Severe asthma patients are at increased risk of major exacerbations and they need to be monitored regularly. The COVID-19 pandemic has impressively impacted on the health care resources. The telemedicine approach applied to the follow-up of asthmatic patients has been proved to be effective in monitoring their disease and adherence to the therapy. The aim of our study was to investigate the satisfaction of severe asthma patients, before the activation of a telemedicine management complemented by a standard of care. An ad hoc questionnaire was developed and sent by e-mail to 180 severe asthma patients. Most of subjects (82%) were confident with the idea of doing self-measurements and self-managing their disease; 77% of subjects favoured to carry out virtual visit and telemedicine. 93% of patients considered easy the self-injection therapy. 94% of subjects felt safe and 93% were not worried while self-administering. Only mild adverse events were reported in 22% subjects after self-administration. Our results showed an agreement between what is considered necessary and practicable by healthcare personnel and what is perceived by the severe asthma patients, in terms of treatment and monitoring of the disease with Telehealth. Biologics have a safety profile and can be easily self-administred at home

This study aims to provide a comprehensive analysis of the More Light for Amazon (MLA) program, examining the roles played by each stakeholder involved in the concession process and identifying the limitations faced for program success. The research employs a content analysis methodology, analyzing a variety of documents, including the Program Operational Manual, Commitment Terms, news articles, and concessionaires' notes. The findings reveal the crucial role of the government as an inducer of actions, establishing objectives and guiding norms for the private sector. Conversely, concessionaires assume the role of program implementers but encounter specific limitations in remote locations, challenging the provision and maintenance of the electrical system in beneficiary communities. The implementation of microgrid systems through concessions enhances coordination and integration between generation and distribution services, allowing for increased government control and ensuring transparency, efficiency, and program effectiveness. These identified elements represent significant challenges for the implementation of public policies in remote regions of the Amazon. Overcoming these challenges take coordinated and strategic actions involving both the government and concessionaires to ensure the complete fulfillment of energy needs in MLA program beneficiary communities.

Background: Tilmicosin, a macrolide antibiotic, has the potential to treat bacterial respiratory infections in donkeys. However, the pharmacokinetics of tilmicosin in donkeys have not been reported. Objectives: The aim of this study was to investigate the pharmacokinetics of tilmicosin in donkey plasma, urine and feces after a single intragastric administration to determine the suitability of tilmicosin for donkeys. Animals: A total of 4 healthy fattening male donkeys were selected with body weights of 148, 140, 145, and 135 kg, with an average body weight of 142.00 ± 4.95 kg. Methods: The donkeys were administered intragastrically a single dose of 10 mg·kg-1 BW tilmicosin. Blood, urine and fecal samples were collected. The concentrations of tilmicosin in plasma, urine, and feces were determined using high-performance liquid chromatography-tandem masss pectrometry. Results: After a single intragastric administration of 10 mg·kg-1 body weight, tilmicosin in donkey plasma reached a maximum concentration of 11.23 ± 5.97 mg·L-1 at 0.81 ± 0.11 h, with a mean residence time of 8.05 ± 2.44 h, a Cl/F of 0.48±0.22 L·kg-1·h-1, and a Vd/F of 9.28 ± 4.10 L·kg-1. The percentage of tilmicosin excreted through the urine of donkeys is (2.47±0.43)%, and the percentage excreted through the feces is (66.43±8.65)%. Conclusions: A single intragastric administration of 10 mg·kg-1 BW of tilmicosin to donkeys was rapidly absorbed and was able to achieve plasma concentrations of against pathogenic bacteria.

This study investigated the influence of nutrient inputs and their timing on saffron yield and quality. The study was conducted from 2016 to 2020 and involved the application of eight different fertilization treatments at various stages of saffron growth. These treatments included single doses in Autumn (A), Winter (W), and Spring (S); double doses in Winter-Spring (AW), Autumn-Spring (AS), and Winter-Spring (WS); and a triple dose in Autumn-Winter-Spring (AWS). A control group (C) received no fertilizer. A compound fertilizer with a 15-15-15 composition was applied across all treatments, with nitrogen (N) rates of 67.5 kg/ha for single doses (A, W, S), 135 kg/ha for double doses (AWF, ASF, WSF), and 202.5 kg/ha for the triple dose (AWSF). Similar rates were applied for phosphorus (P) and potassium (K). The findings demonstrated that fertilization generally enhanced saffron attributes. The triple dose treatment yielded the most effective results. The timing of fertilization also played a crucial role, as split applications during different growth stages led to higher production especially winter fertilization. However, spring fertilization had limited impact due to decreased plant activity and reduced nutrient absorption during that period. Although the yield increased, the qualitative aspects of saffron, including color (crocin), taste (picrocrocin), and aroma (safranal), were not significantly influenced by the fertilization treatments. Nevertheless, these attributes remained within the natural limits defined by ISO-3632, indicating that fertilization practices did not compromise saffron quality. Our study highlights the significance of nutrient inputs and their timing in optimizing saffron yield. It provides valuable insights for developing efficient fertilization programs to enhance saffron production while preserving its quality characteristics.

Home-dwelling older people without health services might develop health issues and challenges. To live longer at home and manage well, it is important to promote health-promotion towards this target group. One approach is through health-promotion dialogues conducted by healthcare professionals in the municipality. The aim of this study is to explore healthcare professionals’ experiences who are conducting health-promotion dialogues to older home-dwellers over 75 years without services. Focus-groups were used to collect data, and a total of nine participants formed three focus groups. Thematic analysis was applied to analyse the material, which resulted in one major theme “The challenging dialogues” comprising three sub-themes, “Mobilise coping skills and health awareness”, “Uncover vulnerability”, and “The ambiguity of the dialogues”. The findings were also discussed by using empowerment as a theoretical lens. The health-promotion conversation uses a resource perspective for elderly to remain independent in old age and can reveal vulnerability and underlying needs. The conversation purpose appears ambiguous for the target group, which leads to unclear service expectations and rejections of the offer. Nevertheless, it seems to be important that this health-promotion service to a larger degree addresses a clear purpose in order to meet the needs of the target group in a broader sense in the aging process.

Agroforestry homegardens are integrated arrangements of common vegetable plants in areas close to residences, which follow a structure similar to that of tropical forests, with the cultivation of multiple species to meet the basic needs of families, such as the provision of food and medicine, as well as ensuring an environment for other family activities. Considering the importance of these environments, this work aimed to address the composition and use of plant species in agroforestry homegardens, in order to support society initiatives and government policies to strengthen the management of natural resources and individual and collective well-being in the region. For this, 119 homegardens were studied in the municipalities of Belterra, Mojuí dos Campos and Santarém, in the state of Pará, in the Brazilian Amazonia, comprising five different zones (peri-urban, urban, floodplain, indigenous land and tourist land), obtaining the data via questionnaires and guided visitation by the residents. A total of 5,323 vegetal individual plants were surveyed, distributed in 188 species and 62 botanical families. The data showed that 80.5% of the individual plants are concentrated in 18.6% of the species, with no significant difference in the average of species per homegarden in the five zones. The predominance of species for food use, primarily fruit-bearing, stands out, showing a possible direction for incentive actions and/or for the ordering of public policies and programs aimed at these spaces. Most homegardens have up to 17 plant species; less than half of homegardens have species intended for medicinal use; and there is percentage parity between native plant species and those of exotic origin, where native plants stand out for shading. Agroforestry homegardens play a crucial role in the conservation and cultivation of species for food purposes, with the cultivation or maintenance of plants based on their various purposes, showing distinct profiles of distribution and choice of species, evidencing their socioeconomic and environmental importance. Thus, it is important that these land use systems are valued, investing financial resources in actions and projects aimed at maintaining and enhancing their benefits for the region.

As there is lack of understanding about the effect of transitioning between different flooring materials on the gait of older adults, this study investigated the effect of transitioning between a carpeted floor and a vinyl floor on the gait characteristics of older adults. Fourteen older (65 years old and over) and 14 younger (18 to 35 years old) adults walked on different transitional floors by measuring various gait parameters. While the older participants had greater toe clearance than their younger counterparts, the older participants had smaller toe clearance on a carpeted floor than on a vinyl floor, which would increase the probability of a trip-induced fall. Further, the study found the slower transitional acceleration of the whole body COM and the increased friction demand, especially during the toe-off phase, rather than heel contact phase, which will lead to a slip-induced fall on a vinyl floor shortly after transitioning from a carpeted floor to a vinyl floor. Although the increased likelihood of a slip or trip accident was found throughout the changes in gait parameters, the older participants did not perceive of slipping and tripping much. Therefore, older adults are recommended to be made aware of the danger of slipping and tripping while transitioning between different flooring materials.

This paper explores Ghana's two-decade journey in developing a digital land information system (LIS), exemplified by Ghana Enterprise Land Information System (GELIS) and Enterprise Land Information System (ELIS). Despite advancements by Ghana’s Lands Commission, manual processes persist and coexist with digital ones. Our study uses a qualitative approach to assess the effectiveness of the LIS implemented in Accra. The study found that Accra’s LIS is highly aligned with clear institutional mandates, roles, and responsibilities as well as the availability of laws and policies to support analogue to digital conversion. Furthermore, a robust approach for protecting data, operating system and software underpins the system. Subsequently, the integration of a digital LIS has enhanced service delivery and accountability. Nonetheless, Accra’s LIS is still at the beginning of a comprehensive learning and development curve. To sustain the LIS requires furtherance in the implementation plan, funding, law implementation, ICT strategy, divisional integration, work processes, data quality, and communication strategy. These findings will inform the next steps of improvement for Accra's LIS and guide its nationwide scaling, contributing to discussions on technology acceptance dynamics in predominantly analogue environments.

Background Multilineage-differentiating stress-enduring (Muse) cells are newly established pluripotent stem cells. The aim of the present study was to examine the potential of the systemic administration of Muse cells as an effective treatment for subacute SCI. Methods: We intravenously administered the clinical product “CL2020” containing Muse cells to a rat model two weeks after mid-thoracic spinal cord contusion. Eight experimental animals received CL2020 and 12 received the vehicle. Behavioral analyses were conducted over 20 weeks. Histological evaluations were performed. After 20 weeks of observation, diphtheria toxin was administered to 3 CL2020-treated animals to selectively ablate human cell functions. Results: Hindlimb motor functions significantly improved from 6 to 20 weeks after the administration of CL2020. The cystic cavity was smaller in the CL2020 group. Furthermore, larger numbers of descending 5-HT fibers were preserved in the distal spinal cord. Muse cells in CL2020 were considered to have differentiated into neuronal and neural cells in the injured spinal cord. Neuronal and neural cells were identified in the gray and white matter, respectively. Importantly, these effects were reversed by the selective ablation of human cells by diphtheria toxin. Conclusions: Intravenously administered Muse cells facilitated the therapeutic potential of CL2020 for severe subacute spinal cord injury.

Patients satisfaction with fast and high-quality services is the most important in the healthcare settings and specially in outpatient departments and private clinics. High quality services on health sector are indicated by continuous quality improvement (CQI). CQI is a progressive incremental process focused on safety of all participants, outcomes, systematic process, regulated and improved working environment at the later than earlier stages. Among the various suggested strategies, we adopted the patents feedback to improve the quality of services our clinic. All of the patient visited hospital were sent a massage on mobile and requested to provide their feedback on our services. Roughly around 5% of all visitors responded and filled up questionnaire. Majority of them were satisfied with the services in various department. However, they provided us some suggestions to identify the further gaps and improve the services in improving patients experience at our clinic. We considered their feedback, identified problems, redesigned the policies and implemented. After implementation of new strategies, we preliminary again evaluated the patients’ feedback on our services. Patients feedback explores that optimized methods of services for the has considerably increased the patients’ satisfaction. Taken together, our this shows that patients’ feedback is very important factor to improve patients’ experience at outpatient clinics using continuous quality improvement tools. For that reason, this study would serve as reference for public health stack holders, administrators and researchers.

Management of tumor lysis syndrome (TLS) associated with cancer chemotherapy for malignant tumors is important because of its potentially fatal course. The use of rasburicase, a recombinant urate oxidase, is recommended for TLS; however, because rasburicase is an enzymatic drug, one should be cautious of anaphylaxis during administration. Using claims data in Japan, we investigated the rate of rasburicase re-administration and the occurrence of anaphylaxis during re-administration in patients with hematopoietic malignancies in a multicenter setting. Re-administration of rasburicase was defined as administration after an interval of 21 days from the first dose. Of 373 patients, 18 were re-administered with rasburicase (re-administration rate: 4.8%). No patient developed anaphylaxis. The median number of days from the first to the last dose of rasburicase was 256.5 days (interquartile range: 138.8–455.8 days). The median daily dose was 7.5 mg (4.5–11.3 mg), and the median total dose was 33.8 mg (19.1–64.1 mg). This claims database analysis revealed that the re-administration rate of rasburicase was low in Japanese patients with hematopoietic malignancies, suggesting that rasburicase was being used appropriately, and that associated anaphylaxis was not observed.

The major global pressures of rapid urbanization and urban growth are compounded by climate impacts resulting in increased vulnerability for urban dwellers, with these vulnerabilities exacerbated during COVID-19. Much of this is concentrated in urban and peri-urban areas where urban development spreads into hazard-prone areas. Often this development is dominated by poor quality homes in informal settlements or slums with poor tenure security. Lessons from a current resilience-building project shows that the fit-for-purpose (FFP) approach to land administration can provide a solution to increase the number of households with security of tenure and improve resilience outcomes as informal settlements grow. This paper discusses the influence of FFP land administration on vulnerabilities to multiple shocks related to climate change and COVID-19. This paper proposes ways the growth of human settlements can be better managed through responsible governance of land tenure rights, and effective land-use planning to improve resilience to different shocks and stresses and provide adequate access to safe land and shelter. Land administration systems can support improved resilience to the multiple stressors of climate and pandemics through improving tenure security and enhancing land use planning controls. Climate change adaptation and risk management need to be better mainstreamed into two major elements of land governance: (i) securing and safeguarding of land rights, and (ii) planning and control of land-use.

