Background: The effect of velamentous cord insertion (VCI) on perinatal outcomes in twin pregnancies is unclear due to conflicting findings. This retrospective study aimed to examine VCI prevalence and related risk factors in twin pregnancies and its association with adverse perinatal outcomes. Methods: Women with twin pregnancies who delivered between January 2012 and December 2021 in a single tertiary hospital were included. The participants were divided into dichorionic (DC) and monochorionic diamniotic (MCDA) groups, and their maternal and fetal characteristics and VCI rates were compared. Logistic regression models were used to identify risk factors for VCI and VCI-related perinatal outcomes. Results: Among the 694 twin pregnancies included in this study, the VCI rate was significantly higher in MCDA than in DC twins. Body mass index and MCDA twins were significant risk factors for VCI, whereas assisted reproductive technology pregnancy was a significant protective factor against VCI. In DC twins, VCI did not affect perinatal outcomes. Conclusion: In MCDA twins, VCI was a significant risk factor for fetal growth restriction, twin-to-twin transfusion syndrome, and preterm birth at

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

This research presents the Cross-Cultural Intelligent Language Learning System (CILS), a novel approach integrating Artificial Intelligence (AI) into language education to enhance cross-cultural communication. CILS utilizes advanced AI technologies to provide adaptive, personalized learning experiences that cater to the unique linguistic and cultural backgrounds of each learner. By dynamically adjusting content and methodology, CILS significantly improves linguistic proficiency and cultural understanding, essential for effective global interactions. The implementation of CILS in platforms such as Busuu and HelloTalk has demonstrated marked improvements in engagement and communication skills among learners. Empirical studies validate the system's effectiveness in real-world settings, showing enhanced learner performance and increased intercultural competence. Additionally, the Technology Acceptance Model (TAM) applied confirms that the usability and perceived usefulness of AI-driven systems strongly influence learner acceptance and sustained use. This study not only underscores the potential of AI in transforming language education but also highlights the critical role of cultural sensitivity in designing educational technologies.

Oedaleus decorus asiaticus, Calliptamus abbreviatus, Angaracris rhodopa, and Myrmeleotettix palpalis are the main grasshoppers that harm the natural grassland in the Hexi Corridor. In this study, the MaxEnt model was employed to identify the key environmental factors affecting the distribution of the four grasshoppers habitats and to assess their distribution under current and future climate change conditions. The aim was to provide a basis for grasshopper monitoring, prediction, and precise control. In this study, 61 occurrences of O. decorus asiaticus, 68 occurrences of A. rhodopa, 58 occurrences of C. abbreviatus, and 92 occurrences of M. palpalis were recorded by GPS, and the distribution of suitable habitats for O. decorus asiaticus, C. abbreviatus, A. rhodopa, and M. palpalis were predicted under current and future climatic scenarios using a MaxEnt model. The average AUC and TSS values of the four grasshoppers were greater than 0.9, and the simulation results were excellent and highly reliable. The mean annual precipitation was the main factor limiting the current range of suitable areas for these four species. Under the current climate, O. asiaticus, C. abbreviatus, and A. rhodopa were mainly distributed in the central and eastern parts of the Hexi Corridor, and M. palpalis was distributed throughout the Hexi Corridor, with a potential distribution area of 1.44×104, 1.43×104, 1.29×104, and 2.12×104 km2, accounting for 15.3, 15.2, 13.7, and 22.5% of the total area of the grasslands in the Hexi Corridor, respectively. The highly suitable areas of O. asiaticus, C. abbreviatus, and A. rhodopa were mainly distributed in the east-central part of Zhangye City, the western part of Wuwei City, and the western and southern part of Jinchang City, with areas of 0.35×104, 0.29×104, and 0.20×104 km2, accounting for 3.7, 3, and 2.2% of the grassland area, respectively. The high habitat of M. palpalis was mainly distributed in the southeast of Jiuquan City, the west, middle, and east of Zhangye City, the west of Wuwei City, and the west and south of Jinchang City, with an area of 0.32×104 km2, accounting for 3.4% of the grassland area. In the 2030s, the range of O. asiaticus, C. abbreviatus, A. rhodopa, and M. palpalis was predicted to decrease.

Cross-cultural mobility is a phenomenon that is increasingly growing, and the resulting stress has become a severe health issue. Thus, we conducted a systematic review of articles reporting research on stress measures of cross-cultural mobility or acculturative stress, emphasizing its internal structure. We adopted the PRISMA procedures for scoping reviews (e.g., searching articles in databases), resulting in the inclusion 20 articles in the final analysis that present evidence of validity based on the internal structure of 16 measures. The most common factors identified were related to cultural stressors, language stressors, and discrimination stressors. After analyzing a cross-cultural mobility stress concept implicit in the definitions used in the articles, we found that most measures of acculturative stress did not evaluate it according to the Stress and Coping Model of Lazarus and Folkman. Most measures only focused on part of the phenomena (some estimated the stressors, others the coping strategies). Few took into account the physiological and psychological responses to internal or external stressors, and even fewer considered its positive aspects (eustress). Consequently, it is pivotal to develop measures that take into account the multiple dimensions of the cross-cultural mobility stress. Other results (e.g., validity evidence of the measures) and limitations of this systematic scoping review are presented and discussed.

Introduction: It has long been accepted that trauma is one of the most important and frequent predisposing factors for onychomycoses . However, the role of direct trauma in the pathogenesis of fungal nail infections was only recently been elucidated in a series of 32 cases of post-traumatic single-digit onychomycosis. The importance of repeated trauma due to foot and toe abnormalities was rarely investigated.Aim of the study: This is a multicenter single-author observational study over a period of 6 years performed at a specialized nail clinic in three countries. All patient photographs taken by the author during this period were screened for toenail alterations and all toe onychomycosis cases were checked whether they contained enough information to evaluate potential foot and toe abnormalities. Particular attention was paid to the presence of hallux valgus, hallux valgus interphalangeus, hallux erectus, inward rotation of the big toe and outward rotation of the little toe, as well as splay foot. Only cases with unequivocal proof of fungal nail infection by either histopathology, mycologic culture or polymerase chain reaction (PCR) were accepted.Results: Of 1653 cases, 185 were onychomycoses proven by mycologic culture, PCR or histopathology. Of these, 179 involved at least one big toenail, 6 affected one or more lesser toenails. Three patients consulted us for another toenail disease and the onychomycosis was diagnosed as a second disease. Eight patients had a pronounced tinea pedum. Relatively few patients had a normal big toe position (n = 9). Most of the cases had a mild to marked hallux valgus (HV) (105) and a hallux valgus interphalangeus (HVI) (143), hallux erectus was observed in 43 patients, the combination of HV and HVI was observed 83 times. Discussion: The very high percentage of foot and toe deformations was surprising. It may be hypothesized that this is not only a pathogenetically important factor but may also play an important role for the localization of the fungal infection as no marked hallux deviation was noted in onychomycoses that affected the lesser toes only. As the management of onychomycoses is a complex procedure involving the exact diagnosis with determination of the pathogenic fungus, the nail growth rate, the type of onychomycosis, its duration and predisposing factors, anomalies of the toe position may be important. Among the most commonly mentioned predisposing factors are peripheral circulatory insufficiency, venous stasis, peripheral neuropathy, immune deficiency and iatrogenic immunosuppression whereas foot problems are not given enough attention. Unfortunately, many of these predisposing and aggravating factors are difficult to treat or to correct. Generally, when explaining the treatment of onychomycoses to the patients, the importance of these orthopedic alterations is not or only insufficiently discussed. In view of the problems encountered with the treatment of toenail mycoses, this attitude should be changed in order to make the patient understand why there is such a low cure rate despite excellent minimal inhibitory drug concentrations in the laboratory.

Bartonella species, intracellular parasitic zoonotic pathogens, has drawn increasing attention for their diverse host range and associated human diseases. This study investigates Bartonella infection in small mammals in Yunnan Province, China, focusing on tissue tropism. 333 small mammals were sampled from 13 species, 3 orders, 4 families, and 4 genera in Heqing and Gongshan Counties. Conventional PCR and real-time quantitative PCR (qPCR) were utilized for detection and quantification, followed by bioinformatic analysis of obtained DNA sequences. Results show a 31.5% detection rate, varying across species. Notably, Apodemus chevrieri, Eothenomys eleusis, Niviventer fulvescens, Rattus tanezumi, Episoriculus leucops, Anourosorex squamipes, and Ochotona Thibetana exhibited infection rates of 44.4%, 27.7%, 100.0%, 6.3%, 60.0%, 23.5%, and 22.2%, respectively. Genetic analysis identified 30, 10, and 5 strains based on ssrA, rpoB, and gltA genes, with nucleotide identities ranging from 92.1% to 100.0%. Bartonella strains were assigned to B. grahamii, B. rochalimae, B. sendai, B. koshimizu, B. phoceensis, B. taylorii, and a new species identified in the Episoriculus leucops (GS136). Tissue distribution analysis revealed varied copy numbers across different tissues, with the highest load in spleen. These findings underscore Bartonella's diverse species and host range in Yunnan Province, highlighting its broad tissue tropism in small mammals.

The concept of sustainable management in culture has been recognised in global strategic documents on sustainable development for more than a decade. It is also increasingly reflected in the cultural polices of particular states, and – very importantly –cultural managers responsible for shaping the cultural offer in cities are becoming more interested in this concept. Despite the increasing attention being paid to this topic among both practitioners and theoreticians of management, in none of these documents or other works can we find any content directly related to the possibility of applying this concept in a town which, due to political turmoil, has been divided by a national border. Hence, this gap was the direct impulse for taking up research in this field. In the article, by using different notions of the market, our own definition of a cross-border market for cultural services was developed, and the conditions for the functioning of this market were presented based on the example town of Cieszyn (Poland) and Český Těšín (Czech Republic). In the opinion of the authors of the article, the development and functioning of a cross-border market for cultural services is essential for the application of the concept of sustainable management of the cultural offer in a town divided by a border. For the purpose of the article, a survey and individual interviews with experts shaping the cultural offer in Cieszyn and Český Těšín were conducted. The results of the research prove that despite numerous cross-border Czech-Polish projects carried out by cultural institutions, there are still many barriers in the town which make it difficult for the residents to benefit from the cultural offer available on the other side of the border. These barriers limit the full implementation and application of the concept of sustainable management of the cultural offer.

Hard tissue apposition along the root canal walls is a slow, normally occurring physiological aging process. In response to tooth wear, local deposition of hard tissue may also occur in the pulp at a slow pace. Sometimes, the rate of hard tissue deposition acceleration may seem to be uncontrolled after dental trauma, autotransplantation, and orthodontic therapy, leading to rapid partial or total obliteration of the root canal space. This situation is called calcific metamorphosis (CM) or pulp canal obliteration (PCO). Although the incidence of pulpal necrosis in these teeth is believed to be infrequent, conventional endodontic therapy in severely calcified canals poses extreme difficulties and a higher risk for procedural accidents. This article aims to review the available approaches for the predictable negotiation of calcified canals and to introduce the buckling resistance activation test (BRAT) technique.

This ethnographic study investigates the cross-cultural challenges encountered in global supply chains, focusing on communication barriers, diverse business practices, trust-building, ethical and legal standards, and cultural competence. By embedding within the day-to-day operations of multinational corporations and conducting in-depth interviews with supply chain professionals, the research provides a nuanced understanding of the cultural dynamics that impact global supply chain management. The findings highlight that effective communication goes beyond language proficiency, requiring an understanding of varying communication styles and contextual nuances. Business practices shaped by cultural values such as power distance and uncertainty avoidance necessitate adaptive management strategies that balance local norms with global standards. Trust and relationship-building are critical, particularly in cultures where personal relationships underpin business transactions, demanding long-term investment in relationship-building activities. Ethical and legal standards vary significantly across regions, presenting challenges that require a nuanced approach to global governance. The study underscores the importance of cultural competence as a critical skill for supply chain professionals, enabling them to bridge cultural gaps and foster productive collaborations. Sustainability efforts, entrepreneurship, and innovation are also influenced by cultural factors, highlighting the need for culturally sensitive strategies. Emotional intelligence is identified as essential for managing cross-cultural interactions, with participants demonstrating high emotional intelligence more effectively navigating the emotional and social complexities of cross-cultural communication. The use of technology in managing cross-cultural challenges is acknowledged, but the findings suggest that it must be complemented by cultural competence. Overall, the study provides valuable insights for companies seeking to enhance their cross-cultural effectiveness, emphasizing the importance of cultural competence, communication, and relationship-building in achieving sustainable success in global supply chains.

