With the rise of powerful computational technologies, healthcare systems are going through a paradigm shift to the era of healthcare 5.0, also known as" smart healthcare". This new-age healthcare system not only enhances the life of patients but also aims to reduce healthcare costs significantly. People's health data collected through various means, including various Internet of Things (IoT) devices, is too sensitive to be regulated by particular organisations owing to increasing privacy and security threats. The sheer size of data makes it difficult for centralised bodies to regulate, due to which third-party involvement is introduced, which again poses threats to the privacy of the data holder. Motivated by the abovementioned gaps, we propose a decentralised approach using Ethereum blockchain technology and Oasis protocol. The patient-driven solution approach effectively solves the privacy problem by providing complete control of data to the owner. Along with this, byproducts such as fine-grained access control and on-chain data processing capabilities are also obtained.

The advent of Large Language Models like Generative Pre-trained Transformer 4 (GPT-4) has introduced a revolutionary approach to bridging the communication gap between complex radiology reports and patient comprehension. This review article explores the pivotal role of GPT-4 in generating patient-friendly summaries of radiology reports, aiming to demystify medical jargon and enhance patient engagement and understanding. Through an examination of the technological underpinnings of GPT-4, this article highlights its capability to accurately interpret and simplify radiological findings into layman's terms. It assesses the impact of such advancements on patient satisfaction, adherence to treatment plans, and overall healthcare outcomes. Furthermore, the review delves into the potential challenges and ethical considerations associated with implementing AI-driven summaries in clinical practice, including accuracy, privacy, and the need for human oversight. By offering insights into the current applications, benefits, and limitations of GPT-4 in radiology, this short review underscores the transformative potential of AI in fostering a more inclusive and patient-centric healthcare communication paradigm.

Hospital bed shortage is a worldwide concern. Beds unavailability has caused elective surgery cancellations, at our hospital peaking in spring 2016 at over 50%. This is often due to difficult patient step-down from intensive care (ICU) and high-dependency units (HDU). In our general/digestive surgery service admitting approximately 1000 patients yearly, ward rounds were run on a consultant firm basis. We report a quality improvement (ISRCTN13976096) introducing in our service a structured daily multi-disciplinary board round framework (SAFER Surgery R2G) adapted from the “SAFER patient flow bundle” and the "Red to Green days” approaches to enhance flow, comparing the previous year to 2017, when our framework was applied for 12 months.We used a Plan-Do-Study-Act (PDSA) methodology. Our intervention consisted in 1) systematic communication of the key care plan after the afternoon ward rounds to the nurse in charge; 2) 30’ 10AM Monday-to-Friday multidisciplinary board rounds, attended daily by the senior-team and weekly by hospital and site managers, revising the key care plan aiming at safe, early discharges, assessing the appropriateness of each inpatient day and tackling any cause of delay. We measured patient flow by average length of stay (LOS), ICU/HDU step-downs and operation cancellations count, monitoring safety through early 30-day readmissions. Compliance was assessed by board round attendance and staff satisfaction rate surveys.After 12 months (PDSA 2, N=1032), LOS significantly decreased from 7.2(±8.9) to 6.3(±7.4) days (p=0.003); ICU/HDU bed step-down flow increased by 9.3% from 345 to 375 (p=0.197), surgery cancellations dropped from 38 to 15 (p=0.100). 30-day re-admissions increased from 0.9% (N=9) to 1.3% (N=14)(p=0.390). Average cross-specialty attendance was 80%. Satisfaction rates were >75%, regarding enhanced teamwork and faster decisions.The SAFER Surgery R2G framework has shown an increase in patient flow in the context of an enhanced multidisciplinary approach, requiring senior staff commitment to remain sustainable.

Background: Positive person-centered attributes of inpatient rehabilitation need to be identified from the patient perspective to be further developed and sustained. Purpose: To identify which attributes patients openly evoke as being great care experiences, using an open appreciative inquiry during the inpatient rehabilitation stay. Methods: Qualitative secondary analysis of appreciative patient comments during a bedside patient experience rounding, facilitated by a neutral party. Two independent analysts employed an inductive, summative form of content analysis. Results: Among 150 patients rounded, 122 provided categorizable appreciative accounts. Over two thirds of the patients (67.2%) focused on “staff attributes” in their great-experience accounts. Those attributes were mostly interpersonal such as being “attentive & caring - beyond clinical duty” and being “encouraging (but not too hard) & reassuring”. These interpersonal staff attributes were reported with words showing deep levels of personal significance or patient appreciation. Beyond staff attributes, the perceived quality of the “patient care” (31.1%) and opportunities for “leisure and social activities” (9.0%) were also frequently evoked. Amenities like food or costumer service were the least evoked, rarely so as an exclusive attribute (0.8% for each). Conclusions: The human(e) factor, especially the interpersonal qualities of staff, emerged as greatly appreciated from the patient experience perspective during inpatient rehabilitation. These experiences help identify which person-centered attributes of care might be further developed and sustained.

Patient group engagement is increasingly used to inform the design, conduct, and dissemination of clinical trials and other medical research activities. However, the priorities of industry sponsors and patient groups differ, and there is currently no framework to help these groups identify mutually beneficial engagement activities. Methods: We conducted 28 qualitative, semi-structured interviews with representatives from research sponsor organizations (n=14) and patient groups (n=14) to determine: 1) how representatives define benefits and investments of patient group engagement in medical product development and, 2) to refine a list of 31 predefined patient group engagement activities. Results: Patient group and sponsor representatives described similar benefits: engagement activities can enhance the quality and efficiency of clinical trials by improving patient recruitment and retention, reduce costs, and help trials meet expectations of regulators and payers. All representatives indicated that investments include both dedicated staff time and expertise, and financial resources. Factors to consider when evaluating benefits and investments were also identified as were suggestions for clarifying the list of engagement activities. Discussion: Using these findings, we refined the 31 engagement activities to 24 unique activities across the medical product development lifecycle. We also developed a web-based prioritization tool (https://prioritizationtool.ctti-clinicaltrials.org/) to help clinical research sponsors and patient groups identify high priority engagement activities. Use of this tools can help sponsors and patient groups identify the engagement activities that they believe will provide the most benefit for the least investment and may lead to more meaningful and mutually beneficial partnerships in medical product development.

Patient experience is key to patient-centered care and overall healthcare quality. This focus aligns with the growing trend of collaborative care, where patients actively participate in deci-sions alongside providers, leading to better outcomes. Patient experience goes beyond clinical results; it encompasses how patients feel throughout the care journey. Integrating patient per-spectives is essential for high-quality care. The study employed a multicenter, cross-sectional survey design utilizing a questionnaire-based approach. The data collection spanned two loca-tions within the Hospital Clínica Bíblica: San José, and Santa Ana, Costa Rica. The survey target-ed patients receiving treatment across the emergency department, surgery service, and inpatient department. A standardized Picker Patient Experience Questionnaire-33 (PPE-33) was adminis-tered to assess patients' overall experience with received services. A total of 390 questionnaires were analyzed. The participant demographics were as follows: 61.79% female, 56.15% aged be-tween 18 and 44, and 55.67% with undergraduate education. The hospital delivered high-quality service, with strong communication and accessibility (93.7%, 92.6%, and 94.4% positive respec-tively). Improvements are needed in patient rights education (22.7% positive), information about the patient's condition (74.3% positive), discharge instructions (36.5% and 71.4% positive for side effects and warning signs respectively) and addressing patient concerns (26.3% to 44.0%). Patients appreciated their privacy (95.2%), effective pain management (96.2%), respectful com-munication (97.0% and 94.8%), and overall respectful treatment. Satisfaction was influenced by factors like patient needs prioritization, rights communication, sociodemographic, health status, and comfort. The ward of admission had no significant impact on the experience. Enhancing pa-tient experience could boost loyalty and healthcare quality.

Individuals with low health literacy (HL) are known to have poorer health outcomes and to have higher mortality rates compared to individuals with higher HL: hence, the improvement of HL is a key outcome in modern healthcare systems. Healthcare providers are therefore asked to support patients’ literacy skills by encouraging the implementation of autonomy-supportive patient centered communication (PCC), which in turn requires the enhancement of patient engagement. Our main hypothesis is that the well-known relationship between autonomy-supportive PCC and HL is mediated by patient engagement which is known to play a role in HL promotion and that is related to PCC as well. The purpose of this study was to formulate a hypothetical structural equation model (SEM) linking PCC to patient engagement and HL. A cross-sectional survey design was employed involving 1007 Italian chronic patients. The hypothetical model was tested using SEM to verify the hypothesized mediation of patient engagement between PCC and HL. Results show that the theoretical model has a good fit indexes and that patient engagement fully mediates the relationship between PCC and HL. This finding suggests healthcare systems to implement a new paradigm where patients are supported to play an autonomous role in their own healthcare.

In Model-Driven Development (MDD), the models, their generation, and imposing changes on them (model transformation) are used for the development of software. Models provide a framework to start from the imagination and abstraction to create and accomplish the final system. Models create a slow and steady transition from whatness to howness, i.e. from the natural path of the generation of software. For supporting this path, the Logic and Functionality of software must be changeable during its evolution. Here we provide a brief introduction to the concept of Model Driven Development.

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

Clinicians are key in reclaiming the medical arts ceded to clinically irrelevant technology and thereby aligning patient with fast-changing biological realities. Narrowing the chasm between virtual and real perceptions of health hazards requires: 1) becoming acutely aware of the habitat loss aggravating the pervasive dissemination of chemicals via conventional food, air, and consumer products and the proliferation of non-ionizing radiation; and 2) making strategic use of slow, system 2 thinking so as to respond wisely to the rampant epidemics of chronic low-dose toxicity disregarded or misdiagnosed for half a century. To respond adaptively, take a moment during each patient encounter to add chronic ambient poisoning to the differential diagnosis and investigate subtle symptoms and signs of irritation in vulnerable organ systems. Enacting adaptive response across our profession could ease the suffering of millions, help avert the sixth extinction, and contribute to continuation of evolved life as we know it.

Patients with chronic obstructive pulmonary disease (COPD) often require frequent hospitalization due to worsening symptoms. Preventing prolonged hospital stay and readmission becomes a challenge for healthcare professionals treating patients with COPD. Although the integration of health and social care supports greater collaboration and enhanced patient care, organizational structure and poor leadership may hinder the implementation of patient-oriented goals. This paper presents a case of a 64-year-old chronic smoker with severe COPD who was to be discharged on long-term oxygen therapy (LTOT). It further highlights the healthcare decisions made to ensure the patient’s safety at home and further provides a long-lasting solution to the existing medical and social needs. The goal was accomplished through a discharge plan that reflects multidisciplinary working, efficient leadership, and change management using Havelock’s theory. While COPD is characterized by frequent exacerbation and hospital readmission, it was emphasized that most failed discharges could be attributed to bureaucratic organizational workflow which might not be in the patient’s best interest. It was further demonstrated that healthcare professionals are likely to miss the window of opportunity to apply innovative and long-lasting solutions to the patient’s health condition in an attempt to remedy the immediate symptoms of COPD

Recently, the availability of many omics data source has given the rise of modelling biological networks for each individual or patient. Such networks are able to represent individual-specific characteristics, providing insights into the condition of each person. Given a set of networks of individuals, a network representing a particular condition (e.g., an individual with a specific disease) may be seen as an anomaly network. Consequently, the use of Graph Anomaly Detection techniques may support such analysis. Among the others, Generative Adversarial Networks present optimal per- formances in anomaly detection. This paper presents ADIN (Anomaly Detection in Individual Networks), a framework based on Generative Adversarial Attributed Networks (GAANs) for anomaly detection in convergence/divergence patients at- tributed networks. Preliminary results on networks generated from computational biology gene expression data demonstrate the effectiveness of our approach in detecting and explaining bladder cancer patients.

