidence through experiential learning and individual initiative. A need for curriculum improvements was expressed. FYs are an essential part of the workforce who exhibited educational gaps and a lack of confidence in plastic surgery knowledge. We suggest improved integration of plastic surgery into the FY curriculum for improved FY knowledge and patient care.

(1) Background: This report aims to illustrate the development, progression, diagnosis and treatment of chronically present articular surface lesions; (2) Methods: In this report, two patients are described from the point of initial presentation of symptoms to surgical consultation based on radiologic findings. These patients underwent corrective surgery in the form of mosaicplasty to repair the lesion present at the articular surface and the underlying subchondral bone. (3) Discussion: Diagnosing juvenile OCD remains challenging due to variable clinical presentation and minute radiologic discoveries. X-rays are useful, however, the gold standard remains to be arthroscopy which can be both diagnostic and therapeutic. Future prospects include the use of novel sonographic methods and the use of artificial intelligence within the given modalities. (4) Conclusions: The detailed imaging provided by MRI, combined with the insights from X-rays and potentially other modalities, allows for a nuanced understanding of the disease. This comprehensive approach ensures that treatment decisions are well-informed, optimizing outcomes for young patients with this condition.

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

Confidence interval of is an interval corresponding to a specified confidence and including the true value. It can be used to describe the precision of a statistical quantity and quantify its uncertainty. Although the principle of maximum entropy (POME) has been used for a variety of applications in hydrology, the confidence intervals of the POME quantile estimators have not been available. In this study, the calculation formulas of asymptotic variances and confidence intervals of quantiles based on POME for Gamma, Pearson type 3 (P3) and Extreme value type 1 (EV1) distributions were derived. Monte Carlo Simulation experiments were performed to evaluate the performance of derived formulas for finite samples. Using four data sets for annual precipitation at the Weihe River basin in China, the derived formulas were applied for calculating the variances and confidence intervals of precipitation quantiles for different return periods and the results were compared with those of the methods of moments (MOM) and of maximum likelihood (ML) method. It is shown that POME yields the smallest standard errors and the narrowest confidence intervals of quantile estimators among the three methods, and can reduce the uncertainty of quantile estimators

The possibility of abrupt transitions threatens to poise ecosystems into irreversibly degraded states. Recently, it has been proposed the use of engineered microbiomes in endangered ecosystems to prevent them to cross tipping points and avoid collapse. Potential targets for such interventions include some of the most prominent life-support systems in the biosphere: drylands and coral reefs. Since engineering can require the introduction of microorganisms not present in resident communities, how can we weight the potential outcomes? One way is to use general models of species interactions where the "synthetic" strain is incorporated into a standard multispecies model. Here we follow this approach by modelling a resource-consumer community where one of the species is a modified one that acts by preserving some key resource. We show how the indirect effect of damping the decay of shared resources results in biodiversity increase, and last but not less, the successful incorporation of the synthetic within the ecological network. Further extensions and implications for future restoration and terraformation strategies are discussed.

Global demand for sleep-tracking wearables, or consumer sleep technologies (CSTs), is steadily increasing. CST marketing campaigns often feature a scientific component, but the scientific relevancy and monetary value of CST features within the sleep research community remains unquantified. Sleep medicine experts were recruited through social media and nonprobability sampling techniques to complete a survey identifying sleep metrics and device features that are most desirable to the scientific community. A hypothetical purchase task (HPT) estimated economic valuation for devices with different features by price. Forty-six (N=46) respondents with an average of 10±6 years’ experience conducting research in real-world settings completed the online survey. Total sleep time was ranked as the most important measure of sleep followed by objective sleep quality while sleep architecture/depth and diagnostic information were ranked as least important. Experts preferred wrist-worn devices that could reliably determine sleep episodes as short as 20 minutes. Economic value was greater for hypothetical devices with longer battery life. These data set a precedent to determine how scientific relevance of a product impacts the potential market value of a CST device. This is the first known attempt to establish consensus opinion or economic valuation for scientifically-desirable CST features and metrics using expert elicitation.

The patterns of food consumption in general and those of meat, in particular, are constantly changing. These changes are due not only to socio-economic and cultural trends that affect the whole society but also to the specific lifestyles of consumer groups. Due to the importance of consumer lifestyle, the objectives of this study were i) to identify the profiles of lamb meat consumers according to their orientation toward convenience, as defined by their eating and cooking habits; ii) to characterize these profiles according to their socio-economic characteristics and their preferences regarding the intrinsic and extrinsic quality signals of lamb meat; and iii) to analyze the willingness to pay for lamb confit. In this study, four types of consumers have been differentiated according to their lifestyles related to lamb consumption. These groups, due to their characteristics, could be called "Gourmet", "Disinterested", "Conservative" and "Basic". The Gourmet group has characteristics that make it especially interesting to market a product such as lamb confit; however, this group is unaware of this product. Therefore, a possible strategy to expand the commercialization of light lamb and the confit product would be guided marketing to this niche market.

High levels of meat consumption are increasingly being criticised for ethical, environmental, and social reasons. Plant-based meat substitutes have been identified as healthy sources of protein in comparison to meat. This alternative offers several social, environmental and health benefits and may play a role in reducing meat consumption. However, there has been a lack of research on how specific meat substitute attributes can influence consumers to replace or partially replace meat in their diets. Research demonstrates that in many countries consumers are highly attached to meat. They consider it as an essential and integral element of their daily diet. For these consumers which are not interested in vegan or vegetarian alternatives to meat, so-called meathybrids could be a low-threshold option for a more sustainable food consumption behaviour. In meathybrids only a fraction of the meat product (e.g. 20% to 50%) is replaced with plant-based proteins. In this paper, the results of an online survey with 501 Belgium consumers are presented with focus on preferences and attitudes relating to meathyrids. The results show that more than fifty percent of consumers substitute meat at least occasionally. Thus, about half of the respondents reveal an eligible consumption behaviour in respect to sustainability and healthiness to a certain degree. Concerning the determinants of choosing either meathybrid or meat it becomes evident that a strong effect is exerted by the health perception. The healthier meathybrids are perceived, the higher is the choice probability. Thus, this egoistic motive seems to outperform altruistic motives like animal welfare or environmental concerns when it comes to choice for this new product category.