Endodontic treatments are performed to avoid extractions and maintain the natural dentition. Root canal treatments are undertaken to eliminate or prevent an infection within the root canal system. Chemical and mechanical root canal debridement are the main methods used in endo-dontics to remove necrotic tissue, microorganisms, and microbial byproducts from the canal. However, to date there is no objective method to clinically determine the proper root canal disin-fection level and thus proceed with the obturation. Clinicians just rely on their experience and habits or can trust in empirical methods such as the insertion of paper cones inside the channel and then check their appearance after the removal. Even in the in vitro and ex vivo scientific stud-ies there is no objective method to analyze and compare the efficacy of different endodontic chemo-mechanical techniques and materials. The most frequently used method is to visually an-alyze some areas with a scanning electron microscope (SEM), even if the resulting images are hardly quantifiable and could greatly vary according to the analyzed area. A new device to clin-ically test the cleanliness of a root canal and display the result in an objective score was recently developed. The device analyzes the luminescence generated by an enzyme cycling method that process the adenosine triphosphate (ATP), adenosine diphosphate (ADP) and adenosine mono-phosphate (AMP) present in organic residues. The aim of the present in vitro study was to test the efficacy and reliability of this novel device in a controlled in vitro environment, before using it in clinical practice.

Zanthoxylum armatum is an forest tree with apomixis characteristic, and RWP-RKs are plant-specific transcription factors known to regulate nitrogen response and embryonic development. However, the genome-wide analysis of RWP-RK family genes in Z.armatum is unclear. In this study, 36 ZaRWP-RK transcription factors were identified in the genome of Z.armatum, among which 15 genes were belonged to the RKD subfamily and 21 belonged to the NLP subfamily. Duplication events of ZaRWP-RK genes were mainly segmental duplication, and synteny analysis revealed close phylogenetic relationship between Z.armatum and Arabidopsis. The analysis of cis-elements indicated that ZaRWP-RK genes may be involved in the regulation of embryonic development of Z.armatum by responding to plant hormones such as abscisic acid, auxin, and gibberellin. Real-time PCR showed that the expression levels of most ZaRWP-RK genes were significantly increased from flowers to young fruits. Protein-protein interaction network analysis further revealed the potential roles of the ZaRWP-RK proteins in apomixis. Collectively, this study provide a theoretical basis for future investigations into the ZaRWP-RK genes and their regulatory mechanisms in the apomixis process of Z.armatum.

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

Having valid and reliable tools that help health professionals to assess fear in children undergoing medical procedures is essential to offer humanized and quality of care in the paediatric population. The aim of this study was to develop the cross-cultural adaptation and the evaluation of the psychometric properties of the Spanish version of the “Child Medical Fear Scale” in its shortened version (CMFS-R). The design consisted of two phases, first of cross-cultural adaptation and second of the psychometric validation of the CMFS-R with a sample of 262 children from Spain. Confirmatory factor analysis was conducted to assess construct validity and the Cronbach alpha and the adjusted item-total score correlation coefficients were performed to study reliability. The results confirmed internal consistency and construct validity of the Spanish version of the CMFS-R, indicating that the scale has an acceptable level of validity and reliability. Therefore, this study brings a new version of the scale to assess fear related to medical procedures for use in the Spanish paediatric population.

Cultural tourism in Tanzania presents a diverse tapestry of traditions, varied ethnic groups, and historical accounts. This article aims to pinpoint areas for further exploration in the cultural tourism sector of Tanzania and analyze their potential impacts. The study conducted a systematic review of the literature following established inclusion criteria as well as the Preferred Reporting Items for Systematic Reviews and meta-analysis guidelines. A total of 21 articles focused on Tanzania Cultural Heritage Tourism from sources such as Google Scholar and web databases were examined, revealing several research gaps, including theoretical, contextual and methodological aspects. Furthermore, the research offers insights into theoretical implications and recommends avenues for future studies that could advance the field by addressing these knowledge gaps providing valuable direction to new researchers interested in exploring these specific areas as well as practitioners seeking a comprehensive understanding of various aspects related to Tanzania's cultural heritage tourism

Authorities and governmental bodies strongly emphasize the importance of residents preparing for natural disasters, particularly underscoring the significance of readiness for geophysical hazards like earthquakes. In this study, which represents comparative quantitative research, the levels and predictors of the impact on preparedness for earthquake-induced disasters in South-Eastern Europe countries such as Montenegro, North Macedonia, and Serbia are examined. Using the snowball sampling technique (online questionnaire), a survey of 1245 respondents (Montenegro (n = 400), North Macedonia (n = 345), and Serbia (n = 500) was conducted from February 2023 to February 2024. The paper is based on the central hypothesis that the most significant predictor of earthquake preparedness in Montenegro, North Macedonia, and Serbia is age, followed by gender and education. Multivariate regression analysis was used to determine the extent to which five scores of the subscales (household preparedness, community preparedness, disaster preparation, earthquake risk awareness, reinforced house) were associated with seventh demographic and socio-economic variables. In addition to the mentioned analysis, other statistical analyses such as T-test, one-way ANOVA analysis, and Pearson correlation were also utilized. The results indicate that age emerges as a predictor in various aspects of earthquake-induced disaster preparedness and awareness in most models, followed by education. These findings confirm the significance of respondents' age in determining levels of preparedness and earthquake awareness. Overall, in North Macedonia, respondents recorded the highest ratings (M = 3.52) for household preparedness for earthquakes, compared to Montenegro (M = 2.98) and Serbia (M = 3.26), where the lowest ratings were recorded. Research findings, taking into account cultural characteristics, can serve as a basis for the development of targeted interventions, strategies, policies, and programs aimed at improving the level of societal preparedness for earthquake-induced disasters.

Background: Assessing body image and personalized rehabilitation in lower limb amputation is essential to measure impact on an individual’s quality of life and psychosocial wellbeing. The aim of this study was to develop a Spanish version of the Amputee Body Image Scale (ABIS-E) for Spanish-speaking lower limb amputee. Methods: A cross-sectional study was conducted including amputee patients in local in Madrid, Spain. Clinical outcomes about body image (Amputee Body Image Scale, ABIS), health-related quality of life (EuroQol-5D-5L), depression and anxiety (Hospital Anxiety and Depression Scale, HADS), pain (Brief Pain Inventory-Short Form, BPI-SF) and functional capacity (Prosthesis Evaluation Questionnaire, PEQ) were collected. Results: Seventy-three participants were assessed. Excellent test-retest reliability (ICC=0.847) and good internal consistency (Cronbach's alpha=0.753) were obtained. Three factors were extracted in the factor analyses. Convergent validity with Pearson's and Spearman's correlation coefficients were calculated for the depression and anxiety questionnaires (HADS) (values between .57 and .67), functional capacity (PEQ) (values between -.35 and .71) and quality of life (EQ-5D-5L) (values between -.37 and .61). Conclusions: The ABIS-E is a reliable and valid tool for measuring body image in the Spanish population with a lower limb amputation, potentially useful in primary care to identify psychosocial problems.

This study aimed to translate and psychometrically validate the Neck Outcome Score (NOOS) in the Polish population according to the recommendations of American Academy of Orthopedic Surgeons (AAOS) for the Cross-Cultural Adaptation of Health Status Measures. Participants completed the NOOS, Neck Disability Index (NDI), and Visual Analogue Scale (VAS) for pain assessment. The questionnaires were completed by 57 women and 32 men with cervical spine ailments. A retest was performed in all patients after 48 hours. The analysis confirmed the high internal consistency (Cronbach's alpha of 0.95) of the Polish NOOS. No floor / ceiling effects were observed. The Polish NOOS showed a significant correlation with NDI (0.87; p<0.001) and VAS (0.79; p<0.001). The intraclass correlation coefficient (ICC) for the test-retest was found to be high (0.97). The Polish version of NOOS can be used for clinical and research purposes as an equivalent to the original English version. This study contributes to the area of patient-reported outcome measures available in the Polish language.

The emphasis in the automotive industry towards sustainable mobility has led to a significant interest in hybrid-electric propulsion systems with high energy density batteries. Addressing the needs of this strategy, the battery market is exploring new technologies to improve the safety and lifespan of electric vehicles. To this end, there is a focus on the all-solid-state battery (ASSB) technology for its cycle capabilities. Filling the current void in the literature pertaining to accurate ageing models for ASSBs, in this work, we present an enhanced version of the numerical ageing model, originally developed for liquid electrolyte based batteries, to forecast the development of the solid electrolyte interface layer that is the major cause of battery capacity fading. The model has been tested on prototype batteries and reveals an accuracy of 99%. The capacity fade in ASSBs has been investigated under different conditions, and the enhanced ageing model has been validated using experimental data from these batteries. The findings suggest that there is potential for solid-state batteries to be commercialized, although significant work is needed to match the manufacturing level of lithium-ion batteries with liquid electrolytes.

This research presents the creation of a Virtual Reality experience for the Balzi Rossi museum, commemorating the centenary of Prince Albert I Grimaldi's archaeological work at the site. The project, a collaboration between the University of Genoa's 3D Lab Factory, Eurodrone, and the Balzi Rossi archaeological museum, aims to preserve and convey the site's heritage through advanced VR technology. Initially employing Unreal Engine 4, the team used photogrammetry for 3D reconstruction of the "Caviglione" and "Florestano" caves, notable for their ancient rock engravings. This first VR model, despite hardware limitations, provided an interactive exploration of the site. The subsequent development phase utilized Unreal Engine 5, incorporating Nanite technology for enhanced visual fidelity. This advancement resulted in a more detailed and immersive VR experience, presenting the Balzi Rossi cliff across different historical periods, including the Würm glaciation. Key to this phase was optimizing the VR experience for performance, focusing on stable frame rates and minimizing motion sickness, and integrating a multi-lingual interface for broader accessibility. Since November 2023, the VR setup at the Balzi Rossi Museum has been an educational and interactive feature, enabling visitors to explore the site's history virtually. This research demonstrates the potential of VR in cultural heritage preservation and education, providing a foundation for future technological improvements in the field.

The early Church had an incredible encounter with the resurrected Christ. Being living witnesses, Christ’s followers spread the Gospel in the world through the power of the Holy Spirit. This piece argued that the Bible contains methodologies used by the Apostles who laid down their lives for the sake of the message of the Cross. Furthermore, it has been contested in this study that the emphasis today has shifted to personal theological agendas of reading the Bible for intellectual preferences. As a result of Christianity’s current emphasis on dogmatic beliefs, various unbiblical approaches to reading the Bible have emerged that ignore the ethical reading of the Bible. This study has reinvestigated the reasons to apply this approach in our modern era to live the Bible rather than any other approach. And one among them is the Enlightenment era which distorted the relationship between ethics and theology (Perry 46). Apart from the above, this study also revealed that many Bible believers have twisted biblical truths because they focus on their convictions. As a result, many strategies fail to provide sound biblical teachings to understand any particular event in the light of the original message of the Bible to reflect upon our situation today. Therefore, in light of the above, on the one hand, the approach of the early Church Fathers is used to reimagine contemporary challenges from this perspective. On the other hand, even though thousands of books have been written on various methodologies to study the Bible, the core concern to critique these current approaches is not personal or denominational, religion-based but rather 'invitational and servational' to live with these biblical beliefs to reorient an ethical approach towards cross-cultural reading in our local and global contexts addressing the problems (injustice and marginalization) and responding to the contemporary challenges.

Stroke survivors often face diverse unmet needs, highlighting the significance of identifying and addressing these needs to enhance rehabilitation outcomes and overall quality of life. This study aimed to validate the modified Needs Assessment Questionnaire (mNAQ) as a reliable and valid tool for assessing the needs of stroke patients in the Greek context. Additionally, the research sought to identify potential differences in the assessment of stroke patients' needs based on their stroke phase and National Institutes of Health Stroke Scale (NIHSS) scores. A sample of 71 adult stroke survivors, adhering to World Health Organization guidelines and providing autonomous consent, participated in the study. The mNAQ, comprising 141 items across 12 domains, was uti-lized to evaluate stroke patients' needs. The NIHSS and Barthel Index (BI) were employed for functional independence and mobility assessment. Data analysis incorporated confirmatory fac-tor analysis, exploratory factor analysis, and Cronbach's reliability analysis to establish con-struct validity and internal consistency. Concurrent and known-groups validity analyses were conducted, and Spearman’s rho correlation explored the relationship between mNAQ and BI scores. Non-parametric analyses were applied to identify differences based on stroke phase and NIHSS scores. The study revealed that the mNAQ initially lacked satisfactory psychometric properties in the Greek context. Subsequent modifications, guided by confirmatory and explora-tory factor analyses, resulted in a refined three-factor scale encompassing 31 items in the domains of communication, mobility, and social functioning needs. This adapted measure effectively dif-ferentiated between acute and chronic stroke patients and those with minor and moderate strokes. In conclusion, the validated 31-item Greek mNAQ emerges as a crucial tool for compre-hensively assessing the needs of stroke patients. Its application holds promise for optimizing post-stroke care, improving functional outcomes, and ultimately enhancing the overall well-being and quality of life for stroke survivors.

This is a theoretical and empirical article. In the first part, an original definition of the cross-border market for cultural services has been developed, based on classic market definitions. The structure and conditions of functioning for this market have also been presented. The next part of the article discusses the supply side of the cross-border market of cultural services for the two twin towns: Cieszyn (Poland) and Český Těšín (Czech Republic). Next, based on the surveys conducted, the participation of residents of both towns in the most important cultural events organised by cultural institutions on both sides of the border was examined.

