Objective: Taiwan Government’s organizations have endeavored to promote the applications of big data and open data. The “My Health Bank” is one of the measures promoted by the National Health Administration, Ministry of Health and Welfare. This study proposes the perspective of the “value co-creation” with the attempt to extend the concept of service ecosystem and apply it on the platform of My Health Bank to examine whether people (patients, families, and caregivers) can promote their health literacy? Method: This cross-sectional study, with people that have registered at “My Health Bank” as subjects. Complying with the inclusion criteria, 401 questionnaires were delivered, with 391 valid ones, excluding those incompletely and inaccurately filled. Result: That the affecting factors of the co-creation of values: age, education level, annual income, and platform operation show to be significant ( p＜0.05); and gender, occupation, and resource exchange do not reach the significant level (p＞0.1). Conclusion: We found My Health Bank changed the inertia of “value creation” in the traditional medical value, it allows the traditional medical and healthcare industry to expose to the impacts of the mega trend of the internet, the transformation of the platform in a necessary trend.

Whitebark pine (Pinus albicaulis Engelm.) is a key component of subalpine and alpine ecosystems in the northern Cascades. The species survival is threatened by white pine blister rust, mountain pine beetles, fire exclusion, and climate change. Trees were monitored in permanent plots in two national parks three times between 2004 and 2016. The proportion of trees showing signs of blister rust infection increased in North Cascades National Park Service Complex from 32% in 2004 to 51% in 2016 and from 18% to 38% in Mount Rainier National Park. Mortality increased from 7% to 21% in North Cascades National Park Service Complex and 38% to 44% in Mount Rainier National Park. Annual mortality rates were calculated for three time periods: 2004-2009, 2009-2015/2016, and 2004-2015/2016. Mortality rates, annualized across the entire study period, were 1.47% in Mount Rainier National Park and 2.27% in North Cascades National Park Service Complex; these rates decreased between the first time period and the second, which could reflect blister rust resistance. Signs of mountain pine beetle were rare and limited to a few trees in individual plots. Although reproductive trees were found in most stands, densities were low and regeneration was dominated by subalpine fir.

Brown rice is a familiar whole grain in Japan. We examined national trends in brown rice consumption among Japanese adults aged ≥ 20 years old, using individual-level data from the National Health and Nutrition Surveys conducted between 2012 and 2019. We employed multivariable logistic regression to identify factors associated with brown rice consumption. The 95th percentile of daily brown rice intake remained at 0.0 grams throughout the study period. The percentage of brown rice consumers increased from 1.8% (95% confidence interval: 1.6–2.1) in 2012 to 2.3% (95% confidence interval: 1.8–3.0) in 2019. Compared with individuals who consumed only white rice, brown rice consumers had significantly higher mean intake levels of macronutrients, legumes, vegetables, fruits, and nuts. Brown rice consumption was positively associated with certain sociodemographic characteristics (being female, older age, residing in a major city, living without very young children, and having higher education levels) and health behaviors (lower body mass index, engaging in regular exercise, and being a former or never smoker). Despite its potential nutritional benefits in balanced diets, only a small fraction of adults in Japan consume brown rice, indicating a need for further promotion, particularly among individuals with characteristics associated with brown rice consumption.

In order to increase the number of tourism in ecotourism, enhance the ecotourism attractions. It is essential to construct the ecotourism service system for the Penghu National Scenic Area because the ecology system is sensitive and frangible. This study adopts the Fuzzy Delphi method and Analytic Hierarchy Process (AHP) to establish an index framework of ecotourism service system of Penghu National Scenic Area. The results indicated that there are 4 dimensions which include 21 factors service attributes are identified as the service system for traveling. The findings are concluded as follows:(1)the security management capability is the main principle for ecotourism service system;(2)the ecological diversity is fundamental for the marine environment and the core resource for ecotourism;(3)the transportation capacity and environmental quality need to improve; (4)the marine environmental resources is the most important item for sound ecotourism development; (5)the enhancement of the operation willingness of local communities can promote ecotourism development;(6)the natural resources should be protected to provide an ideal recreational environment for ecotourism;(7)the development of ecotourism needs to support local conservation to achieve sustainability. The perspectives of sustainability and service system are involved to support the value of this study, which can continuously sustain Penghu archipelago.

Population studies have demonstrated an association between sodium (Na) and po-tassium (K) intake and levels of blood pressure (BP) and cholesterol. The aim of this study was to describe the dietary intake and distribution of Na and K in Mexicans, and their as-sociation with metabolic risk outcomes. We analyzed a national survey that included 4,219 participants. Dietary information was obtained through a 24-hour recall. Foods and beverages were classified based on the degree of processing. BP and biomarkers in blood and urine were measured. The mean intake (mg/d) of Na was 1512 in pre-schoolchildren, 2844 in schoolchildren, 3743 in adolescents, and 3132 in adults. The mean intake of K was 1616 in pre-schoolchildren, 2256 in schoolchildren, 2967 in adolescents, and 3401 in adults. Processed and ultra-processed foods (UPF) contribute to sodium intake: 49% in preschool and schoolchildren, 47% in adolescents, and 39% in adults. Adults in the fourth quartile of sodium intake had lower serum concentrations of cholesterol (181.4 mg/dL) and HDL-c (35.5 mg/dL). The Mexican population has high Na and low K intakes. There is a relationship between Na sodium consumption and cholesterol, and LDL levels. UPF contributes to almost 40% of the sodium consumed by Mexicans.

Background: In 2020, health providers were expected to provide care to individuals with coronavirus disease 2019 (COVID-19) putting them at risk of acquiring COVID-19. The possibility of acquiring poorly understood infectious diseases while providing care may have an impact on the mental health of providers. We conducted a study to explore the effects of COVID-19 on the mental health of healthcare providers. Methods: Between April and August 2021, we conducted in-depth interviews with 60 health providers in the infectious disease unit (IDU) and other units in the hospital (non-IDU). Health providers completed an online self-administered survey form with demographic data (age, sex, average income, and known contact with a COVID-19 patient). We used semi-structured interview guides to understand health providers’ lived experiences with stress, anxiety, depression, and their associated factors. We transcribed interviews verbatim, coded and analyzed the transcripts to derive thematic concepts related to mental health experiences. Results: Health providers had a median age of 37 years, [IQR 20.0-58.0], 56.7% were female, 30.0% nurses, 18.3% medical doctors, and 11.7% laboratory technologists. Health providers reported increased stress during the pandemic attributed to high demand for patient care, changes in social life, and fear of COVID-19 infection. They also reported experiences of anxiety and depression as a result of limited knowledge at the beginning of the pandemic and the perception that ‘COVID-19 resulted in death’. Testing positive for COVID-19, high exposure to COVID-19 risks, and death of patients and colleagues reportedly affected health providers’ mental health. Additionally, health providers reported mental health support through debriefing meetings, peer-to-peer support, and psychological counseling with privacy and confidentiality concerns. Conclusion: Health providers faced mental health issues such as stress and anxiety while taking care of COVID-19 patients. An effective mental health response requires institutional practices that address context-specific challenges such as privacy and confidentiality.

The Ministry of Health (MOH) in the Kingdom of Saudi Arabia (KSA) established a National School-based Screening Program (NSBSP) for health screening of school-going children. Students from specific grades were systematically screened for several health problems including obesity, visual and auditory problems, dental cavities, scoliosis, and attention-deficit/hyperactivity disorder (ADHD). This cross-sectional study aimed to determine the prevalence of these health problems among primary school students based on secondary data obtained from the NSBSP. We included 444,259 screened school children from the 1st and 4th grades of 50% of the selected schools (both private and public) across the KSA during the academic year 2018-2019. Among them, the most prevalent health problems identified were dental cavities (38.7%), eye refractory errors (10.9%), and overweight and obesity (10.5%); the less prevalent problems included ADHD (2.81%), auditory problems (0.6%), and scoliosis (0.48%). A greater prevalence of most health problems was observed in girls than boys. The NSBSP successfully aided the detection of health conditions with high and low prevalence among primary school students in the KSA, and thus, identification of health problems of specific concern. Implementation of effective school health services for the prevention, early detection, diagnosis, and treatment of these health problems is imperative.

Abstract: Objective: To assess both individual and interactive effects of prenatal medical conditions depression and Diabetes, and health behaviors including smoking during pregnancy on infant birth defects. Methods: The data for this research study were collected by the Pregnancy Risk Assessment Monitoring System (PRAMS) in 2018. Birth certificate records were used in each participating jurisdiction to select a sample representative of all women who delivered a live-born infant. Complex sampling weights were used to analyze the data with a weighted sample size of 4,536,867. Descriptive statistics were performed to explore frequencies of the independent and dependent variables. Bivariate and multivariable analyses were conducted to examine associations among the independent and dependent variables. Results: The results indicate and significant interaction between the variables smoking and Depression and Depression and Diabetes (OR= 3.17; p-value <0.001 and OR= 3.13; p-value <0.001 respectively). Depression during pregnancy was found to be strongly associated with delivering an infant with a birth defect (OR= 1.31, P-value < 0.001). Conclusion: Depression during pregnancy and its interaction with smoking and Diabetes are vital in determining birth defects in infants. The results indicate that birth defects in the United States can be lowering Depression in pregnant women.

Accountable Care Organizations (ACOs) are healthcare delivery systems that aim to coordinate and improve the quality of care for patients while reducing costs. ACOs bring together doctors, hospitals, and other healthcare providers to work as a team to care for a defined population of patients. The idea behind ACOs is to shift the focus from paying for each individual service provided to patients, known as fee-for-service, to paying for the overall care and well-being of patients.ACOs typically operate under a shared savings model and also encourages providers to use data and technology to better coordinate care and improve patient outcomes.ACOs can be physician-led organizations, hospital-led organizations, and collaborations between healthcare providers. The success of ACOs depends on many factors, including the level of cooperation and collaboration among healthcare providers, the quality of care provided, and the ability to effectively manage costs.Despite their potential benefits, ACOs also face challenges, including the difficulty of coordinating care across multiple healthcare providers, the need to invest in technology and data management systems, and the challenge of changing provider behavior.This study assessed a number of systemic reviews and journals to assess the impact of ACO’s on population health. ACO’s have shifted away from costly care patterns and thus helped many countries.

Objective: This study investigated the effect of the hierarchical medical system under the national health insurance program on resident’s healthcare-seeking behavior in Taiwan. Background: Healthcare authorities in Taiwan initiated the allowance reduction of outpatient visits at regional hospitals and higher hierarchical hospitals from 2018. The ultimate goal is to implement a hierarchical medical system and provide the residents accessible as well as consistent medical services. Methods: This research was conducted through the questionnaire survey method and data were collected between August and December 2018 from the records of subjects who had recently sought medical attention. A total of 1,340 valid questionnaires were returned. Results: Regarding the effect on healthcare-seeking behavior, the following factors were significant: being aged between 40 to 49 (p＜.1), subjects with an educational background of junior high school (p＜.05), those who were not aware of the policy (p＜.001), and an awareness about both the hierarchical medical system and the policy to reduce outpatient visits to large hospitals (p＜.001). Conclusion: The public should be made aware about the hierarchical medical system to improve healthcare.

This short note proposes a national Geographic Information System (GIS) - based health infrastructure to deal with epidemics and pandemics. Currently, there is no pan-India health infrastructure available that can compile, update, and report the spread of epidemic diseases. It not only curtails the opportunity of finding the real-time data on the spatial distribution of a disease but prevents one to inquire into the causes of the disease through epidemiological analysis. The proposed infrastructure in this study is a pan-India one and can broadly be divided into two parts, hotspot mapping and accessibility to services. In the first part, hospitals are proposed to act as nodes of data collection, sending data to a national GIS portal. This portal shall have the capabilities of plotting the data using map rendering services such as Google and Bing Maps. This way, hotspots can be visualized in no time, benefitting the government and common citizenry alike. The second part deals with the accessibility of citizenry to a wide range of services, i.e., healthcare services, grocery outlets, emergency services, baby food, and many other essential services of the day to day life. In order to implement this, we propose that the government need to enforce a mandatory submission of locational coordinates of all Goods and Services Tax (GST) enrolled service providers. Once the coordinates are submitted, the government can effectively control the opening and closing of services and inform the citizenry at the same time. The proposed infrastructure is going to help deal with the extraordinary situations during epidemic and pandemics similar to what the world is currently facing in the form of Corona Virus Disease 2019 (COVID-19). Furthermore, the infrastructure can be scaled up or down as per the spread of a disease. The health-GIS platform proposed in this concept paper, shall help India in controlling and managing the epidemic more efficiently.

This study analyzes the effect of economic growth and income distribution on health inequality using data from the Organization for Economic Cooperation and Development (OECD). A panel analysis was conducted by combining 21 years of data (from 2000 to 2020) from 38 OECD countries. Life expectancy and avoidable mortality were set as the dependent variables; gross domestic product and poverty gap were set as the independent variables; body mass index, consumption, smoking rate, healthcare personnel, number of beds in health service facilities, national medical expenses, and unemployment were set as control variables. First, economic growth and poverty gap significantly affect life expectancy and avoidable mortality. It has been confirmed that to resolve health inequality, growth during growth and distribution must be prioritized. Second, it has been confirmed that as the poverty gap increases, life expectancy increases and the avoidable mortality rate decreases. A mechanism different from the existence of a medical security system targeting the lowest class or an increase in the welfare of society worked. In conclusion, as a policy proposal to alleviate health inequality, this study suggests that policy intervention is necessary to block or alleviate the negative impact of income inequality in health care policies.

The aim of the study was to examine the use of video-based communication and its association with loneliness, mental health and quality of life in older adults (60-69 years versus 70+ years) during the COVID-19 pandemic. A cross-sectional online survey was conducted in Norway, UK, USA and Australia during April/May 2020, and 836 participants in the relevant age groups were included in the analysis. Multiple regression analyses were conducted to examine associations between use of video-based communication tools and loneliness, mental health and quality of life within age groups, while adjusting by sociodemographic variables. Video-based communication tools were found to be more often used among participants aged 60-69 years (60.1%), compared to participants aged 70 or above (51.8%, p < 0.05). Adjusting for all variables, use of video-based communication was associated with less loneliness (β = -0.12, p < 0.01) and higher quality of life (β = 0.14, p < 0.01) among participants aged 60-69 years, while no associations occurred for participants in the oldest age group. The use of video-based communication tools was therefore associated with favorable psychological outcomes among participants in their sixties, but not among participants in the oldest age group. The study results support the notion that age may influence the association between use of video-based communication tools and psychological outcomes amongst older people.

