Background: Abdominal wall hernias are a common condition that is seen in daily general surgery patients. However, still more researches are needed to be conducted regarding hernias. The aim of this study is to see the prevalence of hernias among patients admitted to the Department of Surgery of a tertiary care center. Methods: A descriptive cross-sectional study was performed among patients who admitted to the department of surgery in a tertiary care center between 1 August 2023 and 20 September 2023. All patients data were extracted to an excel sheet. Results: We had 760 patients who visited in this period. Only 272 patients (27.9 %) were diagnosed with hernias. We found 52.6 % of patients were male and 47.4 % of patients were female. The age between 46- 60 years old was the most to have hernias (97 patients). Inguinal hernias were the common among other types. Diabetes mellitus, hypertension, COPD, and hydrocele were found in 10.7 % of all patients. Conclusion: The prevalence of hernias in this study was nearly to other studies that conducted in the same conditions. Early diagnosis and patient’s education are the corner stone to prevent morbidities and mortalities.

(1) Background: We aimed to identify factors associated with the presence of apical lesions (AL) on panoramic radiographs and to evaluate the predictive value of the identified factors. (2) Methodology: Panoramic radiographs from 1071 patients (age: 11-93 a, mean: 50.6 a ± 19.7 a) with 27532 teeth were included. Each radiograph was independently assessed by five experienced dentists for AL. A range of shallow machine learning algorithms (logistic regression, k-nearest neighbor, decision tree, random forest, support vector machine, adaptive and gradient boosting) were employed to identify factors on patient and tooth level associated with AL and to predict AL. (3) Results: AL were detected in 522 patients (48.7%) and 1133 teeth (4.1%), whereas males showed a significantly higher prevalence than females (52.5%/44.8%; p<0.05). Logistic regression found that an existing root canal treatment was the most important risk factor (adjusted Odds Ratio 16.89; 95% CI: 13.98-20.41), followed by the tooth type ‘molar’ (2.54; 2.1-3.08) and the restoration with a crown (2.1; 1.67-2.63). Associations between factors and AL were stronger and accuracy higher when using less complex models like decision tree (F1 score: 0.9 (0.89-0.9)). (4) Conclusions: The presence of AL was higher in root-canal treated teeth, those with crowns and molars. More complex machine learning models did not outperform less complex ones.

The design of randomized controlled trials for low-resource settings has unique challenges. One challenge is ensuring recruitment success in the face of a lack of information about prevalence of disease in the population. What disease burden data may exist is old and from distant regions, adding guesswork into site design. This leads to a high chance that the sample size will not be recruited in any reasonable timeframe—a challenge even in high-resource settings. While cross-sectional prevalence studies could be used as a type of feasibility study informing trials by generating near real-time prevalence estimates for the future trial site, such studies take years to complete. This duration makes insertion of such a study in trial design impossible. An empirically supported combination of new approaches that sidesteps unnecessary hurdles is presented, the Pop-Up Prevalence with Private Ethics (PUPPE) design. PUPPE includes using a COVID-validated, more targeted method of data collection, use of accepted ethics review from universities or hospitals to avoid lengthy public ethics review, and—if needed—post-study in silico participant randomization. Only this design would enable clinical trial designers to insert fit-for-purpose prevalence studies within the design phase of their trials, leading to informative outcomes.

Background: Chronic diseases are major causes of morbidity, disability, and death worldwide. In many cases, they are potentially preventable and treatable. Glaucoma is one of the leading causes of morbidity and blindness, the early recognition of which can help reduce the adverse outcomes of the disease. Health illiteracy among these patients and the absence of self-management of these diseases are barriers to effective management worldwide. Therefore, the present study aimed to calculate the level of health literacy and activity level of patients’ activation in self-management and to explore the link between them among patients with glaucoma in outpatient clinics. Material and methods: Convenience sampling of patients with glaucoma attending the outpatient ophthalmology clinics of a university hospital in Heraklion-Greece was performed. Convenience sampling was used to recruit 312 participants. Data were collected between November 2023 and May 2024. The Patient Activation Measure-13 (PAM-13) questionnaire, in its Greek version, was used to evaluate patients’ activation level in self-management, whereas the Greek version of the European Health Literacy Survey Questionnaire 16 (HLS-EU-16) was used to assess health literacy. Results: Participants were classified as level 1(disengaged & overwhelmed) level in self-management (= 40.7, SD: ±29.9) and a sufficient health literacy level (= 10.7, SD ±3.7). However, there was no statistically significant relationship between health literacy levels and patient activation in self-management (p=0.602). Conclusions: Glaucoma patients experience challenges with health literacy and self-management activation, though there is no significant relationship between these two parameters. Multifaceted interventions seem essential for enhancing patients’ activation. Further research involving larger sample sizes, multi-center studies, and interventional design is needed.

Background: Cardiovascular disease (CVD) has been one of the leading causes of death and disability-adjusted life years lost worldwide. Blood pressure, lipid, and cholesterol are good predictors of CVD risk and correspond upon age and physical fitness. However, few studies have explored the variation trend of CVD risk factors across different populations upon age and their muscle strength. Objective: to analysis the variation tendency of CVD risk factors in blood according to age and relative grip strength among different populations. Method: 25363 participants were recruited in this cross-sectional study and 24709 were included in the analysis. A logistic regression and a Bayesian probabilistic analysis based on Markov Chain Monte Carlo (MCMC) Modeling is conducted to build probability prediction models of hypertension, hyperlipidemia, and hypercholesterolemia according to age, relative grip strength, body weight conditions, and physical activity levels. Results: 1) age might be the main influence factor of hypertension, which is regarded as one of the primary CVD risk factors. However, although keeping a high level of physical activity might have positive effect on preventing hypertension because that individuals with normal body weight and higher physical activity shows a lower probability of being diagnosed with hypertension, it might could not prevent individuals from getting hypertension with age. 2) After 60, individuals of normal body weight seem more likely to have hyperlipidemia than those are overweight or obese. 3) Larger relative grip strength might not be able to offset the negative effects of obesity, overweight and physical inactivity on hyperlipidemia. 4) The probability of getting hypercholesterolemia varies less with age and relative grip strength. Conclusion: Body weight management and keeping high levels of physical activity are recommended at any age. It might benefit to increase some bodyweight after 60 years old.

Background and Objectives: The prevalence of osteoporosis is high, reportedly affecting 200 million people worldwide. A major problem associated with osteoporosis is that femoral fractures cause a decline in general function and loss of independence, greatly reducing patients’ quality of life. Notably, osteoporosis is an asymptomatic chronic metabolic disease, and its detection is thus often delayed. Interestingly, mandibular cortical index (MCI) classification using dental panoramic radiography is reportedly useful for early detection of osteoporosis. However, this visual classification method can lead to differences in diagnosis among surgeons. Therefore, this preliminary study was performed to analyze cone-beam computed tomography (CBCT) data and examine an objective MCI classification using the findings obtained. Materials and Methods: MCI classification (classified as C1, C2, or C3) was performed by three examiners on 70 women (91 sites) aged ≥20 years. The mandibular cortical width of all sites was measured using CBCT images. Results: The results showed that the mandibular cortical width was not particularly correlated with age or number of present teeth, and no significant quantitative differences were found between C1 and C2. However, coronal CBCT images of C2 revealed multiple characteristic bone trabecular structures. Conclusions: These structures may be an important finding affecting the classification of two-dimensional dental panoramic radiography images.

Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDL-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be routinely captured through standard surveillance activities. This study aimed to characterize the prevalence and demographic profile of dyslipidemia in T2D patients in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and blood tests. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (p = .368). High low-density lipoprotein cholesterol (LDL-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (p = .013 and p = .036, respectively). High total and high LDL-C parameters were significantly associated with hypertension (p = .029 and p = .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.

This study aims to quantify carotenoids and tocopherols in human milk from healthy Chinese women, and to explore their associations with region, lactation stage, and maternal socio-economic and obstetric factors. Human milk was obtained from 509 healthy mothers and the compounds of carotenoids and tocopherols were analyzed by high-performance liquid chromatography after mild saponification and solvent extraction. Socio-economic and obstetric characteristics of the mothers and their dietary intakes through a single 24-hour dietary recall were evaluated. The median content of each component [μg/100mL, median (interquartile range)] in colostrum and mature milk was, respectively, β-carotene 8.0 (4.7-15.2) and 1.8 (1.4-2.7), β-cryptoxanthin 6.2 (2.4-12.9) and 1.8 (1.1-3.4), lutein 5.7 (2.9-10.2) and 3.4 (1.5-6.0), lycopene 6.3 (4.0-9.9) and 1.4 (1.1-2.0), zeaxanthin 1.0 (0.6-1.5) and 1.0 (0.6-1.4), α-tocopherol 645 (388-1176) and 211 (131-321), γ-tocopherol 68 (48-121) and 77 (45-120). The levels of all those vitamins presented regional differences, and decreased as lactation stage increased except for zeaxanthin and γ-tocopherol. Associations of carotenoid contents with maternal education, delivery mode, and present body mass index were found in multivariate analyses. These results suggest that some region, lactation stage, obstetric and socio-economic factors are associated with human milk concentrations of carotenoids and tocopherols in healthy Chinese mothers.

Only cross-sectional studies have demonstrated muscle deficits in children with spastic cerebral palsy (SCP). The impact of functional impairments on altered muscle growth remains unclear. This prospective longitudinal study modelled the morphological muscle growth in 87 children with SCP (age range 6 months to 11 years, Gross Motor Function Classification System [GMFCS] level I/II/III=47/22/18). Repeated ultrasound assessments were performed during 2-year (y) follow-up with an interval of minimal 6 months. Three-dimensional freehand ultrasound was applied to assess medial gastrocnemius muscle volume (MV), mid-belly cross-sectional area (CSA) and muscle belly length (ML). Non-linear mixed models compared trajectories of (normalized) muscle growth between GMFCS-I versus GMFCS-II&amp;III. MV and CSA growth trajectories showed piecewise model with 2 breakpoints, with the highest growth before 2y and negative growth rates after 6-9y. Before 2y, children with GMFCS-II&amp;III already showed lower growth rates compared to GMFCS-I. From 2-9y, the growth rates did not differ between GMFCS-levels. After 9y, a more pronounced reduction in normalized CSA was observed in GMFCS-II&amp;III. Different trajectories in ML growth were shown between the GMFCS-level subgroups. These longitudinal trajectories could be used to monitor the SCP muscle pathology during childhood and to optimize treatment planning and goals aiming to stimulate muscle growth

Knowing the number of cases of an epidemic is the first function of epidemiological surveillance. An important underreporting of cases was observed in many places during the first wave of COVID-19 pandemic. To estimate this underreporting in the COVID-19 outbreak of Borriana (Valencia Community, Spain), during “Falles” mass gathering events in March 2020, a cross-sectional study was performed in June 2020 querying public health register. Logistic regression models were used. From a total of 468 symptomatic COVID-19 cases diagnosed in the outbreak by anti-SARS-CoV-2 serology, 36 cases were reported (7.7%), thus an underreporting of 92.3% (95% Confidence Interval [CI] 89.5%-94.6%), 13 unreported cases for every reported case. Only positive SARS-CoV-2 polymerase chain reaction cases were predominantly reported due to a limited testing capacity and following a national protocol. Significant factors associated with underreporting were no medical assistance for COVID-19 disease, adjusted odds ratio [aOR] 10.83 (95% CI 2.49-47.11), no chronic illness, aOR=2.81 (95% CI 1.28-6.17), middle and lower social classes, aOR=3.12 (95% CI 1.42-6.85), younger age, aOR=0.97 (95% CI 0.94-0.99), shorter duration of illness, aOR=0.98 (95% CI 0.97-0.99). To improve surveillance, studies of representative population samples are necessary to estimate the magnitude of future epidemics, and novel approaches are recommended.

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

In recent years there has been a clear increase in bottled water consumption, globally which translates to significant health and environmental concerns. This cross-sectional study aims to understand the attitude and preferences of university students in Qatar towards use of bottled and tap water for drinking purposes using an online survey questionnaire. The number of students who responded to the online survey was 14% of the entire student population within the university (n = 688). Overall, majority of the students reported plastic bottled water as the main source of drinking water they preferred to use on campus (n=468; 68.02%), with a higher proportion of females (72.08%) preferring the use of plastic bottled water. Out of the 468 students who preferred plastic bottled water, safety was the most important factor (43.80%) followed by convenience (16.88%) and taste (15.60%). Cost (15.17%), personal/family habits (5.13%), Environmental concerns (2.14%) and minerals (1.28%) were found to be the least important factors. Among the 45 students who preferred tap water over plastic bottled water, cost (46.67%) was the dominant factor followed by convenience (20.00%) and environmental concerns and safety (13.33% each), taste (4.44%), and personal/family habits (2.22%). This study recommends campaigns to focus on attitude and behavior change and not solely emphasize knowledge; 71.7% believed that plastic water bottles are more harmful to the environment, yet the greater majority still resorted to this source. There is an immediate need to further educate students through environmental and health literacy programs on water consumption and quality. Enabling the population to understand the positive and negative aspects of their choices, may be an effective remedy to ensuring a healthy population and healthy environment.

