Background and objective: Addressing the global morbidity associated with pulmonary disease is an important need for the respiratory community. However, there is also a growing momentum to show the efficacy of new tools of diagnosis. Despite this, there are few physiotherapeutic tools that help identify and categorize these conditions. The aim was to analyze the variables of physiotherapy index of the ventilatory workload (PIVW) in people with chronic obstructive pulmonary disease (COPD) during stability and exacerbation in an outpatient setting. Material and Methods: Analyzed retrospectively of 198 clinical records were reviewed. The PIVW was extracted in stability and exacerbation of these patients with COPD. After applying the exclusion and inclusion criteria; 54 patients were classified. Through the statistical analysis of chi-square, a significant association was reported for each of the variables and the total PIVW score. Results: when analyzing the baseline with the peak of PIVW, there was a significant increase in patients COPD exacerbation. Similarly, the variables that constitute the loads, translations and supports underwent a significant increase from baseline to exacerbation (p<0.0001), except for the additional oxygen contribution, where the frequency of patients was the same in basal and exacerbation as well. Conclusions: the PIVW, serves to determine ventilatory problemas in outpatients, characterizing the specific changes of loads, translators or assistance.

The objective was to assess the instrumental validity and the test-retest reliability of a low-cost hand-held push dynamometer adapted from a load-cell based hanging scale (tHHD) to collect compressive forces in different ranges of compressive forces. Three independent raters applied 50 pre-established compressions each on the tHHD centered on a force platform in 3 distinct ranges: ~70 N, ~160 N, ~250 N. Knee isometric strength was also assessed on 19 subjects in two sessions (48h apart) using the tHHD anchored by an inelastic adjustable strap. Knee extension and flexion were assessed with the participant seated on a chair with the feet resting on the floor, knees, and hips flexed at 90°. The isometric force peaks were recorded and compared. The ICC and the Cronbach’s α showed excellent consistency and agreement for both instrumental validity and test-retest reliability, as the correlation and determination coefficients. The SEM and the MDC analysis returned adequate low values with a coefficient of variation less than 5%. The Bland-Altman results showed consistency and high levels of agreement. The tHHD is a valid method to assess the knee isometric strength, showing portability, cost-effectiveness, and user-friendly interface to provide an effective form to assess the knee isometric strength.

Mycotoxins are fungal secondary metabolites, which can cause acute and chronic toxic effects in animals and humans. The present study aimed to determine multi-mycotoxin levels in Algerian workers using urine as target. A method based on a QuEChERS (quick, easy, cheap, effective, rugged, and safe) extraction procedure followed by LC-MS/MS (liquid-chromatography tandem mass spectrometry) was optimized and validated for determination of 11 mycotoxins in 96 urine samples. Different sorbents were tested to be used in the dispersive solid-phase extraction (d-SPE) cleanup step of QuEChERS. The final method was fit-for-purpose and showed good analytical performance in terms of specificity, linearity and precision. All samples contained at least 2 mycotoxins, being toxin-2 (T-2) the most common, which was found in 92.7% of the samples, followed by zearalenone (ZEN) with 90.6% of positive samples, and ochratoxin A (OTA) with 86.4%. T-2 levels ranged from 0.3 μg/L to 36.3 μg/L, while OTA ranged from 0.3 μg/L to 3.5 μg/L and ZEN ranged from 7.6 μg/L to 126.8 μg/L. This was the first mycotoxin biomonitoring study carried out in the Algerian population. The findings highlight the need of accurate data for better risk assessment and the development of better regulation to manage mycotoxin contamination in this country.

In August 4 2011, United Nations Environmental Program (UNEP) submitted an unprecedented, scientific, groundbreaking Environmental Assessment Report (EAR) of Ogoniland, to the Nigerian government. This was the outcome of a 14–month intensive evaluation of the extent of pollution. It was intended that UNEP’s recommendations would be implemented to restore the devastated environment, on the one hand, and on the other, counteract the numerous environmental health issues that have for decades, plagued Ogoniland. However, five years post EAR, and, despite the seriousness of the situation, no significant resolution has occurred, both on the part of the government, and on the part of Shell Petroleum Development Company (SPDC) or Shell. To date, millions of Niger Delta residents, particularly those living in the oil-bearing communities, continue to suffer severe consequences. Although, the assessment was conducted in Ogoniland, other communities in the Niger Delta are also affected. This article explores prevailing issues, using Ogoniland (a microcosm of the Niger Delta) as an example. A multidisciplinary approach for sustainable mitigation of environmental health risks in the Niger Delta is paramount, and Environmental Management tools offer valuable strategies. Adopting UNEP’s recommendations for addressing environmental health problems requires implementing the Environmental Management/Environmental Management System (EM/EMS) model.

The lack of application of management models that allow strategies to be converted into action and then measure their results in order to apply improvement actions to meet the objectives in small and medium-sized companies (SMEs); they generate problems in their management causing the closure of their operations unexpectedly; To mitigate the risks of closure and bankruptcy with the support of ICT, an alternative was presented considering that risk management is important in decision making at a strategic, tactical and operational level. The objective is to design a prototype to mitigate risks and prevent threats to avoid the closure of this type of company. Through the analysis of related articles, applying sequences of methodological steps; It was determined that the proposed results are aimed at how to identify and mitigate the risks and threats that cause their bankruptcy and closure. Prototypes resulted that allow mitigating risks, preventing threats and minimizing vulnerabilities in the management of SMEs. It was concluded that the proposed prototype to detect threats and vulnerabilities provides an optimal security model for small and medium-sized companies; As a result of the simulations, a security percentage of 77.92% was established, which means that the greater the number of risks and threats, the greater the probability that a small and medium-sized company will close.

SStatistical characteristics of the wind speed in Samaria region of Israel have been analyzed by processing 11 years of wind data provided by the Israeli Meteorological Service, recorded at 10 m height above the ground. The cumulative mean wind speed at measurement height was shown to be 4.53 m/s with standard deviation of 2.32 m/s. Prevailing wind direction is shown to be char-acterized by cumulative mean azimuth of 226° with standard deviation of 79.76°. The results were extrapolated to 70-meter height in order to estimate wind characteristics at hub height of a me-dium-scale wind turbine. Moreover, Weibull distribution parameters were calculated annually, monthly and seasonally, demonstrating a good match with histogram-based statistical repre-sentations. Shape parameter of the Weibull distribution was shown to reside within a narrow range of 1.93 to 2.15, allowing us to assume a Rayleigh distribution, thus simplifying wind tur-bines energy yield calculations. The novelty of the current paper is related to gathering wind statistics for a certain area (Samaria) we are not aware of any published statistics regarding wind velocity and direction in this area. The data may be interesting for potential regional wind energy development in which the obtained Weibull distribution can be used in calculations of expected power generation of particular turbines with known power dependence on velocity. We also point out that the fact that realistic wind velocity statistics is well described by an analytic formula (Weibull distribution) is not trivial, and in fact the fit may have been poor.

Housing is always crucial for the sustainable development of communities, specifically in urban areas, due to the population density of cities. The present study constructs its own structure on the basis of the recent papers investigating various sustainability factors for the urban housing sector. By doing a comprehensive systematic literature review, one of the most extensive lists of urban housing sustainability factors is gathered from 118 recent related papers. The factors are prioritized by their frequency of investigation and categorized by their scale(s) and sector(s) of influence. According to the results, the top three significant factors affecting urban housing sustainability are “natural resource or energy consumption/efficiency of the building/equipment (during the construction, operation, etc.)”, “materials performance (durability, cost, thermal capacity, permeability, ability to re-use, recycled, eco-friendly materials)”, and “access to public services/infrastructure: availability/quality of services and/or distance/time of travel time to the services (public transport, education/health/shopping/leisure facilities, parks, etc.)”. By analyzing the results with an integrative approach, it is understood that environmental factors are the most considered ones (more considered than the factors with influence on all sustainability sectors) where institutional factors received the least attention. Also, the most significant measures are the ones that have impacts on both ‘building’ and ‘neighborhood/community’ scales. It should be noticed that the neighborhood/community scale indicators are seen, almost, as important as the measures that affect the building itself. The results of this study can be helpful in establishing future housing-related policies, and also in having more efficient housing sustainability assessment tools.

Background: Myocarditis is commonly diagnosed in the intensive care cardiology unit (ICCU). No current recommendation nor guideline aids aetiological assessment. Methods: From September 2021 to October 2023, 84 patients with acute myocarditis underwent thorough and systematic serum and blood cell panel evaluations to determine the most common causes of the myocarditis. Results: Of the 84 patients (median age 34 years, range 22–41 years, 79% male), 16 presented with complicated myocarditis. The systematic aetiological assessment revealed that 36% of patients were positive for lupus anticoagulant, 12% for antinuclear antibodies, 8% for anti-heart antibodies, and 12% for anti-striated muscle antibodies. Viral serology did not yield any significant results. After the aetiological assessment, one patient was diagnosed with an autoimmune inflammatory disorder (Still’s disease). T-cell subset analyses indicated that myocarditis severity tended to increase with the T-cell lymphopenia status. Conclusions: A comprehensive, systematic aetiological assessment was of limited value in terms of predicting the clinical or therapeutic outcomes in myocarditis patients presenting to the ICCU.

BACKGROUND: Body mass index (BMI) is calculated by dividing a person's height in meters by their weight in kilograms and is always expressed in kg/m². BMI is a reliable risk indicator for various diseases that can develop due to a higher percentage of body fat. There is a possibility of developing certain medical conditions including heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems and some malignancies that increase with BMI. OBJECTIVE: This study seeks to identify the trends in the Body Mass Index (BMI) of women visiting Better Life Primary Health Care Centre in Ondo City, Ondo State, Nigeria for various healthcare services. METHODOLOGY: Seventy (70) women who participated in this study were randomly selected using systematic random sampling. Their necessary information was obtained using a prepared record sheet to collect their data. Results were analysed using SPSS version 21. RESULTS: The results show mean age of the respondents is 30.50 + 6.52921 21 (30%) were between 31 – 35 years, 21 (30%) were traders, 36 (51%) had tertiary education, 39 (55.7%) were between 151 – 160 cm in height. 32 (45.7%) were between 60 – 80 kg in weight and 30 (42.9%) had normal weight, respectively. CONCLUSION: Body Mass Index (BMI) calculation is an essential tool that can help in identifying one of the significant public health issues that leads to obesity; a predisposing factor to various medical conditions like hypertension, musculoskeletal issues, heart diseases, cancers, and lots more. It is therefore important to incorporate BMI calculation into routine checks to prevent or reduce health burdens that may arise from obesity.

Adapted and personalized motor activities prove to be effective for meeting the specific needs of children with SEN, tailoring to their unique limitations and abilities. Our focus was to craft and apply a structured program for psychomotor abilities development, targeting balance and motor-cognitive skills. The study aims to enhance the behavior and psychomotor manifestations of 28 students with SEN (aged 12-14) from two institutional centers in Romania. The "Sfântul Ștelian" Inclusive Education School Center of Costesti, Arges (CC-12 subjects), and the "Sfânta Filofteia" Inclusive Education School Center of Ștefănești (CS-16 subjects). Across a 36-week training regimen, participants engaged in sessions lasting 30 minutes, twice weekly. Evaluation of their psychomotor skills involved a battery of tests: assessing balance, both with eyes open and closed, brain processing speed, upper limb motor laterality. Initial and final data were gathered to assess their motor development and physical state. Instruments utilized included the Optojump Next optical system for movement analysis, Witty SEM intelligent semaphore, Sensamove balance miniboard. Statistical analysis compared the initial and final assessments using the Kolmogorov-Smirnov test and Wilcoxon Z test. Out of the total comparisons made between the initial and final assessments for the evaluation of the psychomotor component, statistically significant differences were found in only 37.5% of these comparisons.

The global construction sector contributes a significant share of total greenhouse gas (GHG) emissions. In Australia, infrastructure activity alone generates 18% of the GHG emissions budget. The use of low-embodied carbon building materials is crucial to achieving sustainability in the construction sector and to fulfill national and international climate goals. Industrial hemp (Cannabis sativa L.) is considered a promising feedstock for sustainable construction materials because of its biogenic carbon content, fast-growing cycles with low agricultural input requirements, and technical functionality which is comparable to traditional materials. This study has applied the life cycle assessment (LCA) guideline of ISO 14040:2006 to estimate the carbon footprint (CF) expressed in carbon dioxide equivalent (CO2eq) emissions of hemp-based building materials in Western Australia. The functional unit is 1 m2 of hemp-based board, and the system boundary includes cradle-to-gate stages, i.e., pre-farm, on-farm, and post-farm activities. The production of 1 m2 of hemp-based board is estimated to be - 2.302 kgCO2eq. Electricity from the public grid for lignin extraction during the post-farm stage is the main contributor to total CO2eq emissions (26%), followed by urea production (14%) during the pre-farm stage. Overall, the use of electricity from the SWIS during the post-farm stage accounts for 45% of total emissions. Sensitivity analysis shows that the CF of hemp-based boards is highly sensitive to the source of energy, i.e., total replacement of the SWIS by solar power decreases the CF from - 2.30 to -6.07 kgCO2eq (164%). The results suggest that hemp-based boards exhibit lower embodied GHG emissions compared to traditional materials, such as gypsum plasterboards.

The management of existing water distribution system (WDS) is challenged by ageing of infrastructure, population growth, increasing of urbanization, climate change impacts and environmental pollution. Therefore, there is a need for integrated solutions that support decision makers to plan today, while taking into account the effect of these factors in the mid and long term. The paper is part of a more comprehensive project, where advanced hydraulic analysis for WDS is coupled with a dynamic resources input-output analysis model. The proposed modeling solution can be used to optimize the performance of a water supply system while considering also the energy consumption and consequently the environmental impacts. Therefore, as a support tool in the management of a water supply system also in the intervention planning. Here a possible application is presented for rehabilitation/replacement planning while maximizing the network mechanical reliability and minimizing risk of unsupplied demand and pressure deficit, under given economic constraints.