Background Due to the Covid-19 pandemic and the strict national policies regarding social distancing behavior in Europe, America and Australia, people became reliant on social media as a means for gathering information and a tool for staying connected to family, friends and work. This is the first trans-national study exploring the qualitative experiences and challenges of using social media while in lockdown or shelter in place during the current pandemic. Methods This study was part of a wider cross-sectional online survey conducted in Norway, UK, USA and Australia during April/May 2020. The manuscript reports on the qualitative free text component of the study asking about the challenges of social media users during the Covid-19 pandemic in UK, USA and Australia. 1991 responses were included in the analysis. Thematic analysis was conducted independently by two researchers. Results Three overarching themes identified were: Emotional/Mental Health, Information and Being Connected. Participants experienced that using social media during the pandemic amplified anxiety, depression, fear, panic, anger, frustration and loneliness. They felt that there was information overload and social media was full of misleading or polarized opinions from which was difficult to switch off. Nonetheless, participants also thought that there was an urge for connection and learning which was positive and stressful and the same time. Conclusion Using social media while in shelter in place or lockdown could have a negative impact on the emotional and mental health of some of the population. To support policy and practice in strengthening mental health care in the community, social media could be used to deliver practical advice on coping and stress management. Communication with the public should be strengthened by unambiguous and clear messages and clear communication pathways. We should be looking at alternative ways of staying connected.

Abstract: Sustainable use of Native American heritage places is viewed in this analysis as serving to preserve their traditional purposes and sustain the cultural landscapes that give them heritage meaning. The research is about the potential impacts of heritage tourism to selected Native American places at Arches National Park, Canyonlands National Park, and Hovenweep National Monument. The impacts of tourists to a heritage place must be understood as having both potential effects on the place itself and on an integrated cultural landscape. Impacts to one place potentially change other places- functions in a Native American landscape and the integrity of the landscape itself. The analysis is based on 696 interviews with representatives from nine tribes and pueblos, who in addition to defining the cultural meaning of places, officially made 349 heritage management recommendations. The U.S. National Park Service interprets Natives American resources and then brings millions of tourists to these through museums, brochures, outdoor displays, and ranger-guided tours. Native American ethnographic study participants argued that tourist education and regulation can increase the sustainability of Native American places in a park and can help protect related places beyond the park.

In Spain, the National Health System, of a public nature, provides care to Spaniards and other residents in Spain. It is a system adapted to the State of Autonomies, decentralized. Each Auton-omous Community has legislative capacity in its organization and management. We studied the agreement of private hospitals by the public system in La Rioja, an Autonomous Community of Spain located in the North of the Iberian Peninsula. Documentary sources from the General archives of La Rioja, the Institute of Riojan Studies, municipal funds (Logroño, Haro, Calahorra), and in-formation from catalogs and censuses of hospitals from the Ministry of Health, National Institute of Statistics, and Institute of Statistics of La Rioja have been reviewed. The hospital model of La Rioja is characterized by a predominance of public beds over private ones, although there is a growing trend in the number of private beds from 2013 onwards, due to the incorporation of two conva-lescent socio-health hospitals. A characteristic element of La Rioja has been the promotion of pub-lic-private collaboration, conceived as a strategic alliance. Regarding agreements, in La Rioja there has been a specialization in the socio-health space, whose formulas have been the management service contract and the concession of work. The development of the Health System in La Rioja, 1986-2019, has been determined by the presence of a mixed public-private hospital system and a progressively lower dependence on specialized hospitals from other Autonomous Communities.

Background and Objectives. To examine trends in the links between induced abortion and subsequent mental health problems for U.S. women approaching completed fertility. Materials and Methods. Panel data on a nationally-representative cohort of 3,842 ever-pregnant women assessed at mean ages of 15, 22, 28 and 37 years from the National Longitudinal Study of Adolescent to Adult Health (Add Health) were examined for pregnancy outcome-related mental health disorders, with extensive adjustment for confounders including sociodemographic dif-ferences, mental health history, and unwanted pregnancies. Outcomes were defined using pub-lished diagnostic criteria or validated index for depression, anxiety disorder, post-traumatic stress disorder (PTSD), and suicide ideation (affective problems); alcohol abuse, drug abuse, opioid abuse, and cannabis abuse (substance abuse problems); and summary counts of affective problems, substance abuse problems and total disorders. Results were adjusted for abortion under-reporting using cross-wave analysis. Results. The relative risk of mental health disorder with exposure to induced abortion followed an inverted “V” pattern as women aged to midlife, increasing from Wave III (age 22; IRR 1.41) to Wave IV (age 28; IRR 1.67), then dropping sharply by Wave V (age 37; IRR 1.20). The population at-tributable fraction of mental health disorder due to abortion dropped from 18.1% at Wave IV to 8.0% at Wave V. Unlike previous Waves, at Wave V mental health risk was more strongly reduced by exposure to childbirth (IRR 0.70, 95% CI .63, .78, p < .001). Reduced relative metrics at Wave V were not due to reduced prevalence of mental health disorders for ever-aborting women, which increased from Wave IV to Wave V by 1.7%, but increased much more, by 20.5%, for never-aborting women. Conclusion. At midlife approaching completed fertility, differential negative psychological out-comes for ever-aborting U.S. women remained elevated but reduced from younger ages.

Background: Indonesia is one of the multicultural countries in the world. The diversity that exists in Indonesia is reflected in differences in race, ethnicity, culture, and religion. It is not surprising that Indonesia will face the threat of national disintegration due to differences. Therefore, Indonesia needs a concept in fostering diversity to create national resilience. Purpose: This study aims to explore how the role of archipelago insights in shaping national geostrategy resilience. Method: The method used in this research is literature review. The search for journals was carried out using the google scholar database with the keywords "archipelago insight" and "geostrategy" and "national resilience". Feasibility studies are assessed based on title, abstract, full text, and research methodology. Data analysis using narrative analysis based on research findings. Result: insight into the archipelago can be used as a basis in shaping a national geostrategy. The perspective in the concept of archipelago insight by fostering the diversity in Indonesia can create unity and integrity to form national geostrategic resilience. Conclusion: The concepts that exist in the archipelago perspective and national geostrategy can foster the diversity that exists in Indonesia. The creation of existing unity and integrity, understanding the perception of seeing differences, is not a threat to realizing national resilience in the Indonesian nation.

This article examines the complex interactions of the multiplier effect within the realm of tourism, with a specific emphasis on national parks. The main objective is to evaluate the multiplier effect within national parks, specifically focusing on Buiratau State National Nature Park in Kazakh-stan as a case study. The multiplier effect is a fundamental principle in the field of economic analysis. Economic multiplier effect is the term used to describe the occurrence when an initial infusion of spending in a certain industry leads to subsequent rounds of extra and sustainable economic activity. In the context of national parks, this phenomenon arises when visitor expendi-tures result in several favorable consequences, including increased employment, infrastructure advancement, and general economic expansion. The article seeks to measure the multiplier effect of tourism activities in Buiratau State National Nature Park through a thorough assessment. This entails examining several variables and datasets pertaining to visitor expenditure and its influ-ence. The study contributes to the existing literature by examining a recently constructed national park in a developing country. It compares the findings of this park with well-established national parks in other areas, emphasizing the distinct problems and opportunities it presents. Further-more, the research presents a methodological framework for evaluating the multiplier effect of national parks, which may be utilized in comparable contexts. This research ultimately enhances our comprehension of the economic implications of national parks and emphasizes their function as drivers for local and regional growth.

To identify gender- and age-related associations between adult dental checkups and unmet dental care needs, we analyzed data of 14,000 participants, ages ≥ 19, from the 7th Korea National Health and Nutrition Examination Survey (2016–2018) (KNHANES VII). Data was collected via self-report questionnaires and interviews. Complex sample chi-square test and multiple logistic regression analysis indicated 31.7% of participants had unmet dental care needs; in the prior 12months, 67.1% had not utilized dental services, and 43.3% had not received dental checkups. Odds ratios (ORs) for dental checkups and unmet dental needs were 8.87 (CI:7.80–10.09, p < 0.001) for those who used dental services and 1.28 (CI: 1.13–1.44, p < 0.001) for those who had not. Significant age-dependent associations between those not receiving dental checkups and the rate of unmet dental care include men and women aged 50–59 years (OR: 1.77; CI = 1.22–2.58 and OR: 1.43; CI: 1.02–2.02; p = 0.040, respectively) and women ≥ 70 years (OR = 1.79, CI = 1.20–2.66, p = 0.004). Reducing unmet dental care needs requires greater public health promotion and education regarding regular dental checkups; additional practical strategies could enhance dental checkup compliance.

This study aims to describe the commitment to national heritage, patriotism, nationalism of elementary school students in the border areas between Indonesia and Timor Leste. This research was conducted in three elementary schools, they are SD Inpres Moto Ain, SD Inpres Class Jau Halimuti, SD Kristen Nanaeklot, and SD Negeri Motabenar from June to August 2018. The subjects of this study were elementary students in the Indonesia-Timor Leste border areas precisely around Motaain City, Belu Regency, East Nusa Tenggara. The research questionnaire was adapted from Karazawa and analyzed with descripriptive statistics. The results of this study showed that the commitment to national heritage, patriotism, and nationalism of elementary students on the Indonesian border areas with Timor Leste is in the very high level.

Background. National surveys reported on variable prevalence of chronic kidney disease (CKD) due to differences in characteristics of population, design, equations used to estimate glomerular filtration rate (eGFR) and definitions. The EH-UH 2 survey is the first study evaluating CKD prevalence, characteristics and awareness in Croatia. Methods. This was a cross-sectional nationwide observational study designed to assess the prevalence and cardio-kidney-metabolic risk factors in Croatia which included 1765 randomly selected subjects. We estimated the prevalence of CKD by means of albumin-to-creatinine ratio (ACR) and eGFR (CKD EPI equation). Comorbidities, anthropometric and social factors related to the prevalence of CKD were analyzed, and CV risk profile was evaluated. Results. The weighted prevalence of CKD (any stage), CKD stage ≥ G3A A2, and CKD defined only as eGFR < 60 ml/min/1.73 m2 were estimated at 17.1%, 9.8% and 7.9%, respectively. The prevalence was higher in men than in women (11.8% vs. 7.9%; p 30 mg/g was 15.1%. Older age, male gender, diabetes, ePWV, and uric acid were independently associated with CKD prevalence. The awareness of CKD of 9.5%. Unaware were older with lower income, less educated, having more frequently diabetes, hypertension (less frequently controlled) and milder renal impairment. Conclusion. In Croatia, the estimated prevalence of CKD is high, being more frequently presented in men than in women. CKD patients have unfavorable CV risk profile. The awareness of CKD is very low reflecting poor health literacy in general population but also in health care workers.

The effort to expand the U.S. study abroad programs to have a global impact has never been fully expressed by Higher Education Institutions (HEIs) and study abroad administrators. Study Abroad since its inception has not been a truly global platform. This article constructively points out the existing potential of Minority Serving Institutions (MSIs) to make the U.S. study abroad a truly global program capable of defending U.S. national interest in this era of inter-dependence among nations, especially as the global knowledge economy and cultural competence advantage take center stage. Study abroad is at a crossroads at the moment, new ideas must be developed for study abroad to justify the true potential of education abroad. Over two decades, four countries in Western Europe have been hosting the highest number of U.S. students in study abroad. There is no evidence that this trend will reach the entire globe as a reciprocity of international students in U.S. colleges and universities.

The use of allometric tools allows estimating the biomass of a plant species with greater precision. Tree roots are the least studied part of the vegetation due to the difficulty in obtaining complete root systems. For this reason, the objective was to generate an allometric model to estimate the amount of biomass accumulated in the root system of Abies religiosa trees in El Chico National Park, Hidalgo. For this purpose, 61 trees of A. religiosa were extracted from 0.06 to 3.56 m in height, using a backpack sprayer of pressurized water that detached the soil from the root. The response variable was root fresh weight and the independent variables were height, diameter and age+1, according to the fit of the models tested. Diameter was the variable with the best fit (r2 = 0.95 ± 0.04), obtaining the following equation PFR = (20.918 + D (2.4475)). The allometric model accurately estimates the below-ground biomass contained in the roots, which will allow us to obtain the complete biomass of an A. religiosa forest by having access to data on both the aerial and root components.

Lymphatic filariasis (LF) is a vector-borne disease caused by parasitic helminths and constitutes a serious public health issue in tropical regions. According to the World Health Organization (WHO), infected cases in Southeast Asia constitute 50% of the estimated 120 million infections globally. In Indonesia, LF is caused by all filarial species, and in 2018, 236 districts from a total of 514 districts in the entire country were declared as endemic areas. The global program to eliminate filariasis has been running for the last 19 years and has been conducted as a full national initiative for the last 8 years in Indonesia. The study describes the surveillance of LF cases and prevalence in Indonesia for the past 17 years (2001-2017) – during the global and national LF elimination programs-, using national registry-based data. The data demonstrates that the national program has been largely effective in the areas it has been active the longest, while there are provinces lagging behind in the successful suppression of LF. The high geographical fragmentation of the country with the associated ecological parameters relating to LF incidence, likely play an important role in maintaining the highly varied incidence rate across Indonesia.

This work investigates the utility of the National Oceanic and Atmospheric Administration’s National Water Model (NWM) for water management operations by assessing the total inflow into a select number of reservoirs across the Central and Western U.S. Total inflow is generally an unmeasured quantity, though critically important for anticipating both floods and shortages in supply over a short-term (hourly) to sub-seasonal (monthly) time horizon. The NWM offers such information at over 5,000 reservoirs across the U.S., however, its skill at representing inflow processes is largely unknown. The goal of this work is to understand the drivers for both well performing and poor performing NWM inflows such that managers can get a sense of the capability of NWM to capture natural hydrologic processes and in some cases, the effects of upstream management. We analyzed the inflows for a subset of Bureau of Reclamation (BoR) reservoirs within the NWM over the long-term simulations (retrospectively, seven years) and for short, medium and long-range operational forecast cycles over a one-year period. We utilize ancillary reservoir characteristics (e.g. physical and operational) to explain variation in inflow performance across the selected reservoirs. In general, we find that NWM inflows in snow-driven basins outperform those in rain-driven, and that assimilated basin area, upstream management, and calibrated basin area all influence the NWM’s ability to reproduce daily reservoir inflows. The final outcome of this work proposes a framework for how the NWM reservoir inflows can be useful for reservoir management, linking reservoir purposes with the forecast cycles and retrospective simulations.