The transition from undergraduate dental student to the actual practicing dentist is a crucial phase and ensuring the preparedness of graduates for the complexity and demands of contempo-rary dental practice is a challenging task. This study aimed to evaluate the self-perceived prepar-edness of undergraduate dental students and house officers in the dental colleges of Pakistan. Cross-sectional national study was planned to collect the information from dental students and new graduates in Pakistan. The pre-validated Dental Undergraduates Preparedness Assessment Scale (DU-PAS) was used. Purposive sampling technique was utilized to recruit house officers and undergraduate dental students from 27 dental schools in Pakistan. The data analysis was car-ried out using the R statistical environment for Windows (R Core Team, 2015). The total of 862 responses with 642 females and 219 males were analyzed in the study. Overall, clinical skills score was 30.56+9.08 and score for soft skills was 30.54+10.6. The mean age of the participants was 23.42+1.28. Deficiencies were reported in various soft skills and clinical skills attributes.The results highlighted the strengths and weaknesses of dental students and new graduates in Pakistani den-tal institutions. The findings may be used to further develop and strengthen teaching and training of dental students in Pakistan.

Background: Gallstones represent a common gastrointestinal disorder, affecting approximately 10-20% of the global population. Oxidative stress plays a pivotal role in the pathogenesis of gallstones; however, there remains a lack of effective clinical indicators to predict their formation. This study addresses this gap by investigating the relationship between oxidative balance score (OBS) and the incidence of gallstones and gallbladder surgery, utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. Methods: This study investigated the association between OBS and the occurrence of gallstones and gallbladder surgery by analyzing data from NHANES for the period 2017–2020, adjusting for potential confounders such as age, sex, race, and comorbidities. Various statistical analyses were applied, including multivariate logistic regression, subgroup analyses, and smoothed curve-fitting models.Results: The results revealed a significant negative correlation between OBS and the risks of both gallstones and gallbladder surgery, with each one-unit increase in OBS associated with a 2.6% reduction in gallstone risk (OR=0.974, 95% CI: 0.958-0.990) and a 3.3% reduction in the risk of gallbladder surgery (OR=0.967, 95% CI: 0.950-0.983). Subgroup analyses confirmed the consistency of these associations across various demographic and health-related factors. Furthermore, a dose-response relationship was observed between higher OBS and a reduced risk of gallbladder surgery.Conclusions: This study demonstrates that a higher OBS is associated with a lower incidence of gallstones and reduced rates of gallbladder surgery, offering new insights into the link between oxidative stress levels and gallstone formation as well as surgical intervention. The findings underscore the potential of OBS as a valuable tool for identifying at-risk populations and informing personalized prevention strategies for gallstone disease.

Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide, and its incidence has been rising in parallel with the prevalence of obesity and diabetes. A critical marker for the progression of NAFLD is advanced hepatic fibrosis (AHF), which can result in cirrhosis and hepatocellular carcinoma. This study sought to investigate the potential associations between five nutrition-related indices—the geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), controlled nutritional score (CONUT), triglyceride-total cholesterol-body mass index (TCBI), and albumin/globulin ratio (AGR)—and the progression of NAFLD and AHF. Methods: This study analyzed the association between five nutrition-related indicators and the occurrence of NAFLD and AHF by utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020.03. After adjusting for demographic, lifestyle, clinical, and laboratory-related factors, the associations were examined employing various statistical techniques, including multivariate logistic regression, subgroup analysis, and smooth curve fitting analysis. Results: This study included 5,514 subjects, of whom 2,088 were diagnosed with NAFLD and 359 with AHF. After adjusting for potential confounding factors using multivariate logistic regression analysis, the results revealed that GNRI, PNI, and TCBI were positively associated with the incidence of NAFLD, while CONUT and AGR demonstrated negative associations with NAFLD. Additionally, GNRI, CONUT, and TCBI were positively associated with the incidence of AHF, while AGR demonstrated a negative association with AHF.Conclusions: The study demonstrates that nutritional status plays a dual role in the progression of NAFLD and AHF, serving as both a risk and protective factor. These findings offer a scientific foundation for the early identification of high-risk populations and the development of individualized nutritional intervention strategies.

For a long time, the transition to adulthood was seen as a troubled period where good development was synonymous with the absence of problems. Positive Youth Development (PYD) emerged as a holistic and strength-based perspective that focuses on the fact that young people may have the internal and external resources for healthy and successful development through five dimensions (5C’s) that empower them: Perceived Competence, Confidence, Character, Connection, and Caring. The aim of this study was to examine the relationship between the global PYD factor (and the 5C’s) and risk behaviors, in addition to analyzing gender differences. This study showed the results of a cross-sectional study of 1044 emerging adults from 11 Spanish universities in 2021. Data collection was performed by applying an online self-report measure. The results showed that the Character was protective against substance abuse, mainly in women, while the connection was related to the participation of betting money and online betting in men. Caring was protective against money bets in the men’s sample. However, controversial results were found regarding Perceived competence, which had a positive association with substance abuse, money bets, and drunk driving. It seems that high levels of Perceived competence, rather than objective competence, were associated with engagement in various risk behaviors, especially in the absence of other C´s. These results are discussed regarding the promotion of PYD to improve successful development and may suggest the need to foster healthy lifestyles and prevent risky behaviors in youth through the 5C's promotion programs within the university context.

Abstract Introduction: Poor structural quality of health facilities for tuberculosis (TB) diagnosis and treatment contributes to unfavorable health outcomes among TB patients. Improving the quality of healthcare services helps to avert TB-related morbidity. Despite these facts, the level of structural quality of health facilitieSs to deliver TB services is not in line with what the national TB and leprosy program (NTLP) recommends. Hence, the present study was conducted to assess the structural quality of health facilities to deliver quality TB services to TB patients among public health facilities in the Sidama region.Objectives: To determine the quality of the structural domain of TB services at public health facilities in the Sidama region of southern Ethiopia.Methods: An institution-based cross-sectional study was conducted from June to July 2023 among randomly selected public health facilities in the Sidama region. We included 40 randomly selected public health facilities that delivered TB services in the study area. Data was collected by experienced data collectors using facility audits, clinical observation checklists, structured questionnaires, and in-depth interviews. An Open Kit Mobile (ODK) application was used to collect data and exported to SPSS version 26. All statistical analysis was done using SPSS version 26.Results: The overall mean quality score for the structural dimension was 50.25 among the 40 health facilities audited in the study area.Conclusion: The quality of TB services regarding structural dimensions was poor in the study area. Therefore, any strategies must give careful attention to increasing the comprehensive structural dimension of quality TB services.

This study investigated the intersecting influence of socioeconomic status and cooking behavior on dietary habits using nationwide Japanese data. The study measured the frequency of balanced meals and breakfast intake as indicators of healthy eating habits and used subjective economic status, subjective spare time, and cooking behavior as the independent variables. It employed multivariate logistic regression analyses to elucidate the relationships among these variables. The results demonstrated that even among economically poor or time-constrained individuals, those preparing meals from ingredients were more likely to eat balanced meals and breakfast than those relying on commercial food or rarely cooking. This finding suggested that cooking behavior can mitigate disparity in healthful eating due to socioeconomic conditions. The study added new insights into the impact of combining socioeconomic status and cooking behavior on dietary habits, which highlights the potential of promoting cooking behaviors, such as teaching cooking skills, as a strategy for reducing socioeconomic dietary disparities.

Introduction: This study explores exposure to misinformation, COVID-19 risk perception, and confidence towards the government as predictors to negative attitudes toward the COVID-19 vaccine. Methods: A cross-sectional survey was carried out from 30 June to 30 August 2021 involving 775 respondents. The survey instrument for the questionnaire is an adaptation from various different studies consisting of five main variables: 1) misinformation about vaccination; 2) risk perception toward COVID-19; 3) attitudes toward the vaccination programme; 4) intention to get vaccinated; and 5) public confidence in the government in executing the vaccination programme. Results: The results of this study indicate that higher exposure to misinformation led to higher levels of negative attitudes toward the COVID-19 vaccine. When the perceived risk of COVID-19 infection was high, mistrust of vaccine benefits was low but there were also higher worries about the future effects of the vaccine. Confidence in government was associated with lower negative attitudes toward the COVID-19 vaccine. Conclusion: The results of this study may help develop an understanding of negative attitudes toward vaccinations in Malaysia and its contributing factors.

Mass crises are disruptive to people's mental health. The study aimed to explore mental distress during COVID-19 quarantine in a sample of university workers in Brazil. The survey included sets of questions about demographics, health, and support, an open question about major concerns, and the Clinical Outcome Routine Evaluation (CORE-OM), a measure of mental distress. 407 professionals participated in the study: mean age of 40 years (SD = 11.2), mostly female (67.8%), married (64.8%) and fulfilling social distancing to avoid COVID-19 infection (99%). Using the Consensual Qualitative Research for simple qualitative data (CQR-M) the main areas of concern were grouped into six domains, as follows: Work, Health, Isolation, Personal life and routine, Social environment, and Future. Many responses were multiple. They form categories indicating specific concerns within these domains. Quantitative data were analyzed by identifying the simple effects of potential predictors of mental distress. The results indicated medium effects of help with household chores, psychiatric treatment, age and physical exercise. Having someone available to listen was the only variable with a large effect in reducing mental suffering. The hybrid approach showed that the psychological experience during the pandemic is quite multifaceted and complex pointing new clues for public mental health.

Background: Public misconception and demand for the indication of antibiotics could lead to inappropriate prescribing and consumption. Successful treatment can only be achieved when the public and industrial users have knowledge on antibiotic use and resistance. This survey is aimed to assess antibiotic usage and knowledge regarding antibiotics and antimicrobial resistance (AMR) among undergraduate students of Universiti Brunei Darussalam (UBD), public university located in Brunei Darussalam. Methods: A cross-sectional study was performed using a self-administered questionnaire. The questionnaire was adapted from the World Health Organization (WHO) Antibiotic Resistance, Multi-country public awareness survey distributed online. Students at UBD were invited to participate in the online survey through internal email. The questionnaire consisted of 5 sections: demographic information, antibiotic usage, knowledge on antibiotics, antibiotic resistance (AMR) and use of antibiotics in agriculture. Data were analyzed descriptively and appropriate inferential statistics was used accordingly. Cronbach’s alpha was also done to determine the internal consistency. The section on antibiotic use and knowledge showed good internal consistency of Cronbach’s alpha 0.66 and 0.86 respectively. Research ethics approval was obtained from the PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam (UBD). Results: A total of 145 students returned the complete questionnaire. The result of the study found that 50% of the students had good level of knowledge of antibiotic and antimicrobial resistance with a mean total knowledge score of 11.4 out of 14. Respondents reported the use of antibiotic in the past (69%). Many of the students could identify the use of antibiotics for the treatment of bacterial infection. However, there were also students who incorrectly thought that antibiotics can be used for cold and flu (43%) and fever (41%). Moreover, 76% of the respondents mistakenly believed that antibiotic resistance is the result of the body becoming resistant to antibiotics. Only 12% of the respondents were found to have poor knowledge in the study. Conclusions: Misconceptions in regards to the use of antibiotics for conditions related to viral illnesses was noticed among the respondents in our study. Thus, improving knowledge on antibiotics is crucial to address those beliefs.

Coronavirus disease (COVID-19) has had devastating impacts on the global economy and public health. This study aimed to assess the level of COVID-19 vaccine acceptance, hesitancy, and associated factors among staff and students of the Federal University of Health Sciences Otukpo, Benue State, Nigeria. A web-based cross-sectional survey was conducted between November 2021 and April 2022, and data were collected and analyzed using descriptive and inferential statistics. Of the 150 completed and analyzed questionnaires, the majority of respondents (80.0%) were between 16 and 45 years old. The study found that 58.4% of participants indicated vaccine hesitancy, with skepticism about the vaccine's fast production/rollout and fear of vaccine side effects being the most common reasons for hesitation. Respondents' age, religion, and category were significant factors influencing vaccine acceptance and hesitancy (P < 0.05). The university community has a high level of awareness of COVID-19 but low vaccine acceptance, resulting in high levels of vaccine hesitancy. The study recommends that policymakers and public health officials should prioritize testing and vaccination for job categories with higher risk of exposure to COVID-19. They should provide accurate information about COVID-19 testing and vaccination and implement workplace-based testing and vaccination programs. These interventions can help to increase COVID-19 testing and vaccination uptake among the university community and mitigate the spread of COVID-19.