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

Candida spondylodiscitis (CS) is a rare disease, for which therapeutic option are limited to fluconazole or echinocandins and the treatment should be administered up to 12 months. In case of reduced azole susceptibility, there is a scarcity of therapeutic options with adequate bone penetration and limited toxicity. We report the first case of successful use of rezafungin for a spondylodiscitis due to Candida parapsilosis with reduced susceptibility to azoles. The patient, affected by paraplegia and short bowel syndrome, was diagnosed with CS with culture on vertebral biopsy guided by a 18-FDG-PET/CT scan. He received rezafungin 200 mg weekly for 26 weeks, after 10 weeks of previous antifungal treatment. He had a full clinical, radiologic and biochemical response to the therapy with rezafungin, with no adverse effects. Rezafungin is a promising therapy for Candida osteomyelitis, especially when first line therapies are ineffective or contraindicated.

Background: Worldwide, microbes are becoming more dangerous by acquiring virulent skills to adapt and develop antimicrobial resistance (AMR). This is a concern as this increases morbidity, mortality, and costs. Consequently, physicians need to be trained inappropriate prescribing, starting with medical students. Objective: Evaluate medical students' confidence in antimicrobial agent prescribing and drug resistance Methods: Cross-sectional study assessing medical students' knowledge, perception, and confidence in prescribing antimicrobial agents and drug resistance in a Malaysian University. A universal sampling method was used. Results: Most respondents believe that educational input regarding overall prescribing was sufficient. Regarding the principle of appropriate and accurate prescriptions, female medical students had less knowledge [Odds Ratio (OR)=0.51; 95% Confidence Interval (CI) 0.25-0.99; p=0.050]. Year-IV and Year-V students had more excellent knowledge than Year-III students regarding confidence in antibiotic prescribing. Year-V students also showed appreciably higher confidence in the broad principles of prescribing, including infectious diseases, compared to those in other years. Conclusion: Overall, medical students, gain more excellent knowledge and confidence regarding prescribing, including antimicrobials, as their academic careers progress.

Abstract Introduction: Although ankle fractures and Achilles tendon injuries are among the most common traumatic presentations when they occur individually, concomitant Achilles tendon rupture and ipsilateral ankle fractures are quite unusual. To our knowledge this is the first report of acute Achilles tendon rupture associated with missed ipsilateral closed bimalleolar ankle fracture. Case Presentation: A 34 years old male patient presented with a traumatic right Achilles tendon rupture after sustaining road traffic accident one day prior. There was an open wound over the tendon substance with absent active plantaflexion of the involved leg. After confirming complete Achilles tendon rupture with positive Thompson test, the patient was prepared for emergency debridement and possible tendon repair differing imaging studies, which missed ipsilateral closed bimalleolar ankle fracture. Conclusion: Routine anteroposterior and lateral X-rays should be used in conjunction with a complete history and physical examination to detect any concomitant fracture with open Achilles tendon rupture.

Consumption is thus fundamentally related to sustainably because every decision pertaining to what to buy, what quantity the buy, how many to consume, or how to dispose of things has a direct influence on the natural world and the generations to come, and the overall impact of every single the customer's purchase is disastrous. A framework-based systematic literature review (SLR) was conducted to better comprehend the body of research on digital innovation and sustainability driving consumer behavior. This was done in order to acquire a deeper understanding of the studies that have already been done in this area. to provide (i) a comprehensive review of the current research landscape and (ii) a rich roadmap for future research. This study evaluated the literature especially in terms of theory, context, traits, and methodology. A total of 107 research articles published between 2013 and 2022 were found using scientific methods in the Scopus database. The findings showed that most research appears to have employed qualitative methodologies and was grounded in the setting of China and Italy. This review could help scholars better grasp the relationship between digital innovation and sustainability, opening the door for additional study and advancement in the field. Additionally, by extending the literature study and emphasizing the elements that can improve digital innovation and sustainability, practitioners will be given a better overall understanding of how to approach the problem.

Introduction: Atrial fibrillation (AF) is a common cardiac arrhythmia whose prevalence rises with age and is linked to increased morbidity and mortality due to the risk of thromboembolism. Management typically involves anticoagulation and rhythm control, but the treatment of elderly patients with multiple comorbidities requires careful consideration of drug side effects and interactions. Cibenzoline, a Vaughan-Williams class IA antiarrhythmic, is effective against AF but has risks of toxicity, especially in older people and those with renal impairment, due to its renal excretion and prolonged half-life in these populations. Discussion: This paper presents a case of an 80-year-old woman with paroxysmal AF who suffered cardiac arrest due to cibenzoline toxicity despite receiving standard adjusted dosages. The patient's cibenzoline blood concentration was significantly higher than the therapeutic range, leading to cardiotoxicity, which was exacerbated by drug interactions with bisoprolol and edoxaban, both metabolized by the CYP3A4 enzyme. Venoarterial extracorporeal membrane oxygenation (V-A ECMO) and intra-aortic balloon pump (IABP) successfully managed the cardiac arrest. This case emphasizes the unpredictable pharmacokinetics of cibenzoline in elderly patients with renal impairment and the need for vigilant therapeutic drug monitoring to avoid adverse events. Conclusions: Cibenzoline can pose a significant risk of severe toxicity in elderly patients with renal impairment, and drug interactions may potentiate this risk. The paper underscores the importance of careful dose adjustment and monitoring of drug levels in this population. In cases of cibenzoline-induced cardiac arrest, V-A ECMO and IABP are effective treatment modalities. The case study serves as a critical reminder for clinicians to remain vigilant for drug-induced complications and to apply aggressive supportive treatments when necessary.