Intensive care unit discharge is an important transition which impacts on patient wellbeing. Nurses can play an essential role in this scenario, potentiating patient empowerment. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement. Embase, PubMed/MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were evaluated in May 2021. Two independent reviewers analyzed the studies, extracted the data, and assessed the quality of evidence. Quality of the studies included was assessed using the Cochrane risk-of-bias tool. Of the 273 articles initially identified, eight randomized controlled trials reported nursing interventions mainly focused on patients’ ICU discharge preparation through information and education. The creation of ICU Nurse-Led and nurses’ involvement in critical care multidisciplinary teams also aimed to support patients during ICU discharge. This systematic review provides an update on clinical practice aimed at improving the patient experience during ICU discharge. The main nursing interventions were based on information and education, as well as the development of new nursing roles. Understanding transitional needs and patient empowerment are key to making the transition easier.

In this short note, the described step-by-step derivations of the industrial energy demand function from the production function framework and provided researchers with two specifications. Then we applied these theoretical specifications to the time series data as empirical analysis. We concluded that theories should be considered at the beginning of the empirical analyses but the data also should be allowed to speak freely. Hence, the main suggestion of this short note is that it would be a better strategy to consider the combination of theory-driven and data-driven approaches in the empirical analyses.

Emergency is a health condition that poses an imminent risk to life. In this context, operations and triage protocols play an important role in the correct functioning of the Emergency Department, a key component of national health systems. The aim of the study was to explore and describe the experiences of a group of patients regarding emergency departments that use the Manchester Triage System, a triage protocol widely adopted in Europe. The research approach used was phenomenography, which allows us to explore in depth the diversity of experiences lived by a group of patients. The data was collected through semi-structured interviews and analysed to identify the categories that allows a qualitative description of patient’s experiences. The results are structured in the following categories: “Healthcare professional roles“, “Waiting time to be cared“, “Triage protocol“ and “Emergency department utilization“. These results can be used to improve the way patients experience emergency situations and to contribute to increasing knowledge about the impact of emergency departments and triage protocols on patients.

Currently, in the scientific literature there is a great interest on the study of strategies to implement patient-centered care. One of the main tools for this is the therapeutic relationship. Some studies suggest that the perception of the environment in which the physical therapy treatment takes place can influence the perception of its quality. A qualitative study using focus groups was performed. Two researchers conducted the focus groups, using a topic guide with predetermined questions. The focus group discussions were audio-recorded, transcribed verbatim and analyzed thematically using a modified grounded theory approach. The setting was three hospitals and six public health centers located in Spain. The inclusion criteria were patients who had received a minimum of 15 physical therapy sessions and with no communication impairments. Thirty-one participants in four focus groups. Participants described a series of specific experiences relating to the environment, which they felt were influential in the establishment of therapeutic patient-centered relationships, including eight physical factors and five organizational factors. The results of this study highlight environmental factors that affect the quality of the therapeutic patient-centered relationship in physical therapy and emphasize the need for physical therapists and administrators to rethink the situation and propose strategies for improvement.

This study aims to understand the role of BPJS Kesehatan as a variable that mediates or mediates the relationship between emergency services and patient satisfaction. This can include how administrative processes, access to services, or costs incurred by BPJS affect the relationship between service and satisfaction. Quantitative studies of a correlational nature are a part of this investigation. In order to forecast endogenous variables (Y) Purchase decisions, researchers conduct correlational studies, which examine the link between one or more variables and other factors. Here, X represents emergency services, Y stands for patient satisfaction, and M for BPJS are the exogenous variables. The purpose of this research is to examine the role of BPJS as a moderator between the impact of emergency services on patients' levels of satisfaction. There were 120 people that filled out the survey, and the margin of error was 10% (based on a 90% truth rate and a 10% error rate). Purposive sampling was used to select participants for the aforementioned studies. Warppls 8.0 and the Warp Partial Least Square program were utilized for data analysis in this investigation. The study found that PKD significantly and positively affected 71% of participants' happiness with the impact they received. With a 63% influence, PKD has a favorable and statistically significant effect on BPJS. Patient satisfaction is significantly impacted by BPJS, which has a favorable association. When looking at the connection between community satisfaction and emergency services, BPJS is a key mediator. Community satisfaction can be enhanced through the provision of fast and excellent emergency services, and BPJS plays a vital role in mediating this relationship. The beneficial effect of emergency services on community satisfaction can be amplified if BPJS is able to offer sufficient coverage while simultaneously reducing costs and expediting administrative processes

This study aims to understand the role of BPJS Kesehatan as a variable that mediates or mediates the relationship between emergency services and patient satisfaction. This can include how administrative processes, access to services, or costs incurred by BPJS affect the relationship between service and satisfaction. Quantitative studies of a correlational nature are a part of this investigation. In order to forecast endogenous variables (Y) Purchase decisions, researchers conduct correlational studies, which examine the link between one or more variables and other factors. Here, X represents emergency services, Y stands for patient satisfaction, and M for BPJS are the exogenous variables. The purpose of this research is to examine the role of BPJS as a moderator between the impact of emergency services on patients' levels of satisfaction. There were 120 people that filled out the survey, and the margin of error was 10% (based on a 90% truth rate and a 10% error rate). Purposive sampling was used to select participants for the aforementioned studies. Warppls 8.0 and the Warp Partial Least Square program were utilized for data analysis in this investigation. The study found that PKD significantly and positively affected 71% of participants' happiness with the impact they received. With a 63% influence, PKD has a favorable and statistically significant effect on BPJS. Patient satisfaction is significantly impacted by BPJS, which has a favorable association. When looking at the connection between community satisfaction and emergency services, BPJS is a key mediator. Community satisfaction can be enhanced through the provision of fast and excellent emergency services, and BPJS plays a vital role in mediating this relationship. The beneficial effect of emergency services on community satisfaction can be amplified if BPJS is able to offer sufficient coverage while simultaneously reducing costs and expediting administrative processes.

Dementia is a major issue for healthcare systems worldwide, necessitating the development of creative and effective strategies for its management. This paper examines the use of Artificial Intelligence (AI) technologies in caring for and managing people with dementia. AI-driven solutions can improve diagnosis, personalize care, optimize medication management, and reduce the burden on caregivers. This paper discusses the implementation of an AI-based framework for creating videos related to people’s memories to support train-therapy or travel- therapy, a non-pharmacological intervention for Alzheimer’s disease patients

Oncology clinical pharmacists are uniquely positioned to make interventions to increase patient activation and engagement. To accomplish this goal, pharmacists can target health system-related, provider-related, and patient-related factors to help enhance patient-centered care and drive behavioral health changes. Interventions that pharmacists must tackle include educating team members and patients on the medication acquisition process, communicating urgency of treatment, optimizing workflows, facilitating guideline recommendations, preventing, and managing treatment toxicities, and promoting patient self-advocacy through education and shared decision-making. As crucial members of the healthcare team, oncology clinical pharmacists can simplify highly complex treatment regimens to facilitate and optimize patients’ ownership of their care. This review will focus on the example of venetoclax treatment in acute myeloid leukemia to demonstrate the impact that pharmacists provide that leads to behavioral change of patients and clinicians.

Visual Patient technology is a situation awareness–oriented visualization technology that translates numerical and waveform patient monitoring data into a new user-centered visual language. Vital sign values are converted into colors, shapes, and rhythmic movements—a language humans can easily perceive and interpret—on a patient avatar model in real time. In this review, we summarize the current state of the research on the Visual Patient, including the technology, its history, and its scientific context. We also provide a summary of our primary research and a brief overview of research work on similar user-centered visualizations in medicine. In several computer-based studies under various experimental conditions, Visual Patient transferred more information per unit time, increased perceived diagnostic certainty, and lowered perceived workload. Eye tracking showed the technology worked because of the way it synthesizes and transforms vital sign information into new and logical forms corresponding to the real phenomena. The technology could be particularly useful for improving situation awareness in settings with high cognitive demand or when users must make quick decisions. This comprehensive review of Visual Patient research is the foundation for an evaluation of the technology in clinical applications, starting with a high-fidelity simulation study in early 2020.

Background: Handover is a critical process for ensuring quality and safety in healthcare. Considerable research suggests that poor handover results in significant morbidity, mortality, dissatisfaction, and excess financial costs. Despite this, little formal attention, education, and evaluation has been given to handover. There is also paucity of data on the opinions of practitioners on the safety of handover.Objectives: The aim of this study was to measure the perceived risk, degree of patient harm and the systems used to support handover, and to understand how this varied by care setting, type of clinical practice, location, or level of experience. Methods: An open, anonymous and confidential online questionnaire covering: (a) respondent characteristics; (b) peer-to-peer handover; (c) internal referrals; (d) discharges and transfers between organisations; and (e) leading and improving handover was conducted with healthcare practitioners and managers from various settings. Results: We gathered a total of 432 completed responses from 26 countries. The average reported performance of handover was rated as 3.9 out of 5.For each type of handover, 12 - 14% reported errors occurring more than weekly. Of those that knew the outcome of such errors, between 29% and 34% reported that they had witnessed moderate or severe harm. 12% and 17% of respondents believed that handover was high or very high risk (See table 4). These respondents were more likely to have witnessed moderate or severe harm, or to be more senior.A wide combination of handover systems was utilised by respondents. 28% - 32% relied exclusively on EPRs (with or without face-to-face contact). 21% used Office documents such as Word and Excel for peer-to-peer handover, and over 30% used hand-written or manual systems. Conclusions: This study suggests the need to do more — and go further — to improve communication and reduce risk during all types of handovers. Clinical leaders should find ways to train and support handover with effective systems, with less experienced staff being the primary focus. More research is needed to demonstrate the interventions that improve the safety of handover.

One of the most common complications of neurogenic bladder secondary to spinal cord injury (SCI) is urinary incontinence, possibly related to bladder-emptying methods and changes in quality of life. This study aimed to identify the occurrence of this complication in adults with SCI and analyze its relationship with bladder-emptying methods, satisfaction, and lifestyle. This is a quantitative, exploratory, cross-sectional study. The variables were collected using the Bowel and Bladder Treatment Index during a telephone interview with 290 participants from February to November 2021. According to the results, 70% of the participants were male and 74.1% performed clean intermediate catheterization (CIC) as the main bladder-emptying method. Moreover, 55.6% were considered incontinent in the last year. Emptying by normal urination and bladder reflex triggering had a statistically significant relationship with urinary incontinence. A statistical association was observed between all the variables of satisfaction and lifestyle with urinary incontinence. Although CIC reduced urine leakage, a considerable number of participants still presented with frequent urine leakage. Urinary incontinence negatively altered satisfaction with the bladder-emptying method, effectiveness of bladder management, quality of life, and personal and social relationships.