The study aimed to evaluate the after-effects of the COVID-19 pandemic on the sleep quality and patterns of women across different cultural settings within Iraq, spanning the period of 2022. A cross-sectional survey was administered to a diverse cohort of women from multiple provinces in Iraq. The survey measured various parameters, including sleep duration, onset latency, and disturbances. The post-pandemic period has seen a notable decline in sleep quality among the female population. Contributing factors include psychological stress, lifestyle changes due to the pandemic, and ongoing socio-economic challenges. The impact on sleep quality exhibited variation across different cultural groups, indicating a significant cultural influence on the pandemic's psychological aftermath. The study concludes that the post-pandemic phase has adversely affected the sleep health of women in Iraq, with cultural factors playing a critical role in these changes. There is a pressing need for culturally sensitive public health strategies to address sleep disturbances and mitigate their long-term effects on women's health. Public health initiatives should be tailored to address the specific cultural contexts within Iraq to improve sleep health among women. Further research is warranted to explore the long-term consequences of disturbed sleep patterns and the effectiveness of different intervention strategies.

The prevalence of back pain (BP) among children and adolescents has increased over recent years. Some authors advocate promoting back-health education in the school setting. It is therefore important to adopt a uniform suite of assessment instruments to measure the various constructs. The present study aimed to perform a cultural adaptation of a validated measurement instrument (BackPEI), beginning with a translation and cultural adaptation phase, followed by a second phase to test reliability using a test-retest design. The translation and cross-cultural adaptation were performed based on the guidelines. Reliability was tested by applying the questionnaire to 224 secondary school students, at two different times with a 7-day interval between the tests. In general, the Spanish version presented adequate agreement for questions 1–20, with only question 9 achieving a low Kappa range of .312 [-.152- .189]. The question about pain intensity did not show differences between the averages for the test (4.72 ± 2.33) and re-test (4.58 ± 2.37) (p = .333), and the responses for these two tests were highly correlated (ICC= .951 [.928- .966]; p= .0001). Psychometric testing indicated that the Spanish version of the BackPEI is well-adapted and reliable, based on the test-retest design, providing similar results to the original Brazilian version.

The extensive collection of paper documents and books stored in the archives of universities worldwide is a hidden cultural heritage that is frequently inaccessible. To overcome this problem, the University of Genoa, Italy, seeks to collect, store, and digitize a wide variety of items, encompassing books, manuscripts, archival materials, and documents related to museum artifacts, which together form a cultural heritage of great importance and historical significance. To make such a cultural heritage accessible to both humans and machines, images and videos must be provided with alternate descriptions, metadata, and speech-to-text transcriptions while ancient texts, for which OCR techniques are often not effective, must be accompanied by word-for-word transcripts. This work presents the design of a transcription system for the “University Museum System” at the University of Genoa, Italy (SMA-UniGe), including user interface elements and users’ engagement techniques. The goal is to create an accessible digital heritage that can be enjoyed by all, facilitated by a community of digital volunteers who are eager to dedicate their time, have a great experience, socialize, and interact on the proposed transcription system. The system exploits gamification theory to transform the typically monotonous task of transcription into a captivating experience. This activity is in line with the so-called University third mission, i.e., the activity of public engagement that aims at generating knowledge outside the academic environment to the benefit of the social, cultural, and economic development.

Heat waves are a significant consequence of climate change threatening public health by increased morbidity and mortality. The aim of this study was to estimate individuals’ knowledge, attitudes and practice related to heat waves. We conducted an exploratory cross-sectional study in Greece during September 2023. We employed a convenience sample of 1055 participants. We used the heat wave knowledge, awareness, practice and behavior scale (HWKAPBS) to measure our outcome. We measured several socio-demographic variables, such as gender, age, educational level, etc. as potential determinants. Mean scores for the knowledge, awareness, practice and behavior factors were 12.5, 22.7, 22.2 and 12.1 respectively. Females had higher scores on the four factors compared with males. We found a positive relationship between self-perceived health status and awareness, practice and behavior about heat waves. Similarly, we identified a positive relationship between self-perceived financial status and awareness and behavior about heat waves. Increased age was associated with increased practice score, while increased educational level was associated with increased knowledge score. Additionally, behavior score was higher among participants in urban areas than those in rural areas. We found statistically significant positive correlations between the four factors. Levels of knowledge, awareness, practice and behavior about heat waves were high in our sample. Several socio-demographic variables affect participants’ knowledge, awareness, practice and behavior concerning heat waves.

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.

Eustachian Tube Dysfunction is considered a common condition among ENT patients and requires careful history, clinical examination and appropriate investigations to obtain a diagnosis. The ETDQ-7 questionnaire is a useful tool to subjectively score severity of symptoms that are related to this pathology (Appendix A). This study aimed to adapt and validate the ETDQ-7 questionnaire in Greece to ensure correct and efficient use in the outpatient setting (Appendix B). The ETDQ-7 was translated into the Greek language following appropriate methodology. Data for the main study were collected from a sample of 75 Greek patients diagnosed with ETD as well as 25 patients that did not have ETD and who served as a control group. The participants completed the adapted ETDQ-7 questionnaire and underwent a clinical examination that was statistically correlated with their ETDQ-7 answers. Face and content validity were confirmed and the questionnaire was found easy to administer and to be completed by our patients. Test-retest reliability revealed similar internal consistency for the questions and good correlation between individual items and total score. Discriminative validity confirmed statistically significant difference between the two patient groups to ensure that the Greek version of ETDQ-7 is useful to confirm the diagnosis. The Greek version of the ETDQ-7 is safe and efficient to use among a variety of investigation methods for the diagnosis of ETD in the Greek speaking population.

Natural vegetation restoration can take decades to achieve and requires information on species composition and trend to inform management strategies. Here we demonstrate the potential and portability of drone, dove and Sentinel-2 imagery for species level classification and trajectory monitoring using three study sites with different revegetation histories. Drone imagery (4 cm) was classified using random forests. Dove (3 m) and Sentinel-2 (10 m) images were acquired close to the anniversary of the drone flights and converted into fractional cover maps showing the proportion of exotics, natives and other land covers using ordinary least squares (OLS) and geographically weighted regression (GWR). The time series of fractional cover maps were converted into positive and negative slope and second-order curvature and summarised as one RGB composite to illustrate trend and observe exotic expansion. Drone classification accuracies ranged from 73%-76% when applied to the full plant species list and between 93% and 97% when grouped into natives, exotics, and other land covers. GWR outperformed OLS for all fractional cover mapping and GWR with dove imagery was more accurate than with Sentinel imagery. The combination of very high-resolution drone acquired imagery with the versatility of dove acquired imagery arms land managers with highly accurate species composition and their spatio-temporal dynamics to promote timely intervention.

The intentional damages to local Cultural Heritage sites carried out in recent months by the Islamic State have received wide coverage from the media worldwide. Earth Observation data provide important information to assess these damages in such non-accessible areas, and automated image processing techniques would be needed to speed up the analysis if a fast response is desired. This paper shows the first results of applying fast and robust change detection techniques to sensitive areas, based on the extraction of textural information and robust differences of brightness values related to pre- and post-disaster satellite images. A map highlighting potentially damaged buildings is derived, which could help experts at timely assessing the damages to the Cultural Heritage sites of interest. Encouraging results are obtained for two archaeological sites in Syria and Iraq.

The paper focuses on the application of a multilevel, integrative and territorial approach to the protection of cultural heritage through planning instruments in Serbia. It points out the problems of the sectoral approach and discusses international recommendations that can be integrated into the planning methodology. The case study is the area of Djerdap National Park, which has an already established international and national importance. The research suggests that the cultural heritage in the area, with the exception of the Roman limes, is still recognized at the level of individual localities. The study emphasizes the importance of aligning all levels of governance to safeguard the whole spatial entity rather than focusing solely on its particular areas. The interna-tional and national importance of the planning area contributes to the strengthening of awareness of heritage and its institutional protection. However, the vitality of the area, which is key to its sustainable development, comes from the local level. Planning documents contribute to the inte-gration of local values and local communities into development programs and projects.

Numerous approaches address over-fitting in neural networks: by imposing a penalty on the parameters of the network (L1, L2, etc); by changing the network stochastically (drop-out, Gaussian noise, etc.); or by transforming the input data (batch normalization, etc.). In contrast, we aim to ensure that a minimum amount of supporting evidence is present when fitting the model parameters to the training data. This, at the single neuron level, is equivalent to ensuring that both sides of the separating hyperplane (for a standard artificial neuron) have a minimum number of data points — noting that these points need not belong to the same class for the inner layers. We firstly benchmark the results of this approach on the standard Fashion-MINST dataset, comparing it to various regularization techniques. Interestingly, we note that by nudging each neuron to divide, at least in part, its input data, the resulting networks make use of each neuron, avoiding a hyperplane completely on one side of its input data (which is equivalent to a constant into the next layers). To illustrate this point, we study the prevalence of saturated nodes throughout training, showing that neurons are activated more frequently and earlier in training when using this regularization approach. A direct consequence of the improved neuron activation is that deep networks are now easier to train. This is crucially important when the network topology is not known a priori and fitting often remains stuck in a suboptimal local minima. We demonstrate this property by training a network of increasing depth (and constant width): most regularization approaches will result in increasingly frequent training failures (over different random seeds) whilst the proposed evidence-based regularization significantly outperforms in its ability to train deep networks.

Background: The practice of self-medication is common worldwide and is an important component of medical self-care. However, the practice can be dangerous and is linked to various risks for the patients and the entire community. This study aimed to estimate the prevalence and factors associated with self-medication among Bangladeshi adults. Methods: A cross-sectional survey was conducted between April and June 2021 among Bangladeshi adults (aged &gt;19 years) using convenient sampling. A total of 1320 data were collected through face-to-face interviews using a standardized questionnaire. Multivariable logistic regression analysis was used to identify factors associated with self-medication practice (SMP). Results: Overall, 41% of adults in our survey reported SMP. The most common illnesses that prompted SMP were common cold/flu (66.4%), gastric problems (65%), and headache (64.4%). The most frequent reasons for SMP were to get better services (30.59%), perceive SMP without side effects (23.28%), and save time with effectiveness (14.56%). Potential risk factors included 10 years (AOR = 1.91; 95% CI: 1.04 - 3.50) and &gt;12 years of schooling (AOR = 5.03; 95% CI: 2.27 - 11.15), being a businessman (AOR = 4.64; 95% CI: 1.74 - 12.37), having ≤6 family members (AOR = 2.13; 95% CI: 1.40 - 3.24), being a member of a social group (AOR = 1.53; 95% CI: 1.10 - 2.12), a health status check after every six months (AOR = 1.52; 95% CI: 1.08 - 2.13), and current ill-health (AOR = 1.41; 95% CI: 1.06 - 1.87). Protective factors identified included ≤30 years of age (AOR = 0.40; 95% CI: 0.17 - 0.93), and practice of modern (AOR = 0.39; 95% CI: 0.22- 0.69) and herbal (AOR = 0.45; 95% CI: 0.21- 0.97) healing types. Conclusion: More than one-third of the study participants reported practicing self-medication. Increasing the community’s awareness of the extreme consequences of SMP and not just the average experience might sway individuals away from SMP, and implementing strict jurisdiction could be a way to minimize the SMP.

Background: Patients with thromboembolic disease, prosthetic valves, or coagulation issues are commonly prescribed anticoagulants and antiplatelets. Although common professional oral hygiene might not represent a health concern for these patients, anticoagulant and antiplatelet medication might constitute a challenge for dentists and dental hygienists since possible prolonged bleeding might interfere with dental procedures. The aim of the present study was to investigate the bleeding time of different anticoagulants and antiplatelets during a professional hygiene session adapting the Ivy test to the oral environment; Methods: 93 consecutive patients undergoing professional oral hygiene were recruited. Debridement during oral hygiene was performed using ultrasonic mechanical instrumentation, and bleeding sites were assessed and treated with gentle pressure using sterile gauzes. The time for bleeding cessation was recorded. Patients were categorized into six groups based on their drug intake, Control: no anticoagulants or antiplatelets DTI: direct thrombin inhibitors (dabigatran) AntiXa: directa factor Xa inhibitors (endoxaban, apixaban, rivaroxaban) VKA: vitamin K antagonists (warfarin, acenocoumarol) SAPT: single anti-platelet therapy (acetylsalicylic acid or clopidogrel) DAPT: dual anti-platelet therapy (acetylsalicylic acid and clopidogrel). Bleeding time was measured in seconds and mean values were assessed among the different groups. Differences between groups were investigated with Kruskal-Wallis test followed by Dunn’s post-hoc correction for multiple comparisons or two-way ANOVA followed by Dunnett post-hoc; Results: Control patients presented the lowest bleeding time 50 sec, followed by AntiXa (98), SAPT (105), DTI (120), DAPT (190) and VKA (203). A statistically significant difference was present among control and DTI (p=0.004), VKA (p&lt;0.001), DAPT (p&lt;0.001). Conclusions: Based on the present outcomes, an increased risk of prolonged bleeding emerged in patients taking VKA and DAPT. However, bleeding did not interfere with the oral hygiene ses-sion The optimal period for dental treatment of these patients should be 2-3 hours before the next dose, without the need to temporarily suspend the medication.