Background: The methods used in low- and middle-income countries (LMICs) household surveys have not changed in four decades; however, LMIC societies have changed substantially and now face unprecedented rates of urbanisation and urbanisation of poverty. This mismatch may result in unintentional exclusion of vulnerable and mobile urban populations. We compare three survey method innovations with standard survey methods in Kathmandu, Dhaka, and Hanoi, and summarize feasibility of our innovative methods in terms of time, cost, skill requirements, and experiences. Methods: We used descriptive statistics and regression techniques to compare respondent characteristics in samples drawn with innovative versus standard survey designs and household definitions, adjusting for sample probability weights and clustering. Feasibility of innovative methods was evaluated using a thematic framework analysis of focus group discussions with survey field staff, and via survey planner budgets. Results: We found that a common household definition excluded single adult (46.9%) and migrant headed households (6.7%), as well as non-married (8.5%), unemployed (10.5%), disabled (9.3%), and studying adults (14.3%). Further, standard two-stage sampling resulted in fewer single adult and non-family households than an innovative area-microcensus design; however, two-stage sampling resulted in more tent and shack dwellers. Our survey innovations provided good value for money and field staff experiences were neutral or positive. Staff recommended streamlining field tools and pairing technical and survey content experts during fieldwork. Conclusions: This evidence of exclusion of vulnerable and mobile urban populations in LMIC household surveys is deeply concerning, and underscores the need to modernize survey methods and practices.

Background/Objectives: This cross-sectional study aimed to investigate the relationship between swallowing function and serum albumin levels in Japanese older people (age ≥ 75 years). Methods: A total of 3258 participants (1325 males, 1933 females; mean age, 80.8 years) who had a dental checkup in Gifu City, Japan, between April 2020 and March 2021 were recruited. Swallowing function was assessed using the repetitive saliva swallow test, with poor swallowing function defined as swallowing fewer than three times in 30 seconds. A serum albumin level &lt; 3.6 G/dL was considered low. Results: In total, 78 participants (2%) had a low serum albumin level. These participants were significantly more likely to be older (p &lt; 0.001), male (p = 0.030), to have circulatory disease (p &lt; 0.001), support/care-need certification (p &lt; 0.001), poor tongue and lip function (p &lt; 0.001), poor swallowing function (p &lt; 0.001), and number of present teeth ≥ 20 teeth (p = 0.001). Furthermore, after adjusting for age, gender, circulatory disease, support/care-need certification, number of present teeth, tongue and lip function, and swallowing function, a low serum albumin level was positively associated with older (odds ratio [OR]: 1.115; 95% confidence interval [CI]: 1.064–1.169), male (OR: 2.208; 95% CI: 1.360–3.584), circulatory disease (OR: 1.829; 95% CI: 1.079–3.099), support/care-need certification (OR: 2.087; 95% CI: 1.208–3.606), and poor swallowing function (OR: 2.379; CI: 1.377–4.112). Conclusions: These results suggest a positive relationship between poor swallowing function and low serum albumin levels in Japanese older people.

The primary aim of this study is to investigate the relationship of the Mediterranean diet (MD) with metabolic syndrome (MetS) and its components in Caucasian subjects between 35 and 74 years. The secondary aim is to analyze sex differences. Methods: A cross‑sectional trial. This study utilized data from the EVA, MARK, and EVIDENT studies, a total of 3417 subjects with a mean age of 60.14±9.14 years (57% men). MetS was defined based on the Joint Scientific Statement National Cholesterol Education Program III. Waist circumference, blood pressure, fasting plasma glucose, and lipid profile were measured. Adherence to the MD was assessed with the 14-item Mediterranean Diet Adherence Screener (MEDAS) questionnaire used in the PREDIMED study. Good adherence was considered when the MD value was higher than the median value. Results: The mean value of the MEDAS questionnaire was 5.83±2.04; (Men 5.66±2.06 and women 6.04±1.99; p&lt;0.001). Adherence to the MD was observed by 38.6% (34.3% men and 40.3% women; p&lt;0.001). MetS was observed in 41.6% (39.0% men and 45.2%women p&lt;0.001). In the multiple regression analysis after adjusting for possible confounders, the mean MD value showed a negative association with the number of MetS components per subject (β=-0.336), and with the different components of MetS: Systolic blood pressure (β=-0.011), Diastolic blood pressure (β=-0.029), glycemia (β=-0.009), Triglycerides (β=-0.004), Waist circumference (β=-0.026), except with the HDL-cholesterol value which showed a positive association (β=0.021); (p&lt;0.001 in all cases). The adjusted logistic regression models showed that an increase in MDA decreases the probability of MetS (OR =0.56) and its components: blood pressure ≥130/85 mmHg (OR = 0.63), fasting plasma glucose ≥100 mg/dL (OR = 0.62); triglycerides ≥150 mg/dL (OR = 0.65); waist circumference ≥88 cm in women and ≥102 cm in men (OR = 0.74), and increases high-density lipoprotein cholesterol &lt;40 mg/dL in men or &lt;50 mg/dL in women (OR = 1.70); (p&lt;0.001 in all cases). The results by sex were similar, both in multiple regression and logistic regression. Conclusion: The results of this study suggest that a greater adherence to the Mediterranean diet decreases the probability of presenting Mets globally and by sex.

The objectives of the research are to investigate the characteristics of the board of directors on the financial performance of the enterprise. Using a sample data from 52 construction and real estate enterprises listed on Vietnam stock exchange in the period 2006-2020. Using typical regression methods such as pooled OLS, FEM, REM and assessing the defects of the research model, the FGLS method is selected. At the same time, due to the existence of endogenous phenomena and the nature of interdependence among enterprises in Vietnam, research using the instrumental variables two-step generalized method of moments (IV-GMM) in order to correct for cross-sectional dependence, autocorrelation, endogeneity, and heteroskedasticity in the analysis. Research results suggest that board size, female board members, meeting frequency, and board members' education have a positive influence on financial performance. Moreover, the independence of the Board of Directors increases, the business efficiency decreases. The research also found a positive relationship of tangible fixed assets, and a negative relationship between capital structure choice, firm size and corporate financial performance.

In recent years, metabolomics has been used as a powerful tool to better understand the physiology of neurodegenerative diseases and identify potential biomarkers for progression. We used targeted and untargeted aqueous, and lipidomic profiles of the metabolome from human cerebrospinal fluid to build multivariate predictive models distinguishing patients with Alzheimer’s disease (AD), Parkinson’s disease (PD), and healthy age-matched controls. We emphasize several statistical challenges associated with metabolomic studies where the number of measured metabolites far exceeds sample size. We found strong separation in the metabolome between PD and controls, as well as between PD and AD, with weaker separation between AD and controls. Consistent with existing literature, we found alanine, kynurenine, tryptophan, and serine to be associated with PD classification against controls, while alanine, creatine, and long chain ceramides were associated with AD classification against controls. We conducted a univariate pathway analysis of untargeted and targeted metabolite profiles and find that vitamin E and urea cycle metabolism pathways are associated with PD, while the aspartate/asparagine and c21-steroid hormone biosynthesis pathways are associated with AD. We also found that the amount of metabolite missingness varied by phenotype, highlighting the importance of examining missing data in future metabolomic studies.

Background: This study aimed to assess the dementia literacy (DL) level of community-dwelling adults in the four cities (Hong Kong, Guangzhou, Macau and Zhuhai) of the Greater Bay Area of China and to determine the preferred mass media for receiving dementia information. Methods: A multi-city cross-sectional study with 788 community-dwelling adults completed the survey. Dementia literacy was indirectly measured by two validated scales, 30-item Alzhiemer’s Disease Knowledge Scale (ADKS) and 20-item Dementia Attitudes Scale (DAS). When the ADKS total score was <15 and DAS total score was <70, it was considered as ‘inadequate dementia literacy’. Participants were also asked to indicate whether they would like to receive dementia information via digital media or traditional media. Chi-square tests and logistic regressions were undertaken. Results: About one-third of the participants had inadequate dementia literacy. Those with young age or secondary education preferred to get dementia information from social media. But people living in public housing would like to get information from government or hospital websites. Middle-aged participants inclined to learn dementia from television or radio. Conclusion: It is worthy to conduct territory-wide public education in dementia and develop strategies according to their preferences in the types of mass media.

Background: Depressive symptoms are a serious public health problem that are associated with BADL and IADL disabilities in Chinese adults.Objective: The limitation of activities of daily living (ADL) affects the mental health of older adults. We distinguished activities of daily living into basic activities of daily living (BADL) and instrumental activities of daily living (IADL) to explore the relationship between these two limitations and depressive symptoms among older Chinese adults using nationally representative cross-sectional data. In addition, this study explored the relationships between BADL, IADL and depression risk in elderly people at the individual and provincial levels and in rural and urban subgroups.Methods: The China Health and Retirement Longitudinal Study(CHARLS) survey used a multistage probability‒proportional‒to-size (PPS) sampling technique. Province-level socioeconomic characteristics were merged with microdata for respondents over 60 years of age from the 2020 China Health and Retirement Longitudinal Study (CHARLS 2020) Wave 5 (n=10,036) by the author. The respondents were asked whether their BADL and IADL were limited . The risk of depression was assessed using the 10-item Center for Epidemiological Studies Depression Scale(CES-D 10). The chi-squared test was used to explore whether having a disability that limits BADL and IADL were associated with mental health status. A binary logistic regression model was used to evaluate this association further after controlling for confounding factors.Results: Overall, 27.5% (2759/10036) and 25.7% (2776/10036) of the participants over 60 years of age were limited in their BADL and IADL, respectively. Regression analyses revealed that older adults whose BADL were not limited (OR=1.942, 95% CI: 1.638–2.303, P < .001) and whose IADL were not limited (OR=1.775, 95% CI: 1.485–2.122, P < .001) had a lower risk of depression than older adults whose BADL and IADL were limited. In addition, older adults who were female (P <.001), were 60-69 years (P < .005), had a partner (P <0.001), were literate (P <.001), lived in a rural area (P <.001), had a retirement pension (P <.001), had 3 or more children (P < .001), did not have any chronic diseases (P < .001), had a fair SRH score (P < .001), drank alcohol (P < .001), exercised (P < .005), did not participate in social activities (P < .001), or had an above average per capita household consumption (P < .001) lived in provinces with the first quartile of GDP per capita (P < .001) and lived in provinces with the second quartile of the number of beds in medical institutions per 10,000 persons (P < .001) were more likely to experience depressive symptoms, while smoking had no effect. In a binary logistic regression, older adults who were single (OR=0.669, 95% CI=0.551, 0.812), illiterate (OR=0.646, 95% CI=0.504, 0.828), living in rural areas (OR=1.485, 95% CI=1.270, 1.735), without retirement pensions (OR=0.671, 95% CI=0.582, 0.819) and with very bad SRH scores (OR=0.411, 95% CI=0.311, 0.544) had a greater risk of depressive symptoms. In the binary logistic regression analysis of the urban and rural subgroups separately, the results indicated that old people whose BADL or IADL were not limited were associated with a risk of depression, especially rural (P < .001) and urban (P < .001) participants.Conclusions: The present study provides evidence of an association between BADL, IADL and depression in older Chinese adults. This study revealed that individuals with limited BADL and limited IADL were predominantly depressed older adults. Binary logistic regression models suggested that disabilities limiting BADL and IADL were more likely to be associated with depressive symptoms in rural Chinese older adults. Older adults should be encouraged to participate in moderate physical and social activities to prevent physical dysfunction. The government and social work organisations should pay attention to the mental health of older adults in rural areas.

Background: The association between the individual and combined effects of moderate-to-vigorous physical activity (MVPA) and sleep quality with physical frailty in community-dwelling older adults is still unknown. Subjects and Methods: A cross-sectional study was conducted with a participants pool comprising older adults who had not been officially assessed as requiring nursing care or support services.. Physical frailty was assessed using Liu's definition based on Fried's concept. MVPA was measured by a triaxial accelerometer, and individuals who meet either MPA for ≥300 min/week, VPA for ≥150 min/week, or both of them were defined as "MVA+." "SLP+" was defined as a Pittsburgh Sleep Quality Index score &lt;5.5 points. We performed an ordinal logistic regression analysis to calculate the odds ratios (ORs) and 95% confidence intervals (CI) regarding the relationship between MVPA and sleep quality with physical pre-frailty and frailty. Results: The final analysis included 811 participants. After multivariate adjustment, compared to the MVA+SLP+, the MVA−SLP+ (OR 2.56, 95%CI: 1.80–3.62) and the MVA−SLP− (OR 3.97, 95%CI: 2.33–6.74) participants showed significantly higher ORs for physical pre-frailty and frailty. Conclusion: Community-dwelling older adults who did not meet MVPA criteria, regardless of sleep quality, had a higher risk of physical pre-frailty and frailty.