Breast cancer (BC) is a prevalent malignancy with various subtypes, each presenting unique diagnostic and therapeutic challenges. Triple-negative breast cancer (TNBC), which comprises 12-17% of breast cancers, is particularly aggressive due to its lack of estrogen receptor (ER), progesterone receptor (PR), and HER2 expression. This case report details the management of a 64-year-old woman with TNBC. Initially presenting with a left breast nodule, she underwent a biopsy that confirmed triple-negative infiltrating ductal carcinoma. Despite negative BRCA genetic testing, her significant family history of cancer and a newly detected right breast lesion led to a bilateral mastectomy. Post-surgery imaging revealed multiple hypodense nodules and a spiculated pulmonary nodule, prompting further investigation. An endoscopic lung biopsy identified a primary pulmonary carcinoma with histological features similar to the breast cancer, indicating the lung as the primary source. This case underscores the complexity of TNBC, the importance of comprehensive diagnostic evaluations, and the need for considering extramammary origins in metastatic cases. The findings emphasize the role of multidisciplinary teams in managing such rare and challenging cases and highlight the necessity for thorough and repeated evaluations in atypical BC presentations.

This study explores consumer perceptions of virtual reality (VR) in marketing, aiming to understand how immersive technology impacts engagement and brand perception. As VR continues to evolve and integrate into various marketing strategies, it becomes crucial to examine its effectiveness and the factors influencing consumer attitudes. Through a detailed thematic analysis, this research identifies key themes such as familiarity with VR technology, immersion and engagement, technical quality, accessibility, personalization, storytelling, social interaction, purchase intentions, and brand perception. The findings reveal that familiarity with VR enhances enthusiasm and comfort, leading to more positive attitudes towards VR marketing. The immersive and multi-sensory nature of VR provides a significant advantage over traditional advertising methods, fostering stronger emotional connections and increasing memorability. However, the quality of the VR experience is critical; high-quality graphics and seamless interactions are essential for maintaining positive consumer perceptions. Technical issues, such as lag and motion sickness, can negatively impact the experience, especially for those less acquainted with VR technology. Accessibility remains a challenge, with limited access to VR headsets restricting the reach of VR marketing campaigns. Personalization of VR content is highly valued, though it must be balanced with ethical considerations related to data privacy. The power of storytelling in VR enhances engagement by allowing consumers to actively participate in narratives. Social interaction within VR experiences adds an extra layer of enjoyment. The study also highlights the practical applications of VR marketing in high-involvement sectors and underscores the need for continuous innovation and consumer feedback to maximize the technology's impact. Overall, VR holds significant potential to transform marketing practices by offering immersive, engaging, and memorable experiences that deepen consumer connections and drive positive outcomes.

Chronic diseases (e.g., heart disease, cancer, diabetes) are of major public concern. Such chronic diseases are often caused by a dietary pattern characterized as relatively high in fat, refined sugar, salt, and cholesterol. Societal interest in consuming healthy foods and the demand for healthy food products has increased significantly. As a result, functional foods have gained significant research attention in the food health and technology innovations field. To date, many studies have investigated the factors that may predict consumer acceptance of functional foods, and a wide range of influential factors have been reported. However, studies conducted in different contexts pose challenges to gaining a clear understanding of the factors influencing consumer acceptance. This scoping review identified 75 articles published with varying populations around the globe that empirically investigated consumers’ acceptance of functional foods. We identified and categorized a wide range of determinants related to consumer acceptance of different types of functional foods. The five categories of determinants were product characteristics, socio-demographic characteristics, psychological characteristics, behavioral characteristics, and physical characteristics. Each of the determinants were more fully described by sub-determinants in our scoping review. These determinants should be considered and used by leaders and scientists in product development to aid decision making and, ultimately, the successful launch of novel functional foods.

The circular economy is an alternative paradigm whose purpose is the protection of the environment, the prevention of pollution and the growth of economic prosperity. This paper covers research which is qualitative in nature but has an exploratory scope through a documentary review, and includes proposals to promote sustainability. A more responsible consumption or use can be achieved by educating the user or consumer to return the product to production or repair through a collection service by way of reverse logistics (recovery of materials), followed by recycling or reuse of the product or its components to then offer these as recovered or recycled products on the market.

In this paper we develop a forecasting algorithm for recurrent patterns in consumer demand. We study this problem in two different settings: pull and push models. We discuss several features of the algorithm concerning sampling, periodic approximation, denoising and forecasting.

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

We report a case in which a 74-year-old man suffering from esophageal achalasia complicated with epiphrenic esophageal diverticulum was successfully treated with a simultaneous laparoscopic surgery. The gentleman was referred with symptoms suggestive of a passage disorder in lower esophagus from 5 years. Esophagogastroduodenoscopy demonstrated an epiphrenic diverticulum at the left wall of the lower esophagus, and esophagography led to the suspicion of a combined esophageal achalasia. A simultaneous laparoscopic surgery, with an abdominal approach was performed in which, following the opening of the esophageal hiatus, the diverticular wall was separated from the mediastinal organs and diverticulectomy was performed with linear staplers. After Heller’s myotomy, Dor’s fundoplication was subsequently performed in which both incisional line of muscle layer and the suturing line of diverticulectomy were wrapped by the fornix of stomach to make up for the wall strength and avoid the suture leakage. It was theoretically considered logical and effective to reinforce this vulnerable site with Dor’s fundoplication. He had an uneventful recovery and a rapid relief from symptoms following surgery.

Human detection from Unmanned Aerial Vehicles (UAV) is gaining popularity in the field of disaster management, crowd counting, people monitoring. Real time human detection from UAV is a challenging task, because of many constraints involved. This study proposes a system for real time detection of humans on videos captured from UAVs addressing three of these constraints namely, flying height, computation time and scale of viewing. The proposed method integrated an android application with a binary classifier based on Haar-features to automatically detect human / non-human class from UAV images. The video frames were parsed and detected humans from image frames were geo-localized and visualized on Google Earth. The performance was evaluated for geo-localization accuracy, computation time and detection accuracy, considering human coverage – pixel size relationship for various heights and scale factor. Based on flying height - human size relationship and tradeoff between detection accuracy vs computation time, the study came up with optimal parameters for OpenCV’s cv2.cascadeClassifier. detectMultiScale function. This paper establishes a strong ground for further research relating to real time human detection from UAV.