The analysis of the morphological features can be framed in different temporal and spatial scales, depending on the specific objectives and methodologies of the various scientific fields that find in them a valuable source of information. The inventory and assessment of the geomorphological heritage may be based not exclusively in geophysical factors, but also in its contribution to the structuring of the biosphere, in its interrelation with other types of heritage or even in its potential for research or education purposes. In this article, we proceeded to the selection of a set of geomorphosites, at different scales, in Serra do Alvão (northern Portugal), seeking to demonstrate the importance of the broad lines of relief and intermediate and detailed landforms to the organization of the cultural landscape. Based on a questionnaire applied to a sample of 104 persons, it was intended to assess the value of the geomorphosites, concerning the scientific, preservation, use, cultural and educational dimensions.

Photoplethysmography (PPG) is widely utilized in wearable healthcare devices due to its convenient measurement capabilities. However, the unrestricted behavior of users often introduces artifacts into the PPG signal. As a result, signal processing and quality assessment play a crucial role in ensuring that the information contained in the signal can be effectively acquired and analyzed. Traditionally, researchers have discussed signal quality and processing algorithms separately, with individual algorithms developed to address specific artifacts. In this paper, we propose a quality-aware signal processing mechanism that evaluates incoming PPG signals using signal quality index (SQI) and selects the appropriate processing method based on the SQI. Unlike conventional processing approaches, our proposed mechanism recommends processing algorithms based on the quality of each signal, offering an alternative option for designing signal processing flows. Furthermore, our mechanism achieves a favorable trade-off between accuracy and energy consumption, which are the key considerations in long-term heart rate monitoring.

The industry is increasingly relying on fish for toxicity assessment. However, current guidelines for toxicity assessment focus on teratogenicity and mortality. From an ecotoxicological point of view, however, these endpoints may not reflect the “full picture” of possible deleterious effects that can nonetheless result in decreased fitness and/or inability to adapt to a changing environment, affecting whole populations. Therefore, assessing sublethal effects add relevant data covering different aspects of toxicity at different levels of analysis. Impacts of toxicants on neurobehavioral function have the potential to affect many different life-history traits, and are easier to assess in the laboratory than in the wild. We propose that carefully-controlled laboratory experiments on different behavioral domains – including anxiety, aggression, and exploration – can increase our understanding of the ecotoxicological impacts of contaminants, since these domains are related to traits such as defense, sociality, and reproduction, directly impacting life-history traits. The effects of selected contaminants on these tests are reviewed, focusing on larval and adult zebrafish, showing that these behavioral domains are highly sensitive to small concentrations of these substances. These strategies suggest a way forward on ecotoxicological research using fish.

This study assesses the impact and sustainability of community development initiatives in Awgbu, Anambra State, spanning from 2015 to 2023. Using qualitative research methods, including interviews with key informants from the Awgbu community and government personnel. The observatory method is also applied which helped the researcher to see activities executed in the community. The research investigates the specific contributions of the Awgbu community to the overall development of Anambra State, how the community has benefitted from state government initiatives, and the extent to which the community responds to government requests and initiatives. The study also explores challenges in the relationship between the state government and Awgbu in terms of community development initiatives and offers recommendations for enhancing this relationship. The findings reveal that the Awgbu community has made significant contributions to the development of Anambra State, particularly in areas such as security, education, and infrastructure. The community has actively responded to government calls, participating in initiatives like the Choose Your Project Initiative (CYPI) and vigilante groups, thus fostering a positive and mutually beneficial relationship with the state government. However, challenges such as leadership crises and communication gaps exist, hindering the community's progress. Recommendations include improving community leadership, enhancing communication, and promoting peace to ensure sustainable community development. This research contributes to a deeper understanding of the dynamics between communities and government in achieving sustainable development and highlights the importance of collaborative efforts for positive outcomes. The findings have managerial and policy implications for both local communities and governments seeking to enhance community development initiatives and foster mutually beneficial relationships.

Achieving water security and availability for all is among the principle agenda of the UN-Sustainable Development Goals. To achieve the goal of water security, particularly in rapidly expanding cities, identification of safe and sustainable water resources is an absolute necessity. The paper conducts an exploratory investigation in the hydro geochemical characteristics of groundwater and thereby, assess the suitability of groundwater as an alternative and reliable resource for public water supply in the Indian city of Surat. A total of 33-groundwater samples, selected on the basis of aquifer depth, land use signatures, were collected from open, bore, dug wells and hand pumps. After the hydrogeochemical analysis, the study evaluated the present state of the groundwater quality and determined the spatial distribution of groundwater quality parameters such as hardness, electrical conductivity, Cl −, pH, SO42-, and NO3 − concentrations. An interpolation technique, known as ordinary kriging, was used to acquire the spatial distribution of parameters of groundwater quality parameters. Based on the permeability index, result showed that 80% of the sampled groundwater quality falls under excellent class i.e. category I with PI value ranging from 1-24%, whereas the rest 20% of the samples has fallen under good class i.e. category II with PI value ranging from 25 to 75% on the suitability of water for irrigation. The results of this study outlines the unsustainability of groundwater for direct consumption, especially without any improved onsite water treatment, but it is appropriate for the irrigation purposes.

We present an updated design process for adapting and integrating existing cyber risk assessment approaches for impact assessment for the risk from IoT to the digital economy. The new design process includes a set of changes to the original standards (e.g. NIST) that are adapted for the IoT cyber risk in this paper. This paper also presents a new framework for impact assessment of IoT cyber risk, specific for the digital economy.

Tungiasis has been included in the WHO list of Neglected Tropical Diseases, but systematic data on the occurrence are scarce. We analyzed data on the occurrence of tungiasis in the 184 munici-palities of Ceará State in Northeast Brazil, based on an online open rapid assessment question-naire focused on health professionals and other key stakeholders. Questions included the occur-rence of tungiasis, severe cases, cases in animals and seasonal variations of the disease. There were in total 1,265 individual data entries available (1 to 104 per municipality) from all munici-palities of the state. A total of 181 (98.3%) of municipalities reported the occurrence of tungiasis in the past or currently, 120 (65.2%) reported current occurrence, 155 (84.2%) severe cases in the past or currently; and 47 (25.5%) reported severe cases currently. A total of 132 (71.7%) municipalities reported tungiasis in animals, most commonly in dogs (97), pigs (80), cats (50), horses (20), cattle (8) and goats (6). Most municipalities mentioned the seasonality of tungiasis (n=146; 79.3%). There was no report of any specific tungiasis control program. Our data show that tungiasis and severe tungiasis commonly occur in Ceará state and that tungiasis is a significant public health issue for both humans and animals. An integrated One Health approach is needed to reduce dis-ease burden, including human and animal health, and the environment.

The study of the distribution and health risk assessment is meaningful to provide basic data for environmental management．To investigate the pollution of potential toxic organics and their health risk to human beings, water samples were collected at 7 sites of main surface water of Beijing during wet and dry seasons respectively. The targeted 92 organics were detected, including phthalates (PAEs), volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs) and phenols. The results showed that: there were 56 organics detected out, and the number ratios of detected compounds to the total compounds of the same kind increased as the following: VOCs, phthalates, phenols, PAHs. 8 VOCs were detected in wet season, and 3 in dry season. The concentration of 2,2-Dichloropropane was highest as 10.62ug/L, while the concentrations of other VOCs were below 5ug/L; There were 11 phthalates detected during dry season. The content of Bis(2-methoxyethyl) phthalate was highest as 188.47ng/L; 17 phenols were found in samples during wet season, and the highest concentration was 1244.73ng/L for 4-nitrophenol; PAHs could be detected in all samples, and the detected compounds and the corresponding average concentrations were higher in wet seasons than those in dry seasons, which indicated that non-point pollution was possibly the main pollution source. The health risk assessment of the detected 56 pollutants by using a model from US EPA showed that, the risk caused by the four kinds of toxic organics in this study was in the acceptable ranges.

Breakwaters influence coastal wave climate and circulation by blocking and dissipating wave energy. Accurate representation of these effects is essential to the determination of coastal circulation and wave processes. MIKE21SW and SWAN are two third-generation spectral wave models which are used widely in coastal research and engineering applications. Recent improved versions of the models are able to consider the influence of breakwater structures. In this study, we used available observations to evaluate the accuracy of model simulations of waves in New Haven Harbor, Connecticut, USA, an estuary with three detached breakwaters near the mouth. We then compare the accuracy and computational efficiency of MIKE21SW and SWAN. Both models were executed on the same unstructured triangular grid. The boundary conditions were derived from a bottom mounted ADCP on the offshore side of the breakwaters. Wind forcing was applied using data from the Central Long Island Sound buoy. We find that both models are largely consistent with observations during storms. The MIKE21SW significant wave height and wave direction simulations were slightly superior; however, SWAN is more efficient and faster due to its implementation of a fully implicit technique for time integration.

Although agricultural crops production systems in subtropical plateau regions currently pose high environmental risks, especially in developing countries, their environmental impacts and emission-reduction potentials remain unclear, and the development potential of such systems is likely huge. We conducted a case study in Yunnan Province, China, to quantify the environmental impacts from crop production during 2002–2021. The life cycle assessment method was employed to identify factors driving the environmental impacts, and potential mitigation strategies were proposed. The yield and total nutrient input of grain crops in Yunnan Province increased over the 20-year period, and environmental footprint of crops production in Yunnan Province was higher than that of other regions. Average annual mean greenhouse gas (GHG) emissions and soil acidification potentials (AP) and water eutrophication potentials (EP) of crops production during 2002–2021 were 732 kg CO2-eq·Mg-1, 15.8 kg SO2-eq·Mg-1, and 2.7 kg PO4-eq Mg-1, respectively. GHG emissions from g crops mainly originated from applying agricultural materials during the crop life cycle. There was a significant correlation between surplus nitrogen and environmental impacts. Scenario testing showed that through crop sowing, nutrient regulation, and crop management, the crop yield could be increased and environmental costs could be reduced. The greatest reductions were found in wheat production: 53.1%, 67.9%, and 67.7% for GHG emissions, AP, and EP, respectively. Adopting comprehensive agricultural management measures could reduce the negative impact of crops production on the environment in subtropical plateau areas and achieve sustainable agricultural development.

In the Netherlands, the assessment of existing prestressed concrete slab-between-girder bridges showed that the thin, transversely prestressed slabs may be critical for static and fatigue punching when evaluated using the recently introduced Eurocodes. On the other hand, compressive membrane action increases the capacity of these slabs and changes the failure mode from bending to punching shear. To improve the assessment of the existing prestressed slab-between-girder bridges in the Netherlands, two 1:2 scale models of an existing bridge, the Van Brienenoord Bridge, were built in the laboratory and tested monotonically as well as under cycles of loading. The result of these experiments is: 1) the static strength of the decks, showing that compressive membrane action significantly enhances the punching capacity, and 2) the Wöhler curve of the decks, showing that compressive membrane action remains under fatigue loading. The experimental results can then be used for the assessment of the most critical existing slab-between-girder bridge. The outcome is that the bridge has sufficient punching capacity for static and fatigue loads, and thus that the existing slab-between-girder bridges in the Netherlands fulfil the code requirements for static and fatigue punching.

The Matāura River is the sixth largest river system in New Zealand and has long been subject to agricultural, industrial, and residential land use activities. The catchment has geographic and economic value and is of great cultural importance for local Māori, who have concerns over potential adverse impacts that anthropogenic stressors exert on the health of the river. There is a dearth of information on the impacts of these stressors towards the health of native species such as the longfin eel Anguilla dieffenbachii. This study assessed the environmental status of the Matāura River using biological and chemical methodologies incorporating A. dieffenbachii as a bioindicator species for exposure to combined anthroprogenic stressors. A range of biomarker endpoints were measured in caged and wild-caught eels (when available) to characterize site-specific responses to combined anthropogenic stressors. While there was no clear indication of cumulative impacts moving from pristine headwaters to the lower reaches of the Matāura River biomarkers of xenobiotic metabolization were induced in A. dieffenbachia and there was evidence of chemical contamination in sediments and tissues.

Rural areas are not only faced with the problems of rural depopulation but also with the problem of water supply and water quality which is a basic necessity of life. In light of this, this paper assesses the rural water supply situation and the bacteriological quality of different water sources in the Obokun Local Government Area of Osun State, Nigeria. The safety of the water sources for human consumption and possible occurrence of the water borne diseases in the study area were determined. The study employed descriptive and analytical methods of data analysis to achieve the objectives of the inquiry. Findings showed that the study area suffered from inadequate water supply and poor locations of the sources of water: The study also revealed that the microbiological quality of the water sources used was unsafe, poor and not acceptable for human consumption. In addition, many man- days-hours were wasted in search of water. It is therefore recommended that the government should make the rural water supply and the maintenance of water quality a priority in its policy formulation.