Nighttime lights (NTL) are a popular type of data for evaluating economic performance of regions and economic impacts of various shocks and interventions. Several validation studies use traditional statistics on economic activity like national or regional Gross Domestic Product (GDP) as a benchmark to evaluate the usefulness of NTL data. Many of these studies rely on dated and imprecise Defence Meteorological Satellite Program (DMSP) data and use aggregated units such as nation-states or the first sub-national level. Yet applied researchers who draw support from validation studies to justify their use of NTL data as a proxy for economic activity increasingly focus on smaller and lower level spatial units. This study uses a 2001-19 time-series of GDP for over 3100 US counties as a benchmark to examine the usefulness of the recently released version 2 VIIRS nighttime lights (V.2 VNL) products as proxies for local economic activity. Contrasts are made between cross-sectional predictions for GDP differences between areas and time-series predictions of GDP changes within areas. Disaggregated GDP data for various industries are used to examine what types of economic activity are best proxied by NTL data and comparisons are also made with the predictive performance of earlier NTL data products.

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

Hypertension stands as the foremost modifiable risk factor for cardiovascular disorders in South Asia. This research demonstrates the superiority of statistical models over traditional approaches in identifying clinical risks related to hypertension. Leveraging individual-level data from the Bangladesh Demographic and Health Survey (2017-18), a unified dataset was created. Adhering to JNC7 and ACC/AHA guidelines for hypertension classification, two prominent regression models were employed to estimate the prevalence of undiagnosed hypertension. A substantial 16% of hypertension cases in Bangladesh remain undetected. The study identifies undiagnosed hypertension as a heightened risk, particularly among the youth and residents of Sylhet and Rangpur divisions. Statistical models exhibit efficacy in discerning undiagnosed hypertension and associated factors in South Asia. Subsequent investigations should incorporate biological markers to enhance statistical models and ascertain their practicality.

Irrigation and fertilizer are two essential factors affecting rice root traits and yield. In this respect, a pot experiment was performed at the boro (dry season irrigated) season of 2021-22 in the Department of Agronomy of Bangladesh Agricultural University, Mymensingh, Bangladesh. The variety Binadhan-10 was planted at two irrigation conditions i.e. saturation (S) and continuous flooding (CF); two potassium (K) dose e.g. 65 kg ha-1 (K65) and 98 kg ha-1 (K98) and two nitrogen (N) dose i.e. 140 kg ha-1 (N140) and 210 kg ha-1 (N210). The experiment was laid in split plot design and replicated thrice. The findings confirmed the effectiveness of irrigation, K and N on root number (RN), root length (RL), root volume (RV), leaf area index (LAI), total dry matter (TDM), yield attributes and yield. Considering interaction among irrigation, K and N, S condition with K65 and N140 showed best performance. At 80 DAT, the highest RN (373.00), RL (1700.00 cm), RV (8.90 cm3 hill-1), LAI (4.94) and TDM (25.83 g plant-1) was obtained from this combination. Grain yield (GY) and root traits except root porosity, showed a significant positive association. Grain yield (GY) was highest (27.12 g pot-1) in S condition with K65 and N140.

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.

Despite extensive research on autism in children, much less attention has been given to the transition into adulthood. This study aims to address this gap by examining the dietary behaviors of young adults with autism during this critical transition period, highlighting the role of diet in enhancing their readiness for adulthood. Forty-seven participants (mean age 21.0 ± 1.1 years), both male and female, were involved in this study. Participants had various comorbidities, such as mood disorders, attention-deficit/hyperactivity disorder, depression, and anxiety disorders, for which they required medication. Dietary behavior was assessed using the Starting the Conversation: Diet survey, while transition readiness was measured with the Transition Readiness Sur-vey. T-test and regression analysis were utilized to evaluate the data. The results indicated that participants did not follow healthy eating habits, as reflected by the dietary scores (1.08 ± 0.07), and were not adequately prepared for adulthood, as shown by the transition readiness scores (3.19 ± 1.10). A statistically significant and negative correlation was found between dietary pat-terns and transition readiness (r = -0.51, p < 0.001), indicating an adverse relationship: transition readiness ratings decline as diet scores rise. Linear regression analysis revealed that dietary habits accounted for 26.20% of the variation in transition readiness, with the confidence interval for the coefficient of dietary habits being -2.89 to -0.95 (p = 0.002). The negative significant correlation between dietary scores and transition readiness scores shows that diet behavior significantly influences participants’ assessed readiness for transition.

Objective: Clostridioides difficile, a Gram-positive, spore-forming bacillus, has emerged as a leading cause of healthcare-associated infections, significantly contributing to infectious diarrhea and increasing healthcare costs. Materials and Methods: This cross-sectional, observational study polled Saudi Arabian nursing staff from July 2023 till December 2023 to evaluate their knowledge, attitudes, and habits regarding C. difficile infection (CDI). They were evaluated using a pre-tested, standardized questionnaire. Results: A total of 358 nurses in Saudi Arabia were surveyed, and 66% reported having knowledge of C. difficile procedures. However, only 30.5% of respondents correctly classified C. difficile as an anaerobic bacillus, while 42% were aware of the organism’s common occurrence in healthy adult volunteers. Additionally. 56% of respondents were aware of risk factors, and 49% could name typical medicines that might cause illness. Merely 24% acknowledged the cytotoxin test as the gold standard for detection. Of those who responded, 27% identified hand washing your hands was the greatest preventive approach and 36% thought that oral metronidazole was the best course of action. Conclusions: These findings highlight the global challenge that nurses are adequately knowledgeable on C. difficile. They stress the necessity of continuing education and training to enhance CDI management and patient outcomes, regardless of geographical variances.

COVID-19 is an infectious disease spreading through human touch. This study explored the risk perception and knowledge towards COVID-19 infection among Bangladeshi adult participants. Two self-administered online surveys were administered at two different time points from 26-31 March 2020 (Early lockdown) and 11-16 May 2020 (Late lockdown) through social media on 1005 respondents (322 and 683 participants, respectively) during COVID-19 lockdown period in Bangladesh. Univariate and multiple linear regression models were used to examine factors associated with risk perception and knowledge towards COVID-19. The mean knowledge (8.4 vs. 8.1, P=0.022) and risk perception (11.2 vs. 10.6, P < 0.001) scores differ significantly between early and late lockdown. Compared to the early lockdown period, the scores for perceived risk of contracting COVID-19 decreased significantly while public knowledge about COVID-19 was lower but not statistically significant. Female participants who practiced high quarantine particularly those who did so at the public health order during the lockdown reported increased knowledge towards the spread of COVID-19 and perceived high risk of contracting COVID-19. Education intervention using awareness to increase public knowledge and perception towards COVID-19 in Bangladesh should target male participants who practiced low quarantine and are less worried about the spread of such novel coronavirus even as the physical distancing persists.

In individuals with spinal cord injury (SCI), rapid skeletal muscle atrophy and metabolic dysfunction pose profound rehabilitation challenges, often resulting in substantial loss of muscle mass and function. This study evaluates the effect of combined neuromuscular electrical stimulation (Comb-NMES) on skeletal muscle cross-sectional area (CSA) and inflammatory signaling within the acute phase of SCI. We applied a novel Comb-NMES regimen, integrating both high-frequency resistance and low-frequency aerobic protocols on the vastus lateralis muscle, to participants early post-SCI. Muscle biopsies were analyzed for CSA and inflammatory markers pre-and post-intervention. The results revealed a preservation of muscle CSA in the Comb-NMES group compared to a control group receiving transcutaneous electrical nerve stimulation and passive movements. Inflammatory signaling proteins such as TLR4 and Atrogin-1 were downregulated, whereas markers associated with muscle repair and growth were modulated beneficially in the Comb-NMES group. The study's findings suggest that early application of Comb-NMES post-SCI can attenuate inflammatory pathways linked to muscle atrophy and potentially promote muscle repair, advocating for its inclusion in early rehabilitation efforts. However, the small sample size and variability in injury characteristics emphasize the need for further research to corroborate these results across a more diverse and extensive SCI population.

Abstract Background Fatigue Syndrome (FS) is described as extreme exhaustion following ordinary activities. Sleep deprivation, the use of antidepressants, autoimmune illnesses, and anemia are also risk factors for FS. Symptoms of FS include headache, dizziness, and dyspnea, among others. Objective: This study focused on assessing the prevalence of fatigue syndrome (FS) and its association with depression and anxiety, among the medical students in Saudi Arabia. Methodology In this cross-sectional investigation conducted in 2023, 740 medical students participated. Data were gathered using an online survey, which encompassed four key sections: Sociodemographic details, the 11-item Chalder Fatigue Questionnaire (CFQ), the 9-item Primary Health Questionnaire (PHQ) assessing depression, and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Analyses were performed by the use of SPSS version 25. Results A total of 740 students were surveyed, 417 (56.4%) satisfied the diagnostic requirements for fatigue syndrome (FS), with most of them being females. Furthermore, 234 (31.2%) and 296 (40.8%) of the participants reported having significant anxiety symptoms and depressive symptoms, respectively. FS was positively correlated with symptoms of anxiety and depression (P

Background: Multiple system atrophy (MSA) is a rapidly progressive neurodegenerative disorder that has no curative treatment. Diagnosis is based on a set of criteria established by Gilman (1998 and 2008) and recently updated by Wenning (2022). We aim to determine the effectiveness of [123I]Ioflupane SPECT in MSA, especially at the initial clinical suspicion. Methods: Cross-sectional study of patients at initial clinical suspicion of MSA, referred for [123I]Ioflupane SPECT. Results: 139 patients (68 men, 71 women) were included, 104 being MSA-probable and 35 MSA-possible. MRI was normal in 89.2% while SPECT was positive in 78.45%. SPECT showed high sensitivity (82.46%) and positive predictive value (86.24), reaching maximum sensitivity in MSA-P (97.26%). Significant differences were found when relating both SPECT assessments in the healthy-sick and inconclusive-sick groups. We also found an association when relating SPECT to the subtype (MSA-C or MSA-P), as well as to the presence of parkinsonian symptoms. Lateralization of striatal involvement was detected (left side). Conclusions: [123I]Ioflupane SPECT is a useful and reliable tool for diagnosing MSA, with good effectiveness and accuracy. Qualitative assessment shows a clear superiority when distinguishing between the healthy-sick categories, as well as between the parkinsonian (MSA-P) and cerebellar (MSA-C) subtypes at initial clinical suspicion.

To reduce the risk of infection of SARS-CoV-2 during the commute to the clinic or due to the contact with medical staff, The American College of Obstetricians and Gynecologists recommended ar-ranging part of the appointments in the form of “telehealth”. The aim of the study was to assess the access to medical care in pregnancy during the Sars-Cov-2 pandemic and the role of telehealth in implementation of prenatal care standards. This is a cross-sectional study. The study group in-cluded 618 women that were pregnant and or gave birth during the COVID-19 pandemic in Poland. The majority of participants experienced difficulties in access to medical care because of the pandemic. Correlation between this experience and the use of hybrid healthcare model was es-tablished. However, affiliation to public or private healthcare group was irrelevant. There was no relationship between healthcare (private/public or in-person/hybrid) and implementation of the prenatal care standards. To ensure safe access to prenatal care for pregnant women, recommen-dations for a hybrid pregnancy management model should be created with detailed information for which appointments patients must be present and which can be done remotely. To reduce movement risk and interpersonal contact, all visits during which tests and screenings take place should be done in-person. Other appointments can be arranged in the form of telehealth

Limited observational studies have described the relationship between sleep duration and overall diet. The present study investigated the association between sleep duration at weekdays and empirically derived dietary patterns in a nationally representative sample of UK adults, aged 19-64 years old, participating in the 2008-2012 UK National Diet and Nutrition Survey Rolling Programme. Survey members completed between three to four days of dietary records. Sleep duration at weekdays was categorised into tertiles to reflect short, normal and long sleep duration. Social jetlag was calculated as the difference between sleep duration at weekends and weekdays. The association between sleep duration/ social jetlag and dietary patterns, derived by principal components analysis, was assessed regressing diet on sleep whilst accounting for the complex survey design and adjusting for relevant confounders. Survey members in the highest tertile of sleep duration had on average 0.45 (95% CI -0.78, -0.12) lower healthy dietary pattern score compared to middle tertile (p =0.007). There was an inverted u-shaped association between social jetlag and a healthy dietary pattern, such that when sleep at weekends exceeded weekday sleep by 1h 45min, scores for indicating a healthy dietary pattern declined (p =0.005). In conclusion, long sleep duration at weekdays and an increased social jetlag are associated with a lower healthy dietary pattern score. Further research is required to address factors influencing dietary patterns in long sleepers.

We aimed to evaluate the association between daily dietary calcium intake and the risk of cardiovascular disease (CVD) in postmenopausal women using data from the Korean National Health and Nutrition Examination Survey (KNHANES). This cross-sectional study included 12,348 women aged 45–70 years who had reached natural menopause. They were classified into three groups according to daily dietary calcium intake: &lt; 400 mg, 400–800 mg, and &gt;800 mg. The risks of CVD, stroke, angina, and myocardial infarction were assessed in each group. Further, we performed subgroup analysis according to the post-menopause duration (≤10 vs. &gt;10 postmenopausal years). We performed logistic regression analysis with adjustment for age, menopausal age, income, urban area, education, insulin use, body mass index, hypertension, diabetes mellitus, dyslipidemia, high alcohol intake, smoking, exercise, oral contraceptive use, and hormonal therapy use. Calcium intake level was not significantly associated with the risk of CVD in the total population and the ≤10 postmenopausal years subgroup. However, in the &gt;10 postmenopausal years subgroup, daily calcium intake &gt;800 mg was associated with significantly decreased risks of all CVD (odds ratio [OR], 0.27; 95% confidence interval [CI], 0.11–0.64), stroke (OR, 0.06; 95% CI, 0.01–0.42), and myocardial infarction (OR, 0.27; 95% CI, 0.11–0.64). Our findings suggest that a dietary calcium intake of &gt;800 mg/day decreases the risk of CVD events in women who have been menopausal for &gt;10 years.