Background Cervical insufficiency, marked by recurrent painless cervix dilation leading to second-trimester pregnancy losses, is traditionally managed through cerclage placement and vaginal progesterone administration. However, a recent experimental approach targeted intra-amniotic inflammation or infection in a selected group of women with cervical dilation over 1 cm, intact membranes, and no uterine contractions in the second or third trimester. Case presentation We report a case of a 21 year old primigravid woman who experienced resolution of mid-trimester cervical insufficiency after the administration of triple antibiotic therapy, as confirmed by ultrasound monitoring. Remarkably, the patient successfully carried the pregnancy to term and delivered a healthy baby. Conclusions This case highlights the potential effectiveness of a novel combination of antibiotics, even in the presence of several high-risk pregnancy conditions, and underscores the possibility of a favorable outcome.

This qualitative study explores consumer responses to sustainable supply chains and green marketing strategies, aiming to uncover insights into consumer behavior, perceptions, and attitudes towards sustainability in the marketplace. Through semi-structured interviews and focus group discussions with 30 participants, the study examines key factors influencing consumer trust in green marketing claims, barriers to adopting sustainable products, generational differences in attitudes towards sustainability, and the impact of social media on consumer perceptions. Findings reveal that consumers value transparency and credibility in green claims, preferring products certified by trusted third parties and companies that demonstrate transparent supply chain practices. Higher pricing, concerns about product effectiveness, and limited availability emerged as significant barriers to consumer adoption of sustainable products, highlighting the need for cost competitiveness and increased market accessibility. Generational cohorts, particularly Millennials and Generation Z, exhibit strong inclinations towards sustainability-driven behaviors, shaping market trends towards ethical consumption practices. Social media plays a pivotal role in influencing consumer perceptions, disseminating information about sustainability, and fostering engagement with environmental issues. The study underscores the importance of clear communication, consumer education, and supportive regulatory frameworks in promoting sustainable consumption behaviors. Practical implications include recommendations for businesses to enhance transparency, innovate sustainable products, align with consumer values, leverage social media platforms, and advocate for regulatory measures that uphold environmental standards. By addressing these insights, businesses and policymakers can effectively meet consumer expectations and contribute to sustainable development goals in the global marketplace.

This qualitative study explores consumer perceptions of supply chain sustainability and its impact on buying decisions. Through in-depth interviews and focus groups, the research investigates the multifaceted factors influencing consumer behaviors towards sustainable products. Findings reveal that environmental impact, social responsibility, transparency, economic considerations, and cultural influences are pivotal in shaping consumer attitudes. While consumers express strong motivations to support sustainability, practical barriers such as higher costs and limited availability often hinder consistent adoption of sustainable practices. Effective communication strategies, including transparency reports and sustainability certifications, emerge as crucial in bridging the gap between consumer intentions and actions. The study underscores the importance of aligning corporate sustainability initiatives with consumer expectations to build trust and foster sustainable consumption patterns. Insights suggest a need for targeted interventions and policy measures to address barriers and promote broader adoption of sustainable behaviors. By understanding and responding to consumer concerns, businesses can enhance their sustainability strategies and contribute to a more environmentally and socially responsible marketplace.

This qualitative study explores consumer perceptions of ethical supply chains and their implications for brand loyalty in contemporary markets. Ethical supply chain practices, encompassing sustainability, transparency, and social responsibility, are increasingly pivotal in shaping consumer attitudes and behaviors. A semi-structured interview approach was utilized to gather insights from a diverse sample of consumers, revealing nuanced perspectives on how ethical considerations influence brand preferences and loyalty. Findings indicate that consumers value brands that demonstrate genuine commitment to ethicality, viewing transparency and accountability in supply chain operations as essential for building trust and credibility. Emotional responses such as admiration and respect were commonly associated with brands perceived as ethical, highlighting the emotional resonance of ethical supply chain practices in consumer decision-making processes. Challenges such as greenwashing and perceived discrepancies between brand promises and actions underscore the importance of authentic communication in aligning consumer perceptions with brand behaviors. The COVID-19 pandemic further emphasized the role of ethical supply chains in ensuring business resilience and consumer trust during global disruptions. Brands that exhibited ethical leadership during the crisis reinforced their reputational capital and strengthened relationships with ethically conscious consumers. This study contributes to understanding the strategic imperative for businesses to integrate and communicate ethical supply chain practices effectively, thereby fostering sustainable competitive advantages and enhancing long-term brand loyalty. Future research directions include exploring evolving consumer expectations, emerging ethical challenges, and innovative strategies for embedding ethicality into supply chain management.This qualitative study explores consumer perceptions of ethical supply chains and their implications for brand loyalty in contemporary markets. Ethical supply chain practices, encompassing sustainability, transparency, and social responsibility, are increasingly pivotal in shaping consumer attitudes and behaviors. A semi-structured interview approach was utilized to gather insights from a diverse sample of consumers, revealing nuanced perspectives on how ethical considerations influence brand preferences and loyalty. Findings indicate that consumers value brands that demonstrate genuine commitment to ethicality, viewing transparency and accountability in supply chain operations as essential for building trust and credibility. Emotional responses such as admiration and respect were commonly associated with brands perceived as ethical, highlighting the emotional resonance of ethical supply chain practices in consumer decision-making processes. Challenges such as greenwashing and perceived discrepancies between brand promises and actions underscore the importance of authentic communication in aligning consumer perceptions with brand behaviors. The COVID-19 pandemic further emphasized the role of ethical supply chains in ensuring business resilience and consumer trust during global disruptions. Brands that exhibited ethical leadership during the crisis reinforced their reputational capital and strengthened relationships with ethically conscious consumers. This study contributes to understanding the strategic imperative for businesses to integrate and communicate ethical supply chain practices effectively, thereby fostering sustainable competitive advantages and enhancing long-term brand loyalty. Future research directions include exploring evolving consumer expectations, emerging ethical challenges, and innovative strategies for embedding ethicality into supply chain management.