(1) Background: There is not much research about obesity in nursing homes although knowledge will help us to develop customized treatment plans and prevention strategies, which may help to decrease the burden for all persons involved. The objective of conducting this study was to describe the prevalence of obesity and the association between obesity and care problems in nursing home patients. (2) Methods: This study is a secondary data analysis of data collected in an annually performed cross-sectional study called “Nursing Quality Measurement 2.0”. A standardized and tested questionnaire was used to collect data. (3) Results: 1236 nursing home patients took part and 16.7% of them were obese. The multivariate logistic regression analysis results show that urinary incontinence is significantly associated with the presence of obesity (OR 2.111). The other care problems of pressure injuries, fecal and double incontinence, physical restraints, falls and pain were not associated with obesity. (4) Conclusion: The results indicate that, in the nursing home setting, health care staff should pay special attention to the patients’ nutritional and continence status and help patients maintain a normal, healthy weight. Conducting more studies with larger sample sizes is recommended, as this will allow differentiation among different obesity classes.

The COVID-19 pandemic has been challenging for society, especially for those residing in long-term care facilities (LTCF). This study aimed to describe rates of infection, hospitalization, and death due to COVID-19 among older people and staff of LTCF in a state of Southeastern Brazil and identify strategies to prevent and control the disease spread. This cross-sectional study was conducted with 164 LTCF (6,017 older people). Among the studied LTCF, 48.7% confirmed COVID-19 infection in older people, resulting in 39.6% hospitalization and 32.3% death among infected. Moreover, 68.9% of LTCF confirmed COVID-19 infection in the staff, with 7.3% hospitalization and 1.2% death. Preventive measures were identified and classified as organizational, infrastructure, hygiene items and personal protective equipment, and staff training against COVID-19. These measures showed strategies and barriers experienced in the daily routine of LTCF during the pandemic. LTCF in Brazil experienced challenges similar to observed worldwide.

The Smart Angel connected medical device allows ambulatory surgery patients to monitor their health by taking their own blood pressure and oxygen levels and by answering a health questionnaire from home. This preventive device must necessarily be "usable" by patients with different profiles. The objective of this article is, therefore, to better understand the links between certain characteristics of potential patients and usability. We conducted an experimental study involving thirty-six participants, investigating the effects of four patient characteristics (i.e. age, education, technophilia and health literacy) on usability measured in terms of effectiveness, efficiency, and satisfaction. The results show a moderate correlation between age, health literacy and usability. However, there is a weak correlation between technophilia and usability and no relationship between the level of education and usability. This study provides theoretical insights into the effects of user characteristics by means of personas in usability (ISO 9241-11).

Our previous study found that intravesical perfusion metformin has excellent inhibitory effects against bladder cancer (BC). However, this administration route allows the drug to be diluted and excreted in urine. Therefore, increasing the adhesion of metformin to the bladder mucosal layer may prolong the retention time and increase the pharmacological activity. It is well known that chitosan (Cs) has a strong adhesion to the bladder mucosal layer. Thus, this study established a novel for-mulation of metformin to enhance its antitumor activity by extending its retention time. In this research, we prepared Cs freeze-dried powder and investigated the effect of metformin-loaded chitosan hydrogels (MLCH) in vitro and in vivo. The results showed that MLCH had a strong in-hibitory effect against proliferation and colony formation in vitro. The reduction in BC weight and expression of tumour biomarkers in orthotopic mice showed the robust antitumor activity of MLCH via intravesical administration in vivo. The non-toxic profile of MLCH was observed as well, using histological examinations. Mechanistically, MLCH showed stronger functional activation of the AMPK/mTOR signalling pathway compared with metformin alone. These findings highlighted the potential of this novel formulation as an efficient candidate for managing BC via intravesical ad-ministration.

The Covid-19 pandemic has forced the transfer of local government public ser-vices to the virtual world. Remote handling of matters in government offices has be-come the norm rather than the exception. The 2016 EU directive on public sector web-sites and mobile applications and the 2019 European Digital Accessibility Act made it mandatory that these services be provided electronically and accessible to people with disabilities. The purpose of the study conducted by the authors was to determine whether the Covid-19 pandemic resulted in the implementation of European solutions in the Polish legal order and whether this implementation resulted in the actual adap-tation of digital activities of local government units (LGUs) to the needs of people with disabilities. The research was conducted in Q4 2022 in two trial formats: 1. In the form of a survey (about 250 LGUs), which covered compliance with for-mal requirements, the level of readiness of the officials to create digitally accessible documents and content, and organizational readiness of the offices. 2. In the form of an analysis of the source code of the websites of 66 Polish cities with county rights - due to the availability of results of the same sample from 2015. The completed research showed that the LGUs in Poland: 1. met the formal and organizational requirements for digital accessibility, 2. did not make the necessary efforts to prepare employees to create digitally ac-cessible documents and content, 3. the surveyed websites had inferior source code in terms of meeting the WCAG standard in 2022 than in 2015. It seems reasonable to conclude that the Covid-19 pandemic had a formal, rather than real, impact on the digital accessibility of services provided by Polish LGUs.

This prospective observational study aimed to describe voriconazole administrations and trough concentrations in patients with Child-pugh class C clinically, and to investigate the variability of trough concentration. A total of 144 voriconazole trough concentrations from 43 Child-pugh class C patients were analyzed. The majority of patients (62.8%) received adjustments. The repeated measured trough concentration was higher than the first and final ones generally (median, 4.33 vs. 2.99, 3.90 mg/L). Eight patients with ideal initial concentration later got supratherapeutic with no adjusted daily dose, implying accumulation. There was a significant difference in concentrations among the six groups by daily dose (P=0.006). The bivariate correlation analysis showed that sex, CYP2C19 genotyping, daily dose, prothrombin time activity, international normalized ratio, platelet, and Model for end-stage liver disease score were significant factors for concentration. Subsequently, the first four factors mentioned above entered into a stepwise multiple linear regression model (variance inflation factor < 5), implying that CYP2C19 testing makes sense for precision medicine of Child-pugh class C cirrhosis patients. The equation fits well and explains the 34.8% variety of concentrations (R^2 = 0.348). In conclusion, it needs more cautious administration clinically due to no recommendation for Child-pugh class C patients in the medication label. The adjustment of the administration regimen should be mainly based on the results of repeated therapeutic drug monitoring.

3,4-methylenedioxypyrovalerone (MDPV) is a new psychoactive substance (NPS) and the most widespread and life-threatening synthetic cathinone of the “bath salts”. Preclinical research has proven the cocaine-like psychostimulant effects of MDPV and its potential for abuse. Cannabidiol (CBD) is a non-psychotropic phytocannabinoid that has emerged as a new potential treatment for drug addiction. Here, we tested the effects of CBD (20 mg/kg) on MDPV (2 mg/kg)-induced conditioned place preference and MDPV (0.05 and 0.075 mg/kg/infusion) self-administration paradigm. We also assessed the effects of the combination of CBD, and MDPV (3 and 4 mg/kg) on anxiety-like behaviour using the elevated plus maze (EPM). CBD mitigated the MDPV-induced conditioned place preference. On the contrary, CBD administration throughout the MDPV (0.075 mg/kg/infusion) self-administration increased drug-seeking and taking behaviours, but only in the high-responders group of mice. Additionally, CBD exerted anxiolytic-like effects, but only in MDPV-treated mice. Taken together, our results indicate that CBD modulation of MDPV-induced motivational responses in mice vary depending on the requirements of the learning task, resulting in a complex response. More research attempting to decipher the behavioural and molecular interactions between CBD and MDPV is needed.

The popularity of multiparticulate formulations (MPs) as a paediatric dosage form continues to increase. MPs comprise of multiple small units that are easy-to-swallow. Currently, MPs are commonly manufactured into unit doses that are either swallowed whole or opened prior to administration. While this is an acceptable approach, dosing is envisioned to be optimized with a ‘standard’ paediatric device which can better harness the flexible dosing potential of MPs. We evaluated a novel oral syringe (SympfinyTM) that is being developed as a tool to dispense and administer MPs to children. Forty children, 4-12 years old, received 0.5, 1.2, and 2.0 mL doses of placebo MPs using the oral syringe with spring water or a drink of choice to complete sample intake. Acceptability was recorded as those able to completely swallow the dose and participants also rated dose acceptability on a 5-point scale. The ability to completely swallow the dose decreased as dose volume increased; the smallest dose was completely swallowed by 87.5% (35/40) children, and 69.4% (27/39) of children confirmed their willingness to take the sample as a daily medicine. Larger doses, 1.2 and 2.0 mL, gave values of 55% and 57.5% for the doses completely swallowed and 58.8% and 51.72% for willingness to take the sample as a daily medicine, respectively. Use of a drink of choice showed no increase in swallowability as compared with water. The novel oral syringe being developed is an appropriate device for dispensing doses flexibly and administering neutral tasting MPs directly to the mouth in the lower dose range without the need for a co-administration vehicle in children aged 4-12 years.

Ellagic acid, a polyphenolic compound present in fruits and berries, has recently been object of extensive research for its antioxidant activity, which might be useful for the prevention and treatment of cancer, cardiovascular pathologies, and neurodegenerative disorders. Its protective role justifies numerous attempts to include it in functional food preparations and in dietary supplements not only to limit the unpleasant collateral effects of chemotherapy. However, ellagic acid use as chemopreventive agent has been debated because of its poor bioavailability associated to low solubility, limited permeability, first pass effect, and interindividual variability in gut microbial transformations. To overcome these drawbacks, various strategies for oral administration including solid dispersions, micro-nanoparticles, inclusion complexes, self-emulsifying systems, polymorphs have been proposed. Here, we have listed an updated description of pursued micro/nanotechnological approaches focusing on the fabrication processes and the features of the obtained products, as well as on the positive results yielded by in vitro and in vivo studies in comparison to the raw material. The micro/nano-sized formulations here described might be exploited for pharmaceutical delivery of this active, as well as for the production of nutritional supplements or for the enrichment of novel foods.

Robot-assisted rehabilitation has emerged as a promising approach for enhancing motor function in stroke survivors. However, the feasibility and effectiveness of home-based robotic training in this population are underexplored, especially in low/middle-income countries. This feasibility study aimed to address this gap by examining the feasibility and effectiveness of independent home-based training using PLUTO, a robotic device for hand training. A total of 7 chronic stroke survivors were recruited, with 5 completing the study. The results revealed high engagement and adherence to the home-based training program, with participants averaging 1659.8 minutes of training over 24.8 days. The PLUTO system demonstrated excellent usability and elicited positive user perceptions. Significant improvements were observed in functional outcomes, as evidenced by a noteworthy increase in Fugl-Meyer Assessment scores (mean increase of 6.2 points, exceeding the minimal clinically important difference (MCID) of 5.35 points). Furthermore, participants showed improvements in the ABILHAND measure (mean improvement of 1.24 logits, surpassing the MCID of 0.2 logits) and the Barthel Index (mean increase of 8.8 points). These findings demonstrate the feasibility and effectiveness of home-based robotic rehabilitation for chronic stroke survivors. This has implications for expanding access to rehabilitation services in low- and middle-income countries, enhancing patient engagement and adherence, and improving functional outcomes. Larger controlled studies are warranted to evaluate the effectiveness of home-based robotic rehabilitation programs.

The reef manta ray (Mobula alfredi) is a highly mobile and plankton-feeding species, classified vulnerable to extinction on the IUCN Red List for Threatened Species. Knowledge on their spatial ecology and the extent of their dispersal remain incomplete, especially within island-fragmented habitats as found in New Caledonia. Satellite telemetry was used to investigate the horizontal movement ecology of reef manta rays in New Caledonia. A total of 21 manta rays were tagged with pop-up satellite archival transmitting tags (21 Fastloc and 2 MiniPAT) that remained deployed for a duration ranging from 3 to 180 days (mean ± SE = 76.7 ± 50.3). Rays presented a strong site fidelity and an important affinity for coastal waters. Long-distance migrations (> 300 km) were also observed, mainly through coastal and shallow water paths. Horizontal movements were compared to a home range area and classified into four distinct patterns: Fidelity, Excursion, Fidelity + Relocation and Relocation. The most dominant pattern was Fidelity where manta rays remained within their home range for the whole duration of the tag deployment. Our findings may assist the design of more appropriate management strategies for the species in New Caledonia and other regions worldwide.

The quadruple burden of diseases, early discharge from hospital and hospital at home have resulted in home-based care services becoming a requirement in South Africa. The home-based care services generate a significant amount of health care risk waste that is mismanaged. However, more attention is given to the health care risk waste generated in hospitals and clinics than to health care risk waste generated by home-based caregivers. Therefore, this study investigates the health care risk waste management practices by home-based caregivers. The study adopted a mixed research approach, qualitative and quantitative methods, using a literature review, interviews, and questionnaires as means of data collection. Results show that there are different types of health care risk waste generated as a result of different activities performed by home-based caregivers, but that the waste was found to be managed in an unsafe manner. The majority of households receiving home-based care did not have basic sanitation facilities such as toilets, running water and waste removal services, aggravating the issue of health care risk waste mismanagement. The study recommends a new policy framework that will lead to safe management practices of generated health care risk waste to be adopted by home-based caregivers.