Recently, the Portuguese parliament approved the decriminalisation of euthanasia for incurable illnesses. As the experiences of other countries show us, it will be a matter of time before mental disorders are addressed. Studying the phenomenon, particularly in vulnerable groups, in advance is essential for proper law drafting. Therefore, instruments which allow an objective assessment and comparison between groups must be available. This study aims to explore the validation of Faria's Attitude about Euthanasia scale in Portuguese older adult patients with mixed anxiety-depressive disorder. A sample of 114 older adult patients with mixed anxiety-depressive disorder collected by convenience in the Psychiatry Department of Senhora da Oliveira Hospital in Portugal was included. The pre-final version of the scale was tested in a small group with good results. The validity of the internal structure was analysed using exploratory factorial analysis. The internal consistency study verified reliability. For construct validity, we assessed the correlation with other validated scales measuring attitudes toward euthanasia, cognitive performance, personality and empathy. Attitude about euthanasia scale showed good internal consistency. One factor was retained in the principal component analysis. Significant correlations verified construct validity. The results support the scale's usefulness and validity. This study makes available a unique instrument to assess the overall tendency of the attitudes towards euthanasia in European-Portuguese, which can be used, for example, to compare Portuguese with Brazilian older adult psychiatric patients suffering from the same disorder. Furthermore, the adapted scale paves the way for other cross-cultural translations, adaptations, validations, and comparative analyses.

Implementing the methodology of clinical simulation in the nursing degree course is a necessity in the European framework of higher education to acquire competences. The objectives of this research were to evaluate the strategies and techniques used during the simulations, identify the contents learned, and determine which of them are transferred to the nursing practice. We performed an observational, descriptive, and cross-sectional study from the nursing students’ perspective during the 2020-21-year course. On the one hand, our results show that the DASH scale helped us to obtain an internal validity of the simulations obtaining a mean score of 6.61 out of 7. On the other hand, the Ad Hoc scale, based on the competences were acquired in the simulations were transferred to the care practices. In conclusion, it is possible to improve care practices by integrating knowledge through clinical simulations.

Background: Inappropriate use of antibiotics has been reported to contribute to the emergence and increase of antimicrobial resistance (AMR) in the world. Antibiotics are prescription-only medicines to be dispensed to a person with a legal prescription inscribed by a qualified medical practitioner. Enforcing the dispensing of antibiotics with prescription is a way to promote the rational use of antibiotics and preventing the development and spread of AMR. It is, therefore, the responsibility of a pharmacist to dispense or supervise the dispensing of antibiotics in pharmacies and ensure its rational use. This study aimed to assess pharmacists’ knowledge, attitude and practice regarding the dispensing of antibiotics without prescription in Tanzania. Methods: An online semi-structured questionnaire was designed, tested and shared with licensed pharmacists in Tanzania through an invitation link sent in their official WhatsApp groups. A list of names, contacts and emails of licensed pharmacists obtained from the Pharmacy Council was used to directly contact and request pharmacist to fill the questionnaire, in case the pharmacist contact was not on WhatsApp, a text SMS invitation was sent. Study data were collected and managed using REDCap electronic data capture tools hosted at Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Data were then downloaded and exported into Statistical Package for Social Sciences (SPSS) version 20 for data analysis; Chi-square test was used to test association for categorical data, where a p-value of less than 0.05 was considered statistically significant. Results: More than 75% of pharmacists had excellent knowledge about the legal requirements for dispensing antibiotics and of the AMR challenge. Of the interviewed pharmacists, seventy-four percent admitted to dispensing antibiotics without prescription in their daily practice. The main reasons for administering antibiotics without prescription were the profitability nature of pharmacy business, a failure of the patient to get a prescription and lack of stringent regulatory authorities. Penicillins, macrolides and floroquinolones were the classes of antibiotics mostly dispensed without a prescription. Conclusion: The study shows that the dispensing of antibiotics without prescription is a common practice in Tanzania. The regulatory authorities should make regular inspections in pharmacies to detect this malpractice. The community should be trained on the importance of taking laboratory tests before getting medications for their sickness by a qualified medical practitioner.

Current VAT rules for cross-border e-commerce companies in the EU are not sustainable, because they are extremely complex and often opaque, due to the lack of tax harmonization. The aim of the research is to explore, using a qualitative method, what kind of harmonization would make the current legislation more uniform, simpler, more transparent, and easier to understand, without conflicting with the rules of any Member State. To this end, the aspects of the new platform regulation introduced on 1 July 2021 and its potential for expansion are assessed through information from possible sales models. The research suggests that the rules on platforms do not cover all possible sales models, which in our view imposes an unnecessary extra administrative burden on some businesses and makes their tax activities less transparent. In the light of the results of the research, we propose that the current EU platform regulation should be extended to cover B2B, B2C transactions and services. As a result of this suggested harmonization, a simpler, more transparent, uniform and sustainable tax system would contribute to the whitening of the economy, generating additional tax revenue for Member States.

(1) Background: The aim of the research was to present and emphasize the importance of magnetic resonance imaging (MRI) in diagnosing Achilles tendon (AT) ruptures by presenting case reports. (2) Materials and Methods: The sample of respondents included 7 patients (4 males and 3 females, 2 athletes and 5 non-athletes), aged 25 to 58 years, with AT injuries, who were examined and treated at the Institute for Treatment and Rehabilitation "Niška Banja", Niš, Serbia. Ankle examinations with MRI were conducted using the Esaote O-scan 0.3 T machine. The examinations were performed without the application of a paramagnetic contrast agent and without the use of anesthesia. Results: The MRI method's sensitivity and overall diagnostic accuracy were excellent, with 100% true positives. In our study, the method accurately detected the presence, location, and severity of AT injuries in all cases. MRI is an important and reliable method for detecting AT injuries, classifying them, monitoring the course of recovery, and assessing the effects of therapy. Conclusions: An unrecognized or delayed diagnosis of an AT injury can lead to chronic changes. Timely diagnosis (clinical examination, ultrasonography, magnetic resonance imaging) and appropriate treatment (conservative or operative) enable patients to return to normal activities, including sports. Unfortunately, the use of MRI is limited by restricted access and the cost of the examination.

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

A simple design of an ultrathin six-band polarization-insensitive terahertz perfect metamaterial absorber (PMMA) composed of a metal cross-cave-patch resonator (CCPR) placed over a ground plane was proposed and investigated numerically. The numerical simulation results demonstrate that the average absorption peaks are up to 95% at six resonance frequencies with high quality-factors (>65). In addition, the absorption properties can be kept stability for both normal incident transverse magnetic (TM) and transverse electric (TE) waves. The physical mechanism behind the observed high level absorption is illustrated by the electric and power loss density distributions. The different absorption mainly originates from the higher order multipolar and multipolar plasmon resonance of the structure, which are sharp different to the most previous studies of the PMMAs. Furthermore, the resonance absorption of the PMMA can be tunable by varying the geometric parameters of the unit cell.

A simple design of an ultrathin six-band polarization-insensitive terahertz perfect metamaterial absorber (PMMA) composed of a metal cross-cave-patch resonator (CCPR) placed over a ground plane was proposed and investigated numerically. The numerical simulation results demonstrate that the average absorption peaks are up to 95% at six resonance frequencies with high quality-factors (>65). In addition, the absorption properties can be kept stability for both normal incident transverse magnetic (TM) and transverse electric (TE) waves. The physical mechanism behind the observed high level absorption is illustrated by the electric and power loss density distributions. The different absorption mainly originates from the higher order multipolar and multipolar plasmon resonance of the structure, which are sharp different to the most previous studies of the PMMAs. Furthermore, the resonance absorption of the PMMA can be tunable by varying the geometric parameters of the unit cell.

Background: Given the extensive translation of the Prolapse Quality of Life Questionnaire (P-QoL) into many languages, it is imperative to develop an Arabic version to facilitate study on Pelvic organ health within the Arabian culture. Objective: To investigate, cross culturally adapt and validate Arabic version of the P-QoL. Study Design: Cross-cultural adaptation and psychometric testing. Methods: A total of 90 participants were included in the study. This cross-sectional study went through two phases; during phase I, the P-QoL was translated and adapted from English into Arabic. The Arabic version was psychometrically validated during phase II using the test-retest reliability internal consistency with Cronbach’s alpha coefficient, convergent construct validity (CC) among the four study tools using Spearman’s coefficient (r) and discriminative validity using Mann-Whitney test to find differences between the means of the two samples. Results: A satisfactory level of semantic, conceptual, idiomatic, and content comparability was reached in the cross-cultural adaptation of the Arabic version of the P-QoL questionnaire. The internal consistency was high in terms of psychometric validation, with a Cronbach’s alpha coefficient of 0.971 for the P-QoL questionnaire. The test-retest results showed a high reliability with interclass correlation coefficient (ICC) of P-QoL = 0.987. The convergent construct validity was highly accepted (moderately strong), reflecting a positive correlation between the Arabic version of the P-QoL and the Australian Pelvic Floor Dysfunction Questionnaire (APFD) r = 0.68 (p &lt; 0.001). Similarly, a significant convergent validity of P-QoL Arabic version and Visual Analogue Scale (VAS) r = 0.47 (p &lt; 0.001) was found, as well as the correlation between the APFD and the VAS r = 0.46 (p &lt; 0.001). However, there were no significant correlation between the SF-12, the P-QoL, the APFD, and the VAS. Conclusion: Based on a significant correlation between the Arabic APFD and the VAS, the results reveal good reliability, internal consistency, and construct validity. It is recommended that Arabic-speaking females with pelvic organ prolapse use the Arabic version of the P-QoL. More research is needed to assess the responsiveness of the P-QoL.

Considering the impact of religiosity on the perceptions regarding life quality, in this paper we focus on the effects of the appurtenance to a religion on the standard of living in several economically developing countries (Turkey, Ukraine, Senegal and Morocco). The data have been collected using a survey carried out in 2012 and the empirical analysis was based on non-parametric tests and multinomial logistic regression. The results indicate there are differences between religious persons and atheists regarding gender, marital status, perceptions of daily life and standards of living. Females and officially married people or single people tend to be more religious. A person claiming to belong to a religion has 2-4-fold more chances to achieve a considerable improvement in the standards of living as compared to an atheist. Moreover, religious people from the analyzed countries are more optimistic about their life overall. Taking into account the sample’s characteristics and the countries chosen, we can claim that the results obtained are truly cross-cultural in nature. Moreover, most of the conclusions reached would be to some extent relevant to other developing economies of Eastern Europe, North Africa and Middle East.

Cartoons in the era of digital media are among the most prevalent medium of entertainment for the children, parents also encourage them to view such contents to engage the children which make an area need to be explained exhaustively by adopting new approaches. There are lot of studies in the past conducted to explain the impacts of the cartoons on the children however, it is remarkable fact that there is lack of the studies in the literature which directly address the observation about the above mentioned impacts in view of the teacher’s. This study deals with the educational, emotional, behavioral and Religious etc. impacts of cartoons on kids in view of teachers of the primary schools as they are considered as the one who can observer these impacts in a profound way. of the of Multan. Different areas of impacts have been analyzed in this study by using survey technique and analysis is conducted and presented in the teacher’s views in this study to examine what they feel that how cartoons are effecting the personalities of the children.

The recognition of a place as a World Heritage Site (WHS) by UNESCO is fundamental to preserve its historical and artistic inheritance and, at the same time, to encourage visits to that area. The purpose of this article is to contribute to the study of the relationship between WHS and cultural tourism, with a marked sustainable character, through the presentation of the results of research conducted in the city of Cordoba (Spain) and which analyses the sociodemographic profile of the tourists, the variables that influence their level of satisfaction and of their loyalty and the classification of the travelers through different variables. The principal results of the research show the significant educational level of the surveyed tourists, as well as the high level of satisfaction with the visit, the high number of countries of origin and the outstanding motivation for knowing the city’s heritage roots.

Domain generalization has led to remarkable achievements in Hyperspectral Image (HSI) classification. Inspired by contrastive language-image pre-training (CLIP), the language-aware domain generalization method has been explored to learn cross-domain-invariant representation. However, existing methods face some challenges: 1) The weak capacity to extract long-range contextual information and inter-class correlation. 2) Due to the inadequacies of the large-scale pre-training for HSI data, the spatial-spectral features of HSI and linguistic features can not be straightforwardly alignment. To address the above problems, a novel network has been proposed with a CLIP framework, which consists of an image encoder, based on an encoder-only transformer to obtain the global contextual information and inter-class correlation, a frozen text encoder, and a cross-attention mechanism, named Linguistic-Interact-with-Visual Engager (LIVE), enhances the interaction between two modalities. Extensive experiments demonstrating superior performance over state-of-the-art methods in HSI Domain Generalization with a CLIP framework.

The importance of personalized medicine is growing, since there is an urged need to avoid unnecessary and expensive treatments. In nuclear medicine, the theranostic approach is an established tool for a specific molecular targeting in means of diagnostics and therapy. The visualisation of potential targets can help to predict if a patient would benefit from a particular treatment or not. Thanks to the quick development of radiopharmaceuticals and diagnostic techniques, the use of theranostic agents is constantly rising. In this article important milestones of nuclear therapies and diagnostics in the context of theranostics are highlighted. It begins with the well-known radioiodine therapy in patients with thyroid cancer and then guides through different approaches for the treatment of advanced cancer with targeted therapies. The aim of this review is to provide a summary of background knowledge, current applications and advantages of targeted therapies and imaging in nuclear medicine practice.