The worldwide competition to vaccinate against COVID-19 has highlighted the importance of immunization measures in containing the virus. Saudi Arabia, like the rest of the globe, must assess socio-demographic subtleties, chronic illnesses, vaccination effects, and public health policy implications as it navigates this complicated environment. This cross-sectional study examined Saudi COVID-19 vaccine in many ways. It examined the socio-demographic makeup of vaccine recipients, the prevalence of chronic conditions in this population, vaccine administration patterns, post-vaccination side effects, and vaccine-infection rates. A questionnaire-based online survey of 401 participants ensured gender, nationality, age, weight, and educational diversity. We analyzed vaccine manufacturer choice for each dosage, side effects after the first and second doses, and chronic diseases in the sample. Pfizer/BioNTech vaccines are preferred for all three doses, reflecting worldwide vaccination acceptance patterns. Side effects were not significantly different between vaccination kinds. Interestingly, immunization reduced infection rates, demonstrating the efficacy of COVID-19 vaccines. The data fills important information gaps and illuminates Saudi COVID-19 vaccination kinetics. These data support the global preference for mRNA vaccines, demonstrating the faith in this breakthrough technology. They also sponsor COVID-19 vaccine safety and effectiveness studies. The dramatic drop in infection rates among vaccinated people shows how vaccinations suppress the pandemic. These findings inform Saudi Arabia's immunization efforts. As booster doses become more common, long-term vaccination research is crucial. Vaccine reluctance, especially in certain demographics, must be addressed. Due to vaccines' protective potential, equitable vaccine distribution and large immunization programs are essential for herd immunity and pandemic management. This thorough cross-sectional study helps policymakers and healthcare practitioners build successful and inclusive COVID-19 immunization regimens in Saudi Arabia.

Experimental tests and numerical analyses were carried out on short, thin-walled channel columns with modified cross-sectional shape. The columns were loaded with an axial compressive force applied at the center of gravity of the cross section. Tests were carried out on a universal testing machine, while numerical analyses were performed in ANSYS software. The purpose of the tests was to determine the values of critical forces for the compressed columns and to determine the values of maximum forces at which failure of the columns occurs. Critical forces were determined based on the strain-averaged method. Based on the study, it was found that the strength and resistance to loss of stability of columns is primarily affected by their stiffness, and therefore by the shape of the cross-sections. In addition, for short columns, it seems more important to determine the value of maximum forces than the values of critical forces.

Studies employing Arellano-Bond and Blundell-Bond GMM estimation for single linear dynamic panel data models are growing exponentially in number. However, for researchers it is hard to make a reasoned choice between many different possible implementations of these estimators and associated tests. By simulation the effects are examined of many options regarding: (i) reducing, extending or modifying the set of instruments; (ii) specifying the weighting matrix in relation to the type of heteroskedasticity; (iii) using (robustified) 1-step or (corrected) 2-step variance estimators; (iv) employing 1-step or 2-step residuals in Sargan-Hansen overall or incremental overidentification restrictions tests. This is all done for models in which some regressors may be either strictly exogenous, predetermined or endogenous. Surprisingly, particular asymptotically optimal and relatively robust weighting matrices are found to be superior in finite samples to ostensibly more appropriate versions. Most of the variants of tests for overidentification restrictions show serious deficiencies. A recently developed modification of GMM is found to have great potential when the cross-sectional heteroskedasticity is pronounced and the time-series dimension of the sample not too small. Finally all techniques are employed to actual data and lead to some profound insights.

Background and Objectives: Ultrasound (US) is a non-invasive tool for the in-vivo detection of peripheral nerve alterations. Materials and Methods: In this study we applied nerve US to assist the discrimination between the spectrum of Amyotrophic Lateral Sclerosis (ALS, n=11), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP, n=5) and genetically confirmed Charcot-Marie-Tooth disease (CMT, n=5). All participants and n=15 controls without neurological diseases underwent high-resolution US of the bilateral tibial nerve. Nerve cross-sectional area (CSA) and nerve microvascular blood flow were compared between the groups and related to cerebrospinal fluid (CSF) measures, clinical symptoms and nerve conduction studies. Analyses are part of a larger multimodal study on the comparison between US and 7 Tesla (T) magnetic resonance neurography (MRN). Results: Patients and controls were matched with respect to their demographical data. CMT had the longest disease duration, followed by CIDP and ALS. CSA was related to age, weight and disease duration. CSA was larger in CMT and CIDP compared to ALS and controls. Blood flow was greatest in CIDP, and higher than in CMT, ALS and controls. In ALS, greater CSA was correlated with greater CSF total protein and higher albumin quotient. US measures did not correlate with clinical scores or nerve conduction studies in any of the subgroups. Conclusion: Our results point towards the feasibility of CSA and blood flow to discriminate between ALS, CIDP and CMT, even in small sample sized groups. In ALS, larger CSA could indicate an inflammatory disease subtype characterized by reduced blood-nerve barrier integrity. Our upcoming analysis will focus on the additive value of 7T MRN in combination with US to disentangle the spectrum between more inflammatory or more degenerative disease variants along the disease groups.

The COVID-19-medical emergency has ended worldwide, yet there is still a need to evaluate the psychological impact of these years of unprecedented changes on students’ life. Methods: This study aims to assess and compare COVID-19-related stressors (Relationships-and-Academic-Life; Isolation; Fear-of-Contagion) and psychophysical symptoms reported by university students in April-2020, April 2021, and April 2022. The predictive role of COVID-19-related stressors on psychophysical symptoms within each time was also tested. Data were collected among 637 university students in April-2020 (n = 197), April-2021 (n = 200), April-2022 (n = 240). Results: In April-2022, perceived Isolation and Fear-of-Contagion decreased from the peak registered in April-2021, but stress related to Relationships-and-Academic-Life remained noteworthy high. A sharp and ongoing increase in psychophysical symptoms was found, with more than 50% of students reporting clinical levels of Sleep-Disorders, Depression, Psychoticism, and Interpersonal-Sensitivity. In April-2022, students still perceiving stress related to Relationships-and-Academic-Life and Isolation were at risk for Anxiety, Somatization, and Sleep-Disorders, while those still perceiving stress related to Fear-of-Contagion were also at risk for Depression, Obsessive-Compulsive, and Psychoticism. Conclusion: Findings emphasized the long-lasting detrimental effects of the COVID-19-related stress. Interventions must pinpoint the complex post-pandemic adjustment process and their effects on university students' psychophysical health.

In cross-country skiing the time difference between a race winner and the person coming second is typically very small. Since much of the energy is spent on overcoming resistive forces, a relatively small reduction of these can have a significant impact on the results. The resistive forces come partly from the friction in the tribological interface, between the ski and the snow, and as with many tribological applications the characterisation of its origin, plays an important role in determining the frictional properties. Also in cross-country ski friction, there are several scales impacting the frictional performance, with the major contributors being the ski-camber profile and ski-base structure. Macro-scale measurements of the ski's camber profile under load, are often used to determine how adequate the ski is for a specific condition. The characteristic properties usually obtained are, the force required to collapse the ski to a certain camber height, the topography of the kick-wax zone, and by simple means a determined lengths of the frictional interface, i.e., the apparent contact length. To this date, there are some mathematical models, but there is no robust way of determining the macro-scale contact properties between a cross-country ski and a counter surface using simulations. In the present paper an Artificial neural networks (ANN) is trained to predict the ski-camber profile for various loads placed at different positions, and a well established deterministic approach is used to simulate the contact between the ANN-predicted ski-camber profile and a linearly elastic body with a flat surface, representing the snow. The results suggest that this method is feasible for the determination of the apparent contact characteristics of different skis. Moreover, we show that the apparent contact area does not linearly depend on the load, and that the elastic properties of the counter surface also has a large impact on the apparent contact area and the average apparent contact pressure.

Enhanced food and nutrition security remains a primary goal for every community. Several interventions have been promoted in dry areas to improve issues on food and nutrition security. However, studies on the level of knowledge, cultural norms, perceptions and attitudes that are key drivers in adoption and uptake to highlight gaps and provide evidence for improvement are limited. This study investigated variables influencing the adoption and implementation of an integrated crop-dairy goat farming system in Elgeyo Marakwet. A descriptive cross-sectional survey entailing qualitative and quantitative approaches among farmers practicing integrated farming was undertaken. A thematic questionnaire was used to collect quantitative data, while key informant interviews and focus groups discussions were used in qualitative research. This study utilized the multi-stage sampling procedure to sample the farmers and sample size was calculated based on Krejcie and Morgan table. Data analysis for quantitative data was done using SPSS software while qualitative data utilized N-vivo software The findings show that farmers have knowledge on the integrated farming system. Age, level of education, land size, gender, perceptions and attitudes influence adoption. Small animals like dairy goats are associated to women in this community hence increasing their participation in access, control and decision making of agricultural resources. The key findings of this study provide baseline data that can form evidence to help inform policy on the indicators contributing to adoption of integrated crop-dairy goat systems to enhance food and nutrition security

The vibrational excitation cross section of a diatomic molecule by positron impact is obtained using wavepacket propagation techniques. The dynamics was carried on a two-dimensional potential energy surface which couples a hydrogen-like harmonic oscillator to a positron via a spherically symmetric correlation polarization potential. The cross section for the excitation of the first vibrational mode is in good agreement with previous reports. Our model suggests that a positron couples to the target vibration by responding instantly to an interaction potential which depends on the target vibrational coordinate.

Background: The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, an analysis was conducted to under-stand how these elements continue to affect young populations in the post-pandemic era. Methods: In April 2023, a comprehensive online survey was administered to families in South Tyrol, Italy, with children aged 7–19 years, to ensure age and gender representation. The survey included par-ent ratings and adolescent (11–19 years) self-reports using standardized instruments to measure the symptoms of mental health problems (Strengths and Difficulties Questionnaire, SDQ), anxiety (Screen for Child Anxiety Related Emotional Disorders, SCARED), and depression (Patient Health Questionnaire-2, PHQ-2). Statistical analyses included descriptive statistics, chi-square tests, and unadjusted odds ratios (ORs). Results: Of the 4,525 valid responses, 1,831 were self-reported by adolescents. Notable gender differences in mental health outcomes were identified, along with significant demographic predictors, such as age, single parenthood, parental mental health problems, and immigrant background. Negative effects were associated with reduced family climate and increased screen time, whereas physical activity showed beneficial effects. Proxy reports overestimated adolescents' mental health problems, whereas self-report tended to underestimate them. Conclusions: Persistent mental health problems and gender disparities high-light the need for a public health approach. This should include accessible support services, resili-ence building, targeted support for vulnerable families and gender-specific interventions.

Background: Disparity in adult mortality (AM) with reference to social dynamics and health care has not been sufficiently examined. This study aimed to identify the gap in the understanding of AM in relation to religion, political stability, economic level, and universal health coverage (UHC). Methods: A cross-national study was performed with different sources of data, using the administrative record linkage theory. We created a new data set using data from the 2013 World Bank data catalogue by region, The Economist (Political instability index 2013), Stuckler David et al. (Universal health coverage, 2010), and religious categories of all UN country members. Descriptive statistics, a t-test, an ANOVA followed by a post hoc test, and a linear regression were used where applicable. Result: The average AM rate for males and females was 0.20 ± 0.10 and 0.14 ± 0.10, respectively. AM was significantly higher in economically weak countries, countries with political instability, countries with traditional religion, without achievement of UHC, and Sub-Saharan Africa (p<0.01). There was high disparity of AM between countries with and without UHC (F = male: 61.89, female: 51.85, p<0.001) and between groups with low and high income (F = male: 36.33, female: 42.39, p<0.001). UHC and political stability would significantly reduce AMR by > 0.41 in both sexes and high economic status would reduce male AMR by 0.44, and female AMR by 0.70, in relation to countries without UHC, with political instability, and low economic status. Conclusions: Disparities in AM can be reduced after the achievement of UHC and economically productive activities for those adults affected by conflict and political unrest.