Antennas are crucial elements for wireless technologies, communications and power transfer across the entire spectrum of electromagnetic waves, including radio, microwaves, THz and optics. In this paper, we review our recent achievements in two promising areas: coherently enhanced wireless power transfer (WPT) and superdirective dielectric antennas. We show that the concept of coherently enhanced WPT allows improvement of the antenna receiving efficiency by coherent excitation of the outcoupling waveguide with a backward propagating guided mode with a specific amplitude and phase. Antennas with the superdirectivity effect can increase the WPT systems performance in another way, through tailoring of radiation diagram via engineering antenna multipoles excitation and interference of their radiation. We demonstrate a way to achieving the superdirectivity effect via higher-order multipoles excitation in a subwavelength high-index spherical dielectric resonator supporting electric and magnetic Mie multipoles. Thus, both types of antenna discussed here possess a coherent nature and can be used in modern intelligent antenna systems.

The case for demand-driven research and development has received important considerations among governments, donors and programme implementing partners in development planning and implementation. Addressing demand is believed to be a bottom-top approach for designing and responding to development priorities and is good for achieving development outcomes. In this paper, we discuss the concept and application of demand driven research for development (DDRD) in Africa. We use evidence of six projects implemented under the BiomassWeb Project in Africa. We focus on parameters on level of engagement of stakeholders - whose demand is being articulated, the processes for demand articulation, capacity building and implementation processes, innovativeness of the project, reporting and sustainability of the project. We find that the nature of the institutions involved in articulation and implementation of demand-driven research and development projects and their partnerships influence the impact and reporting of demand-driven projects.

This study analyzed the risk of falls in the elderly and the safety of the environment in a teaching hospital in Brazil. The Morse Falls Scale was used to stratify the risk of falls in 45 hospitalized elderly individuals, and a checklist was used to analyze the hospital environment. The analysis was based on the chi-square test and multiple regression. The moderate risk of falls was predominant (51.1%). The variable age group (p-value = 0.024) showed statistical evidence of association with the risk of falls. However, the multiple regression analysis showed no difference between the age groups and the risk situation for falls. The hospital wards showed an adequate arrangement of furniture, but some aspects had inadequacies, such as objects in the corridors, non-functional bells in some beds, and inadequacy of the toilet bowls in terms of the recommended height, the absence of non-slip flooring and the support bar in some bathrooms. In conclusion, the moderate risk of falls among the elderly and the adequacy of the hospital environment to technical standards were evident, with the exception of failures in the emergency communication system and sanitary installation.

HIV infection invariably attracts the attention of medical staff in complex medical specialties. To achieve the goal of elimination by 2020, various approaches are required, including the establishment of prevention, diagnosis, monitoring, treatment, control measures. These should be supported by statistical studies that report on restricted or extended geographical areas, to the level of social class and age. Such an approach, combing the medical and social science perspectives (medicosocial) can prove useful for developing control measures. Due to the complexity of this immunodeficiency pathology, the condition also attracts comorbidities (most notably tuberculosis). Hence, prospective strategies need to be developed and oriented towards the goal of eradicating HIV infection. This paper presents strategies for consideration.

Patient safety is one of the indicators of the quality of health services in the hospital, for that, it is necessary to have efforts from the hospital to create a system that can minimize the occurrence of errors and unexpected events that can harm patients, nurses as health workers who are the most numerous in the home. sick and with the patient for 24 hours, has an important role in maintaining patient safety. This study aims to explain how the role of nurses and cooperation between health workers in implementing patient safety measures in the hospital. The method used in this study is a literature review by analyzing and exploring relevant articles and focusing on interprofessional collaboration to improve patient safety. The articles used in this study were taken from 3 direct, Proquest, Pubmed science databases published in the last 3 years, namely between 2019-2021, nurses as part of the health team are required to be able to work together with other health professionals in hospitals with various characteristics, including education, gender, age, employment status and length of work, nurses are required to be committed to maintaining patient safety in the hospital.

An outbreak caused by coronavirus disease 2019 (COVID-19) occurred in Wuhan City, Hubei Province, China, in December 2019. Up to March 2, 2020, at least 80180 cases have been reported. Most of the patients had a history of visiting Hubei Province or contacting with people who had ever stayed in or passed by Hubei Province, or exposed to symptoms. Some patients got infected only from asymptomatic contacts. This study aimed to report the epidemic features and lab identification of a patient confirmed with COVID-19 infection only from asymptomatic contact.

Objective: To map the literature pertaining to adult Person-Centered Rehabilitation (PCR).Data Sources: Following our previously published scoping review protocol, data were identified through: three major databases, snowball searches and expert consultation.Study Selection: Two independent reviewers identified English-language papers which addressed adult physical rehabilitation and met one or more of the six pre-defined inclusion categories for PCR content. Data Extraction: Two independent reviewers extracted key characteristics of included papers (e.g. aims, methods, participants). Quantitative methods (descriptive statistics, regression analysis) and qualitative content analyses were used to synthesize the results. Data synthesis: Of 5084 unique records initially screened, 145 papers were included: 111 empirical, including 11 systematic reviews. Empirical papers had data from 13498 clients and 3849 providers, in total. Yearly publications grew exponentially from 2000 to 2017 (r²= 0.65; p<0.01). Publications were unevenly distributed by countries (e.g. United States’ publications per population size was 45 times lower than New Zealand’s). Most papers focused in more than one profession, setting-type or health conditions, respectively 57.2%, 66.2%, and 60.7%. Finally, more than half of the empirical papers (53.2%) studied implementation of PCR approaches, including its effect. Conclusion: This scoping review synthesizes key characteristics and publication trends in the PCR literature, which is mainly empirical and growing exponentially over time. Stakeholders can use the identified trends, gaps, and literature map to guide further PCR research, and both clinical and organizational practices. The high prevalence of papers focused on multiple professions, settings-type, or health conditions reinforces the need for developing a transdisciplinary, trans-service model of PCR, which will be derived from a thematic analysis of this body of literature.

Philips Visual Patient Avatar represents an alternative method of patient monitoring that, according to computer-based simulation studies, enhances diagnostic accuracy, confidence and reduces workload. After its clinical integration, we assessed pediatric anesthesia providers' perspectives on this technology. This is a single-center qualitative study, conducted at the University Hospital Zurich using in-depth individual interviews. We aimed to identify the advantages and limitations of Visual Patient Avatar in pediatric anesthesia and to assess children and parents' reactions from caregivers' perspective. Thematic analysis was used to identify the dominant themes. Fourteen members of the institution's pediatric anesthesia team were interviewed. The most prevalent themes were: children's positive reactions towards the Visual Patient Avatar (92.9%) and enhanced speed in problem identification (71.4%). Additionally, 50% of participants reported finding the Visual Patient Avatar useful for diverting children's attention during anesthesia induction, and 50% suggested that its vital sign thresholds should be adaptable for different age groups. The study revealed that the Visual Patient Avatar was recognized as a valuable tool in pediatric anesthesia, enabling prompt identification of underlying issues and receiving positive feedback from both children and parents. The most commonly voiced wish for improvement in the study was the ability to customize the Visual Patient Avatar's thresholds for different age groups.

Visual Patient Avatar ICU is an innovative approach to patient monitoring enhancing the user's situation awareness in intensive care settings. It dynamically displays the patient's current vital signs through changes in color, shape and animation. The technology can also indicate patient-inserted devices, such as arterial lines, central lines and urinary catheters, along with their insertion locations. We conducted an international, multi-center study using a sequential qualitative-quantitative design to evaluate users' perception of Visual Patient Avatar ICU among physicians and nurses. Twenty-five nurses and twenty-five physicians from the ICU participated in the structured interviews. Forty of them completed the online survey. Overall, ICU professionals expressed a positive outlook on Visual Patient Avatar ICU. They described Visual Patient Avatar ICU as a simple and intuitive tool that improved information retention and facilitated problem identification. However, a subset of participants expressed concerns about potential information overload and a sense of incompleteness due to missing exact numerical values. These findings provide valuable insights into user perceptions of Visual Patient Avatar ICU and encourage further technology development before clinical implementation.

While nursing is an ethical profession, unethical behavior among nurses is increasing worldwide. This study examined the effects of an ethics seminar on nurses' moral sensitivity and ethical behavior. A total of 37 nurses (17 experimental, 20 control) were recruited. The ethics seminar was held over a 6-month period from May to October, 2018, and comprised six sessions held once a month for two hours. Moral sensitivity and unethical behavior were measured at the start and end of the seminar. Moral sensitivity and unethical behavior showed a negative correlation (r= -.455, p&lt;0.01). After the ethics seminar, the experimental group's moral sensitivity was significantly increased (t = -1.039, p = 0.314). The mean scores of unethical behavior at pre and post-test in the experimental group were 12.59 and 9.47, respectively. This was a statistically significant difference (t = 3.118, p = 0.004). There was no statistically significant difference in the mean score in both moral sensitivity and unethical behavior in the control group. We conclude that ethics seminars can enhance moral sensitivity and reduce the risk of unethical behavior among nurses. Regular ethics seminars and training must be provided to nurses as a matter of policy.

The movement toward prevention trials in people at-risk for Parkinson’s is rapidly becoming a reality. The authors of this article include a genetically at-risk advocate with the LRRK2 G2019S variant and two patients with rapid eye movement sleep behavior disorder (RBD), one of whom has now been diagnosed with Parkinson’s disease (PD). These authors participated as speakers, panelists, and moderators in the “Planning for Prevention of Parkinson’s: A Trial Design Forum” hosted by Massachusetts General Hospital in 2021 and 2022. Other authors include a young onset person with Parkinson’s (PwP) and retired family physician, an expert in patient engagement in Parkinson’s, and early career and veteran movement disorders clinician researchers. Several themes emerged from the at-risk participant voice concerning the importance of early intervention, the legitimacy of their input in decision-making, and the desire for transparent communication and feedback throughout the entire research study process. Challenges and opportunities in the current environment include lack of awareness among primary care physicians and general neurologists about PD risk, legal and psychological implications of risk disclosure, limited return of individual research study results, and undefined engagement and integration of individuals at-risk into the broader Parkinson’s community. Incorporating the perspectives of individuals at-risk as well as those living with PD at this early stage of prevention trial development is crucial to success.

A clinical simulation web-based program, known as FIRST2ACT (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends) is designed to increase the efficacy of cli-nicians’ actions in the recognition and immediate response to a patient’s deterioration. This study, which was nested in a larger mixed method project, used ten focus groups (n=65) of graduate, enrolled, registered nurses, Associate Nurse Unit Managers, and general manag-ers/educators/coordinators from four different institutions to investigate whether nurses felt their practice was influenced by participating in either a face-to-face or web-based simulation educa-tional programme about patient deterioration. Results indicate individuals who were less ‘tech-savvy’ appreciated the flexibility of web-based learning, which increased their confidence. Face-to-face students appreciated self-reflection through performance evaluation. While face-to-face simulations were unable to completely duplicate symptoms, they did show nurses' adaptability. Both interventions enhanced clinical practice by improving documentation and re-plies while also boosting confidence and competence. Web learners initially experienced tech-related anxiety, which gradually subsided, demonstrating healthcare professionals' resilience to new learning approaches. Overall, the study highlighted the advantages and challenges of web-based and face-to-face education in clinical practice, emphasising the importance of adapta-bility and reflective learning for healthcare professionals. Further exploration of specific topics is required to improve practice, encourage knowledge sharing among colleagues, and improve early detection of patient deterioration.