Cultural routes are a composite set of heritage, referring to any ancient routes of human communication. As one of the key products of cultural tourism, they providing visitors with a rich cultural experience across regions. We systematically review reports and studies related to the tourism development of 38 cultural routes cases around the world, with a special focus on their distribution, typology, planning patterns and tools for cultural tourism. We summarized eight tools, there are some differences in how often these eight tools are used by the different types of routes and different planning patterns for routes tourism. The study also made an evaluation system based on the conservation principles of cultural routes to find out how different tools of tourism affect the conservation and development of the historical region. It was found that although many efforts have been made by tourism decision-makers to protect and develop cultural routes there are still many problems and challenges in the process of tourism development along cultural routes. We close the paper by making a few recommendations for decision makers and researchers concerning future routes’ tourism planning and study.

In the context of sustainable development, integrating the work aspect into health promotion systems is essential, ensuring that employees maintain a healthy balance between their professional and personal lives, which respects and amplifies the potential of every individual. Lately, there has been a noticeable shift of medical professionals from the public to the private sector. This trend paints a bleak picture, highlighting the vulnerabilities of a system teetering on the brink of failure, with significant impacts on patient care. Among the myriad reasons behind this shift, burnout stands out prominently. Medical professionals face increasing pressures due to understaffing, limited organizational support, and insufficient resources, leading to feelings of cynicism, exhaustion, and detachment from their roles. Utilizing the Maslach et al. questionnaire, we assessed the risk of burnout among physicians in public hospitals to identify and underscore preventive measures and improvements, correlating our findings with key aspects of organizational empowerment. Our research indicates that enhancing interpersonal relationships and resources—both within teams and between the organization and its physicians—is crucial for the revival of the healthcare system. This approach aims at improving the delivery of healthcare services and offering appropriate recognition to healthcare professionals, aligning with the principles of sustainable employment.

By analyzing the urban landscape, this investigation focuses on commercial typologies in historical urban areas and its relationship with the urban landscape and its heritage values. Trade plays an essential role in historical urban areas, both in the past and in the present, since it is part of the urban landscape—creating it and modifying it, but also preserving it. Historical protected urban areas contain diverse elements reflecting the impacts of commercial activities that have existed in cities throughout history. At present, the urban landscape of commercial activity is made up of a multiplicity of typologies and formats which interact with the historical landscape and its values, using them to strengthen its strategies of attraction, differentiation, and sales. Shop owners contribute to the preservation of historic urban areas by maintaining the commercial functions within them. Therefore, we affirm that the role of commercial activity in the preservation of urban protected areas is essential. However, further research is needed because this aspect has not been addressed in depth by the scientific community specializing in the management of cultural heritage.

Globally, over the past several months millions of persons contracted the coronavirus disease 2019 (COVID-19) resulting in significant mortality. Health care systems are negatively impacted including the care of individuals with cancers and other chronic diseases such as chronic active hepatitis, cirrhosis and hepatocellular carcinoma. There are various probable pathogenic mechanisms that have been presented to account for liver injury in COVID-19 patients such as hepatotoxicity cause by therapeutic drugs, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of the bile duct cells and hepatocytes, hypoxia and systemic inflammatory response. Liver biochemistry tests such as AST, ALT, GGT and ALP are deranged in COVID-19 patients with liver injury. Hepatocellular damage results in the elevation of serum AST and ALT levels in early onset disease while a cholestatic pattern that develops as the disease progress causes higher levels of ALP, GGT, direct and total bilirubin. These liver biochemistry tests are prognostic markers of disease severity and should be carefully monitored in COVID-19 patients. We conducted a systematic review of abnormal liver biochemistry tests in COVID-19 and the possible pathogenesis involved. Significant findings regarding the severity, hepatocellular pattern, incidence and related clinical outcomes in COVID-19 patients are highlighted.

The energy efficiency of existing buildings is a crucial factor in addressing Europe’s energy con-sumption challenges, accounting for nearly 40% of the total energy usage. The ongoing energy crisis, driven by the reliance on fossil fuels and increasing prices, has underscored the urgency of adopting sustainable and energy efficient practices especially to the existing building stock. Cyprus is par-ticularly vulnerable due to its heavy dependence on imported fuels for electricity generation and faces significant challenges in transforming its existing building stock into energy-efficient and sustainable structures. Extensive focus has been made by the government on the energy-efficient retrofit of non-residential public buildings. This study examines an existing cultural hall. The case study of the Cultural Hall represents the building stock before 2010 which is lacking thermal in-sulation, double glazing and any energy efficient element. It then offers an ideal case study to ex-plore sustainable solutions which can be easily adopted from the construction industry and from the building owners. The primary objective of this research is twofold: first, to develop a comprehensive retrofit plan to transform the cultural hall into a net-zero energy building; and second, to explore how this transformation can give value back to the local community. After running two simulation scenarios and providing two energy performance certificates, one with at the existing state and one with the intended retrofit measures, it is clear that the building can be a net zero energy consump-tion building. Some interesting results derived, present also how this building can provide value back to the community i.e. through solar carports for EV charging.

Hospital-acquired infections (HAIs) contribute to increased length of hospital stay, high mortality and higher health-care costs. Prevention and control of HAIs is a critical public health concern. We conducted a cross-sectional survey of 213 hospital health-care workers in Qassim, Saudi Arabia. We assessed Knowledge, Attitude and Practice (KAP) of standard infection control precautions using a structured questionnaire. Predictors of KAP were investigated using multivaraible logistic regression analyses and independent sample t tests. Prevalence of good (≥80% correct response) knowledge, attitude and practice were 67.6%, 61.5% and 73.2%, respectively. Predictors of good knowledge included age over 34 years (adjusted odds ratio: 30.5, p<0.001), and receiving training (13.3, p<0.001). Predictor of positive attitude was having >6 years of experience (5.5, p<0.001). While, the predictors of good practice were having >6 years of experience (2.9, p<0.01), previous exposure to HAIs (2.5, p<0.05) and training (3.5, p<0.01). However, being female (0.22, p<0.001) and older (>34 years) (0.34, p<0.01) were negatively associated with knowledge. Results indicate that older academic programs might not have adequately covered infection crontrol. Arranging training for HCWs might be useful in improving their knowledge of standard infection control precautions and is also expected to facilitate positive attitude and practice.

This paper constitutes a comprehensive literature review within the field of cultural tourism, with a particular focus on the concept of the cultural route as a tourist-cultural product. Within this framework, the paper offers an overview of contemporary technological challenges, concerns, and limitations. It thoroughly explores cutting-edge technologies pertaining to the promotion of cultural heritage, both in general and in the specific context of realizing the concept of the cultural route, a tourist-cultural service enriched by the utilization of new media. Additionally, it extensively references the latest techniques and models for enhancing the user experience of digital cultural tourism products. Moreover, the paper showcases existing digital platforms and tools that encapsulate and emphasize the notion of cultural tourism. It assesses the respective methodologies, technologies, and techniques employed in each case, accompanied by illustrative instances of their applications.

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

This study examined how practice distribution schedules influenced accuracy and efficacy in the tennis serve. 24 recreational players were randomized into two experimental groups. Both groups carried out 4 series of 10 services per session during 12 sessions. Massed practice group did not rested between services and rested 10 seconds between series. Distributed practice group rested 10 seconds between services and 30 seconds between series. The accuracy and efficacy were registered and computed based on the 2D digitalization. The learning and retention were tested in a post-test and retention test. The learning program increased the efficacy in the post-test in both groups (p =.001 massed group; p =.015 distributed group). On the retest, the group of massed practice decreased efficacy (p =.021). In accuracy, the group of massed practice reduced its performance in the post-test (p =.015). The effects of the program on the accuracy in the retention test were not observed. It is concluded that this type of sports learning programs, applied at a recreational level, can provide a rigorous approach that contributes with guarantees to the learning of tennis.

Over recent years globalisation has occasioned a dramatic rise in cross-cultural interactions – until this was disrupted by the COVID-19 pandemic (OECD 2018, Nelson &amp; Luetz 2021). The ability to competently engage in a multicultural world is often considered the “literacy of the future” (UNESCO 2013, OECD 2018). Global interconnectedness has brought studies into intercultural competence to centre stage (UNDP 2004, Bissessar 2018, Nelson et al. 2019). This has increased the demand for cross-cultural education experiences that facilitate such learning. However, there is a dearth of empirical research into the issues and effects surrounding short-term cross-cultural educational experiences for adolescents. This mixed methods study extends previous research by looking specifically into what impact short-term cross-cultural experiences may have on the formation of intercultural competence and emotional intelligence of Australian high school students. This study used two instruments for measuring intercultural competence and emotional intelligence in a pre- and posttest quasi-experimental design (n=14), the GENE Scale and TEQ. Moreover, it conducted in-depth post experience qualitative interviews (n=7) that broadly followed a phenomenological paradigm of inquiry. The findings suggest that fully embodied cross-cultural immersive experiences offer benefits in areas of intercultural competence and emotional intelligence and can offer meaningful application in areas of current affairs. A greater understanding of the linkages between immersive cross-cultural experiences and intercultural competence offers prospects for policy makers, educators, pastoral carers, and other relevant stakeholders who might employ such experiential learning to foster more interculturally and interracially harmonious human relations.

The article discusses the issue of the sustainable development of the cross-border market for cultural services in a city divided by the state border. The article uses the example of Cieszyn and Český Těšín, a city divided following the decision of the Council of Ambassadors in 1920. The research carried out so far indicates the main constraints in the harmonious functioning of the cross-border market for cultural services in this city, such as: different cultural policies implemented on both sides of the city, language barriers as well as legal and administrative differences. Therefore, the authors undertook research aimed at recognising the role of Euroregional structures in stimulating the sustainable development of this region. On the basis of the analysis of the Cieszyn Silesia Euroregion's documentation and the results of qualitative and quantitative research, the article describes the role of the Euroregion in building a cross-border market for cultural services. Recommendations were also prepared that could constitute the principles of a common cultural policy not only for Cieszyn and Český Těšín, but also for other European cities in the Schengen Area, which, like Cieszyn and Český Těšín, have been divided by a state border.

in the following article I analyze the trend of cultural and creative employment in the Italian regions between 2004 and 2022 through the use of ISTAT-BES data. After presenting a static analysis, I also present the results of the clustering analysis aimed at identifying groupings between Italian regions. Subsequently, an econometric model is proposed for estimating the value of cultural and creative employment in the Italian regions. Finally, I compare various machine learning models for predicting the value of cultural and creative employment. The results are critically discussed through an economic policy analysis.

This study presents the main ideas of sustainable cultural tourism development, a form of tourism associated with work discover and explore the culture of each region. It implies taking into account economic, environmental and socio-cultural aspects by tourism planning and management. The paper presents the historical background of the idea of sustainability, the factors that affect the sustainability of culture in tourism development. The author emphasizes the negative effects of tourism on cultural preservation that can be prevented by applying the principles of sustainable development; at the same time, propose solutions to balance economic development and cultural preservation.

The essence of cross-modal generation and retrieval modeling for image-text interactions lies in semantic consistency. Among these, cross-modal representation alignment serves as the foundational requirement for achieving cross-modal semantic consistency. The crux of our proposed method entails the collaborative training of an image captioning model(referred to as the ’captioner’) and a pair of contrastive encoders for image-text matching(referred to as the ’concoder’). This synergistic approach yields concurrent enhancements in concoder’s performance, captioner’s proficiency, and cross-modal semantic coherence. We coin the proposed method as ‘ReCap’. To begin, we initialize the concoder through knowledge distillation from a pre-trained model. During the training process, we use the output of the initialized concoder as input to a residual attention network, jointly training it with the captioner to achieve semantic consistency. Subsequently, we iteratively update the concoder during the image-text momentum encoding phase using the residual attention network, creating a closed-loop for semantic consistency resolution. Upon completion of training, the concoder and captioner modules can be used independently to perform tasks related to cross-modal retrieval and cross-modal generation of text and images. In order to substantiate the efficacy of our proposed method, we initially conducted empirical experiments encompassing image-text retrieval and image captioning tasks, employing a widely recognized benchmark dataset, MSCOCO. Subsequently, we assessed the fine-grained cross-modal alignment performance of the concoder through an image classification task on the iNaturalist 2018 dataset. The achieved performance metrics notably surpassed those achieved by several incumbent state-of-the-art models, thus validating the proficiency of our method. Finally, motivated by the practical requirements of handling the nature conservation image data, we performed caption annotation for the iNaturalist 2018 dataset. Subsequently, we trained the ReCap on this annotated data. Experimental results demonstrate that our proposed method can maintain semantic consistency between cross-modal retrieval and image caption generation for species with similar visual features but distinct semantics. This achievement signifies a meaningful exploration in the field of cross-modal semantic consistency representation, holding significant practical value in the domain of biological research.