The fact that Thailand’s energy policy has set a new renewable energy target of 30% of total final energy consumption by 2036. It also has the potential of solar energy and community demands in remote areas. However, most of the renewable energy technology will still be able to achieve renewable energy goals, similar to the case of the national policy that promotes Solar Home System (SHS) in remote areas, lack of good handling. Therefore, achieving the goal of the renewable energy policy should be in position using the right strategy. This article presents the result of a case study in the Akha upland community, northern Thailand, where we used the mixing method and factor analysis to analyze strategies for SHS related criteria. The key scopes and challenge included bottom-up planning concepts and subsidies from expert persons, while contributions to factors have an impact on developing sustainable SHS, include the creating approval of SHS technologies, developing of SHS management, promoting of SHS technologies, and supporting of SHS policies, respectively. Mainly, social factors provide positive effects, which thus influence the sustainable development of process SHS in terms of the creation of approval. Furthermore, there should be managed appropriately for each community, for the positive imagery of solar power.

Coenzyme CoQ10 (CoQ10) is an endogenous lipid-soluble antioxidant that effectively protects lipids, proteins and DNA from oxidation due to its ability to undergo redox transitions between oxidized and reduced forms. Various oxidative stress-associated infectious and somatic diseases have been observed to disrupt the balance of CoQ10 concentration in tissues. As a high molecular weight polar lipophilic compound, CoQ10 exhibits very limited oral bioavailability, which restrains its therapeutic potential. Nevertheless, numerous studies have confirmed the clinical efficacy of CoQ10 therapy through the oral administration of high doses over extended time periods. Experimental studies have demonstrated that in emergency situations, intravenous administration of both oxidized and reduced forms CoQ10 leads to a rapid increase in its concentration in organ tissues, offering protection in ischemic conditions for organ tissues. This suggests that the cardio- and neuroprotective efficacy of intravenously administered CoQ10 forms could present new opportunities in treating acute ischemic conditions. Based on these findings, the review provides reasoning supporting further research and implementation of CoQ10 dosage forms for intravenous administration in emergency situations into clinical practice.

Oxytocin (OXT), a pro-social peptide, is increasingly recognized as a potential protective substance against drug addiction. In the context of ethanol, previous researches have shown OXT properties to reduce self-administration, alleviate motor impairment in rodents, and reduce craving in humans. However, its role in behavioral sensitization, a neuroadaptive response resulting from repeated drug exposure linked to increased drug incentive, remains unexplored. OXT is also associated with modulating the Hypothalamic-Pituitary-Adrenal (HPA) axis, with corticosterone well-known as a significant factor in behavioral sensitization development. This study aimed to investigate the effects of Carbetocin (CBT), an analogue of OXT, on the expression of behavioral sensitization to ethanol and concurrent alterations in plasma corticosterone levels in male and female Swiss mice. We also aimed to confirm previous studies on OXT impact on ethanol consumption in male mice, but with a focus on CBT, using the two-bottle choice model and drinking in the dark (DID) methodology. For the sensitization study, mice received either ethanol (1.8 g/kg, ip) or saline treatments daily for 15 consecutive days, followed by treatment with carbetocin (0.64 mg/kg, ip) or a vehicle for 6 days. Subsequently, on day 22, all animals underwent an ethanol challenge to assess the expression of behavioral sensitization. Plasma corticosterone levels were measured on days 21 and 22. CBT effectively prevented the expression of ethanol-induced behavioral sensitization in both male and female subjects, with no alterations detected in corticosterone levels. In the ethanol consumption study, following an initial phase of ethanol acquisition, mice underwent a 6-day treatment with CBT i.p or saline before being reexposed to ethanol. We also found a reduction in ethanol consumption due to CBT treatment. In conclusion, carbetocin emerges as a promising and effective intervention in mitigating ethanol-induced behavioral sensitization and reducing ethanol intake, highlighting its potential significance in alcohol addiction treatment.

This study is centred on Insecurity and Electoral Administration in Nigeria. Elections are the leading mechanism for selecting governments and a cardinal feature of democratisation. The quest for fair representation, development, good governance, inclusiveness and a true sense of belonging has been the driving force for election. The conduct of credible elections remains one of the thorny and fundamental issues in a democracy. The trajectory of electoral administration in Nigeria is long and tortuous; it precedes independence and is punctuated by the elite's scheming and cunning, electoral fraud, gimmicks and violence. Nigeria has had its fair share of insecurity from diverse sources such as banditry, insurgency, recurring violent religious crises, ethnic, resource and poverty-induced militancy, and crises occasioned by the clamour for self-determination. This has left the electoral management body in a quandary and has undoubtedly imperilled the administration of elections in Nigeria and equally accentuated the temerity for a holistic approach in reversing the trend and engendering the right atmosphere for the administration of elections. This study depends mainly on secondary sources and uses qualitative means in data analysis. It is revealed in this study that violence and various degrees of interruptions have taken the front burner in the democratisation process and are one of the dangerous dimensions in electoral administration; electoral politics remains one of the remarkable principal bases of clashes, political failure and social dislocation, Elections and their administration are some of the most complicated, time-sensitive activities undertaken by any country which will be exacerbated by insecurity. Democratic elections are successful when the electorate can make informed decisions; when faith in the process is sustained; when fraud is disincentivised, detected and punished. When insecurity is whittled down, mitigated or eradicated. The need for electoral security can never be overemphasised.

Little is known about family medicine academic staff in Taiwan, and basic data about this workforce may aid healthcare decision makers. We analysed data on Taiwan’s 13 medical schools collected by the Taiwan Association of Family Medicine from June to September 2019. Items included medical school names and total staff, and the gender, age, degree, working title (part-time/full-time), academic level, and sub-specialty of each current family medicine faculty member. A total of 116 family medicine faculty members were reported; most were male (n= 85, 73.3%). Ages ranged between 30 and 69 years, with a mean (SD) age of 43.3 (8.09). Faculty members with a master’s degree were the largest group (n= 49, 42.2%), and most were academic lecturers (n=49, 42.2%). Additionally, only about one-fourth (n=26, 22.4%) of family medicine faculty in medical schools were full-time, while the other three-fourths (n=90, 77.6%) were part-time faculty; most were located in northern Taiwan (n=79, 68.1%) and specialized in gerontology and geriatrics (n=55, 47.4%) and hospice palliative care (n=53, 45.7%). Our research provides the most complete census of family medicine academic physicians in medical schools in Taiwan. The results inform efforts to improve the establishment and development of family medicine departments in Taiwan.

Community-level mass treatment with azithromycin has been associated with a mortality benefit in children. However, antibiotic exposures result in disruption of the gut microbiota and repeated exposures may reduce recovery of the gut flora. We conducted a nested cohort study to examine associations between mass drug administration (MDA) with azithromycin and the gut microbiota of rural Malawian children aged between 1-59 months. Fecal samples were collected from the children prior to treatment and 6 months after two or four biannual rounds of azithromycin treatment. DNA was extracted from fecal samples and V4-16S rRNA sequencing used to characterize the gut microbiota. Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria were the dominant phyla while Faecalibacterium and Bifidobacterium were the most prevalent genera. There were no associations between azithromycin treatment and changes in alpha diversity, however, four biannual rounds of treatment were associated with increased abundance of Prevotella. The lack of significant changes in gut microbiota after four biannual treatments supports the use of mass azithromycin treatment to reduce mortality in children living in low- and middle-income settings.

Barcode medication administration (BCMA) is advocated as a technology that reduces medication errors relating to incorrect patient identity, drug or dose. Little is known, however, about the impact it has on nursing workflow. Our aim was to investigate the impact of BCMA on nursing activity and workflow. A comparative study was conducted on two similar surgical wards within an acute UK hospital. We observed nurses during drug rounds on a non-BCMA ward and a BCMA ward. Data were collected on drug round duration, timeliness of medication administration, patient identification, medication verification and general workflow patterns. BCMA appears not to alter drug round duration, although it may reduce the administration time per dose. Workflow was streamlined, with a reduction in use of the medicines room. The rate of patient identification increased from 74% (of 47) patients to 100% (of 43), with 95% of 255 scannable medication doses verified using the system. This study suggests that BCMA does not affect drug round duration; further research is required to determine the impact it has on timeliness of medication administration. There was reduced variability in the medication administration workflow of nurses, along with an increased patient identification rate and high medication scan rate, representing potential benefits to patient safety.

In this article, a critical reflection is made that involves questioning the notion of historic urban landscapes profiled in the Memorandum of Vienna (UNESCO, 2005) and the Paris Recommendation (UNESCO, 2011) as a conceptual paradigm on which to base urban conservation in the 21st century. Its limited methodological development and the assumption of change as an inherent part of the urban condition constitutes the source of many of the problems and difficulties posed by management and protection of contemporary cities, since there is no consensus as to what the acceptable limits of change should be in historic urban landscapes - difficulties that become ever more apparent, given the background of Weberian administrative doctrines present in current governance models. Likewise, the concept of Buffer Zones as a landscape management tool is analyzed, with the aim of establishing new methodological proposals that enable spatial organization to be regulated by defining areas of harmonization that are made up of flexible and multifunctional spaces for cooperation where territorial scale comes into contact with modernization of the historical fabric.

Choice of the salts of therapeutic agents or active pharmaceutical ingredients (API) is based on the physicochemical properties of API and the dosage form considerations. The appropriate salt can have positive effect on overall therapeutic and pharmaceutical effects of API. However, the incorrect salt form can negatively affect the overall pharmaceutical outcomes of the API. This review addresses various criteria for choosing appropriate salt form along with the effect of salt forms on API’s pharmaceutical properties. In addition to comprehensive review of the criteria, this review also gives a brief historic perspective of the salt selection process.

This study aims to spatially analyze the distribution characteristics of vacant homes in Asan-si, Chungcheongnam-do, and understand the differences in factors causing vacant homes by type. We use a variety of statistical methods to examine these factors and identify key influencing factors such as the number of vacant stores, changes in overall population, land use complexity, and physical characteristics of land and buildings. The findings reveal that the factors contributing to the occurrence of vacant homes vary significantly by region and property type, highlighting the need for region-specific policies. For instance, in old town areas, small lot ratios and land use complexity are significant, while in rural village, the average number of floors and land use complexity play a major role. This study underscores the diversity of factors influencing vacant homes, suggesting that policies should be tailored to the unique characteristics of different regions to effectively address this issue.

Objective: To investigate the feasibility and preliminary effects of a 12-week home-based moderate intensity cycling programme in stroke survivors. Design: Single-blinded, parallel group, Randomised Controlled Trial Setting: Home-based Participants: Participants will be survivors of first-ever stroke and randomly assigned to an Active Cycling Group (ACG) or control group. Intervention: The ACG performed a 12-week home-based cycling programme, three sessions per week. Work intervals were executed at 75% of the maximal heart rate (HR_max), recovery intervals at 50% of HR_max. Work interval duration increased from three ten-minute intervals to 30 minutes continuous cycling. The control group completed a 12-week neurocognitive exercise programme. Main outcome measurements: Primary outcome measures are compliance with training, adherence to protocol and safety as measured by adverse events. Secondary outcome measurements included a: simplified modified Rankin Scale questionnaire (stroke severity), Six-Minute Walking Test (walking ability), Ten-meter Walk Test (walking ability), Rivermead Mobility Index (walking ability), graded submaximal cycling test (exercise capacity), Physical Activity for Individuals with Physical Disability questionnaire (physical activity), EQ-5D-5L (quality of life), Stroke Specific Quality of Life questionnaire (quality of life), Montreal Cognitive Assessment (cognition), General Self-Efficacy Scale (self-efficacy), and Exercise Self-Regulation Questionnaire (self-regulation).

Objectives: To analyze cumulative incidence and mortality by COVID-19 in the different types of nursing homes, in the first and second wave.Methods: Data source: Transparency portal of the Generalitat de Catalunya, official COVID-19 register of all Catalan nursing homes (from March to December 10, 2020). Variables: Affectation of disease and mortality by COVID-19 in geriatric centers in Catalonia, stratified by size of center and type of management. Univariate, bivariate and multivariate linear regression analysis, IBM^TMSPSS^® v.20.Results:N = 1,057 residences (63,682 beds, average = 60.48). 52% have <50 beds, 42.8% between 50-150 beds, and 5%> 150 beds. COVID-19: Cumulative incidence: 21,370 (confirmed + suspicious); mortality: 5,010 (confirmed + suspicious).233 residences did not register COVID-19 patients (22%) and 636 did not register COVID-19 deaths (60.2%).According to the type of supplier, the lowest incidence of COVID-19 was in non-accredited (36.2% without cases), then concerted / collaborators (19.3%) and own of the Generalitat de Catalunya (7.9 %, p = 0.000). The centers with the fewest deaths were the non-accredited (78% without deaths), followed by contracted / collaborators (56.8%) and those of the Generalitat de Catalunya (41.3%, p = 0.000).Depending on the size, no COVID-19 patients were registered: 168 centers <50 beds (30.5%); 64 of the 50-150 beds (14.2%); and 1 of the> 150 beds (1.9%) (p = 0.000). 395 of the <50 beds did not register deaths due to COVID-19 (71.8%), 232 of the 50-150 beds (51.3%), and 9 of the> 150 beds (17%) (p = 0.000).Discussion:Of the 1,057 centers analyzed, 22% did not register cases and in 60% there were no deaths from COVID-19.Residences without concert / collaboration with the Generalitat and with fewer beds showed a lower cumulative incidence and mortality due to COVID-19 during the first wave.