Replacement of fee-for-service with capitation arrangements, forces physicians and institutions to minimize health care costs, while maintaining high-quality care. In this report we describe how patients, their families (and caregivers) can work with members of the medical care team to achieve these twin goals of maintaining (and perhaps improving) high-quality care and minimizing costs. We describe how increased self-management enables patients and their families/caregivers to provide electronic patient-reported outcomes (i.e., symptoms, events) (ePROs) as frequently as the patient or the medical care team consider appropriate. These capabilities also allow greater reliance on the use of mobile technologies (mHealth) to provide ongoing assessments of physiologic measurements/phenomena. Remote surveillance of these communications allows longer intervals between (fewer) visits of patients to the medical-care team when this is appropriate and earlier interventions when that is appropriate. Systems are now available that alert medical care providers to situations when interventions might be needed.

Cable-Driven Parallel Robots (CDPRs) are a special kind of parallel manipulator which use cables to control the position and orientation of the mobile platform or end-effector. The usage of cables instead of rigid links offer some advantages over their conventional rigid counterparts. As cables can only pull, but not push, the number of cables (n) required to command the end-effector is always n+1. This configuration is known as fully-constrained and it is the most extended configuration for CDPRs. Although CDPRs have many advantages, such as their ability to cover large working areas, one of their main problems is that their working area (workspace) is limited in comparison to its frame area (planar case), or frame volume (spatial case), due to the minimum and maximum allowed tensions. Depending of these tensions values the workspace can be notoriously decreased. In order to tackle this problem, lots of works focus on solving kinematics or dynamics problems for cable sagging, i.e., they take into account sagging when modelling the robot kinematic and include these poses inside the usable robot workspace. Taking into account phenomenons like this increases the mathematical complexity of the problem, and much more complex techniques are required. On the other hand, the lack of workspace problem can be tackled by adding active or passive elements to the robot design. In this sense, this paper proposes two mechanical modifications: to add passive carriages to the robot frame and to use a single cable loop to command the end-effector position and orientation. This work presents the kinematic, static and dynamic models of the novel design and shows the gain of workspace for a planar case while taking into account different parameters of the robot.

This paper uses the spatial analysis software GeoDa as a tool, takes GRP (Gross regional product) of Sichuan Province in 2012 and 2018 as the dependent variable, and takes the city (autonomous prefecture) factor-driven, investment-driven and innovation-driven indicators as the dependent variable to explore the impact of innovation activities on regional economic development and the spatial distribution characteristics of regional economy. Through the comparison of the global correlation and local correlation, this paper explores the crux of the regional economic polarization and unbalanced development, and puts forward some measures to solve the existing economic development problems, such as cultivating and improving the regional industrial dependence, accelerating the regional transportation accessibility and convenience, and constructing the regional collaborative innovation system, So as to achieve the strategic goal of the construction of innovative Province in Sichuan Province.

Aim: The aim of the study is to analyze quantitatively the scientific literature covering nursing studies on patient safety. Method: The Web of Science database is queried in this retrospective bibliometric analysis to identify relevant publications. The study themes, contributing journals, countries, institutions, and authors were evaluated quantitatively. Thus, a total of 5470 publications concerning patient safety in nursing were included and analyzed. Findings: The number of studies conducted increased every year from 1992 to 2023. While the country whose articles receive the most citations (31072) is the United States of America (USA), Turkey is ranked as last with the lowest number of citations (581). Journal of Clinical Nursing, with 338 articles, appeared to have the highest number of publications, Chaboyer W. appeared to have the highest number of citations with a total of 1426 and 45 publications. The countries that have the strongest international cooperation for research in this field are the USA, England, Australia and China. Results: After examining the literature in the field of patient safety in nursing through bibliometric analysis, it is seen that themes such as patient safety, medication errors, nursing care, nursing, education, systematic review, quality care and leadership were emphasized as important considerations.

This study aimed to investigate the knowledge of patients with hypertension about their condition, adherence to antihypertensive medication, and the factors influencing it. A cross-sectional study was conducted in two cardiology outpatient clinics of two tertiary hospitals, in Greece. The study included 188 patients diagnosed with hypertension. The patient’s knowledge about their disease and adherence to medication were assessed by using the HK-LS and A-14 scales, respectively. Patients had sufficient knowledge levels about their disease, but significantly low levels of adherence to medication. Patients with higher knowledge levels were more adherent to medications [r(188) = 0.885, p &lt; 0.001]. By using multivariate analysis, higher age (p = 0.018), residence in a more populous area (p = 0.041), more years with the disease (p = 0.012), and a lower number of medications (p = 0.03) were associated with higher levels of knowledge. Conversely, younger age (p = 0.036), lower educational levels (p = 0.048), fewer years with the disease (p = 0.001), and a higher number of medications (p = 0.003) were associated with lower adherence to medication. The Greek patients' hypertension knowledge was sufficient, however, adherence to medication was significantly low. Healthcare managers could utilize our findings to design targeted interventions for improving adherence to medication for these patients.

Tinnitus is a symptom often associated with hearing loss (HL) and is in many cases more burdening to the individual than the HL itself. Many approaches have been made to explain the development and chronification of the phantom percept as well as different treatment strategies to lower the tinnitus related burden. In many studies, the variance of the HL data is high and therefore the interpretation of specific data might be difficult. With this retrospective study, we attempt to explain a part of this variance by investigating specifically the effects of non-auditory comorbidity categories on pure-tone audiometric data in a tinnitus patient collective that was homogeneous with respect to auditory comorbidities. We found age dependent as well as number of non-auditory comorbidity (e.g. diabetes mellitus) dependent differences in the mean HL of the tinnitus patients as well as differences in the peak HL frequency relative to the tinnitus frequency. The analysis of the age dependent HL within the different non-auditory comorbidities revealed specific – partially opposed – effects of endocrine, circulatory, muscle-skeletal and digestive disease categories on the hearing thresholds of tinnitus patients. Taken together we argue that in future tinnitus (and non-tinnitus) patient studies also non-auditory comorbidities should be taken into account as possible covariables that might explain the variance found in the auditory threshold development of these patients.

Long Covid is a debilitating condition that has been well-documented over the past 4 years and shares many similarities with other post-viral chronic illnesses. Despite this, clinicians are not confident in recognising the signs of Long Covid, or effectively managing the symptoms of their patients. This paper presents a single patient case report from a biomedical researcher who has had Long Covid for 2 years; it is written in relatively plain language to be accessible to both patients and clinicians across multiple specialities. The author has had the ability and expertise to keep up with the Long Covid research literature, and from that has cobbled together a management strategy that has alleviated her own symptoms, and those of other people with whom she has shared her protocol. The author’s experience of developing and managing her Long Covid is presented here, in the hopes that it may be of assistance to clinicians in identifying and managing Long Covid in their own patients.

Background: Poor patient flow can lead to adverse outcomes for patients and organisational inefficiency. Many hospitals have addressed suboptimal patient flow by increasing resourcing, such as bed stock and staffing, however, this is an unsustainable approach. In determining the nature of poor patient flow issues, it is important to collect data from healthcare professionals who manage patient flow on a daily basis. Doing so provides insights into the current state of patient flow management in its entirety, whilst also helping with the development of sustainable solutions.; Methods: Thirteen semi-structured interviews were conducted with clinicians who were directly involved with patient flow at a tertiary care centre in Tasmania, Australia. Results: Through a thematic analysis method, four major themes were developed: managing patient flow, communication for decisions, tools as enablers and barriers and increasing complexity. Conclusions: The findings of this study provide great insights into patient flow issues, with potential solutions identified to address them.

Obtaining a proper position for THA’s components is a crucial aspect for the implant perfor-mance and consequently patient outcomes. Patient specific kinematic seems to be a key factor to reach the optimal implant positioning. The aim of this study was to assess the accuracy and safety of a computed dynamic analysis system which through patient specific guides tries to improve implant positioning and functional orientation according to patient’s spinopelvic mobility and anatomy.A total of 100 consecutive patients were prospectively enrolled. All patients received an OPS dynamic hip preoperative planning. A TC scan protocol follow up analysis has done at 6 month after surgery.The mean deviation from the planned acetabular inclination and anteversion was 4.3° e 3.8° respectively. The 98% of cases was within +/- 10° of Lewinnek safe zone both for inclination and anterversion. The height of osteotomy deviated on the average of 1.6mm. The 100% cases were included within 4mm of osteotomy. Patient specific and laser guided instru-mentation is safe and accurately reproduce the dynamic planning in terms of components orien-tation, osteotomy level, leg length and offset.

Background: Falls in hospitalized older patients lead to increased length of stay and poorer discharge outcomes. The Comprehensive Unit-based Safety Program (CUSP) represents a quality improvement intervention for patient safety. Objective: To evaluate CUSP implementation for the prevention of falls at a teaching hospital. Method: An interdisciplinary CUSP team, received a four-hour online module and one-day face-to-face training. The intervention was developed using the WHO implementation science plan-do-study-act framework. Process evaluation was conducted using the UK Medical Research Council framework. The primary outcome measure of patient safety culture was determined using the Safety Attitude Questionnaire (SAQ), while annual fall rates were considered the secondary outcome measure. Results: Safety rounds were conducted during the two-year intervention period, each attended by five to eight HCPs, with nine to 29 patients reviewed each month. Risk factors, plans and actions were administered to individual patients, while local issues were identified and resolved through engagement of senior executives. SAQ domains increased from before (n=39) to after (n=30) the intervention of CUSP. Fall rates reduced from 11.18 per 1,000 bed days pre-implementation to zero falls post-implementation. Conclusion: Improvements in patient safety culture were observed after the implementation of CUSP alongside a reduction in fall rates.

Obsessive-compulsive disorder (OCD) remains, despite significant scientific progress, a pathological condition that is incomprehensible, due toits paradoxical psychological and behavioral symptoms. The presentwork aims at assessing current phenomenological understandings of this pathology. Among the cognitive models used today, post-rationalist cognitivism and cognitive neuropsychological psychotherapy, which both incorporate a phenomenological approach, seem most effective at grasping OCD patients’ experiences of the world, which are typically characterized by hyper-reflexivity, at the expense of "natural evidence." For OCD patients, the emotional sense of the world becomes a set of sterile rules that determine a suffering life.