The campuses of Nigerian universities especially the old ones, like the University of Ibadan, comprise old trees which can pose a threat to pedestrians, structures, and roads within the school environments. However, there is no adequate information on these avenue trees thereby impeding their sustainable management. Therefore, this study provides the basic information needed by developing a geodatabase for the avenue trees along Benue, Emotan and Oduduwa roads within the University of Ibadan, Ibadan, Nigeria. The coordinates of all the avenue trees, and some within the selected roads were obtained. Tree growth data collected include; diameter at the breast height (dbh), diameter at the base, middle and at the top, crown height, crown diameter, and total height of all the avenue trees. Tree visual evaluation for diseases (TVED) was carried out for root decay, and termite attack on any part of the tree (stem, leaves and visible part of the root). Risk rate was assessed as low, medium and high, depending on the potential target (human, vehicles, structures). The risk rate depended on the incidence of leaning towards a building or road, cracked branches, root attack by termites, basal decay or branch decay. The growth data were used to compute the tree volume while the avenue trees were georeferenced. The physical health status of the avenue trees was determined using TVED data. The spatial distribution of the avenue trees was developed in GIS while all the analysed data were pulled together to develop a geodatabase for the avenue tress using design templates of BOOTSTRAP, comprising of Hypertext Markup Language, Cascade Style Sheets, JavaScripts and Hypertext Preprocessor. A total of 121 individual avenue trees belonging to 14 species were identified in the study area. The analysis of the geospatial distribution shows that Emotan Road had a lesser spatial distribution of avenue trees compared to Benue and Oduduwa roads. Furthermore, the health risk assessment of the trees in the study area indicated that 17.35% of the individual avenue trees had defects. The database created is user-friendly, suitable and has the ability for easy data storage and quick information retrieval on the avenue trees to enhance their maintenance and risk management. This can be accessed using the link http://159.203.29.155/rebs/rebs.php.

In public health literature the risk of death or disease associated with a dietary, environmental of behavioral factor is most commonly denoted by odds ratio (OR), hazard ratio (HR) or risk ratio (RR). The ratio indices have several desirable statistical properties. However, the most important question is whether there are some evolved innate norms of perception of risk that people use and what they are. We conducted a simple one question survey of 98 individuals with different age, sex, educational and professional backgrounds. The respondents were asked to judge the relative perceived risk of four different hypothetical habits for which data on the percentage of people affected by the disease with and without the habit was given. They were asked to rank the risks for the four habits. Results showed that the habits that had the highest difference between probability of acquiring the disease were ranked high on risk perception. The probability ratios did not affect risk perception significantly. Further age, sex, profession or formal training in statistics did not affect the response significantly. Even individuals that were formally trained to use OR and HR as risk indicators, preferred using probability differences over ratios for judging their own risk in the perceived context. This preliminary inquiry into intuitive statistical perception suggests that designing statistical indices based on people’s innate perception may be a better strategy than trying to train people to understand the indices designed by expert statisticians.

The PILAR model provides a dynamical systems perspective on collaboration. Two studies are performed using peer assessment data, both testing empirical support for the five Pillars (prospects, involved, liked, agency, respect) that constitute member’s perceptions of collaboration viability. The first study analyses peer-assessment data collected online from 458 first-year engineering students (404 males; 54 females). A nine-item instrument was inherited from past year’s usage in the course, expanded with four additional items to elaborate upon the agency and liked Pillars. Exploratory factor analysis was conducted on student responses to test whether they thematically aligned to constructs consistent with the five Pillars. As anticipated, twelve of the thirteen items grouped into five components, each aligned with a Pillar, providing empirical evidence that the five Pillars represent perceptions of collaboration. The second study replicated the first study using a retrospective analysis of 87 items included in the Comprehensive Assessment of Team Member Effectiveness (CATME) peer-assessment tool. The associated factor analyses resulted in five components and conceptual alignment of these components with Pillars was evident for three of five CATME components. We recommend a peer-assessment instrument based upon PILAR as potentially more parsimonious and reliable than an extensive list of behaviours, such as employed by CATME. We also recommend including items that target inter-rater bias, which is aligned with the liked Pillar, that instruments such as CATME exclude.

Life cycle assessment (LCA) is being included formally in EcoDesign regulations. Especially product carbon footprint will be mandatory in Europe. However, life cycle impact assessment including global warming potential (GWP) in LCA is hampered by several challenges. One of these is lack of water vapor characterization indexes for GWP. A life cycle inventory profile for air transport fuel including water vapor emissions is evaluated with state-of-the-art practice, i.e. EF Method and ILCD 2011 Midpoint+ and neglecting water vapors high altitude GWP compared to carbon dioxide. Then the characterization factor in GWP100 for water vapor and alternate normalization for particulates are introduced. The results are compared. The main findings are that the EF method and ILCD both generate rather realistic results for Particulate Matter and Respiratory Inorganics mid-point indicators, respectively, but the amount of premature deaths should be better allocated to different specific emissions, and that water vapor may dominate the GWP100 result over the usual carbon dioxide. LCIA mid-points need measurable and understandable bases. The common knowledge of water vapor’s GWP100 should not be neglected in LCIA for air transport and beyond where relevant.

The global trend towards increased demand for organic food, greener environments, and the integration of biological control agents into pest management strategies has greatly enhanced the need for biological pesticides (biopesticides). Biopesticides are generally environmentally friendly and are made from micro-organisms or other natural substances. Despite their great potential, relatively few have been registered and commercialised in Nigeria compared to other African countries such as South Africa and Kenya. Biological active agents are so diverse such that ap-plying the same safety standards or environmental conditions to all of them is almost impossible. A review of risk assessment processes and comparative assessments of Nigeria's biopesticide regulations with other developing African countries and developed regions was conducted. Prolonged field testing, lack of bridged risk assessments and technical checklists have been identified as key factors hampering the timely development and commercialisation of biopesti-cides in Nigeria. Recommendations on necessary changes to the existing Nigeria biopesticide regulations have been made. Risk assessment matrices for microbial and biochemical biopesti-cides and a scientific/technical checklist have also been developed. Harmonisation and data ex-change among other countries in the region will also enhance the advancement of scientific and technical knowledge for sustainable regulation and cross-border trade.

The response of building elements during earthquakes has been an area of concern for different researchers around the world. The NSEs are the first elements to attain failure, the buildings after damages in safety priority are classified as in “Life Safety” mode, but in reality, they are in “Collapse Safety” mode and the occupants inside the buildings are in a state of “Non-Life Safety” as a result of falling of the hazardous NSE’s like cladding's, partitions, hanging objects. In addition to the Life Cycle Cost Assessment (LCCA), the Social Life Cycle Assessment (SLCA) is overlooked by the majority of the researchers, the community must be prepared to respond to an event more efficiently without any major casualties or loss of life. It is expected that by the end of 2050, almost double the construction will take place, the embodied energy during the pre-construction, post-construction and demolition generates a lot of CO2s into the environment, hence sustainability should be given due importance, helping in the achievement of Sustainable Developmental Goals (SDGs).

The COVID-19 pandemic has highlighted the vitalness of telehealth in our medical world, where considering a restructuring of healthcare services has become paramount. In fact, telemedicine has recently earned a valuable place in many specialties; and its implications in cardiology and cardiovascular medicine were among the leading interests. In this letter, we gathered previous evidence supporting the merit of telemedicine in the fields of cardiology and cardiovascular medicine—medical branches in which patients require meticulous care and continuous monitoring—as well as protrusions of concerns about the uncertainty regarding the efficacy of telemedicine’s future implications and technologies. In sum, in the context of this still on-going pandemic, medical institutions must strive to improve telehealth technologies and implement solid future research directions in this growing field—to be able to persevere in meeting the needs of the patients. As long as no conclusive evidence exists regarding the fields where telemedicine is most worthwhile, healthcare systems will always keep the dread of wasting resources on developing ineffective programs. We conclude that telemedicine has been attributed a considerable attention in managing cardiac and cardiovascular conditions; nevertheless, further studies with solid designs are still needed to confirm its validity and utility in those specialties.

In this paper, aiming at the safety evaluation of ultimate bearing safety capacity of ultra-high-performance-concrete (UHPC) composite pile bridge foundation, the symmetrical reliability method with forward and inverse analysis considering the randomness of parameters is proposed to evaluate the safety performance of composite pile foundation. The proposed method, consid-ering the randomness of parameters, was used to calculate the safety factor of ultimate bearing capacity of composite pile foundation to meet the prescribed target reliability requirements. An example was used to verify the correctness of the proposed method. The proposed method was applied to an actual engineering example and the sensitivity of the parameters were analyzed, the calculation results show that: ignoring the randomness of the parameters will overestimate the safety of the composite pile foundation; the target reliability index has a great influence on the safety of composite pile foundation; the influence of statistical parameters of random variables on the safety of UHPC composite pile foundation cannot be neglected; the initial iteration value of the safety factor has no effect on the final calculation result. The proposed method has high ac-curacy and applicability, and provides an effective way for the safety factor estimation of ultimate carrying capacity of UHPC composite pile foundation.

CKD in HF patients is very common condition, their dysfunction is closely linked and influence each other, so their management required multidisciplinary and personalized approaches. The diagnosis of HF and CDK relies on signs and symptoms. Several tools, such as blood-based biomarkers and echography help us to clarify and discriminate the main characteristics of these patients. Evidence in improving survival due to new drug-employment in HF, has increasingly challenged physicians to manage patients with multiple diseases, especially in patients with CKD. The difficulty is in the safe administration of these drugs in patients with HF and CKD. Knowing up to which values ​​of creatinine or renal clearance any drug can be administered is fundamental. We wanted to summarize, on this sizable and complex topic, the experiences of various prior study to get clearer ideas and a more precise reference about the assessment and management of HF and CKD.

Investments in digital infrastructure in marginalised communities are set to increase in the next decade. These are premised on the potential of digital technologies to contribute towards solving societal problems, including the fragility of food value chains in rural areas. Although there are mixed empirical findings on the impact of these digital infrastructure investments, huge investments are continuing amid changing ICT policies in most developing countries. This paper, using a case study of a local livestock value chain in a rural community in Zimbabwe, argues for the application of non-conventional approaches towards digital infrastructure transformation impact assessment. Using selected theories and frameworks (socio-ecological systems framework, choice framework and technology affordances theory) as well as empirical data from a project in a rural community, the paper shows that real-time impact assessment using context-specific metrics may reveal hidden digital infrastructure transformation impacts, positive and negative, that are often overlooked when traditional impact assessment approaches are employed. The findings of this study contribute towards improving approaches towards ICT impact assessment. Practitioners engaging in impact assessment are challenged to move beyond dependence on traditional metrics (e.g. access) to the adoption of participatory processes to decipher context-appropriate metrics.

Radon, a carcinogenic radioactive gas, is a leading cause of lung cancer according to the World Health Organization. European Member States are required to develop and implement National Radon Action Plans (RAPs) to address its dangerous health effects. However, assessing the effectiveness of these RAPs presents challenges for authorities. This study aims to explore the possibility for a systematic and standardised assessment method to evaluate the effectiveness of RAPs strategies and its implementation. The method involved analysing the strategies of 27 EU Member States and the UK, conducting legal document analysis and group interviews with responsible authorities. Additionally, four regional workshops and one final European workshop were held. The research took place from March 2021 to May 2023. Findings indicate that evaluating RAP effectiveness is challenging due to limited existing common criteria or indicators. To address this, the study proposes guiding questions for each element required by the EU Directive, as well as additional questions related to education and training. This contribution benefits RAP owners and European regulatory authorities, supporting the development of effectiveness indicators for RAPs. BY improving assessment methods, we can enhance the effectiveness of strategies in mitigating the risks associated with radon exposure.

Background: Malnutrition is a frequent condition in the elderly and is associated with prolonged hospitalization and increased mortality. However, the impact of malnutrition among elderly patients with acute myocardial infarction has not been clarified yet. Methods and Results: We have enrolled 174 patients aged 65 years and over, admitted with the diagnosis of acute myocardial infarction (AMI) who underwent to the evaluation of nutritional status by Mini Nutritional Assessment (MNA) and of mortality risk by Grace score 2.0. All-cause mortality was the outcome considered for this study. Over a mean follow-up of 24.5 ± 18.2 months, 43 deaths have been registered (24.3%). Non-survivors were more likely to be older, with worse GFR, lower SBP, lower albumin and MNA score, higher prevalence of Killip classification III-IV grade, and higher Troponin I levels. Multivariate Cox proportional analysis revealed that Grace score and MNA showed a significant and independent impact on mortality, (HR = 1.76, 95% CI = 1.34–2.32 and HR = 0.56, 95% CI = 0.42–0.73, respectively). Moreover, the clinical decision curve revealed a higher clinical net benefit when the MNA was included compared to the partial models without MNA. Conclusions: Nutritional status is an independent predictor of long-term mortality among elderly patients with AMI. MNA score in elderly patients with AMI may help prognostic stratification and identification of patients with/at risk of malnutrition in order to apply interventions to improve nutritional status and maybe survival in this population.

An exploratory Life Cycle Assessment was carried out to provide insight into the environmental impacts of using the green seaweed Ulva spp. as a feedstock for production of bioplastic. The study focused on the production of lactic acid as a precursor of polylactic acid. The studied production process consists of (1) the cultivation of Ulva spp. in Integrated Multitrophic Aquaculture, (2) the processing of the biomass for solubilisation of sugars, (3) the fermentation of the sugars to lactic acid and (4) isolation of lactic acid from the fermentation broth. The study identifies environmental hotspots and compares the experimental seaweed production chain with conventional feedstock. The main hotspot identified is electricity consumption during seaweed cultivation. This impact of electricity consumption can be lowered by reducing energy use and sourcing renewable energy, and by improving the material efficiency in the product chain. To improve understanding of the environmental impacts of the production process, future studies can broaden the system boundaries and broaden the scope of sustainability issues included in the environmental assessment.

Due to various industrial developments and artificial inputs, there are emerging environmental contaminats(ECs) of serious concern in a wide range of environmental media. With recent advancements in scientific knowledge and industrial technology, the definition of emerging environmental contaminats has expanded. Among them, emerging contaminants are typically present in trace amounts and pose serious ecological risks and potential hazards to human health, animals and plants, with cumulative effects on organisms. However, Traditional treatment techniques have proven ineffective in eliminating and preventing subsequent environmental problems from new pollutants such as microplastics, antibiotics and fluorocarbons. Consequently, extensive research has been conducted to address these issues. Effective removal methods prioritize not only removal efficiency, but also environmental friendliness and regenerative capacity. The purpose of this paper is to summarize the sources, forms of presence, environmental and human health hazards, and removal technologies of ECs, and to provide various examples of different sources.

