In the context of modern healthcare, the concept of patient-centered care (PCC) has emerged as a crucial aspect, prompting the need for innovative frameworks to empower patients and enhance healthcare outcomes. This paper introduces the Patient-Oriented Medical Ontology Conceptual Framework (POMOCF), a powerful framework aimed at giving patients control over their personal and healthcare information. It prioritizes patient independence by allowing for direct control of electronic health records (EHRs) and facilitates the gathering of information through document upload or scanning. In the POMOCF front-end framework, we propose to maintain scalability, along with robust authorization, authentication, and secure data protocols, all of which are detailed within the framework. This approach enhances data accuracy and security, improving data management efficiency. As part of our ongoing development, we are planning to implement an innovative inference system that will automatically analyze and extract relevant details from the uploaded authorized document, provide real-time updates, and maintain data accuracy. This approach further strengthens data accuracy and prevents unauthorized modifications, thereby making the data management process more efficient. POMOCF leverages medical ontology principles to ensure standardized clinical concepts and improved semantic interoperability. Our integration plans involve integrating genotypic data for personalized medicine initiatives and strengthening the front-end infrastructure. By linking front-end interfaces with advanced technological solutions, we aim to provide effective healthcare delivery, promoting personalized care and enhancing patient outcomes.

While the simple model of the total atmospheric carbon sink effect as a linear function of concentration has provided excellent prediction results, several problems remained to be investigated and solved. The most obvious open issue is the correct treatment of land use change emssions. It turns out that the model improves by mostly neglecting them after 1959. This effectively implies that land use change emissions have been constant and small since then. The key investigation starts with the observation, that the total carbon sink has a short term component which be explained by temperature changes commonly known as El Nin˜o. The apparent paradox is analysed and explained, why contrary to the short term changes no temperature caused trend can be detected in the model, despite the fact that several contributing processes exhibit temperature dependency. The result of this analysis leads to the model extension, where the total effect of sinks and natural emissions are a linear function of concentration and temperature. This model not only explains current measurements but also paleo climate from ice-core time series.

Conversational artificial intelligence (AI) has shown strong capabilities in providing low-cost and timely interventions for a wide range of people and increasing well-being. Therefore, this study examined ChatGPT’s efficacy in conducting psychological counseling and its potential for providing accessible psychological interventions, especially in school settings. This study assessed the strengths and limitations of AI to inform future research. Data were generated from ChatGPT’s responses to 80 counseling questions that college students asked during a school counseling setting. All the responses generated during these simulated counseling sessions were then analyzed using three primary metrics—warmth, empathy, and acceptance—following APA guidelines. The analysis adopted several natural language processing methodologies for emotion detection and empathy measurement to quantify ChatGPT’s high efficacy in presenting the appropriate emotions and reactions for counseling. Some responses demonstrated randomness, which is crucial for consideration regarding the use of ChatGPT or relevant technology in psychological counseling. The Discussion section also highlights future directions in the application of conversational AI to enhance students’ mental health.

In order to clarify some more concepts, we start by classifying some forms of populism and visualize them as precursors of totalitarianism. It goes without saying that media control or at least media domination (especially in this recent age of digitalization) becomes important within this context, because the Turing galaxy follows essentially the development of the Gutenberg galaxy, but at the same time, quite different from the latter, it multiplies, enhances, and accelerates anonymous data pressure that alters the quality of the ongoing discourse. This is what we would like to discuss here in more detail by also asking for a possibly anthropological principle that underlies these developments.

Background: Student-specific stress is pervasive and impairs health and attainment. Experimentally induced self-affirmation can reduce stress, but little is known about the mechanisms underlying this effect, and the role of individual differences. The present study explores the relationship between spontaneous self-affirmation, student-specific stress, and overlapping constructs of positive self-regard during the COVID-19 pandemic. Methods: The study investigated inter-relationships between spontaneous self-affirmation, student-specific perceived stress and potential covariates including self-esteem, self-integrity and habitual positive self-thought. University students (N = 151) aged 18 to 50 responded to an online questionnaire including the Spontaneous Self-Affirmation Measure, College Student Stress Scale, Rosenberg Self-Esteem Scale, Habitual Index of Positive Thinking and Self-Integrity Scale. Results: Unexpectedly, regression analysis revealed that spontaneous self-affirmation was a positive predictor of student-specific stress, seemingly driven by relational affirmations. Self-esteem and habitual self-thought were negative predictors of student-specific stress, whilst self-integrity was not a predictor. Conclusions: Habitual positive self-thought may offer a sustainable solution to student-specific stress, but spontaneous self-affirmation does not. A reduction in defensive responses, elicitation of negative emotions, or use of conditional relationships in relational affirmation

Many have speculated that events of personal and financial loss in Rembrandt’s life caused depression and that this is revealed by examination of his self-portraits particularly those painted in old age. Some report detecting various physiological diseases associated with aging, including vision impairment, which may have affected his mood and work. Aging and neurodegenerative disease which often accompanies it, are both associated with depression. Recent advances in imaging and computer technology make it possible to empirically examine changes in artistic style which can contribute to understanding artists’ physical and mental health. In the current study changes in contrast, colour and fractal dimension were measured in the entire corpus of Rembrandt’s painted self-portraits and portraits to determine whether changes in style indicate depression or disease. Productivity was also examined as an indirect indicator. Given the high salience attributed to self-images, it also examined whether differences in style could be detected between self-portraits and portraits of related and unrelated others. The results indicate that it is unlikely that Rembrandt suffered from unipolar or bipolar depression, age-related cognitive decline, or neurodegenerative disease. The data are consistent with someone experiencing episodes of low mood consistent with normal grieving and adversity followed by resilient recovery. There is evidence of a gradient in saliency and complexity between self-portraits and related and unrelated portraits, of a less formal style in portraits of related others and of a ‘late’ style identified by leading art historians consistent with macular degeneration. The results are also consistent with an association of aesthetic preference with mid-level fractal values tending towards the Golden Mean long associated with beauty in nature and in art.

Spontaneous, unwilled subjective imagery and symbols often emerge in psychotherapy that can appear baffling and confound interpretation. Moreover, early psychoanalytic theories seemed to diverge as often as they agreed on the meaning of such content. Nevertheless, reviewing key findings in the empirical science of spontaneous thought, as well as insights gleaned from neurosciences and especially embodied cognition, it is now possible to construct a more coherent theory of interpretation that is clinically useful. Given that thought is so thoroughly embodied, it is possible to demonstrate that universalities in human physiology yield universalities in thought. Such universalities can then be demonstrated to form a kind of biologically directed universal “code” for understanding spontaneous symbolic expressions that emerge in psychotherapy. An example is given that illustrates how this can be applied to clinical encounters.

This study examines demographic factors which may influence opinions concerning medical students’ self-care and substance use behaviors as a means of providing insights into how future doctors view these issues compared to Australian doctors and members of the public. We conducted national, multicenter, prospective, on-line cross-sectional surveys using hypothetical scenarios to three cohorts- Australian medical students, medical doctors, and the public. Participants’ responses were compared for the different contextual variables within the scenarios and the participants’ demographic characteristics. In total 2,602 medical students, 809 doctors and 503 members of the public participated. Compared with doctors and the public, medical students were least tolerant of alcohol intoxication, and most tolerant of using stimulants to assist with study, and cannabis for anxiety. Doctor respondents more often aligned with the public’s opinions on the acceptability of the medical students’ behaviors. Although opinions are not equivalent to behaviour, Australian students’ views on the acceptability for cannabis to help manage anxiety, and inappropriate use of prescription-only drugs are concerning; these future doctors will be responsible for prescribing drugs and managing patients with substance abuse problems. However, if current Australian medical student’s opinions on alcohol misuse persist, one of the commonest substance addictions amongst doctors may decrease in future.

Objectives: This study proposes a model that integrates three determinants of social cognitive theory (SCT) to explain the impact of FoMO on SNS usage. Design: A cross-sectional study is conducted using data for 259 participants recruited from a website. Main Outcome Measures: The analysis focuses on FoMO, social influence, positive outcome expectancy, refusal self-efficacy, and SNS-related behavior cloud-based sites. Data are examined using descriptive analysis and structural equation modeling. Results: The proposed model reported proper goodness of fit. FoMO does not directly or indirectly impact SNS usage through the determinants of SCT. However, social influence and refusal self-efficacy have a direct effect. Conclusions: The roles of the three determinants of SCT vary by stage of SNS usage. FoMO and refusal self-efficacy are more strongly related with SNS addiction. Further research, particularly longitudinal and intervention studies, is needed to examine the effects of specific factors on SNS addiction.

Immunosuppressed individuals, such as people living with HIV (PLWH), remain vulnerable to severe COVID-19. We analyzed the persistence of specific SARS-CoV-2 humoral and cellular immune responses in a retrospective, cross-sectional study in PLWH on antiretroviral therapy. Among 104 participants, 70.2% had anti-S IgG antibodies and 55.8% had significant neutralizing activity against the Omicron variant in a surrogate virus neutralization test. Only 38.5% were vaccinated (8.76 ± 4.1 months prior), all displaying anti-S IgG, 75% with neutralizing antibodies and anti-S IgA. 29.8% had no SARS-CoV-2 serologic markers and displayed significantly lower CD4 counts and HIV viral load. Severe immunosuppression (present in 12.5% of participants) was linked to lower levels of detectable anti-S IgG (0.0003), anti-S IgA (p < 0.0001) and lack of neutralizing activity against Omicron variant (p < 0.0001). T-cell responses were present in 86.7% of tested participants, even in those lacking serological markers. In PLWH without severe immunosuppression, neutralizing antibodies and T-cell responses persisted for up to 9 months post-infection or vaccination. Advanced immunosuppression led to diminished humoral immunity, but retained cellular immune.

Loss of muscle mass and strength are progressing with aging. Exercise is a beneficial method to prevent physical disfunction and habitual exercise improve the muscle quality. Therefore, we evaluated the effects of a long-term habitual exercise on the senescence-accelerated mice prone8 (SAMP8). 27wk SAMP8 were used in this study. Mice were classified into 28 (28w) and 44 weeks old. The 44-week group was divided into the sedentary group (44w) and a group exercising for 16 weeks (44w+Ex). The 44w+Ex performed habitual exercise from 28 to 44 weeks. Additionally, grip strength tests were performed with mice aged 28 and 44 weeks. Mice were dissected and collected muscle samples and measured muscle weight at 44w. Gastrocnemius was decreased in 44w but were unchanged in 44w+Ex. Grip strength in 44w was lower trend, but there was no change in 44w+Ex. The phosphorylation levels of Akt and p70S6K as a protein synthesis marker were decreased in 44w. Cytochrome c oxidase subunit IV(COXIV) mRNA and protein levels decreased in 44w. These results suggested that long-term habitual exercise attenuated muscle mass and strength decline through improving muscle protein synthesis and mitochondrial function. In conclusion, long-term habitual exercise attenuated muscle mass and strength decline.

Habitual entrepreneurs became an important group of entrepreneurs who make a large contribution to the process of wealth creation. Previous studies have indicated that habitual entrepreneurship is a widespread phenomenon. It highlights the need to focus on the habitual entrepreneurs to understand the dynamic aspect of entrepreneurship. The aim of the article is to present the results of preliminary research on the relationships of entrepreneurial behavior of novice entrepreneurs and habitual entrepreneurs, in particular their motivation and impact on the entrepreneurial process. Research were conducted on a sample of 373 small innovative enterprises in the fourth quarter of 2017. The scale of habitual entrepreneurs in the examined sample is 32.44% and is comparable with research carried out in other countries. Survey results reveal that habitual entrepreneurs have greater tendency to create opportunities (introduction new products or services) than novice entrepreneurs. Habitual entrepreneurs also have higher development rate (increase of turnover) and larger share in the international market than novice entrepreneurs. The article also contains indications for further research into the phenomenon of multiple entrepreneurship.