This paper presents an in-depth study of the stress wave behavior propagating in a Rayleigh–Love rod with a sudden cross-sectional area change. The analytical solutions of stress waves are derived for the reflection and transmission propagation behavior at the interface of the cross-sectional area change in the rod, considering inertia and Poisson’s effects. Examples solved by the finite element method are provided to verify the correctness of the analytical results. In addition to the forward analysis of Rayleigh–Love wave propagation in rods impacted by a striker rod, a nondestructive testing method is proposed to conduct the defect assessment in the rod type of the structure component with a sudden cross-sectional area change within a cover medium by using the measured signals at the measurable zone of the rod to be inspected.

Background: New insecticides with novel modes of action such as neonicotinoids have recently been recommended for public health use by WHO. Resistance monitoring of such novel insecticides requires a robust protocol to monitor the development of resistance in natural populations. In this study, we comparatively used three different solvents to assess the susceptibility of malaria vectors to neonicotinoids across Africa.Methods: Mosquitoes were collected from May to July 2021 from three agricultural settings in Cameroon (Njombe-Penja, Nkolondom, and Mangoum), the Democratic Republic of Congo (Ndjili-Brasserie), Ghana (Atatam), and Uganda (Mayuge). Using the CDC bottle test, we compared the effect of three different solvents (ethanol, acetone, acetone+MERO) on the efficacy of neonicotinoids against Anopheles gambiae s.l. In addition, TaqMan assays were used to genotype key pyrethroid-resistant markers in An. gambiae and to evaluate potential cross-resistance between pyrethroids and clothianidin.Results: Lower mortalities were observed for all populations when using absolute ethanol or acetone alone as solvent (11.4- 51.9% mortality for Nkolondom, 31.7- 48.2% for Mangoum, 34.6- 56.1% for Mayuge, 39.4- 45.6% for Atatam, 83.7- 89.3% for Congo and 71.05- 95.9% for Njombe pendja) compared to acetone + MERO for which 100% mortality was observed for all the populations. Synergist assays (PBO, DEM and DEF) revealed a significant increase of mortality suggesting that metabolic resistance mechanisms are contributing to the reduced susceptibility. A negative association was observed between the L1014F-kdr mutation and clothianidin resistance with a greater frequency of homozygote resistant mosquitoes among the dead than among survivors (OR=0.5; P=0.02). However, the I114T-GSTe2 was in contrast significantly associated with a greater ability to survive clothianidin with a higher frequency of homozygote resistant among survivors than other genotypes (OR=2.10; P=0.013). Conclusions: This study revealed a contrasted susceptibility pattern depending on the solvents with ethanol/acetone resulting in lower mortality, thus possibly overestimating resistance, whereas the addition of MERO consistently increased the efficacy of neonicotinoids in terms of percentage mortalities and time to final mortality. The addition of MERO could however prevent the early detection of resistance development. We therefore recommend monitoring susceptibility using both acetone alone and acetone+MERO (8-10µg/ml for clothianidin) to capture the accurate resistance profile of the mosquito populations.

Background: Acceleration of mass vaccination strategies is the only pathway to overcome the COVID-19 pandemic. Healthcare professionals and students have a key role in shaping public opinion about vaccines. This study aimed to evaluate the attitudes of dental students globally towards COVID-19 vaccines and explore the potential drivers for students' acceptance levels; Methods: A global cross-sectional study was carried out in February 2021 using an online ques-tionnaire. The study was liaised by the scientific committee of the International Association of Dental Students (IADS), and data was collected through the national and local coordinators of IADS member organizations. The dependent variable was the willingness to take the COVID-19 vaccine, and the independent variables included demographic characteristics, COVID-19-related experi-ence, and the drivers of COVID-19 vaccine-related attitude suggested by the WHO-SAGE; Results: A total of 6639 students from 22 countries representing all world regions responded to the ques-tionnaire properly. Their mean age was 22.06 ± 2.79 (17-40) years, and the majority were females (70.5%), in clinical years (66.8%), and from upper-middle-income economies (45.7%). In general, 22.5% of dental students worldwide were hesitant, and 13.9% rejected COVID-19 vaccines. The students in low- and lower-middle-income (LLMI) economies had significantly higher levels of vaccine hesitancy compared to their peers in upper-middle- and high-income (UMHI) economies (30.4% vs 19.8%; p < 0.001); Conclusions: The global acceptance level of dental students for COVID-19 vaccines was suboptimal, and their worrisome level of vaccine hesitancy was influenced by the socioeconomic context where the dental students live and study. The media and social media, public figures, insufficient knowledge about vaccines, and mistrust of governments and the pharmaceutical industry were barriers to vaccination. The findings of this study call for further implementation of epidemiology (infectious diseases) education within undergraduate dental curricula.

This paper focuses on the impact of defects density and carrier capture cross-section area in the electron transport material (ETM), hole transport material (HTM), and absorber layers on the performance of perovskite solar cells and quantum efficiency (QE). Furthermore, the impact of defects density at the interface between ETM/absorber and absorber/HTM is also studied. SCAPS-1D software is used in the current study in determining solar cell performance. The proposed perovskite solar cell structure is a planar FTO/TiO2/ CH3NH3PbI3/ Cu2O. The results indicated that increasing the defect density in the absorber layer significantly affects cell performance, while in ETM and HTM layers, the cell parameters remain unaffected. It is also found that the defect capture cross-section has a similar behavior to the defect density in the main layers (ETM, absorber, and HTM). In addition, it is observed that by increasing the defects density in the ETM/absorber and absorber/HTM interfaces layer, the cell parameters FF, Jsc, and PCE have been slightly decreased, with no effect on Voc. Moreover, it is also noted that the quantum efficiency QE is sharply reduced. Finally, this paper introduced the correlation between the defect density and the capture cross-section, which is the first attempt to find such a relationship in perovskite solar cells to the knowledge of the authors.

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

There is a growing public health need for effective preventive interventions against dengue, and a safe, effective and affordable dengue vaccine against the four serotypes would be a significant achievement for disease prevention and control. Two tetravalent dengue vaccines, Dengvaxia (Sanofi Pasteur) and DENVax (Takeda Pharmaceutical Company), have now completed phase 3 clinical trials. While Dengvaxia resulted in serious adverse events and is restricted to individuals with prior dengue infections, DENVax has shown, at first glance, some encouraging results. Using the available data for the TAK 003 trial, we estimate, via the Bayesian approach, vaccine efficacy (VE) of the post-vaccination surveillance periods. Although better measurement over long time was expected for the second part of the post-vaccination surveillance, variation in serotype-specific efficacy needs careful consideration. Besides observing that individual serostatus prior to vaccination is determinant of DENVax vaccine efficacy, we also compare the VE estimations for 12 and 18 months and we observe that the efficacy is decreasing over time. The comparison of efficacies over time is informative and very important, bring up the discussion of the role of temporary cross-immunity in dengue vaccine trials and the impact of serostatus prior to vaccination in the context of dengue fever epidemiology.

(1) Background: This report examines the unique demands of off-road triathlon (XT) by presenting physiological, field, and race data from a national champion off-road triathlete using several years of laboratory and field data to detail training and race intensity. (2) Methods: Laboratory and field data were collected when the athlete was at near peak fitness and included oxygen consumption (VO2), heart rate (HR), power output (W), and blood lactate (BLC) during cycling and running, while HR, cycling W, and running metrics were obtained from training and race data files over a period of seven years. Intensity was described using % HR max zones (Z) 1 &lt; 75%, 2 = 75 - 87%, and Zone 3 &gt; 87%, and W. An ordinary least squares analysis was used to model differences between event types. (3) Results: Weather conditions were not different across events. XT events had twice the elevation change (p&lt;0.01) and two-three times greater W’ (p&lt; 0.001) than road triathlon (ROAD), but similar HR intensity profiles (max, avg, and zones); both events are predominately performed at &gt; Z2 or higher intensity. Championship XT events were longer (p&lt;0.01) , with higher kJ expenditure (p&lt;0.001). OLS modelling suggested three variables were strongly related (R2 = 0.84; p &lt; 0.0001) to cycling performance: event type (XT vs ROAD), total meters climbed, and total bike duration. Championship XT runs were slower than either regional (p&lt;0.05) or ROAD (p&lt;0.01) runs, but HR intensity profiles similar. OLS modelling indicates that slower running is linked to either greater total bike kJ expenditure (R2 = 0.57; p&lt;0.001), or total meters gained (R2 = 0.52; p&lt;0.001). Race simulation data support these findings but failed to produce meaningful differences in running. Conclusions: XT race demands are unique and mirror MTB and trail running demands. XT athletes must be mindful of developing anaerobic fitness, technical ability, and aerobic fitness, all of which contribute to off-road cycling economy. It is unclear whether XT cycling affects subsequent running performance different from ROAD cycling.

Cross-linked polyethylene (XLPE) is a highly all-important material renowned for its exceptional physical and chemical properties, and it is extensively utilized in various industries such as con-struction, piping, cable insulation and medical equipment. The cross-linking process of polyethylene involves chemical or physical bonding of polymer chains to enhance its resistance to heat, chemicals and mechanical stress. This study offers a comprehensive overview of recent research and potential advancements in this field, with a particular focus on the development of efficient techniques and environmentally sustainable cross-linking systems. It evaluates the opportunities and challenges faced by cross-linked polyethylene materials across diverse applications, providing valuable insights for future research in this area.

We consider a four-dimensional Riemannian manifold M with an additional structure S, whose fourth power is minus identity. In a local coordinate system the components of the metric g and the structure S form skew-circulant matrices. Both structures S and g are compatible, such that an isometry is induced in every tangent space of M. By a special identity for the curvature tensor, generated by the Riemannian connection of g, we determine classes of Einstein and almost Einstein manifolds. For such manifolds we obtain propositions for the sectional curvatures of some characteristic 2-planes in a tangent space of M. We consider a Hermitian manifold associated with the studied manifold and find conditions for g, under which it is a K\"{a}hler manifold. We construct some examples of the considered manifolds on Lie groups.

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

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

Forests have multifunctional roles. They not only increase forest carbon sinks through afforestation and management, but also indirectly realize multiple benefits of "economy + ecology + society". Therefore, we construct a multiple output-benefit system of forest carbon sinks based on the development of forest carbon sinks in provinces of China. This system is also able to distinguish the importance of forest carbon sinks from other outputs. For the efficiency evaluation of multi-level output systems, this paper constructs a cross-evaluation model based on evidential reasoning method, the original efficiency information by conducting efficiency evaluation before information fusion. Further, the spillover effects and influencing factors of forest carbon sink efficiency are analyzed through a spatial regression model to explore the spatial characteristics of forest carbon sink efficiency in China. The results show that: (1) there is a large gap between the cross-efficiency levels of forest carbon sinks in various regions of China, with significant spatial correlation. For the perspective of direct output benefits, the cross-efficiency of the eastern region is higher, while the cross-efficiency of the northwestern region is lower; for the perspective of indirect output benefits, the cross-efficiency of the southeastern region is higher. (2) China's forest carbon sink has a significant positive spillover effect, and the indirect output cross-efficiency has a significant negative impact on the forest carbon sink in its own region. Further analyzing the impact of indirect output cross-efficiency, it is found that the cross-efficiency of the ecological dimension and the cross-efficiency of the social dimension have a significant negative impact on the forest carbon sink in its own region, and the economic dimension has a significant positive impact on the forest carbon sink in its own region. In conclusion, corresponding policy recommendations are proposed for the development of forest carbon sinks to promote the realization of the dual-carbon goal.

In winter sports, the equipment often comes into contact with snow or ice, and this contact generates a force that resists motion. In some sports, such as cross-country skiing, this resistive force can significantly affect the outcome of a race, as a small reduction in this force can give an athlete an advantage. Researchers have examined the contact between skis and snow in detail, and to fully understand this friction, the entire ski must be studied at various scales. At the macro scale, the entire geometry of the ski is considered and the apparent contact between the ski and the snow is considered and at the micro scale the contact between the snow and the ski base ski-base textures. In the present work, a method for characterising contact between the ski-base texture and virtual snow will be presented. Six different ski-base textures will be considered. Five of them are stone-ground ski bases, and three of them have linear longitudinal textures with a varying number of lines and peak-to-valley height, and the other two are factory-ground “universal” ski bases. The sixth ski base has been fabricated by a steel-scraping procedure. In general, the results show that a ski base texture with a higher Spk-value has less real contact area, and that the mutual differences can be large for surfaces with similar Sa-values. The average interfacial separation is, in general, correlated with the Sa-value, where a “rougher” surface exhibits a larger average interfacial separation. The results for the reciprocal average interfacial separation, which is related to the Couette type of viscous friction, were in line with the general consensus that a “rougher” texture performs better at high speed than a “smoother” one, and it was found that a texture with high Sa and Spk values resulted in a low reciprocal average interfacial separation and consequently low viscous friction. The reciprocal average interfacial separation was found to increase with increasing real contact area, indicating a correlation between the real area of contact and the Couette part of viscous friction.