Mild traumatic brain injury (mTBI) is the most common brain injury, seen in sports, falls, vehicle, or workplace injuries. Concussion is the most common type of mTBI. Assessment of impairments from concussion are evolving, with oculomotor testing suggested as a key component in a multi-modality diagnostic protocol. The aim of this study was to evaluate the reliability of one eye-tracking system, the EyeGuide Focus. Seventy-five healthy adolescent and adult participants (adolescents: n=28; female=11, male=17, mean age 16.5 ± 1.4 years; adults n=47; female=22; male=25, mean age 26.7 ± 7.0 years) completed three repetitions of the EyeGuide Focus within the one session. Intraclass correlation coefficient (ICC) analysis showed the EyeGuide Focus had overall good reliability (ICC 0.79, 95%CI: 0.70, 0.86). However, a familiarization effect showing improvements in subsequent trials was noticeable in both cohorts (p<0.001) with adolescent participants showing greater familiarisation effects than adults. No differences were observed between sexes (p=0.69). Overall, the EyeGuide Focus was found to be reliable, but the observation of familiarization effects suggests that a standardized protocol of a minimum of three trials be employed, similar to other eye-movement testing applications.

Female sexual functioning and satisfaction are impaired by the presence of sexual difficulties. Current study aims to analyze the differences on sexual satisfaction in women according to types of sexual problems (absence of sexual problems, self-perceived and assessed by the FSFI cut-off). A total of 329 women answered to a specific question about presence of self-perceived sexual problems, the Sexual Satisfaction Scale for Women, and the Female Sexual Functioning Index. Main findings revealed that sexually health women had better levels of sexual satisfaction when compared to women who self-report sexual difficulties and women who scored clinical levels in FSFI. Also, women who scored clinical levels in FSFI scored lower on sexual satisfaction compared to women who self-report sexual difficulties. Female sexual satisfaction was negatively affected by sexual difficulties assessed according to the FSFI cut-off. Although with lower impact, self-perceived sexual problems also affect negatively sexual satisfaction in women.

The three heat-induced coffee contaminants acrylamide, furfuryl alcohol (FA) and 5-hydroxymethylfurfural (HMF) were analyzed in a collective of commercial samples as well as in Coffea arabica seeds roasted under controlled conditions from very light Scandinavian style to very dark Neapolitan style profiles. Regarding acrylamide, average contents in commercial samples were lower than in a previous study in 2002 (196 compared to 303 µg/kg). The roasting experiment confirmed the inverse relationship between roasting degree and acrylamide content, i.e. the lighter the coffee the higher the acrylamide content. However, FA and HMF were inversely related to acrylamide and found in higher contents in darker roasts. Therefore, mitigation measures must consider all contaminants and not be focused isolatedly on acrylamide, specifically since FA and HMF are contained in much higher contents with lower margins of exposure compared to acrylamide.

As required by the EU legislation and the national risk management duties, the pesticide residues were determined by four specialized laboratories in 9,924 samples taken from 119 crops of economic importance and imported foodstuffs during 2017-2021 in Hungary. The screening method applied covered 622 pesticide residues as defined for enforcement purposes. The limit of detection ranged between 0.002-0.008 mg/kg. The 1.0% violation rate was lower than in the European Union for all commodities. No residue was detectable in 45.9% of the samples. For detailed analyses of the results, eight commodities (apple, cherry, grape, nectarine/peach, sweet peppers, and strawberry) were selected as they were analyzed over 195 samples and contained most frequently residues. Besides testing their conformity with national MRLs, applying 0.3MRL action limits for pre-export control, we found that 73% of the sampled lots would be compliant with ≥90% probability based on second independent sampling. Multiple residues (2-23) in one sample were detected in 36-50% of the tested lots. Noting the provisions of integrated pest management and the major pests and diseases of selected crops, normally 3-4, exceptionally 7-9 active ingredients of different mode of actions should be sufficient for their effective and economic protection.

Consumption of milk contaminated with antibiotic residues above the maximum residue limit (MRL) causes direct toxicity to humans and the development of superbugs that leads to the failure of antibiotic therapy and threatens human life. Besides, long-duration exposure might alter the nature of gut microflora results in the enhancement of many diseases. Therefore, we examined 300 raw and processed packet milk samples using thin layer chromatography (TLC) and ultra high performance liquid chromatography (UHPLC) method against five veterinary antibiotics and assessed the risk for consumers in Chattogram, Bangladesh. Risk analysis was calculated by using hazard quotient on the basis of 165 ml per capita milk consumption. We found a total of 7% prevalence of antibiotic residues in raw milk samples which were higher (8%) in individual samples than the pooled samples (4%). However, we did not find any processed packet milk samples as positive. The mean concentration of oxytetracycline residue was detected 61.29 µg/l and amoxicillin was 124 µg/l in individual milk samples. Risk analysis showed the hazard quotient values of 0.0056 for oxytetracycline and 0.0017 for amoxicillin residue which was confirmed that, no significant health risk associated with the consumption of milk produced and marketed in the study area. Our study might fill the gap of knowledge to measure the safety status of milk regarding public health issues.

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

The oil spilled from the Gulf war caused land pollution and various petroleum compounds. Among petroleum compounds, polycyclic aromatic hydrocarbons (PAHs) are known for toxicity, and have been designated as carcinogenic, mutagenic, and endocrine disrupting substances by the United States Environmental Protection Agency (USEPA). According to the USEPA, toxic equivalents quotient (TEQ), and mutagenic equivalents quotient (MEQ) can be calculated by multiplying the toxic equivalency factor (TEF) and mutagenic equivalency factor (MEF) by the concentration of PAHs. The USEPA calculates the relative TEF for other PAHs by setting the TEF value of benzo(a)pyrene, which is highly toxic, to 1. Relative MEF is also calculated in the same way. In this study, the TPH concentrations of crude oil-contaminated soils collected from the Burgan in Kuwait were measured to be 5, 8, and 20% and TEQ and MEQ of the soils were calculated by multiplying the 16 PAHs concentrations measured for each sample by TEF and MEF, respectively. When the TPH concentration was increased by 4 times from 5% to 20%, the TEQ was increased by about 9 times and the MEQ was increased by about 10 times. Therefore, it was concluded that as the TPH concentration increases, the carcinogenicity and mutation rate increase greatly. In addition, ecotoxicity assessment was performed using luminescent bacteria to compare the relationship between the calculated TEQ and MEQ and actual ecotoxicity, and benzo(a)pyrene among 16 PAHs showed a coefficient of determination of 0.95. In this study, ecotoxicity in PAHs-contaminated environment can be estimated by analyzing benzo(a)pyrene as a representative substance.

Introduction With the global population increasingly relying on the internet for information, YouTube has emerged as a significant platform for communication and information sharing, particularly in the field of medicine. However, concerns persist regarding the reliability and quality of medical information on YouTube, given the lack of regulation and guidelines. This study aims to systematically evaluate the reliability of health-related information on YouTube. Methods: Data collection was conducted in September 2023 on YouTube, with stringent selection criteria for videos. Videos were evaluated using the "Internet Health Information Certification Standards" by the Korean Medical Association and the Global Quality Scale. A plastic surgeon assessed information quality based on specific criteria. The study analyzed the influence of keywords on information accessibility and compared the evaluation tools. Results: 76 Korean search results were analyzed using keywords. Certified South Korean medical providers appeared more in "ptosis surgery" results (50%) than "droopy eyelid diagnosis" (5%). Medical professionals produced 86.7% of videos, with some non-medical content. "Ptosis surgery" had the highest KMA scale score (16.3), "droopy eyelid diagnosis" the lowest (13.8). Out of 76 videos, 39 by plastic surgeons, 20 by ophthalmologists, and 5 by dermatologists. A GQS comparison showed specialists with higher scores (3.12) than non-specialists (1.53). Conclusion: YouTube and similar platforms offer valuable access to medical information, but quality and reliability remain significant concerns. Collaborative efforts from government agencies, medical organizations, and users are essential to enhance the quality of online health information. Users should also cultivate critical thinking skills to discern trustworthy information.

In this paper, we have investigated the impact of an early learning assessment on students' motivation for improving their performance throughout the semester. An observation analysis was conducted on an entry level mechanical engineering course in which students are enrolled in during their first semester of engineering work. This study analyzes the effect that a first exam, with an average below a passing grade, has on student's outcome in the course. It was hypothesized that students were motivated to achieve their desired grade outcomes following inadequate performance on the first exam. This was investigated by diving into the results of the course and referencing initial performance to the remaining exam and assessment outcomes. Students were placed into grade bands ranging from 0 to 100 in 20% increments. Their results were tracked and it was shown that for the second mechanics exam, averages jumped 43.333%, 35.35%, and 30.055% for grade bands of 0 to 20, 20 to 40, and 40 to 60 respectively. Assessment grades increased as well with the remaining assessments being averaged to a score of 91.095%. Variables contributing to student performance came from both with-in and outside the classroom. Learning communities, material differentiation, and student and professor adaptation all contributed to the rise in performance. It was concluded that the internal and external variables acted in combination with one another to increase student dedication to achieve success.

The present paper deals with the investigation, at conceptual level, of the performance of short-medium-range aircraft with hydrogen propulsion. The attention is focused on the relationship between figures of merit related to transport capability, such as passenger capacity and flight range, and the parameters which drive the design of liquid hydrogen tanks and their integration with a given aircraft geometry. The reference aircraft chosen for such purpose is a box-wing short-medium-range airplane, object of study within a previous European research project called PARSIFAL, capable to cut the fuel consumption per passenger-kilometre up to 22%. By adopting a retrofitting approach, non-integral pressure vessels are sized to fit into the fuselage of the reference aircraft, under the assumption that the main aerodynamic, flight mechanic and structural characteristics are not affected. A parametric model is introduced to generate a wide variety of fuselage-tank cross-section layouts, from a single tank with the maximum diameter compatible with a catwalk corridor to multiple tanks located in the cargo deck , and an assessment work-flow is implemented to perform the structural sizing of the tanks and analyse their thermodynamic behaviour during the mission. This latter is simulated with a time-marching approach that couples the fuel request from engines with the thermodynamics of the hydrogen in the tanks, which is constantly subject to evaporation and, depending on the internal pressure, vent-ed-out in gas form. Each model is presented in detail in the paper and results are provided through sensitivity analyses to both the technology parameters of the tanks and the geometric parameters influencing their integration. The guidelines resulting from the analyses indicate that light materials, such as the Aluminium alloy AA2219 for tanks’ structure and polystyrene foam for the insulation, should be selected. Preferred values are also indicted for the aspect ratios of the vessel components, i.e. central tube and endcaps, as well as suggestions for the integration layout to be adopted depending on the desired trade-off between passenger capacity, as for the case of multiple tanks in the cargo deck, and achievable flight ranges, as for the single tank in the section.

Videogames have become educational, communicative and social tools among the youngest, favouring the acquisition of skills, abilities and values, encompassing an endless number of themes, and help to experience and to face, in the first person, a great diversity of environmental situations and ecology problems. Thus, the present article aims: a) the evaluation of a sample of 20 educational videogames about water, making use of some empirical criteria of quality; and b) the design, validation and application of an integrate quality indicator of educational videogames on water, based on the aspects of narrative, gameplay and didactics to that sample, which allows us to obtain a ranking. The findings reflect a ranking of games allows to suggest that the nature of the game (simulation, adventures, platforms or questions) does not determine the quality of the game, although generally simulations and adventure games are placed in a range of medium or high quality, as well as those games that pursue objectives related to the design and management of a territory in a sustainable way. The paper provides teachers with quality criteria based on narrative and gameplay that complement and enriches the pedagogical dimension.

The ingestion of contaminated aquatic products presents a potential risk for human exposure to bisphenols (BPs) residues. Nevertheless, there is little empirical research on this topic. To fill the current data gap, this study used stochastic sampling to gather 245 representative samples of aquatic products from local markets in Shenzhen. The samples comprised eight species and fell into three aquatic product categories: fish, crustaceans, and bivalves. A total of eight BPs were detected from aquatic products, namely, bisphenol A (BPA), bisphenol AF (BPAF), bisphenol AP (BPAP), bisphenol B (BPB), bisphenol S (BPS), bisphenol P (BPP), bisphenol Z (BPZ), and bisphenol F (BPF). All BPs were detected in aquatic products, except for BPAF, indicating pervasive contamination by BPs in aquatic products. BPS demonstrated the highest detection rate both before and after enzymatic hydrolysis, whereas BPAP exhibited the lowest detection rate before enzymatic hydrolysis, and BPB displayed the lowest detection rate after enzymatic hydrolysis. The concentration difference before and after enzymatic hydrolysis proved to be statistically significant. Moreover, 49%-96% of BPs in aquatic products were found in the combined state, underscoring the essentiality of conducting detections on aquatic product samples following enzymatic hydrolysis. While the health risks associated with ingesting BPs residues through aquatic product consumption were found to be minimal for residents at risk of exposure, the results suggest the necessity for more stringent regulations governing the consumption of aquatic products.

Malnutrition is a serious problem with negative impact on the quality of life and the evolution of our patients, contributing to an increase in morbidity, hospital stay, mortality and health spending. Early identification is fundamental to implement the necessary therapeutic actions involving adequate nutritional support to prevent or reverse malnutrition. This review presents two complementary methods of fighting malnutrition: nutritional screening and nutritional assessment. Nutritional risk screening is conducted using simple, quick-to-perform tools and is the first line of action in detecting at-risk patients. It should be implemented systematically and periodically on admission to hospital or residential care, as well as on an outpatient basis for patients with chronic conditions. Once patients with a nutritional risk have been detected they should undergo a more detailed nutritional assessment to identify and quantify the type and degree of malnutrition. This should include health history and clinical examination, dietary history, anthropometric measurements, evaluation of the degree of aggression determined by the disease, functional assessment and, whenever possible, some method of measuring body composition.