Abstract: Background: Stunting is primarily a public health concern in LMIC. The involvement of Integrated Service Post cadres is one of the strategies to combat stunting in Indonesia. Objective: This study aimed to determine the effect of a short course on cadres knowledge. Method: A single group pre-post test design was conducted in Yogyakarta, Indonesia, from March to May 2022. Thirty cadres were selected based on the following criteria: willingness to participate, the number of stunted children in their Integrated Service Post (Posyandu), and full attendance at short course. The knowledge scores were measured by a structured questionnaire after short course (post-test 1) and 4 weeks later (post-test 2). We apply STATA 16 to calculate the mean difference (MD) using a t-test and Generalized Estimated Equation (GEE). Furthermore, the adequacy of the short course was evaluated with in-depth interviews. Result: On post-tests 1 and 2, cadres' knowledge of IYCF, children growth monitoring (CGM) and children development monitoring (CDM) significantly improved. The GEE analysis showed that a short course significantly improves cadres' knowledge after age control, education, occupation, and years of experience. Conclusion: Short course in-creased their affection, self-efficacy, and confidence, hence, they are capable of assisting children through home visits.

Background: In long-term care facilities, there are many residents who do not have the ability to seek shelter by themselves in the case of an emergency. Thus, it is extremely important that the staff of nursing homes are equipped with correct disaster prevention concepts, emergency survival responses, and hazard mitigation measures. Purpose: Discuss the intervention effectiveness of different fire prevention and emergency response trainings at nursing homes and the relationship and predictivity of awareness to self-efficacy. Method: Recruit staff from two nursing homes through purposive sampling, using a two-team pre-and post-test design to collect results from 41 individuals in the experiment group and 40 individuals in the control group. The research tool is the “Nursing Home Fire Prevention and Emergency Response Awareness and Self-Efficacy Scale,” to compare the effectiveness of advanced and general fire safety trainings. Result: After receiving improved advanced fire safety training, the total score and the result of the experiment group on fire prevention and emergency response awareness and self-efficacy had both performed better than the control group who received general fire safety training (p < .001); fire prevention and emergency response awareness has significant and positive correlation with self-efficacy (r=.601, p < .001), and awareness is a significant predictor variable to self-efficacy (p < .001). Conclusion/Practical Application: This study finds that the key to improving learning effectiveness includes adding fire science concept chapter when creating fire safety training material in order to strengthen basic awareness; fire safety training should comprehensively introduce all related duty responsibilities of staff fire defense formation, in turn enabling mutual responsive support for the needs of the site; also, to become familiarized with the knowledge requires appropriate frequency of training and enhancing the staff’s awareness to fire prevention and emergency response, which is the most important key of learning effectiveness.

A brain-computer interface for controlling elements commonly used at home is presented in this paper. It includes the electroencephalography device needed to acquire signals associated to the brain activity, the algorithms for artefact reduction and event classification, and the communication protocol.

The present paper offers a reading of three selected novels by two Anglophone Arab writers Diana Abujaber and Fadia Faqir. Our reading is fundamentally based on a philosophical post-humanist perception of other ethnic minorities as being inferior and un-human. In interpreting the three novels, Arabian Jazz (2003), My Name is Salma (2007) and Willow Trees Don’t Weep (2014), a main concern is to bring to light how Arabs –and Muslims –have been zombified and de-humanized in Western mainstream media and culture based on a biased stigmatization and stereotyping of a large heterogeneous ethnic group wherein religions, traditions, languages and cultures are diverse. Also, a pivotal preoccupation is going to be the exiling journey of the protagonists from their homelands to Western countries, and how these journeys contribute to the post-humanization of the self, the identity and the culture of Arab displaced immigrants.

Transdermal drug delivery systems have become an intriguing research topic in healthcare technology and one of the most frequently developed pharmaceutical products in the global market. In recent years, researchers and pharmaceutical companies have made significant progress in developing new solutions in the field. This study sheds light on current trends, collaboration patterns, research hotspots, and emerging frontiers of transdermal drug delivery. Herein, a bib-liometric and patent analysis of data recovered from Scopus and The Lens databases, respectively, is reported over the last 20 years. From 2000 to 2022, the annual global publications increased from 131 in 2000 to 659 in 2022. Researchers in the United States, China, and India produced the highest number of publications. Likewise, most patent applications have been filed in the USA, China, and Europe. The recovered patents are 7,275, grouped into 2,997 patent families, of which 314 were granted. This study could support the work of decision-makers, scientific managers, or scientists to create new business opportunities or save money, time, and intellectual capital, thus, defining when a research or technology project should be a priority or not.

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

The data-oriented paradigm has proven to be fundamental for the technological transformation process that characterizes Industry 4.0 (I4.0) so that Big Data & Analytics is considered a technological pillar of this process. The literature reports a series of system architecture proposals that seek to implement the so-called Smart Factory, which is primarily data-driven. Many of these proposals treat data storage solutions as mere entities that support the architecture's functionalities. However, choosing which logical data model to use can significantly affect the performance of the architecture. This work identifies the advantages and disadvantages of relational (SQL) and non-relational (NoSQL) data models for I4.0, taking into account the nature of the data in this process. The characterization of data in the context of I4.0 is based on the five dimensions of Big Data and a standardized format for representing information of assets in the virtual world, the Asset Administration Shell. This work allows identifying appropriate transactional properties and logical data models according to the volume, variety, velocity, veracity, and value of the data. In this way, it is possible to describe the suitability of SQL and NoSQL databases for different scenarios within I4.0.

The state of community lock-down due to COVID-19 pandemic caused restricted movements of people. There are existing evidence of the negative impact of quarantine and isolation to the mental health of a person in different contexts. A scoping review of literature using Google Scholar was conducted to discover records about the public mental health while in a community quarantine due to COVID-19 pandemic. A methodological approach suggested by Arksey and O’Malley was utilized. It comprised (a) identifying the research questions, (b) identifying relevant literatures, (c) selecting literature, (d) charting the extracted data, and (e) summarizing, analyzing, and reporting the results. As of April 17, 2020, there were only 4 original articles found that discuss psychosocial aspect of the COVID-19 crisis. After an online survey, they present evidence that (1) there is an outward change in the people’s behavior toward self-care during the pandemic and (2) trusting the community governing bodies can minimize the level of anxiety and stress. Other literatures found are original articles in preprint (n=8), letters, commentaries, editorial (n=6), review paper (n=4), and WHO guideline (n=1). It is evident that the psychosocial aspect of COVID-19 crisis needs more attention from the scholars and a large research gap can be lessened trough expansion of online platforms.

This paper presents a compartmental model aimed at investigating the pharmacokinetics of medical THC after oral administration. The model was developed to be multi-compartmental, describing the kinetics of THC and its metabolites in bodily tissues. Utilizing the law of mass action, the model was converted into ordinary differential equations (ODEs), illustrating the rate of concentration changes of THC and its metabolites in each compartment. Subsequently, we applied the nonstandard finite difference (NSFD) method to construct numerical solution schemes. These schemes were implemented in the MATLAB program, along with estimated pharmacokinetic rate constants. The results of the investigation demonstrate that the simulation curves depicting the plasma concentration-time profiles of THC and THC-OH closely resemble the actual data samples, indicating that this model accurately describes the pharmacokinetics of medical THC and its metabolites. Moreover, the model exhibits predictive capabilities regarding the pharmacokinetics of THC and its metabolites in various tissues. Consequently, the model serves as a valuable tool for enhancing our understanding of the pharmacokinetics of THC and its metabolites and for guiding adjustments to dosage and administration durations for oral medical THC products.

The new need to move to an online mode of administration has necessitated the adoption of Software-as-a-Service (SaaS) and Platform-as-a-Service (PaaS). The conventional paper-based administrative memorandum is relatively costly, requires manpower, insecure and non-confidential, prone to unauthorized access and has a relatively slow cycle time; among others. An electronic memo (e-memo) can save cost, offer high speed of processing, reliability and security. The aim of this work was to conceptualize, design and develop a novel semantic web-based memo platform that allows for handling memos within an organization. The tools used include HTML, CSS, PHP, JavaScript, jQuery and AJAX, MySQL. The developed system was tested in three stages. Testing was done in the Department of Computer Science of the institution of case study, then in the Faculty of Science and finally in the entire Lagos State University. Agile development method was used in the development process. The designed system was hosted on a cloud-server and a total of 43 test cases were considered and an average of four minutes was recorded for a complete memo cycle. eMemo allows users to generate, sign, treat and memo electronically. It is such a useful tool that will enhance information processing in a faster, standardized and more secure manner.

The article analyses the main aspects of upstream social marketing for implementing of mobile government (MGov). The methodology of current research is based on the systematic literature review in the fields of MGov and social marketing. According to our findings, most researchers investigated MGov from the side of citizens (consumers) and emphasised the benefits to them while changing their attitudes and behaviours in employing mobile applications. However, as there is a lack of the researches from the side of governmental bodies, in this paper, we were contrary looking for new meanings, attitudes and values from their perspective. Limitations of employment of MGov occur due knowledge gap among decision makers and public policy formers (upstream audience). Therefore, we argue that upstream social marketing for the upstream audience would bring the success in faster MGov implementation. Specific social marketing would be mostly valuable on the municipal level that is the closest substance to the society. Thus, in our paper we emphasise the benefit of the MGov for the local upstream audience and propose possible external marketers as well as the motivating theses based on these 7P of marketing mix for the successful MGov on municipal level.

This paper describes a system that is used to gather data from Smart Home sensors measuring energy consumption, analyze and predict future consumption by using machine learning algorithm for prediction. It focuses on the architecture of the system as well as the need for such system to exist in practice – why the consumption should be measured at all and how that measurement can be put to good use for achieving energy efficiency.

Urinary tract infections (UTIs) are highly prevalent in long-term care facilities, constituting the most common infection in this setting. Our research focuses on analyzing clinical characteristics and antimicrobial prescriptions for UTIs in residents across nursing homes (NH) in Spain. This cross-sectional report is part of a before/after intervention study using a multifaceted approach based on the normalization process theory to improve healthcare quality provided by nursing staff in 34 NHs in Spain. In this study we present the results of the first audit including 719 UTI cases, with an average age of 85.5 years and 74.5% being women. Cystitis and pyelonephritis presented distinct symptom patterns. Notably, 6% of asymptomatic bacteriuria cases were treated. The prevalence of dipstick usage was 83%, raising concerns about overreliance, including in the 46 asymptomatic cases, leading to potential overdiagnosis and antibiotic overtreatment. Improved diagnostic criteria and personalized strategies are crucial for UTI management in NHs, emphasizing the need for personalized guidelines on management of UTIs, to mitigate indiscriminate antibiotic use in asymptomatic cases.

Sociality in animal populations is a continuum, and interactions between conspecifics are meaningful for all vertebrates. Ignorance of social structures can lead to misunderstanding their ecology and, consequently, to unsuccessful species management. Here, we combined genetic and spatial data on radio-collated brown bears (Ursus arctos) to investigate kin-related home range overlap and kin-related centroid distance within central and eastern Finland. We found that the extent of overlap of home ranges was positively linked with relatedness among adult females. A similar positive correlation could be detected between home range centroid distance and relatedness among adult females. Moreover, there were significant differences between the two studied regions: female brown bears in central Finland were more closely related to each other, and the sizes of their home ranges were larger than those in eastern Finland. The smaller home ranges and lower degree of relatedness among bears in eastern Finland might be a result of the substantially higher hunting pressure in the area, combined with immigration of new unrelated individuals from Russia.

This paper proposes the localisation of room occupants in home environments using Unobtrusive Sensing Solutions (USSs). The ability to localise room occupants in home environments can help in the objective monitoring of sedentary behaviour. While wearable sensors can provide tangible information on health and wellness, they have battery life issues and the inability to perform prolonged monitoring. This work uses heterogeneous USSs in the form of an Infrared Thermopile Array (ITA-64) thermal sensor and a Multi-Chirp Frequency Modulated Continuous Wave Mono-pulse (MC-FMCW-M) Radar sensor to monitor room occupants. Digital filters and background subtraction algorithms were used to process the thermal images gleaned from the ITA-64 thermal sensors. The MC-FMCW-M Radar sensor used multi-chirp and Doppler shift principles to estimate the exact location of the targeted room occupants. The estimated distances from the Radar Sensor were compared with ground truth values. Experimental results demonstrated the ability to identify thermal blobs of occupants present in the room at any particular time. Data analyses indicated no significant difference (p = 0.975) and a very strong positive correlation (r = 0.998) between the ground truth distance values and those obtained from the Radar Sensor.

Preterm birth is a leading cause of infant morbidity and mortality in the world. In 2020, 1 in 10 infants were born prematurely in the United States. Globally, the World Health Or-ganization estimates 15 million infants are born prematurely. The efficacy of current ther-apeutic interventions for preterm birth have been called into question due to limited repli-cable success. Recent advancements in the field of nanomedicine have made it possible to utilize the vaginal administration route to effectively and locally deliver drugs to the fe-male reproductive tract. Also, studies using murine models have provided important in-sights about the cervix as a gatekeeper for pregnancy and parturition. It seems plausible that the field of reproductive biology is on the cusp of a paradigm shift in the context of treating preterm birth. The present review focuses on the complexities associated with treating the condition and novel therapeutics that have produced promising results in pre-clinical studies.