European Union (EU) regulations on in vitro diagnostics (IVD) and on serious cross-border threats to health provide for the establishment of European Reference Laboratories (EURLs) and their harmonisation and cooperation with National Reference Laboratories (NRLs). While the EURLs under the IVD Regulation will be operational by 1 October 2024, the EURLs under the Regulation on serious cross-border threats to health will be operational by January 2025. Although NRLs may have been operating for a long time on the basis of national legislation, they should now cooperate with each other and with EURLs in a network of centres of excellence for the authorisation and post-market surveillance of IVDs and for the epidemiological surveillance and control of communicable diseases. The term "reference laboratory" has long been used colloquially to refer to many kinds of laboratories, regardless of their tasks, competencies, responsibilities and designation. To clarify the roles and functioning of EURLs and NRLs, we evaluated the relevant current EU provisions and compared the findings with those of reference laboratories designated by other organisations, calibration (reference) laboratories and referral laboratories, which are simply referred to as "reference laboratories".

Woodland bat assemblages are usually structured in space by distance from the ground, water and obstacles, features often defining chiropteran hunting tactics. Consequently, bat species composition differs strongly among various habitats even within the same forest patch. However, when conducting local bat survey in Wolin National Park (WPN), we revealed unexpected uniformity in qualitative and quantitative structure of bat assemblages, based on mist netting and ultrasound recording. In total, 10 vespertilionid species were detected. In all methods and sampled habitats a single species, Pipistrellus pygmaeus, predominated, while no Barbastella barbastellus, an old forest specialist, was detected, despite the abundance of preferred daily roosts. We also reviewed literature for mist netted bat samples in four different habitats of lowland Polish forests. Samples usually clustered based on habitats and the same habitat classes often clustered very closely, despite representing geographically distant forests. The exception was WPN, where all four habitat classes formed a tightly packed cluster. We suppose that P. pygmaeus might act as a hyperabundant native species, a successful generalist that reduces the contribution of more specialized taxa in the assemblage. It probably benefits from both forest renaturation and anthropogenic cross-boundary subsidy, the latter including both roost availability and prey abundance.

In Japan, bariatric surgical treatment was started in 1982. The Japanese Society for Treatment of Obesity (JSTO) was established in 2007 and then JSTO started national registry of bariatric surgery cases and multidisciplinary educational program. 44 facilities registered 4055 bariatric surgical cases until 2021. In this study, the purpose is to clarify the indication, the safety and the effectiveness of the sleeve gastrectomy using national registry data base compiled by JSTO. Preoperative BMI was ranged from 27.6 to 90.7kg/m², and the mean value was 42.7. As gender, men/women was 1/1.3. Age was 42.2 as mean.　As preoperative comorbidities, DM ratio was 54.4% of the patients, Hypertension 64.5%, dyslipidemia 65.1%, and sleep apnea syndrome 69.8%. As operation method, laparoscopic method were taken in 99.7% of the cases. The intra operative incidents rate was 0.9 %. Conversion rate to open method was 1.1%. Postoperative morbidity ratio was 5.6% and mortality was 0 %. Reoperations were performed in 1.5 % of the cases. Postoperative hospital stay was 5 days in Median value. Body weight loss was 27.6 kg in the mean value after follow up days of 279±245. As the effect on the preoperative metabolic comorbidities, DM has improved in 82.9 % of the cases, hypertension 67.9 % and Dyslipidemia 66.6%. In conclusion, using JSTO database, we evaluated the indication, postoperative complications and weight loss effect of sleeve gastrectomy in Japan. Regarding the evaluation of the effect on preoperative comorbidities, future follow-up based on more detailed criteria was considered to be necessary.

Background: Extensive-stage SCLC (ES-SCLC) treatment has recently been revolutionized by the advent of immune checkpoint inhibitors. This survey was conducted to evaluate the current pattern of care among Italian clinicians, in particular about the integration with radiation therapy (RT). Methods: In June 2023, 225 Italian cancer care professionals were invited to 21-question web-based survey about the ES-SCLC management through personal contacts and the Italian Association for Radiotherapy and Clinical Oncology (AIRO) network. Results: We received 90 responses, the majority were radiation oncologists (89%) with more than 10 years of experience (51%). Preferred management of ES-SCLC in patients with a good performance status was concomitant chemo-immunotherapy (84%). Almost all respondents recommended prophylactic cranial irradiation (PCI) (85%), taking into account age and thoracic response; PCI was performed mainly between the end of chemotherapy before starting immunotherapy (37%), with three-dimensional conformal technique (46%). Furthermore, 83% of respondents choose to deliver thoracic RT in case of both intrathoracic and extrathoracic response with a RT schedule of 30 Gy/10 fractions. Stereotactic RT is increasingly being used in oligoprogressions. Conclusions: Our analysis showed the variability of real-world management of ES-SCLC. Future clinical trials and developments are needed to improve the multidisciplinary treatment of these patients.

This study aims to enhance multimodal transportation systems by mitigating CO2 emissions and enhancing operational efficiency. It introduces a novel centralized cargo concentration approach tailored for regions facing geographical challenges. The method proposes for direct transportation of cargo from its loading origin to export ports, bypassing intermediate hubs. The mathematical model determines the most efficient means of transport for each route, factoring in variables like distance, volume, and cargo type. Research results indicate that, in scenarios with a high concentration of cargo, multiple hubs may not be necessary, which could streamline transportation and logistics operations. Modal preferences vary based on regional dynamics and cargo characteristics, with rail and sea transport emerging as preferable options under specific circumstances, surpassing the efficacy of road transport. The proposed model showcases reductions in both logistics costs and CO2 emissions compared to road-centric scenarios. It underscores the strategic integration of diverse transportation modes as pivotal for enhancing efficiency and sustainability. This study furnishes a framework adaptable to optimizing multimodal transportation systems in regions sharing similar geographical and logistical attributes.

Introduction: Child stunting remains a public health concern. It is characterized as poor cognitive and physical development in children due to inadequate nutrition during the first 1,000 days of life. Across South Asia, Pakistan has the second-highest prevalence of stunting. This study has assessed the most recent nationally representative data, the National Nutrition Survey (NNS) 2018, to identify the stunting prevalence and determinants among Pakistani children under five. Methods: The NNS 2018, a cross-sectional household-level survey, was used to conduct a secondary analysis. Data on malnutrition, dietary practices, and food insecurity was used to identify the prevalence of stunting among children under five years by demographic, socioeconomic, and geographic characteristics. The prevalence of stunting was calculated using the World Health Organization (WHO) height for age z-score references. Univariate and multivariable logistic regressions were conducted to identify factors associated with child stunting. Results: Analysis showed that out % of 52,602 children under five, 40.0% were found stunted. Male children living in rural areas were more susceptible to stunting. Furthermore, stunting was more prevalent among children whose mothers had no education, were between 20 and 34, and were employed. In the multivariable logistic regression, male children (AOR=1.08, 95% CI[1.04-1.14], P<0.001) from rural areas (AOR=1.07, 95% CI [1.01-1.14], P=0.014), with the presence of diarrhea in the last two weeks (AOR=1.15, 95% CI [1.06-1.25], P<0.001), with mothers who have no education (AOR=1.57, 95% CI [1.42-1.73], P<0.001) or lower levels of education (Primary: AOR=1.35, 95% CI [1.21-1.51], P<0.001; Middle: AOR=1.29, 95% CI [1.15-1.45], P<0.001) had higher odds of stunting. Younger children aged <6 months (AOR=0.53, 95% CI [0.48-0.58], P<0.001) and 6-23 months (AOR=0.89, 95% CI [0.84-0.94], P<0.001), with mothers aged 35-49 years (AOR=0.78, 95% CI [0.66-0.92], P=0.003) had lower odds of stunting. At the household level, the odds of child stunting were higher in the poorest households (AOR=1.64, 95% CI [1.46-1.83], P<0.001), with ≥7 members (AOR=1.09, 95% CI [1.04-1.15], P<0.001), with no access to improved sanitation facilities (AOR=1.14, 95% CI [1.06-1.22], P<0.001) and experiencing severe food insecurity (AOR=1.07, 95% CI [1.01-1.14], P=0.02). Conclusion: Child stunting in Pakistan is strongly associated with various factors, including gender, age, diarrhea, residence, maternal age and education, household size, food and wealth status, and access to sanitation. To address this, interventions must be introduced to make locally available food and nutritious supplements more affordable, improve access to safe water and sanitation, and promote female education for long-term reduction in stunting rates.

Antimicrobial resistance (AMR) is a global health problem threatening safe, effective healthcare delivery in all countries and settings. The ability of microorganisms to become resistant to the effects of antimicrobials is an inevitable evolutionary process. The misuse and overuse of antimicrobial agents has increased the importance of a global focus on antimicrobial stewardship (AMS). This review provides insight into the current AMS landscape and identifies contemporary actors and initiatives related to AMS projects in eight African countries (Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Uganda, and Zambia), which form a network of countries participating in the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme. We focus on common themes across the eight countries, including the current status of AMR, infection prevention and control, AMR implementation strategies, AMS, antimicrobial surveillance, antimicrobial use, antimicrobial consumption surveillance, a one health approach, digital health, pre-service and in-service AMR & AMS training, access to and supply of medicines, and the impact of COVID-19. Recommendations suitable for adaptation are presented, including the development of a national AMS strategy and incorporation of AMS in pharmacists’ and other healthcare professionals' curricula for pre-service and in-service training.

United Nations Framework Conventions on Climate Change (UNFCC) conventions in their conference of parties (COPs) has continuously considered and agreed reducing emission level in order to minimize the impact of global climate change. Reducing emission due to deforestation and degradation (REDD) ,was considered as one of the major activities in this regard during Kyoto protocol in 2009 which laid foundation for the participating countries to be compensated financially for reduced carbon emission. Mexico convention -2012 required the countries to develop and implement a transparent and consistent monitoring, reporting and verification (MRV) process. Later in Paris agreement-2015, the parties agreed to limit the global warming to 2 degree centigrade and with further efforts to 1.5-degree centigrade furthering entailing the parties to prepare and communicate nationally determined contributions (NDCs) every five years. Nepal aimed to decrease the average annual deforestation rate by 0.05 percent from existing 0.44 percent in the terai region and 0.1 percent in the Chure. Nepal decided to develop its forest reference level (FRL) in national level for the historical period 2000-2010 considering Carbon dioxide and carbon pools above and below ground. As per the Forestry Sector Strategy, Nepal aims to increase carbon stock growth by at least 5% by 2025 as compared to 2015 and decrease mean annual deforestation rate to 0.05. After major change in administrative division in Nepal, forest management responsibility has shifted down to the Sub-national level. But forest resource studies have not been conducted yet in these levels. Despite a small country, Nepal has at least four clear physiological regions. The amount of carbon stock stored by different forest type are different depending upon species distribution, carbon volume and density for each species, and their distribution along ecological and physiological regions. Sal (shorea Robusta), for example, having one of the highest carbon densities, is a major forest types in Nepal. The purpose of this study was to generate forest map of the country, calculate carbon stock, gain and loss, and their rate in each province due to deforestation/afforestation using remote sensing data. Further Sal forest map was generated and its contribution in carbon stock was calculated using averaged national carbon density as well as using regional density method. According to the study, around 5.1 million hectares of Nepali land was forest in 2015 increasing from 4.2 million hectares in 2005. However, Sal forest has decreased during the same period. Province 1 contributed the maximum (130 Tg) and Province 2 the minimum (40Tg) of Carbon stock in 2015. Using the conventional method of calculation with national average density (108.08 t/ha), a total of 36.7T CO2 yr-1 carbon sink was observed in the Country. Whereas, with the new approach of calculation, a total of 44.7 T CO2 e of carbon sink per year was estimated during the same period. This approach holds potential for qualifying as an MRV process of Nepal. The subnational level forest and carbon statistics produced during this study can be important assets for the better forest governance. This can also pave way for policy formation and preparation of action plan for sustainable forest management and intervention strategy and obtaining better financial incentives participating in the reduction of emission due to deforestation and forest degradation (REDD) plus programs.

The natural vegetation study was conducted in Kafta-sheraro national park (KSNP) North, Ethiopia to explore floristic composition, structure and regeneration of woody species in the home of African elephant. In the park, the above information is not well documented which is necessary for conservation. Data were collected From August to December 2018. The vegetation data were collected from 161 quadrats of size 20m×20m, 5mx5m for shrub ̸ tree, sapling and seedling respectively. Individual trees and shrubs DBH >=2.5cm and height >=2m were measured using Tape meter and Clinometer respectively. DBH, frequency, density, basal area, and IVI were used for vegetation structure. A total of 70 woody species 46 (65.7%) trees, 18 (25.7%) shrubs and 6 (8.6%) tree ̸ shrub) were identified. The total basal area and density of 79.3 m2 ha-1, and 466 ±12.8 (S.E.) individuals ha-1 were calculated for 64 woody species. Fabaceae was the most dominant family occupied 16 species (23.0%) followed by Combretaceae 8 species (11.4%). Acacia mellifera and Combretum hartmannianum were the most dominant and frequent species. Abnormal patterns of selected woody species were dominantly identified. Regenerating status all the woody plant species was categorized as “Fair” (18.75%), “Poor” (7.81 %) and “None” (73.44%). However, there is good initiation for conservation of the park; still the vegetation of the park was threatened by firewood collection, charcoal production, fire, intensive farming, mining and over grazing. Therefore, the study area as the habitat for the population of the African elephant; the KSNP should be recommended the highest conservation priority and studied the soil seed bank of species having poor regeneration condition.

The annual budget for the United States National Park Service was roughly three billion dollars in 2016. This is distributed amongst 405 National Parks, 23 national scenic and historic trails, and 60 wild and scenic rivers. Entrance fees and concessions generate millions of dollars in income for the National Park Service; however, this metric fails to account for the total value of the National Parks. In failing to consider the value of the ecosystem services provided by the National Parks we fail to quantify and appreciate the contributions our parks make to society. This oversight allows us to continue to underfund a valuable part of our natural capital and consequently damage our supporting environment, national heritage, monetary economy, and many of our diverse cultures. We explore a simple benefits transfer valuation of the United States national parks using National Land Cover Data from 2011 and ecosystem service values determined by Costanza (et al). This produces an estimate suggesting the parks provide $84 billion / year in ecosystem service value. If the natural infrastructure 'asset' that is our national park system had a budget comparable to a piece of commercial real estate of this value, the annual budget of the National Park Service would be roughly an order of magnitude larger at something closer to $30 billion rather than $3 billion.

A large variety of remote sensing-based land use/land cover (LULC) products are currently available on national and global scales. This literature review and in-situ validation study evaluates the suitability of these products for local scale applications in the complex terrain of the Ethiopian mountains. For the review, 146 research papers were analyzed. Most studies (73%) have been published since 2013 and are based on individually computed maps. Not a single study relied on readily available LULC products. Nine readily available LULC products with 20, 30, 300, 500 and 1,000 m spatial resolution have been identified at national and global scales. To complement and extend this body of research, the recent (since 2013) LULC products were validated using 185 ground truth points collected in the Bale Mountains National Park between 1,500 and 4,385 m a.s.l. The results indicate a rather poor overall accuracy (<50%).