Infectious mononucleosis (Mono) is mostly caused by the Epstein-Barr virus (EBV), and can spread through infected people sharing food and drinks with others. Once this virus gets into your system, it is there to stay. The virus can get activated when a person has low immunity and can cause major complications. Furthermore, if physicians miss the diagnosis of this disease, and prescribe penicillin-based antibiotics, it can cause severe rash and adverse reactions that compromise patient safety. This paper develops a simple Hidden Markov Model using which a Viterbi algorithm provides the maximum a posteriori probability estimate for the most likely hidden state path, given a sequence of symptoms arising as observations from a patient with hidden EBV positive or negative states. Apart from bringing awareness to help reduce missed diagnoses and subsequent adverse events, this work provides a tool for health care systems to better incorporate prompts during electronic medical record (EMR) interactions to help physicians catch potential missed diagnoses during a visit. This research demonstrates how statistical models can be used to assess likelihood of underlying conditions that require tests to be offered by physicians in order to make a definitive diagnosis. The model developed and applied herein for estimating likelihood of EBV infection from a series of observations has the potential to alter guidelines within healthcare systems to ensure that the safety of patients, particularly teens, is not compromised due to a lack of definitive diagnosis for Mono at point of care.

Therapeutic patient education (TPE) aims to empower the patients and their caregivers to effectively care for and manage their conditions. Such educational programs have been shown to improve health behaviors, disease outcomes and quality of life among different patient populations. The field of TPE has evolved extensively over decades, owing to interdisciplinary research. No study so far has been done to map this field, to identify the stakeholders and gaps requiring future research. By leveraging the theory of co-citation, Citespace was used to visualize the bibliographic data pertaining to TPE research. A total of 54,533 articles published in English language were analyzed to identify influential funders, regions and institutes contributing to this field. Besides these, important theoretical and empirical work that has shaped this field has also been mapped. Our analysis revealed several important insights. Most of the important theories which helped shape TPE were inspired from the social sciences. Five important themes of research were identified including disorders, study designs utilized in TPE research, scope of the TPE literature, and outcomes, and populations. The research focused on improving perceptions, behaviors, and attitudes for health promotion, reducing stigma as well as self-management and medication adherence. Most of the research was developed in the context of high income countries. The future research should more involve patients and use digital technology. Meta-analytical studies need to be done to identify the specificities of TPE interventions across different disorders. More research should involve low and middle income countries (LMIC) to ensure knowledge and technology transfer.

Background: The level of students' understanding of the knowledge of patient safety concepts in infection prevention and control and awareness of treatment is in the low category. Clinical education that provides problem-based learning models in real areas helps students to better understand patient safety. This study is designed to analyze the evaluation and reflection of the role of nursing education institutions in the achievement of patient safety competencies by nursing students.Method: "Searching for articles in research journals is obtained from Sciencedirect, Ebscohost, Garuda, Proquest and Scopus. As many as 228 articles were obtained consisting of nursing journals and health journals with the keywords clinical education, competence, and patient safety. After that, the screening process was carried out based on the inclusion criteria and obtained 25 articles that met the criteria. "Results: the results of the evaluation show that there is a big role in educational institutions in designing curricula, learning models, and clinical education models in an effort to achieve patient safety competencies in nursing students.Conclusion: the learning model about patient safety organized by many educational institutions is considered ineffective in producing the achievement of patient safety competencies for nursing students. This makes it necessary to develop models, reform the patient safety curriculum that is embedded in real areas in clinical education practice

The aim of the study was to determine the attitude of dentist toward learning communication skills and to recognize the factors influencing attitude toward learning communication skills. A cross-sectional study using a self-administered, 26-item, adapted Communication Skills Attitude Scale (CSAS) was carried out among dentist working in a public sector hospital in Qatar. Overall, two scores could be ascertained from the adapted CSAS: the mean positive attitude score (PAS) and negative attitude score (NAS). Non-parametric tests for statistical significance were utilized to assess relation between PAS and NAS scores and demographics. Fifty-nine dentists completed the survey giving an overall response rate of 53.6%. The mean (SD) PAS and NAS scores were 3.98 (SD=0.54) and 3.26 (SD=0.49) respectively. Female dentist was more positive towards learning communication skills than male. No statistically significant correlation was found between both PAS and NAS scores and respondents’ age. Dentists’ had both positive and negative attitudes towards learning communication skills. Considering the high NAS scores, it is recommended to introduce communication skills formal training sessions

Pharmacists’ roles in providing patient care remain limited in Indonesia, hence this study aimed to determine the preparedness of pharmacy graduates from one university in Indonesia to deliver patient care. Pharmacy graduates (both registered pharmacists [104] and recent graduates eligible for registration [45]) were sent a validated self-administered survey. The survey sought their perceptions about whether they had acquired 16 patient care related attributes. Further, it sought their opinion on the desirability of having those attributes. Data were analysed using SPSS version 22.0. Sixteen of 104 (15.4%) registered pharmacists and 40 of 45 (88.9%) recent pharmacy graduates participated in the study. More than 50% of participants in both groups were female and most participants were aged in their 20s. Of the recent pharmacy graduates the majority perceived they had at least partially acquired four of 16 list attributes. Male and female recent graduates had significantly different beliefs about their leadership ability (p=0.004). In comparison, most registered pharmacists perceived they had 10 out of the 16 listed attributes. The findings of this study suggested that pharmacy graduates should be better prepared to deliver patient care, and that curriculum redesign with expansion of experiential learning is required.

Collaboration across the agriculture supply chain is essential to address the high-yield demand and sustainable practices amid global overpopulation. Limited resources, such as soil, are compromised by excessive chemical agents and nutrient use. The Internet of Things (IoT) and smart farming offer solutions by optimizing agent application, data analysis, and farm monitoring. Evidence from numerous studies indicates that collaboration in the supply chain, including farmers, can improve efficiency and productivity, reduce costs, and enhance crop quality. This research focuses on implementing IoT technology to enhance decision-making for crop yield optimization and sustainable practices on a real farm. By collaborating with a farm in the southern region of Zagreb, Croatia, farmers were trained on sensor usage and yield monitoring. Small farms in that region face challenges in improving yields due to limited capacity and lack of entrepreneurial skills. The DMAIC methodology was applied to define the problem and measure relevant parameters. The analysis demonstrated consistent patterns between electrical conductivity (EC) measurements and potassium levels in soil. It suggests the potential for estimating potassium concentrations based on EC readings, or vice versa. Leveraging EC as a proxy for potassium levels could offer a cost-effective means of assessing soil fertility and nutrient dynamics. Additionally, the PCA biplot analysis highlighted that pH value behaved independently. Understanding these dynamics enhances knowledge of soil variability and informs sustainable soil management practices.

Purpose of review The forest industry has deployed ICTs to improve productivity of forest supply chains. In this sense, digitalization of data flows significantly impacts wood supply chains, from forest to mills, which must react flexibly to market fluctuations of forest products. The goal of this study was to conduct a literature review on data flow implementations in management systems of wood supply chains and to evaluate their applicability in supply chains to analyze the opportunities for improving them in practice. Recent findings We utilized the ScienceDirect database, Scopus and Web of Science in order to document data flows in systems and actual applications. Due to ongoing outsourcing, the wood procurement chains, and the wood supply chains were identified in the forest industry. Several different technologies can be implemented also in wood supply chains to digitalize the data flow depending on the specific needs of organizations. In this regard, digitalization of Big Data causes significant changes in elements of supply models that should be integrated and standardized in the optimization and simulation systems. Summary A modelling guide is suggested for accurate dynamic solution of problems of forest logistics. Then, the opportunities in digitalization for connecting different data flows, technologies, and stakeholders are discussed thoroughly. We conclude that data-driven dynamic optimization, and locally implemented digitalization contributes to wood supply modeling in the establishment of standards for cloud-based platforms at time-related and sequential measures which will ensure successful forest logistics through the planning and the monitoring of wood supply chains.

The separation of Li+ and [Bmim]+(1-Butyl-3-methylimidazolium) by electrically driven membrane technology was studied. The effects of the types and modification processes of cation exchange membranes, current density, total cation concentration, temperature, and anion types on separation efficiency were investigated. The results indicated that it is feasible to achieve efficient separation of Li+ and [Bmim]+ using the selectivity of cation exchange membranes under electric field. Membrane CMX and the modified membrane A and B which obtained from the CMX showed obvious selective of Li+ from [Bmim]+. When the current density is 5 mA/cm2 and the feed concentrations of Li+ and [Bmim]+ are 0.3 mol/L and 0.2 mol/L, the selective transport coefficient of the modified membrane B can reach 6.2 in the first 120 minutes of the process. Reducing current density and increasing total cation concentration can improve separation efficiency. Lowering the temperature can improve the separation effect, but improvement is not obviously. Changing the anion of the feed from chloride ion to acetate has no effect on the separation.

Digital filtering is a fundamental technique in digital signal processing, which operates on a digital sequence without any information on how the sequence was generated. This paper proposes a methodology for designing the equivalent of digital filtering for neuromorphic samples, which are a low power alternative to conventional digital samples. In the literature, filtering using neuromorphic samples is done by filtering the reconstructed analog signal, which is required to belong to a predefined input space. We show that this requirement is not necessary, and introduce a new method for computing the neuromorphic samples of the filter output directly from the input samples, backed by theoretical guarantees. We show numerically we can achieve a similar accuracy compared to the conventional method. However, given that we bypass the analog signal reconstruction step, our results show significantly reduced computation time for the proposed method and good performance even when signal recovery is not possible.

Cable interference in cable-driven mechanisms (CDM) is a major challenge in their applications. The wrench closure workspace (WCW) in a fully constrained mechanism may not be realized unless cable interference is considered. This paper classifies all possible types of cable interferences for planar cable-driven mechanisms and presents an analytical solution to find the boundaries of the constant-orientation interference region. It is shown that interference between cables starts and ends when one end of a cable coincides with another cable which can be thought as lying a point on a line segment. This geometrical view is developed and applied to provide a framework for the analysis of cable interference. By subtracting the interference space form WCW, the interference-free workspace is obtained in which the robot is able to operate.

The exposure of employees to specific risks is usually due to increasing levels of work-related stress, which negatively affects their skills and effectiveness in their job duties, lead-ing to the onset of physical/mental illnesses, mistakes, or even accidents. The aim of this study is to investigate the psychosocial risks experienced by nurses in tertiary hospitals in Greece and their association with their attitudes towards safety and the occurrence of medication errors. The research was conducted in four tertiary hospitals in Greece, with the participation of 514 nurses of all educational levels. Questionnaires were used to collect data on work-related stress, professional burnout, and medication errors. The results highlighted that psychosocial risks, such as high work pressure and lack of support, are directly linked to professional burnout and an increased likelihood of medication errors. The necessity of social support, job autonomy, and work-life balance are underscored as critical factors for reducing stress and improving the quality of care. Specific strategies are proposed to enhance the mental health of nurses and improve working conditions.

The complexity of the current social context leads healthcare professionals to deal daily with users who are increasingly varied in terms of culture, language and religion. Transcultural nursing is a practical discipline that aims to respond to the patient's need for assistance, but must not ignore the study and knowledge of the patient, with his history, his culture, but also with his expectations, in order to respond to his care needs with effectiveness, efficiency, adequacy and respect. This work originates from the desire to investigate the "state of health" of the relationship between nurses/health workers and migrant patients, researching the variables that improve or worsen it. It aims to investigate how diversity affects the care provided to migrant people, highlighting the difficulties felt by nurses and define the areas of possible care improvements. It seems possible to affirm that the nurses and health workers interviewed still respond to the problem of migrant patients with a strong spirit of participation and availability, without, however, this motivational charge being accompanied by a widespread "nursing" awareness of the problem.