Contact toxicity against Periplaneta americana has never been tested with S. collinsiae root extract. Hexane, dichloromethane, ethanol and water extracts were tested in final-instar nymphs and adult P. americana by topical application method. The dichloromethane extract showed the high-est potency of contact toxicity against the final-instar nymphs (41-100% corrected mortality at 48 hours), lowest LC50 (1.5±0.2 %w/v at 48 hours), and lowest LT50 (36.1±0.8 hours at 10%w/v) while the water crude extract lacked the contact toxicity (0-0% corrected mortality at 48 hours). Signs of toxicity, such as excited movement, trembling body, motionlessness, and swollen abdomen segment including irregularly extended foregut were found at the both stages of P. americana dropping with solutions of dichloromethane extract. Detection of didehydrostemofoline distri-bution using IMS revealed that didehydrostemofoline distributed in the tissue of the dead fi-nal-instar nymph and adult P. americana contacting with dichloromethane extract, but it was not found in tissue of euthanized P. americana which exposed to the water extract. Didehydrostemo-foline in the extract was a cause of toxicity signs and death of P. americana via a contact route. Thus, dichloromethane extract and didehydrostemofoline could be used as an active ingredient and chemical marker in aerosol and spray formulations for cockroach control.

Opioids are highly addictive substances with a relapse rate of over 90%. While preclinical models of chronic opioid exposure exist for studying opioid dependence, none recapitulate the relapses observed in human opioid addiction. The mechanisms associated with opioid dependence, the accompanying withdrawal symptoms and the relapses that are often observed months or years after opioid dependence are poorly understood. Therefore, we developed a novel model of chronic opioid exposure whereby the level of administration is self-directed with periods of behavior acquisition, maintenance and then extinction alternating with reinstatement. This profile arguably mirrors that seen in humans, with initial opioid use followed by alternating periods of abstinence and relapse. Recent evidence suggests that dietary interventions that reduce inflammation, including omega-3 fatty acids such as docosahexaenoic acid (DHA), may reduce substance misuse liability. Using the self-directed intake model, we characterize the observed profile of opioid use and demonstrate that a diet enriched in polyunsaturated fat acids (PUFAs) ameliorates oxycodone-seeking behaviors in the absence of drug availability and reduces anxiety. Guided by the major role gut microbiota have on brain function, neuropathology, and anxiety, we profile the microbiome composition and the effects of chronic opioid exposure and DHA supplementation. We demonstrate that withdrawal of opioids led to a significant depletion in specific microbiota genera whereas DHA supplementation increased microbial richness, phylogenetic diversity, and evenness. Lastly, we examined the activation state of microglia in the striatum and found that DHA supplementation reduced the basal activation state of microglia. These preclinical data suggest that a diet enriched in PUFAs could be used as a treatment to alleviate anxiety induced opioid-seeking behavior and relapse in human opioid addiction.

The effects of orally administered lactic acid bacteria metabolites on the skin were studied using an atopic dermatitis-like murine model created by feeding mice with HR-AD. The lactic acid bacteria metabolites were obtained by inoculating 35 strains of 16 species of lactic acid bacteria into soy milk and culturing them. The atopic dermatitis-like murine model was created by feeding HR-1 mice HR-AD for 40 days. The skin condition of mice that were fed HR-AD worsened compared with normal mice, i.e., reduced water content in the stratum corneum, increased transepidermal water loss (TEWL), reduced ceramide AP content in the stratum corneum, and increased epidermis thickness. When mice that had been fed the HR-AD diet was administered a raw liquid of lactic acid bacteria metabolites orally, the measured values related to water content in the stratum corneum, TEWL, ceramide AP content in the stratum corneum, and epidermis thickness improved. To find out the active components for these effects, filtrate and residue from the raw liquid of lactic acid bacteria metabolites and lipid components extracted from the raw liquid were examined at the same time. Results showed that the water-soluble components or residue after filtration did not demonstrate effects but the raw liquid and the lipid fraction did. These findings suggest that lactic acid bacteria metabolites improve skin injury in an atopic dermatitis-like murine model.

Consumer IoT (CIoT) manufacturers seek customer feedback to enhance their products and services, creating a smart ecosystem like a smart home. Due to security and privacy concerns, Blockchain-based federated learning (BCFL) ecosystems can let CIoT manufacturers update their Machine Learning (ML) model using end-user data. FL uses privacy-preserving ML techniques to forecast customers' needs and consumption habits, and blockchain replaces the centralised aggregator to safeguard the ecosystem. However, Blockchain technology (BCT) struggles with scalability and quick ledger expansion. In BCFL, local model generation and secure aggregation are other issues. This research contributes a novel architecture emphasising Gateway Peer (GWP) in blockchain network to resolve scalability, ledger optimisation and secure model transmission issues. In the architecture we replace the centralised aggregator by the blockchain network, while GWP restricts the number of local transactions to execute in BCN. Considering the security and privacy of FL processes, we have added differential privacy and advanced normalisation techniques to ML processes. The approaches strengthen end-users' cyber security and encourage the adoption of technological innovation standards by service providers. The proposed approach has been tested extensively using a well-respected Stanford Cars dataset. We experimentally demonstrate that the proposed architecture makes the network scalable and optimises the ledger significantly. In addition, the normalisation technique outperforms batch normalisation when features are under DP protection.

The propagation of the coronavirus disease 2019 (COVID-19) reshaped the relationship between income and food-away-from-home (FAFH) expenditure in Mexico during 2020. Although the number of households participating in this market fell across income deciles and regions due to the pandemic, the impact on their budget shares is not uniform. Using data from the Encuesta Nacional de Ingresos y Gastos de los Hogares (ENIGH) 2020, we estimated an Engel curve of the Working-Lesser functional form for FAFH. Among the independent variables are the number of family members 65 years of age and older, and dummies to indicate whether the household experienced food insecurity or received remittances. The estimation was carried out following the Heckman two-step method, suitable for censored-response data. The results suggest that the budget share for FAFH drops as income increases. The number of older adults and food insecurity discourage the decision to participate in FAFH expenditure and increase its budget share, whereas remittances encourage participation and reduce its budget share. The corrected conditional elasticity is 0.4609; the sign and the magnitude indicate that FAFH is a necessity good.

Multicomponent training is recommended for people with dementia living in long-term care homes. Nevertheless, evidence is limited and people with severe dementia are often excluded from trials. Hence, the aim of this study was to investigate (1) the feasibility and (2) the requirements regarding a multicomponent training for people with moderate to severe dementia. The study was conducted as an uncontrolled single arm pilot study with a mixed methods approach. 15 nursing home residents with a mean age of 82 years (range: 75-90 years; female: 64%) with moderate to severe dementia received 16 weeks of multicomponent training. Feasibility and requirements of the training were assessed by a standardized observation protocol. Eleven participants regularly attended the intervention. The highest active participation was observed during gait exercises (64%), the lowest during strength exercises (33%). It was supportive if exercises were task-specific or related to everyday life. This study confirms that a multicomponent training for the target group is (1) feasible and well accepted. To enhance active participation (2) individual instructions and the implementation of exercises related to everyday life is required. The effectiveness of the adapted training should be tested in future randomized controlled trials.

As consequence of COVID-19, millions of households suffered mobility restrictions and changes in their lifestyle during several months. The aim of this study was to evaluate the effects of COVID-19 home confinement in food habits, lifestyle and emotional balance of the Spanish population. This cross-sectional study used data collected via an anonymous online questionnaire during the last month before lockdown finished in Spain in a total of 675 participants. 38.8% of the respondents experienced weight gain while 31.1% lost weight during confinement. The increase in body weight was positively correlated with the age (Rs = 0.14, p &lt;0.05) and BMI (Rs = 0.20, p &lt;0.05). We also identified that 39.7% reported poorer quality sleep, it was positively correlated with BMI (Rs = -0.18, p &lt;0.05) and with age (Rs = -0.21, p &lt;0.05). 44.7% of the participants had not performed physical exercise during confinement with differences by sex (p &lt;0.05), by age (p &lt;0.05), by BMI (p &lt;0.05) and sleep quality (p &lt;0.05). According to emotional-eater questionnaire, 21.8% and 11% were classified as emotional eater and very emotional eater, respectively. We emphasize the importance of adopting a healthy lifestyle, as the COVID-19 pandemic nowadays is ongoing.

Restraint use in Australian residential aged care has been highlighted by the media, and investigated by researchers, government and advocacy bodies. In 2018, the Royal Commission into Aged Care selected ‘Restraint’ as a key focus of inquiry. Subsequently, Federal legislation was passed to ensure restraint is only used in residential aged care services as the ‘last resort’. To inform and develop Government educational resources, we conducted qualitative research to gain greater understanding of the experiences and attitudes of aged care stakeholders around restraint practice. Semi-structured interviews were held with 28 participants, comprising nurses, care staff, doctors, physiotherapists, pharmacists and relatives. Two focus groups were also conducted to ascertain the views of residential and community aged care senior management staff. Data were thematically analyzed using a pragmatic approach of inductive and deductive coding and theme development. Five themes were identified during the study: 1. Understanding of restraint; 2. Support for Legislation; 3. Restraint-free environments are not possible; 4. Low-level restraint, and 5. Restraint in the community is uncharted. Although most staff, health practitioners and relatives have a basic understanding of restraint, more education is needed at a conceptual level to enable them to identify and avoid restraint practice, particularly ‘low-level’ forms and chemical restraint. There was strong support for the new restraint regulations, but most interviewees admitted they were unsure what the legislation entailed. With regards to resources, stakeholders wanted recognition that there were times when restraint was necessary and advice on what to do in these situations, as opposed to unrealistic aspirations for restraint-free care. Stakeholders reported greater oversight of restraint in residential aged care but stated that community restraint use was largely unknown. Research is needed to investigate the extent and types of restraint practice in community aged care.

Activities of daily living (ADLs) are fundamental routine tasks that the majority of physically and mentally healthy people can independently execute. In this paper, we present a Semantic Framework for detecting problems in ADLs execution, monitored through Smart Home sensors. In the context of this work, we conducted a pilot study, gathering raw data from various sensors and devices installed in a smart home environment. The proposed Framework combines multiple Semantic Web technologies (i.e. ontology, RDF, triplestore) to handle and transform these raw data into meaningful representations forming a Knowledge Graph. Subsequently, SPARQL queries are used to define and construct explicit rules to detect problematic behaviours in ADLs execution, a procedure that leads to generating new implicit knowledge. Finally, all available results are visualized in a clinician dashboard. The proposed framework can monitor the deterioration of ADLs performance for people in the spectrum of dementia, by offering a comprehensive way for clinicians to describe problematic behaviors in the every-day life of an individual.

Better understanding of the quality of life among nursing home residents with dementia is im-portant for developing interventions. The objectives of this cross-sectional study were to examine factors associated with poor health-related quality of life in older adults with dementia living in nursing homes in Hanoi, Vietnam. In-person interviews were conducted with 140 adults 60 years and older with dementia and information about their quality of life was obtained using the Quality of Life in Alzheimer’s Disease scale (QOL-AD). A number of sociodemographic and clinical factors associated with poor health-related quality of life (lowest tertile) were assessed through the results of physical tests, interviews with nursing home staff, and review of medical records. The average age of the study sample was 78.3 years, 65% were women, and their av-erage QOL-AD total score was 27.3 (SD = 4.4). Malnutrition, total dependence in activities of daily living, and urinary incontinence were associated with poor quality of life after controlling for multiple potentially confounding factors. Our findings show that Vietnamese nursing home residents with dementia have a moderate quality of life and interventions based on comprehen-sive geriatric assessment remain needed to modify risk factors associated with poor health-related quality of life.

Home care centers face both an increase in demand and many variations during the execution of routes, compromising the routes initially planned: robust solutions are not effective enough, it is necessary to move on to resilient approaches. We create a close to reality use case supported by interviews of staff at home health care centers, where caregivers are faced with unexpected events that compromise their initial route. We model, analyze and compare three resilient approaches to deal with these disruptions: a baseline approach without any collaboration, a distributed collaborative approach, and a centralized collaborative approach, where we propose a centralization and sharing of information to improve local decision-making. The latter reduces the number of late arrivals by 11% and the total time of late arrival by 21%, and also halves the number of routes exceeding the end of work time (contrary to the distributed collaborative approach, due to the time wasted reaching colleagues). The use of a device, such as a smartphone application, to centralize and share information thus allows better mutual assistance between caregivers. Moreover, we highlight several possible openings like the coupling of simulation and optimization to propose a more resilient approach.

To examine the association of sleep quality and work from home with physical inactivity (PI) in leisure time during Covid-19 pandemic. A population-based household survey was conducted in two Bra-zilian municipalities from October to December 2020. Leisure-time physical activity (PA) was self-reported, and individuals who practiced less than 150 minutes of moderate PA or 75 minutes of vigorous PA weekly were classified as PI. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). WFH was assessed by: "Currently, how is your work routine regarding location? Associations were investigated using logistic regression and directed acyclic graphs (DAG) for the multivariate models. A total of 1,750 adults were interviewed, 69.1% were PI and 51.9% had poor sleep quality. Furthermore, 79.8% were not in WFH. In multivariate analysis, leisure PI was associated with poor sleep quality (OR:1.59: 95% CI: 1.02-2.48), and not being in WFH (OR:1.62: 95% CI: 1.05-2.50). When performing the combined analysis between these two factors, and who were not in WFH were four times more likely to be PI at leisure (OR=4.22;95%CI:2.05-8.65). The results indicate a high prevalence of PI, with poor quality sleep and non-WFH associated with leisure PI. These combined factors exacer-bated the occurrence of PI.