Colleges and universities play a crucial role in fostering innovation, making it essential to explore effective strategies for promoting innovation at the institutional policy level. This paper focuses on the establishment of intellectual property (IP) model cities as a starting point and conducts an empirical analysis using innovation data from 234 cities and 942 colleges and universities between 2007 and 2017. By constructing a multi-temporal double-difference model, this study reveals that the establishment of IP model cities effectively fosters innovation in colleges and universities. Further analysis demonstrates that this promotion effect is particularly significant in the western region, key cities, key colleges and universities, as well as in the fields of invention and utility model patents. These conclusions withstand a series of robustness tests, confirming their validity. In terms of the underlying mechanisms, it is found that the national IP pilot city policy has a substantial impact on university innovation by promoting research and development (R&D) investment and strengthening innovation cooperation. The insights provided by this study offer valuable policy recommendations for leveraging the innovation potential of the IP model city policy, thereby driving economic transformation, upgrading, and fostering innovation development in China.

The adoption of a fully battery-based Electric Vehicles (EVs) in Kuwait apparently seems to be less than one percent and hence Kuwait has the lowest indexed-rank among countries around the globe. The absence of fast-charging stations for fully-battery-based EVs and landlords' reluctance to install home fast-charging plugs are the primary reasons for extremely low adoption rates in this country. Because the government of Kuwait is reluctant to give permission for expatriates to own property in Kuwait, fully battery-based EV ownership is restricted to Kuwaiti nationals who reside in their private properties. To accomplish the present objectives, a quantitative de-scriptive method (closed-ended questions) was used to collect data from a sample of 227 Kuwaiti nationals who owned gasoline cars. The finding of the present study indicates that more than half of the participants stated that they preferred to purchase an EVs within the next three years if certain criteria were met, inclusive of government-controlled pricing policies and charging stations availability, fast-driving lanes, and free of charge parking spaces. Furthermore, more than 40 percent of respondents stated that they would contemplate purchasing an electric vehicle if the price of gasoline or diesel increased by 19 to 50 percent. The finding also indicates that more than forty percent of respondents said that believed that EVs are fire- and crash-safe and roughly half of the participants would pay between 6 and 20% more for an EVs because they be-lieve that EVs are environmentally friendly and significantly faster than gasoline vehicles. In addition, participants rewarded EVs with an excellent mark for their environmental, economic, and technological attributes and benefits.

The European Union's current pressure on Member States to adopt the Green Deal and the Fit for 55 package is leading to an accelerated drive to put in place measures to meet the 2030 climate targets. At the same time, many discussions at international bilateral meetings of EU country representatives raise the question of the realism of setting climate targets and therefore the ability to meet these commitments. The results elaborated in this analytical study offer a realistic picture of the possibilities of meeting strategic climate targets using the example of the use of forest dendromass for the ability to achieve a 22% share of renewable energy sources (RES) in gross final energy consumption by 2030 in the Czech Republic. The study points out that at present the use of forest dendromass from primary pro-duction is at its maximum and meeting the climate targets for increasing the share of RES in the energy mix represents a major problem in the long term. The findings published in this study also point to the objective threat of increased use of dendrmass in the energy sector to the maintenance of sustainable forest management and the preservation of forest quality.

The purpose of this original study is to critically analyze the emergence and development of the national models of financial regulation; international standards and codes; regional and national financial regulation and supervision (the case of UK, USA, Sweden, EU and Finland). The research raises both academic and regulatory concerns. It aims at shaping changes (innovations) in the supervisory practices of national and international regulators in response to new developments in FinTech markets, digital products, financial instruments and risks. Secondly, it will stimulate more systematic work on regulatory databases, registration and reporting procedures in various economies in different financial markets. The author identifies five main systems of national financial regulatory markets: the multi-tiered, multi-agency US system; the Twin Peaks model (UK); the mega-regulatory model (Sweden). There is a thorough review of international standards and institutions that work for the stability of financial systems. The analysis of regional and national systems of financial regulation and supervision is based on the examples of the EU and Finnish institutions. National macro and microeconomic regulation and supervision have been examined with a focus on the US Federal Reserve and the US Treasury. National and international regulatory institutions have been evolving along several lines. First, minimum capital and credit risk requirements for banks (80s of the 20th century) are complemented in the 21st century by buffer reserves, liquidity and leverage standards. Second, regulation focuses on ensuring the sustainability of the national economy. The regulatory focus is on ensuring the sustainability of national and global financial systems. Third, there is an increase in the number of supervised institutions. Fourth, there is a division of functions between central banks (macroeconomic regulation) and one or two mega-regulators (microeconomic regulation and supervision). Fifth, there is a division of labour between the international financial institutions (BIS, IMF, WB) and national regulators. Sixth, the focus is on protecting consumers and investors, and countering money laundering and the financing of terrorism. Seventh, there is an understanding for a common approach by central banks to new financial technologies and cybersecurity.

There is a lack of information on vaccination for pregnant women in the Brazilian literature. Our aim was to evaluate the data on vaccines recorded on the pregnancy card and knowledge about the importance of vaccination for women admitted for labor in a reference public tertiary maternity unit in Presidente Prudente, São Paulo, Brazil. Vaccine data as prescribed by the National Immunization Program of Brazil (NIP) in prenatal cards for patients in labor from the 45 municipalities of the western region of São Paulo state were obtained. A questionnaire relating to knowledge about the types and importance of vaccination in pregnancy was applied. All vaccines indicated by the NIP were registered in only 12.0% of the prenatal cards, and 33.0% of cards registered any vaccines. In this group, 16.6% were aged between 14 and 21 years, and tetanus and COVID-19 were the most prevalent vaccines that they had heard of during prenatal care. Data on vaccines was poorly recorded in the cards, suggesting a lack of attention and unpreparedness of professionals working in primary care. Our study has countrywide and global relevance, and may be applied mainly in Latin American countries facing similar difficulties and limitations with low rates of vaccination during pregnancy.

This study aimed to examine trust in information provided by public authorities and financial measures put in place to address the impact of COVID-19. Using a cross-national approach among four Western countries; the United States of America, Norway, Australia, and the United Kingdom provides an analysis of responses related to trust and how they were associated with age group, gender, education level, employment status, size of place of residence, infection sta-tus, and social media use. When controlling for all included variables in logistic regression analyses, the likelihood of having trust in the public authorities’ information was higher for women, those with higher levels of education, and those living in urban areas. Being infected with the coronavirus, and spending more time daily on social media was associated with lower likelihood reporting trust in information. Although policies implemented to respond to eco-nomic concerns varied cross-nationally, higher age, identifying as female, being employed, liv-ing in a city, and lower levels of social media usage were associated with higher likelihood of trusting in the financial measures put in place to counteract the economic effects of COVID-19.

COVID-19 has been a global healthcare concern impacting multiple aspects of individual and community wellness. As one moves forward with different methods to reduce the infection and mortality rates, it is critical to continue to study the impact that national and local ‘social distancing’ policies have on the daily lives of individuals. The aim of this study was to examine loneliness in relation to risk assessment, measures taken against risks, concerns, and social media use, while adjusting for sociodemographic variables. The cross-sectional study collected data from 3469 individuals from USA, UK, Norway, and Australia. Loneliness was measured with the de Jong Gierveld Loneliness Scale. Multiple linear regression was used in the analysis of associations between variables. The results showed that concerns about finances were more strongly associated with social loneliness, while concerns about the future was more strongly associated with emotional loneliness. Longer daily time spent on social media was associated with higher emotional loneliness. In conclusion, pandemic-related concerns seem to affect their perceptions of loneliness. While social media can be used productively to maintain relationships, and thereby prevent loneliness, excessive use may be counterproductive.

The article presents the trends in penitentiary work with convicts of different cultures, focuses on their activation, individualisation of work, and organizational difficulties. The purpose of the research has been to discover the ways in which prison staff react to situations requiring flexibility justified by cultural differences of the inmates. The research questions have included: How does prison staff respond to the needs of culturally different inmates? How do the respondents’ reactions correlate with professional experience? Based on the literature, a hypothesis has been established that prison staff avoids individualized treatment of convicted foreigners. Despite the perceived differences in culture, religion, and their different mentality, prison procedures aim at uniformity. Tendencies towards resistance and stiffness to the needs of culturally different people become prevailing. The research method used has included a diagnostic survey (n = 232, F: 40, M: 192) conducted in prison officers in Poland. The written interview technique has been used, where the respondents has reacted to 3 situations of convicts, reflecting their national, religious, and cultural distinctiveness. In their responses, the respondents have decided on the way of action in the situation, as well as their motivation. The operationalization of the source material has been performed in two ways. There has been applied the content analysis method according to the grounded theory (B.G. Glaser, A.L. Strauss), resulting in the creation of categories marking actions and motives. A multiple correspondence analysis (MCA) of the built categories has been carried out using the Statistica program, as well as the correlation analysis of variables with the Cramer's V coefficient. The results of the analysis show statistically created, indicated manners of reacting that have occurred in the studied sample. Additionally, they point out an independent variable - seniority, which has correlated with the quality of the response.

An identification key to twenty-nine species of Porina known from the country is provided. In addition, new records of Porina interstes, P. nuculastrum, and P. rhaphidiophora are described from the protected rain forests in southern Vietnam. A detailed taxonomic account of each species is provided and supported by its ecology, distribution, and illustrations.

Under the new pattern of "Double-Cycle" economy, how to restructure the domestic economic structure to cope with the continuous softening of the global economic structure is an urgent issue. This paper empirically examines the impact of digitalization level on the division of labor in National Value Chain (NVC) within cities using panel data from 263 cities between 2001 and 2016, employing a spatial Durbin model.The study demonstrates that the digitization level can enhance division of labor in NVC in neighboring regions through spatial spillovers. An increase in digitization not only positively deepens the construction of NVC but also contributes to the development of NVC in adjacent areas.The digitization level can deepen the division of labor in NVC through the impact of cost reduction, consumption upgrading, and market integration. This effect exhibits regional variations, with consumption upgrading playing a crucial role in expanding the division of labor in NVC in the eastern region through improving digitization levels, while cost reduction is a key factor in the central region. The research results of this paper provide some empirical evidence for further progress and transition of China's NVC developing mode from the perspective of digital level.

Purpose: Glyphosate and glyphosate-based herbicides (GBH), extensively utilized as herbicides worldwide, have been associated with numerous health issues. Previous experimental studies have indicated their potential to disrupt selenium homeostasis by either interfering with uptake or increasing oxidative stress. However, there is a significant research gap concerning the connection between glyphosate exposure and selenium status in epidemiological studies, particularly within nationally representative samples. Methods: In this study, we examined data from the 2013-2018 National Health and Nutrition Examination Survey (NHANES), involving 3011 participants aged 3 and above. Our main objective was to examine the connection between urinary glyphosate levels, whole blood selenium, and selenium intake. Results: Our analysis did not uncover an association between urinary glyphosate and selenium intake. Nevertheless, we observed a negative correlation between urinary glyphosate levels and whole blood selenium, with a ß coefficient of -1.984, S.E. = 0.639, and P = 0.003 in the final model. We also reported a notable decrease in the average concentrations of whole blood selenium as glyphosate tertiles increased, with P-values for trend of 0.033. Furthermore, the association was particularly prominent among females, non-Hispanic whites, and individuals with lower selenium intake. Conclusions: In this thorough examination of NHANES data, our study uncovers a possible detrimental connection between glyphosate exposure and whole blood selenium levels. These findings underscore the importance of further investigation into the health consequences of glyphosate exposure and its potential influence on selenium status, thereby raising awareness of potential implications for public health.

Background: Coronavirus disease 2019 (COVID-19) caused several cardiovascular complications, including acute myocardial infarction(AMI) in infected patients. Our study aims to understand the overall trends of AMI among COVID-19 patients during the first two years of the pandemic and the disparities and outcomes between the first and second years. Methods: Our retrospective analysis via the 2020 and 2021 National Inpatient Sample(NIS) for hospitalizations between April 2020 and December 2021 analyzed adults with a primary diagnosis of COVID-19 who experienced events of AMI. We compared month-to-month events of AMI and mortality of AMI patients with COVID-19, patient characteristics, and outcomes between the 2020 and 2021 AMI samples. Results: There were 2,541,992 COVID-19 patients, with 3.55% experiencing AMI. The highest rate of AMI was in December 2021 (4.35%). No statistical differences in trends of AMI mortality were noted over the 21 months. AMI cases in 2021 had higher odds of undergoing PCI (aOR 1.627, p

(1) Background: Since the pandemic, adolescent girls have increasingly faced mental health challenges. We examined prevalence trends and associated risk factors for depression among adolescent girls. 2) Methods: Data for girls aged 12 to 17 years (N=4346) from the 2021 cross-sectional National Survey on Drug Use and Health were analyzed. Factors associated with depression were examined using multiple regression analysis. (3) Results: Rates of severe depression were significantly higher (p&lt;.001) in older girls (adjusted odds ratio [AOR]: 1.63, 1.61, those who did not have authoritative parents (AOR: 3.40), and those with negative school experiences (AOR: 4.03). Black and Asian/Native Hawaiian or other Pacific Islanders were less likely to report severe depression than white girls. As previously reported, non-White girls were significantly less likely to receive treatment for depression (p&lt;.05). Parents’ characteristics and school experiences had no effect on the likelihood of receiving mental health treatment. (4) Conclusion: Depression has become increasingly common among American adolescent girls, who are now three times as likely as adolescent boys to have had recent experiences with depression. Our results show that family structure, parenting style, and negative school experiences significantly contribute to the rate of depression and that treatment disparities exist with regard to race and ethnicity.

Various bat species often occupy the same habitats. Cohabitation should induce different preferences in spatial or trophic components of the bat ecological niche, to reduce their competition. This determines the differences in the trematode fauna of Myotis spp. The purpose of our research was to study the biodiversity of trematodes in syntopic populations of five Myotis species in the Samarskaya Luka National Park. In 2005–2007 we studied 867 bat specimens by the methods of complete helminthological dissection. In total, 11 trematode species were found in Myotis bats. Only three trematode species, Plagiorchis koreanus, Prosthodendrium chilostomum and Parabascus duboisi were revealed in all studied Myotis spp. Prosthodendrium cryptolecithum was recorded for the first time in Russia. Digenean species diversity is higher in Myotis daubentonii and M. dasycneme. The trematode fauna of M. brandtii, M. nattereri and M. mystacinus is less diverse. The determining factor in the infection of bats by trematodes is feeding on semi-aquatic insects, possible second intermediate hosts of these parasites. Our results confirm the data that the ecological niches of the five Myotis species partially overlap. An analysis of the trematode fauna in Myotis spp. showed that in the Samarskaya Luka there may be weak competition for food items among bats.