Background: With the rapid improvement of the healthcare technologies, security and privacy of the most sensitive data, health data is at risk. Protecting patient privacy has many components, even though the data are in electronic format. Although patient privacy is thoroughly discussed in the literature, there is no study presenting all components of patient privacy protection. Methods: In this study, a complete evaluation framework is presented, as an evaluation tool, an inventory is developed, reliability and validity of the inventory is examined. Study is conducted in three phases: Conceptual framework development, inventory development and an evaluation case study. In the evaluation, fuzzy conjoint analysis is employed to handle the subjectivity and am-biguity. As the result of the evaluation, the institution is given a patient privacy protection ma-turity grade, between 1 and 5, where 1 is the worst and 5 is the best grade. Results: In the case study, XXX’s biggest hospital, employing 800 nurses, is evaluated. Half of the nurses, 400, have partici-pated in the study. Literature tells healthcare institutions do not invest enough to protect patient privacy, and the study results support this finding. Institution’s maturity grade resulted as level 2, which is bad. Conclusion: The study measures he privacy maturity with many evaluation com-ponents. Result of the evaluation explains to the patients and the public if their data is safe or not. With this maturity grade, patients have an idea about which institution to choose, public can conclude the institutions’ reliability in terms of patient privacy.

The study aimed to showcase how implementing a patient blood management (PBM) program effectively cut unnecessary red blood cell (RBC) transfusions in a New York City urban community teaching hospital. Analyzing seven years from 2013 to 2019, a retrospective review of RBC transfusions was conducted. Following PBM introduction, considerable improvements were observed annually. These included a drop in mean pretransfusion hemoglobin levels from 7.26g/dL (2013) to 6.58g/dL (2019), a 34% reduction in yearly RBC unit transfusions, and fewer units given to patients with pre-Hgb levels ≥7g/dL (1210 units in 2013 to 310 units in 2019). Furthermore, the study noted a decline in two-unit RBC orders when Hgb levels were ≥7g/dL from 65 orders in 2013 to merely 3 in 2019. The estimated total cost-savings attributed to the six-year PBM program duration after full implementation in 2014 amounted to $2.1 million US dollars. Overall, PBM implementation significantly decreased RBC transfusions and enhanced transfusion practices. The findings emphasize that successful PBM strategies don't always necessitate extensive resources or increased budgets but instead rely on the application of intuitive methods, as evidenced by this study.

Public health is an important aspect of community activities, making research on health necessary because it is a crucial field in maintaining and improving the quality of life in society as a whole. Research in public health allows for a deeper understanding of the health problems faced by a population, including disease prevalence, risk factors and other determinants of health. This work aims to explore the potential of hospital patient data analysis as a valuable tool for understanding community implications and deriving insights for effective community health interventions. The study recognises the significance of harnessing the vast amount of data generated within hospital settings to inform population-level health strategies. The methodology employed in this study involves the collection and analysis of deidentified patient data from a representative sample of a hospital in Indonesia. Various data analysis techniques, such as statistical modelling, data mining and machine learning algorithms, are utilised to identify patterns, trends and associations within the data. A program written in Python is used to analyse patient data in a hospital for five years from 2018 to 2022. These findings are then interpreted within the context of public health implications, considering factors such as disease prevalence, socioeconomic determinants and healthcare utilisation patterns. The results of the data analysis provide valuable insights into the public health implications of hospital patient data. The research also covers prediction for the patient data to the hospital based on disease, age and geographical residence. The research prediction shows that in 2023, the number of patients was not considerably affected, but in in March to April 2024, the number significantly increased to 10,000 patients. These recommendations encompass targeted prevention strategies, improved healthcare delivery models and community engagement initiatives. The research emphasises the importance of collaboration between healthcare providers, policymakers and community stakeholders in implementing and evaluating these interventions.

The aim of this study was to compare the effectiveness of propofol-based sedation and midazo-lam sedation in same-day bidirectional endoscopy (BDE) in children. The charts of children (≤15 years old) who had undergone same-day BDE were retrospectively reviewed. Demographic data, indications, sedatives and their dosages, clinical outcomes, endoscopic findings, adverse events, and patient time requirements were compared in cases with propofol-based and midazolam se-dation. A total of 91 children [51 boys, mean age 13 years (range 9-15)] were enrolled. Propofol alone or in combination with midazolam and/or pentazocine was given in 51 (propofol-based sedation group) while midazolam alone or in combination with pentazocine was given in 40 (midazolam sedation group). The mean doses of propofol, midazolam and pentazocine were 96 mg (range 40–145 mg), 4.1 mg (range 3–5 mg) and 7.5 mg in the propofol group while the mean doses of midazolam and pentazocine were 6.2 mg (range 4–10 mg) and 15 mg in the midazolam group, respectively. The total procedure times and endoscopic findings between the two groups were similar, but the median patient time requirement in the propofol group was significantly shorter than that of the midazolam group (7.3 h vs. 8.4 h, P<0.001). No adverse events occurred in either group. Propofol-based sedation shortened patient time requirements in same-day BDE compared with midazolam sedation in children.

This paper presents an OSA patient interactive monitoring system based on the Internet of Things (IoT) framework. This system allows OSA patients to get timely rescue when they are sleepy outside. Because the Beidou position marker has an interactive function, it can reduce the anxiety of the patient while waiting for the rescue. At the same time, if a friend helps the OSA patients to call the doctor, the friend can also report the patient's condition in time. This system uses the popular IoT framework. At the bottom is the data acquisition layer, which uses wearable sensors to collect vital signs from patients, with a focus on ECG and SpO2 signals. The middle layer is the network layer that transmits the collected physiological signals to the Beidou indicator using the Bluetooth Low Energy (BLE) protocol. The top layer is the application layer, and the application layer uses the mature rescue interactive platform of Beidou. Since the GPS indicator has not included the communication satellite, So it has no SMS function. OSA patients can only passively wait for a rescue. Moreover, due to the lack of satellites in Asia and the insufficient density of the ground-enhanced system, the positioning error of OSA patients is large. The Beidou system developed by China itself, the main coverage of the satellite is in Asia, and is equipped with a high-density ground-based augmentation system. Therefore, the Beidou model improves the positioning accuracy and is equipped with a special communication satellite, which increases the short message interaction function. Therefore, patients can report disease progression in time while waiting for a rescue. After our simulation test, the effectiveness of the OSA patient rescue monitoring system based on the Internet of Things framework and the positioning accuracy of OSA patients have been greatly improved. Especially when OSA patients work outdoors, the cell phone base station signal coverage is relatively weak. The satellite signal is well covered, plus the SMS function of the Beidou indicator. Therefore, the system can be used to provide timely patient progress and provide data support for the medical rescue team to provide a more accurate rescue plan. After a comparative trial, the rescue rate of OSA patients using the detection device of this system was increased by 15 percentage points compared with the rescue rate using only GPS satellite phones.

While obesity is recognized as a key global public health issue, there has been no research to date on the perceptions of care for people with this condition held by individuals in positions of organizational power. The aim of this study was therefore to describe the perceptions and experiences of clinical leaders and managers of providing care to inpatients with obesity at a metropolitan public health service. This study applied an interpretative phenomenological analysis (IPA) approach to qualitative research, conducting interviews with 17 participants. Their perceptions of care for inpatients with obesity encompassed both their personal understanding as an individual, and their observations about the organizational, patient and carer perspectives. Three overall themes were identified: 1) The problem of inpatients with obesity, 2) Inpatients with obesity as sources of risk and 3) Personal and professional perceptions of inpatients with obesity. While clinical leaders and managers were aware of potential impact of stigma and weight bias on the care given to this cohort, elements of implicit bias, stereotyping, ‘othering’ and ambivalence were frequently present in the data. Ongoing efforts to improve care for patients with obesity must therefore include efforts to address perceptions and attitudes at all organisational levels of the workforce.

The concept of patient confidentiality is nearly as old as the practice of health professions and, has evolved and transformed over the years, from one jurisdiction to the other. Patient confidentiality can be a fundamental human right, an ethical duty or, a legal duty. The Saudi laws have evolved around its Shari’ah-based legal culture, its history and the international human right laws (IHRLs). These elements have moulded the Saudi Arabia’s unique perspective on patient confidentiality. Its confidentiality laws are found scattered in several legislations. Is the Saudi patient confidentiality law able to adequately deal with the contemporary challenges? The study reviewed the relevant Saudi laws in the light the International Humana Rights Laws. Findings suggest that there are issues bordering on the lack of quality comprehensive data protection laws, on clarity and foreseeability of the existing laws, and on the accessibility of the courts. Furthermore, the lack of a system of law reporting and stare decisis potentially gave the judges a wider latitude of discretion in interpreting the laws. Therefore, the study recommends for a comprehensive data protection law with a clear definition of “confidential information”, of data controllers and their role, and of specific safeguards against potential abuses. Others include defining legitimate purposes for using the patient’s data, and his role, and the extent to which he can control the use of his own data. Consistency in legal interpretations, and an improved law reporting system could positively enhance the overall outcome.

Patient safety is a top priority for all healthcare systems globally. Promoting the adoption of policies for reporting and learning from errors is an important strategy for improving care safety. Therefore, the aim of our study was to detect how much patient safety culture influences the reporting of adverse events and the use of the incident reporting tool. The study protocol was developed according to PRISMA guidelines. Articles were searched electronically in PubMed/MEDLINE, the COCHRANE library, and Google Scholar by two independent reviewers, and those that met the eligibility criteria were included. Synthesis of qualitative data from included studies was performed by graphical descriptive statistical analysis. The results of the systematic review showed that health care organizations' increasing focus on staff development of a safety culture has led to a significant increase in incident reporting rates over the years. Moreover, in situations where safety culture is placed at the top of the nations, there is a higher frequency of incident reporting. An efficient incident reporting system should be an essential foundation for healthcare organizations, as it allows them to collect experiences and data and provide feedback to healthcare providers and staff involved in care.

Malawi has developed an excellent, nation-wide system for monitoring people infected with HIV and keeping track of key epidemic markers. Their success lies in two things: the focus on simplicity and the use of data collection not only to track the epidemic and identify problems but also to give regular feedback and support to every clinic in the country. This achievement is the more remarkable given that Malawi is one of the poorest countries in the world, ranking 190 out of 194 countries by GDP, but has one of the most severe epidemics of HIV in the world, ranking 9th out of 168 countries by HIV prevalence. We first discuss the current state and likely future epidemic trends in Malawi: unless we know where we are and where we are going we cannot decide what to do or how to do it to in order to achieve a better outcome. We then discuss the history and development of Malawi’s patient monitoring system, as reported in their Integrated HIV Program Reports,ix which have been published quarterly since the beginning of 2004. We consider the current state of patient monitoring and support as reflected in the most recent report for the third quarter (Q3) of 2016 and comment on some of the questions that this raises. Finally, we consider ways in which the current system could be improved by strengthening Malawi’s analytical capacity and making better use of this unique data set. The focus here is on HIV in adultsv because if ART is initiated early in all adults living with HIV this should include testing all pregnant women for HIV and starting them on treatment immediately. However, PMTCT is especially important and care must be given to reducing MTCT and identifying the long-term child survivors of mother-to-child transmission and this demands a complementary assessment. There is an ongoing debate about the relative merits of treatment and prevention in reducing transmission and it should be made clear that the primary reason for starting people on treatment early is that it is in the best interest of the individual patient to start treatment as soon as possible after becoming infected. Allowing a person’s immune system to deteriorate to any degree is not consistent with the clinician’s commitment to ‘first do no harm’ and even those with the highest CD4⁺ cell count are at a substantially increased risk of death. What matters, therefore, is to get as many people as possible onto ART, ensure that they remain virally suppressed, and consider prevention in this context.