(1) Background: Cardiorespiratory fitness (CRF) is a prognostic factor regarding long time morbidity and mortality. To assess CRF the well-known gold standard is cardiopulmonary exercise testing (CPET), which is a time consuming and expensive test. Therefore, alternative methods for routine evaluation of CRF are needed for the general population as well as for specific patient groups such as children and young adults with congenital heart disease. The Stair Climbing Test (SCT) is a simple and resource saving test reported in the current literature. This test is used in various settings to assess different health associated risk factors including cardiorespiratory fitness, muscular resilience, therapy effectiveness or pre- and postoperative morbidity and mortality.

Identity is the basis and foundation of the cultural landscape. Despite the emphasis of international documents and charters on its various aspects and necessity, today, the cultural landscape is threatened by extinction due to changes of many parameters. Accordingly, it is crucial to find an approach that can sustain cultural identity and its values in the changing world of the twenty-first century. Given the qualitative and the changing nature of cultural identity, achieving an approach which can lead to its continuation is not straightforward. By reviewing and analyzing international conventions and documents, on the one hand, and expert opinions, on the other hand, the present study, therefore, aimed to find out how the approach of cultural landscape values conservation can lead to the continuation of cultural identity in the natural and cultural heritage of Uraman Takht. This paper employed qualitative research methods as a basis for data collection and analysis, which primarily involved the use of content analysis along with field observations and interviews with stakeholders and indigenous residents.

This study inscribes itself in the global discussion about the issue of environmental awareness, beliefs and behaviors. Here we focus on the role that cultural differences and scientific media dieting play in explaining heterogeneities in students' awareness and expectations about the two environmental issues of deforestation and species (plant and animal) extinction in the Middle East and North America. To this end, we use the cross-sectional survey data of the OECD's Program for International Student Assessment (PISA) 2015, along with seemingly unrelated Bi-variate ordered Probit modeling techniques. The results show that compared to their North American Counterparts, students' in the Middle East are 14.2% less aware of, and 14.5% less optimistic about the issue of deforestation, while 38.9% less aware of, and 59.0% less optimistic about the issue of species extinction. In addition, we found that science club attendance and broad science reading in books are the two most effective communication media for raising students awareness about the two environmental issues. In fact, every one level increase in students' awareness is found to raise their optimism by 20.4% for the issue of deforestation, and 15.0% for the issue of plant and animal extinction. Therefore raising young people environmental awareness and optimism through proper communication strategies, could be invaluable for achieving an economic development in line with our need to preserve the natural environment and ecosystem services for generations to come.

A significant part of the literature on innovative practice in medicine relates to seizing opportunities and curbing harms for patients in desperate situations. Unfortunately, the term innovation has multiple meanings and a rich rhetorical flourish that adds confusion and misunderstanding to an already difficult debate. This paper aims to enhance the current definition of innovative practice for medicine. First, we replace the term innovation with the more literal of new non-validated practice. To identify this meaning, we analyse the traditional research ethics’ distinction between research, validated practice, and innovation in the Belmont Report. Second, we propose the following explicit definition of new non-validated practice: the first or recent use of diagnostic, therapeutic or preventive interventions that introduce a significant change, with an insufficient level of evidence of safety or efficacy for regular healthcare, and with the main aim to benefit individual patients. This definition is a promising conceptual tool to inform empirical research, ethicists, and the harmonization of its regulation and legislation (e.g. right-to-try laws).

This paper looks at key elements of global culture that are driving a new paradigm shift in museums causing them to question their raison d'être, their design and physical space, recognizing the need to accommodate visitor interaction and participation, and to reprioritize institutional outcomes and goals reexamining their priorities. As heritage sharing in online spaces reaches across national, political, and social boundaries on platforms and networks, this has been driven by museum engagement with Internet life during the pandemic. Museum relationships and interactions with communities both local and global, continue to challenge core values and precepts, leading to radical changes in how museums define their roles and responsibilities. In this new cultural landscape, museums are responding to human digital identity in a tidal wave of human interactions on the Internet, from social media to online sharing of images and videos. This is revealing shared perspectives on cultural conflict as being tied to freedom of expression of one’s heritage embedded in digital identity.

Improper illumination of cultural heritage buildings and monuments can be a source of enormous light pollution that can have a major impact on the overall environment of the illuminated area. Such lighting can be the result of carelessness or a wrong/badly designed lighting system. This paper presents one of the methodologies that can significantly reduce light pollution, especially the spilt light out of the façade. The methodology is based on using luminaires with specially made shutters with the appropriate silhouette of the object. The shutter is planned with the help of an object photo and sizes measured at the location. The methodology was tested during the renovation of the lighting system of different churches in Slovenia and is described in the example of the Church of St. Thomas near Ptuj, Slovenia. The results showed that the methodology is effective and can significantly reduce light pollution that occurs when such buildings are incorrectly lit.

Background: Asthma is a widespread chronic respiratory disease that poses a significant public health challenge. The current study investigated the associations between air pollution and asthma severity among individuals residing near the Sohar industrial port (SIP) in Oman. Despite the presence of multiple major industrial complexes in Oman, limited knowledge regarding their impact on respiratory health is accredited. Hence, the primary objective of this study is to offer valuable insights into the respiratory health consequences of industrial air pollution in Al Batinah North. Methods: The state health clinics' records for patient visits related to asthma were collected for the timeframe spanning 2014 to 2022. Exposure was defined as the distance from SIP, Majan Industerial Area (MIA) and Sohar Industerial Zone (SIZ) to determine high, intermediate, and low exposure zones (12 km, respectively). Exposure effect modifications by age, gender, and smoking status were also examined. Results: The conducted cross-sectional study of 410 patients (46.1% males and 53.9% females) living in over 17 areas around SIP revealed that 73.2% of asthmatics were under 50 years old, with severity significantly associated with closeness to the port. Risk ratios were estimated to be (RR:2.42; CI95%: 1.01–5.78), (RR:1.91; CI95%: 1.01–3.6), and (RR:1.68; CI95%: 0.92–3.09) for SIP, MIP and SIZ areas, respectively, compared to the control area. Falaj Al Qabail (6.4 km) and Majees (6 km) had the highest number of asthma patients (N. 69 and N. 72), and highest percentages of severe asthma cases among these patients (28% and 24%) with significant risk ratios (RR:2.97; CI95%: 1.19–7.45 and RR:2.55; CI95%: 1.00–6.48), correspondingly. Moreover, severe asthma prevalence peaked in the 25-50 age group (RR:2.05; CI95%: 1.26–3.33), and this linkage between asthma and age was much more pronounced in males than females. Smoking and exposure to certain contaminant (dust and smoke) increased also the risk of severe asthma symptoms, but their effects were less important in the high risk zone, suggesting much more important risk factor. A neural network model accurately predicted asthma risk (94.8% accuracy), with proximity to Sohar Industrial Port as the most influential predictor. Conclusion: The study highlights the High asthma burden near Sohar Industrial Port, linked to port proximity and smoking and wind direction as major risk factors. These findings inform vital public health policies to reduce air pollution and improve respiratory health in the region, prompting national policy review.

The general purpose of the Design Thinking approach (concept taken over in Romanian without its translation and which involves conception-oriented thinking) is to support the conception and design of products, services, processes, strategies, spaces, architecture and experiences ideal for use optimal. Applying the approach leads to the development of practical and innovative solutions to the problems identified in the product and / or technology design departments of companies. As described in the article Design Thinking is a process springing from the user-centered conception-design paradigm. The objective of the article is to highlight the need to combine urban study within Design Thinking, in the case of all areas of conception-design of solutions.

Two major sample configurations are adopted in all the instruments for fabric hand measurement, flat sample as in KES and FAST types machines, and wrinkled sample as in PhabrOmeter. This paper compares the two sample types to examine which one if any offers a better coverage and reflection of the fabric sensory attributes. Fabrics have unique behaviors of drape, wrinkle and tactile sense which are entirely due to the simultaneous occurrence of both in-plane membrane deformation and out-of-plane bending deformation in multiple curvature. Such singular deformation mode cannot be detected by any machines using flat sample, whereas during a PhabrOmeter test, the fabric sample genuinely produces drape, wrinkle in addition to other related deformations. This paper then introduced the theoretical research pertaining to the measurement. Then a split sample experiment is conducted to demonstrate the importance of the internal connections in fabric during drape and wrinkle processes. As such fabric interconnection will be barely disclosed during tests using flat samples, another important advantage of PhabrOmeter is hence clearly shown.

The literature offers limited information on the effect of obesity on the rate of force development, a critical parameter for mobility in older adults. The objectives of this study were; to explore the influence of obesity on RFD in older adults and to examine the association between this neuromuscular parameter and walking speed. 42 older adults were classified into two groups: the control group (CG, n=22; age=81.13±4.02 years; Body mass index (BMI)=25.13±3.35 kg/m²), and the obese group (OG, n=20; age=77.71±2.95 years; BMI=34.46±3.25 kg/m²). Walking speed (m/s) was measured using the 10-meter walking test. Neuromuscular parameters of the plantar flexors were evaluated during a maximal voluntary contraction test using a dynamometer. The RFD was calculated from the linear slop of the force – time curve in two phases: from the onset of the contraction to 50 ms (RFD50-100) and from 100 to 200 ms (RFD100-200). The gait speed was lower in the OG compared to the CG (p

In an era characterized by the ever-shifting landscapes of the digital realm, this paper intricately examines the interplay between digital culture, cultural dynamics, and beliefs in academia. Utilizing insights from cutting-edge language models, the study uncovers nuanced cultural expressions among Arts and Sciences students navigating the digital domain. Employing qualitative methods including interviews, observations, in-depth literature reviews, and thematic analysis, findings highlight digital interactions' transformative impact on cultural narratives and the potential of digital ethnography as a lens for understanding intricate cultural phenomena. This research enriches digital ethnography and cultural dynamics, offering fresh perspectives on the symbiotic relationship between digital culture and traditional beliefs, underscored by data from a maximum purposeful sampling of thirty (30) participants. Overall, this exploration emphasizes digital culture's dynamic role in shaping and reflecting cultural convictions, contributing to the understanding of cultural dynamics and evolving digital ethnography in the academic landscape.

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

The diversity and inclusion discussion permeates many sectors of society. Within this dialogue, science and scientists are acutely aware of the value of diversity and the need for inclusion. While demographic diversity in science has received considerable recent attention, very little research and understanding exists on inclusion. Our study presents empirical data on the meaning of inclusion using a crowdsourcing approach that sought responses to the question “What does inclusion mean to you?”. The most prominent concepts were those of empathy, warmth, support, love, acceptance and curiosity; diverse perspectives; and participation. We clustered conceptual elements of inclusion into four themes: access and participation, embracing diverse perspectives, a welcome environment, and team belonging. On the basis of these data, we theorize a conceptual framework model from which inclusion may be put into practice. Our model suggests a dynamic process of inclusion operating from principal structural elements of 1) a foundation that involves place, access and participation, and space; 2) reciprocal engagement as an engine for inclusion; and 3) expression of inclusion as culture. The framework model demonstrates a means by which the practice of diversity can be more than shifts in demographic statistics, and instead promote the full expression of benefits derived when the many dimensions of diversity are truly included.

In the second decade of the 21st century, social media changed the nature of communication and cooperation between participants of the culture services market. They became, among other things, an important marketing instrument in the area of contact with the customers of the cultural offer. However, despite their growing importance in various areas of activity of organisations in the cultural sector, the issue of building the cultural institution's brand equity by social media users is relatively seldom raised. Research on the impact of online consumer activity on brand equity is at an early stage of development. Therefore, this article is an attempt to fill the research gap in this area. The article presents the results of a survey conducted in 2018 on a group of 1021 consumers of cultural services, who at the same time regularly used social media. The statistical analysis carried out and the research results obtained prove that the 3C sustainable system developed by the authors, concerning the activity of consumers of cultural services in social media, stimulates the consumer-based brand equity (CBBE). Statistically significant relations have been observed in particular for CBBE components related to the awareness of a cultural institution's brand and for the relationship related to the perception of its quality. The study opens a review of literature on social media and consumer-based brand equity (CBBE). Next, based on the COBRA model (consumer's online brand-related activities), a proposal of the 3C sustainable system, concerning the activity of consumers of cultural services in social media, has been presented. The further part of the article presents research hypotheses, a conceptual model, research methodology as well as results and conclusions. The last part of the article discusses the results obtained and indicates the existing management implications.

This study aimed to investigate the relationship between sleep duration, dementia severity, age, and ANS regulation. This cross-sectional pilot study included 27 older patients with probable Alzheimer’s disease, hospitalized at a psychiatric center. We measured heart rate variability to assess ANS regulation at night, evaluated dementia severity using the Clinical Dementia Rating scale, and obtained sleep duration data from sleep diaries maintained by psychiatric nurses. The data were analyzed using repeated-measures generalized linear models with age, sex, dementia severity, and medication (antipsychotics) as covariates. A sleep duration of 7–8 h per night was associated with better ANS regulation than other sleep durations, as indicated by sympathovagal balance (p = 0.005). ANS dysregulation was characterized by a 20.7% increase in sympathetic nervous system activity and a 14.8% decrease in parasympathetic nervous system (PSNS) activity. We found a significant correlation between dementia severity and PSNS activity (p = 0.04) and observed an inverted U-shaped association between sleep duration and ANS regulation. This pilot study demonstrated that a sleep duration of 7–8 h per night may be critical in maintaining optimal ANS regulation. Bidirectional associations between sleep duration, inadequate sleep duration, aging, and ANS regulation warrant further investigation.