Remote sensing (RS) as a landscape planning and management tool for socio-cultural diversity and inclusiveness in protected(reserved) areas through monitoring of the land-use changes, settlement/living patterns, predominant trades/socio-economic activities in the urban-rural locations, and the demography in Sub-Saharan Africa (SSA). The eighteen federal governments recognized nature reserves in Nigeria being the giant of Africa because of their green landscapes, rich biodiversity, and human resources. This study aimed to explore the application of remote sensing to assess the extent of land degradation and encroachment in the 18 recognized national parks in Nigeria. A review of the protection of national parks using remote sensing and monitoring the trend of national park invasions which could either be natural or man-made. The study is in line with the United Nations SDG Goal 15: Life on Land- “Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss”. Located in the West Africa subregion lying on Latitude: 9° 04' 39.90" N (9.077899) and Longitude: 8° 40' 38.84" E (8.677599), with an estimated population of over 220,000,000 people. This study through an intensive review of various literature adopted a mixed approach for the analysis and assessment of the geospatial data, the updated aerial photographs obtained through the Landsat imageries (Google Earth Pro, 2023), and the use of GIS for Geospatial analysis which enables the collection and analysis of spatial and geographic data gathering land use/land covers (LULC) maps, soil type, and elevation maps. While exploring the geophysical ecology and biodiversity conservation of some selected national parks in Nigeria, while also providing cost-effective alternatives for biodiversity monitoring and conservation strategy development. A review of national implementation strategies on biodiversity conservation with the deployment of remote sensing technologies, it is now feasible to obtain large details of the surface of the planet without conducting arduous field activities with the assistance of the availability of multi-date, multi-resolution, multi-sensor aerial information to help prevent for encroachment, loss, and degradation of the natural landscapes.

Identifying the psychological impacts of the COVID-19 pandemic on the general population can help with planning and preparing for future pandemics. The main objective of the current study was to examine the psychological impacts of the COVID-19 pandemic among Iranian citizens in 2021. The current study used an online cross-sectional survey via web-based questionnaires among Iranian citizens. Perceived feelings during the COVID-19 pandemic were measured by the validated self-reported inventory by Reynolds et al, 2007. The collected data were analyzed using descriptive statistics, including percent, mean, and standard deviation, as well as inferential statistics, including, correlation, chi-square, independent t-test, and analysis of variances (ANOVA) by SPSS.22. The average age of the respondents was 34.62 (±11.86). The most frequent feelings experienced by Iranian citizens were boredom (44.0%), nostalgia (40.6%), anxiety (35.3%), and nervousness (34.1%). Female participants, younger respondents, unemployed, single individuals, and those living in the urban areas experienced significantly higher levels of the negative feelings. The results of the study showed the high prevalence of the psychological effects of the COVID-19 pandemic in Iranian citizens, particularly among women, single, and unemployed people. Therefore, we need to develop more supportive and consultative packages for future pandemics as well as implement psychological rehabilitation after the crises.

The Portuguese health system has a universal, public, general National Health Service (NHS), tending towards free healthcare access. Created in 1979, this delivery model developed from the integration and complementarity between the different response levels (primary, hospital, continuing, and palliative care). However, over these 40 years, the initially centralized system underwent a decentralization process with the creation of Regional Health Administrations in the five mainland administrative regions. Since then, the entire NHS has settled around this new organization. The most recent step started in 2018 with decentralizing primary health care skills to 190 municipalities. This paper presents the various critical issues involved in the latest gradual decentralization process in health, intending to bring services closer to the citizens, and more focused on their needs. The article identifies and discusses the implications of this experience based on the steps foreseen in the already published legal texts.

Abstract This article examines the implementation of the Swedish national environmental quality objectives and discusses what can be learnt for the equivalent process for the set of global UN 2030 goals (SDGs), established in 2015. The empirical basis is a study on 50 large companies in Sweden and their use of these objectives in their policy formulation. The SDGs are crafted with a broader approach than the Swedish national environmental quality objectives. Therefore, the SDGs probably better reflect the agenda of the business community since they have a global character, cover the whole spectrum of important sustainability issues and provide a mutual agenda for the business community world-wide. More than 90 percent of the large companies in the study have explicitly committed themselves to the SDGs, only 1-2 years after they were published, whereas similar commitments hardly exist for the national environmental quality objectives, even 20 years after its establishment. A large majority of the large companies in this study know about the SDGs, have actively endorsed them, and started to adjust their activities accordingly. At the end, the results of these endorsements remain to be seen.

Zinc deficiency, a common malnutrition in children and women is a global public health problem.Burden of zinc deficiencyis more in countries with low meat and high cereal food consumption like Nepal. Nationally representative data on zinc status in Nepal is lacking at present. This study analysed the data from the recent Nepal National Micronutrient status survey 2016(NNMSS-2016) to determinethe prevalence of zinc deficiency and associated risk factors among children aged 6-59 months (n=1462) and non-pregnant women aged 15-49 years(n=1923) from three ecological zones, Hill, Terai, and Mountainof the country. Venous blood was collected from the participants to measure micronutrients such as zinc, markers of anaemia, vitamin A, and markers of inflammation. Stool was collected to assessthe soil-transmitted helminths (STHs) and Helicobacterpylori infection. Socio-demographic, household and other relevant information were collected by a structured questionnaire. Logistic regression was used to examine the predictors of zinc deficiency among the participants.The overall zinc deficiency in children was found to be 22.9% while it was higher in non-pregnant women (24.7%). Predictors associated with zinc deficiency among enrolled children in the study were,living in rural areas (AOR=2.25, 95% CI, [1.13, 4.49]),occurrence of diarrhoea during the two weeks preceding the survey (AOR=1.57, 95% CI, [1.07, 2.30]), household wealth quintile (AOR= 0.48, 95% CI,[0.25, 0.92]) and vitamin A status (AOR=0.49, 95% CI,[0.28, 0.85]. Risk factors associated with zinc deficiency among the non-pregnant women were being underweight (AOR=1.60, 95% CI,[1.15, 2.23]), fever occurrence during two weeks preceding the survey (AOR=1.45, 95% CI,[ 1.06, 1.99]), H. pylori in the stool (AOR=1.32, 95% CI, [1.03, 1.70]), being rich (AOR=0.64, 95% CI,[0.42, 0.98]) and being in the risk of folate deficiency (AOR=0.60, 95% CI,[0.37, 0.96]). We conclude that community focused intervention programs including health and nutrition counselling and livelihood opportunities focusing groups at high-risk may improve the zinc status in Nepal.

Background: Although National Licensing Examinations (NLEs) may be a costly process, they can predict better performance for many following years. The current licensing requirements will not entail and new requirements will be requested. Therefore, this study suggests a framework for the development of the Medical Licensing Exam by exploring the opinions of Egyptian medical practitioners and educators regarding the exam format and criteria. Objective and methods: to describe the needed steps to develop the EMLE through a two-phase exploratory mixed-method study that had been conducted among the Egyptian medical sectors: medical practitioners and educators. Results: There were 50 clinical and academic educators shared in the online discussion about EMLE development. Then, a survey was carried out on 266 participants with various working places in which 198 of the participants were staff in the Higher Education Ministry and 68 physicians in the Ministry of Health. The input from both had contributed to the development of the following framework that is divided into two main sections; the Exam Logistics and the Exam Set up. The exam Logistics included the exam committee, prerequisites for the exam, the admission criteria and fees, and the validity of the license. While the Exam Set up included exam setting, structure, standard-setting, pass marks and reset policy. Conclusion: A Multidisciplinary team resources for the exam setting. Fairness and objectivity were highlighted through several factors; development of the exam blueprint, types of assessment methods, post-exam analysis, and standard-setting. Finally, the reset policy, fees, and validity of the license were recommended with a student-centered perspective that was suggested for the exam committee.

Coronavirus is now a significant human pathogen with the emergence of SARS-CoV-2. Until now there has been no data to support a threat to agricultural industries. Using a comparative genomic protein analysis, this study examined the angiotensin-converting enzyme II (ACEII) gene of 17 animal species with an emphasis on agriculture. To determine viral vulnerability the 20 known SARS-CoV-2 receptor-binding domain (RBD)/ACEII receptor interaction sites were compared to determine their potential susceptibility to the SARS-CoV-2 virus. With the known bat host’s (XP_032963186) number of binding sites as a threshold, we note that ALL animal species examined in this study contained significant numbers (≥10) of SARS-CoV-2 binding sites and could be at risk for SARS-CoV-2 infection. The data from this study suggest SARS-CoV-2 imposes a grave threat to the safety and security of the agricultural industry. Urgent studies are needed to determine if infected animals can transmit SARS-CoV-2 before and/or after processing.

Over the last few decades, urban expansion and population shifts have modified the existing landscape throughout the U.S. Protected areas and development are compatible lenses, yet stakeholders’ involvement in decision-making is often missing from environmental governance. We examine how stakeholders living and working in proximity to Everglades National Park (EVER) perceive environmental and social changes to the park and community park relations. EVER was selected as a study site for several reasons: proximity to urban areas, rich biological diversity, largest subtropical wilderness in the U.S., International Biosphere Reserve, World Heritage Site, and prominence as a tourist destination for the region. Forty-one semi-structured interviews were conducted with neighborhood groups, representatives from gateway communities, and conservation organizations. An analysis of the interview data generated six research themes: loss of native species, urban development, a shortage and contamination of water, hurricanes, climate change, and increased recreation use. The results of this study add to the literature by providing a better understanding of the relationships stakeholders have with national parks. The results will provide useable knowledge that may help stakeholders and public land managers design strategies related for sustainable plans for the park and its surrounding communities.

In China, "new quality productive forces" have become an important focus for high-quality development; accelerating this development is an important task for the Chinese government in 2024. Such development relies on the traction of the digital economy. In view of this, developing “new quality productive forces” driven by the Chinese digital economy requires focusing on blocking points, such as the insufficient vitality of data, inadequate algorithmic regulation, the uneven distribution of computing power resources and the immature market environment. In order to dredge these blocking points, it is necessary to establish basic rules on data, strengthening algorithm supervision, building a national integrated computing power network, and optimizing the market environment.

The aim of this article is three-fold: firstly, it is to highlight how the different Bantustans with the focus to Transkei, Bophuthatswana, Venda, and Ciskei also know as the (TBVC) States secured extra territories. However, these Bantustans remained unrecognized in the international community because of their financial dependence to the apartheid regime. Secondly, the successes and failures of this process are fundamental in understanding the territorial monopolies of the Bantustans and thirdly we will interrogate how the Bantustan residents who were against the process mobilized other residents to reject the proposal and attempts of territorial expansion. Furthermore, this article contributes to the broader Bantustan’s historiography on the intended economic spin-offs with these endeavors. We contend that the above have received little scholarly attention. The methodology of this article draws from an historical approach and utilizes a range of different archival documentary sources, most importantly material housed in South Africa’s national archives and British Commonwealth archives. In conclusion, we argue in this article that these developments of territorial expansion had little benefits for the Bantustans and the extended territories adjacent to them.

Meat loss and waste are estimated at each stage along the food chain, but the methods used are complex and the data needed often fragmented. We, therefore, evaluated the feasibility of estimating meat loss and waste using a simpler method comparing meat availability and consumption, using Swiss meat consumption according to a national nutrition survey and Swiss meat availability according to food balance sheets. As availability is reported at the fresh meat level and consumption as consumed, items of the latter were converted to fresh meat equivalents before comparing consumption with availability. Consumed unprocessed meat was directly converted to fresh meat equivalents and consumed meat products after having identified their meat ingredients. Meat availability, meat consumption as consumed and as fresh meat equivalent were 138.4 g/d, 105.5 g/d, and 112.1 g/d, respectively. The resulting total meat loss and waste was 19% and varied from −36% to 38% for the different meat types. Estimating meat loss and waste based on meat availability and consumption derived from a national nutrition survey yielded results varying to such an extent that the evaluated method to estimate meat loss and waste cannot be recommended.

Tesso Nilo National Park is one of the protected areas designated as KPA by the Decree of the Minister of Forestry No.225/Menhut-II/2004 dated July 19, 2004 covering an area of ​​38,576 ha, then expanded again through the Decree of the Minister of Forestry No.663/Menhut/2009 dated 19 October 2009 with an area of ​​± 83,068 ha. The Tesso Nilo National Park area is experiencing the dynamics of land cover changes, namely the conversion of forest land which causes the forest area to become increasingly narrow in this area. With the reduction in forest area in this area, it causes a decrease in ecosystem network connectivity due to forest fragmentation that occurs, so that forests are separated and further apart. This study aims to analyze changes in land cover in the Tesso Nilo National Park area to find out information on changes in habitat ecosystems in the last 20 years. the observations were made using satellite images in 1999, 2010 and 2019. so that it can be seen the effect of forest fragmentation on ecosystems in the Tesso Nilo National Park area. From the results of the analysis, it was found that the area of ​​forest cover in the Tesso Nilo National Park decreased from 1999 to 2019 and caused changes in the connectivity network of forest ecosystems, which was found in the study, the weakest connectivity separated forest fragments as far as 17394.47 meters due to forest cover fragmentation.

Despite the shift to private sector-driven affordable housing in Nigeria for decades, the housing deficit has continued to increase to the disadvantage of low-income families. This paper explores the enabling strategies for stimulating private-driven affordable housing in Nigeria. A case study of the Millard Fuller Foundation projects was undertaken and semi structured interviews were administered to 12 residents of the estates and the developer to explore their experience and highlight the considerations for designing appropriate strategies. The data generated was analysed using thematic analysis with the support of Nvivo. The study identifies four major components of construction costs- land, design, materials, and finance that policy improvement can target to stimulate private investment. It shows that developers are likely to adopt practices that will reduce these costs with repercussions for end-users. Mindful of this, and the concern to make returns on investment, strategies should aim to harmonise both developers’ interest and that of the end-users through widespread infrastructural development to make land available in all locations, and incremental owner-building approach so that end users can take decisions for their housing. Furthermore, access to the National Housing Fund (NHF) mortgages should be enhanced by recognising supplementary incomes in the loan origination procedures

Biocontrol strategies are gaining tremendous attention with the growing awareness of the irreparable harm caused by the continuous use of synthetic pesticides. This study examines the proteolytic and chitinolytic activities of Bacillus velezensis CE 100 and its termiticidal effect through cuticle degradation. The proteolytic and chitinolytic activities of B. velezensis CE 100 systematically increased with cell growth to the respective peak of 68.3, and 128.3 units/mL after seventh days of inoculation, corresponding with the highest cell growth of 16 x 107 colony forming units (CFU)/mL. The in vitro termiticidal assay showed that B. velezensis CE 100 caused a rapid and high rate of termite mortality with the median lethal time (LT50) of &gt; 1h, and the highest mortality rate of 91.1% and 92.2% recorded at 11h and 12h in the bacterial broth culture and crude enzyme fraction, respectively. In addition to broken setae and deformed sockets, termites treated with the bacterial broth culture exhibited degraded epicuticles, while the crude enzyme fraction caused severe disintegration of both the epicuticle and endocuticle. These results indicate a tremendously higher prospect of B. velezensis CE 100 in the biological control of subterranean termites compared to the previously used entomopathogenic bacteria.