This article is an early draft on a proposed alternative to the current Marxist mode of thought; one that seeks to reject the generally ill-conceived and dogmatic proposals formulated by Marx in favour of another predicated on the more unwavering emotional ideals of the philosophy that preceded it. It eliminates that dogmatic mode in favour of a wholly social society, one that is founded upon the Marxist superstructure and intends hence to capture that humanity and re-form particularly economic principles that are used to construct the utopia into what is instead an entirely socially idealised frame of living.

Negative mental health in students currently is classified as a global crisis with the highest and lowest student achievers recognized at greatest risk. Public schooling, in reproducing accepted psychosocial beliefs through standardized learning, developed separately from necessitating student mental health, in contrast to self-directed learning. Differing from standardized learning, the objective of self-directed learning in public schools is the creation of relevant support structures for student mental health, promoting positive psychosocial outcomes. The designed separation of public schooling from both mental health and self-directed learning was first acknowledged—and lamented—by John Dewey, over 100 years ago, in anticipating today’s mental health crisis. Yet, in responding effectively to the limitations of COVID-19, self-directed learning became an acknowledged learning method in public schools, potentially able to be accommodated by them regularly in support of mental health through the use of online technology. This study investigates the COVID-19 results of self-directed online learning in public schools through a Google Scholar search of peer reviewed research regarding self-directed learning, online learning, and mental health during COVID-19, recommending support for self-initiated self-directed online learning so that self-directed learning can continue, post COVID-19, improving student mental health in public schools, leading to positive psychosocial outcomes.

Surface acoustic wave (SAW) is effective for the manipulation of fluids and particles in microscale. The current approach of integrating interdigitated transducers (IDTs) for SAW generation into microfluidic channels involves complex and laborious microfabrication steps. These steps often require the full access to clean room facilities and hours to align the transducers to the precise location. This work presents an affordable and innovative method for fabricating SAW-based microfluidic devices without the need of clean room facilities and alignment. The IDTs and microfluidic channels are fabricated in the same process and thus precisely self-aligned in accordance with the device design. With the use of the developed fabrication approach, a few types of different SAW-based microfluidic devices have been fabricated and demonstrated for particle separation and active droplet generation.

The well-known coupling between the magnetic and electric fields in electromagnetic radiation is revisited in light of the recent introduction of a microscopic theory for the Ørsted magnetic field induction. I argue that, if the Ørsted magnetic field induction does indeed have a microscopic origin rather than the continuum solution offered by the Maxwell-Ampere equation, the "electromagnetic wave"' propagating in vacuum will not have a magnetic component.

Organically-coated nanomaterials are intensively studied and find numerous applications in a wide range of areas ranging from optics to biomedicine. One of the recent trends in material science is the application of bio-mimetic polydopamine coatings that can be produced on a variety of substrates in a cost-efficient way under mild conditions. Such coatings not only modify the biocompatibility of the material but also add functional amino groups to the surface that can be further modified by classic conjugation techniques. Here we show an alternative strategy of substrates modification using not dopamine but dopamine conjugates. Compared to the classic scheme the proposed strategy allows for separation of the "organic" and "colloidal" stages and simplifies identification and purification steps. Modification with pre-modified dopamine allowed to achieve high active components loading up to 10.5% wt. A series of organo-inorganic hybrids were synthesized and their bioactivity was analyzed.

Background: Recently some photon models of a Wigner's friend experiment have led investigators to suggest objective reality does not exist, and to publish non-academic articles with such claims. The public is not equipped to evaluate the severe limitations of these experiments. The separation of Wigner from the experiment and use of only reversible coherent processes for the friend allow operations that are not possible in ordinary reality according to the latest quantum research. Methods: We suggest directly testing the implied claim that objective reality, including incoherent objects with irreversible non-destructive memory, can be held in superposition. We suspect it will fail, but provide for a graduated approach that may discover something about the conditions for superposition collapse. To this end we design a thought experiment to model the objective world, investigating under what conditions experimenters in the same world (ensemble member) will be able to record a result and find it does not appear to change. An observer has a viewing apparatus and a memory apparatus. A second uncorrelated viewer of the same recorded result is employed to obtain objectivity. By hypothesis the uncorrelated second viewer obtains the same view of the measurement record as the first observer. There are not two measurements. This is not an investigation of hidden variables. Results: To model the objective world, incoherent and irreversible processes must be included. To test for superposition, coherence has to be established. These seem to present a contradiction. Conclusions: The thought experiment has suggested new places to look other than size for the origin of objective reality from the quantum world, casts doubt on the Many-Worlds interpretation, and provides a method of testing it.

We introduce and analyse a simple formal thought experiment designed to reflect a qualitative decision dilemma humanity might currently face in view of climate change. In it, each generation can choose between just two options, either setting humanity on a pathway to certain high wellbeing after one generation of suffering, or leaving the next generation in the same state as this one with the same options, but facing a continuous risk of permanent collapse. We analyse this abstract setup regarding the question of what the right choice would be both in a rationality-based framework including optimal control, welfare economics and game theory, and by means of other approaches based on the notions of responsibility, safe operating spaces, and sustainability paradigms. Despite the simplicity of the setup, we find a large diversity and disagreement of assessments both between and within these different approaches.

One of the oldest problems in physics is that of calculating the motion of N particles under a specified mutual force: the N-body problem. Much is known about this problem if the specified force is non-relativistic gravity, and considerable progress has been made by considering the problem in one spatial dimension. Here I review what is known about the relativistic gravitational N-body problem. Reduction to one spatial dimension has the feature that gravitational radiation is absent, thereby allowing for a clear comparison between the physics of one-dimensional relativistic and non-relativistic self-gravitating systems. After describing how to obtain a relativistic theory of gravity coupled to N point particles, I discuss in turn the 2-body, 3-body, 4-body, and N-body problems. Quite general exact solutions can be obtained for the 2-body problem, unlike the situation in general relativity in 3 spatial dimensions for which only highly specified solutions exist. The 3-body problem exhibits mild forms of chaos, and provides one of the first theoretical settings in which relativistic chaos can be studied. For N4 other interesting features emerge. Relativistic self-gravitating systems have a number of interesting problems awaiting further investigation, providing us with a new frontier for exploring relativistic many-body systems.

In wireless sensor networks (WSNs), each sensor node can estimate the global parameter from the local data in distributed manner. This paper proposed a robust diffusion estimation algorithm based on minimum error entropy criterion with self-adjusting step-size, which are referred to as diffusion MEE-SAS (DMEE-SAS) algorithm. The DMEE-SAS algorithm has fast speed of convergence and is robust against non-Gaussian noise in the measurements. The detailed performance analysis of the DMEE-SAS algorithm is performed. By combining the DMEE-SAS with diffusion minimum error entropy (DMEE) algorithms, an Improving DMEE-SAS algorithm is proposed, in non-stationary environment where tracking is very important. The Improving DMEE-SAS algorithm can avoid insensitivity of the DMEE-SAS algorithm due to the small effective step-size near the optimal estimator, and obtain a fast convergence speed. Numerical simulations are given to verify the effectiveness and advantages of these proposed algorithms.

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 >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 >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.

Gastric cancer is an aggressive disease with increasing global incidence in recent years. Human epidermal growth receptor 2 (HER2) is overexpressed in approximately 10-20% of gastric cancers. The implementation of targeted therapy against HER2 as part of the standard of care treatment in metastatic disease has improved the prognosis of this subset of patients. However, gastric cancer still has high mortality rates and urgently requires new treatment strategies. The combination of immunotherapy with HER2-targeted therapies has shown synergistic effects in preclinical models, being the rationale behind exploring this combination in clinical trials in locally advanced and metastatic settings. Additionally, the irruption of antibody-drug conjugates and other novel HER2-targeted agents has led to the development of numerous clinical trials showing promising results. This review presents the molecular mechanisms supporting the use of HER2-targeted drugs in combination with immunotherapy and provides an overview of the therapeutic scenario of HER2-positive disease. We focus on the role of immunotherapy but also summarize emerging therapies and combinations under clinical research that may change the standard treatment in HER-2 positive disease in the future.

Improvement of hydrophysical properties and corrosion resistance of self-compacting concrete to the effects of alternate freezing-thawing and aggressive soils of southern and central Kazakhstan is of interest to a wide range of researchers from the side of practical application of the obtained results in construction practice. It is proposed to form a spatially reinforced fine crystalline structure of cement matrix with maximum dense packing by using a complex modifier (Hyperplasticiser + Polymer + Microsilica + Fibro fibers) in the composition of self-compacting concretes (SCC). The introduction of the calculated amount of the above additives increases the operational reliability of the current SCC compositions, increasing the water resistance to W16, frost resistance to F=500, increasing the compressive strength by 20%, reducing the mass loss of samples during corrosion leaching to 50%. It has been experimentally established that the proposed addition of complex modifier (Hyperplasticiser + Polymer + Microsilica + Fiber fibers) to the SCC composition allows obtaining self-compacting concrete of high quality with improved performance characteristics (compressive strength, water resistance, frost resistance and corrosion resistance). Studies have shown that the complex modifier-modified SCC compositions have a high degree of resistance in aggressive environments and leaching corrosion. Based on the results of the conducted tests, it is possible to recommend the obtained SCC compositions for production of building products working in the zone of alternating freezing-thawing and aggressive soils.

PURPOSE: Breast cancer tumors frequently have intratumor heterogeneity. Tumors with high intratumor heterogeneity have caused therapeutic resistance and have human epidermal growth factor receptor 2 (HER2) heterogeneity in response to HER2-targeted therapies. This study aimed to investigate whether high HER2 heterogeneity levels were clinically related to poor prognosis for HER2-targeted adjuvant therapies resistance in primary breast cancers. METHODS: This study included patients with primary breast cancer (n = 251) treated with adjuvant HER2-targeted therapies. HER2 heterogeneity was manifested by the shape of HER2 fluorescence in situ hybridization amplification (FISH) distributed histograms with HER2 gene copy number within a tumor sample. Those heterogeneity classified each tumor into the biphasic grade graph (high heterogeneity [HH]) group and the monophasic grade graph (low heterogeneity [LH]) group. Both groups were evaluated for disease-free survival (DFS) and overall survival (OS) for a median of ten years of annual follow-up. RESULTS: Of 251 patients with HER2-positive breast cancer, 46 (18.3%) and 205 (81.7%) were classified into the HH and LH groups, respectively. The HH group had more distant metastases and a poorer prognosis than the LH group (DFS: P < 0.001 (HH:63% vs LH:91% at 10 years), and OS: P = 0.012 (HH:78% vs LH:95% at 10 years). CONCLUSION: High HER2 heterogeneity is a poor prognostic factor in patients with HER2-positive breast cancer. A novel approach of heterogeneity, which is manifested by the shape of HER2 FISH distributions, might be clinically useful in the prognosis prediction of patients after HER2 adjuvant therapy.

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

The needs for environmental reporting to include positive outcomes considering differences between creation of less harm, benefits and net benefits are explored. To become mainstream, nature-positive development needs positive messaging, measures and metrics to guide, plan and assess urban outcomes. With the accelerating climate crisis and negative messages getting the upper-hand, it’s important to avoid paralysis by bad news. Whilst striving for a nature-positive world, more effort should be on moving beyond zero to qualify and quantify benefits, gains, and regenerative outcomes instead of oscillating around damage and loss sticking points. Life Cycle Benefit Assessment (LCBA) is a method to measure gains in accelerating restoration and climate security. It enables a good news focus as its reach is to quantify and show positive gains beyond the negative and zero loss outcomes. The paper aims to clarify concepts, challenges and quantitative methods then review real-world third-party-certified case studies. Climate security, human wellness and resource viability gains inside safe operating space within planetary boundaries are quantified as positive benefits. Contrary to conventional Life Cycle Impact Assessment (LCIA) LCBA assigns damage and loss as negative debts and benefit as positive gains. It concludes that LCBA offers business and design a new environment assessment tool, with research needed on economic and other outcomes.