This study aims to analyze various types of pellet fuels used as energy sources in Bulgaria, focusing on their energy characteristics and the consumer preferences. Both standard and specialized methods such as thermogravimetry (TG) and differential scanning calorimetry (DSC) are used for the analyses. The results from TG and DSC indicate that during the drying of the samples, moisture is evaporated from their surface, along with the release of volatile substances. The processes during the analysis are accompanied by energy absorption, with the main stage being combustion, where the primary amount of heat is generated. Standard analysis methods show that wood pellets usually contain about 7.31% moisture, 0.72% ash and have a calorific value of 18.33 kJ/kg, while sunflower pellets contain about 7.62% moisture, 2.42% ash and have a calorific value of 19.63 kJ/kg. Mixed pellets contain about 7.07% moisture, up to 0.69% ash and have a calorific value of 18.05 kJ/kg. A specialized marketing research was conducted to investigate consumer attitudes and preferences toward purchasing different types of solid biomass fuels on Bulgarian market. This study provides information on the quality of pellets as fuel by offering a detailed analysis of their fuel properties and ensuring their effective utilization as an energy source.

Previous research on consumer perceptions of salmon has often neglected Indigenous rights within the Canadian salmon industry. This study acknowledges the decline in salmon farm licenses in British Columbia and aims to achieve three main objectives: (1) gain a comprehensive understanding of four consumer perceptions—environmental sustainability, economic considerations, Indigenous rights, and price increase—across diverse consumer profiles through a cross-national online survey; (2) identify factors influencing these four consumer perceptions; and (3) assess the impact of these perceptions, along with socio-demographic variables and consumer motivations, on seven purchasing behaviors related to Canadian salmon products. Data analysis employs the graded response model and cumulative link models. The results illustrate how consumer profiles influence the four perceptions and their key determinants. Additionally, the study quantifies the impact of environmental sustainability, economic considerations, Indigenous rights, and a price increase on consumer purchasing behaviors.

This study uses the social impact theory to analyse consumer behaviour amidst Covid-19. Fear of scarcity has changed consumer buying behaviour in crisis times such as the now abating global health crisis – i.e., Covid-19. The study asserts that the existing five-stage model of consumer purchasing decisions does not fit neatly in turbulent times. It proposes a shortened four-stage process of need recognition, purchase, ownership and satisfaction as a better and more adaptable fit. Cutting out information search and evaluation of alternatives in the old model, and replacing these with ownership, is where the main contribution of the study lies. The study has implications for managing the marketing mix as we know it. It asserts that not all the 4Ps of the marketing mix are important in crisis times.

Electronic Word of Mouth (eWOM) has been widely used by the majority of consumers in different digital platforms. This exploratory study was conducted with the aim to get further insights about online consumer behavior through social networking sites and online reviews sites in order to help tourism businesses develop sustainable eWOM strategies. In order to carry out this objective, an exploratory study has been developed to analyze the existing literature of eWOM strategies and online consumer behavior. The systematic literature review analysis establishes two main topics: (i) tourism (ii) eWOM. The scientific database of Web of Science has been used to collect relevant literature of the subject matter. The search term “Tourism” and “eWOM” were applied. The database of Web of Science produced a total of 124 articles and with the different filters applied during the PRISMA 2009 Flow diagram the process resulted in a selection of 13 studies. The results of the research will provide a broader knowledge for scholars of social sciences and businesses for adopting sustainable strategies of the increasing influence of eWOM in tourism.

The craft beers are outlined as a distinctively flavored, brewed and distributed regionally, using top-fermenting (ale) yeast, bottom-fermenting (lager) yeast or spontaneously fermentation. Craft beers are largely consumed and produced in Brazil and presents great level of polyphenols, which would affect the consumer’s preference. In this way, we analyzed the relation between polyphenols, bitterness and composition of main different styles of craft beers and the consumer´s preference. Six different styles were analyzed according its polyphenol content, bitterness, chemical composition, sensory profile and preference. For preference, a panel with 62 non-trained assessors was used. For sensory profile, the quantitative descriptive analysis was performed, using expert assessors (n = 8). The preferred style was Classic American Pilsner and the style less preferred was Standard American Lager. The craft beer more preferred showed a decreased bitterness (9.52), polyphenol content (0.61 mg EAG/mL), total solids (6.75 ºBrix) and turbidity (7.27 NTU). This beer exhibited reduced sensory notes of malty, fruity, smoked, hoppy and phenolic, but a higher perception of floral, sweet and yeast notes. The bitter attribute has a reduced perception. This study advances understanding the sensory profile and complexity of craft beers styles from Southern Brazilian.

Coronavirus disease 2019 (COVID-19) has affected medical practice. More than 7,000,000 patients died worldwide after being infected with COVID-19; however, no specific laboratory markers have yet been established to predict death related to this disease. In contrast, electrocardiographic changes owing to COVID-19 include QT prolongation and ST-T changes; however, there have been no studies on ambulatory electrocardiographic markers of COVID-19. We encountered three patients diagnosed as having COVID-19 who did not have a prior history of significant structural heart diseases. All had abnormalities in ambulatory echocardiogram parameters detected by high-resolution 24-h electrocardiogram monitoring: positive late potentials (LPs) and T-wave alternans (TWA), abnormal heart rate variability (HRV), and heart rate turbulence (HRT). Case 1 involved a 78-year-old woman with a history of chronic kidney disease, Case 2 a 76-year-old man with hypertension and diabetes, and Case 3 a 67-year-old man with renal cancer, lung cancer, and diabetes. None of them had a prior history of significant structural heart disease. Although no significant consistent increases in clinical markers were observed, all three patients died, mainly because of respiratory failure with mild heart failure. LP, TWA, HRV, and HRT were all positive in three cases with no significant structural cardiac disease at the initial phase of admission. There is a possibility that LP, TWA, HRV, and HRT have the potential to be risk stratifiers of COVID-19 pneumonia in the early phase of admission. Further accumulation of data regarding ambulatory electrocardiographic markers in patients with COVID-19 is needed.