Background: Previous study of sexual minorities has documented both instability in the sex of sex partners and incongruity among all three dimensions of sexual orientation (attraction, behavior and identification), but no attempt has been made to relate the two. How, if at all, does past change affect present incongruity? This study attempts, for the first time, to examine this question. Method: Using a representative probability sample of the British population (n = 15,162), the current dimensions of sexual orientation were compared across changes in sex partner type—opposite-sex only (O/Sex), same-sex only (S/Sex), or both opposite-sex and same-sex (B/Sex)— over three time periods—before 5 years ago (Time 1), 5 years to 1 year ago (Time 2), and the past year (Time 3)—for the nonheterosexual population. Differences and trends in population-weighted percentage frequencies stratified by sex were assessed by t-test or inspection of 95% confidence intervals. Results: Overall incongruity and instability were high: 74% of men and 85% of women did not report congruent lifetime sexual attraction, behavior and identification; of persons reporting any same-sex sex partners at Time 1, 82% reported a different partner type at Time 3. Most change (80% for women, 84% for men) involved a single partner type transition (transience) rather than multiple changes (fluidity) and movement toward increased heterosexual orientation (69%; 65% to O/Sex partners. From Time 1 to Time 3, 19% of persons with S/Sex partners moved to O/Sex partners; 0.1% of persons with O/Sex partners moved to S/Sex partners. Instability moderately reduced already high incongruity for the majority moving toward increased heterosexual orientation, but increased already low incongruity for the minority moving toward increased same-sex orientation. Among presently S/Sex partnered persons (comprising 12% of sexual minorities), incongruity was reported by 1.4% of persons with stable partnership history and 11% of persons with unstable partnership history (p=.0052). For all except presently S/Sex partnered persons (comprising 88% of sexual minorities), incongruity was reported by 97% of persons with stable partnership history and 86% of persons with unstable partnership history (p=.0000). Conclusion: For most sexual minority persons, partner type instability contributed to a modest reduction of high sexual minority orientation incongruity after moving toward increased heterosexual practice. Among current S/Sex partnered persons, however, instability strongly increased incongruity between identification and behavior or attraction. These results are consistent with minority stress theory but inconsistent with homosexual immutability, and counsel caution regarding legal restrictions on support for sexual minority persons moving toward increased heterosexual partnership.

A healthy park-people relation depends essentially on the fair and sustainable maintenance of rural livelihood. When protected area is designated, rural people may face restrictions of access to land and resource use for multiple ecosystem services. In Wuyishan of China, we analysed the role of traditional tea cultivation during consistent protected area management to find ways to maintain stability of this social-ecological system in the new national park era. We used an intensive social survey to investigate tea’s role, perception of ecosystem services and impacts on tea cultivation from consistent conservation policies. Results showed that tea cultivation brought major household income and associated with multiple culture services. Protected area management affected land use and conservation outcomes were more obvious to farmers than economic and social ones. From the perspective of a social-ecological system, tea cultivation in national should be conservation-compatible activities from which the potentially lost economic value is remedied by ecological and cultural valorisation. To sustain the resilience of the social-ecological system, we proposed a three-scale management framework to regulate biophysical elements at land plot scale, to link production and market at the mountain level, and to secure tenure and encourage community participation at the landscape level.

Due to rising global warming and climate change, biodiversity protection has become a critical ecological concern. The rich biodiversity zones are under threat and are deteriorating, necessitating national, regional, and provincial efforts to safeguard these natural areas. The effective conservation of National Parks and Nature-protected Areas helps to improve biodiversity conservation, forest, and urban air quality. The continuous encroachment and abuse of these protected areas have degraded the ecosystem over time. While exploring the geophysical ecology and biodiversity conservation of these areas in West Africa, Kainji National Park was selected for this study because of its notable location, naturalness, rich habitat diversity, topographic uniqueness, and landmass. The conservation of national parks and nature-protected areas is a cornerstone of biodiversity conservation globally. This study is aimed at the target of United Nations Sustainable Development Goal 13, 2030- Climate Action, targeted at taking urgent action towards combating climate change and its impacts. The study captures both flora and fauna that are dominant in the study area. The 15 identified tree species were selected from over 30 species with 563,500,000 (an average of 3,700,000 in each sample frame) trees for every tree species/type with a total of 63% tree green canopy cover. The study areas divided into three zones were randomly sampled within a stratum of 25x25km frames divided into 150 sample frames for proper analyses using the i-Tree Eco v6.0.23. The following microclimatic data were captured and analyzed; photosynthetically active radiation, rain/precipitation, temperature, transpiration, evaporation, water intercepted by trees, avoided a runoff by trees, potential evaporation by trees, isoprene and monoterpene by trees. This study also further discusses the tree benefits of a green, low carbon, and sustainable environment within the context of biodiversity conservation considering carbon storage, carbon sequestration, hydrology effects, pollution removal, oxygen production, and volatile organic compounds (VOCs). There is a quick need for remotely-sensed information about the protected areas at regular intervals and government policies must be strict against illegal poaching, logging activities and other hazardous human impacts.

Recovery of forest after logging can be tested in many ways: the presence of particular species of fauna or flora, the similarity of the biodiversity of the recovering forest to that on neighbouring areas of undisturbed forest; or the characteristics of soils and streams whose conditions may have drastically changed during logging. Three cases of rainforest recovery after logging and clearance from Australia and Borneo exhibit different starting and different goals for recovery. Faunal indicators of recovery vary with size and with species dependence of the rainforest. Endemic forest species may have difficulty in recovering. Tree species richness and abundance may recover in two decades, but canopy closure takes longer. Compacted soils may retain low infiltration capacities for many decades. This diversity in recovery rates is confirmed when compared with those used elsewhere. Because the starting points for recovery vary, from damage by tropical cyclones and landslides, to clearance for shifting cultivation, pasture or agriculture, to post-logging conditions, universal indicators may be inappropriate. The desired endpoints of recovery also range from a “wilderness” state to a National Park for human enjoyment, biodiversity preservation, safeguarding rights of traditional forest-dwelling peoples, or a second round of selective logging.

The energy transition requires integration of different energy carriers, including electricity, heat, and transport sectors. Energy modeling methods and tools are essential to provide a clear insight into the energy transition. However, the methodologies often overlook the details of small-scale energy systems. The study states an innovative approach to facilitate sub-national energy systems with 100% renewable penetration and sectoral integration. An optimization model, OSeEM-SN, is developed under the Oemof framework. The model is validated using the case study of Schleswig-Holstein. The study assumes three scenarios representing 25%, 50%, and 100% of the total available biomass potentials. OSeEM-SN reaches feasible solutions without additional offshore wind investment, indicating that they can be reserved for supplying other states’ energy demand. The annual investment cost varies between 1.02 bn – 1.44 bn €/yr for the three scenarios. The electricity generation decreases by 17%, indicating that with high biomass-based combined heat and power plants, the curtailment from other renewable plants can be decreased. Ground source heat pumps dominate the heat mix; however, their installation decreases by 28% as the biomass penetrates fully into the energy mix. The validation confirms OSeEM-SN as a beneficial tool to examine different scenarios for sub-national energy systems.

The emergence of existing and novel vector-borne disease pathogens is highly unpredictable because there are so many possible causal factors of sociological, ecological, biological, behavioral and political origin. Traditional data-driven forecasting tools have limited use in circumstances featuring low-probability crises for which trend data is unreliable and non-predictive. Commercial and security sectors have been quick to adopt various forms of wargames to address this gap and provide intelligent insights on possible outcomes in the short, mid and long term future. The lack of commitment and action against vector-borne diseases by governments and local authorities requires a new approach that presents risk in terms of potential actions, possible outcomes and resulting consequences.

Blockchain technology can achieve decentralization, multi-party verification, anti-tampering, anonymity, traceability of transactions, and the application of distributed ledger. Countries around the world continue to seek the blockchain business models, technologies and applications, and have different visions and policies for the development of blockchain. This study conducts a comparative policy framework of theoretical analysis of the blockchain technology between the USA and China. Using the innovative policy tools proposed by Rothwell and Zegveld, the above mentioned governments are analyzed from the viewpoint of twelve policy tools. The results show that the USA and China all prefer to use “Environmental-side” policy. The USA has paid more attention to “Legal and regulatory”, “Public services” and “Procurement”. China has the highest proportion of policies in “Political tools”, followed by “Legal & regulatory”, while “Scientific and technical”, “Education” and “Overseas agent” come in third . The blockchain technology has developed vigorously among industries and its applications have gradually diversified. The results are provided to various stakeholders as a reference for policy planning.

The creation of the National Muslims Women’s Advisory Group (NMWAG) in 2008 by Britain’s New Labour Government was part of a strategy which sought to engage different levels of Muslim communities beneath an overarching focus on reducing ‘Islamic extremism’. To do so however, Government acknowledged that it would need to support Muslim women to overcome some of the constraints it believed were placed on Muslim women in contemporary Britain. Deeming theology and religious interpretation to be one of those constraints, Government saw the need to empower Muslim women to ‘influence and challenge’ religious and theological discourses as a priority. This article therefore offers a case study on a project that was commissioned by Government that sought to empower Muslim women to ‘influence and challenge’ theological interpretations in collaboration with the NMWAG. Having gained unprecedented access to the NMWAG, its activities and engagement with Government, this article presents previously unpublished findings from that project to focus on two key themes: Muslim women, their identity and position; and theology, leadership and the participation of women. Having explored these in detail, this article concludes by critically reflecting on the way in which Government engaged and interacted with Muslim women, the role and relative success of the NMWAG and, most importantly, the extent to which the NMWAG was able to ‘influence and challenge’ interpretations of Islamic theology.

In the second half of the 19th century new methods for quarrying and processing natural stone are developed. In the Nordic countries Sweden, Norway and Finland this technological pro­gress goes hand in hand with a systematic geological mapping and large-scale exploitation of natural stone deposits. As a result, new constructions are developed—changing the building practice in these countries. With the end of historicism a new architecture arises that particularly in Norway and Finland acquires a national-romantic character. This paper examines the interaction between geological exploration, commercial development, technical inventions and the development of a national-romantic architecture.

The establishment of protected areas and the practice of ecotourism are generally considered to be one of the crucial means for achieving sustainable development. This study focused on the development of ecotourism in oceanic island national parks, applying System Dynamics theory to explore the core mechanisms, system behaviors, and promotion strategies of sustainable development. We adopted the driving force–state–response (DSR) indicator framework and combined it with System Dynamics theory to construct a sustainable development model for ecotourism in oceanic island national parks. Through this model, we discovered that the intricate causal relationships between indicator factors form three dominant causal feedback loops that drive system behavior. The three causal feedback loops comprise one reinforcing loop and two balancing loops. Through the interaction and mutual regulation between these three loops, preliminary estimates can be made regarding the specific behavioral trends that promote ecotourism in oceanic island national parks. In addition, we further investigated whether the implementation of fee-based policies in oceanic island national parks contributes to these parks’ sustainability goals. Subsequently, this model could be developed into a numerical simulation program based on System Dynamics theory, thereby enabling the computer simulation of system behavior under various scenarios and conditions.

This article delves into the complex tension between national self-rule and international involvement, in the context of global politics, examining the inherent challenges of upholding both principles when confronted with human rights abuses and the pursuit of global peace. The introduction presents the fundamental dilemma: self-governance versus moral obligations. The problem statement calls for a nuanced approach to address the intricate complexities of sovereignty and intervention, acknowledging the potential misuse by oppressive regimes and the ongoing challenges of determining when and how intervention is warranted. The article advocates for a more responsible and effective approach to global conflicts and human rights violations, balancing national sovereignty with judicious intervention when required. The methodology employs both literature review and case analysis to construct a framework for objectively assessing when international intervention is justified in instances of human rights abuses. The conclusion stresses the criticality of objective intervention criteria, transcending cultural, political, and economic biases, and advocates for a globally accepted approach that celebrates diversity while promoting global stability.

Background: Patients with bipolar disorder (BD) receive traditional Chinese Medicine (TCM) for unmet clinical needs with psychotropic medications. However, the clinical characteristics of practices and outcomes of TCM in BD are not fully understood. This cohort study investigated the clinical characteristics, principal diagnoses, TCM interventions, and TCM prescriptions in patients with BD. Methods: 12,113 patients with BD were withdrawn from Taiwan's longitudinal health insurance database 2000 (LHID 2000) between 1996 and 2013. Chi-squared test for categorical variables and independent t-test for continuous variables. A p-value less than 0.05 indicated significance. Results: One-thousand and three hundred nineteen patients who visited TCM clinics after the diagnosis of BD were in the TCM group, while those who never visited TCM were in the non-TCM group (N= 1,053). Compared to the non-TCM group, patients in the TCM group had younger average age, a higher percentage of female individuals, more comorbidities of anxiety and alcohol use disorders, and higher mood stabilizer usage rates. The TCM group exhibited pain-related indications, including joint pain, myalgia, myositis, headache, and sleep disturbances. Corydalis yanhusuo and Shu-Jing-Huo-Xue-Tang were the most useful single herb and herbal formulas. Conclusions: Physicians need to be aware of the use of TCM in Patients with BD.