(1) Background: Alzheimer’s disease (AD) presents a significant challenge in terms of discovering novel diagnostic methods and therapies. Previous research has shed light on the neuroprotective properties of Apelin-13 in neurodegenerative disorders. However, elucidating the mechanism underlying its efficacy in combating AD-related nerve injury is imperative. In this study, we aimed to investigate the mechanism of action of Apelin-13 in an in vivo model of AD induced by streptozocin (STZ); (2) Methods: We utilized an STZ-induced nerve injury model of AD in mice to investigate the effects of Apelin-13 administration. The Apelin-13 was administered intranasally, and cognitive impairment was assessed using standardized behavioral tests. The main methods included behavioral assessment, histological analysis, and biochemical assays to evaluate synaptic plasticity and oxidative stress signaling pathways; (3) Results: Our findings indicate that intranasal administration of Apelin-13 ameliorated cognitive impairment in the STZ-induced AD model. Furthermore, we observed that this effect was potentially mediated through the enhancement of synaptic plasticity and attenuation of oxidative stress signaling pathways; (4) Conclusions: The results of this study suggest that intranasal administration of Apelin-13 holds promise as a therapeutic strategy for preventing neurodegenerative diseases such as AD. By improving synaptic plasticity and mitigating oxidative stress, Apelin-13 may offer a novel approach to neuroprotection in AD and related conditions.

: Cardiac surgery (CS) with extracorporeal circulation (ECC), induces oxidative stress and systemic inflammatory response, which may seriously affect postoperative lung function. We aimed to test if high parenteral (200mg/kg/24h) perioperative (48h) doses of Vitamin C (VitC) may reduce the incidence and severity of postoperative pulmonary complications (PPC) in selected CS patients. Single centered, prospective, randomized, single-blinded, interventional study included 150 patients, assigned to control group A (n=75) and interventional group B (n=75). Group B intraoperatively received 1/4 of the planned daily Vit C dose (200mg/kg/24h), diluted in 10 ml of normal saline, divided into three parts, while Group A received an equal volume of normal saline at the same time frames. After 6 h from the first intraoperative dose, the following regimen was applied: Group B: 200 mg/kg/24h - 30 min i.v. infusion of VitC in 50 ml of normal saline, every 6h, for the next 48h, and Group A: 30 min i.v. infusion of an equal volume of normal saline every 6 hours, for the next 48h. Modified Kroenke’s score was used to determine the incidence and severity of PPC. The overall incidence of PPC was 36.7% and was significantly lower in Group B (13.3% v.s. 60.0%, p&lt;0.001). The severity of PPC was also significantly lower in Group B [1(1) v.s. 3(2), p&lt;0.001]. Besides, patients from Group B had significantly less damaged lungs and better postoperative renal function, shorter ICU stay, fewer ICU re-admissions, and lower hospital mortality. High parenteral daily VitC doses (200mg/kg/24h) given to selected CS patients for 48h after CS are safe and effective in reducing the incidence and severity of PPC. Further multicenter RCT is needed to confirm these results.

With the pressure of the increasing density of urban areas, some public infrastructures are moving to the underground to free up space above, such as utility lines, rail lines and roads. In the big data era, the three dimensional (3D) data can be beneficial to understand the complex urban area. Comparing to spatial data and information of the above ground, we lack of the precise and detailed information about underground infrastructures, such as the spatial information of underground infrastructure, the ownership of underground objects and the interdependence of infrastructures in the above and below ground. How to map reliable 3D underground utility networks and use it in the land administration? First, to explain the importance of this work and find a possible solution, this paper observes the current issues of the existing underground utility database in Singapore. A framework for utility data governance is proposed to manage the work process from the underground utility data capture to data usage. This is the backbone to support the coordination of different roles in the utility data governance and usage. Then, an initial design of the 3D underground utility data model is introduced to describe the 3D geometric and spatial information about underground utility data and connect it to the cadastral parcel for land administration. In the case study, the newly collected data from mobile Ground Penetrating Radar is integrated with the existing utility data for 3D modelling. It is expected to explore the integration of new collected 3D data, the existing 2D data and cadastral information for land administration of underground utilities.

Mental healthcare conditions in India are severely deficient, particularly concerning the living conditions of patients. Post-treatment, numerous individuals with mental illness are abandoned by their families, who may lack the willingness or financial means to care for them. These recovered patients often experience setbacks due to the absence of facilities aimed at developing the skills necessary for reintegrating into society. The lack of separate accommodations for recovered individuals forces them to reside with other patients, worsening their condition. The government is struggling to accommodate and finance the care of recovered patients, affecting those in need of treatment as hospital bed space becomes overwhelmed by the increasing number of cured individuals. Therefore, there is an urgent need for halfway homes. These facilities offer a range of services, including social, medical, psychological, and educational support, alongside housing. The term "halfway houses" reflects their position between fully independent living and highly regulated in-patient or correctional facilities. Following treatment, many patients experience abandonment by their families or encounter difficulties returning home due to memory loss. Recovered patients often live in confined spaces, lacking essential social skills. Therefore, establishing a workspace focused on teaching social and other necessary skills before reintegrating them into society would be a beneficial approach. This would provide a structured environment for individuals who have spent significant time in seclusion, assisting them in developing the skills needed to navigate societal challenges effectively. Recent reports indicate that over 2,000 cured patients are still housed in mental hospitals across the country, according to the NHRC. The NHRC has raised concerns about the situation, noting that all 46 Government Mental Healthcare Institutions in India display very poor and inhumane treatment of patients, leading to the issuance of notices. NHRC visits have revealed deplorable conditions in all 46 mental institutes across the country.

Researchers are always looking to find ways to use energy more efficiently while keeping people comfortable at home. They've tried different methods like fuzzy logic and genetic algorithms to do this. In this paper, we introduce a novel model that combines different techniques like data smoothing, optimization, machine learning, and control algorithms to reach this goal in smart homes. The proposed model is made up of three main parts: smoothing, optimization, and control. The smoothing part uses the Kalman filter to get rid of any unnecessary noise and make sure the data used to predict energy use is clean and smooth. The optimization part uses both genetic with firefly algorithms and artificial neural networks to minimize the gap between the actual environmental conditions and the conditions users find comfortable. It adjusts the comfort settings in real-time using machine learning. The control part uses Mamdani fuzzy logic to make sure energy is delivered in the best way possible to the systems that control temperature, lighting, etc., making the home comfortable and saving energy at the same time. Comparative analyses demonstrate the superiority of the proposed model over existing algorithms, including the Particle Swarm Optimization (PSO) algorithm. Additionally, the paper discusses the importance of adaptive controllers in addressing issues associated with incorrect PID controller selection and highlights the benefits of using the FA-GA in energy optimization and comfort improvement. Overall, the proposed model offers an effective solution for efficient energy consumption optimization and enhanced user comfort in diverse settings through the integration of advanced algorithms and optimization modules.

This study investigates why young adults live with their parents in Sweden. As young adults’ living arrangements affect decisions about marriage, education, childbirth, and participation in the workforce, more knowledge for policy makers is crucial to implementing effective policies to support young adults and promote financial independence and well-being. Using a data set from 1998 to 2021 at the municipal level in Sweden, we used a spatial autoregressive panel data model to examine the proportion of young adults living at home and regional disparities. The study uncovers intraregional variations, illustrating how different municipalities within Sweden exhibit different patterns of young adults living at home. Our findings reveal that economic factors, such as unemployment, significantly impact this pattern. The dynamics of the housing market, demographic factors, cultural differences, and location-specific characteristics also play an essential role in explaining this pattern. The findings suggest that the key drivers are the lack of rental housing, high unemployment rates, a high degree of urbanisation, interregional migration, and lack of social capital.

Abstract: Background: The Hospital-at-home (HAH) model is a viable alternative for conven-tional in-hospital stays worldwide. Serum electrolyte abnormalities are common in acute pa-tients, especially in those with many comorbidities. Pathologic changes in cardiac electrophysi-ology pose a potential risk during HAH stay. Periodical Electrocardiogram (ECG) tracing is therefore advised, but few studies evaluated the accuracy and efficiency of compact, self-activated ECG devices in the HAH settings. This study aimed to evaluate the reliability of such a device in comparison to a standard 12-lead ECG. Methods: We prospectively recruited consecu-tive patients admitted to the Sheba Beyond, virtual hospital, in the HAH department, during a 3-month duration. Each patient underwent a 12-lead ECG recording using the legacy device, and a consecutive recording by a compact 6-lead device. Baseline patients’ characteristics during hospi-talization were collected. Level of agreement between devices was measured by Cohen’s Kappa coefficient for inter-rater reliability (Ϗ). Results: Fifty patients were included in the study. 26 (52%) had electrolyte disturbances. Abnormal D-dimer values were observed in 33 (66%) pa-tients, and 12 (24%) patients had elevated troponin values. We found a level of 94.5% raw agreement between devices with regards to nine of the options included in the automatic read-out of the legacy device. The calculated Ϗ was 0.72, classified as substantial consensus. The rate of raw consensus regarding ECG intervals’ measurement (PR, RR, QT) was 78.5% and the calculated Ϗ was 0.42, corresponding to a moderate level of agreement. Conclusion: This is the first report to our knowledge regarding the feasibility of using a compact, 6-Lead ECG device in the setting of HAH to be safe and bearing satisfying agreement level with a legacy, 12-lead ECG device, en-abling quick, accessible arrythmia detection in this setting. Our findings bear a promise to the future development of telemedicine-based hospital at home methodology.

Respiratory therapist(RT)internet-supervised At-Home Telespirometry(AHT)was validated in pilot 22/95=23% ALS Clinic population. Erect, supine Vital Capacity(eFVC, sFVC)were measured longitudinally using ZephyRx smartphone interface and database recording in-clinic-conventional(Viaire-Vyasis-)and at-home-portable(MIR-Spirobank-Smart-)spirometers. Bland-Altman(BA)analysis supported content validity-precision and 7-day-test-re-test-validity [mean difference=0.15L(conventional–portable;95%CI -0.40L, 0.70L); = 2.7% predicted (conventional-portable;95%CI -12.1%, 17.5%) ]meeting ATS-ERS performance standards. RT Internet-supervised AHT measured sFVC was more frequently obtained[35/52=67.3 %]in-home-vs-in-clinic sFVC[9/21=42.9 %](Chi-Square;P=0.0533). Monthly mean eFVC slope decline for the eFVC > 60 % predicted baseline cohort was – 1.24% predicted per month[95% CI -2.15 ,-0.33% predicted]statistically significantly(P=0.015)less compared with the – 5.86% predicted per month[95% CI -9.44, -2.29 % predicted]decline for the eFVC < 60 % predicted baseline cohort and in this cohort was associated with statistically significant decreased survival(P=0.0219). RT Internet-supervised AHT facilitated initiation of non-invasive ventilation(NIV)in 5/22[23%]patients including 3/4[75%] homebound subjects. RT Internet-supervised AHT can be deployed for ALS patients stratified according to baseline eFVC for earlier detection of eFVC and sFVC decreases between clinic visits. A prospective research study[NCT05106569]is ongoing to further define the capability of online deployment of Respiratory therapist(RT)internet-supervised AHT in the timely initiation of NIV use to improve ALS respiratory care in larger numbers of ALS subjects.

The common dolphin is the second most bycaught species in Korean waters. To provide key information about their habitat boundaries and hotspots for spatial conservation and management, the spatial use of this species was examined using data obtained from sighting and bycatch surveys of cetacean during the past 20 years. The 95% minimum convex polygon and 95% density contour of fixed kernel suggested that the boundary of home range of common dolphins is limited to the coastal region (Busan-Sokcho) of the East Sea/Sea of Japan. From 50% density contours dawn by kernel density estimation, it was suggested that their hotspots are around the cost of Ulsan-Pohang, Doghae, and Sokcho within the home range. Common dolphins are not at all distributed in the Yellow Sea. Hence, shallow waters, such as the coastal region of the Yellow Sea, are not suitable habitats for common dolphins.

Introduction: In the marginalised countries most neglected health issue is Newborn mortality. A study was undertaken to assess the influence of factors and newborn care practices influencing newborn health in the rural area of Bareilly district. Methodology: The Descriptive cross-sectional study was organized in the rural areas of Bareilly. Study participants were selected based on the mothers who gave birth to a baby during the last six months. The mothers who delivered in that area within six months were included, and using the semi-structured questionnaire, data was collected. Data analyzed using Microsoft Excel and SPSS 2021 version for windows. Results: Mothers initiating early breastfeeding were more commonly 78 (52.3%) observed in the younger mothers at 24-29 years, followed by 48(32.3%) at 30-35 years, the difference was statistically significant (p<0.05). Delayed bathing was observed in nearly 125 (70.1%) three fourth in the age of 24-29 years, followed by 29 (16.8%) in the age period 30-35 years. It was observed that unsafe cord care practices were observed more among 8(53.4%) nuclear families than 7(46.6%) joint families, and it was found to be statistically insignificant. Conclusion: The practice of essential newborn care still needs to improve in Bareilly; there is a need to create awareness to the mothers and family members on newborn and early neonatal care aspects, such as promoting exclusive and early initiation of breastfeeding and delayed bathing practices.

Background: Australia’s healthcare system is complex and fragmented which can create challenges in healthcare, particularly in rural and remote areas. Aboriginal people experience inequalities in healthcare treatment and outcomes. This study aimed to investigate barriers and enablers to accessing healthcare services for Aboriginal people living in rural and remote Australia. Methods: Semi-structured interviews were conducted with healthcare delivery staff and stakeholders recruited through snowball sampling. The communities were selected for their high proportion of Aboriginal people and geographical representation (coastal, rural, and border). Thematic analysis identified barriers and enablers. Results: Thirty-one interviews were conducted (n =5 coastal, n=13 remote, and n=13 border) and six themes identified: 1) Improved coordination of healthcare services; 2) Better communication between services and patients; 3) Trust in services and cultural safety; 4) Importance of prioritizing health services by Aboriginal people; 5) Importance of reliable, affordable and sustainable services; 6) Distance and transport availability. These themes were often present as both barriers and enablers to healthcare access for Aboriginal people. They were also present across the healthcare system and within all three communities. Conclusions: This study describes a pathway to better healthcare outcomes for Aboriginal Australians by providing insights into ways to improve access.