The COVID-19 pandemic changed the world of medical education, moving it years ahead of time into the future. Many concepts needed to be changed, so did the methodologies. Nevertheless, clinical assessment remained tricky. This work highlights the outcome of the work of College of Medicine and Medical Sciences at the Arabian Gulf University in Bahrain in performing virtual clinical examination using Zoom™. Tips in this article are meant to help plan, implement and evaluate clinical assessments virtually.

In modern automobiles, Infotainment High-Performance Computing (HPC) systems play a vital role in enhancing the capabilities of drivers and passengers by providing advanced features consisting of music, navigation, communication, entertainment, etc. However, as the use of information technology in vehicles increases, it results in cybersecurity threats such as data breaches and the loss of sensitive information. To improve the security of the infotainment system in automotive vehicles, the research conducted threat modeling at the component level using Microsoft’s STRIDE tool and performed risk assessment by using SAHARA (Safety-Aware Hazard Analysis and Risk Assessment) and DREAD methodologies to evaluate associated risks. It provides a systematic representation of threats, associated risks, and generic mitigation strategies to counter cybersecurity attacks. Through the threat modeling process, 34 potential security threats were identified. The study also provided a comparative analysis to calculate the risk values of the threats to prioritize for treatment. These identified threats and associated risks need to be considered to avoid potential cyberattacks, before deploying the infotainment HPC system in real-world automotive vehicles.

Body-Esteem Scale is an assessment tool for adolescents and adults that evaluate three dimensions of self-evaluations of one’s body. Body-Esteem Scale has been translated and validated in some countries since America down to Europe. Lack of translation and reliability evidence in Portugal was detected. This study aimed to translate and test the validity and reliability of the Body Esteem Scale for Adolescents and Adults (BESAA) in students in the context of Portuguese higher educa-tion. A total of 173 students (60.7% are female) with a mean age of 19.7 (standard deviation = 2.2) years participated. Categorical Principal Component Analysis was used to assess the underlying dimensions of BESAA. Construct validity was evaluated through correlation with the Appearance Schemas Inventory – Revised and a three-factor model (“Appearance”, ‘‘Weight’’ and “Attribu-tion’’) was established. Confirmatory factor analysis was performed to verify the construct validity of the instrument. Items that had factor weights (λ)<.40 were removed, as well as those that were considered redundant by the modification indices estimated by the Lagrange Multipliers (LM) method (LM>11, p<.001). We observed high correlations between theoretically similar factors, and low correlations between different factors. The Portuguese BESAA showed adequate validity and reliability.

The use of multi-gene panels for germline testing in breast cancer enables the estimation of cancer risk and guides risk-reducing management options for tested individuals and their family members. We performed an analysis in our clinical database to identify breast cancer patients undergoing genetic testing with positive reports. We reviewed positive results with respect to the different levels of information provided in the reports; risk estimation and management, cascade family testing, information from secondary findings and actionable information for treatment decision-making. A total of 415 positive test reports were identified with 57.1%, 18.1%, 10.8% and 13.5% of individuals having pathogenic/likely pathogenic variants in high (BRCA1, BRCA2, PALB2, PTEN, TP53), moderate (ATM, CHEK2, NBN), low (BARD1, BRIP1, CHEK2, MLH1, MSH2, MSH6, NF1, RAD51C) and with insufficient evidence for breast cancer risk genes (FANCA, FANCM, NBN, MRE11, PMS2, RAD50, RAD51B, XRCC2, MUTYH), respectively. 6.7% of individuals were double heterozygotes with two pathogenic variants. Germline findings in 92% of individuals are linked to evidence-based treatment information and receive risk estimates for predisposition to breast and/or other cancer types. The use of germline findings for treatment decision making expands the indication of genetic testing to include individuals that could benefit from targeted treatments.

The supply of mental health processes in primary care has gaps. This study aims to analyze the association of agreement criteria and flows between primary care teams and the Family Health Support Center (NASF) for mental health collaborative care, considering the difference between capital and non-capital cities in Brazil. This cross-sectional study was conducted based on secondary data from the Primary Care Access and Quality Improvement Program. Agreement criteria and flows were obtained from 3883 NASF teams of the matrix support or collaborative care. The Chi-square test and multiple Poisson regression were used; p &lt; 0.05 was considered statistically significant. Prevalence ratios of negative associations demonstrated protective factors for support actions: follow-up at Psychosocial Care Center, management of psychopharmacotherapy, offer of other therapeutic actions, care process for users of psychoactive substances, and offer of activities to prevent the use of psychoactive substances. Collaborative care in primary care was effective, and capital cities were a protective factor compared with non-capital cities.

Pasture-based production systems are predominant in major beef-producing countries, however, these systems lack validated protocols to assess animal welfare under commercial conditions. The objective of this study was to validate an animal welfare protocol for fattening Zebu cattle farms in tropical pasture systems. The initial protocol was developed with the participation of producers, professionals, the general public, and the Colombian health authority, through workshops with a participatory approach and collaborative knowledge management. The validation was carried out in 24 pasture-based commercial Zebu cattle farms in the middle Magdalena region of Colombia. Visits were made with an average duration of 2.5 hours, which included the evaluation of 788 fattening cattle. The protocol evaluated animal-based, resource-based, and livestock management indicators through a questionnaire-guided interview to evaluate cattle handling and health, animal-based measurements, and documentation management. A protocol validation process was carried out by selecting indicators that remained unchanged, adjusting those that were feasible to implement, and eliminating inadequate or unnecessary indicators. The application of the protocol demonstrated that there are valid and feasible measures to include in the evaluation protocols of pasture-based fattening systems. Likewise, the active participation of producers is crucial to achieving a greater commitment to the implementation of this protocol.

The present study was conducted to estimate the exposure and risk characterization of the children population of Serbia to Aflatoxin M1 (AFM1) from milk and milk-based food. A total of 3404 samples comprising of milk and different milk-based food samples were collected from various regions of Serbia from 2017 to 2019. Evaluation of the AFM1 exposure was carried out using the deterministic method, whereas risk characterization was evaluated with the calculation of the Margin of Exposure (MOE) and the risk of Hepatocellular Carcinoma (HCC). Detection rates for AFM1 in milk and milk-based food samples ranged between 2% and 79%, with the highest incidence (79%) and mean level (22.34  0,018 ng kg-1) of AFM1 was detected in pasteurized and UHT milk. According to the three consumption estimates, the values of EDI were higher for toddlers as compared with children. Children aged 1–3 years had the highest risk of exposure to AFM1 in milk, with an estimated daily intake of 0.164 and 0.193 ng kg-1 bw day-1 using a lower bound (LB) and the upper bound (UB) exposure scenarios, respectively. Such difference could result from the higher consumption versus weight. Based on the EDI found in this study, the risk of AFM1 due to consumption of milk and milk-based food was low since MOE values obtained were 10000. In addition, the risk of HCC cases/year/105 individuals of different age groups showed that the value of HCC using potency estimates of 0.0017 (mean) was maximum (0.00034) in the age group 1–3 years which indicates no health risk for the evaluated groups. The present study revealed the importance of controlling and preventing AFM1 contamination in milk through continuous monitoring and regular inspection to reduce the risk of AFM1 exposure, especially in children.

Research professors develop scientific products that impact and benefit society, but their competencies in doing so are rarely evaluated. Therefore, employing a mixed two-stage sequential design, this study developed a self-assessment model of research professors’ competencies with four domains, seven competencies, and 30 competency elements. Next, we conducted descriptive statistical analysis of those elements. In the first year, 320 respondents rated themselves on four levels: initial, basic, autonomous, and consolidated. In the assessment model’s second year, we compared 30 respondents’ results with those of their initial self-assessment. The main developmental challenge was Originality and Innovation, which remained at the initial level. Both Training of Researchers and Transformation of Society were at the basic level, and Digital Competency was at the autonomous level. Both Teaching Competence and Ethics and Citizenship attained the consolidated level. This information helps establish priorities for accelerating researchers’ training and the quality of their research.

Background: Some studies have shown that an increase in visceral fat is associated with postoperative clinical and oncologic outcomes. However, no studies have used bioelectrical impedance analysis (BIA) to determine the effects of visceral fat on the oncologic outcomes of colorectal cancer (CRC). This study aimed to investigate the relationship between visceral fat area (VFA) and clinical, and oncologic outcomes in CRC. Methods: This study included 203 patients who underwent anthropometric measurements by BIA before surgical treatment for CRC between January 2016 and June 2020. Results: According to the cutoff level of VFA by receiver operating characteristic curve analysis, 85 (40.5%) patients had a low VFA, and 119 (59.5%) had a high VFA. Multivariate analysis found that preoperative CRP (hazard ratio [HR], 3.882; 95% confidence interval [CI], 1.001–15.051; p=0.050) and nodal stage (HR, 7.996; 95% CI, 1.414–45.209; p=0.019) were independent prognostic factors for overall survival, while sex (HR, 0.110; 95% CI, 0.013–0.905; p=0.040), lymphovascular invasion (HR, 3.560; 95% CI, 1.098–11.544; p=0.034), and VFA (HR, 4.263; 95% CI, 1.280–14.196; p=0.040) were independent prognostic factors for disease-free survival (DFS). Conclusion: High VFA preoperatively measured by BIA was associated with inflammations and was an independent prognostic factor for DFS.

Optoelectronic devices are gold standard for 3D evaluation in clinics but due to the complexity of such kind of hardware and the lack of access for patients affordable, transportable and easy to use systems must be developed to be largely used in daily clinics. The Kinect^TM sensor presents various advantages compared to optoelectronic devices: price, transportability but also some limitations: (in)accuracy of the skeleton detection and tracking as well as the limited amount of available points that make 3D evaluation impossible. To overcome these limitations a novel method has been developed to perform 3D evaluation of the upper limbs. This system is coupled to rehabilitation exercises allowing functional evaluation while performing physical rehabilitation. To validate this new approach a double step method was used. The first step is a laboratory validation where the results obtained with the Kinect^TM have been compared with results obtained with an optoelectronic device, 40 healthy young adults participated in this first part. The second step was to determine the clinical relevance of such kind of measurement. Results of the healthy subjects were compared with a group of 22 elderly adults and a group of 10 chronic stroke patients to determine if different patterns can be observed. The new methodology and the different steps of the validations are presented in this paper.

The hazard and the carcinogenic risks due to the exposure to some potentially toxic elements by the Santiago Island (Cape Verde) population where calculated, considering soil ingestion, inhalation and dermal contact as exposure pathways. The topsoil of Santiago Island is enriched in Co, Cr, Cu, Ni, V, Zn, Mn and Cd to upper crust values. Hazard indices (HI) were calculated for these metals and As exposures, of Santiago Island population and the calculations were performed for children and adults. For children HI are higher than 1 for Co, Cr and Mn. So there is indication of potential non-carcinogenic risk for children, due to the high Co (HI=2.995), Cr (HI=1.329) and Mn (HI=1.126), values in soils. For the other elements and for adults there is no potential non-carcinogenic risk. Cancer risk was calculated for As, Cd, Cr and Ni exposures, for adults and children and the results are always lower than the carcinogenic target risk of 1x10-6, for As, Cd, and Ni. However, cancer risk are higher than the carcinogenic target risk for Cr, for adults. Regarding As, for children the fraction due to Riskingestion represents 51.6%, while Riskinhalation represents 48.0% and Riskdermalcontact represents only 0.4% of total risk. For adults Riskinhalation represents 81.3%, Riskingestion represents 16.6% and Riskdermal contact represents 2.1%. These results reflect the higher daily ingestion dose for children and the higher inhalation rate and higher dermal contact surface for adults. For the other elements and for adults the cancer risk due to Cr, Ni and Cd inhalation is always higher than for children, reflecting the higher inhalation rate for adults.

This research assess the effects of training program based on the usage of the digital learning objects in teaching practice at the Northern Borders University staff. E Assessment through the tablets and smart phones and the teachers’ attitudes towards such way of evaluation is the major objective of this study as the researcher expects that the assessment mechanism in the university through utilization of tablets and smart phones and its application will inevitably bring in a systematic improvement in the assessment and evaluation process of the curricula. Moreover, making use of the e learning objects in training will make a significant change in e training program of the university. Hence, the researcher has chosen voluntary random samples from the university teaching staff (men\women) from various different faculties (medicine, medical sciences, science, education and arts, business administration, home economics, and science and literature). These samples included 300 members of the teaching staff. In a group of 20 to 25 members, a personal training was conducted regarding the usage of tablets and smart phones and its applications in the assessment process. Each group participated by producing a complete e-assessment for their students in the Northern Borders University and by the e learning system i.e. Blackboard and Question Mark. The research also depends on the semi-experimental design of multiple groups and on testing the groups’ pre and post achievement tests. In addition, the research identifies the level of the university teaching staff in using the tablets and the smartphones and its applications in the assessment process by the note card that the individuals have during the test.