Tuna species are an important resource to the people of the Pacific, particularly small island countries like Tonga, that have few alternative natural resources. These countries are dependent on this fishery for their nutrition, recreation, government revenue, employment, welfare and culture. Threatening these benefits, however, are global warming and climate uncertainties that affect the presence and distribution of tuna in the Pacific islands countries and territories. There-fore, one of the most important development goals for Tonga involves managing its tuna fish-eries in order to optimize these benefits within the context of climatic impacts. This paper has two main goals. Firstly, we discuss Tonga’s commitment to implement the existing tuna man-agement policies. This commitment permeates through a range of activities to monitoring catch regulations and regulate locally based foreign vessels to fish in the Economic Exclusive Zone of Tonga. This reflects the implementation of an information-based management framework namely, the Tonga National Tuna Fishery Management and Development Plan that is revised every five years. Secondly, the paper identifies key scientific research programs, which form the basis to design more informed future policies towards tuna management. These researches include : i) examining of the bathymetric features of the island nation’s fishing ground, ii) model-ling the spatio-temporal distribution of tuna and, iii) characterizing tuna habitats within an oceanic environment using biophysical oceanographic data within Geographic Information Sys-tem, and iv) impacts of climate change on tuna

The status of vegetation and the impacts of mammalian herbivores on rangelands are complex, and such studies in Kenya are scanty. We investigated the dynamics of ground cover vegetation in Hell’s Gate National Park in relation to mammalian herbivory. Removal of palatable vegetation is postulated to enhance the development of invasive plant species. We investigated the influence of mammalian herbivores on vegetation diversity and dynamics in this rangeland. Three sampling blocks approximately 3 Km apart measuring 100 m x 50 m were established, each divided into three belt-transects (100 m x 10 m), and separated by a 10 m buffer zone. 2 m by 2 m quadrats at 20 m intervals were established in each transect. We measured composition the richness of plant and mammal species, and herbivory levels four times for six months (September 2018 to February 2019). Plant cover (P&lt; 0.001) and species diversity (P&lt; 0.001) differed significantly among sampling blocks and between seasons (P&lt; 0.001). Non-metric multidimensional scaling of plant species and herbivores showed co-occurrence of Zebras with Sida tenuicarpa and giraffes with Solanum incunum. We conclude that the removal of preferred plants through herbivory may be giving an edge to invasive species in the park.

This study aimed to investigate the occurrence of the artificial sweetener aspartame (E951) in a wide range of foods and beverages sampled by food control authorities in Germany between 2000 and 2022. The dataset was obtained through the Consumer Information Act. The results showed that aspartame was present in a wide range of product groups tested, most commonly in powdered drink bases (84%) and flavored milk drinks (78%). In the solid food groups, the highest mean aspartame content was found in chewing gum (1543 mg/kg, n=241), followed by sports foods (1453 mg/kg, n=125), fiber supplements (1248 mg/kg, n=11), powdered drink bases (1068 mg/kg, n=162), and candies (437 mg/kg, n=339). Liquid products generally had the highest aspartame content in diet soft drinks (91 mg/l, n=2021), followed by regular soft drinks (59 mg/l, n= 574), flavored milk drinks (48 mg/kg, n=207), and mixed beer drinks (24 mg/l, n=40). These results suggest that aspartame is widely used in foods and beverages in Germany and that certain product groups contain higher concentrations of the sweetener than others. However, the levels of aspartame found were generally within the legal limits set by the European Union. These findings provide the first comprehensive overview of aspartame in the German food market and may be particularly useful in informing the forthcoming working groups of the WHO International Agency for Research on Cancer (IARC) and the WHO/FAO Joint Expert Committee on Food Additives (JECFA), which are in the process of evaluating the human health hazards and risks associated with the consumption of aspartame.

Land use land cover change analysis is one of the most particular techniques to understand how land was used in the past, what types of changes are to be expected in the future, as well as the forces and processes behind the changes. Thus, the objective of this study was to investigate the land use land cover changes and its driving forces in Mago National Park, southern Ethiopia. Satellite image of Landsat5 TM (1988, 1998 and 2008) and Landsat8 OLI/TIRS (2018) with a time span of 30 years were employed. In addition, field observation, and social survey were conducted to study the drivers of land use land cover changes. QGIS 3.2 and SPSS (for social data analysis) software’s’ were used for satellite image processing, accuracy assessment, map preparation and descriptively analyze the driving forces of LULCC respectively. Supervised classification with maximum likelihood algorithm was conducted for satellite image analysis and generation of information using Quantum GIS 3.2 Post classification change detection method was applied to quantify the land use/land cover change. The result of the study indicated riverine forest, woodland, grassland, water body, degraded land and bare land as a major land use land cover class in the park. The result of land use land cover classification showed that in 1988 most of the study area was covered by woodland and grass land. In the first period (1988-1998), woodland, riverine forest, water body and bare land decreased by 6.76%, 37.98%, 22.37% and 70.14% respectively, while grass land, and degraded land increased by 16.11% and 85.67% respectively. In the second period, (1998 -2008), woodland, riverine forest and degraded land were decreased by 5.44%, 4.61%, and 80.74% respectively, while grass land, water body and bare land is increased by 14.74%, 3.76% and 52.58% respectively. From 2008-2018 riverine forest, grassland, water body and bare land decreased by 1.33%, 15.16% and 4.82% and 25.02% respectively, while woodland increased by 11.84%, and degraded land increased by 85.49% respectively. Riverine forest, water body, grass land and bare land showed decrement and that of woodland, degraded land indicated increment during study period. From 1988-2018, woodland, riverine forest, water body and bare land indicated decrement and the remaining grass land and bare land cover types indicated increment during study period. The result of social survey indicated that expansion of agriculture, human induced fire, overgrazing and hunting are proximate driving forces of the change in Mago National Park. Population pressure from a different area, poverty, decreased farmlands productivity; education, weak law enforcement and cultural factors are the major underlying causes of the observed changes. Therefore, proper land use planning, legal support, and strong law enforcement are the key recommendations to sustain natural resources of the study area.

Most developing countries with petroleum resources are constrained in the ability to refine their oil and gas resources. This virtually results in the involvement of the International Oil Company (IOC) by the National Oil Company (NOC) of a particular nation to enter into an agreement to achieve the production of oil based on an agreed framework. However, in cur-rent development, there is little focus on the contractual agreement, particularly on the pro-duction sharing agreement by the IOC in the exploration of petroleum resources of developing countries. The primary objective of this paper is to critically explore the contract structure of production sharing agreement by the IOC in the exploration and development of petroleum resources in developing countries. Content analysis was used as the methodology of the study after examining several literatures. The findings indicate that the contract structure of the production sharing agreement (PSA) between NOC and IOC plays a significant role in the cost and risk of exploration and development of oil. In addition, it is noted that the joint committee of the NOC and IOC plays a paramount role in monitoring the operations of PSA between the NOC and IOC. Hence, from the gross oil production, the NOC gets its share as profit while IOC gets its share income tax. As an instrument of contract structure in the oil and gas sector, PSA needs further entrenchment between IOC and NOC to avoid likely issues that can emanate between the two parties in the face of current developments.

Background: Intelligence quotient (IQ) is a measure of intellectual ability of performing, comprehension, and learning. Previous studies reported that intelligence measures predict various measures of job performance and income. Emotional awareness (EA) is the measure of emotional capacity to recognize and make sense of one’s emotions, as well as those of others. A high level of emotional awareness (EA) indicates one can learn from expressed emotions quickly. Both IQ and EA are important for personal and professional success.Objective: This study tests the hypothesis that the average national income rank is best predicted by the combined effect of the population's average intelligence quotient (one's ability to perform and learn) and emotional awareness (ability to recognize and make sense of emotions).Method: The population’s average intelligence quotient (IQ), emotional awareness (EA), and indices of good governance, which include corruption perception index and educational expenses for each country, were obtained from public data sources. The outcome variable was per capita gross national income. All the variables that are statistically significant in univariate analysis were included in the multivariate regression analyses but excluded from the final model if not statistically significant.Result: The total number of countries included in the final analysis was 81 because of missing values in different variables. Intelligence quotient (IQ) and emotional awareness (EA) were found to be highly correlated, at 0.77 and 0.32 respectively, with the per capita gross national income. The independent effects of intelligence quotient (IQ) and emotional awareness (EA) were found significant in the multivariate model after adjusting for measures of good governance. The R square value for the final multivariate model was 0.82. The corruption perception index (CPI) and educational expenses were strongly correlated with other measures of good governance such as democracy index, functioning of government, electoral process and pluralism, political participation, and civil liberty, but these variables were found not significant in the multivariate model. Conclusion: The study concludes the effect of intelligence quotient (IQ) and emotional awareness (EA) are complementary to each other but intelligence quotient (IQ) is a stronger predictor than emotional awareness (EA) for gross national income or wealth. We also find that indicators of good governance, including corruption perception index and educational expenses, have important associations with per capita gross national income. This study implies a nation may build more wealth if the educational system focuses on developing emotional awareness in addition to intelligence. The study concludes the effect of intelligence quotient (IQ) and emotional awareness (EA) are complementary to each other but intelligence quotient (IQ) is a stronger predictor than emotional awareness (EA) for gross national income or wealth. We also find that indicators of good governance, including corruption perception index and educational expenses, have important associations with per capita gross national income. This study implies a nation may build more wealth if the educational system focuses on developing emotional awareness in addition to intelligence.

This paper addresses crashes involving heavy goods vehicles (HGV) in Europe focusing on long-haul trucks weighing 16 tons or more (16t+). The identification of the most critical scenarios and their characteristics is based on a three-level analysis: general crash statistics from CARE addressing all HGVs, results about 16t+ trucks from national crash databases and a detailed study of in-depth crash data from GIDAS, including a crash causation analysis. Most European HGV crashes occur in clear weather, during daylight, on dry roads, outside city limits, and on non-highway roads. Three main scenarios for 16t+ trucks are characterized in-depth: (1) rear-end crashes in which the truck is the striking partner, (2) conflicts during right turn maneuvers of the truck and a cyclist riding alongside and (3) pedestrians crossing the road in front of the truck. Among truck-related crash causes, information admission failures (e.g. distraction) were the main causing factors in 72% of cases in scenario (1) while information access problems (e.g. blind spots) were present for 72% of cases in scenario (2) and 75% of cases in scenario (3). The results provide both a global overview and sufficient depth of analysis in the most relevant cases and thereby aid safety system development.

Education is the bedrock of any nation. It is essential for individual and societal growth and development. This triggers the demand for quality education which simultaneously increases with a growing demand for quality assurance. This study investigated the role of quality assurance in achieving the expected outcome of education in Bosnia and Herzegovina’s higher education system. Comparative development is looked at by examining other National Qualification Frameworks. The study was based on textual reviews and descriptive analysis on student enrollment and programs of studies. Unlike the global trend, it can be seen that student enrollment is on the decline in Bosnia and Herzegovina. It was found that quality assurance is an indispensable tool for strengthening the higher education system and for achieving the desired change and outcomes, that education offers. It was also found that study programs and curricula are pivotal for teaching and learning processes, and that a unified qualification framework is essential for achieving set objectives of education at all levels. The study recommended, among other things, that sound quality assurance systems as well as appropriate structure for monitoring and accreditation be put in place and be judiciously followed in order to achieve the desired outcomes in conjunction with the set objectives of higher education. Moreover, vital thoroughly analyzed pressures (i.e., democratic, economic, and systemic) barriers show signs of epistemological, political, and institutional barriers in the country.

Chaparral shrublands are the dominant wildland vegetation type in southern California and the most extensive ecosystem in the state. Disturbance by wildfire and climate change have created a dynamic landscape in which biomass mapping is key in tracking the ability of chaparral shrub-lands to sequester carbon. Despite this importance, most national and regional scale estimates do not account for shrubland biomass. Employing plot data from several sources, we built a random forest model to predict above ground live biomass in southern California using remote sensing data (Landsat NDVI) and a suite of geophysical variables. By substituting the NDVI and precipi-tation predictors for any given year we were able to apply the model to each year from 2000-2019. Using a total of 980 field plots, our model had a k-fold cross validation R2 of 0.51 and a RMSE of 3.9. Validation by vegetation type ranged from R2 = 0.17 (RMSE=9.7) for Sierran mixed conifer to R2 = 0.91 (RMSE = 2.3) for sagebrush. Our estimates showed an improvement in accuracy over a two other biomass estimates that included shrublands, with an R2 = 0.82 (RMSE = 4.7) compared to R2 = 0.068 (RMSE = 6.7) for a global biomass estimate and R2 = 0.29 (RMSE = 5.9) for a regional biomass estimate. Given the importance of accurate biomass estimates for resource managers we calculated the mean year 2010 shrubland biomass for the four national forests which ranged from 3.5 kg/m2 (Los Padres) to 2.3 kg/m2 (Angeles and Cleveland). Finally, we compared our estimates to field-measured biomass from the literature summarized by shrubland vegetation type and age class. Our model provides a transparent and repeatable method to generate biomass measure-ments in any year, thereby providing data to track biomass recovery after management actions or disturbances such as fire.

Remote sensing technologies may play a fundamental role in the environmental assessment of open-cast mining and the accurate quantification of mine land rehabilitation efforts. Here, we developed a systematic geographic object-based image analysis (GEOBIA) approach to map the amount of revegetated area and to quantify the land-use changes in open-cast mines in the Carajás region situated in the eastern Amazon. Based on high-resolution satellite images from 2011 to 2015 from different sensors (GeoEye, WorldView-3 and Ikonos), we quantified forests, cangas (natural metalliferous savanna ecosystems), mine land, revegetated areas and water bodies. Based on the GEOBIA approach, threshold values were established to discriminate land cover classes using spectral bands, and the NDVI and NDWI indices and LiDAR digital ground and slope models. The overall accuracy was higher than 90%, and the Kappa indices varied between 0.82 and 0.88. During the observation period, the mining complex expanded; for that, canga and forest vegetation was converted to mine land. At the same time, the amount of revegetated area increased. Thus, we conclude that our approach is capable of providing consistent information regarding land cover changes in mines, with a special focus on the amount of revegetation necessary to fulfill environmental liabilities.

Knowledge on river quality variations and of exceeding quality limits is essential for the allocation of water to different uses and for applying remedial measures. Thessaly plain was extremely fertile, and up until the early 20th century the area was a breadbasket for Greece. The highly important for the national agricultural production, albeit severely degraded Pinios river, has been assessed for its Chemical-Physicochemical (C-P) status, based on the results of the National Monitoring Program for the years 2018-2020, considering 218 seasonal samples. Forty percent (40%) of the total sample number, and 70% of the 30 monitoring stations revealed a lower than good C-P status, predominately as a result of elevated phosphate, total phosphorous and nitrate concentrations. Exceptionally, the Pinios river seems to be predominately affected by point sources of organic pollution, and secondarily by agricultural return flows and land flushing processes, whereas dominant mineralization and nitrification processes control the concentration and speciation of N and P compounds. The COVID lock-down seems not to have affected aquatic quality through an increase of WWT effluents or/and diminishing of atmospheric pollution, whereas the improvement of C-P status at the river outflow via dilution by local mountain springs is threatened by an ongoing dry spell affecting the country. Within the upcoming RBMPs, urgent remediation measures in Pinios basin should both target point sources of pollution and control agrochemicals, particularly focusing on adaptation strategies on extreme weather events.