Self-sustained learning (SSL) is considered a crucial factor in promoting students’ long-term learning and development in a sustainable society. To deepen the understanding of SSL, especially in the context of learning English as a second language, the current study examined the influence of intercultural communicative skills, language mindset, and positive L2 self on SSL in English learning among 1,238 college students in China. The results showed that students not only had a strong language mindset, positive L2 self, and intercultural communicative skills but also scored higher in long-term self-sustained English learning. Findings from the Structural Equation Modeling indicated that both language mindset and intercultural communicative skills positively predicted positive L2 self and self-sustained English learning. Furthermore, language mindset and intercultural communicative skills had an indirect impact on self-sustained English learning through positive L2 self. These findings suggest that to promote English learners’ SSL, instructors should help facilitate students’ intercultural communicative skills and foster a growth language mindset, as well as positive language learning beliefs.

Estrogen receptor-positive (ER+) breast cancer is common among postmenopausal women and is frequently treated with Letrozole. Letrozole inhibits aromatase from synthesizing estrogen from androgens. Decreased estrogen slows the growth of tumors and can be an effective treatment. Letrozole resistance is increasingly being observed, which poses a unique problem for patients. We reanalyzed transcriptomic data comparing individuals who responded to Letrozole therapy (responders) to those who were resistant to treatment (non-responders). We identified SOX11 and S100A9 as two genes that significantly differed between these patients; with “PLK1 signaling events” being the most significant signaling pathway. We also identified PRDX4 and E2F8 as the top transcriptional biomarkers for ER+ treatment resistance. Many of the other significant gene products play a known role in ER+ breast cancer or other types of cancer, which partially validate our results. Several of the gene products we identified do not have a characterized role in ER+ breast cancer. Our analysis identified a set of genes that warrant further research to elucidate the molecular mechanism of Letrozole resistance in this patient population, as well as novel high-performing biomarkers. We anticipate that these findings could contribute to improved therapeutic outcomes in human patients.

The application of non-uniform spiral gratings to control structure, topological parameters and propagation of orbital angular momentum (OAM) beams was studied experimentally with coherent near-infrared light. Adapted digital spiral grating structures were programmed into the phase map of a high-resolution liquid-crystal-on-silicon spatial light modulator (LCoS-SLM). It is shown that characteristic spatio-spectral anomalies related to Gouy phase shift can be used as pointers to quantify rotational beam properties. Depending on sign and gradient of spatially variable periods of chirped spiral gratings (CSG), variations of rotation angle and angular velocity as a function of propagation distance were measured. Propagation-dependent self-torque is introduced in analogy to known local self-torque phenomena of OAM beams as obtained by the superposition of temporally chirped or phase modulated wavepackets.

In European thought, the relationship among the fields of psychology, education, and health is both complex and obscured. Foucault’s acclaimed work, The Order of Things, offers a framework to evaluate their interconnection by identifying three distinct periods of European thought since the 16th century with respect to the ordering of phenomena—Renaissance, Classical and Modern. Theoretically dense and often difficult to decipher, the book’s categorization of language, value and being has been understandably underused, yet it provides deep insights into what have come to be known as psychology, education and health and remains invaluable in understanding the origin, limits and consequences of these fields. How Foucault’s analysis can be interpreted concerning the development of these areas as to each of the three periods of European thought is investigated. An approach based on narrative research appraises the analysis offered in the book. The results, presented for the first time in table form, compare these three periods, demonstrating a continuing practical value to Foucault’s insights. With the aid of the framework revealed by these tables, the boundaries and relationship of psychology, education and health become clear and their limitations—plus potential solutions to them—can be identified to mitigate anticipated negative consequences.

Muscle mass and strength decrease with aging, but habitual exercise can maintain muscle health. β-Hydroxy-β-methyl butyrate calcium (HMB) and black ginger (BG) are anti-oxidants that have been reported to improve muscle protein metabolism and energy production; these molecules may have synergistic effects. The senescence-accelerated mouse-prone 8 (SAMP8) model is a useful model of muscle aging. Therefore, in this study, we explored how the combination of habitual exercise, HMB, and BG affected muscle aging. We used 28-week-old SAMP8 mice divided into five groups: control, exercise (Ex), Ex+BG, Ex+HMB, and Ex+BG+HMB (Ex+Comb). Mice were required to run on a treadmill for 16 weeks at 5 days per week. In 44-week-old mice, grip strength tests and dissection were conducted. Muscle weight was measured, and the gastrocnemius muscle was subjected to quantitative polymerase chain reaction and immunoblotting. Muscle mass and strength were preserved in the Ex+Comb group, and mitochondrial function was preserved through suppressing oxidative stress. Muscle protein synthesis signaling was improved in the Ex+Comb group. Autophagy and the ubiquitin system were normalized by Ex+Comb treatment. Overall, habitual exercise and HMB plus BG treatment maintained muscle health by suppressing oxidative stress, preserving mitochondrial function, and maintaining muscle protein metabolism in SAMP8 mice.

A large body of evidence has linked unhealthy eating patterns with an alarming increase in obesity and chronic disease worldwide. However, existing methods of assessing dietary intake in nutritional epidemiology rely on food frequency questionnaires or dietary records that are prone to bias and selective reporting. Herein, metabolic phenotyping was performed on 42 healthy participants from the Diet and Gene Intervention (DIGEST) pilot study, a parallel two-arm randomized clinical trial that provided complete diets to all participants. Matching urine and plasma specimens were collected at baseline and following 2 weeks of provision of either a Prudent or Western diet with a weight-maintaining menu plan designed by a dietician. Targeted and nontargeted metabolite profiling was conducted using three complementary analytical platforms, where 80 plasma metabolites and 84 creatinine-normalized urinary metabolites were reliably measured (CV < 30%) in the majority of participants (> 75%) after implementing a rigorous data workflow for metabolite authentication with stringent quality control. We classified a panel of metabolites with distinctive trajectories following 2 weeks of food provisions when using complementary univariate and multivariate statistical models. Unknown metabolites associated with contrasting dietary patterns were identified with high resolution MS/MS and/or co-elution after spiking with authentic standards. Overall, 3-methylhistidine and proline betaine concentrations increased consistently after participants were assigned a Prudent diet (q< 0.05) in both plasma and urine samples with a corresponding decrease in the Western diet group. Similarly, creatinine-normalized urinary imidazole propionate, hydroxypipecolic acid, dihydroxybenzoic acid, and enterolactone glucuronide, as well as plasma ketoleucine and ketovaline increased with a Prudent diet (p< 0.05) after adjustments for age, sex and BMI. In contrast, plasma myristic acid, linoelaidic acid, linoleic acid, a-linoleic acid, pentadecanoic acid, alanine, proline, carnitine and deoxycarnitine, as well as urinary acesulfame K increased among participants following a Western diet. Most metabolites were also correlated (r > ±0.30, p< 0.05) to changes in average intake of specific nutrients from self-reported diet records reflecting good adherence to assigned food provisions. Our study revealed robust biomarkers sensitive to short-term changes in habitual diet for accurate monitoring of healthy eating patterns in free-living populations, which is required for validating evidence-based public health policies for chronic disease prevention.

This paper presents the design and analysis of a novel 3-degree-of-freedom (3-DOF) parallel ma-nipulator equipped with self-sensing Ni-Ti (Nitinol) actuators. The manipulator's architecture and mechanical design are elucidated, emphasizing the integration of Nitinol actuators. The self-sensing technique implemented in a previous work was extended to a 20 mm actuator length, and the actuator was used to design the 3 DOF manipulator. Kinematic analyses were conducted to eval-uate the manipulator's performance under various operating conditions. A dynamic model was implemented for the dynamic dimensioning of the actuators, which work synergistically with a bias spring. The manipulator was realized, and a control strategy was implemented. Experimental tests, although documenting some positioning accuracy issues, show the efficacy and potential applica-tions of the proposed manipulator in robotics and automation systems, highlighting the advantages of self-sensing Nitinol actuators in small parallel manipulator designs.

The present study aims to evaluate the antibacterial activity of five commercially available essential oils (EOs): Lavender (LEO), Clove (CEO), Oregano (OEO), Eucalyptus (EEO), and Peppermint (PEO) against the most-known MDR Gram-positive and Gram-negative bacteria - Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922) and Pseudomonas aeruginosa (ATCC 27853) - alone and in various combinations. Gas Chromatography-Mass Spectrometry (GC-MS) analysis established their complex composition. Then, the antibacterial activity was investigated in vitro by diffusimetric antibiogram method, using sterile cellulose discs with Ø 6 mm impregnated with 10 µl of sample and sterile borosilicate glass cylinders loaded with 100 µl of sample; MIC (µg/mL) for each EO was calculated from IZD values (mm) measured after 24 hours. The following EO combinations were evaluated: OEO+CEO, CEO+EEO, CEO+PEO, LEO+EEO, and EEO+PEO. Then, the influence of each dual combination on 3 conventional antibacterial drugs – Neomycin (NEO), Tetracycline (TET), and Bacitracin (BAC) - activity was investigated. The most active EOs against S. aureus and E. coli were LEO and OEO (IZD = 40 mm). They were followed by the CEO and EEO (IZD = 20-27 mm); PEO exhibited the lowest antibacterial activity (IZD = 15-20 mm). EEO alone showed the highest inhibitory activity on P. aeruginosa (IZD = 25-35 mm). It was followed by the CEO, LEO, and EEO (IZD = 7-11 mm), while PEO proved no antibacterial action against it (IZD = 0 mm). Only one synergic action was recorded (OEO+CEO against P. aeruginosa); EEO+PEO revealed partial synergism against S. aureus and CEO+PEO additive behavior against E. coli. Two triple associations with TET showed partial synergism against E. coli, and the other 2 ones (with NEO and TET) evidenced the same behavior against S. aureus; all contained EEO+PEO or CEO+PEO. Most combinations reported indifference. However, numerous cases were of antagonism between constituents included in double and triple combinations, and EOs with the strongest antibacterial activities belong to the highest antagonistic combinations. A consistent statistical analysis supports our results, showing that EOs with moderate antibacterial activities could generate combinations with higher inhibitory effects based on synergistic or additive interactions.

Elevated circulating triglyceride levels have been linked to an increased risk of diabetes, although the precise mechanisms remain unclear. This study aimed to investigate whether low-density lipoprotein (LDL) cholesterol, homeostatic model assessment (HOMA) for insulin resistance, and C-reactive protein served as mediators in this association across a sample of 18,435 US adults. Mediation analysis was conducted using the PROCESS Version 4.3 Macro for SPSS. Simple medi-ation analysis revealed that all three potential mediators played a role in mediating the associa-tion. However, in the parallel mediation analysis, where all three mediators were simultaneously included, HOMA for insulin resistance remained a significant mediator (indirect effect coefficient, 0.47; 95% confidence interval [CI], 0.43—0.52; p < 0.05) after adjusting for all tested confounding factors. Conversely, LDL cholesterol (indirect effect coefficient, -0.13; 95% CI, -0.31—0.05; p > 0.05) and C-reactive protein (indirect effect coefficient, 0.01; 95% CI, -0.003—0.02; p > 0.05) ceased to be significant mediators. HOMA for insulin resistance accounted for 49% of the association between triglycerides and diabetes. In conclusion, HOMA for insulin resistance was the dominant mediator underlying the association between triglycerides and diabetes. Therefore, reducing triglyceride levels may hold promise for improving insulin sensitivity in diabetic patients.

Glass and ceramics have a fundamental and crucial role in our lives due to their properties and aesthetic decoration. However, they create serious environmental problems, mainly due to their high occupation of landfills and harmful emissions. Both wastes could be utilized to reduce the natural resources' adverse environmental effects and exhaustion. With increasing environmental concerns to reduce solid waste as much as possible, the concrete industry has adopted several methods to achieve this goal. Hence this study examines the performance of self-compacted concrete (SCC) utilizing various percentages of recycled waste materials such as those deposited from glass and ceramic industries. The idea of utilizing recycled waste materials in concrete manufacturing has gained massive attention due to their impressive results in rheological and mechanical state. Recycled glass (RG) and ceramic waste powder (CWP) were utilized to replace fine aggregate and cement, respectively. Five mixes were designed, including the control mix, and the other four mixes with different dosages of RG and CWP as fine aggregate and cement replacement ranging between 5 to 25%. Mixes were tested for both rheological and mechanical properties to evaluate their compilment with SCC requirements as per codes and guidelines. The results revealed that 20%CWP or less as cement replacement and 10% or less of RG as fine aggregate replacement would provide suitable rheological properties along with mechanical ones. Utilizing recycled glass and ceramic waste powder provides strength like the mix designed with natural resources, which helps us structure economically and environmentally friendly.