To evaluate the impact of a new Substance Use Disorder (SUD) education program on medical students' representations, we selected the Substance Abuse Attitude Survey (SAAS) questionnaire, which we adapted to our curriculum and cultural context. To validate this adapted version, we conducted an exploratory factor analysis following the administration of our 29-items bSAAS questionnaire to 657 medical students in Belgium (response rate: 71,1%). 23 items correlated to 3 factors namely "Stereotypes and moralism", "Treatment optimism" and "Specialised treatment" were retained (70% of total variance explained, Cronbach's alpha= 0.80) and constituted the new questionnaire called beSAAS. The factor "Specialised treatment", stood out from previous studies which could be explained by our target population and the impact of the formal, informal, and hidden curriculum in medical education. This study highlighted certain factors influencing stereotypical representations such as age, gender, origin, and personal or professional experience with substance use. Our study allowed us to retain the beSAAS as a good questionnaire to evaluate SUD stigma and highlighted interesting findings to improve SUD training in medicine. Further studies are needed to complete its validity and reliability.

Background: Falls risk assessment tools are used in hospital inpatient settings to identify pa-tients at increased risk of falls (which may be related to muscle loss/sarcopenia) to guide and target interventions for falls prevention. In 2022, Western Health, Melbourne, Australia, intro-duced a new falls risk assessment tool, the Western Health St. Thomas’ Risk Assessment Tool (WH-STRATIFY), a modified version of The Northern Hospital’s risk tool (TNH-STRATIFY), which replaced the Peninsula Health Risk Screening Tool (PH-FRAT). Aims: To determine the predictive accuracy of three falls risk assessment tools (PH-FRAT, TNH-STRATIFY and WH-STRATIFY) on admission to Geriatric Evaluation Management (GEM) units. Method: A retrospective observational study was conducted on four GEM units. Data was col-lected on 54 consecutive patients who fell during admission and 62 randomly sampled patients who did not fall between December 2020 and June 2021. Participants were scored against three falls risk assessment tools. The event rate Youden (Youden IndexER) indices were calculated and compared using default and optimal cut points to determine which tool was most accurate for predicting falls. Results: Using default cut points to compare falls assessment tools, TNH-STRATIFY had the highest predictive accuracy (Youden IndexER = 0.20, 95% confidence interval CI = 0.07, 0.34). The PH-FRAT (Youden IndexER = 0.01 and 95% CI = -0.04, 0.05) and WH-STRATIFY (Youden IndexER = 0.00 and 95% CI = -0.04, 0.03) were statistically equivalent and not predictive of falls compared to TNH-STRATIFY. When calculated optimal cut points were applied, predictive accuracy im-proved for PH-FRAT (Cut point 17, Youden IndexER = 0.14 and 95% CI = 0.01, 0.29) and WH-STRATIFY (Cut point 7, Youden IndexER = 0.18 and 95% CI = 0.00, 0.35). Overall, all tools had low predictive accuracy for falls. Conclusion: TNH-STRATIFY had the highest predictive accuracy for falls. The predictive accu-racy of WH-STRATIFY improved and was significant when the calculated optimal cut point was applied. The optimal cut points of falls risk assessment tools should be determined and validated in different clinical settings to optimise local predictive accuracy, enabling targeted falls risk mitigation strategies and resource allocation.

Functional somatic disorders (FSD) characterized by persistent and disabling physical symptoms are common in adolescents. Diagnostic uncertainty and insufficient illness explanations are proposed perpetuating factors that may constitute barriers for treatment engagement. This study evaluates the impact of manualized assessment and psychoeducation on diagnostic certainty and various clinical outcomes in adolescents with multi-system FSD. Ninety-one adolescents (15-19 years) included in a randomized trial testing group-based therapy (AHEAD) received systematic assessment (4 hrs.) and a subsequent psychiatric consultation (1.5 hrs.). Clinical outcomes included self-reported physical health, symptom severity, illness perception, illness related behavior, and psychological flexibility assessed before and approximately two months after assessment, prior to specialized treatment. Data were analyzed using t-tests. Immediately following assessment 71 (80.7%) adolescents out of 88 reported a higher diagnostic certainty and 74 (84.1%) reported that attending assessment gave them positive expectations for future treatment. A clinically relevant improvement of physical health was not observed at two months but considerable reductions were seen on symptom severity, illness worry, negative illness perceptions, limiting illness behavior and psychological inflexibility. The results underpin the importance of systematic assessment and psychoeducation which may be effective in their own right in specialized treatment of adolescents with severe FSD.

The study proposes a theoretical method for evaluating the 'safety against derailment' indicator of a specialized train composition for the transportation of very long rails. A composition of nine wagons, suitable for the transportation of rails with a length of 120 m, is considered. For the remaining recommended rail lengths, the number of wagons is reduced or increased, the method being modified depending on the required configuration. In accordance with the requirements of EN 14363:2019, the composition is in a curve with a radius of R=150 m. The rails bend, some of them contact the vertical stanchions of the wagon and cause additional transverse forces, which are balanced in the rail track. This is a prerequisite for derailment of the vehicle. The goal of the study is to determine the additional transverse forces that arise because of the bent rails. The task is statically indeterminate, and considering the dimensions of the rails, its solution becomes seriously difficult. For the purposes of the study, the finite element method was used. Based on the displacements of the support points of the rails (caused by the geometry of the curve) the bending line of the elastic load is determined and the forces in the supports are calculated. A group of five rails is considered, with results multiplied proportionally for cases other than five. The resulting forces are considered when determining the derailment safety criterion defined by EN 14363:2019.

Behavioural disorders in dogs are common and have severe welfare consequences for dogs. This study aimed to assess the factors that are significant and predictive of behaviour problems in dogs using the Animal Welfare Assessment Grid (AWAG) to further understand what factors influence their welfare. 177 AWAG assessments were undertaken across 129 dogs that clinicians deemed to have a behavioural disorder. Wilcoxon-rank sum tests were used to assess the difference in scores between dogs with behaviour disorders and a cohort of healthy dogs (n=117). This analysis showed that all physical factors besides body condition, all procedural factors besides procedure pain, and all psychological, and environmental factors were significantly different between healthy dogs and dogs with behaviour disorders. Spearman Rank Correlation Coefficient (RS) revealed several significant strong positive correlations including the procedural impact on the dog’s daily routine with aggression towards unfamiliar people and procedure pain, as well as other correlations between the dog’s behaviour during assessment with the frequency at which they encounter fears and anxieties, clinical assessment and procedure pain, and reaction to stressors and social interactions. These findings highlight the interdependent nature of the various influences of welfare. Logistic regression analysis identified that aggression towards the caregiver, fears and anxieties frequency, and choice, control, and predictability were all significant predictors of behaviour disorders. The findings have important implications for veterinary, behaviour, and animal welfare professionals as any changes across these factors may indicate poor welfare linked to emotional disorders in dogs.

Technological advances in game-mediated robotics provide an opportunity to engage children with cerebral palsy (CP) and other neuromotor disabilities in more frequent and intensive therapy by making personalized, programmed interventions available 24/7 in children’s homes. Though shown to be clinically effective and feasible to produce, little is known of the subjective factors impacting acceptance of what we term assistive/rehabilitative (A/R) gamebots by their target populations. This research describes the conceptualization phase of an effort to develop a valid and reliable instrument to guide the design of A/R gamebots. We conducted in-depth interviews with 8 children with CP and their families who had trialed an exemplar A/R gamebot, PedBotHome, for 28 days in their homes. The goal was to understand how existing theories and instruments were either appropriate or inappropriate for measuring the subjective experience of A/R gamebots. Key findings were the importance of differentiating the use case of therapy from that of assistance in rehabilitative technology assessment, the need to incorporate the differing perspectives of children with CP and those of their parents into A/R gamebot evaluation, and the potential conflict between the goals of preserving the quality of the experience of game play for the child while also optimizing the intensity and duration of therapy provided during play.

The Inventory Déjà Vu Experiences Assessment (IDEA) is the only screening instrument proposed to evaluate Déjà vu (DV) experience. Here we intended to validate the Italian version of IDEA (I-IDEA) and at the same time to investigate the incidence and subjective qualities of DV phenomenon in Italian healthy adult individuals on basis of an Italian multicentre observational study. In this study we report normative data on the I-IDEA, collected on a sample of 542 Italian healthy subjects aging between 18 to 70 years (average age 40, range 18-70) with a formal educational from 1-19 years. From September 2013 to March 2016 were recruited 542 healthy volunteers from ten outpatient neurological clinics in ItalyAll participants (i.e family members of neurological patients enrolled, medicine’s student, physicians) had no neurological or psychiatric illness and they gave informed consent to participate in the study. All subjects enrolled had self-administered the questionnaire and they are able to complete I-IDEA test without any support. In total 396 (73%) of the 542 healthy controls had DV phenomenon. The frequency of DV was inversely related to age as well as to derealisation, jamais vu, precognitive dreams, depersonalization, paranormal activity, remembering dreams, travel frequency and daydreams (all P<0.012). The Italian version of IDEA maintains good properties in Italian version, thus confirming that this instrument is reliable for detecting and characterising the DV phenomenon.

The Simultaneous Localization And Mapping (SLAM) scanner is an easy and portable Light Detection And Ranging (LiDAR) data acquisition device. Its main output is a 3D point cloud covering the scanned scene. Regarding the importance of accuracy in the survey domain, this paper aims to assess the accuracy of two SLAM scanners: the NavVis VLX and the BLK2GO Scanner. This assessment is conducted for both outdoor and indoor environments. In this context, two types of reference data are used: the Total Station (TS) and the static scanner Z+F Imager 5016. To carry out the assessment, four comparisons are tested: cloud to cloud, cloud to mesh, mesh to mesh, and edge detection board assessment. However, the results of the assessments confirm that the accuracy of indoor SLAM scanner measurements (5 mm) is greater than that of outdoor ones (between 10 mm and 60 mm). Moreover, the comparison of cloud to cloud provides the best accuracy regarding direct accuracy measurement without manipulations. Finally, based on the high accuracy, scanning speed, flexibility, and the accuracy differences between tested cases, it is confirmed that SLAM scanners are effective tools for data acquisition.

Clinical trials for Alzheimer’s disease (AD) face multiple challenges, such as the high screen failure rate and even allocation of heterogeneous participants. Artificial intelligence (AI), which has become a potent tool of modern science with the expansion in the volume, variety, and velocity of biological data, offers promising potential to address these issues in AD clinical trials. In this review, we introduce the current status of AD clinical trials and topic of machine learning. Then, a comprehensive review is focused on the potential applications of AI in the steps of AD clinical trials, including the prediction of AD biomarkers and differential diagnosis of AD in the prescreen during eligibility assessment and the likelihood stratification of patients who will progress to AD dementia and fast cognitive decline group from the slow decline group in randomization. Finally, this review provides challenges, developments and the future outlook on the integration of AI into AD clinical trials.

Background: The present study analyzes the evaluation of communication skills by standardized patients (SPs) and medical evaluators (Es) in an OSCE setting. Methods: The OSCE involved 189 sixth-year medical students, as well as 34 SPs and 63 Es. Communications skills were evaluated in 8 stations, simultaneously by SPs and Es. The SPs were actors who had been trained in the clinical case and who acted in accordance with a standardized script in a simulated clinical situation. The evaluators, also standardized, were Resident Doctors or staff Doctors from the Hospital Services involved. Results: The global scores awarded to students for communication skills were very similar in both groups, although the score awarded by Es was significantly higher, and a direct relationship was also observed between the mean scores awarded by both groups. Evaluators awarded significantly higher scores than SPs in 7 out of the 10 items on the checklist. Female medical students also scored significantly higher than their male counterparts in many items, including external appearance, listening, cordiality, optimism, interest, expression and empathy. Conclusions: Our data indicate that SPs and Es evaluated communication skills in a similar manner in an OSCE setting, a finding which suggests that health-related professionals can be used as an alternative to SPs, thus helping to lower economic costs. Our study also confirms a gender difference (in favor of women) in the evaluation of communications skills by both groups.Our data indicate that SPs and Es evaluated communication skills in a similar manner in an OSCE setting, a finding which suggests that health-related professionals can be used as an alternative to SPs, thus helping to lower economic costs. Our study also confirms a gender difference (in favor of women) in the evaluation of communications skills by both groups.

The city administration of China planned numerous metro projects and more metros can hardly avoid undercrossing a bridge. While metro shield construction when undercrossing a bridge (MSCUB) is frequently located in complicated natural and social context, which made the construction process more susceptible to safety accidents. Therefore, it is crucial to look into safety risk of MSCUB. The paper identified the safety risk factors during SSCUR by using literature review and experts’ evaluation, proposed a novel safety risk assessment model by integrating CFA and FER, and then selected a project case to test the validity of the suggested model. Research results show that (a) a safety risk factors list of MSCUB was identified, including 4 first-level safety risks and 37 second-level safety risk factors; (b) the proposed safety risk assessment model can be used to measure the risk values of the overall worksite safety risk, the first-level safety risks and the safety risk factors of MSCUB; (c) environment-type safety risk and personnel-type safety risk have higher risk values when shield construction undercrossing a bridge; (d) when compared to worker-type safety risk, manager-type safety risk is the higher risk value. The research can enrich the theoretic knowledge of MSCUB safety risk assessment and provide references to safety managers for conducting scientific and effective safety management on the construction site when subway undercrossing a river.

A review of quantitative risk assessment (QRA) models of L. monocytogenes in produce was carried out, with the objective of appraising and contrasting the effectiveness of the control strategies placed along the food chains. Despite nine of the thirteen QRA models recovered focused on fresh or RTE leafy greens, none of them represented important factors or sources of contamination in the primary production, such as type of cultivation, water, fertilisers or irrigation method/practices. Cross-contamination at processing and during consumer’s handling was modelled using transfer rates, which were shown to moderately drive the final risk of listeriosis; highlighting therefore the importance of accurately representing the transfer coefficient parameters. Many QRA models coincided in the fact that temperature fluctuations at retail or temperature abuse at home were key factors contributing to increasing the risk of listeriosis. In addition to a primary module that could help assess current on-farm practices and potential control measures, future QRA models for minimally-processed produce should also contain a refined sanitisation module able to estimate the effectiveness of various sanitisers as a function of type, concentration and exposure time. Finally, L. monocytogenes growth in the products down the supply chain should be estimated by using realistic time-temperature trajectories, and validated microbial kinetic parameters, both of them currently available in the literature.