Comprehensively understanding the spatial ecology and habitat preferences of endangered species is essential for population restoration and conservation. We investigated the home range and movement of the endangered Amur soft-shell turtle (Pelodiscus maackii) in the Ussuri River, Heilongjiang Province, Northeastern China. The study involved tracking 19 Amur soft-shell turtles from late June to mid-October, 2022, resulting in complete and partial home range size data for eight subadults and two adults, respectively. The primary analysis focused on eight subadults, and the models that best described daily movement were identified. We also explored the potential factors influencing home range size. Mean movement rate ranged from 39.18 ± 20.04 m to 72.45 ± 29.36 m and was positively correlated with the linear home range and water temperature. The most insightful home range estimate was a 95% kernel density estimate, employing likelihood cross-validation smoothing with constraints set to the river boundaries. The mean home range size was 1.02 ha and was not correlated with body size. Subadults tended to establish well-defined home ranges over time; whereas, defining home ranges for adults proved challenging. This research addresses a gap regarding the ecology of the Amur soft-shell turtle and provides a foundation for future conservation plans.

The background of this work is related to the scheduling of household appliances, taking into account variations in energy costs during the day, due to official Brazilian domestic tariffs: constant and white. The white tariff can reach an average price of around 17\% lower than the constant, but charges twice its value at peak hours. In addition to cost reduction, we propose a methodology to reduce user discomfort due to time shifting of controllable devices, presenting a balanced solution through the analytical analysis of a new method here called tariff space, derived from white tariff posts. To achieve this goal, we explore the geometric properties of the movement of devices through the tariff space (geometric locus of the load), over which we can define a limited region in which the cost of a load under the white tariff will be equal to or less than the constant tariff. As a trial for the efficiency of this new methodology, we collected some benchmarks (such as execution time and memory usage) against a classic multi-objective algorithm (Hierarchical) available in the language portfolio in which the project has been executed (Julia language). As a result, both methodologies achieve similar results, but the one presented in this article shows a significant reduction in processing time and memory usage, which could lead to the future implementation of the solution in a simple, low-cost embedded system like an ARM cortex M.

Meals on Wheels (MoWs) are critical in enabling adults with care and support needs to live independently. However, many individuals are unaware that the service exists. The aim of this study was to review the websites of local authorities in the UK, and those of 3^rd-party providers they signpost to, to establish the quality of online information available on MoWs services, and the websites’ overall quality. Two data capture forms were used to extract information from local authority and 3^rd-party providers, consisting of 35 items across five domains, and 36 items across five domains, respectively. Items were awarded a score based on whether certain criteria were met or not, resulting in a maximum total score of 50 and 43 points for each local authority, and 3^rd-party provider, website, respectively. A total of 271 websites (223 local authority and 48 3^rd-party provider) were reviewed. The mean total score was 14.9 (SD 10.6, range: 1-40 points) for local authority websites, and 21.4 (SD 5.3, range: 10-35 points) for 3^rd-party provider websites. For all websites combined, online provision of MoWs information was generally poor, with the vast majority of websites (69.4%, n=188) assessed as requiring improvement, whereas only 4.4% of websites (n=12) were assessed as very good. These findings suggest that local authorities and 3^rd-party providers in the UK should seek to improve their online information provision on MoWs to enhance awareness of the service, and ensure that potential service users, and individuals who refer them to the service, can access high-quality information on MoWs.

Quite a number of new metered parking systems have been introduced in recent years by the local authorities of various spa towns in Poland in connection with home zone conversion projects. The traffic signs posted in these locations were limited to the beginning and end of the demarcated parking area. Traffic circle (TC) is an example of traffic calming measures (TCM) used in home zones to slow down the traffic (case study – home zone in a small spa village). This article presents the results of a study investigating the speed reductions obtained with a home zone and traffic circle used as traffic calming measures. The indispensable speed surveys were carried out in relation to this study in two periods: in summer when the streets are crowded with tourists and in September with little pedestrian traffic. Two research hypotheses were formulated as part of the speed data analysis to verify the slowing effect of traffic circle and the relevance of traffic circles design parameters and location, road function and the surrounding streetscape. For each hypothesis statistical analyses were carried out using two nonparametric tests: two-sample Kolmogorov–Smirnov test and median test. The third research hypothesis formulated in this study was related to sustainable development factors related to fuel consumption and traffic-related air pollution including carbon dioxide, carbon monoxide, nitrogen oxide and hydrocarbons. This hypothesis was verified by estimating the amount of air pollution in the home zone under analysis in three different situations (scenarios): in summer with the travel speed reduced by pedestrian traffic to ca. 8–10 km/h and in September with a small number of pedestrians and 20–25 km/h resulting speed between traffic circles, reduced at traffic circle, and in a theoretical 30 km/h zone with 25–30 km/h assumed speed between traffic circles, dropping at traffic circle. These analyses confirmed the appropriateness of traffic circle as a home zone traffic calming measure, as long as its design is based on a detailed analysis of the relevant factors, including location, road function and the surrounding streetscape.

Home enteral nutrition (HEN) is recommended for patients with nutritional requirements who can stay in the familiar environment. HEN guidelines recommend assessing health-related quality of life (HRQoL) to evaluate the effect of the treatment. NutriQoL® is a specific questionnaire developed to assess HRQoL in patients receiving HEN and validated in Spanish population. An observational, descriptive, and prospective study was carried out in two Spanish hospitals to describe the evolution of HRQoL, nutritional and health status in patients receiving HEN in routine clinical practice. Fifty-seven patients participated in the study, of whom 36 were followed-up after their inclusion. Most of them were at risk or moderate malnutrition (61.1%) or showed severe malnutrition (27.8%) at baseline. Patients with HEN showed an overall good HRQoL with a mean basal NutriQoL® score of 69.4, which increased to 74.3 after 12 months of follow-up; fifteen patients showed a clinically significant difference (≥4 points) after three months. The proportion of at-risk or severely malnourished patients decreased at the end of the follow-up period and, according to the physicians, their health status improved. Additionally, physicians considered useful the HRQoL evaluation in clinical practice. In conclusion, HRQoL is probably related to nutritional status improvement and, thus, should be considered for nutritional evaluation in clinical practice.

With increased participation in telework expected to continue, to support emerging hybrid work models in the aftermath of the Covid-19, it is important to consider the long-term impact this practice could have on sustainability outcomes. This paper describes a systematic review of 113 academic journal articles and identifies associations between telework and sustainability, explored by previous researchers. Those associations were categorized and discussed, based on their contributions to different United Nations Social Development Goals. Most of research was found to focus on countries classified as having a very high human development index status, and regions with a low, medium or high human development index, largely ignored. The SWOT matrix technique was used to illustrate the strengths and weaknesses identified in the current literature as well as threats and opportunities for future work. This can help to ensure policy coherence and that strategies to promote one outcome, such as economic productivity improvements, does not undermine another, such as improved health. Practical implications and potential research opportunities were identified across a range of SDG impact areas, including good health and well-being, gender equality, reduced inequality, climate mitigation, sustainable cities and resilient communities. On the whole, our impression is that increased rates of telework present an important opportunity to improve sustainability outcomes, however, it will be important that integrated and holistic policy is developed that mitigates key risks.

Urinary and fecal incontinence as well as skin pressure injury are common healthcare problems in nursing home; however, these prevalence and related risk factors were not well understood in the Japanese special elderly nursing home settings. We surveyed the prevalence of urinary, fecal and double incontinence, and skin pressure injury among the elderly living in special elderly nursing home in Japan. A nationwide cross-sectional epidemiological survey was conducted with a total of 4,881 residents. The prevalence of urinary, fecal and double incontinence was 82.9%, 68.9% and 64.9%, respectively. Skin pressure injury was found in 283 residents (283/4881, 5.8%). Age, Care-Needs level, loss of voiding desire, and fecal incontinence were significant risk factors for urinary incontinence. Residential period, Care-Needs level, loss of voiding and defecation desires, and urinary incontinence were significant risk factors for fecal incontinence. Only male sex was a significant risk factor for skin pressure injury. Our study revealed continence status and the prevalence of pressure skin injury among older adult residents who receive an end-of-life care in special nursing homes in Japan. Further studies should be conducted to examine whether recovery of urinary and fecal sensations improves continence status.

Virus-infected Flu is a common disease. To date, no specific drugs are available to manage the symptoms of cough, headache and sputum production. An alternative Chinese herb medicine is introduced for virus-infected Flu or similar infection. Before hospitalization, some of patients may scare for cross-infection with mild symptoms or hardly go to hospital if encountered a temporary lockdown or quarantine. Some Chinese practice self-treatment of cough, headache and sputum production by inhalation of volatile chemicals from onion and garlic. Author used to take the same alternative approach of inhalation of onion, garlic or scallions for self-treatment when suffered virus caused flu with cough, headache and sputum production at onset disease. In this article, the biomedical effects of onion and garlic are reviewed. To help patients with mild symptoms of virus infected Flu, a simple home-based treatment was suggested to self-treatment because of temporary isolation and hardly going to hospitalization. The alternative approach may also suggest for some mild virus infected respiratory diseases caused by virus at onset disease.

Internet of things security will be a big challenge for the enterprises working behind the build-up of the internet of things, and it’s application. With IoT, another buzzword is blockchain-based cryptocurrency bitcoin. Blockchain technology has proven itself as one of the most secured existing technology. In this paper, we have discussed the significant challenges that will come up in identity management due to the heterogeneity of devices. We have proposed a solution for privacy preservation using secure identity management and possible communication methodology by using public key-based cryptography used in the blockchain. We have taken the ecosystem of smart home management and smart health management. At last, we have concluded with the discussion of futuristic applications of blockchain in other applications of the internet of things.

In contrast to physical sustainable measures carried out in homes, such as insulation, the installation of a Home Energy Management System (HEMS) has no direct and immediate energy-saving effect. A HEMS gives insight into resident behaviour regarding energy use. When this is linked to the appropriate feedback, the resident is in a position to change his or her behaviour. This should result in reduced gas and/or electricity consumption. The aim of our study is to contribute towards the effective use of home energy management systems (HEMS) by identifying types of homeowners in relation to the use of HEMS. The research methods used were a literature review and the Q-method. A survey using the Q-method was conducted among 39 owners of single-family homes in various Rotterdam neighbourhoods. In order to find shared views among respondents, a principal component analysis (PCA) was performed. Five different types of homeowner could be distinguished: the optimists, the privacy-conscious, the technicians, the sceptics, and the indifferent. Their opinions vary as regards the added value of a HEMS, what characteristics a HEMS should have, how much confidence they have in the energy-saving effect of such systems, and their views on the privacy and safety of HEMS. The target group classification can be used as input for a way in which local stakeholders, e.g. a municipality, can offer HEMS that is in line with the wishes of the homeowner.

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

Long-term care (LTC) settings are increasingly used for palliative care in Japan. This study aimed to assess the proportion of LTC settings that provide palliative care services for older clients with advanced dementia in Japan and the trends across the types of settings. A nationwide questionnaire survey was conducted between November 2022 and January 2023, targeting 1,000 geriatric hospitals (GHs), 1,000 geriatric health services facilities (GHSFs), and 1,000 home nursing care stations (HNCSs). The palliative care practices for older patients with advanced dementia and their families in the agencies were assessed. Less than half of the GHs supported family participation or the spiritual needs of their older clients with dementia, while many had access to pain and symptom assessments and analgesic prescriptions by physicians. Less than half the GHSFs used pain assessment tools, assessed and supported family caregivers' pain and distress, and supported family participation in palliative care. More than 80% of the HNCSs practiced most of the listed palliative care. Current palliative care practices for older adults with dementia vary among GHs, GHSFs, and HNCSs. This emphasizes the need for targeted approaches to improve the provision of palliative care for patients with dementia across LTC settings in Japan.

This research explores the impact of working from home on employees' happiness, collaboration, and promotion prospects using machine learning techniques. The study is guided by three research questions aiming to investigate the correlation between working from home and employees' collaboration and promotion prospects. Moreover, the research aims to find a relationship between the number of households and employees' happiness levels while working from home. The data is collected from ICT engineers working at a technology company in Sweden through a questionnaire-based survey. Probability sampling was selected for data collection to reduce bias and enhance the generalizability of the findings. The data is pre-processed and then analysed in Jupyter Notebook using the Python programming language. Various libraries and models, including Pandas, NumPy, Matplotlib, Seaborn, and Scikit-learn, were employed for data analysis. Both Pearson correlation and p-values in Pearson correlation were used in this study to analyse the relationships between different variables.However, based on the results, this study did not find any significant relationship between working from home and employees' promotion prospects or collaboration issues. Additionally, the results did not provide evidence of a significant relationship between the number of households of employees and their happiness levels while working from home.

Sensor fusion algorithms and models have been widely used in recent times. Although research evidence has informed the use of sensor fusion models in diverse applications, there is room for improvement, especially in home-based health monitoring applications which require less supervision and technical knowledge of users. The present work compares data mining-based fusion software packages such as RapidMiner Studio, Anaconda, Weka, and Orange, and proposes a data fusion framework suitable for in-home applications. 574 privacy-friendly (binary) images and 1,722 datasets gleaned from thermal and Radar sensing solutions respectively, were fused using the software packages on instances of homogeneous and heterogeneous data aggregation. Experimental results indicated that the proposed fusion framework achieved an average Classification Accuracy of 84.7% and 95.7% on homogeneous and heterogeneous datasets respectively, with the help of data mining and machine learning models such as Naïve Bayes, Decision Tree, Neural Network, Random Forest, Stochastic Gradient Descent, Support Vector Machine, K-Nearest Neighbours and CN2 induction. Further evaluation of the sensor data fusion framework based on cross validation of features indicated average values of 94.4% for Classification Accuracy, 95.7% Precision and 96.4% for Recall.