The study explores how different dimensions of perfectionism influence psychological well-being (PWB) in emerging adults. Literature has deepened the relationships between maladaptive perfectionism (e.g., excessive self-criticism, perceived discrepancy from the standards) and low PWB. Less is known about whether and how adaptive perfectionism (e.g., pursuing personal standards) relates to PWB. Secondly, the study has investigated whether self-compassion (i.e., self-benevolence, seeing personal imperfections as a common condition) may mediate the relationships between adaptive/maladaptive perfectionism and PWB. Participants (N=217, 18-35 y. o.) completed self-report questionnaires measuring: adaptive/maladaptive perfectionism (Almost Perfect Scale-Revised, APS-R: high standards and order/discrepancy, respectively), PWB, and self-compassion (SCS). Adaptive perfectionism resulted associated with PWB, particularly higher presence of purpose in life, environmental mastery, self-acceptance, and personal growth. Conversely, discrepancy resulted the most robust predictor of low PWB (β=-.68), followed by high standards with a positive direction (β=.23; Rc²=.514, p&lt;.001). A strong negative association emerged between discrepancy and SCS (r=-.67, p&lt;.001). A mediation analysis shows that self-compassion has an indirect effect reducing the strength of the relationship between discrepancy and low PWB. Results suggest focusing on self-compassion as a buffer factor that reduces the negative impact of maladaptive perfectionism on psychological well-being. Implications for education and health psychology are discussed.

Using the example of a generator model with dedicated inertia, a theoretical study of two coupled self-oscillators with capacitive coupling, their sequential single-frequency synchronization, chaos and two-frequency synchronization with an adiabatic change in the magnitude of the coupling between partial self-oscillators was carried out. The parameters of self-oscillators and the values of the coupling coefficient at which the specified operating modes of coupled self-oscillators exist are determined. The results of numerical studies, illustrating the conditions for excitation of single-frequency, chaotic and dual-frequency oscillations in a system of coupled self-oscillators are presented.

In this paper, a new type of self-excited thermomechanical oscillator containing an oscillating shape memory alloy (SMA) filament with two symmetrically arranged spheres is investigated. The self-excitation of the oscillations is due to a heater of constant temperature, which causes periodic contractions of the filament when it approaches it. The contracted filament moves away from the heater a distance sufficient to cool it. Under the action of the weight of the spheres, the cooled filament re-approaches the heater, causing the above processes to repeat periodically. On the basis of experimental studies, approximating functions of the heater's heat field distribution are derived. A dynamic model of the oscillator has been created, in which the minor and major hysteresis in the SMA alloy and the distribution of the heat field around the heater have been taken into account. By numerical solutions of the differential equations, the laws of motion of the spheres are obtained. The displacements of the spheres in two perpendicular directions were measured using an experimental system. The obtained experimental results validate the proposed dynamic model and its assumptions with a high degree of confidence. Conclusions are drawn about the stochastic nature of the oscillations due to the hysteresis properties of the SMA and the temperature variation of the natural frequency of the oscillating system.

Edvard Munch, a founder of Expressionism was pre-occupied with depicting his subjective experience and the most prolific painter of self-portraits since Rembrandt. Based on evidence that faces and self-related images are more salient than other objects it is plausible that self-portraits, in which the subject and object are the same, reflect the artist’s state of mind. Although he suffered from a variety of physical and psychological illness Munch was not diagnosed with any specificity in his lifetime. Posthumous diagnoses include schizophrenia, anxiety, bipolar and other disorders. Recent research has revealed altered visual perception in such patients. The present study empirically analysed three stylistic elements of Munch’s painted self-portraits and portraits: contrast, colour and fractal dimension and his painted productivity, to determine if variations correlate with critical life events and if so whether they indicate states of mind. It found significant increases in contrast and colour brightness and persistent high complexity during critical periods supporting the conclusion that Munch is diagnostically best described as suffering from early onset schizophrenia and comorbid social anxiety disorder.

When training deep neural networks tasks, the most popular choices are cross-entropy loss. On the other hand, in general speaking, a decent loss function can take on shapes that are considerably more flexible and ought to be adapted for different activities and datasets. In most of the classification tasks, generally if the true class is not correctly recognized by the network (top1), that class is placed among the five classes with the highest probability (top5). This shows that the network does not necessarily recognize the correct class with a low probability, but a class similar to it (such as 3 vs. 8 in mnist) assigns a higher probability and this causes a mistake in that task. Accordingly, we proposed a loss function deals with the error of class that the neural network incorrectly recognized as correct, in addition to the correct class error. We call our proposed loss as False Positive Loss (FPL), with the intention of viewing and designing loss functions not only through the utilization of true class but also through the utilization of the value of false positive classes. One of the core properties of our proposed loss is full adaptability, which makes False Positive Loss be fully capable of getting reformulated by using other widely used loss functions formulas based on the task or the need of the users. Extensive experimental results demonstrate that our suggested loss function outperforms other well-known losses on a variety of tasks and datasets. As can be observed, the performance of our False Positive Loss is superior to that of the cross-entropy loss when it comes to tasks involving 2D picture classification. We have compared our loss with cross entropy as the most common classification loss function on some models (such as ResNet-18, ResNet-50 and Efficientnet-V2) through classification known as a basic computer vision task. with both random or pre-trained initial weights. As a result, in some cases the models with our loss outperform the same tasks with cross entropy from the viewpoint of some metric (i.e. accuracy and FP). For example, the resnet-50 on cifar-10 dataset with random initialization indicated a top1 accuracy of 94.93 with cross entropy and 95.25 with our loss, while for top5 accuracy the results are 99.86 and 99.87, respectively.

Chilean geography is highly variable, not only from a climatic and hydrological point of view, but also a morphological one, showing unpredictable natural patterns with marked contrasts throughout the country, for which sometimes it is considered as a "crazy" geography. In this paper we have investigated this apparent disorganized character by exploring the fractal properties of fluvial networks extracted from basins distributed across the continental territory. Analytical and semi-empirical methods were applied, finding striking patterns of organization in the distributions of Horton parameters and the fractal dimension of the drainage networks. Fractal dimension reveals to be quite dependent on the drainage area of each unit, showing clear groupings by tectonic and climatological factors. Such dimension reveals to be an important geomorphic parameter, if not the only one able to capture the real morphology of a fluvial network. From our results and despite the diversity of landforms, hydrological, climatic and tectonic conditions, Chilean’s geography is perhaps not as crazy and disorganized as believed.

To better understand the shape memory materials and self-healing materials, a new series of liquid-crystalline shape memory polyurethane (LC-SMPU) composites, named SMPU-OOBAm, were successfully prepared by incorporating 4-octyldecyloxybenzoic acid (OOBA) into the PEG-based SMPU. The effect of OOBA on the structure, morphology and properties has been carefully investigated. The results demonstrate that SMPU-OOBAm have liquid crystalline properties, triple-shape memory properties and self-healing properties. The incorporated OOBA promotes the crystallizability of both soft and hard segments of SMPU, and the crystallization rate of the hard segment of SMPU decreases when the OOBA-content increases. Additionally, the SMPU-OOBAm forms a two-phase separated structure (SMPU phase and OOBA phase), and it shows two-step modulus changes upon heating. Therefore, the SMPU-OOBAm shows triple-shape memory behavior, and the shape recovery ratio decreases with an increase in the OOBA content. Finally, SMPU-OOBAm shows self-healing properties. The new mechanism can be ascribed to the heating-induced “bleeding” of OOBA in the liquid crystalline state and the subsequent re-crystallization upon cooling. This successful combination of liquid crystalline properties, triple-shape memory properties and self-healing properties make the SMPU-OOBAm composites with many promise applications in smart optical devices, smart electronic devices and smart sensors.

Exercise facilitates weight control, partly through effects on appetite regulation. Single bouts of exercise induce a short-term energy deficit without stimulating compensatory effects on appetite, whilst limited evidence suggests that exercise training may modify subjective and homeostatic mediators of appetite in directions associated with enhanced meal-induced satiety. However, large variability in responses exists between individuals. This article reviews the evidence relating to how adiposity, sex and habitual physical activity modulate exercise-induced appetite, energy intake and appetite-related hormone responses. The balance of evidence suggests that adiposity and sex do not modify appetite or energy intake responses to acute or chronic exercise interventions, but individuals with higher habitual physical activity levels may better adjust energy intake in response to energy balance perturbations. The effect of these individual characteristics and behaviours on appetite-related hormone responses to exercise remains equivocal. These findings support the continued promotion of exercise as a strategy for inducing short-term energy deficits irrespective of adiposity and sex, as well as the ability of exercise to positively influence energy balance over the longer term. Future well-controlled studies are required to further ascertain potential mediators of appetite responses to exercise.

Speeding is a significant global issue, with disparities in speed outcome and speed research between low- and middle-income countries (LMICs) and high-income countries (HICs). This study aims to address speed research gaps by examining the prevalence of self-reported speeding and factors influencing drivers' speeding behavior (SB) using the Theory of Planned Behavior (TPB). An online survey involving 387 anonymous drivers was conducted in Yaoundé. Results showed that all drivers reported exceeding speed limits, with 81% exceeding by 5km/h, 12% by 10km/h, and 7% by more than 10km/h in urban areas. On highways, 54% reported exceeded the limit by more than 10km/h. Age, driver's license, and gender showed significant associations with speed limits non-compliance. The study results suggests that the TPB can be useful in assessing speeding behavior, as the inclusion of TPB variables led to a more than 50% proportionate increase in SB variance. Structural equation modeling revealed attitude towards speeding as the strongest predictor of speeding intention (SI), along with certain demographics indirectly influencing SB through SI. Perceived behavioral control (PBC) and SI directly influenced SB. These findings emphasize the potential of interventions targeting attitude, intentions, and perceived behavioral control to modify speeding behavior and improve road safety.

In a hypothetical scenario where space travels outside the solar system is possible and affordable, I examine the possible implications of infinite resources and the universalization of freedom in the social and individual spheres. I argue that freedom is the figure of man's emancipation and the supreme end of history, which represents a theme affirming the infinite and indefinite progress of history and science. Also discussed is Bakunin's theory of the critique of contractualism, which denies the idea of a mythical and primordial natural freedom that existed before the constitution of society. Furthermore, I highlight the deep pathos of romantic culture that feeds into Bakunin's anarchist thought and emphasize the relevance of the notion of freedom in the context of future space travel.

Background: Learning arrangements in health care profession education are increasingly taking place in digital environments. VR in nursing education, as one of the digital elements, is the subject of controversial debate. On the one hand it supports the authenticity of case studies by adding realistic perspectives and information. On the other hand, the costs of developing and maintaining software and hardware hinder long-term implementation. Methods: In this paper, we describe our findings and insights from two different research projects focused on the incorporation of digital tools, particularly virtual reality (VR), into nursing education. Based on the German context, our aim is to promote the adoption of innovative digital methods in nursing education and to offer invaluable experiences from the field. Results: Starting with a brief recapitulation of the projects, we then elucidate the pedagogical strategies for embedding VR-driven scenarios in nursing education. Based on our experiences during the projects we identify various positive aspects, such as change of perspective and simulating acute situations. Key findings: Although potential drawbacks remain, we advocate long-term implementation and specific use of VR at the interface between theory and practice. Nevertheless it is crucial to establish regular evaluation observing the value of digitalisation, especially VR; for nursing education.