A review of the published quantitative risk assessment (QRA) models of L. monocytogenes in seafood was performed, with the objective of appraising the effectiveness of the control strategies placed along the food chain. Whereas all the 13 QRA models retrieved were of short scope, covering at most from end of processing to consumption; the majority (85%) focused on smoked or gravad fish. Since the modelled pathways commenced with the packaged product, none of the QRA models addressed cross-contamination events. Many models agreed on the fact that keeping the product’s temperature at 4.0-4.5 ºC leads to greater reductions in the final risk of listeriosis than reducing the shelf life by one week; and that the effectiveness of both measures can be surpassed by reducing the initial occurrence of L. monocytogenes in the product (at the end of processing). It is therefore necessary that future QRA models for RTE seafood contains a processing module that can provide insight into intervention strategies that can retard L. monocytogenes growth, such as the use of bacteriocins, ad-hoc starter cultures and/or organic acids, and other strategies seeking to reduce cross-contamination at the facilities, such as stringent controls for sanitation procedures. Since risk estimates were shown to be moderately driven by growth kinetic parameters, namely, the exponential growth rate, the minimum temperature for growth, and the maximum population density, further work is needed to reduce uncertainties about them.

Peri-urban forests often have extensive networks of greenways that allow for outdoor recreation. However, information associated with these greenways often does not include their degree of naturalness, which is usually reduced to descriptions of flora and fauna and often overlook the factors that reduce naturalness. Therefore, in some cases, the naturalness of these greenways is not as high as expected. Having a quantification of their naturalness would be useful, especially for hikers interested in appreciating and enjoying nature. Additionally, this information would help outdoor recreation managers to design trails or decide which ones to promote as "greenways". The objectives of this study are (1) to design a method to calculate and map the naturalness of greenways using two approaches, one based on perceptual fieldwork and the other on Geographic Information Systems (GIS); (2) to apply the designed method to a specific greenway; and (3) to compare both methodological approaches. The results show that, for the greenway studied, the naturalness scores obtained are low in all three types of analyses used. Around 70% of the greenway sections in the GIS visibility analysis and 80% in the GIS proximity analysis have a low naturalness index, while this value is reduced to 40% with the fieldwork analysis. Although the results of the GIS approach (proximity and visibility) generate naturalness indices and spatial patterns that are very similar, they differ significantly from those derived from the fieldwork analysis. The discussion of the results suggests that the three methodologies used are valid for analysing the degree of naturalness of the trails, but if used together, it would be possible to add flexibility to the type of variables incorporated in the analysis.

Combination treatment, i.e., the use of two or more drugs for the same condition, is frequent in medicine if monotherapy yields an insufficient therapeutic response. We here review and challenge clinical study designs and formats of reporting outcomes for the evaluation of the benefit/risk ratio of combination treatment over monotherapy. We demonstrate that benefits of combination treatment at the group level over-estimate the probability of benefit at the single patient level based on outcome simulations under almost any imaginable setting. Based on these findings we propose that studies testing combination treatment should always report on percentages of responders to monotherapy and combination treatment. We provide equations that allow calculation of the percentage of patients truly benefitting from combination (responders to both monotherapies) and that of patients exposed to risk of harm from adverse effects without a reasonable expectation of individual benefit. These considerations are explained based on real clinical data, mostly from the field of functional urology (male lower urinary tract symptoms).

One of the main drivers behind the urbanization process is attributed to economic fundamentals of urban growth, which boost migration from rural to urban context. This migration can be studied geographically, with increasing rates of population as the main component in developing countries, over Asia and Africa, specifically. Research has been focusing in creating models and adaptative schemes to manage and plan cities to promote sustainable development for housing large quantities of population and preserve a long-term living environment. The approach from a smart city perspective, adjusted to the rapid urbanization condition can be helpful to deal urban issues by convergence and interaction between urban agents and information technology. At academia, few works have addressed the role of Smart Cities to face the challenge of rapid urbanization. The aim of this study is to research and analyze if strategies with smart city vision can lessen environmental impacts at cases with rapid urbanization, and how can we leverage technology to promote environmental sustainability at rapid urbanization phenomena occurring at developing countries using RIAM environmental assessment method in the case of Beijing, China'.

Material efficiency is a key element of new thinking to address the challenges of reducing impacts on the environment and of resource scarcity, whilst at the same time meeting service and functionality demands on materials. Directly related to material efficiency is the concept of the Circular Economy, which is based on the principle of optimising the utility embodied in materials and products through the life cycle. Whilst steel, as a result of high recycling rates, is one of the most ‘circular’ of all manufactured materials, significant opportunities for greater material efficiency exist, which are yet to be widely implemented. In the field of Life Cycle Management, Life Cycle Assessment (LCA) is commonly used to assess the environmental benefits of recovering and recycling materials through the manufacturing supply chain and at end-of-life. As well as containing information to calculate environmental impacts, LCA models also provide the flows of materials through the product life cycle and can also be used to quantify material efficiency and the circularity of a product system. Using an example taken from renewable energy generation, this paper explores the correlation between product circularity and the environmental case for strategies designed to improve material efficiency. An LCA-based methodology for accounting for the recovery and re-use of materials from the supply chain, and at end-of-life, is used as the basis for calculating the carbon footprint benefits of five material efficiency scenarios. Resulting carbon footprints were then compared with a number of proposed material circularity indicators. Two conclusions from this exercise were that i) LCA methodologies based around end-of-life approaches are well placed for quantifying the environmental benefits of material efficiency and circular economy strategies and ii) when applying indicators relating to the circularity of materials these should also be supported by LCA studies.

Coastal inundation is an increasing problem. Sea-level rise will greatly increase the frequency and depth of inundation, forcing vulnerable communities to adapt. Communities will need to decide when and how to adapt. The process of decision-making along adaptive pathways is now being used internationally to plan for adaptation over time by anticipating decision points in the future however it unfolds. This process requires risk and uncertainty considerations to be transparent in the scenarios used in such planning. We outline a framework for uncertainty identification and management within coastal hazard assessments which recognizes different types of decision and identifies the types of uncertainty that must be accounted for, such as statistical, scenario and deep uncertainty types. We show how coastal-inundation hazard can be mapped and presented in a way that clearly separates sources of uncertainty, so that they are transparent within a dynamic adaptive pathways planning process. Traditional coastal inundation maps show inundated area only. We present maps of inundation depth and frequency which clearly show the degree of exposure, where that exposure occurs, and how much sea-level rise can be tolerated. The new uncertainty framework and mapping techniques can better identify decision points and their expected time range, which provides more useful input to the adaptation process than traditional coastal inundation assessments.

Municipal solid waste management is a major concern for developing countries all over the world. The collection and transportation accounts for major portion of expenditure in developing country like India. The compaction of waste is being practiced in some major cities of India as they provide economical benefit but the environmental benefits of compaction are not very clear. The preset study evaluates the environmental impacts due to transportation of non-compacted and compacted waste from the transfer station to the landfill site using life cycle assessment approach. The study compared transportation of non-compacted waste with the waste compacted by the truck mounted refuse compactor and portable stationary compactor. The functional unit defined was the amount of waste generated per day in the study area taken as Patna city and GaBi 10.5 used for impact assessment. The study found that the transportation of waste compacted by truck mounted refuse compactor had the least environmental impacts on all impact categories. The study recommends the compaction of waste by the truck mounted refuse compactor and then proceed for transportation. Also, the compaction of waste is recommended as it improve the overall environment performance of municipal solid waste management.

The purpose of this study was to select target nutrients to be included in the nutritional standards of school lunches in Korea. The dietary intake data of children and adolescents aged 6-17 years old from the Korea National Health and Nutrition Examination Survey Ⅵ were analyzed for eight groups based on gender and age (6-8, 9-11, 12-14, and 15-17 years old). First, the usual intake of the 3,091 subjects was estimated and assessed to identify nutrients with insufficient or excessive intake prevalence. Along with the nutrients identified by the assessment, the energy and nutrients prioritized in the meal planning procedure of the 2015 Dietary Reference Intakes for Koreans were the initial candidates: energy, the percentages of energy from carbohydrates, protein, and fat, vitamin A, riboflavin, niacin, vitamin C, calcium, phosphorus, sodium, and iron. Phosphorus was excluded due to little evidence of clinical symptoms caused by insufficient intake. Sodium was excluded because reliable data on added salt were not available among the school lunch recipes in Korea. Therefore, energy, the percentages of energy from carbohydrates, protein, and fat, vitamin A, riboflavin, niacin, vitamin C, calcium, and iron were selected to be included in the nutritional standards of school lunches in Korea.

Putting value to ecosystem services is something that society still refuses or simply ignores because it is not aware of the benefits that ecosystems provide us. In fact, people should be aware that a good understanding of ecosystem services can lead to win-win situations. Being aware of the importance of preserving the ecosystem and attaching value to its services will enable the development of self-sustaining strategies and appropriate policies for better ecological governance. Decades of over exploitation of natural resources, introduction and spread of alien species and, also, climate change, forest fires among other threats, have fostered biodiversity loss. The European Union Biodiversity Strategy has as one of its main goals to stop biodiversity loss and the degradation of ecosystem services; if possible, to recover the most threatened and degraded ecosystems, based on 20 Actions divided into 6 Targets. The present work falls within the scope of Action 5 of Target 2 – Improve knowledge of ecosystems and their services in the EU. The specific focus of this study is the Site of Community importance “Dunas de Mira, Gândara and Gafanhas” (Portugal) and the assessment of its ecosystem services, in accordance with the methodology proposed by the MAES (Mapping and Assessment of Ecosystems and their Services) Working Group. The work currently under way, a small segment of which is presented here, aims to identify, map and, when possible, assign value to the ecosystem services. For this purpose, modern GIS technologies will be used. This approach was implemented using a combination of data and tasks, including the photo-interpretation of Sentinel 2 (COPERNICUS Program) satellite imagery. The data geoprocessing tasks and image segmentation were developed using QGIS software and IMPACT Toolbox software (developed by the Joint Research Center – JRC, of the European Union), respectively. The analysis of Land Use and Burned Areas maps for the SCI "Dunas de Mira, Gândara and Gafanhas" led us to conclude that Forests ecosystems, the most affected by the fire of October 2017, continue to have the greatest expression in the area under study even though they have lost more than 50% of the area, and their services were also the ones most affected by the fire.

The wastewater circular economy (WW-CE) promises a solution to improve water and sanitation management worldwide. However, the transition from conventional to circular wastewater treatment plants (WWTPs) requires facilitation to aid in decision makers understanding of integral sustainability impacts of alternative WW-CE configurations. This research implemented Life Cycle Sustainability Assessment (LCSA), combining Life Cycle Assessment, Social Life Cycle Assessment and Life Cycle Costing with a Multi-criteria Decision Making (MCDM) model to quantify environmental, socio-cultural, and economic impacts of conventional WWTPs with the WW-CE. Two real WWTPs in Chile have embraced the WW-CEs and adopting the title of Biofactories. These were considered as case studies, compared under three scenarios to demonstrate the sustainability trade-offs of the transition from no sanitation to conventional WWTPs and Biofactory WW-CE configurations. Results demonstrated that the transition to WW-CEs improved integral sustainability according to the LCSA model implemented in both WWPTs. This study highlights the urgent need to adopt sustainable decision-making models to not only improve sanitation coverage, but also improve sustainability performance of the sanitation industry across the globe.

There is a need to assess the knowledge of healthcare providers on the use of maternal analgesics during lactation, while a valid instrument is not yet available. This study aimed to develop a valid and reliable questionnaire on the knowledge of analgesics (acetaminophen, ibuprofen, aspirin, tramadol, codeine, oxycodone) during lactation, using a prospective, stepwise approach. To generate a pool of item subgroups, literature was assessed as first step. This preliminary version was subsequently reviewed in two focus groups [midwives (n=4), pediatric nurses (n=6)], followed by an expert panel (n=7, 2 rounds) to confirm content validity [item-level and scale content validity]. This resulted in a instrument consisting of 33 questions, and 5 clincial case descriptions specific for both disciplines. Based on known-groups validity between midwives and pediatric nurses (assuming an a priori difference related to their curricula), high construct validity was subsequently demonstrated in a pilot e-survey (86 midwives, 73 pediatric nurses). We therefore conclude that an instrument to assess knowledge on lactation-related exposure to analgesics was generated, that can be further developed and validated. Furthermore, pilot findings suggest suboptimal knowledge for both professions, so that adaptations in their curricula and postgraduate training are warranted.

Heavy metals are toxic, persistent and non-degradable. After sedimentation and adsorption, they accumulate in water sediments. The aim of this study was to understand the heavy metal pollution of Qinjiang River sediments on the ecological environment and apportioning sources. The mean total concentrations of Mn, Zn, Cr, Cu, and Pb are 3.14, 2.33, 1.39, 5.79, and 1.33 times higher than the background values, respectively, except for the Co, Ni, and Cd, which are lower than the background values; Fe, Co, Ni, Cd, Cr, Cu, and Pb are all primarily in the residual state, while Mn and Zn are primarily in the acid-soluble and oxidizable states, respectively. Igeo, RI, SQGs and RAC together indicate that the pollution status and ecological risk of heavy metals in Qinjiang River sediments are generally moderate; among them, Fe, Co, Ni, Cd, Cr, and Pb are not harmful to the ecological environment of the Qinjiang River. Cu is not readily released because of its higher residual composition, depicting that Cu is less harmful to the ecological environment. Mn and Zn, as the primary pollution factors of the Qinjiang River, are harmful to the ecological environment. This heavy metal pollution in surface sediments of the Qinjiang River primarily comes from manganese and zinc ore mining. Manganese carbonate and its weathered secondary manganese oxide are frequently associated with a significant amount of residual copper and Cd, as a higher pH is suitable for the deposition and enrichment of these heavy metals. Lead-zinc ore and its weathering products form organic compounds with residual Fe, Co, Cr, and Ni, and their content is related to salinity. The risk assessment results of heavy metals in sediments provide an important theoretical basis for the prevention and control of heavy metal pollution in Qinjiang River.