The study aimed to determine the effect of heat stress (HS) on reproductive parameters [calving to first service (CTFS) and first service conception rate (FSCR)] and general physiological responses [rectal temperature (RT) and respiratory rate (RR)] in tropical Holstein Friesian dairy cows raised in Ratchaburi province, Thailand. Cows were divided into a moderate HS (n = 22) and a mild HS (n = 22) group. Cycling cows were detected and injected with PGF2α at the beginning of the experimental period. Reproductive and physiological parameters were recorded. The average temperature humidity indices experienced by the cows were 80.67 ± 0.79 and 77.81 ± 1.09 for the moderate and mild HS groups, respectively. Cows showed significantly lower RT and RR in the mild (38.47 ± 0.21°C and 41.04 ± 4.55 bpm, respectively) than in the moderate HS group (38.87 ± 0.15°C and 51.17 ± 10.52 bpm). Under mild HS, cows showed a better response to injection of PGF2α than those under moderate HS. The percentage of cows that ovulated after being induced by PGF2α and showed estrus signs was higher in the mild than the moderate HS groups (54.55% versus 18.18%). Furthermore, the FSCR of cows under mild HS tended to be higher than in the moderate HS group (54.55 % and 42.11%, respectively), while the average CTFS interval was significantly shorter under mild than moderate HS (69.47 ± 18.18 and 84.60 ± 27.68, respectively). These results indicate that HS impairs reproductive performance in cross-bred Holstein cows, especially in moderate HS conditions.

RAxML-NG is a new phylogentic inference tool that replaces the widely-used RAxML and ExaMLtree inference codes. Compared to its predecessors, RAxML-NG offers improvements in accur-acy, flexibility, speed, scalability, and user-friendliness. In this chapter, we provide practicalrecommendations for the most common use cases of RAxML-NG: tree inference, branch supportestimation via non-parametric bootstrapping, and parameter optimization on a fixed tree topo-logy. We also describe best practices for achieving optimal performance with RAxML-NG, inparticular, with respect to parallel tree inferences on computer clusters and supercomputers. AsRAxML-NG is continuously updated, the most up-to-date version of the tutorial described inthis chapter is available online at: https://cme.h-its.org/exelixis/raxml-ng/tutorial .

Paleoclimatic and paleoceanographic studies routinely rely on the usage of foraminiferal calcite through faunal, morphometric and physico-chemical proxies. The application of such proxies presupposes the extraction and cleaning of these biomineralized components from ocean sediments in the most efficient way, a process which is often labor intensive and time consuming. In this respect, in this study we performed a systematic experiment for planktonic foraminiferal specimen cleaning using different chemical treatments and evaluated the resulting data of a Late Quaternary gravity core sample from the Aegean Sea. All cleaning procedures adopted here were made on the basis of their minimum potential bias upon foraminiferal proxies, such as the faunal assemblages, degree of fragmentation, stable isotope composition (δ18O and δ13C) and/or Mg/Ca ratios that are frequently used as proxies for surface-ocean climate parameters (e.g., sea surface temperature, sea surface salinity). Six different protocols were tested, involving washing, sieving, and chemical treatment of the samples with hydrogen peroxide and/or sodium hexametaphosphate (Calgon ®). Single species foraminifera shell weighing was combined with high-resolution Scanning Electron Microscopy (SEM) and synchrotron X-ray Microtomography (SμCT) of the material processed by each of the cleaning protocols, in order to assess the decontamination degree of specimen’s ultrastructure and interior. It appeared that a good compromise between time and cleaning efficiency is the simultaneous treatment of samples with a mixed hydrogen peroxide and Calgon solution, while the most effective way for an almost complete decontaminate of the calcareous components from undesirable sedimentary material is a two-step treatment - initially with hydrogen peroxide and subsequently with Calgon solutions.

Cancer cells require substantial amounts of energy and substrates for their metabolic hyperactivity, enabling the synthesis of new cells at the expense of healthy ones. Preliminary in vitro data suggest that a mix of free essential amino acids (EAA-mix) can promote cancer cell apoptosis by enhancing autophagy. This study aimed to confirm, both in vitro and in vivo, whether EAA intake could influence the development of colon cancer in mice. We investigated changes in cancer proliferation in CT26 cells treated with EAA-mix, and in mice fed with EAA rich modified diets (EAARD) as compared to those on a standard laboratory diet (StD). CT26 cells were injected subcutaneously (s.c.) or intraperitoneally (i.p.). After 21 days, tumors were removed and measured. In vitro data corroborated that EAA-mix impairs cancer growth by inducing autophagy and apoptosis. In vivo data revealed that mice on StD developed significantly larger (s.c.) and more numerous (i.p.) cancers than those on EAARD. EAA administration appears to influence cancer cell survival with notable anti-proliferative properties.

IntroductionParamedicine is a domain of practice and health profession that specialises in the provision of health and social care across a range of settings including, but not limited to, emergency and primary care. Paramedics work in a variety of clinical settings such as paramedics services, hospitals, and clinics, in the community as well as non-clinical roles, such as education, leadership, policy work, public health and research. A previous competency framework for paramedics in Canada had become increasingly poorly aligned with contemporary practice. We sought to develop a competency framework that represents contemporary paramedic practice in Canada. MethodsThis project was guided by a conceptual framework informed by systems thinking and used a six-step model for developing competency frameworks. We engaged paramedics from across Canada in working groups to explore various contexts of paramedic practice. We gathered data using multiple methods and coded this data into activity statements. We grouped these statements and developed or expanded corresponding professional activities through five drafts of the framework from 2022 to 2024. A technical committee reviewed and edited the draft framework throughout the process, culminating in a public review period from January to March 2024, and a subsequent final version of the National Competency Framework for Paramedics (NCFP). ResultsThe National Competency Framework for Paramedics reflects contemporary paramedic practice in Canada. It describes the professional activities of paramedics organised under five domains - Person-Centred Care; Collaborative Care; Safe Care; Self-Care; and Professional Care. Paramedics perform these activities across multiple contexts of practice by enacting a variety of roles depending on the event. Discussion and conclusion By exploring the variety of practice contexts and the expectations of paramedics across Canada, the NCFP provides a holistic, contemporary description of paramedic practice in Canada, providing a foundation for professional practice in a variety of settings. The five domains provide a comprehensive representation of paramedic practice helping to ensure care is ultimately and sufficiently aligned with the needs of the community and settings in which paramedics can practice. The NCFP can be used to inform education programs to better prepare paramedics for complex, interprofessional health and social care practice now and as practice continues to evolve.

This qualitative research explores the intricate relationship between cultural influences on supply chain practices and their implications for marketing strategies. Cultural dimensions such as individualism versus collectivism, uncertainty avoidance, and contextuality significantly shape decision-making processes, risk management strategies, and relationship dynamics within global supply chains. Through semi-structured interviews with supply chain managers, marketing executives, and cultural experts across diverse industries and regions, this study investigates how cultural values impact supply chain operations and consumer engagement strategies. Key findings highlight that collectivist cultures prioritize consensus-building and long-term relationships, fostering trust and collaboration among supply chain partners. In contrast, individualist cultures emphasize efficiency and accountability but may face challenges in relationship building. Risk management practices vary with cultural orientations towards uncertainty, influencing the adoption of structured versus flexible approaches to mitigate disruptions. In terms of marketing implications, the study underscores the importance of cultural sensitivity in crafting effective strategies. High-context cultures require marketing messages that resonate emotionally through implicit communication and cultural symbolism, while low-context cultures prefer clear, direct messaging focusing on product benefits. The study concludes by advocating for cultural competence as a strategic imperative for global businesses, enabling them to leverage cultural diversity for innovation and competitive advantage. It emphasizes the need for continuous adaptation to cultural nuances and market dynamics to foster inclusive collaboration and achieve sustainable growth in a globalized economy.

This paper presents an Artificial Intelligence approach to mining context and emotions related to olfactory cultural heritage narratives, in particular to fairy tales. We provide an overview of the role of smell and emotions in literature, as well as highlight the importance of olfactory experience and emotions from psychology and linguistic perspectives. We introduce a methodology for extracting smells and emotions from text, as well as demonstrate the context-based visualizations related to smells and emotions implemented in a novel Smell Tracker tool. The evaluation is performed using a collection of fairy tales from Grimm and Andersen. We find out that fairy tales often connect smell with emotional charge of situations. The experimental results show that we can detect smells and emotions with F1 score of 92.7 and 79.2, respectively.

Based on an ethnozoological study carried out from December 2018 to November 2019, this paper attempts to document the usage of squirrel species for various purposes by the Adi, Idu Mishmi, Miju Mishmi, Tangsa, Chakma and Monpa tribe living near the villages adjoining the protected areas located in the districts of East Siang, Lower Dibang Valley, Dibang Valley, Lohit, Changlang and West Kameng of Arunachal Pradesh, India. The paper also describes the use of certain squirrel species as a part of their traditional culture and lists their names in English, Vernacular and Latin names. The study has led to an understanding that eight squirrel species are used by the tribes for cultural, food and medicinal purposes. This work contributes to ethnozoological research by describing a knowledge system of squirrel species use and the association of squirrel species with the cultural believes of the tribes.

Domestication had a dramatic influence on the cultural evolution of human histories, and on the biological evolution of domesticated species. Domestic dogs occurred earlier in the Americas than other domesticated animals. Older records in the continent come from North America, dated 11,000-8,400 ybp, and in the Andes from 5,600-5,000 ybp. In order to present an overview of human-dog interaction in the Americas, and to identify gaps in knowledge of this subject, we reviewed 178 publications on zooarchaeological record of burials, genetics, morphology, and ethnological information of American dogs, revisiting the history and interactions across the continent. There is no evidence of an in-situ dog initial domestication. Pre-Columbian diversity in North America includes at least three varieties, whereas in South America six varieties were documented. Historical descriptions of phenotypes (e.g. humped dog) may represent an expression associated with mutations. We find that archaeological, historical, and ethnographic records reveal non-traditional uses and hybridizations with other canids. For example, the Coast Salish people exploited woolly dogs for manufacturing blankets. Dog acquisition by some Amazonian cultures began towards the end of the nineteenth century. Overall more than 41 dog breeds originated in the Americas and are currently recognized by kennel clubs. The main gap in knowledge points to the relationships between American breeds, local hybridizations, migratory routes of dogs following Indigenous peoples’ social networks, historical-cultural contexts, and quantification of morphological diversity. North and Central American dogs have been more intensively studied than those from the Amazon regions or Patagonia. We find that the history of domestication in the Americas is far from simple and integrative studies are needed.

Documenting cultural heritage by using artificial intelligence (AI) is crucial for preserving the memory of the past and a key point for future knowledge. However, modern AI technologies make use of statistical learners that lead to self-empiricist logic, which, unlike human minds, use learned non-symbolic representations. Nevertheless, it seems that it is not the right way to progress in AI. If we want to rely on AI for these tasks, it is essential to understand what lies behind these models. Among the ways to discover AI there are the senses and the intellect. We could consider AI as an intelligence. Intelligence has an essence, but we do not know whether it can be considered “something” or “someone”. Important issues in the analysis of AI concern the structure of symbols -operations with which the intellectual solution is carried out- and the search for strategic reference points, aspiring to create models with human-like intelligence. For many years, humans, seeing language as innate, have carried out symbolic theories. Everything seems to have skipped with the advent of Machine Learning. In this paper, after a long analysis of history, the rule-based and the learning-based vision, we propose KERMIT as a unit of investigation for a possible meeting point between the different learning theories. Finally, we propose a new vision of knowledge in AI models based on a combination of rules, learning and human knowledge.

Effective sports training should be attuned to the athlete's specific conditionings and characteristics. In motor learning research, two often neglected factors that influence this resonance are the learner's athletic background and the structural diversity of exercises (e.g., relative similarity). This study examines the effects of three learning approaches (i.e., contextual interference (CI), differential learning (DL), and free-play control condition (CO)) on the parallel learning of Handball (HB), Volleyball (VB), and Basketball (BB) skills, considering participants' prior sport backgrounds. Forty-five males (15 HB, 15 VB, and 15 BB players) with a mean age of 22±1.4 years and at least 6 years of experience in the mastered discipline voluntarily participated in this study. A pre-post-retention test design including a 6-week-intervention program was employed. In terms of short-term (pre-post) gain, only the DL- group significantly improved their performance in both non-mastered disciplines (p=0.03 for the BB free-throw and p=0.05 for the HB shooting tests), with a trend (ES=0.53) towards an improvement in the performance of the mastered VB underarm-pass skill. In terms of relatively permanent gains, the CI group significantly improved their performances from pre- to retention-test only in the non-mastered BB free-throw skill (p=0.018). In contrast, the DL group significantly improved their performance at retention compared to the pre-test in both non-mastered BB (p=0.004) and HB (p=0.003) skills, with a trend (ES=0.4) towards improvement in the mastered VB test. In both short, and relatively permanent terms, higher composite score gains were observed in DL compared to CI (p=0.001 and 0.002) and CO (p=0.001 and <0.0001). In conclusion, the present findings provide additional support for the potential advantages of the DL model over those of CI. These findings can serve as the basis for tailored training and intervention strategies and provide a new perspective for addressing various issues related to individual and situational learning.