For many engineering applications it is sufficient to use the concept of simple materials. However, higher gradients of the kinematic variables are taken into account to model materials with internal length scales as well as to describe localization effects using gradient theories in finite plasticity or fluid mechanics. In many approaches length scale parameter have been introduced that are related to a specific micro structure. An alternative approach is possible, if a thermodynamically consistent framework is used for material modelling as shown in the present contribution. However, even if sophisticated and thermodynamically consistent material models can be established there are still not yet standard experiments to determine higher order material constants. In order to contribute to this ongoing discussion system identification based on the method of self-adaptive filtering is proposed in this paper. To evaluate the effectiveness of this approach it has been applied to second-order gradient materials considering longitudinal vibrations. Based on thermodynamically consistent models that have been solved numerically it has been possible to prove that system identification based on self-adaptive filtering can be used effectively for both narrow-band and broadband signals in the field of second-order gradient materials. It has also been found that the differences identified for simple materials and gradient materials allow for condition monitoring and detection of gradient effects in the material behavior.

Owing to the nondiffracting, self-accelerating, and self-healing properties, Airy beams of different nature have become a subject of immense interest in the past decade. Their interesting properties have opened doors to many diverse applications. Consequently, the questions of how to properly design spatial manipulation of Airy beams or how to implement them in different setups have become important and timely in the development of various optical devices. Here, based on our previous work, we present a short review on the spatial control of Airy beams, including the interactions of Airy beams in nonlinear media, beam propagation in harmonic potential, and the dynamics of abruptly autofocusing Airy beams in the presence of a dynamic linear potential. We demonstrate that under the guidance of nonlinearity and external potential, the trajectory, acceleration, structure, and even the basic properties of Airy beams can be adjusted to suit specific needs. We describe other fascinating phenomena observed with Airy beams, such as self-Fourier transformation, periodic inversion of Airy beams, and the appearance of spatial solitons in the presence of nonlinearity. These results have promoted the development of Airy beams, and have been utilized in various applications, including particle manipulation, self-trapping, and electronic matter waves.

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

In this paper we propose a novel self-supervised approach of keywords and keyphrases retrieval and extraction by an end-to-end deep learning approach, which is trained by contextually self-labelled corpus. Our proposed approach is novel to use contextual and semantic features to extract the keywords and has outperformed the state of the art. Through the experiment the proposed approach has been proved to be better in both semantic meaning and quality than the existing popular algorithms of keyword extraction. In addition, we propose to use contextual features from bidirectional transformers to automatically label short-sentence corpus with keywords and keyphrases to build the ground truth. This process avoids the human time to label the keywords and do not need any prior knowledge. To the best of our knowledge, our published dataset in this paper is a fine domain-independent corpus of short sentences with labelled keywords and keyphrases in the NLP community.

TThis paper delves into the extension and characterization of radial positive definite functions into non-integer dimensions. We provide a thorough investigation by employing the Riemann-Liouville fractional integral and fractional Caputo derivatives, enabling a comprehensive understanding of these functions. Additionally, we introduce a secondary characterization based on the Bernstein characterization of completely monotone functions. The practical significance of our study is showcased through an examination of the positivity of the fundamental solution of the space-fractional Bessel diffusion equation, highlighting the real-world applicability of the developed concepts. Through this work, we contribute to the broader understanding of radial positive definite functions and their utility in diverse mathematical and applied contexts.

Positive education is seen as a transformative methodological approach capable of improving the act of teaching and learning and, above all, essential for the development of students' personal skills and competences. However, few studies have been carried out on this subject in the field of lifelong and adult education. This study works with a sample of 399 people over 16 years of age and students of the Universidad Popular de Dos Hermanas in order to show the relationship between the Pygmalion effect and learned helplessness in the process of acquiring knowledge in adulthood. In this way, three tools were used: a questionnaire that showed teachers' perceptions of students' qualities and behaviour and two that provided information on self-concept, self-esteem, personal and social skills and other variables directly related to emotional intelligence and positive education. It shows how exposure to negative operational conditioning factors influences the psychosocial and socio-educational development of students in every possible way, while on the other hand, it indicates the importance of positive education to compensate for this phenomenology by improving the development and growth of those who study and participate in non-formal education. Likewise, the factorial interrelation of both positive and negative conditioning factors and their incidence on learning is shown; the importance of neutralising the negative components and strengthening the positive reinforcement and the role played by the community and education professionals as catalysts and behavioural modulators at any stage of learning and age group for the achievement of the objectives of the student and of education itself in a broad sense

The social- and self-directed behaviours of two golden lion tamarins (Leontopithecus rosalia) was investigated while having residence in the tropical house of Aalborg Zoo, Denmark. The behaviour of the female had been distinct from the male since 2018. Despite several diagnostic examinations and medicinal treatments, the cause of the aberrant and apparently stereotypical behavioural patterns remained undetermined, which initiated this study. The pair were recorded throughout a predetermined observation period and these recordings were analysed to illuminate the behaviours of the individuals. The results showed that there were differences in the type, frequency, and durations of both social- and self-directed behaviours between the sick female and the healthy male. The female expressed both social- and self-directed behaviours more frequently and for longer durations, while the male were more socially reserved and did not engage in social behaviours as frequently. Furthermore, subsequent necropsy of the female revealed uro-genital disease.

This study addresses the critical challenge of Speech Enhancement (SE) in noisy environments, where the deployment of Deep Neural Networksolutions on microcontrollers is hindered by their extensive computational demands. Focusing on this gap, our research introduces a novel SE method optimized for MCUs, employing a 2-layer GRU model that capitalizes on perceptual speech properties and innovative training methodologies. By incorporating self-reference signals and a dual strategy of compression and recovery based on the Mel scale, we develop an efficient model tailored for low-latency applications. Our GRU-2L-128 model demonstrates a significant reduction in size and computational requirements, achieving a 14.2× decrease in model size and a 409.1× reduction in operations compared to traditional DNN methods like DCCRN, without compromising performance. This advancement offers a promising solution for enhancing speech intelligibility in resource-constrained devices, marking a pivotal step in SE research and application.

Purpose: To explore the clinical relationship between age, interocular differences in the corrected distance(CDVA) and near(CNVA) high contrast logMAR acuities, refractive errors, aniseikonia, axial lengths, pupil sizes, and higher order ocular aberrations (HOAs) on clinical measures of stereoacuity in asymptomatic, presbyopic, habitual spectacle wearers. Methods: 91 subjects underwent clinical assessment of i)subjective refractive error, ii)stereoacuity[arcsecs] at 6m&40cm(Randot Stereotests), iii)aniseikonia[%] at 6m (Awaya test,vertical and horizontal meridia) iv)higher order aberrations(Hartman-Shack aberrometer) v)eyeball length and pupil size(IOL master 700). The resultant aniseikonia(AR) was calculated for pairs of aniseikonia values using Pythagorean theorem. Results: Mean(±sd,95%CI) age of the subjects was 56.2years(±8.10,54.6-57.9). Root mean square(RMS) interocular differences(±sd,95%CI) in spherical refractive errors, axial lengths and pupil sizes were 0.66D(±0.93,0.47-0.85), 0.24mm(±0.33,0.17-0.31), 0.15mm(±0.11,0.12-0.17). Median(mode,interquartile range) values for AR were 2.8(1.0,1.3-4.0). Significant correlations(p

(1) Background: Emotional resilience is defined as the capacity of individuals to cultivate positive emotions and effectively navigate through negative emotions in terms of stress or adversity. Recent research has focused on the significant impact of adolescents’ negative emotions, as opposed to positive emotions, on mental health. The examination of positive emotion provides a distinct viewpoint on the relationship between emotional resilience and mental health in adolescents. Consequently, the current research conducted two separate investigations to examine the impact of adolescent emotional resilience on mental health, as well as the mediating influence of positive emotion. (2) Methods: Study 1 comprised a cross-sectional analysis of 3086 Chinese adolescents, while Study 2 involved a longitudinal examination of 266 Chinese adolescents. (3) Results: Results indicated that emotional resilience was associated with enhanced levels of life satisfaction, self-esteem, and overall mental health, while also demonstrating a negative correlation with symptoms of depression and anxiety. Positive emotions were found to have a partial mediating effect on the relationship between emotional resilience and mental health. These results indicate that emotional resilience not only has a direct impact on mental health but also influences mental health indirectly through positive emotions. (4) Conclusions: The findings highlighted the role of emotional resilience in mitigating psychological problems and enhancing mental health in Chinese adolescents. The implications and limitations were discussed.

Mental Disorders are an important public health problem. The main of this study was to analyze the prevalence of Mental Disorders and Environmental Quality. Data on the Prevalence of Mental Disorders, Gross Domestic Product, and Median Years of Schooling from 178 countries were used. A positive association was observed and was independent of Gross Domestic Product and Median Years of Schooling.

Medullary thyroid carcinomas (MTCs) are rare thyroid tumors occurring in both sporadic and hereditary forms and whose pathogenesis is related to RET proto-oncogene alterations. MTCs originate from parafollicular cells, which produce calcitonin that represents the biochemical activity of MTC. Total thyroidectomy is the main treatment for MTC and often cures patients with confined diseases. In cases of metastasis, the approach depends on the rate of progression of disease. We report a case of a 54 years old female with a single, incidentally discovered, thyroid nodule of 1 cm, classified as suspicious MTC after a stimulation test with i.v. calcium. After surgery, we examined the nodule using immunohistochemistry, immunofluorescence and electron microscopy. In addition to calcitonin, we found that it expressed intracellular positivity for the RTK receptors ERBB1 and ERBB2. Consistently with MTC features, ultrastructural examination of the tumor displayed heterogeneous spindle-shaped cells containing two groups of secretory granules. Due to the significant correlation found between high ERBB1/ERBB2 levels in MTCs and extrathyroidal growth, the detection of ERBB1 and ERBB2 expression suggests that the two oncoproteins may possibly be involved in tumor proliferative responses and/or differentiation of C-cells. The biological, prognostic and therapeutic significance of these patterns would merits further investigations.

We develop new theory from a broad case-study approach to explore a better understanding of what constitutes knowledge and its value as identifiable to human-machine teams. From past research, this trail of exploration will lead to these initial questions: What is the value of debate in the furtherance of knowledge? Will machines with AI be able to contribute to a debate if we humans cannot define it or determine its value sufficiently for a machine’s understanding, contribution, exploration and identification? Like humans, as teammates, machines must be able to determine with AI what constitutes the usable knowledge that contributes to a team’s success in the field (e.g., testing "knowledge" in the field, identifying new knowledge, using knowledge to develop innovation) or its failure (viz., trouble shooting; identifying weaknesses; discovering vulnerabilities, hiding by deception). It matters not whether a debate is public, private or unexpressed by an individual human or machine agent alone; we speculate in this exploration that the process advances the science of autonomous human-machine teams and assists in interpretable machine learning. We conclude with questions and a speculation: How does a human become aware or express its awareness of knowledge? Can a machine be as expressive as its human teammates? And how does a human-machine teammate become aware that its teammates possess sufficient knowledge to perform a task? We speculate that the structure of “knowledge," once found, is resistant to alternatives (i.e., it is ordered); that its functional utility is generalizable; and that its applications are multifaceted (akin to maximum entropy production). The complexity of the team is taken into consideration in our search for knowledge, which can also be used as an information metric.

Today, enhancing food preservation and safety in the spirit of the bioeconomy suggests the use of biodegradable polymers such as poly-L-lactic acid (PLA) in food packaging and the replacement of chemical additives with natural antioxidant/antibacterial agents such as essential oils and their derivatives. Herein a novel carvacrol (CV) @ natural zeolite (NZ) nanohybrid was developed by employing a new vacuum adsorption desorption method which results in the adsorption of a high CV amount on NZ equal to 61.7 %wt. This CV@NZ nanohybrid was successfully dispersed in a PLA/triethyl citrate (TEC) matrix via a melt-extrusion process to obtain PLA/TEC/xCV@NZ nanocomposite films with 5, 10 and 15 CV@NZ %wt. content. PLA/TEC/xNZ films were also de-veloped for comparison. The overall study resulted in a biodegradable active film with the fol-lowing properties: 10%wt. CV@NZ content (PLA/TEC/10CV@NZ), self-healable properties, 22% higher tensile strength and 40% higher elongation at break, 45% higher water barrier and 40% higher oxygen barrier than pure PLA/TEC matrix. This film also provides high CV release content, high CV control release rate as well as significant antioxidant activity and antibacterial activity against the food pathogens Staphylococcus aureus and Salmonella enterica spp. enterica serovar Typhimurium. This film not only succeeds in extending the shelf-life of fresh pork minced, as shown by total variable count measurements in four days, but also prevents lipid oxidation of fresh minced pork and maintains the minced meat in higher nutritional conditions, as revealed by the heme iron content determination, and in a much better and acceptable sensory condition than the commercial packaging paper.