Efficient thermal management of modern electronics requires the use of thin films with highly anisotropic thermal conductivity. Such films enable the effective dissipation of excess heat along one direction while simultaneously providing thermal insulation along the perpendicular direction. In this study, we investigate the thermal conductivity of bilayer graphene (BLG) sheets using non-equilibrium molecular dynamics, examining both in-plane and cross-plane thermal conductivities. The in-plane thermal conductivity of 10 nm × 10 nm BLG with zigzag and armchair edges at room temperature is found to be around 204 W/m.K and 124 W/m.K, respectively. The in-plane thermal conductivity of BLG increases with sheet length. For all sizes, BLG with a zigzag edge exhibits higher thermal conductivity than that of the armchair edge, with this difference becoming more pronounced as the lengths of the sheets increase. In addition, increasing temperature from 300 K to 600 K decreases the in-plane thermal conductivity of a 10 nm× 10 nm zigzag BLG by about 34%. Similarly, the application of a 12.5% tensile strain induces a 51% reduction in its thermal conductivity compared to the strain-free values. Armchair configurations exhibit similar responses to variations in temperature and strain, but with less sensitivity. Furthermore, the cross-plane thermal conductivity of BLG at 300 K is estimated to be 0.05 W/m·K, significantly lower than the in-plane results by approximately four orders of magnitude. The cross-plane thermal conductance of BLG decreases with increasing temperatures, specifically, at 600 K, its value is almost 16% of that observed at 300 K.

The South Asian economy is on the rise but struggling with power shortages and heavy dependence on fossil fuels. For sustained growth, there is a need for access to readily available energy sources, such as electricity. Trading clean electrical energy among neighbouring countries can ensure access to readily available points. South Asia has a diverse range of energy sources, including hydropower, that are available in the region. However, sectorial barriers can impede energy trading. This study has attempted to assess the readiness and barriers to Nepal’s cross-border energy trade with India and Bangladesh using the Analytic Hierarchy Process (AHP). This study also recommends possible measures to strengthen preparedness and address the challenges in energy trade that can be tailored and applied to other cross-country situations.

In this work, two plasmonic structures with two different periodic nanostructures (nanodisk and nanostrip arrays) separated from the gold layer by an ultrathin dielectric Al2O3 layer are proposed, and their optical properties are simulated as 3-dimensional models using COMSOL Multiphysics software tool. The optical responses, such as the amplification of the electric field and the scattering, absorption and extinction cross sections of the two structures, are investigated and compared. The results show that both structures show strong field enhancement in their gap layer, and the structure with the periodic array of metal nanodisks shows stronger field enhancement and larger absorption, extinction, and scattering cross sections in its dipole resonance wavelength, which is defined as a bright plasmonic mode. In addition, some weaker resonant modes are observed for both structures and the reason for their generation is dis-cussed. The analysis of different possible modes in such structures is crucial for their application in various fields.

Urethral pain syndrome (UPS) is still a pathology in which the diagnosis is formulated as a "diagnosis of exclusion". The exact pathogenetic mechanisms are not yet fully understood and clear recommendations for the prevention and treatment of UPS are absent. The goal of the study was to assess the condition of the tissues in the female urethra in UPS, by using transvaginal ultrasound (TVUS) and cross-polarization optical tomography (CP OCT). TVUS showed an expansion in the diameter of the internal lumen of the urethra, especially in the proximal region compared with the norm. Compression elastography revealed areas with increased stiffness (presence of fibrosis) in urethral and surrounding tissues. When studied with CP OCT it was shown that with UPS, the structure of the tissues in most cases was changed: trophic alterations in the epithelium (hypertrophy or atrophy) and fibrosis of underlying connective tissue were observed. The proximal fragment of the urethra with UPS underwent changes identical to those of the bladder neck. This paper showed that the introduction of new technology — CP OCT — in conjunction with TVUS will allow verification of structural changes in tissues of the lower urinary tract at the level of their architectonics and will help doctors understand better the basics of the UPS pathogenesis.

This cross-country four-year longitudinal study investigated the development of processing speed throughout primary school education. The analyses were conducted on data collected from 441 schoolchildren in Grades 1, 2, 3 and 4 (aged 6.42 to 11.85 years) in the Kyrgyzstan and Russia. Mixed effects growth modeling was applied to estimate average and individual growth trajectories for processing speed at two cross-country samples. Latent class growth modeling was conducted to identify different types of growth trajectories for processing speed and to compare the distribution of the types within the analyzed samples. According to the results, processing speed significantly increases across primary school years. The trajectory is characterized by nonlinear changes with more intensive growth between Grades 1 and 2, which later slows down until Grade 4. There were no significant cross-country differences in the initial score of processing speed or developmental changes in processing speed across primary school years. The development of processing speed is described by a model with three quadratic growth types but minimally differs. It is concluded that in both samples, the development of processing speed may be characterized by homogeneity, with the most intensive growth from Grade 1 to Grade 2 and subsequent linear improvement until Grade 4.

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

Texture has long been considered an important attribute for food acceptance. However, which specific textural characteristics contribute to overall acceptance of a food is not well understood. It has been suggested that texture contrasts and combinations are a universal feature in giving foods a desirable texture, yet this notion is largely based upon anecdotal data. This study uses multiple survey research methods to assess the importance of texture contrast and combinations across cultures (Poland, U.S.A., and Singapore). Participants (n = 288) completed a survey that included overt measures of food texture contrast importance as well as free response questions regarding texture. The overall importance of texture for food liking was not different across the populations. However, the participants from Singapore and Poland gave more importance to a desirable food having multiple textures than the U.S.A. cohort. When looking at free responses, participants were twice as likely to mention combinations (multiple textures) with a texture contrast when describing foods they liked, in comparison to foods they disliked. This was observed across all 3 cultures. However, the type and quantity of texture terms used within combinations were different among cultures. For instance, Asians enjoyed more texturally diverse food combinations than the other two cultures. These findings highlight the importance of texture contrasts and combinations in three distinct cultures.

This paper presents a novel CNN-based architecture, referred to as Q-Net, to learn local feature descriptors that are useful for matching image patches from two different spectral bands. Given correctly matched and non-matching cross-spectral image pairs, a quadruplet network is trained to map input image patches to a common Euclidean space, regardless of the input spectral band. Our approach is inspired by the recent success of triplet networks in the visible spectrum, but adapted for cross-spectral scenarios, where for each matching pair there are always two possible non-matching patches; one for each spectrum. Experimental evaluations on a public cross-spectral VIS-NIR dataset shows that the proposed approach improves the state-of-the-art. Moreover, the proposed technique can also be used in mono-spectral settings, obtaining a similar performance to triplet network descriptors, but requiring less training data.

Chaotic theory is commonly being researched for application in image encryption scheme (IES). In this paper, a novel two-dimensional cross hyperchaotic Sine-modulation-Logistic map (2D-CHSLM) based on the famous Sine and Logistic maps. The hyperchaotic behaviors of 2D-CHSLM is testified with the help of their bifurcation diagrams, trajectory plots, Lyapunov exponents, sample entropy, C0 complexity, permutation entropy and 0-1 test. A new bit-level IES with traditional encryption structure is proposed utilizing 2D-CHSLM. The 2D-CHSLM-IES performs a 2D-CHSLM-based bit-level confusion using zig-zag transform and a 2D-CHSLM-based cross coupled diffusion operations for generating a highly secure cipher-image. Then the simulations and security analyses are further carried out with the help of key space, key sensitivity, histogram, correlation, information entropy, differential attack, noise and data loss attacks, prove that the security of the proposed 2D-CHSLM-IES

We have studied Juniperus oxycedrus subsp. badia in the central and southern Iberian Peninsula. Here, the macrobioclimate ranges from Mediterranean-pluviseasonal-oceanic and Mediterranean-pluviseasonal-continental, thermotype from thermomediterranean and supramediterranean. The relevés were taken following the Braun-Blanquet phytosociological methodology. A statistical treatment was applied to establish a separation among Juniperus communities. To understand the presence of Juniperus communities in territories dominated by species of the genus Quercus, we applied the formula of Thornthwaite to calculate potential evapotranspiration. The general cluster analysis clearly separates two groups of plant communities and separates the different associations in each group. All plant communities growing on rocky crests and in steeply extreme sloping areas are significantly influenced by the soil. The Ombroclimatic Index does not explain the presence of plant communities influenced by substrate: so, we propose a new Ombroedaphoxeric Index which explains the presence of the Juniperus communities in territories with a thermotype ranging from the thermo to the supramediterranean belt. The areas of distribution of Juniperus species are expanding due to the spread of rocky areas: this phenomenon causes a rise in edaphoxerophilous areas and a decrease in climatophilous one. We propose four new plant associations and with this update on their structures and floristic compositions, it is possible to make an efficient form of conservation in both territories studied (Spain and Portugal) with specific cross-border-cooperation projects.

In this research, univariate and bivariate statistical methods were applied to rainfall, river and piezometric level datasets belonging to 24 years long time series (1986-2009). These methods, that often are used to understand the effects of precipitation on rivers and karstic springs discharge, have been used to assess, piezometric level response to rainfall and river level fluctuations in a porous aquifer. A rain gauge, a river level gauge and three wells, located in Central Italy along the lower Pescara river valley in correspondence of its important alluvial aquifer, provided the data. The statistical analysis has been used within a known hydrogeological framework, which has been refined by mean of a photo-interpretation and a GPS survey. Water-groundwater relationships were identified following the autocorrelation and cross-correlation analyses; the spectral analysis and mono-fractal features of time series were assessed, in order to provide information on multy-year variability, data distributions, their fractal dimension and the distribution return time within the historical time series. The statistical-mathematical results were interpreted through field work that identified distinct groundwater flowpaths within the aquifer and enabled the implementation of a conceptual model, improving the knowledge on water resources management tools.

Since the introduction of Cross-laminated Timber (CLT) in Austria in the early 1990s, the adoption of this 90°-crosswise-laminated product has seen exponential growth worldwide. Compared to traditional laminated timber products (e.g. glulam), CLT provides improved dimensional stability, but with reduced out-of-plane bending stiffness. To improve the bending stiffness, while maintaining relative dimensional stability, a modified orientation of the inner layers in a diagonal direction can be used. This novel product is Diagonal-Cross-laminated Timber (DCLT), a composite timber product, consisting of inner layers which are rotated at different angle-ply orientations between 0 and 90 degrees to the outer layers. To properly model the out-of-plane bending behavior of the DCLT, analytical models and Finite Element Analysis (FEA) were used and the results were validated by third-point bending tests performed on DCLT panels with angle-ply orientations of 10°, 20°, 40°, 70°, and a conventional CLT 90° panel. The results indicate that DCLT panels with angle-ply cross-layers have a structural advantage in out-of-plane bending over traditional CLT (90°) panels. The development of DCLT and its introduction to the industry could enable the use of lower-quality timber that would not otherwise satisfy structural requirements for CLT.

This study investigated defect formation and strain distribution in high Mg content Al-Mg alloys during normal rolling and cross-rolling processes. The finite element analysis (FEA) revealed the presence of wave defects and strain localization-induced zipper cracks in normal cold rolling, which were confirmed by experimental results. The concentration of shear strain played a significant role in crack formation and propagation. However, the influence of wave defects was minimal in the cross-rolling process, which exhibited a relatively uniform strain distribution. Nonetheless, strain concentration at the edge and center regions led to the formation of zipper cracks and edge cracks, with more pronounced propagation observed in the experiments compared to FEA predictions. Furthermore, texture evolution was found to be a crucial factor affecting crack propagation, particularly with the development of the Goss texture component which is observed by electron backscattered diffraction analysis at bending points. The Goss texture hindered crack propagation, while the Brass texture allowed cracks to pass through. This phenomenon was consistent with both FEA and experimental observations. To mitigate edge crack formation and propagation, potential strategies involve promoting the formation of the Goss texture at the edge through alloy and process conditions, as well as implementing intermediate annealing to alleviate stress accumulation. These measures can enhance the overall quality and reliability of Al-Mg alloys during cross-rolling processes. In summary, understanding the mechanisms of defect formation and strain distribution in Al-Mg alloys during rolling processes is crucial for optimizing their mechanical properties. The findings of this study provide insights into the challenges associated with wave defects, strain localization, and crack propagation. Future research and optimization efforts should focus on implementing strategies to minimize defects and improve the overall quality of Al-Mg alloys in industrial applications.

The purpose of this study was to analyze the cross-linguistic influence of previously learned languages and working memory capacities on the vocabulary performance of two different typological languages. The objectives of this study were (1) to compare the working memory capacities of bilingual adults in relation to the vocabulary performance of two different languages never learned by the participants, and (2) to analyze to what extent the typology of previously learned languages influences working memory capaci-ties in relation to the vocabulary performance of French and Nahuatl. A group of 43 Mexican-Spanish college students participated in this experimental study. The participants completed a series of working memory tasks in Nahuatl and French. The results showed that working memory capacities were lower in Nahuatl than in French. Thus, a correlation was found between their first and second language and vo-cabulary performance in French. We can consider the influence of previously learned languages as a significant factor in vocabulary acquisition in accordance with the participants' working memory capacities.