Thin people who undergo implant insertion into the chest wall face a high risk of implant exposure to the external environment. Five months after an 8-year-old boy underwent implantable cardioverter-defibrillator (ICD) implantation in a subcutaneous pocket in the left anterolateral chest wall to manage long QT syndrome, ICD replacement became necessary owing to exposure risk from distal and lateral thinning of the ICD pocket. Pocket rupture and exposure would increase the risk of infection; therefore, we performed ICD removal and primary pocket closure. Two weeks later, a new suprafascial pocket was created, acellular dermal matrix (ADM) was attached to the inner wall to prevent ICD protrusion, and a new ICD was inserted. One year postoperatively, the ADM was engrafted, and no complications were observed. A thin subcutaneous layer increases the risk of ICD implantation complications. Inner wall strengthening with ADM can help prevent pocket rupture.

Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is an extremely rare type of vasculitis characterized by inflammation within small blood vessels or tissues that may cause damage to the lungs, heart, kidneys, and other organs. Here, we present a rare case of EGPA with cardiac involvement that presented with acute heart failure. Clinical findings: A 44-year-old woman with a history of bronchial asthma and sinusitis pre-sented with fever, shortness of breath, fatigue, unintentional weight loss, and polyarthritis. Physical examination revealed a fine basal crepitation and mononeuritis multiplex. Diagnosis: The peripheral film revealed dimorphic features, an elevated eosinophil count, low hemoglobin (Hb), and abnormally high lactate dehydrogenase levels. The cardiac enzyme levels were elevated upon admission. Cardiac magnetic resonance imaging (CMR) revealed global hypokinesia and features suggestive of myocarditis. Echocardiography showed a low ejection fraction of 25%. Thus, the patient diagnosed with EPGA and myocarditis presented with acute heart failure. Interventions: The patient was administered high-dose corticosteroids (intravenous bolus methylprednisolone 500 mg for three days, followed by 1 mg/kg of prednisolone) and cyclo-phosphamide 750 mg intravenously. Outcome: After one months, the patient showed a marked improvement in clinical and labora-tory parameters. The ejection fraction improved to 30-40%, the eosinophil count returned to normal, and the hemolytic anemia resolved. The patient was sent home with mycophenolate mofetil 1 g twice a day as maintenance therapy. Conclusion: Patients with EGPA have a higher morbidity and mortality rate when they have cardiac in-volvement. The pathophysiological mechanism of cardiac involvement in EGPA warrants con-sideration of immunosuppressive therapy in addition to standard heart failure treatment.

This study investigates the influence of digital marketing on consumer purchasing decisions, focusing on how various strategies impact consumer behavior. By analyzing data collected from in-depth interviews and thematic analysis, the research highlights several key factors driving consumer engagement and purchases. Personalized content emerged as a significant factor, with tailored recommendations and customized email campaigns creating a sense of individual attention and enhancing consumer involvement. Social media platforms played a pivotal role, with advertisements, influencer endorsements, and user-generated content significantly affecting purchasing decisions. The impact of visual content, including high-quality images and videos, was also notable, as these elements helped consumers better understand products and increased their confidence in making purchases. Email marketing proved effective, particularly when offering exclusive discounts and creating a sense of urgency. Mobile marketing demonstrated its growing influence, with consumers valuing the convenience of mobile-friendly websites and app notifications. The integration of artificial intelligence further improved the shopping experience by providing instant assistance and personalized recommendations. Ethical considerations, such as data privacy and honest advertising, were essential for maintaining consumer trust and loyalty. User-generated content provided authentic insights that influenced purchasing decisions, while omnichannel strategies offered a seamless and flexible shopping experience. Gamification elements, including reward programs and interactive challenges, enhanced consumer engagement and motivation. The study concludes that a multifaceted approach to digital marketing, incorporating these strategies, is crucial for effectively engaging consumers and driving sales. The findings offer valuable insights for marketers aiming to optimize their digital marketing strategies in the evolving digital landscape.

The article proposes a mathematical model for creating playlists based on the emotional utility of the consumer, aiming to maintain high user interest in music streaming platforms (Lugos Abarca, 2024). The proposed method follows these steps: first, it calculates the MEEPE of Songs on the digital platform; subsequently, it quantitatively defines the Consumer's MEEPI before exposure to music; then, it operates the MEEPE of the Songs with the consumer's initial MEEPI using the known resolution process (Lugos Abarca, 2023); finally, it employs an emotional utility function to determine possible levels of emotional satisfaction and establish the playback order. This results in the creation of an efficient theoretical model. It is recommended to expand the computational study of the model in future research by using a broader set of songs and considering various initial MEEPI of the consumer. The article's originality lies in its ability to predict, quantitatively and theoretically, the level of satisfaction a music consumer could experience when listening to a playlist.

Industries are required to utilize treatment technologies to reduce contaminants in wastewater prior discharge and valorize by-products to increase sustainability and competitiveness. Most acid leaching gypsum purification studies have obviated the treatment of the highly acidic wastewater produced. In this work, acidic wastewater from acid leaching purification of post-consumer gypsum was treated to recover a valuable solid product and reusable water. The main aims of this work were to determine the impact of recirculating acidic and treated wastewaters on the efficiency of the acid leaching purification process and to valorize the impurities in the wastewater. Samples were characterized through X-ray fluorescence and X-ray diffraction. SimaPro 9.5 and ReCiPe 2016 midpoint method were used for the life cycle assessment of three wastewater management approaches. The reuse of the acidic wastewater did not improve the chemical purity of gypsum. Soluble impurities were precipitated at pH 10.5 as a magnesium-rich gypsum that could be commercialized as fertilizer or soil ameliorant. The alkaline treated water was reused for 6 acid leaching purification cycles without impacting the efficiency of the purification process. An acid leaching-neutralization-filtration-precipitation approach demonstrated superior overall environmental performance. Barriers and enabling measures for the implementation of an in-house wastewater treatment were identified.