This paper studies the flexural behavior of the bridge deck link slabs made with the Polyvinyl Alcohol-Strain Hardening Cementitious Composites (PVA-SHCC). Tensile and flexural properties of the PVA-SHCC with four volume fractions, i.e., 0%, 1%, 1.5%, and 2%, were evaluated first. Next, using the similarity theory, composite models with a geometric similarity ratio of 1: 5 were designed to represent the bridge deck with the link slabs. The models considered three materials for link slabs, including concrete, cement mortar and self-compacting PVA-SHCC; and two different curing ages at 7 and 56 days. Bending tests were performed to investigate the flexural behavior of the models. Based on the fractal theory, cracking characteristics of the models with different types of link slabs were compared, and the relationship between Df and the flexural behavior of the models were studied. Numerical models were built to correlate with the results from the bending tests. It is illustrated that the flexural behavior of the self-compacting PVA-SHCC link slab is better than that of concrete and cement mortar link slabs, where the crack initiation and propagation can be postponed.

The present paper reports an exact approach quantifying the electromagnetic contribution to the anomalous magnetic moment occurring in isolated system comprised of non-composite particle carrying elementary electric charge. Essential averaging procedure and regularization of the electromagnetic field potentials necessary when quantifying the electromagnetic self-interactions and when deriving equations of motion without singularities and obeying the conservation laws are thoroughly discussed. The study shows that the dynamics of the considered system is associated to unique classical transcendental equations of motion satisfied by the particle's velocity and the electromagnetic contribution to the anomalous $g$-factor known from the quantum electrodynamics. The equations of motion lead to an exact analytical expression for the anomalous $g$-factor that provides more accurate result than that calculated with the aid of quantum electrodynamics. It matches the experimentally measured value reported in the literature to a one part per trillion. We obtain a_e=0.00115965218000(65) thus reveling the potential of non-perturbative, non-probability methods in predicting the electron's anomalous g-factor.

The research proposes a self-directed paradigm with self-design using the existing technology with LMS modules, discussions, and self-tests. The research establishes its criteria for assurance of teaching and learning known as 7x2C for the compliance of content, and appearance along with other criteria for the analysis. The above technology of web and LMS is tested for a business course that is technology-oriented in creating an experiential learning system for Covid-19 awareness. Similarly, among other ideas, an environment for educating learners about diabetes and obesity has been designed. The project is known as Sunchoke with its theme of Grow, Eat, and Heal. The educators can use their technology and apply self-directed pedagogy to transform this approach to their customized ways by using their content and rubrics.

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

Lipophilic oligonucleotide derivatives are a potent approach to the intracellular delivery of nucleic acids. The binding of these derivatives to serum albumin is a major determinant of their fate in the body, as its structure contains several sites of high affinity for hydrophobic compounds. This study focuses on the features of self-association and non-covalent interactions with human serum albumin of novel self-penetrating oligonucleotide derivatives. The study revealed that the introduction of a triazinyl phosphoramidate modification bearing two dodecyl groups at the 3' end region of the oligonucleotide sequence has a negligible effect on its affinity for the complementary sequence. Dynamic light scattering verified that the amphiphilic oligonucleotides under study can self-assemble into micelle-like particles ranging from 8 to 15 nm in size. The oligonucleotides with dodecyl groups form stable complexes with human serum albumin with a dissociation constant of approximately 10-6 M. The oligonucleotide micelles are simultaneously destroyed upon binding to albumin. Using an electrophoretic mobility shift assay and affinity modification, we examined the ability of DNA duplexes containing triazinyl phosphoramidate oligonucleotides to interact with Ku antigen and PARP1, as well as the mutual influence of PARP1 and albumin or Ku antigen and albumin upon interaction with DNA duplexes. These findings, together with the capability of dodecyl-containing derivatives to effectively penetrate different cells, such as HEK293 and T98G, indicate that the oligonucleotides under study can be considered as a platform for the development of therapeutic preparations with a target effect.

Cutaneous melanoma (CM) is a candidate for screening programs, since its prognosis is excellent when diagnosed in an early disease stage. Targeted screening of those at high risk for developing CM, a cost-effective alternative to population-wide screening, requires valid procedures to identify the high-risk group. Self-assessment of the number of nevi has been suggested as a component of such procedures, but its validity has not yet been established. We analyzed the level of agreement between self-assessments and expert assessments of the number of melanocytic nevi in the area between the wrist and the shoulder of both arms based on 4548 study subjects in whom mutually blinded double counting of nevi was performed. Nevus counting followed the IARC protocol. Study subjects received written instructions, photographs, a mirror, and a “nevometer” to support self-assessment of nevi larger than 2 mm. Nevus counts were categorized based on the quintiles of the distribution into five levels defining a nevus score. Cohen’s weighted kappa-coefficient was estimated to measure the level of agreement. In the total sample, agreement between self-assessments and expert-assessments was moderate (raw agreement: 50.29%, weighted κ=0.596). Self-assessed nevus counts were higher than those determined by experts (mean differ-ence: 3.33 nevi). The level of agreement was independent of sociodemographic and cutaneous factors; however, participants’ eye color had a significant impact on the level of agreement. Our findings show that even with comprehensive guidance, only a moderate level of agreement between self-assessed and expert-assessed nevus counts can be achieved. Self-assessed nevus information does not appear to be reliable enough to be used in individual risk assessment to target screening activities.

The antimicrobial quantitative structure–activity relationship of plant flavonoids against Gram-positive bacteria was established in our previous works, and the cell membrane was confirmed as a major site of action. To investigate whether plant flavonoids have similar antibacterial effects and mechanisms against both Gram-negative and Gram-positive bacteria, here, the minimum inhibitory concentrations (MICs) of 37 plant flavonoids against Escherichia coli were determined using the microdilution broth method, and then the correlation between their lipophilic parameter ACD/LogP or LogD_7.40 value and their MIC was analyzed. Simultaneously, the correlation between the ACD/LogP or LogD_7.40 value and the MIC of 46 plant flavonoids reported in literature against E. coli was also analyzed. Both sets of results showed that there is a significant correlation between the LogP value and the MIC of plant flavonoids against Gram-negative bacteria. However, it is difficult to effectively predict the MIC of plant flavonoids against Gram-negative bacteria from their lipophilic parameters. By comparing two regression curves derived from plant flavonoids against Gram-negative and Gram-positive bacteria, it was further discovered that the antibacterial activities of most plant flavonoids against Gram-negative bacteria are stronger than those against Gram-positive bacteria when their LogP values are less than about 3.0, but the opposite is true when their LogP values are more than about 3.6. Moreover, this comparison also suggests that unlike mainly acting on the cell membrane of Gram-positive bacteria, plant flavonoids have multiple mechanisms against Gram-negative species, while the cell membrane is also an important action site among them. Combined with the correlation analyses between the enzyme inhibitory activity and the LogP value of the reported flavonoids, it was further suggested that DNA gyrase is another important target of plant flavonoids against Gram-negative bacteria.

Up to 25% of early human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC) patients will relapse despite the improvement achieved by the introduction of HER2-targeted therapy. Beyond trastuzumab, other agents approved for early HER2+ BC include the monoclonal antibody pertuzumab, the antibody-drug conjugate (ADC) trastuzumab-emtansine (T-DM1) and the reversible HER2 inhibitor lapatinib. New agents, such as trastuzumab-deruxtecan or tucatinib in combination with capecitabine and trastuzumab, have also shown an improvement in the metastatic setting. Other therapeutic strategies to overcome treatment resistance have been explored in HER2+ BC, mainly in HER2+ that also overexpress estrogen receptors (ER+). One strategy has been to target the cyclin-dependent kinases 4/6 (CDK4/6) as they are downstream of HER2 and many of the cellular pathways associated with resistance to HER2-targeted therapies play a key role in cell cycle and proliferation. Different trials have explored these strategies with encouraging results, but definitive results are needed. In addition, HER2+ BC is known to be more immunogenic than other BC subgroups, with high variability between tumors. Different immunotherapeutic agents have been investigated in this setting, with promising but controversial results obtained to date.

Background: Visual acuity (VA) assessments are crucial in ophthalmology but traditionally rely on in-clinic evaluations. The emergence of telemedicine has spurred interest in creating dependable self-administered VA tests for use beyond standard clinical environments. This study evaluates the practicality and validity of a self-administered Near VA card test against traditional Snellen and Rosenbaum Pocket Vision Screener (RPVS) methods for home monitoring and enhancing clinical workflow. Methods: In a cross-sectional study a near VA card (Hadassah Self-Visual Acuity Screener-HSVA) was developed with written and videotaped instructions for self-use. Patients with a minimal best corrected VA (BCVA) of 1.0 LogMAR in at least one eye were recruited from Ophthalmology and Optometry clinics. Outcomes included mean BCVA difference between the self-administered and those obtained by the examiner, and correlations among BCVA values obtained by Snellen, RPVS, HSVA and previous distance BCVA according to the patient electronic medical records. Results: A total of 275 participants (mean age: 42.5±19.4 years, range: 18-89 years, 47% female) were included. Test-retest reliability analysis for the HSVA demonstrated very good correlation and repeatability (n=38 patients.; Rs=1.0, P

Rapid SARS-CoV-2 self-tests have the potential to expand access to COVID-19 testing and improve community-level case detection, particularly in resource-constrained countries such as Kenya. However, prior to their introduction, their acceptability must be assessed. This qualitative study explored key decision-takers’ values towards SARS-CoV-2 self-testing in Kenya. Healthcare workers, representatives of civil society, and potential implementors from Mombasa and Taita-Taveta were selected as decision-takers. Semi-structured interviews and focus group discussions were used to collect data on their values towards self-testing. A thematic analysis approach was applied. Most informants considered that the Kenyan public is equipped to accept and use self-testing safely as an approach to help to reduce workload at public healthcare facilities, and know one’s COVID-19 status in a private manner. The informants emphasized the need to provide counselling to end-users, to support those needing to self-isolate, and to engage different civil society stakeholders in information provision on self-testing. Fear of stigma and of forced isolation were noted as potential deterrents to self-testing uptake for some individuals. In conclusion, there is high acceptability of self-testing in Kenya among decision-takers. However, enhanced education, counselling, and addressing deterrents to testing would be helpful to ensure effective use of SARS-CoV-2 self-testing in Kenya.

: BACKGROUND: The prevalence of smoking among students is a growing concern, particular-ly among medical students. Being associated with stress, competitiveness, and various social in-fluences, smoking can have detrimental effects on self-esteem and self-efficacy and may create a vicious cycle that may contribute to students’ well-being and academic performance out-comes.METHODS: A cross-sectional study on 456 medical students was conducted via an online survey using structured questionnaires on socio-demographic characteristics, smoking habits, nicotine dependence, self-esteem, and self-efficacy. RESULTS: The prevalence of smoking was 31.1% The scores of self-esteem and self-efficacy were positively correlated with smoking habits (W1=0.957, W2=0.975, P<0.05). Students presented rather low smoking addiction with male stu-dents having slightly higher scores than female students on self-esteem and self-efficacy, mili-tary students had higher self-esteem scores than civilians with physical activity having a posi-tive correlation with non-smoking behavior. CONCLUSION: According to our results, self-esteem and self-efficacy were slightly positively correlated with smoking habits. Furthermore, there was no statistically significant association between other social factors and smoking. Our results may develop a theoretical basis for medical students’ psychological variables studying for further implementation of university educational programs and preventive interventions em-powering students towards an overall better quality of life, addressing, among others, smoking behaviors.