Machine unlearning is a critical process designed to allow machine learning models to forget or remove specific data upon request, particularly for privacy protection. While the primary objective of unlearning is to safeguard sensitive information, it introduces substantial privacy and security risks. This paper explores the two major categories of threats to machine unlearning: privacy attacks and security attacks. Privacy attacks, such as membership inference and model inversion, exploit residual information to infer or reconstruct sensitive data that should have been erased. Security attacks, particularly specific data poisoning, involve the injection of malicious data into the training process, which may leave lingering effects even after the unlearning process. In this paper, we provide an in-depth examination of these threats and propose several defense mechanisms. Differential privacy, adversarial training, and query limitations are highlighted as key defenses against privacy attacks, while data validation, adversarial examples, and post-unlearning audits are critical in mitigating security risks. Additionally, we discuss emerging methodologies like data provenance tracking and fine-tuning as crucial for ensuring unlearning processes are thorough and effective. Through these analyses, we aim to provide a comprehensive framework for strengthening the security and privacy of machine unlearning systems, enabling their broader adoption across industries such as healthcare, finance, and AI-driven technologies.

The advent of artificial intelligence (AI) has revolutionized digital marketing, offering unprecedented levels of personalization. AI-driven personalization leverages machine learning algorithms and data analytics to tailor content, advertisements, and recommendations to individual consumers based on their behavior, preferences, and demographics. This paper explores the effectiveness of AI-driven personalization in enhancing customer engagement, increasing conversion rates, and improving overall marketing efficiency. It also examines the ethical considerations associated with these technologies, including data privacy, consent, and the potential for manipulation or bias. While AI-driven personalization can lead to more relevant and engaging consumer experiences, it raises critical ethical questions that must be addressed to ensure responsible and fair use. The study concludes with recommendations for marketers and policymakers to balance the benefits of AI personalization with the need for ethical standards and consumer protection.

Aquaculture contributes to the sustainable development of food security, marine resource conservation, and economy. Shifting aquaculture feed from fish meal and oil to terrestrial plant-derivatives may result in cost savings. However, many carnivorous fish cannot be sustained on plant-derived materials, necessitating the need for the identification of important factors for farmed fish growth and to investigate whether components derived from terrestrial plants can be used in feed. Herein, we focused on the carnivorous fish leopard coral grouper (P. leopardus) to identify the essential growth factors and clarify their intake timing from feeds. Furthermore, we evaluated the functionality of starch, which are easily produced by terrestrial plants. Results reveal that carbohydrates, which are not considered essential for carnivorous fish, can be introduced as a major part of artificial diet. The development of artificial feed using starch offers the possibility of increasing the growth of carnivorous fish in aquaculture.

Nonlinear optimization (NOPT) is a meaningful tool for solving complex tasks in fields like engineering, economics, and operations research, among others. However, NOPT has problems when it comes to dealing with data variability and noisy input measurements that lead to incorrect solutions. Furthermore, nonlinear constraints may result in outcomes that are either infeasible or suboptimal, such as non-convex optimization. This paper introduces a novel regularized physics-informed neural network (RPINN) framework as a new NOPT tool for both supervised and unsupervised data-driven scenarios. By using custom activation functions and regularization penalties in an artificial neural network (ANN), RPINN can handle data variability and noisy inputs. Besides, it uses physics principles to build the network architecture, computing the optimization variables based on network weights and learned features. In addition, it uses automatic differentiation training to make the system scalable and cut down on computation time through batch-based back-propagation. The test results for both supervised and unsupervised NOPT tasks show that our RPINN can provide solutions that are competitive compared to state-of-the-art solvers. In turn, RPINN’s robustness against noisy input measurements makes it particularly valuable in environments with fluctuating information. Additionally, RPINN’s ANN-based foundation offers significant flexibility and scalability.

A panorama of the current historiography on the Supernova of 1054 is outlined. Shklovsky (1968) [1], and Murdin (1985) [2] show how the interpretation of this phenomenon converged on a Su-pernova event. Here we reconsider the historical data, assuming a Gamma-Ray Burst (GRB) as its source. A Supernova correlated with the GRB explains well the fading time observed by the an-cient Chinese astronomers, in daytime and in night time, while the GRB power-law explains the present X-rays and GeV emission of the Crab. On the ground of recent understanding of the first episode of binary driven Hypernova GRB (BDHN GRB) in terms of the collapse of a ten solar masses core, we propose the possible identification of the real Supernova event at earlier time than Chinese chronicles. This work allows a new understanding of the significance of historical astronomical observations, including a fireball, due to gamma-rays air shower observation, and a plague of acute radiation syndrome, documented with several thousands of victims in the Eura-sian area (Egypt, Iraq and Siria).

The benefits of event-driven architecture (EDA) derive from how systems and components are loosely coupled, which can facilitate independent development and deployment of systems, improved scaling and fault tolerance, and integration with external systems, especially in comparison to monolithic architectures. With the advent of new technologies such as containers, and microservices, a new generation of distributed event streaming platforms are commonly used in event-driven architecture for efficient event-driven communication. However, the asynchronous and distributed nature of EDA poses several problems that include handling failures, the dependence of an end-to-end transaction on individual component stability, etc. In this paper, we describe a new approach to designing self-regulating distributed applications with autopoietic and cognitive workflow management. This approach is based on the new science of information processing structures derived from the General Theory of Information. Just as a genome enables self-organizing and self-regulating biological structures, a digital genome enables a specific software application with several components, the ability to use distributed resources and self-regulate the evolution of the system based on functional and non-functional requirements, and best-practice policies that maintain the stability, safety, and survival under non-deterministic fluctuations in the demand for resources. In addition, cognitive workflow management assures end-to-end transaction delivery.

Background: MOST-plus is a multicenter, randomized, open-label, adaptive Phase II trial evaluating the clinical benefit of targeted treatments matched to molecular alteration in advanced/metastatic solid tumors. Sorafenib was tested on patients with tumors harboring sorafenib-targeted genes Methods: The MOST-plus trial used a randomized discontinuation design. After 12 weeks of sorafenib (400 mg, po BID), patients with progressive disease dis-continued study, patients with objective response were proposed to continue sorafenib, whereas patients with stable disease (SD) were randomly assigned (1:1) to maintenance or interruption of treatment. Primary endpoint was RE-CIST version 1.1 progression-free rate at 16 weeks after randomization (PFR-16w). Secondary endpoints included progression-free survival (PFS), overall survival (OS), and toxicity. Statistical analyses used a sequential Bayes-ian approach with interim efficacy analyses. The enrolment could be stopped in the case of a 95% probability for the estimated PFR-16w to be higher in the maintenance than in the interruption arm (NCT02029001). Results: 151 patients were included, of whom 35 had SD at 12 weeks of Soraf-enib. For the 35 patients with SD on sorafenib, the PFR-16w was 65% [95% credibility interval 43.4–83.7] in the continuation arm and 25% [7.8–48.1] in the interruption arm. Median PFS and OS were improved in maintenance versus interruption arm (mPFS: 5.6 [95%CI 1.97–6.77] months versus 2.0 [95%CI 1.61–3.91] months (p =0.0231) and mOS : 14.3 [95%CI 8.9–23.8] versus 8.0 months [95%CI 3.5–15.2] (p =0.0857)). Conclusion: Sorafenib showed activity in progressive patients with solid tu-mors harboring somatic genomic alterations in sorafenib-targeted genes. Con-tinuing sorafenib when SD is achieved improves PFR compared to interruption

Plant Factory Transplanter (PFT) is a key component of the plant factory system. Its operation status directly affects the quality and survival rate of planted seedlings, which in turn affects the overall yield and economic efficiency. To monitor the operation status and transplanting quality of a transplanting machine in a timely manner, the primary task is to use a computerized and easy-to-use method to monitor the transplanting units. Inspired by the latest developments in augmented reality and robotics, a DT model-based and data-driven online monitoring method for plant factory transplanting equipment is proposed. First, a data-driven and virtual model approach is combined to construct a multi-domain digital twin of the transplanting equipment. Then, taking the vibration frequency domain signal above the transplanting manipulator and the image features of the transplanting seedling tray as input variables, the evaluation method and configuration method of the PFT digital twin system are proposed. Finally, the effect of the transplanter is evaluated, and the cycle can be repeated to optimize the transplanter to achieve optimal operation parameters. The results show that the digital twin model can effectively use the sensor data to identify the mechanical vibration characteristics and avoid affecting transplanting quality due to mechanical resonance. At a transplanting rate of 3000 plants/h, the transplanting efficiency can be maintained at a high level and the vibration signal of X, Y, Z-axis above the transplanting manipulator is relatively calm. In this case, Combined the optimal threshold method with the traditional Wiener algorithm, the identification rate of healthy potted seedlings can reach 94.3%. Through comprehensively using the optimal threshold method and 3D block matching filtering algorithm for image threshold segmentation and denoising, the recognition rate of healthy seedlings has reached over 96.10%. In addition, the developed digital twin can predict the operational efficiency and optimal timing of the detected transplanter, even if the environmental and sensor data are not included in the training. The proposed digital twin model can be used for damage detection and operational effectiveness assessment of other plant factory equipment structures.

Understanding the flow in urban environments is an increasingly relevant problem due to its significant impact on air quality and thermal effects in cities worldwide. In this review we provide an overview of efforts based on experiments and simulations to gain insight into this complex physical phenomenon. We highlight the relevance of coherent structures in urban flows, which are responsible for the pollutant-dispersion and thermal fields in the city. We also suggest a more widespread use of data-driven methods to characterize flow structures as a way to further understand the dynamics of urban flows, with the aim of tackling the important sustainability challenges associated to them.

The aim of this study is to model hydrodynamic processes of the Istanbul Strait with its stratified flow characteristic and calibrate the most important parameters using local and global search algorithms. For that two open boundary conditions are defined, which are in the North and South part of the Strait. Observed bathymetric, hydrographic, meteorological and water level data are used to set up the Delft3D-FLOW model. First, the sensitivities of model parameters on the numerical model outputs are assessed using PEST toolbox. Then, the model is calibrated based on the objective functions focusing on the flowrates of upper and lower layers. The salinity and temperature profiles of the Strait are only used for model validation. The results show that the calibrated model outputs of Istanbul Strait are reliable and consistent with the in-situ measurements. The sensitivity analysis reveals that the Spatial Low-Pass Filter Coefficient, Horizontal Eddy Viscosity, Prandtl-Schmidt Number, Slope in log-log Spectrum and Manning Roughness Coefficient are most sensitive parameters affecting flowrate performance of the model. The agreement between observed salinity profiles and simulated model outputs is promising whereas the match between observed and simulated temperature profiles is weak showing that the model can be improved particularly for simulating the mixing layer.