We formulate a more straightforward, symmetry-based techniques in manually computing the determinant of any n×n matrix by revisiting Dodgson’s condensation method and strategically applying elementary row operations and the definition and properties of determinants. The result yields a more simplified mnemonical algorithm than the usual reduction by elementary row operations and co-factor expansion and with minimal terminal divisions performed compared to Dodgson’s internal divisions.

This article presents the results of a cross-disciplinary applied study exploring investors’ protections in the context of distributed ledger technology (DLT) smart contracts. Fusing legal, business, and technical perspectives, we developed a framework for protection from non-commercial risks for stablecoins, taking advantage of DLT and AI. A key concept we propose is the monitoring of disinformation and fake news to prevent malicious parties from abusing our solution. Based on the similarities between central bank digital currencies (CBDCs) and stablecoins, we propose scaling up our results to all future internet investments performed without face-to-face contact between the investor and the company.

The danger is still very large from cross site scripting attacks. When designing web applications We must follow as much as we can prevention rules and don’t leave any loophole to our programs. Experience is a great factor for programmers to know these attacks and for a trainee programmer is a difficult task to spot all the weak points. In this article we present a tutorial on launching an XSS attack and also we propose simple solutions.

Sentinel-1 (S1) extra-wide (EW) swath data in cross-polarization (horizontal-vertical, HV or vertical-horizontal, VH) are strongly affected by the scalloping effect and thermal noise, particularly over areas with weak backscattered signals, such as sea surfaces. Although noise vectors in both the azimuth and range directions are provided in the standard S1 EW data for subtraction, the residual thermal noise still significantly affects sea ice detection by the EW data. In this paper, we improve the denoising method developed in previous studies to remove the additive noise for the S1 EW data in cross-polarization. Furthermore, we propose a new method for eliminating the residual noise (i.e. multiplicative noise) at the sub-swath boundaries of the EW data, which cannot be well processed by simply subtracting the reconstructed 2-D noise field. The proposed method of removing both the additive and multiplicative noise was applied to EW HV-polarized images processed using different Instrument Processing Facility (IPF) versions. The results suggest that the proposed algorithm significantly improves the quality of EW HV-polarized images under various sea ice conditions and sea states in marginal ice zone (MIZ) of the Arctic. This is of great support for the utilization of cross-polarization SAR images in wide swaths for intensive sea ice monitoring in polar regions.

Chikungunya virus (CHIKV) is an alphavirus that causes febrile illness punctuated by severe polyarthralgia. After the emergence of CHIKV in the Western Hemisphere, multiple reports of congenital infections were published that documented neurological complications, cardiac defects, respiratory distress, and miscarriage. The Western Hemisphere is endemic to several alphaviruses and whether antigenic cross-reactivity can impact the course of infection has not been explored. Recent advances in biomedical engineering have produced cell co-culture models that replicate the cellular interface at the maternal fetal axis. We employed a trans-well assay to determine if cross-reactive antibodies affected the movement and replication of CHIKV across placental cells and into an embryoid body. The data show that antibodies to Venezuelan equine encephalitis virus (VEEV) significantly reduced CHIKV viral load in embryoid bodies. The data highlight that viral pathogenesis can be cell-specific and that exploiting antigenic cross-reactivity could be an avenue for reducing the impact of congenital CHIKV infections.

This work explores the use of Kuhn verdazyl radicals as building blocks in multifunctional molecular materials in an exemplary study, focusing on the magnetic and the electron transfer (ET) characteristics, but also addressing the question whether chemical modification by cross-coupling is possible. The ET in solution is studied spectroscopically whereas solid state measurements afford information about the magnetic susceptibility or the conductivity of the given samples. The observed results are rationalized based on the chemical structures of the molecules, which have been obtained by X-ray crystallography. The crystallographically observed molecular structures as well as the interpretation based on the spectroscopic and physical measurements are backed up by DFT calculations. The measurements indicate that only weak, antiferromagnetic coupling is observed in Kuhn verdazyls owed to the low tendency to form face-to-face stacks, but also that steric reasons alone are not sufficient to explain this behavior. Furthermore, it is also demonstrated that ET reactions proceed rapidly in verdazyls/verdazylium redox couples and that Kuhn verdazyls are suited as donor molecules in ET reactions.

This proposal was prepared in the very first weeks of 2020 because of the outbreak of COVID-19. There are good reasons to suppose that rotavirus vaccine can be used as protection tool to effectively and safely fight and mitigate SARS-CoV-2 infection and the impact caused by COVID- 19 in adult humans, due to the development of cross and trained immunity following rotavirus vaccination. Up-to-date, some rotavirus vaccines are available and approved, two of them have a large experience in results and safety. Little experience has been achieved in the use of rotavirus vaccine in adults. However, it can be expected that it would be safe and effective in adults and in the elderly as well. This proposal explains the background of this hypothesis based on lungs and intestine relationships.

As an important element of methane prevention in mining facilities, measurements of concentration serve to obtain information about methane hazards. Information about methane concentration must be linked to the place and time of its occurrence to create valuable data for ongoing hazard analysis. The article presents the results of a methane hazard analysis based on an airflow and methane concentration model, validated using measurement data. Subsequently, simulations of crew movement and the operation of individual methane detectors working according to the algorithms of the Methane Hazard Detection System were conducted based on this model.

KeraVio is a new portable corneal cross-linking (CXL) treatment modality in which violet light (VL)-emitting spectacles are used along with topical transepithelial riboflavin. We preliminarily identified endogenous riboflavin in the human cornea without the administration of riboflavin drops, and the relatively low intensity of VL irradiation increased corneal stiffness in porcine corneas (TVST 2021). This study was conducted to evaluate the clinical results of KeraVio without riboflavin drops. Patients with progressive keratoconus were enrolled and randomly divided into the VL irradiation alone group (Group 1) and the no irradiation group (Group 2; control group) (jRCTs032190267). The eyes were exposed to VL (375 nm, irradiance 310 μW/cm2)-emitting glasses for 4.5 hours daily for 6 months. The mean changes in the maximum keratometry value (Kmax) from baseline to 6 months were 0.94 ± 2.65 diopters (D) and 1.76 ± 2.75 D in Group 1 and Group 2, respectively (p=0.705). No differences were found between patients who did and did not receive VL irradiation in terms of the clinical outcomes of keratoconus. VL irradiation alone likely does not halt keratoconic progression, and the administration of riboflavin is necessary.

Apart from headwind changes, crosswind changes may be hazardous to the aircraft operation. This paper presents two cases of recently observed crosswind changes from the range height indicator scans of ground-based remote-sensing meteorological equipment, namely, an X-band microwave radar and a short-range LIDAR. Rapidly evolving winds have been observed by the equipment in tropical cyclone situations, and they are found to have high level of turbulence and possibly to be associated with vertically propagating waves. In order to study the feasibility of predicting such disturbed airflow, mesoscale meteorological model and computational fluid dynamics model with high spatial resolution are used in this paper. It is found that the models could capture the rapidly evolving airflow features rather well, including the turbulence level, the waves, the rapidly changing wind speeds and the presence of reverse flow. This paper aims at providing a reference to the airports to consider the feasibility of performing high resolution numerical simulation of rapidly evolving airflow to alert the pilots in advance for airports in complex terrain and setup of buildings.

Multimodal sentiment analysis is rapidly gaining traction due to its ability to comprehensively interpret opinions expressed in video content, which is ubiquitous across various digital platforms. Despite its promising potential, the field is hindered by the limited availability of high-quality, annotated datasets, which poses substantial challenges to the generalizability of predictive models. Models trained on such scarce data often inadvertently assign excessive importance to irrelevant features, such as personal attributes (e.g., eyewear), thereby diminishing their accuracy and robustness. To address this issue, we propose an Enhanced Modal Fusion Learning (EMFL) methodology aimed at significantly improving the generalization capabilities of neural networks. EMFL achieves this by optimizing the integration and interpretation processes of multimodal data, ensuring that sentiment-relevant features are prioritized over confounding attributes. Through extensive experiments conducted on multiple benchmark datasets, we demonstrate that EMFL consistently elevates the accuracy of sentiment predictions across verbal, acoustic, and visual modalities. These findings underscore EMFL's efficacy in mitigating the impact of non-relevant features and enhancing the overall performance of multimodal sentiment analysis models.

Recent advancements in machine learning have ushered in innovative techniques for augmenting datasets, particularly through contrastive learning in the computer vision domain. This study pioneers the application of contrastive learning for sentiment analysis, introducing a novel approach termed EmoConLearn. By fine-tuning contrastive learning embeddings, EmoConLearn significantly surpasses BERT-based embeddings in sentiment analysis accuracy, as evidenced by our evaluations on the DynaSent dataset. This research further delves into the efficacy of EmoConLearn across various domain-specific datasets, highlighting its versatility. Additionally, we investigate upsampling strategies to mitigate class imbalance, further enhancing EmoConLearn's performance in sentiment analysis benchmarks.

In the recent decades, per- and polyfluoroalkyl substances (PFAS) have garnered widespread public attention due to their persistence in the environment and detrimental effects on the health of living organisms, spurring the generation of several transcriptome-centered investigations to understand the biological basis of their mechanism. In this study, we collected 2144 publicly available samples from 7 distinct animal species to examine the molecular responses to PFAS exposure and to determine if there are conserved responses. Our comparative transcriptional analysis revealed that exposure to PFAS is conserved across different tissues, molecules and species. We identified and reported several genes exhibiting consistent and evolutionarily conserved transcriptional response to PFAS, such as ESR1, HADHA and ID1, as well as several pathways including lipid metabolism, immune response and hormone pathways. This study provides the first evidence that distinct PFAS molecules induce comparable transcriptional changes and affect the same metabolic processes across inter-species borders. Our findings have significant implications for understanding the impact of PFAS exposure on living organisms and the environment. We believe that this study offers a novel perspective on the molecular responses to PFAS exposure and provides a foundation for future research into developing strategies for mitigating the detrimental effects of these substances in the ecosystem.

This research has critically argued that a vigilant combination of flexibility and certainty in spatial planning can bring about the most optimum planning outcomes. Therefore, to reproachfully evaluate the core argument, this research has tried to empirically respond to the research question of which balance of government intervention and market freedom produces the optimal economic, social and spatial outcomes. This research question has been further translated into an associated central hypothesis i.e., a hybrid planning system with an optimal balance between discretionary and regulatory planning approach can bring about the desired economic, social, and spatial outcomes.

Registry and survey data gave an opportunity to compare possible roles of social attitudes and social values in control and limit the COVID-19 pandemic. We analysed social values and time series of daily R0 (reproduction rate) estimates for 27 European countries. Embedded and affective autonomy are significantly negatively associated (p-Value<0.05) with controlled R0. It could mean that well interconnected societies with high attention to maximize utilities are more likely to couple with COVID-19. Hierarchy is significantly positively associated (p-Value<0.05) with controlled R0. Thus, hierarchical structures could inhibits control of COVID-19. The results emphasize the need to pay more attention to social values context in evaluating the effectiveness of mitigation strategies internationally.

There is tremendous interest, in the economic literature, for the determinants of firms’ capital structure decisions. A rich body of empirical works now exists that purports to identify firm- and country-level factors affecting firms’ financing patterns. In addition, more recently, a new stream of studies has emerged that investigates cross-regional variation in small firms’ capital structure. While small firms’ leverage does seem to vary across regions, at least in countries where significant regional differences in economic and financial development and in the quality of institutions exist, not much yet is known about variation in debt maturity, in debt in relation to equity, and between different types of small firms. The present paper aims to fill this gap through an empirical analysis of cross-regional variation in the capital structure of a sample of about 30,000 Italian small firms over a 13-year period, including the aftermath of the credit crunch that followed the 2007-8 global financial crisis. The findings confirm the view that small firms in underdeveloped regions are more financially constrained, but also amend some of the results shown in the literature, in particular by showing how small firms in Italy’s Southern regions have higher levels of equity and fixed assets than small firms in other regions.

As digitalization expands across all sectors, the economic toll of software defects on the U.S. economy reaches up to $2.41 trillion annually. High-profile incidents like the Boeing 787-Max 8 crash have shown the devastating potential of these defects, highlighting the critical importance of software testing within quality assurance frameworks. However, due to its complexity and resource intensity, the exhaustive nature of comprehensive testing often surpasses budget constraints. This research utilizes a machine learning (ML) model to enhance software testing decisions by pinpointing areas most susceptible to defects and optimizing scarce resource allocation. Previous studies have shown promising results using cost-sensitive training to refine ML models, improving predictive accuracy by reducing false negatives through addressing class imbalances in defect prediction datasets. This approach facilitates more targeted and effective testing efforts. Nevertheless, the generalizability of these models across different projects (cross-project) and programming languages (cross-language) remained untested. This study validates the model's applicability across diverse development environments by integrating various datasets from distinct projects into a unified, using a more interpretable ML approach. The results demonstrate that ML can support software testing decisions, enabling teams to identify up to seven times more defective modules with the same testing effort as a benchmark.