Most buying decisions are affected by the customer's analysis of the advantages and disadvantages of the product and its emotional aspects. Psychological and marketing studies have confirmed the role of customer emotions in various stages of the purchasing process. The present study aims to identify the dimensions and factors that potentially influence customer emotions in buying luxury cosmetics. First, in order to identify the various aspects of customer emotions, a qualitative study was conducted using in-depth semi-structured interviews with 23 customers of luxury cosmetics and health products in Telegram groups. This study led to the identification of various dimensions of customer emotions and a list of factors that potentially act as antecedents of emotions in the target population. In the next step, based on group consensus, the antecedents affecting customer emotions were determined. The members of the panel at this stage included 15 specialists and experts in the fields of marketing, psychology, companies importing luxury cosmetics and hygiene products which are active in online networks, as well as managers of luxury cosmetics and hygiene groups in online spaces. The consensus of experts was reached in three stages and 36 factors affecting customers' emotions were determined and ranked based on the relevance or strength of the perceived effect from the point of view of experts. Finally, they were classified into three categories as group and product variables, situational variables, and individual variables.

Four discrete models using the exact spectral derivative discretization finite difference (ESDDFD) method are proposed for a chaotic five-dimensional, conformable fractional derivative financial system incorporating ethics and market confidence. Since the system considered was recently studied using the conformable Euler finite difference (CEFD) method and found to be hyperchaotic, and the CEFD method was recently shown to be valid only at fractional index , the source of the hyperchaos is in question. Through numerical experiments, illustration is presented that the hyperchaos previously detected is in part an artifact of the CEFD method as it is absent from the ESDDFD models.

Post-industrial recycling (PIR) and post-consumer recycling (PCR) are measures to sustain re-sources by improving materials’ circularity and sustainability. Currently, circularity is mostly measured as the degree of reutilization of a material from 0 to 100 % at product or company lev-el. This lacks in assessing the resources’ usage over multiple product life cycles. Therefore, we propose to assess circularity as (i) the frequency resources are used in products (effective circu-larity eC) and (ii) a vehicle to reduce virgin resource use and environmental impacts (environ-mentally efficient circularity eeC). Besides, to compare the environmental impacts of using recy-cled materials from PIR or PCR, we analyse their impact reduction potential (IRP) indicating the environmental benefits of recycling in relation to virgin material put onto the market. We demonstrate the suggested indicators for a case study material: polypropylene. For this polymer type, the eC ranges between 0.93 and 9.08 uses of the resource on average depending on collec-tion, sorting, and recycling rates. Likewise, the eeC ranges between 0.31 and 1.50 uses per kg of CO2 equivalents emitted. PCR has a higher IRP regarding climate change impacts than PIR in all analysed scenarios. The results reveal the relevance of PCR and PIR beyond the product life cycle.

Obtaining classification confidence at the pixel level is a challenging task for accuracy assessment in remote sensing image classification. Among the various methods for estimating classification confidence at the pixel level, interpolation-based methods have drawn special attention in the literature. Even though they have been widely recognized in the literature, their usefulness has not been rigorously evaluated. This paper conducts a comprehensive evaluation of three interpolation-based methods: local error matrix method, bootstrap method, and geostatistical method. We applied each of the three methods to three representative datasets with different spatial resolutions, spectral bands, and the number of classes. We then derive the estimated classification confidence and true classification confidence and compared the results with each other using both exploratory data analysis (bi-histogram) and statistical analysis (Willmott's d and Binned classification quality). The results indicate that the three interpolation methods provide some interesting insights on various aspects of estimating per-pixel classification confidence. Unfortunately, the interpolation assumes that classification confidence is smooth across the space, which is usually not true in practice. In other words, interpolation-based methods have limited practical use.

We describe an interesting case report about a patient with hemophilia A with severe chronic elbow arthropathy who underwent multiple surgical because of his condition. We collected all the clinical and imaging findings, and we compared the decision-making flow chart and the surgery performed with the most recent indications, treatments and complications reported in the literature. The aim of this case report is to show how usually the hemophilic patient even if young usually comes to our attention from the beginning with complex and advance musculoskeletal disease. Elbow hemophilic arthropathy is a complex disease and the management in these patients could be more difficult than others because of the higher risk of complications rate after all surgical procedures, for this reason it’s very important to treat these patients in hub centers with expertise in well-coordinated multidisciplinary teams. The path from diagnosis to surgical treatment of hemophilic elbow arthropathy can be a risky one, as it happened in this case.

Consumer trust in supply chain certifications plays a pivotal role in shaping contemporary consumer behavior and marketing effectiveness. This qualitative research investigates consumer perceptions of supply chain certifications and their impact on purchasing decisions and brand loyalty. Through semi-structured interviews and focus group discussions with 30 participants, the study explores themes such as credibility, transparency, perceived value, and the influence of certifications on consumer trust. Findings reveal that consumers value certifications that signal ethical sourcing practices and sustainability commitments, viewing them as assurances of product quality and social responsibility. Credibility and transparency in certification processes emerged as critical factors influencing consumer trust, while perceived benefits such as environmental sustainability and fair labor practices positively influenced purchase intentions. Moreover, certifications were found to enhance brand loyalty by aligning with consumers' ethical values and beliefs. However, the study identifies challenges including high certification costs, complexity in compliance, and consumer skepticism, which hinder broader adoption and effectiveness of certifications. The implications of these findings suggest that businesses can enhance consumer trust and market competitiveness by investing in rigorous certification standards, clear communication strategies, and sustainable practices. Addressing barriers through improved transparency and consumer education is crucial for maximizing the impact of certifications on ethical consumption. Future research directions include longitudinal studies on certification impacts and comparative analyses across industries and global markets to further enrich understanding of consumer behavior and certification influences.