Two polyurethanes (PUs) were similarly synthesized by reacting a cycloaliphatic isocyanate with 1,4 butanediol and two polyols of different nature (polyester, polycarbonate diol) with molecular weights of 1000 Da. The PU made with polycarbonate diol polyol (YCD) was the only showing intrinsic self-healing at 20 °C. For assessing the mechanism of intrinsic self-healing of YCD, a structural characterization by molecular weights determination, infrared and X-ray photoelectronic spectroscopies, differential scanning calorimetry, X-ray diffraction, thermal gravimetric analysis and dynamic mechanical thermal analysis was carried out. It was concluded that the self-healing at 20 °C of YCD was due to non-covalent dynamic exchange interactions among the carbonate groups of the soft segments. Therefore, the chemical nature of the polyol played a key role in developing PUs with intrinsic self-healing at 20 °C.

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

Positive recurrence for a single-server queueing system is established under generalised intensity conditions of service which does not assume existence of the density distribution function of service but a certain integral type lower bound as a sufficient condition. Positive recurrence implies existence of the invariant distribution and a guaranteed slow convergence to it in the total variation metric.

This study investigated the associations of imageability with fear reactivity. Imageability ratings of four word classes: positive and negative (i) emotional and (ii) propriosensitive, neutral and negative (iii) theoretical and (iv) neutral concrete filler, and fear reactivity scores – degree of fearfulness towards different situations (TF score) and total number of extreme fears and phobias (EF score), were obtained from 171 participants. Correlations between imageability, TF and EF scores were tested to analyze how word categories and their valence were associated with fear reactivity. Imageability ratings were submitted to recursive partitioning. Participants with high TF and EF scores had higher imageability for negative emotional and negative theoretical words. The correlations between imageability of negative emotional words and negative theoretical words for EF score were significant. Males showed stronger correlations for imageability of negative emotional words for EF and TF scores. High imageability for positive emotional words was associated with lower fear reactivity in females. These findings were discussed with regard to negative attentional bias theory of anxiety, influence on emotional systems, and gender-specific coping styles. This study provides insight into cognitive functions involved in mental imagery, semantic competence for mental imagery in relation to fear reactivity, and a potential psycholinguistic instrument assessing fear tendency.

Today, issues related to people’s mental health and well-being have been described as a challenge for society, globally as well as in Sweden. This calls for new approaches to mental health promotion. The aim was to evaluate the adequacy of the content and structure, describing experiences of study circles as a means of supporting participants' self-care and self-compassion. The overall design is a descriptive, QUAL+quan design, where quantitative and qualitative results are integrated. Five participants participated in a focus group interview, of whom four completed questionnaires. One individual interview was conducted with the study circle leader. Study circles can be an arena for mental health promotion as learning and sharing of experience contributes to a sense of coherence, as well as self-compassion and a genuine concern for one’s own and others' wellbeing, but not considered an alternative to psychiatric care, for those in need of professional services. Study circles can be a possible means to support self-care and thereby promote mental health in the general population, and a valuable contribution to public health. However, in addition to modifications of the content, further research is needed on the qualifications for study circle leaders as well as the dissemination of study circles.

It was the aim of this study to examine whether the usage of the vaccine COXEVAC® (Ceva Santé Animale) could reduce the consumption of antibiotics in Q-fever-positive dairy farms. Additionally, the effects of other herd-level factors on the consumption of antibiotics were investigated. In this longitudinal cohort study, 36 farms with vaccination and 13 farms without vaccination participated. In all herds, Coxiella burnetii had been directly or indirectly diagnosed. To compare the treatment frequency of antibiotics between the vaccinated group and the non-vaccinated group, the consumption of antibiotics for each farm was collected using the veterinary documents about the application and delivery of antibiotics. To gather detailed information about herd data, nutrition, milking management, housing, and animal health, the farmers were interviewed with the help of a questionnaire. The results suggest that there might be an association between the vaccination against Q fever and a reduced consumption of antibiotics. Neither herd size nor milk yield level influenced the consumption of antibiotics in the study herds. Type of flooring and udder cluster disinfection while milking were associated with a lower and higher therapy frequency, respectively. Further studies are necessary to elucidate the cause-effect relationship between vaccination and the consumption of antibiotics.

Fatigue performance and self-repairing activity of asphalt binders are two properties that highly influence the fatigue cracking response of asphalt pavement. There are still numerous gaps of knowledge to fill linked with these two characteristics. For instance, current parameters fail to fully accommodate these two bitumen phenomena. This study aims to propose a new procedure to address this issue utilizing the linear amplitude sweep (LAS) test, LAS with rest period (RP) (LASH) test, and simplified viscoelastic continuum damage (S-VECD) model. This research work used four different types of asphalt binders: neat asphalt (NA), self-healing thermoplastic polyurethane (STPU)-modified bitumen (STPB), self-healing poly (dimethyl siloxane) crosslinked with urea bond (IPA1w)-modified bitumen (IPAB), and styrene–butadiene–styrene (SBS)-modified bitumen (SBSB). Before the testing process, all the materials were subjected to short-term and long-term aging. The new procedure showed a superior capacity to analyze and accommodate all bitumen fatigue performances and self-repairing activities compared to the current method. Another finding proved that asphalt binders with higher self-restoration behavior failed to show better fatigue performance. A breakthrough finding demonstrated that asphalt binder fatigue response augmented when the RP was applied at a higher damage intensity (S) value. STPBs and IPABs reached their highest increments of fatigue response, containing 1.0% of STPU and 0.5% of IPA1w, respectively. Those augmentations were 207.54% and 232.64%, respectively.

Today's unstable labor market increasingly requires flexibility and adaptability to cope with the threat of unemployment. It can cause distress in people and have a more significant negative impact on fragile workers, such as migrants. This study aimed to test whether a Career Counseling intervention designed for Migrants (CCfM) can develop Career Adaptability and, therefore, both Work Self-efficacy (WSe) and Job Search Self-efficacy (JSSe) perceptions. It was conducted in Italy and involved a sample of 233 migrants, who were asked to respond to a questionnaire available in three languages (Italian, French, and English). Data analysis showed that an improvement was demonstrated in all the variables considered, namely career adaptability (including concern, control, confidence, and curiosity), WSe, and JSSe, even though the CCfM was not directly designed to increase the last one. In addition, the development of career adaptability explained the increase in migrants' WSe and JSSe, and the initial level of career adaptability was found to explain the increase in WSe due to the initial positive level of curiosity.

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

Few prior works study self-driving cars by deep learning with IoT collaboration. SDC-Net, which is an end-to-end multitask self-driving car camera cocoon IoT-based system, is one of the research that tackles this direction. However, by design SDC-Net is not able to identify the accident locations, it only classifies if it is a crash scene or not. In this work, we introduce an enhanced design for the SDC-Net system by 1) replacing the classification network with a detection one, 2) adapting our benchmark dataset labels built on the CARLA simulator to include the vehicles bounding boxes while keeping the same training, validation, and testing samples, 3) modifying the shared information via IoT to include the accident location. We keep the same path planning and automatic emergency braking network, the digital automation platform, and the input representations to formulate the comparative study. SDC-Net++ system is proposed to 1) output the relevant control actions, especially in case of accidents: accelerate, decelerate, maneuver, and brake, and 2) share the most critical information to the connected vehicles via IoT, especially the accident locations. A comparative study is also conducted between SDC-Net and SDC-Net++ with the same input representations: front camera only, panorama and bird-eye views, and with single-task networks: crash avoidance only, and multitask networks. Multitask network with a BEV input representation outperforms the nearest representation in precision, recall, f1-score, and accuracy by more than 15.134%, 12.046%, 13.593%, and 5%, respectively. SDC-Net++ multitask network with BEV outperforms SDC-Net multitask with BEV in precision, recall, f1-score, accuracy, and average MSE by more than 2.201%, 2.8%, 2.505%, 2%, and 18.677% respectively.

Cyber Physical Systems (CPS) has been a popular research area in the last decade. The dependability of CPS is still a critical issue, and rare survey has been published in this domain. CPS is a dynamic complex system, which involves various multidisciplinary technologies. To avoid human error and to simplify management, self-management CPS (SCPS) is a wise choice. And to achieve dependable self-management, systematic solution is necessary to verify the design and to guarantee the safety of self-adaptation decision, as well as to maintain the health of SCPS. This survey first recalls the concepts of dependability, and proposes a generic environment-in-loop processing flow of self-management CPS, and then analyzes the error sources and challenges of self-management through the formal feedback flow. Focus on reducing the complexity, we first survey the self-adaptive architecture approaches and applied dependability means; then we introduce a hybrid multi-role self-adaptive architecture, and discuss the supporting technologies for dependable self-management at the architecture level. Focus on dependable environment-centered adaption, we investigate the verification and validation (V&V) methods for making safe self-adaptation decision and the solutions for processing decision dependably. For system-centered adaption, the comprehensive self-healing methods are summarized. Finally, we analyze the missing pieces of the technology puzzle and the future directions. In this survey, the technical trends for dependable CPS design and maintenance are discussed, an all-in-one solution is proposed to integrate these technologies and build a dependable organic SCPS. To the best of our knowledge, this is the first comprehensive survey on dependable SCPS building and evaluation.

The experience of ego dissolution and self-transcendence induced by psychedelic substances offers a profound challenge to our conventional understanding of the self and our relationship with the natural world. This paper delves into the philosophical underpinnings and implications of this phenomenon, exploring how the temporary breakdown of ego boundaries during a psychedelic experience may foster a sense of profound interconnectedness with nature. Drawing from Western and Eastern philosophical traditions, as well as recent insights from neuroscience and consciousness studies, we examine the potential of psychedelic-induced self-transcendence to catalyze a shift in our perspectives on the human-nature relationship. The paper investigates the philosophical implications of this experience, including its resonance with deep ecological philosophies and its potential to inspire more ecocentric ethical frameworks. Furthermore, we explore the possible practical implications of fostering a sense of ecological connectedness through psychedelics, such as promoting environmentally sustainable behaviors and addressing the pressing challenges of climate change and ecological degradation. Ultimately, this exploration highlights the value of engaging with altered states of consciousness as a means to reconsider our place within the intricate web of life on Earth.

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

Abstract: The concept of sustainability applied to sports activities means ensuring that the economic benefits brought about by their development are not obtained at the expense of causing ecological damage or interference in local cultural habits. A cable-ski is a nautical ski system whereby a motorboat is substituted by a cable traction system powered by an electric motor. The effect on the quality of the water in those places that can boast cable-ski facilities has been described in cold freshwater lakes. Objective: Our purpose was to study the evolution of water quality in a ten-year period after the installation of a cable-ski facility in a warm, salted, semi-stagnant pond. Material and Method: Review of the data gathered from the routine test carried out by the Laboratory of the Council of Alcúdia from 2010 to 2019 Results: The levels of dissolved oxygen have increased, being significantly higher in the period 2016 – 2019 than in that of 2010 – 2015. The turbidity of the water has also seen a reduction in the second period with respect to the first. Conclusion: It seems that cable-ski improves the quality of water even warm, high-conductivity, semi-stagnant conditions

This study explored the effectiveness of a virtual music therapy program, based on positive psychotherapy principles, for college students during the COVID-19 pandemic. Twenty-four undergraduate students with partial PTSD were initially assigned to either an experimental group or a control group, with 11 participants in each group by the study's end. The experimental group underwent 15 video sessions of the therapy program, completing one session per weekday over three weeks. The program involved worksheets targeting goals aligned with positive psychology, such as positive affect, life meaning, personal strengths, gratitude, hope, and happiness. Activities included writing music autobiographies, creating and analyzing song lyrics, and exploring various music pieces. The effectiveness of the intervention was measured using the 21-item Depression Anxiety Stress Scale and the Korean Version of Positive Psychological Capital (K-PPC) before, immediately after, and three weeks post-program. The experimental group showed significant improvements in stress, anxiety, depression, self-efficacy, resilience, and the K-PPC total score compared to the control group. These improvements were maintained at the three-week follow-up. The findings suggest that positive psychology-based virtual music therapy can significantly enhance the mental health of highly stressed college students, especially during challenging times like the COVID-19 pandemic.