The rapid pace of urbanization, coupled with the growing need for environmental sustainability and technological innovation, has brought smart city initiatives to the forefront of global urban development. This paper provides a comparative analysis of smart city policies from leading cities such as Oslo, Zurich, and Canberra, and derives strategic insights for Qatar. By examining the strategies, priorities, outcomes, and challenges associated with implementing smart city initiatives in these cities, the study identifies areas of alignment and divergence with Qatar's own smart city policy framework. The research highlights potential opportunities for cross-learning and suggests how Qatar can leverage lessons from international best practices to enhance its smart city initiatives. Key areas of focus include fostering strategic partnerships, promoting innovation, and ensuring effective governance and data management systems. The findings provide actionable insights to improve the effectiveness of Qatar's smart city projects, aligning them with the Qatar National Vision 2030.

AI-driven tools can identify nursing students' strengths and weaknesses, thus enabling the development of customized learning plans that target specific areas for improvement. This targeted approach can enhance knowledge retention and skill development, resulting in better prepared healthcare professionals. Nursing students are required to overcome their own psychological stress during their internship in order to understand sick children’s emotional reactions, as well as to be able to interact and communicate with such children. The application of AI picture-based teaching e-books helps nursing students to understand how to use therapeutic games to improve communication with sick children. A comparison of the differences between nursing teachers’ self-efficacy scores and nursing students’ application of AI picture-based teaching e-books (experimental group) and narrative handouts (control group) was achieved via therapeutic games to deal with sick children’s fear of medical examinations and treatments. In addition, a comparison was also conducted on the differences between the impact of the self-efficacy of the experimental group and that of the control group in dealing with sick children’s behavioral responses with respect to fears of medical examinations and treatments. This study is a quasi-experimental study, in which the self-efficacy scores of 30 nursing students were collected and analyzed in both the experimental group and the control group before and after intervention in dealing with sick children’s behavioral responses to fears of medical examinations and treatments. It was found that the self-efficacy score of the experimental group was higher than that of the control group (β coefficient is 0.356) when assessing the self-efficacy scores and behavior of the experimental and control groups in dealing with sick children’s fears of medical examinations and treatments through one-way analysis of covariance (one-way ANCOVA), moreover, a statistically significant difference (p < 0.05) was observed. The experimental group’s score of behavioral responses to the fears of sick children to examinations and treatments was lower than that of the control group (β coefficient was -1.540), wherein a statistically significant difference (p < 0.05) was shown. The self-efficacy of the experimental group in dealing with sick children’s fears of medical examinations and treatments had a statistically significant impact on the sick children’s behavioral responses to the fear of medical examinations and treatments (p < 0.05). In addition, the higher the self-efficacy scores of the experimental group in dealing with sick children’s fear of medical examinations and treatments, the lower the sick children’s behavioral responses to fears of medical examinations and treatments (the β coefficient was -0.914), the control group’s self-efficacy scores in dealing with sick children’s fears of medical examinations and treatments did not have a statistically significant impact on the sick children’s behavioral responses to fears of medical examinations and treatments (p > 0.05). This study proves that the application of AI picture-based teaching e-books by nursing teachers is more effective than narrative handouts in improving nursing students’ self-efficacy when using therapeutic games to deal with, as well as reduce, sick children’s fears of medical examinations and treatments.

Sub-national governments (SNGs) in developing countries have increasingly explored green municipal bonds as a financing tool, driven by promises of lower borrowing costs, enhanced reputation, and support for sustainable economic development. This study aims to critically examine these claims by analysing the actual costs and complexities associated with green municipal bonds (GMBs). The research involves a comparative analysis of traditional municipal bonds and GMBs, focusing on the financial and operational challenges faced by SNGs. Detailed case studies from Mexico City and Cape Town are used to illustrate the practical implications of issuing GMBs. The findings reveal that, despite similar or slightly lower interest rates, GMBs often entail higher issuance costs due to the need for certification, monitoring, and reporting of green projects. These additional costs, coupled with the necessity of hiring external consultants, make GMBs more expensive and difficult to replicate after initial transactions. Furthermore, the study highlights that the demand from investors has not met initial expectations. While green-aligned investors show a higher appetite for GMBs, they constitute only a small portion of the finance market. Traditional investors, primarily focused on financial returns, are less inclined to invest in GMBs solely based on their green label. Consequently, many SNGs have reverted to issuing traditional “vanilla” municipal bonds while still using the proceeds to fund green initiatives. This shift underscores the need for a realistic assessment of GMBs’ viability in developing countries and calls for a re-evaluation of strategies for promoting sustainable economic development through green finance.

The evaluation of logging in a forest management area using only the volume variable is not sufficient to assess the effectiveness of the harvest. The objective was to evaluate harvested volume using different logging variables to point out possible divergences between what was planned and what was actually carried out, in order to indicate adjustments to next annual operating plans (AOPs). The database comes from a community forest management area in the Tapajós National Forest, considering three sources: forest inventory, AOP planning and the post-exploration report. The yield considering the number of trees felled and the effective volume were compared with the AOP planning. The volume estimated by the generic equation was compared with the cubed volume and the commercial height variable was evaluated. Of the 6,267 trees selected, 5,090 trees were harvested (3.2 trees ha^-1), indicating a yield of 85% of the estimated volume. Of the 25 commercial species logged, the most representative were: Manilkara huberi, Vochysia maxima, Lecythis lurida, Couratari guianensis and Hymenaea courbaril. It can be concluded that the number of trees, cubed volume and commercial height are post-exploration yield response variables and not just volume, as is currently used in Sustainable Forest Management Plans (SFMPs).

The impact of COVID-19 pandemic on the cardiovascular healthcare services in Croatia has not been systematically examined. In this study, we compared utilization and provision of cardiovascular services in Croatia during the pre-pandemic period (2017 to end of 2019) and pandemic period (2020 to end of 2021) by using large nationwide data from the Croatian Health Insurance Fund, an institution covering 95% of all insurance claims in Croatia. We report that the use of advanced heart failure treatment modalities increased while the number of coronary angiographies decreased while the number of performed percutaneous coronary interventions remained similar, even increasing in the setting of acute myocardial infarction, comparing pandemic to pre-pandemic period. Similarly, the number of transcatheter aortic valve implantations increased significantly during the pandemic era. There was a significant increase in laboratory diagnostic testing with troponin and natriuretic peptide assays during the pandemic period while the use of most cardiovascular services remained stable or only slightly decreased, compared to pre-pandemic period. These data suggest that Croatian cardiovascular healthcare services during COVID-19 pandemic showed resilience and managed to maintain or even increase the number of various diagnostic and interventional procedures despite the widespread societal and logistical challenges encountered during pandemic.

Tourism carrying capacity remains pivotal for ensuring sustainable development within protected terrains, accentuating the balance between conservation, socio-economic benefits, and visitor satisfaction. This study delves into the intricate dimensions of this balance, focusing on the Katon-Karagay National Park (KKNP). Merging comprehensive empirical data accrued from fieldwork within the park, calculations surrounding recreational loads, and a synthesis of relevant literature, the study designed a methodology. This included calculated techniques incorporating ecological and tourist social capacities, the psychocomfort approach, and an ongoing monitoring approach, supplemented by exclusive data from the park's administration. Key findings underscored the significance of an adaptive balance, revealing specific permissible recreational loads for different park zones. For instance, zones of quiet recreation evidenced up to 5 people/ha, while active recreation zones fluctuated between 20 to 100 people/ha. Monitoring evidenced critical environmental changes, shaping recommendations for effective tourism flow regulation, ensuring alignment with established norms and ecological preservation. The exploration substantiates the indispensability of a meticulously structured approach to ascertain tourism carrying capacity, emphasizing the harmony achievable between environmental sanctity and human pursuits. KKNP's empirical data serves as a paradigm, guiding sustainable tourism frameworks for similar ecologically sensitive regions.

Amongst the advantages of using Worldwide Interoperability Microwave Access (WiMAX) technology at the last-mile level as access technology include an extensive range of 50 km Line of Sight (LOS), 5 to 15 km Non-Line of Sight and few infrastructure installations compared to other wireless broadband access technologies. Despite positive investments in ICT fibre infrastructure by developing countries, including Botswana, servicing end-users is subjected to high prices and service disparities. The alternative, the Wi-Fi hotspot initiative by the Botswana government, falls short as a solution for last-mile connectivity and access. This study used OPNET simulation Modeller 14,5 to investigate whether Botswana’s national broadband project could adopt WiMAX IEEE 802.16e as an access technology. Therefore, using the simulation method, this paper evaluates the WiMAX IEEE 802.16e/m over three subscriber locations in Botswana. The results obtained indicate that the deployment of the WiMAX IEEE 802.16e standard can solve most of the deployment issues and access at the last-mile level. Although the findings suggest that WiMAX IEEE 802.16e is more suitable for high-density areas, it could also solve rural areas’ infrastructure development challenges and provide the required high-speed connectivity access. However, unlike the Wi-Fi initiative, which requires more infrastructure deployment and less on institutional and regulatory frameworks, the deployment of WiMAX IEEE802.16e requires institutional and regulatory standards.

The aim of the study is to characterize the U.S. and Lithuanian defense cooperation from 1990–2020 including arms procurements. Findings suggest close defense cooperation between countries at Presidential, Congressional, and Defense Ministry/Secretary levels. The most developed cooperation areas are joint participation in international operations, improvements of the Lithuanian Armed Forces’ capabilities, and an increase of the U.S. military presence in the Baltic region. An analysis of Lithuanian defense procurements between 1990–2020 indicates that the majority of defense armaments were acquired from the U.S. using the Foreign Military Sales venue while other options to obtain armaments were not used.

Moose (Alces alces) are generalist herbivores but are important aquatic-terrestrial ecotone specialists. Aquatic macrophytes are a high-quality food source for moose during the summer, however their relative importance to moose diet is difficult to study. We used stable isotope analysis of carbon and nitrogen from moose hooves and forage (terrestrial plants, aquatic macrophytes, and arboreal lichen) to estimate the diet of moose at Isle Royale National Park, Michigan, USA, and to evaluate the isotopic variability along chronologies of serially sampled hooves. We hypothesized that aquatic macrophyte consumption and winter body condition (as measured by bone marrow fat content) would be greater at the eastern end of the island where aquatic habitats were most abundant. We were unable to evaluate spatial differences in aquatic macrophyte consumption, but overall, our mixing model results suggest that between 13% and 27% of summer moose diet was from aquatic sources. Among moose that died during winter, body condition was impaired and hoof δ¹⁵N (measured at the hairline) was higher at the western end of the island, where aquatic habitats are sparse. Although isotope chronologies preserved in hooves could significantly enhance our understanding of ungulate foraging ecology, interpretation of such chronologies is presently limited by our lack of knowledge pertaining to hoof growth rate and seasonal dynamics in relation to age and health. Significant isotope distinction among terrestrial plants, aquatic macrophytes, and arboreal lichens indicate that continued methodological advances in stable isotope ecology will lead to more precise estimates of the contribution of aquatic feeding to moose population dynamics.

The Western ‘discovery’ of Japanese cinema in the 1950s prompted scholars to articulate essentialist visions understanding its singularities as a result of its isolation from the rest of the World and its close links to local aesthetic and philosophical traditions. Recent approaches however, have evidenced the limitations of this paradigm of ‘national cinema’. Higson (1989) opened a critical discussion on the existing consumption, text andproduction-based approaches to this concept. This article draws on Higson´s contribution and calls into question traditional theorising of Japanese film as a national cinema. Contradictions are illustrated by assessing the other side of the ‘discovery’ of Japanese cinema: certain gendaigeki works that succeeded at the domestic box office while jidaigeki burst into European film festivals. The Taiyōzoku and subsequent Mukokuseki Action created a new postwar iconography by adapting codes of representation from Hollywood youth and western films. This article does not attempt to deny the uniqueness of this film culture, but rather seeks to highlight the need to reformulate the paradigm of national cinema in the Japanese case, and illustrate the sense in which it was created from outside, failing to recognise its reach transnational intertextuality.

This paper considers two types of Protestant ethnic groups of some areas of Urals and Western Siberia. The first type consist of representatives of members of different ethnic groups consisting of well-educated professionals, incorporated into industrial society and associated with the intellectualism of Protestantism. The second type is represented by the indigenous peoples of the Polar Urals and Western Siberia, who use the Protestant religious organizations as tool for restoring life-sustaining elements of the native peoples’ traditional economy. I employed the inductive approach and the comparison method; during the fieldwork I used ethnographic participant observations, sociological structured interviews and closed-ended questionnaires. The empirical data have been collected in the Southern, Middle and Polar Urals and Western Siberia.

This qualitative investigation delves into the intricate interplay of cultural factors within supply chain integration, aiming to elucidate how diverse cultural dimensions shape communication dynamics, decision-making processes, and collaborative efforts among global supply chain practitioners. Employing a phenomenological approach, the study explores the lived experiences and subjective perceptions of supply chain managers and professionals, providing nuanced insights into the profound impact of national culture, organizational culture, digital technologies, and sustainability considerations on supply chain operations. Key findings highlight the significant influence of national culture, as conceptualized by Hofstede's cultural dimensions, on supply chain interactions. These dimensions—such as power distance, individualism versus collectivism, uncertainty avoidance, and masculinity versus femininity—play crucial roles in shaping how individuals perceive authority, manage risks, negotiate agreements, and engage in collaborative practices across diverse cultural contexts. Cultural norms and values deeply influence both intra-organizational dynamics and inter-organizational relationships within global supply chains. Organizational culture emerges as a pivotal determinant of supply chain integration success. Cultures characterized by transparency, trust, inclusivity, and a commitment to continuous improvement create environments conducive to effective cross-border collaboration. Conversely, organizations with conflicting or ambiguous cultural norms face challenges in aligning goals, fostering mutual understanding, and maintaining open communication channels with international partners. The study underscores the transformative role of digital technologies in enhancing supply chain management practices. Technologies such as blockchain, artificial intelligence, and the Internet of Things improve supply chain visibility, optimize operations, and enhance decision-making processes, strengthening resilience against disruptions. The adoption and integration of these technologies depend on organizational readiness, technological capabilities, and cultural acceptance within supply chain networks. Cultural factors influence the adoption pace, implementation strategies, and utilization patterns of digital technologies, emphasizing the need for strategic alignment between technological investments and cultural norms to maximize their potential benefits. Furthermore, sustainability considerations are critical in shaping cultural values and priorities within supply chain networks. Organizations increasingly recognize the importance of environmental sustainability, ethical sourcing practices, and corporate social responsibility in shaping their reputations, stakeholder relationships, and long-term business goals. Cultural factors significantly influence organizations' approaches to sustainability, guiding their strategic decisions and operational practices.