We follow the PRISMA extension for scoping reviews to review the emerging international body of empirical evidence on consumers’ attitudes and willingness to pay (WTP) for novel foods produced with New Plant Engineering Techniques (NPETs). NPETs include genome/gene editing, cisgenesis, intragenesis, RNA interference and others. These novel foods are often beneficial for the environment and human health and more sustainable under increasingly prevalent climate extremes. These techniques can also improve animal welfare and disease resistance when applied to animals. Despite these promising attributes, evidence suggests that many, but not all, consumers discount these novel foods relative to conventional ones. Our review sorts out findings to identify conditioning factors that can increase the acceptance of and WTP for these novel foods in a significant segment of consumers. International patterns of acceptance are identified. We also analyze how information and knowledge interact with consumer acceptance of these novel foods and technologies. Heterogeneity of consumers—across cultures and borders and in attitudes towards science and innovation—emerges as a key determinant of acceptance and WTP. Acceptance and WTP tend to increase when socially beneficial attributes—as opposed to producer-oriented cost-saving attributes—are generated by NPETs. NPET-improved foods are systematically less discounted than transgenic foods. Most of the valuation estimates are based on hypothetical experiments and surveys and await validation through revealed preferences in actual purchases in food retailing environments.

High levels of meat consumption are increasingly being criticised for ethical, environmental, and social reasons. Plant-based meat substitutes have been identified as healthy sources of protein that, in comparison to meat, offer a number of social, environmental and health benefits and may play a role in reducing meat consumption. However, there has been a lack of research on the role they can play in the policy agenda and how specific meat substitute attributes can influence consumers to replace partially replace meat in their diets.

Commercial sleep devices and mobile-phone applications for scoring sleep are gaining ground. In order to provide reliable information about the quantity and/or quality of sleep, their performance needs to be assessed against the current gold-standard, i.e. polysomnography (PSG; measuring brain, eye and muscle activity). We here assessed some commercially available sleep trackers, namely; a commercial activity tracker: Mi band (Xiaomi, BJ, CHN), a scientific actigraph: Motionwatch 8 (CamNTech, CB, UK), and a much used sleep application: Sleep Cycle (Northcube, GOT, SE). We recorded 27 nights in healthy sleepers using PSG and these devices. Surprisingly, all devices had very poor agreement with the gold standard. Sleep parameter comparisons revealed that specifically the Mi band and the sleep cycle application had difficulties in detecting wake periods which negatively affected the total sleep time and sleep efficiency estimations. However, all 3 devices were good in detecting the most basic parameter, the actual time in bed. In summary, our results suggest that, to-date; available sleep trackers do not provide meaningful sleep analysis but may be interesting for simply tracking times in bed. A much closer interaction with the scientific field seems necessary if reliable information shall be derived from such devices in the future.

Breast cancer remains a significant health concern worldwide, necessitating early detection and treatment. The rapid appearance or a change in the shape of skin lesion on the breast or just of the nipple-areola complex(NAC), especially if it is unilateral needs to be evaluated. Several primary or secondary tumours such as inflammatory skin lesions can affect this body area. Ultrasound, mammography, or magnetic resonance imaging (MRI) are the most used non-invasive diagnostic techniques for breast cancer, but in recent years reflectance confocal microscopy (RCM) and optical coherence tomography have emerged as additional tools to diagnose cases characterized by cutaneous changes.The introduction of new techniques such as reflectance confocal microscopy (RCM), may open new perspectives in the non-invasive diagnosis of mammary paget disease (MPD). RCM is a non-invasive diagnostic technique that allows high-resolution images of the skin at microscopic level in real time. It is non-invasive, painless and repeatable, making it a valuable tool in the early diagnosis and monitoring of skin diseases. We describe an atypical clinical presentation of mammary paget disease early diagnosed by reflectance confocal microscopy evaluation.

As a mediator variable, self-confidence is one of the most effective elements of the decision-making process of consumer behaviour. This research has studied the effects of different aspects of consuming fashion on the self-confidence and behaviour of consumers in Tehran’s clothing market. This study has considered the acceptance of new products, interest in mode and fashion, utilitarianism, and personal taste in its analysis. This research aims to understand the fashion buying behaviour amongst Iranian consumers in consideration of their attitude towards self-confidence and aspects of fashion consumption. The statistic sample is 400 consumers from Tehran’s clothing market who have been chosen based on the random availability procedure. The primary tool in this research was a questionary used to testify the assumptions and a model fit created by using structural equations and factor analysis. This research showed that the interest in mode and fashion, personal taste, utilitarianism, and new products positively impact self-confidence. In addition, the positive impact of self-confidence on fashion buying behaviour was confirmed.

In this paper, we define the consumer preference relation from scratch. We study algebraic and topological properties for the preference magma that reflects the consumer. We also consider the influence of society on an individual's preference.

This study examines the factors influencing consumer adoption of on-demand social media platforms characterized by ephemeral content. As these platforms rapidly gain popularity, understanding adoption drivers is crucial for researchers and practitioners. The study develops and tests a comprehensive model integrating traditional technology acceptance factors with platform-specific constructs. Using partial least squares structural equation modelling on data from 180 social media users in Kerala, India, the research reveals that convenience is the strongest predictor of adoption intention, followed by perceived usefulness, interpersonal influence, and enjoyment. Surprisingly, factors like perceived ease of use, social influence, and platform-specific features such as ephemerality and visual focus did not significantly impact adoption directly. Age showed a marginal negative effect, while gender had no significant impact. The findings challenge some prevailing assumptions about on-demand social media adoption and highlight the need for refined models specific to this context. The study contributes to technology adoption literature by demonstrating the primacy of convenience in driving the adoption of these platforms. It also offers practical insights for developers and marketers, suggesting that prioritizing convenience and perceived usefulness in design and marketing may be more effective than emphasizing specific features. Future research directions are proposed to address limitations and further explore this evolving digital landscape.

The objective of this research is to propose a utility function that calculates the possible level of satisfaction that a music consumer would achieve after listening to a song according to the emotional response obtained from a song. Assuming that the consumer's musical preferences are satisfied if the predominant emotions of his current emotional state increase; the probabilistic emotional-musical model (Lugos Abarca, 2023) is used to construct such a utility function. By posing a hypothetical scenario, realistic results were obtained, which guarantee, in principle, its use in theoretical practice. The originality of this research lies in proposing a mathematical tool to study, quantitatively, the decision making of a musical consumer influenced by his emotions. The main conclusion being its importance in the music industry, since the function could predict, theoretically, whether a song will be accepted or rejected by the consumer in comparison with the competition.