Positive Health (PH) has been described as a promising transformative innovation to address the challenges of promoting well-being and reducing the burden of disease. The aim of this study is to review the current state of knowledge about PH as introduced by Huber et al. (2016) within the available scientific literature. A rapid review of the literature following the Cochrane Rapid Review recommendations. Three databases were searched (PubMed, Google Scholar, and CINAHL). Data were extracted and synthesized using a narrative approach. A total of 55 articles were included. Initial evaluation studies reveal promising results both at individual and collective levels. However, a need is expressed in several articles for further refinement of the conceptualization of PH and ways to make the effects of the PH approach more measurable. Professionals also expressed a desire for a more informed application and elaboration of the PH method across various settings and populations to enhance its effectiveness in practice. This rapid review highlights the transformative potential of PH in shifting from a disease-focused to a health-oriented paradigm of healthcare. It underscores the need for continued research regarding further development of the concept and its practical method, along with the necessity for methodological innovation.

Bacteremia and fungemia are significant causes of morbidity and mortality which frequently occur as co-infections with viral respiratory infections including SARS-CoV-2. It was aimed to evaluate the microorganisms isolated from blood cultures of SARS-CoV-2 positive and negative patients and investigate their antimicrobial resistance patterns. A retrospective analysis was performed with the total number of 22,944 blood cultures sent to the laboratory between November 2020 and December 2021. Blood cultures were performed on the BD Bactec automated system. Identification was performed using conventional methods, VITEK-2 and MALDI-TOF MS. Antibacterial/antifungal susceptibility tests were performed according to EUCAST/CLSI recommendations. SARS-CoV-2 tests were performed with RT-PCR. It was detected 1,630 culture positivity belonging to 652 patients. Totally 633 of 652 patients were tested for SARS-CoV-2; 118 (18.6%) were positive and 515 (81.3%) were negative. The bacteria and fungi isolated at the high-est rate in SARS-CoV-2 positive patients were methicillin-resistant coagulase negative staphylococci (MR-CoNS) (21.5%), Escherichia coli (12.4%), Klebsiella pneumoniae (12.4%), Candida albicans (1.65%) and Candida glabrata complex (1.65%); while in negative patients, E. coli (21.3%), MR-CoNS (13.5%), K. pneumoniae (12.05%), C. albicans (2.1%), Candida parapsilosis (1.1%) and Candida tropicalis (0.9%). The fact that the most common isolate was MR-CoNS in SARS-CoV-2 positive patients (p = 0.028); the detection of Acinetobacter baumannii was more frequent (p = 0.001) and the isolation of carbapenem-resistant K. pneumoniae was at a higher rate than in SARS-CoV-2 negative patients; also, the increase in multidrug-resistant strains indicate that healthcare-associated infec-tions should not be disregarded while focusing on the outbreak.

Objectives: Essential thrombocythemia (ET) is a chronic myeloproliferative neoplasm characterized by elevated platelet counts and an increased risk of thrombotic events, including ischemic strokes. Methods: We conducted a retrospective analysis of data from consecutive ischemic stroke patients with ET between March 2014 and February 2023. Results: This case series describes the clinical presentation, radiological features, and management of five patients with ET-associated ischemic strokes, all harboring the JAK2 mutation. The diverse radiological findings suggest that both large and small vessel diseases may be influenced by the prothrombotic state induced by ET. A significant elevation in platelet count was observed to correlate with the emergence of new acute infarctions in some cases. Conclusions: The study highlights combined use of antiplatelet and cytoreductive therapy in preventing secondary stroke events in patients with ET and JAK2 mutations. The heterogeneity of stroke patterns in this population necessitates a comprehensive understanding of the underlying pathophysiological mechanisms and tailored therapeutic approaches.

Women have been leading organizations and communities for centuries, but their journeys in leadership have sometimes been challenging. This paper aims to reflect on women's positive and negative experiences in leadership roles and understand the factors contributing to their successes and challenges.To explore these issues, we will draw on various academic literature, including studies on gender and leadership and case studies of women in leadership positions. We will also examine the cultural and social factors that affect women's experiences in leadership, including bias and discrimination, societal expectations, and work-life balance challenges.One key theme from this analysis is the importance of role models and support networks in helping women succeed in leadership roles. Women with access to mentorship, sponsorship, and peer networks are more likely to thrive in their roles and overcome the challenges they may face. However, lacking female role models and mentors can make it difficult for women to advance in their careers and contribute to feelings of isolation and imposter syndrome.Another important theme is the need for organizations and society to address systemic biases and discrimination that prevent women from reaching their full potential. This can include initiatives such as unconscious bias training, flexible work arrangements, and policies that support gender diversity and inclusion.In conclusion, this paper highlights women's positive and negative experiences in leadership roles and emphasizes the need for ongoing efforts to support and empower women in leadership. By addressing the challenges women face and building a culture of inclusion and support, organizations and society can help unlock the full potential of women leaders and create a more equitable and just world.

In real financial market, the delayed market feedback and the delayed effect of government macro-control are inevitable. And both the delay of market feedback and the delay of macro-control effect bring about the mathematical difficulties in studying stabilization and synchronization of the hyper-chaotic financial system. However, employing Lyapunov function method, differential mean value theorem, suitable bounded hypotheses and pulse control technology results in the globally asymptotical stabilization and synchronization criteria. It is the first paper to drive the stabilization and synchronization criteria under the assumptions of the double delays. Finally, numerical examples illuminate the effectiveness of the proposed methods.

As paradigm of complex behavior, Self-organized Criticality (SOC) reflects the ability of nonequilibrium dynamical systems to self-adjust into metastable states that are scale independent. The goal of this report is to tentatively show that the hierarchy of Standard Model masses and mixing angles follows from the universal scaling attributes of SOC.

Online education allows learners to develop knowledge and skills flexibly and conveniently—such observation among students whose characteristics involve student engagement, self-regulation, and self-efficacy. However, studies to characterize Filipino online learners seem lacking. Thus, this study aimed to characterize science education tertiary students in the Philippines concerning their online student engagement (OSE), self-regulated learning (SRL), and online learning self-efficacy (OLSE). The unprecedented events brought by COVID-19 pandemic also urged the implementation of online modalities while there is no available information on students’ online learning profiles. Hence, researchers used a survey research employed through ex post facto approach to determine the effects of the demographic profile on OSE, SRL, and OLSE. The survey was participated by N=373 respondents who answered the questionnaire with informed consent administered via Google Forms. Results revealed that OSE indicators moderately characterized students, while SRL and OLSE indicators are true of them, substantiated by the overall mean M=3.85(SD=0.90), M=3.86(SD=0.92), and M=3.14(SD=0.73), respectively. Also, multivariate tests showed no significant effect among the independent groups (p&gt;0.05), except for gender and OLSE interaction (p&lt;0.05) so, only in OLSE was a significant difference found in gender. In conclusion, Filipino online learners are moderate across aspects of student engagement, self-regulation, and self-efficacy.

In this study, a novel flexible ethanol gas sensor was created by the deposition of CoFe2O4 (CFO) thin film was on a thin mica substrate using pulsed laser deposition. Transition electron microscopy (TEM) investigations clearly demonstrated the successful growth of CFO on the mica, where a well-defined interface was observed. Ethanol gas-sensing studies showed optimal performance at 200 °C, with the highest response, 19.2, to 100 ppm ethanol. Operating the sensor in self-heating mode under 7 V applied voltage, which was corresponds to a temperature of approximately 200 °C, produced a maximal response to ethanol of 19.2. This aligned with the highest responses observed during testing at 200 °C, confirming the sensor’s accuracy and sensitivity to ethanol under self-heating conditions. In addition, the sensor exhibited good selectivity to ethanol and excellent flexibility; maintaining its high performance after bending and tilting up to 5000 times. As this is the first report on flexible self-heated CFO gas sensors, we believe that this research holds great promise for the future development of high-quality sensors based on this approach.

EUS–TA in unresectable pancreatic cancer requires not only a tissue diagnosis but also tissue collection in anticipation of comprehensive genomic profiling. However, the optimal puncture target remains controversial. Therefore, the Primary and Metastatic Lesions in Pancreatic Cancer (PRIMATE) study was designed to clarify the optimal target by comparing the success rates for meeting OncoGuide NCC Oncopanel (NOP) analysis criteria on pre-check primary and metastatic lesion specimens obtained during the same EUS–TA session in patients with invasive pancreatic ductal adenocarcinoma. In this ongoing prospective study, two specimens, each from primary and metastatic lesions, are obtained by EUS–TA (typically using a 19G fine-needle biopsy needle) in patients with invasive pancreatic ductal adenocarcinoma. The primary endpoint is the proportion of EUS–TA specimens that meet NOP analysis criteria during pre-check (i.e., tumor cellularity ≥ 20% and tissue area ≥ 4 mm2), which are then compared between primary and metastatic lesions. This study has been approved by the National Cancer Center Institutional Review Board (Research No. 2022-168). The results of this study will be reported at an international conference and published in an international peer-reviewed journal. The trial registration number is UMIN 000048966.

De-escalation is currently taking place both in surgical and systemic treatment of breast cancer. The introduction of trastuzumab, the first monoclonal antibody against the HER2 receptor over 20 years ago was a milestone in the treatment of HER2 positive breast cancer and marked the beginning of a new era in targeted tumor therapy. In the sense of de-escalation, omitting non-targeted cytotoxic chemotherapy altogether is often hailed as the ultimate goal of oncological research. Especially in case of small, node-negative, HER2 positive early breast cancer, it remains a challenge for clinicians to establish the safest and most efficient treatment plan while considering the significant potential for toxic side effects associated with chemotherapy and HER2 targeted therapy, and the generally excellent prognosis. In this context, several ongoing studies are currently assessing chemotherapy-free regimens as part of strategies aimed at de-escalating therapy in the field of HER2 positive early breast cancer. Despite promising early results from these studies, combination of anti-HER2 treatment with chemotherapy backbone remains standard of care.

: Background and objectives: One of the most severe symptoms of extrapulmonary tuberculosis (TBEP) is tuberculous meningitis (TBM) which is linked to significant morbidity and high mortality. It is well recognized that HIV-positive people are more likely to develop TBEP, including TBM, especially if they have severe immunodeficiencies. Material and methods: We conducted a retrospective clinical study based on hospital medical records of the diagnosed patients with HIV/AIDS and Tuberculous Meningitis in North-eastern Romania, hospitalized at "Sf. Parascheva" Clinical Hospital of Infectious Diseases from Iasi. We aim to highlight the profile and the caracteristics of the HIV/AIDS and Tuberculous Meningitis coinfection cases. The time frame under study was from January 1st, 2010, to December 1st, 2022. Results: Our Center has a total number of patients on record of 1692. Patients co-infected with HIV- TB were 195 of which 19 cases were HIV- TBM coinfection and it was more common in women. From this total, 6 cases were late presenters and 13 patients were already in the center's records with a deficient immunological viral status, non-compliant, and non-adherent to antiretroviral therapy. The average age in the study group was 27 years old. The mean admission day number was 17.73 days. CSF findings (qualitative and quantitaitve examination, biochemestry) were in accordance with the literature. Conclusions: The key to the management of the HIV-positive patient is the multidisciplinary approach and access to antiretroviral therapy. We must find and eliminate obstacles affecting patients and the healthcare system. In order to increase ART uptake among HIV-infected TB patients and to put an end to the TB and HIV epidemics.

The COVID-19 pandemic has exposed the inadequacies of the current healthcare system and needs a paradigm change, which is holistic, and community based illustrated by the healing wheel. The present paper proposes that existential positive psychology (PP 2.0) represents a promising approach to meet the rising needs in palliative care. This framework has a twofold emphasis on (a) How to transcend and transform suffering as the foundation for wellbeing, and (b) how to cultivate our spiritual and existential capabilities to achieve personal growth and flourishing. We propose that these objectives can be achieved simultaneously through dialectical palliative counselling, as illustrated by Wong’s integrative meaning therapy (Wong, 2020) and Lo’s Conceptual Model of CALM Therapy in palliative care (Lo et al., 2014). We then discuss existential suffering in general and at the last stage of life in particular; we also review recent research and interventions on existential suffering in palliative patients. Finally, we outline the objectives and the strategies of IMT in providing palliative counselling for palliative care and hospice patients.