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

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

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

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

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

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

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

This article examines the diagnosis of the Agricultural Innovation System (SIA) in the department of Tolima, Colombia, as part of a project led by the Colombian Ministry of Agriculture and Rural Development and the Technological University of Pereira (TUP), which also evaluated the National Agricultural Innovation System (NAIS) in regions such as Chocó, Bolívar, and Meta. A methodology was used that involved a survey with 58 questions on a Likert scale to 300 participants, evaluated with congruence and relevance indexes, identifying key variables in the operation of the Agricultural Innovation System (AIS). A survey was also applied to actors of the National Innovation System for Higher Education in Agriculture, A survey was also applied to map the participating actors in the regional agricultural innovation systems of Tolima to identify gaps in extension, innovation, development, sustainability, ICT, education and training. Among the conclusions, it stands out that the associativity subsystem presents the lowest lag and is close to a score of two on the scale of gaps, evaluation carried out among the five subsystems including extension, ICT, environmental aspects, and pub-lic policy. The department of Tolima shows low performance in innovation and ICT, while the extension is less lagging. In Chaparral there is a general lag, with innovation being the worst evaluated subsystem. Rovira obtains high scores in most subsystems, although innovation and ICT have lower scores. At the national and regional levels, innovation is low, and articulation among NARS actors is insufficient, which highlights the need to promote good practices, strategies, and projects.

Background: Open AI developed ChatGPT, a language model based on the GPT architecture, designed for text-based communication. Trained on diverse internet texts, ChatGPT generates contextually appropriate responses using machine learning. It understands input through analysis and context interpretation, generating coherent and contextually relevant responses. Interaction is possible through messaging platforms. Materials and Methods: In November 2023, we utilized ChatGPT 3.5, the default version at that time, to answer questions from the Italian National Residency Program Admission Tests (SSMs) of 2021, 2022, and 2023. The questions cover clinical, diagnostic, analytical, therapeutic, and epidemiological scenarios, sometimes accompanied by images. The study compared ChatGPT's answers to the official corrections on the Italian Ministry of University and Research (MUR) website. The scoring method used for evaluation was 1 point for correct answers, 0 points for unanswered questions, and -0.25 points for incorrect answers, reflecting the SSM test scoring system. Results: In summary, ChatGPT was tested with a total of 420 questions, 140 for each test. It achieved an overall accuracy of 80.48%, providing correct answers for 338 questions and incorrect answers for 82 questions. When faced with questions containing both text and images, it answered 55% correctly and 45% incorrectly. The model's performance varied over time, with an 82.14% accuracy rate in 2021 and 2022 (115 correct out of 140) and a 77.14% accuracy rate in 2023 (108 correct out of 140). Applying thisscoring method to the SSM test, ChatGPT would have scored 105 points in 2021 and 2022, and 100 points in 2023. Conclusions: ChatGPT has exhibited above-average performance in the last three SSM tests, highlighting its robust capability to interpret clinical scenarios and offer precise diagnostic and therapeutic guidance. Despite this, some limitations persist, notably the software's inability to interpret non-textual information.

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

The Centers for Disease Control and Prevention (CDC) indicates that individuals with prediabetes are significantly less likely to develop type 2 diabetes if they participate in a lifestyle change program that results in at least 5% weight loss and 150 minutes of physical activity per week. The CDC recognizes distance learning as an effective delivery mode for lifestyle change programs to prevent type 2 diabetes. The purpose of this study was to assess enrollment, engagement, and effectiveness of a type 2 diabetes prevention program (DPP) using synchronous distance technology. Eat Smart, Move More, Prevent Diabetes (ESMMPD) is an intensive 12-month DPP delivered using synchronous distance technology. Throughout 26 lessons, participants focused on healthy eating, physical activity, and mindfulness behaviors. Study findings showed a significant decrease in A1C (-0.24 p<.0001). Weight loss averaged 5.66% for those who completed the program. Based on the Wilcoxon signed-rank test, participants demonstrated statistically significant changes in self-reported confidence in their ability to perform all 18 health-promoting behaviors assessed (p<.0001). Participation in the program also resulted in the adoption of health promoting behaviors. A DPP using synchronous distance technology is an effective delivery mode to help participants adopt healthy behaviors, increase physical activity, and achieve the weight loss necessary to prevent or delay the onset of type 2 diabetes.

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

The present article seeks to analyse the period 1938-1940, when the Romanian interwar democracy was suspended through the promulgation of the anti-liberal Constitution of 27 February 1938. The Constitution abolished the political parties and trade unions, replacing them with new institutions established according to royal decrees: the royal single party, known as the National Renaissance Front (Frontul Renaşterii Naţionale, FRN) and corporations of workers and employers, respectively. Starting from that moment, the regime, through its representatives, made recourse to a nationalist rhetoric directed against the democratic parliamentary system. Moreover, a cult of personality of the monarch can be identified in the speeches of the royal corporatist ‘parliament’, as well as in the doctrine of FRN and the Nation’s Party (its successor), but also in the regime’s youth organisation, ‘The Country’s Sentinel’ (Straja Ţării), whose First Sentinel was the authoritarian monarch himself. Thus, the cult of personality of Carol II represented one of the sources of inspiration for the dictator Nicolae Ceauşescu and for the leaders of this totalitarian regime.

This study aimed to evaluate the early-childhood comorbidities of cerebral palsy (CP) in children with low birth weight (LBW) and assess the impact of maternal bio-psychosocial factors on the risk of CP in preterm infants across varying birth weights. Data for 15,181 prematurely born infants from 2009 to 2013 and 151,810 matched controls from Taiwan's National Health Insurance Research Database were analyzed. Period prevalence of CP, and comorbidities of LBW were verified, and odds ratios (ORs) were calculated. Results confirmed that increasing prematurity and low birth weight (LBW) rates in Taiwan. LBW was associated with higher CP prevalence. Maternal age extremes (&lt;20 and &gt;40 years) were significant risk factors of CP in LBW infants. LBW infants showed higher risks of respiratory, circulatory, and nervous system and psycho-developmental comorbidities compared to controls. Infants with the lowest birth weights had even higher ORs for these comorbidities. However, gastrointestinal and nutritional comorbidities were less prevalent in premature infants. Maternal factors such as family income, number of hospital admissions, and length of hospital stay were significantly correlated with birth weight and subsequent complications. Each additional gestational week significantly reduced the risk of complications in premature infants. Additionally, maternal bio-psychosocial factors were associated with birth weight and related outcomes in premature infants, emphasizing the importance of addressing these factors in prenatal care and interventions.