Meals on Wheels (MoWs) provide access to daily meals and social contact to adults with care and support needs.MoWs could be essential for the increasing rates of an ageing population and adults living with complex needs in England, yet many do not know that the service exists. This study aimed to explore the perceptions of MoWs service users, and people who refer them to MoWs (‘referrers’), with accessing and setting up the service in England, and what information would be valued when considering accessing MoWs services.Semi-structured interviews were conducted in May-July 2022 with seven service users and 21 referrers, recruited from four MoWs providers across England. Data were analysed using thematic analysis. Participants indicated various pathways into the service, but referrers (family members) were more likely to be the ones enquiring about, and setting up, MoWs for service users. Once an enquiry about MoWs had been made, the service was perceived as straightforward to set up.However, existing preconceptions and stereotypes about the service (e.g. bringing to mind ‘school meals’, aimed solely at older adults) were perceived to act as barriers to accessing MoWs.Information that participants deemed important to have available when deciding on whether to access MoWs related to the meals (e.g. nutritional value, variety, need for any preparation, catering for individual needs), the specific services provided (e.g. wellbeing checks, daily social contact), the reliability and flexibility of delivery, and the cost of services. These findings could inform MoWs providers’ public awareness strategies about MoWs, in order to facilitate referrals to the service for adults with care and support needs.

The study reports about a case of a lung cancer patient with increasing difficulties in falling asleep and frequent periods of wakefulness. Severe dyspnea related to pneumonitis caused as a side effect of immunotherapy worsened the situation. Eventually, fear of falling asleep developed, including panic attacks and anxiety of choking, which was shown to lead to nights of complete wakefulness. The patient did not only sleep poorly; he did not sleep at all at night for several days, as evidenced by the notes he made during the night. Polygraphy showed no evidence of sleep-disordered breathing, but frequent periods of wakefulness and reduced basal saturation around 90% during sleep due to lung changes such as extensive functional failure of the left upper lobe with position-dependent shunts. The authors hypothesized that the symptoms described were causally related to a drop in oxygen saturation in the patient's blood. Therefore, they pursued the goal of finding a measurement technique that is as inexpensive as possible and that the patient can operate without outside assistance and great effort. So the patient started using a low-cost wearable device that allows simultaneous measurements of blood oxygen content, pulse rate and movement intensity. It consists of a finger ring with pulse oximetry sensor and a wristband with the control unit containing a vibration motor. The described device reliably warned of disturbances in oxygen concentration in the blood during the night with its vibration alarm. By use of that device during the whole night at home, the events of reduced oxygen saturation and the anxiety symptoms were reduced. Sleep disturbances with sudden awakenings did not occur when using the device. The patient benefited from the security gained in this way and slept much more peacefully, and he could spend nights without waking up again. In conclusion, wearable oximeters with vibration alarm can be recommended for patients’ home care in lung cancer patients.

Capturing complexity is both a conceptual and a practical challenge in palliative care. The HexCom model has proved to be an instrument with strong reliability and valid for describing the needs and strengths of patients in home care. In order to explore whether it is also perceived to be helpful in enhancing coordinated and patient-centered care at a practical level, a methodological study was carried out to assess the face validity of the model. Particularly, a Delphi method involving a group of 15 experts representing the full spectrum of healthcare professionals involved in palliative care was carried out. The results show that there is a high level of agreement, with a Content Validity Index-Item greater than 0.92 both with regard to the complexity model and the HexCom-Red, HexCom-Basic and HexCom-Clin instruments, and higher than 0.85 regarding the HexCom-Figure and the HexCom-Patient instruments. This consensus confirms that the HexCom model and the different instruments that are derived from it are valued as useful tools for a broad range of healthcare professional in coordinately capturing of complexity in healthcare practice.

In recent years, the management of health systems is a main concern of governments and decision makers. Home health care is one of the newest methods of providing services to patients in developed societies that can respond to the individual lifestyle of modern age and the increase of life expectancy. The home health care routing and scheduling problem is a generalized version of the vehicle routing problem, which is extended to a complex problem by adding special features and constraints of health care problems. In this problem, there are multiple stakeholders such as nurses for which an increase of their satisfaction level is very important. In this study, a mathematical model is developed to expand traditional home health care routing and scheduling models to downgrading cost aspects by adding the objective of minimizing the difference between the actual and potential skills of the nurses. Downgrading can lead to a dissatisfaction of the nurses. In addition, skillful nurses have higher salaries and high-level services increase equipment costs and need more expensive trainings and nursing certificates. Therefore, downgrading can enforce hidden huge costs to the managers of a company. To solve the bi-objective model, an -constraint based approach is suggested and the model applicability and its ability to solve the problem in various sizes are discussed. A sensitivity analysis on the Epsilon parameter is conducted to analyze the effect of this parameter on the problem. Finally, some managerial insights are presented to help the managers in this field, and some directions for future studies are mentioned as well.

We applied evolutionary game theory to extend a resource constrained security game model for confidentiality attacks in an Advanced Metering Infrastructure (AMI), which is a component of IoT-enabled Smart Grids. The AMI is modelled as a tree structure where each node aggregates the information of its children before encrypting it and passing it on to its parent. As a part of the model, we developed a discretization scheme for solving the replicator equations. The aim of this work is to explore the space of possible behaviours of attackers and to develop a framework where the AMI nodes adaptively select the most profitable strategies. Using this model, we simulated the evolution of a population of attackers and defenders on various cases resembling the real life implementation of AMI. We discuss in depth how to enhance security in AMI using evolutionary game theory either by a priori analysis or as a tool to run dynamic and adaptive infrastructure defence.

Aim: this scoping review was designed to identify studies that assess the adverse drug reactions (ADRs) for older people in Australian aged-care facilities. This review critically evaluated each published study to identify the risk of, or actual adverse drug events in older people. Inclusion criteria: This review considered any clinical studies that examined the adverse effects of medications in older people who were living in aged-care facilities. This review considered qualitative studies, analytical studies, RCTs, descriptive cross-sectional studies, and analytic observational studies that explored the use of medications and their adverse effects on older people in clinical settings (including aged care facilities). Methods: An initial search of the PubMed, OvidSP, EBSCOHost, MEDLINE, ScienceDirect, Wiley Online, SAGE, and SCOPUS databases, with full text was performed, followed by an analysis of the article’s title and abstract. Additionally, MeSH was used to describe the article. The initial round of the database search was based on inclusion criteria from studies that assessed tools or protocols aiming to identify the adverse effects of medications on the elderly population suffering chronic conditions or multiple co-morbidities. Two reviewers screened the retrieved papers for inclusion. The data presented in this review are in tabular forms and a narrative summary which aligns with the review’s objectives. Results: Seven studies were identified, and the extracted data from these studies were grouped according their characteristics and the auditing results of each study. Conclusion: There was no comprehensive or broadly adverse drug reaction assessment tool derived from Australian data that has been used on the elderly in an Australian healthcare setting.

The management of the electrical energy still raises a huge interest for end-users at the household level. Home electricity management systems (HEMS) have recently emerged both to warrant uninterruptible power and high power quality, and to decrease the cost of electricity consumption, by either shifting it in off peak time or smoothing it. Such a HEMS requires a bidirectional DC-AC converter, specifically when an energy transfer is required between a storage system and the AC-grid, and vice versa. This article points out the relevance of an innovative topology based on sinusoidal waveforms from the generation of sine half-waves. Such a topology is based on a DC-DC stage equivalent to an adjustable output voltage source and a DC-AC stage (H-bridge) which are in series. The results of a complete experimental procedure prove the feasibility to improve the power quality of the output signals in terms of total harmonic distortion (THD-values about 5%). The complexity of the proposed converter is minimized in comparison with multilevel topologies. Finally, wide band-gap semiconductor devices (SiC MOSFETs) are helpful both to warrant the compactness and the high efficiency (about 96%) of the bidirectional converter, whatever its operation mode (inverter or rectifier mode).

In the Emergency Department (ED), pain is one of the symptoms that is most frequently reported, making it one of the most significant issues for the emergency physician, but is frequently under treated. Intravenous (IV), oral (PO), and intramuscular (IM) delivery are the standard methods for administering acute pain relief. Firstly, we compared the safety and efficacy of IN analgesia to other conventional routes of analgesia to assess if IN analgesia may be an alternative for the management of acute pain in ED. Secondary, we analyzed the incidence and severity of adverse events (AEs) and rescue analgesia required. We performed a systematic review-based keywords in Pubmed/Medline, Scopus, EMBASE, the Cochrane Library and Controlled Trials Register finding only twenty randomized Clinical trials eligible in the timeline 1992-2022. A total of 2098 patients were analyzed and compared to intravenous analgesia showing no statistical difference in adverse effects. In addition, intranasal analgesia also has a rapid onset and quick absorption. Fentanyl and ketamine are two intranasal drugs that appear promising and may be taken simply and safely while providing effective pain relief. IN is simple to administer, non-invasive, rapid onset and quick absorption; it might be a viable choice in a variety of situations to reduce patient suffering or delays in pain management. Analgesia needs to be tailored to each patient's features and type of pain: IN Fentanyl and Ketamine look promising and may be administered easily and safely while providing effective pain relief.

Fit-for-purpose land administration (FFPLA) seeks to simplify cadastral mapping via lowering the costs and time associated with conventional surveying methods. The approach can be applied to both initial establishment and on-going maintenance of system. In Ethiopia, cadastral maintenance remains an on-going challenge, especially in rapidly urbanizing peri-urban areas, where farmers' land rights and tenure security are often jeopardized. Automatic Feature Extraction (AFE) is an emerging FFPLA approach, proposed as an alternative for mapping and updating cadastral boundaries. This study explores the role of the AFE approach for updating cadastral boundaries in the vibrant peri-urban areas of Addis Ababa. Open-source software solutions are utilized to assess the (semi-) automatic extraction of cadastral boundaries from orthophotos (segmentation), designation of 'boundary' and 'non-boundary' outlines (classification), and delimitation of cadastral boundaries (interactive delineation). Both qualitative and quantitative assessments of the achieved results (validation) are undertaken. A high-resolution orthophoto of the study area and a reference cadastral boundary shape file are used, respectively, for extracting the parcel boundaries and validating the interactive delineation results. Qualitative (visual) assessment verified the completed extraction of newly constructed cadastral boundaries in the study area, although non-boundary outlines such as footpaths and artefacts are also retrieved. For the buffer overlay analysis, the interactively delineated boundary lines and the reference cadastre were buffered within the spatial accuracy limits for urban and rural cadasters. As a result, the quantitative assessment delivered 52% correctness and 32% completeness for a buffer width of 0.4m and 0.6m, respectively, for the interactively delineated and reference boundaries. The study further demonstrated the potentially significant role AFE could assist in delivering fast, affordable, and reliable cadastral mapping. Further investigation, based on user input and expertise evaluation, could help to improve the approach and apply it to a real-world setting.

Aim: To analyze a single center's experience with Short Bowel Syndrome/ Chronic Intestinal Failure (SBS/CIF) in adult patients treated with Home Parenteral Nutrition (HPN). Materials and methods: In the last thirty years, 13 patients with SBS/CIF were included in an HPN program. Results: Between 1992 and 2023, 13 patients were included in an HPN program. The primary underlying pathology was acute mesenteric ischemia. The median age of the starting HPN was 44 years old. Most are submitted to several surgeries of extensive intestinal resection with posterior intestinal reconstruction. Five of the 13 patients have died while on HPN for a median of 42 months. The causes of death HPN-related were catheter sepsis, endocarditis with cardiac failure, or hepatic failure. One patient died due to underlying pathology: pelvic abscesses and bleeding related to radiotherapy. Eight patients remain alive with a median time of HPN of 173 months. During the HPN support, the most frequent complications were venous catheter infection and venous territory thrombosis. None of the eight patients alive have hepatic failure. Two patients recently started teduglutide, with good tolerance, and need reduction of HPN support. All these eight patients have a satisfactory quality of life (parenteral support needs range between five to two nutrition bags per week). Conclusion: HPN remains the gold standard of SBS/CIF treatment, although Teduglutide may reduce HPN needs and HPN complications and provide a better quality of life. An HPN multidisciplinary healthcare group support is essential to ensure these patients' survival and quality of life. Keywords Short bowel Syndrome, Chronic Intestinal failure, Home Parenteral Nutrition, Teduglutide, Complications of Parenteral Support.

Plant biotechnology is dependent today on accessing broader plant genetic resources for food and agriculture (PGRFA) diversity for ensuring food security for our future. Heterogenous agricultural lands are considered today as hotspot for biodiversity, and they also exist in the hilly mountain areas of Romanian’s Carpathians. The scope of this review is to describe traditional home-hardens related to the land use of households and cultivated species from Moșna commune, Sibiu County, Romania. The survey was realized with the support of authorities and local stakeholders from 2010 up to 2019. The results of this survey revealed that maintenance of crop species structure and land use of traditional households is longer than 100 years. Consequently at least 15 traditional Saxon home-gardens of 120 taken into the study may be defined. Today these home-garden covers a media of 26% of the total area of a household and should be part of a surface ranging between 5,000 and 1,500 m2. The first Local Council Decision in Romania in 2019 supporting the recognition of landraces and home-gardens as heritage values was officially adopted supporting the need to more access bottom-up approaches for supporting biodiversity conservation.