Some herbicides exert hormetic or biphasic non-monotonic dose-response (NMDR), which is one of the major challenges for ecological risk assessment (ERA) of pesticides pollution. In this study, fish embryo toxicity test (FET) with Javanese medaka (Oryzias javanicus) to sublethal concentration of diuron was determined. Inverted U-shape heart rate was observed at 3 days post-exposure (dpe) and 7 dpe. However, at 13 dpe the heart rate (104 ± 2.90 heartbeat/min.) decreased in 10.00 mg.L-1 exposed-embryos. At 20 dpe, hatchability and survival rate were reduced in 5.00 mg.L-1 and 10.00 mg.L-1 exposed groups. Hormetic developmental deformities were observed in embryo-larvae of Javanese medaka. The results revealed a biphasic effect of low concentrations of diuron on some morphological and physiological features of Javanese medaka embryo-larvae, which might be attributed to endocrine disruption of this herbicide. Further studies to support these effects were recommended.

Purpose: To identify factors linked with nutritional risk via the Malnutrition Universal Screening Tool scale assessment among critically ill patients from a hospital in Cali (Colombia). Materials and methods: A retrospective, analytical observational study was conducted with patients admitted to an intensive care unit (ICU). Sociodemographic, clinical, hematological, and biochemical parameters were analyzed, as well as their association with nutritional risk and patient mortality. Binary logistic regression was applied to outline nutritional risk. Results: Overall, 28.4% prevalence of elevated nutritional risk was observed. An association was found between nutritional risk and hemoglobin and hematocrit values, primary diseases accounting for ICU admission, gastrointestinal symptoms, and nutritional support route (p < 0.05). Mortality was 11.6% and it was correlated with nutritional risk, hemoglobin, and blood urea nitrogen. Conclusions: Gastrointestinal symptoms and the type of nutritional support received during hospitalization may increase nutritional risk, whereas polycythemia was a protective factor. We found an associative model to determine nutritional risk with high specificity and an adequate diagnostic validity index.

Optic nerve sheath diameter (ONSD) can help predict the neurologic outcome of patients with post-cardiac arrest (CA) return of spontaneous circulation (ROSC). We aimed to investigate the effect of ONSD changes before and after CA on neurologic outcomes in patients with ROSC after CA using brain computed tomography (CT). The study included patients hospitalized after CA, who had undergone pre- and post-CA brain CT from January 2001 to September 2020. The patients were divided into good and poor neurologic outcome (GNO and PNO, respectively) groups based on the neurologic outcome at hospital discharge. We performed between-group comparisons of the amount and rate of ONSD changes on brain CT and calculated the area under the curve (AUC) to determine their predictive value for neurologic outcomes. Among the 96 enrolled patients, 25 had GNO. Compared to the GNO group, the PNO group showed significantly higher amount (0.30 vs. 0.63 mm; p=0.030) and rate of change (5.26 vs. 12.29 %; p=0.041). The AUC for predicting PNO was 0.64 (95% CI=0.53–0.73; p=0.04) and patients with a rate of ONSD change &gt;27.2% had PNO with 100% specificity and positive predictive value. Hence, ONSD changes may predict neurologic outcomes in patients with post-CA ROSC.

Endemic freshwater fish from semiarid environments are among the most threated species in the world due to the water overexploitation and habitat fragmentation problems. Stepped or pool-type fishways are used worldwide to reestablish longitudinal connectivity and mitigate fish migration problems. Many of them are being installed or planned in rivers of semiarid environments, however, very few studies about fish passage performance through pool-type fishways has been carried out to date on these regions. The present work focuses on the passage performance of two potamodromous cyprinids endemic of these regions, with different ecological and swimming behavior: southern Iberian barbel (Luciobarbus sclateri) and Iberian straight-mouth nase (Pseudochondrostoma polylepis), in two of the most common types of stepped fishways: vertical slot and submerged notch with bottom orifice fishways. Experiments were carried out during the spawning season in the Segura River (South-Eastern Spain), using a PIT tag and antennas system. Ascent success was greater than 80%, with a median transit time lower than 17 minutes per meter of height in all trials and for both species and fishway types. Results show that both types of fishways, if correctly designed and built, provide interesting alternatives for the restoration of fish migration pathways on these regions.

Cash crops are agricultural crops intended to be sold for profit as opposed to subsistence crops, meant to support the producer, or to support livestock. Since cash crops are intended for future sale, they translate into large financial value when considered on a wide geographical scale, so their production directly involves financial risk. At a national level, extreme weather events including destructive rain or hail, as well as drought, can have a significant impact on the overall economic balance. It is thus important to map such crops in order to set up insurance and mitigation strategies. Using locally generated data -such as municipality-level records of crop seeding- for mapping purposes implies facing a series of issues like data availability, quality, homogeneity etc. We thus opted for a different approach relying on global datasets. Global datasets ensure homogeneity and availability of data, although sometimes at the expense of precision and accuracy. A typical global approach makes use of spaceborne remote sensing, for which different land cover classification strategies are available in literature at different levels of cost and accuracy. We selected the optimal strategy in the perspective of a global processing chain. Thanks to a specifically developed strategy for fusing unsupervised classification results with environmental constraints and other geospatial inputs including ground-based data, we managed to obtain good classification results despite the constraints placed. The overall production process was composed using ``good-enough" algorithms at each step, ensuring that the precision, accuracy, and data-hunger of each algorithm was commensurate to the precision, accuracy, and amount of data available. This paper describes the tailored strategy developed on the occasion as a cooperation among different groups with diverse backgrounds, a strategy which is believed to be profitably reusable in other, similar contexts. The paper presents the problem, the constraints and the adopted solutions; it then summarizes the main findings including that efforts and costs can be saved on the side of Earth Observation data processing when additional ground-based data are available to support the mapping task.

The effects of climate change on yield and quality for different climate regions had high uncertainty. Risk assessment is an effective measure to assess the seriousness of the projected impacts for decision-makers. The modified quality model was used to simulate integrated impacts of climate change, environment and management on wheat yield and quality. Then, the Canadian Earth System Model (CanESM2) was used to forecast the daily meteorological data, and Statistical Down Scaling Model was used for downscaling. CERES-Wheat was combined with the forecasted meteorological data to simulate the future wheat yield and grain protein concentration (GPC). The risk of wheat yield and quality in three climatic regions of Shaanxi combined with two climate change scenarios of CanESM2 were assessed. Temperature increased 0.22-3.34 °C and precipitation increased 10-60 mm for RCP4.5 and RCP8.5. Elevated temperature and precipitation had positive effects on yield in all regions. The yield risk of most regions with climate change decreased 3.8%-25.1%. The GPC risk of all regions with climate change decreased 7.3%-27.2%. Irrigation decreased yield risk greatly in all regions, while had totally different effects for the three climatic regions. Yield risk with irrigation decreased 37.7%-52.1% in different climate. In contrast to previous studies, GPC risk with irrigation increased greatly 25.8%-28.9% in humid region, 3.9%-8.8% in sub-humid region, and decreased 37.7%-52.1% in semi-arid region. Climate change decreased yield risk and GPC risk together. While irrigation decreased yield risk greatly in all regions, had totally different effects for the three climatic regions.

Circular economy has recently emerged as a key strategy for promoting sustainability and reducing waste in various industrial sectors. This paper provides an overview of circularity in aerospace, wind energy, transportation, automotive and sports goods using data and information from the literature and the EC funded project "RECREATE". The survey reviews the different definitions, assessment methods and metrics used to explore and evaluate circularity, including assessment frameworks such as Life Cycle Assessment (LCA) and assessment indicators. Furthermore, explores the challenges, possibilities and the available tools for enhancing circularity, such as digital tools. The survey highlights the importance of a holistic and systemic technique to circularity, concerning all stakeholders along the value chain. Overall, this study aims to contribute to a better understanding of circular economy and provides insights for future research.

Past exploration for U deposit in the Philippines discovered the mineralization of radioactive allanite in Palawan. The allanite occurs as sand component in the heavily populated beach of Erawan, San Vicente, Palawan. This work assessed the risks associated with the radionuclides in Erawan beach by in situ ground radiometric survey of K, U, and Th in 694 sampling points. Principal component analysis (PCA) and Pearson correlation coefficient were used to determine the similarity between the radionuclides and to identify other probable anthropogenic sources of radionuclides. Our results show that the mean activity concentrations of K (597.8 Bq kg^-1) and Th (93.15 Bq kg^-1) are equivalent to 1.5 and 3.1 times of the world average natural radioactivity levels in soil, respectively, while the mean U (34.7 Bq kg^-1) is similar to the world average. The mean radiological risk assessments like radium equivalent, gamma specific activity index, external hazard index, internal hazard index, absorbed gamma dose rate, annual effective dose equivalent, annual gonadal equivalent dose, and excess lifetime cancer risk are 213.96 Bq kg^-1, 0.78, 0.58, 0.67, 97.24 nGy h^-1, 119.25 µSv y^-1, 684.39 µSv y^-1, and 0.42 (10^-3), respectively. Th consistently correlated most to the risks. We attribute the occurrence of Th to the presence of allanite, K to fertilizer use for farming, and U to both the allanite and farming. The results of our study can provide important baseline data for future detailed studies or monitoring of the long-term effects of elevated radiation levels to the local population of Erawan.

Considering the manufacturing of automotive components, there exists a dilemma around the substitution of traditional Cast Iron (CI) with lighter metals. Nowadays, aluminium alloys, being lighter compared to traditional materials, are considered as a more environmentally friendly solution. However, the energy required for the extraction of the primary materials and manufacturing of components is usually not taken into account in this debate. In this study, an extensive literature review has been performed to estimate the overall energy required for the manufacturing of an engine cylinder block using (a) cast iron and (b) aluminium alloys. Moreover, data from over 100 automotive companies, ranging from mining companies to consultancy firms, have been collected in order to support the soundness of this investigation. The environmental impact of the manufacturing of engine blocks made of these materials is presented with respect to the energy burden; the “cradle-to-grave approach” has been implemented to take into account the energy input of each stage of the component lifecycle starting from the resource extraction and reaching to the end-of-life processing stage. Our results indicate that although aluminium components contribute towards reduced fuel consumption during their use phase, the vehicle distance needed to be covered in order to compensate for the up-front energy consumption related to the primary material production and manufacturing phases is very high. Thus, the substitution of traditional materials with lightweight ones in the automotive industry should be very thoughtfully evaluated.

The study is devoted to analyzing the economic sustainability of the town of Amherst, MA. The city's top employer and core enterprise is the University of Massachusetts Amherst, with over 32,000 students and almost 2,000 staff members. Based on a literature review, a hypothesis was put forward that a university city should have a high level of economic sustainability. To assess economic sustainability, the USCESI Index was developed. It evaluates sustainability in three groups of parameters: society, economy, and ecology. The first group includes the level of racial diversity, the level of education of the population, and the access to medical services. The second group consists of the Gini coefficient by income level, the median cost of housing, and the unemployment rate. The environmental situation is assessed according to the Air Quality Index developed by the US Environmental Protection Agency. For comparison, the town of Braintree, MA, was taken. The USCESI was calculated for both locations. The analysis showed that both Amherst and Braintree have a high degree of economic sustainability. However, it was revealed that proximity to a significant economic center has a more powerful positive impact on economic sustainability than the location of a large university.

Lymphedema is a chronic and debilitating disease that affects up to 250 million patients worldwide. Recent advances in understanding its pathophysiology, along with improved diagnosis and microsurgical techniques, have enhanced our ability to cope with the challenging task of treating this disease. This review provides an overview of the disease from a surgeon's point of view, including existing imaging modalities used for preoperative assessment, as well as surgical procedures used in its treatment. Advantages and drawbacks of various existing modalities used for pre or intraoperative assessment of lymphatic vessels are discussed. Lymphedema treatment has shifted from palliative debulking procedures (liposuction and direct excision) to those aimed at restoring lymphatic flow and countering the pathophysiology of the disease (lymphaticovenous anastomosis and vascularized lymph node transfer). A combination of both approaches can result in a synergistic benefit for patients and are discussed in this review. Despite recent advances, some controversies persist, and further studies are needed to better define surgical treatment algorithms.

Post-extubation dysphagia (PED) can lead to serious health problems in critically ill patients. Contrasting its high incidence rate of 12.4% reported in a recent observational study, many ICUs lack routine bedside screening, likely due to limited awareness. This study aimed to establish baseline data on the current approaches and the status of perceived best practices in PED screening and treatment, as well as to assess awareness of PED. A nationwide cross-sectional, online survey was conducted in all fourteen adult ICUs in the Republic of Cyprus in June 2018, with a 100% response rate. Over 85% of ICUs lacked a standard screening protocol for PED. The most commonly reported assessment methods were cough reflex testing and the water swallow test. Treatment approaches included muscle strengthening exercises without swallowing and swallowing exercises. Only 28.6% of ICUs acknowledged PED as a common issue. The study identified significant gaps in awareness and knowledge regarding PED screening and treatment in Greek-Cypriot ICUs. Urgent implementation of comprehensive dysphagia education programs within the units is necessary, and interdisciplinary collaboration among nurses, intensivists, and speech and language therapists is crucial to improve the quality of care provided.