The Fruit Harvest Helper, a mobile application developed by Northwest Nazarene University’s (NNU) Robotics Vision Lab, aims to assist farmers in estimating fruit yield for apple orchards. Currently, farmers manually estimate the fruit yield for an orchard, which is a laborious task. Fruit Harvest Helper seeks to simplify their process. While prior research efforts at NNU concentrated on developing an iOS app for blossom detection, this current research aims to adapt that smart farming application for apple detection across multiple platforms, iOS and Android. The old and new applications were designed with an intuitive user interface that is easy for farmers to use, allowing for quick image selection and processing. Unlike before, the adapted app utilizes a color ratio-based image segmentation algorithm implemented in OpenCV C++ to detect apples in apple tree images selected for processing. The results of testing the algorithm with a dataset of images indicate an 8.52% Mean Absolute Percentage Error (MAPE) and a Pearson correlation coefficient of 0.6 between detected and actual apples on the trees. These findings were obtained by evaluating the images from both the east and west sides of the trees, which was the best method to reduce the error of this algorithm. Although the Fruit Harvest Helper shows promise, there are many opportunities for improvement. These opportunities include exploring alternative machine-learning approaches for apple detection, conducting real-world testing without any human assistance, and expanding the app to detect various types of fruit. The Fruit Harvest Helper mobile application is among the many mobile applications contributing to precision agriculture, nearing readiness for farmers to use in yield monitoring and farm management.

The study aimed to estimate the prevalence of respiratory symptoms and to assess respiratory health risks associated with Particulate Matter (PM) exposure among the residents of Windhoek, Namibia. Objectives: To measure particulate pollution concentration in Windhoek through monitoring of particulate matter concentration and to identify any associations between particulate pollution, individual location and respiratory health among the Windhoek resident’s. Methods: an adapted standardized self-administered questionnaire was used to collect respiratory health related data as well as previous exposure, while PM monitoring was done using ASTM D1739 reference method. Results: A high prevalence was observed for cough (43%), breathlessness (25%), and Asthma (11.2%). PM was found to be a significant risk factor for episode of cough and phlegm, while high PM exposure category had increased odds ratio for episode of phlegm and cough (OR: 2.5, 95% CI: 0.8-8.0). No association was observed between location and respiratory health outcomes. Conclusion: The study found high levels of PM concentration across all Windhoek suburbs which were above the German, American and EPA. Enactment of legislation relating to the control and monitoring of PM related emissions at point of generation is required at country and city level.

The conceptualisation of happiness varies across different cultures. In Chinese culture, happiness is not only inclusive of oneself, but also hinges on the people is related to and society. Chinese social development have influenced psychological traditionality and modernity and individual's happiness. In Experienment1, 450 participants were recruited and surveyed to examine the levels of happiness amongst Chinese undergraduates with diverse cultural values. The results showed that individuals with both traditional and modern psychological orientations had high levels of happiness. Those with higher psychological traditionality showed more satisfaction with family relationships and social happiness, while those with higher psychological modernity demonstrated a higher level of relational happiness. In Experienment2, 280 participants were recruited, and a "happiness token distribution" and "happiness importance survey" were employed to draw a 'happiness circle' for Chinese undergraduates. The results revealed that those with a higher degree of psychological traditionality assigned a greater proportion of their happiness to ascribed relationships. In contrast, those with a higher degree of psychological modernity allocated a larger share of their happiness to interactive relationships and social relationships. Individuals with lower values of both traditionality and modernity perceived themselves as the most important component in their happiness circle.

The paper presents the results of high precision control survey carried out in the underground mining of Oyu Tolgoi project using terrestrial laser scanning technology. The purpose of the measurements is to ensure the heading, total length and volume of the penetration and excavation works are being implementing in accordance with the planned and designed dimensions. We established a network of 18 reference points in the tunnel of the selected underground level which were repeatedly measured 4 times by two round readings of the Trimble S7 tacheometry and processed by using the Trimble Business Center software. All points except the one was within the permissible error. Based on these points the excavation length and volumes were determined using the Trimble SX12 laser scanner. The difference between the planned work quantity provided by the Oyu Tolgoi project and the actual values measured by the laser scanning was calculated using the comparative method. The TLS partial control measurements in the excavations made through the ore bodies revealed the length of 20285.72 m and volume of 441128.80 m3 for underground 7 mine levels while their project values were 16158.26 m length and 422837.50 m3 volume, respectively.

The practice of teaching and scientific research on cadaveric material remains crucial for medical education, especially in surgical disciplines. However, in Italy, this practice has been neglected due to legislative insufficiency and financial constraints. Although innovative methods and tools like simulators and e-learning have been adopted, direct hands-on experience with human cadavers remains irreplaceable for medical and surgical education. The absence of clear legislation governing cadaveric dissection has limited availability for teaching and research, resulting in economic burdens for universities and individuals seeking proper surgical training. To address this issue, the Law No. 10/2020 and the recent implementing decree were introduced in Italy, providing detailed legislation on the donation of bodies for educational and research purposes. The law emphasizes the importance of respecting the donor's specific choices and aligns with constitutional principles promoting culture, research, and health protection. However, some critical issues related to consent procedures, duration of body availability, and preservation of anatomical parts remain. Additionally, the law's dissemination among the population needs improvement. Future optimization could include allowing donors to choose the timing of body donation and considering different timeframes for body availability. Furthermore, the implementation of consent procedures could be simplified to increase donations. The law should also address the need for appropriate reception centers and allocate resources for effective dissemination. Despite these challenges, Law No. 10/2020 represents a significant step forward in enhancing medical-surgical training, scientific research, and the overall quality of patient care in Italy.

In recent years, there has been a surge of proposals for innovative approaches to public planning. It has become apparent that the traditional emphasis on "economic development" as the predominant objective of public policy is no longer adequate to promote a thriving society. Common Agricultural Policy in Europe faces challenges to adopt and implement the dynamic of culture. However, culture as a pillar of sustainable development is not a new topic. This concept has been incorporated into economic studies with increasing tension. The present study aims to measure scientific interest through published scientific studies and papers related to the contribution of culture in the context of European development programs and strategies. A total of (n=902) published documents during the period 1990-2023 from the Scopus database were explored to identify (n=27) appropriate publications for research analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach and flow diagram. Bibliometric analyses using Vos Viewer (Center for Science and Technology Studies, Leiden University, Leiden, The Netherlands) and constructed term co-occurrence network plots based on bibliometric evidence were performed. The results show that there was no scientific interest. The systematic review and bibliometric analysis of the present paper could provide a valuable and seminal reference for the researchers of rural development and the relevant policymakers.

This research ventures into the critical public health challenge of childhood obesity by exploring the dynamic interplay between psychological well-being and Body Mass Index (BMI) throughout various developmental stages of childhood. It delves into how emotional regulation, attachment dynamics, and social relationships correlate with obesity from early childhood to adolescence. Highlighting key findings, such as the negative correlation between psychological resilience and higher BMI in young children, the impact of social relationships on obesity risk during pre-adolescence, and the link between adaptive emotional strategies and higher BMI in adolescents, this study brings to the fore the nuanced relationship between psychological factors and obesity. Utilizing the interdisciplinary process of bioinformatics, this research synergizes psychometric and biomedical data to unearth psychological markers critical for crafting targeted, age-appropriate interventions. This study advocates for a holistic healthcare approach, emphasizing the integration of psychological support within obesity prevention and management strategies, thereby underscoring the indispensable role of psychological factors in the fight against childhood obesity. The application of bioinformatics methods to analyze complex datasets demonstrates how collaboration across medical specialties can enrich our understanding and response to childhood obesity, contributing significantly to the development of comprehensive, bioinformatics-enhanced healthcare solutions.

Background: Previous investigations have found a correlation between abnormal curvatures and a variety of patient complaints such as cervical pain and disability. However, no study has shown that loss of the cervical curve is a direct result of exposure to a motor vehicle collision (MVC). This investigation presents a retrospective consecutive case series of patients with both a pre-injury cervical lateral radiograph (CLR) and a post-injury CLR after exposure to a MVC. Computer analysis of digitized vertebral body corners on CLRs was performed to investigate the possible alterations in the geometric alignment of the sagittal cervical curve. Methods: Three spine clinic records were reviewed, over a 2-year period, looking for patients where both an initial lateral cervical x-ray and an examination were performed prior to the patient being exposed to a MVC; afterwards an additional exam and radiographic analysis were required. A total of 41 patients met the inclusion criteria. Examination records of pain intensity on numerical pain rating scores (NPRS) and neck disability index (NDI), if available, were analyzed. The CLRs were digitized and modeled in the sagittal plane using curve fitting and the least squares error approach. Radiographic variables included total cervical curve (ARA C2-C7), Chamberlain’s line to horizontal (skull flexion), horizontal translation of C2 relative to C7, segmental translations (retrolisthesis and anterolisthesis), and circular modelling radii. Results: There were 15 males and 26 females with an age range of 8-65 years. Most participants were drivers (28) involved in rear end impacts (30). The pre-injury NPRS was 2.7 while the post injury was 5.0; p &lt; 0.001. The NDI was available on 24 /41 (58.5%) patients and was found to increase following exposure to the MVC: 15.7% to 32.8%, p &lt; 0.001. An altered cervical curvature was identified following exposure to MVC, characterized by an increase in radius of curvature and an approximate 8° reduction of lordosis from C2-C7; p &lt; 0.001. The mid cervical spine (C3-C5) showed the greatest curve reduction with localized mild kyphosis at these levels on average. Several participants developed segmental translations that approached the instability value of translation &gt; 3.5mm. Conclusions: Abnormalities of cervical lordosis occurred following exposure to a MVC. The average loss of cervical curvature was 8° from C2-C7, with mild flexion of the mid cervical segments. Snap through type or dynamic buckling during the MVC may explain our findings. The primary contribution of this study to the motor vehicle collision literature is that altered cervical lordosis may result from MVC exposures and the consequences of an altered cervical alignment, in turn, may lead to future pain, disability and decreased health-related quality of life.

There are many modern and traditional methods in valuing the performance of the company among them EVA, CVA are modern methods where as EPS, ROI, ROE etc. are some of the traditional methods. modern and traditional methods are not only used to check the performance of a company but it also used in investment decisions by the investors. Stern Stewart, managing partner of M/s Stern Stewart & Co. introduced a modified concept of economic profit in 1990 in the name of Economic Value Added (EVA) as measure of business performance and CVA is only a cash consideration in EVA. In this paper an attempt is made to study which method is used by the investors while taking the investment decisions i.e. traditional methods are modern methods. 100 respondents (Investors) are questioned and collected their views, we are assuming that there is no impact of traditional or modern methods while taking investment decisions by the investors.

The onset of the Coronavirus 2019 (COVID-19) pandemic has challenged the worldwide healthcare sector, including dentistry. The highly infectious nature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and risk of transmission through aerosol generating procedures has profoundly impacted the delivery of dental care services globally for months causing prioritization of critical dental needs and suspension of routine dental procedures. As dental practices with strengthened infection control strategies and preventive measures are re-opening in the “new normal” period, it is the responsibility of healthcare professionals to constantly analyze new data and limit the spread of COVID-19 in dental care settings. With the new variants of SARS-CoV-2 rapidly emerging in different geographic locations, a definite need to comply more than ever with the rigorous public health measures to mitigate COVID -19 transmission exists. The aim of this article is to provide dental clinicians with essential information regarding both the spread of SARS-CoV-2 virus and protective measures against COVID-19 transmission in dental facilities. By compiling guidance and standard protocols recommended by credible national and international organizations, this article serves as an aid to navigating through this unprecedented time with ease. Much to learn about COVID-19 exists and because of constant ongoing research, we are not aware of all of the newly found information. However, in this paper, we reviewed the available literature recommended for the best current practices that must be taken for a dental office to function safely and successfully.

Additive manufacturing (AM) provides opportunities to design objects differently than traditional manufacturing methods allow, but only if designers understand the possibilities AM presents. In this study, we examined whether an AM workshop combined with an idea generation session could inspire engineering professionals to use AM solutions to solve current technical problems they face. All subjects were employees at an organization that will be referred to as Company X, a multinational commercial organization based in North America. During the study, we collected ideas for 24 projects generated before and after a training workshop focused on design for AM. In the workshop, we provided three hours of instruction about design for two metal-based AM processes. The participants’ ideas were assessed using four specific metrics: (1) cost, (2) time,(3) completeness of solution, and (4) quality, which was a function of feasibility, usefulness, and novelty. Using these data, we explored whether the workshop was effective in inspiring the participants to use AM methods and techniques from AM research in their concept generation and whether participants’ AM solutions showed improvement in cost, implementation time, and quality over non-AM designs generated before the workshop.