The aim of this paper is to develop an intelligent event-driven Electrocardiogram (ECG) processing module in order to achieve an efficient solution for diagnosis of the cardiac diseases. The suggested method acquires the signal with an event-driven A/D converter (EDADC). The output of EDADC is passed through the activity selection and interpolation blocks. It allows focusing only on the important signal parts and resampling it uniformly. Later on, the signal is de-noised. The autoregressive (AR) method is used to extract the classifiable features of the de-noised signal. Afterwards, the output is classified by employing different robust classification techniques such as support vector machines (SVMs), K- Nearest Neighbor (KNN) and Artificial Neural Network (ANN). The event-driven feature enables to adapt the system processing load according to the signal temporal variations. This interesting feature of the devised system aptitudes a drastic reduction in its processing activity and therefore in the power consumption as compared to the traditional ones. A comparison of the performance of different classifiers is also made in terms of accuracy. Results show that the proposed system is a potential candidate for an automatic diagnosis of the cardiac diseases.

Remanufacturing is a viable option to extend the useful life of an end-of-use product or its parts, ensuring sustainable competitive advantages under the current global economic climate. Challenges typical to remanufacturing still persist, despite its many benefits. According to the European Remanufacturing Network a key challenge is lack of accurate, timely and consistent product knowledge as highlighted in a 2015 survey of 188 European remanufacturers. With more data being produced by electric and hybrid vehicles, this adds to the information complexity challenge already experienced in remanufacturing. Therefore, it is difficult to implement real-time and accurate remanufacturing for the shop floor; there are no papers that focus on this within an electric and hybrid vehicle environment. To address this problem this paper attempts to (1) identify the required parameters/ variables needed for fuel cell remanufacturing by means of interviews (2) rank the variables by Pareto analysis (3) develop a casual loop diagram for the identified parameters/ variables to visualise its impact on remanufacturing (4) model a simple stock and flow diagram to simulate and understand data and information-driven schemes in remanufacturing.

Manufacturing organizations shall recognize sustainability as a business occasion to capitalize on, rather than an undesirable pressing situation. Still, empirical evidence shows that this opportunity is hard to capture and communicate in global strategic decisions, through planning by tactical management, to daily operational activities. This paper systematically reviews the modeling challenges at the crossroad of value and sustainability decisions making, spotlighting methods and tools proposed in literature to link sustainability to customer value creation at strategic, tactical and operational level. While statistical results show that the topic of sustainability and value modeling is trending in literature, findings from content analysis reveal that recent attempts to promote a value-based view in the sustainability discussion remain at a strategic level, with most of the proposed indicators being suited for managerial decision-making. The lack of support at operational level points to the opportunity of cross-pollinating sustainability research with value-centered methodologies originating from the aerospace sector. The Value Driven Design framework is proposed as main hub from which to derive models supporting engineers and technology developers in the identification of win-win-win situations, where sustainable improvements are aligned with business advantages.

Individualized nursing care allows a systematic assessment and intervention, considers the patient's preferences, values, and context, and contributes to a positive care trajectory. However, its operationalization has proven to be challenging. This research aims to determine which items of nursing care individualization are most integrated into nurses' clinical practice, and those that are less included. A cross-sectional study was conducted on 122 eligible and registered nurses at a Hospital Center, in Ophthalmology (operating room and inpatient ward), Cardiology Service, Internal Medicine, and Medical Emergency Unit, in Portugal. The Indi-vidualized Care Scale nursing version (ICS-Nurse) was used for the assessment, including three sub-dimensions: clinical situation, personal life situation, and decisional control over care-related decisions. Analyses were performed using Cronbach's Alpha and Principal Component Analysis to confirm the relationships between the variables, suggested by the literature and previous studies. In the results, no statistically significant differences were identified between the sociodemographic profile and the sub-dimensions of individualization. Nurses overall have a good perception of the importance of individualized care (4.06 ± 0.46 ICS-A-NURSE), but face difficulties in its implementation during the last shift worked (3.97 ± 0.49 ICS-B-NURSE). The sub-dimensions more integrated into the care environment were clinical situations and decisional control, and the less integrated were the personal lives of patients. This study identifies key aspects of the individualization of nursing care in acute and perioperative settings, as its omission represents a failure to address the multidimensional health needs of patients, families, and caregivers. We suggest the development of training programs that promote a holistic approach, as well as future studies that consider patient outcomes related to the individualization of nursing care.

Dysmenorrhea symptoms are frequent and often self-treated using non-prescription medicines. To further characterize women with dysmenorrhea using a combination of hyoscine butylbromide and paracetamol (PLUS) for self-management of their complaints, we performed a secondary analysis of a published pharmacy-based patient survey. 314 women (mean age 32.3 years) with dysmenorrhea reported a pain and cramps intensity of 7.45 ± 2.13 on a 0-10 Likert scale, which was reduced to 2.86 ± 1.81 upon treatment. Associated impairments of work/daily chores, leisure activities, and sleep were improved by 64.6%, 62.2% and 70.4%, respectively. The onset of symptom relief was within 60 min in 84.7%. Tolerability was rated as very good or good by 97.2%. These findings confirm the efficacy and tolerability data on PLUS from randomized controlled trials in a larger group of women conducting self-management of their dysmenorrhea.

On 11 March 2020, the COVID-19 emergency was declared and a large number of patients were admitted to the ICUs. Consequently, ICUs had to recruit nurses from other units as well as Nursing students without working experience in critical patients care. Since Critical nursing competence is crucial to avoid medical errors, the aim of this study was, to describe the level of safety and nursing competence in critical patient care of recruited nurses and students, during the COVID-19 pandemic in ICUs. A cross-sectional descriptive study of 66 participants using the validated competency assessment questionnaire for nurses in hospital care (COM-VA©) was performed. Our results showed that the level of safety perceived in critical patients care by the students on placement in ICUs and mentors scored higher than the rest of the participants. Interestingly, whereas the participant’s COM-VA© score indicated a level of competence good enough to work autonomously, the supervisor/mentor’s COM-VA© evaluation showed that only the group of students on placement obtained this level of competency. Altogether, we found that students on placement in ICU possesses a higher level of safety and COM-VA© scores than the rest of participants probably due to the close support of the mentor.

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.

The aim of this single-center, open-label, non-controlled randomized study was to evaluate which formulation of vitamin D between cholecalciferol and calcifediol is most effective in the treatment of hypovitaminosis D in older adults. Demographic characteristics, clinical history and comprehensive geriatric assessment were recorded at admission. Eligible patients randomly received an equivalent vitamin D supplement either with cholecalciferol or calcifediol from hospital admission to three months after discharge. Among the 140 older patients included (mean age 83±6.6, 57.8% females), 69 received cholecalciferol and 71 calcifediol. The mean plasma values of 25OH-Vitamin D3 found at the enrollment were 16.8 ± 9.9 ng/mL in patients receiving cholecalciferol and 18.8 ± 13.3 ng/mL in those treated with calcifediol (p =0.31). At the 3-month follow up, the mean concentration of 25OH-Vitamin D3 was significantly higher in patients treated with calcifediol than in patients treated with cholecalciferol (respectively, 30.7 ± 8.4 vs 45.4 ± 9.8 ng/mL, p &lt;0.001). Supplementation with cholecalciferol or calcifediol results in both cases effective in reaching optimal circulating values of 25OH-VitaminD3 in the older patients suffering from hypovitaminosis D. However, supplementation with calcifediol led to average circulating values of 25OH- VitaminD3 significantly higher (over 50%) than those obtained with cholecalciferol.

Background: Healthcare attention is sometimes considered purely technical, but communication has proven to be closely related to clinical results and patient satisfaction. Therefore, evaluation of communication in the scope of healthcare is a priority. The purpose of this study was to validate and adapt, if necessary, the Spanish version of the Communication Styles Inventory (CSI) in a sample of nursing professionals. (2) Methods: The sample was made up of 2313 nursing professionals selected at random from various medical centers in Spain, and is therefore a sample actively employed at the time data were acquired. We started out from the Communication Style Inventory, a questionnaire for evaluating the predominance of certain individual communication behaviors on six scales (expressiveness, preciseness, verbal aggressiveness, questioningness, emotionality and impression manipulativeness). (3) Results: Confirmatory Factor Analysis of the model proposed showed god fit indices. The reliability of the model shown by the Cronbach’s alpha of α=.81 was adequate, and so was single-level and aggregate consistency. Finally, in the analysis of variance by type of contract, configural, metric and scalar invariance was acceptable, but not strict invariance. (4) Conclusions: This instrument progresses in measuring non-technical attributes, such as communication styles, in nursing personnel.

Introduction: The attitudes of doctors and nurses toward patient safety is a significant factor in hospital safety climates and medical error rates. Yet, there are very few studies of patient safety attitudes in Saudi hospitals and none conducted in hospital emergency departments. Aims: The current study aims to investigate the discrepancy between the patient safety attitudes of doctors and nurses in a Saudi hospital emergency department. Materials and Method: The study employed a qualitative research designvia semi-structured interviews with Saudi and non-Saudi doctors and nurses working in a Saudi hospital emergency department to determine their attitudes and experiences about the patient safety climate. Results: The findings showed doctors and nurse held some similar safety attitudes, however, nurses reported issues with doctors with respect to their teamwork, communication, and patient safety attitudes. Moreover, several barriers to the patient safety climate were identified such as limits to resources, teamwork, communication, and incident reporting. Conclusion: The findings provide one of the few research contributions to knowledge on the differential patient safety attitudes of Saudi and non-Saudi doctors and nurses and suggest the application of such knowledge would enhance positive patient outcomes in emergency departments.

Objective. To describe patient satisfaction with pre-hospital emergency knowledge and determine if patients and professionals share a common vision on the satisfaction predictors. Methods. A qualitative study conducted in two phases. First, a systematic review following the PRISMA protocol was carried out searching publications between January 2000 and July 2016 in Medline, Scopus, and Cochrane. Second, three focus groups involving professionals (advisers and healthcare providers) and a total of 79 semi-structured interviews involving patients were conducted to obtain information about what dimensions of care were a priority for patients. Results. Thirty-three relevant studies were identified. A majority conducted in Europe using questionnaires. They pointed out a very high level of satisfaction of callers and patients. Delay with the assistance and the ability for resolution of the case are the elements that overlap in fostering satisfaction. The published studies neither reviewed the overall care process nor related the measurement of the real time in responding to an emergency with the satisfaction. The patients and professionals concurred in their assessments about the most relevant elements for patient satisfaction, although safety was not a predictive factor for patients. Response capacity and perceived capacity for resolving the situation were crucial factors for satisfaction. This qualitative approach yielded assistance targets to be improved. Conclusions. Published studies have assessed similar dimensions of satisfaction. Furthermore, despite the fact that few explanations may be given due to the no face to face attention, taking into account the patient’s emotional needs or maintaining contact with the patient until the emergency services arrive are high predictors of the satisfaction.

The swift progress in low-dimensional nanocarbons, specifically in the realm of the authentic one-dimensional carbon chain featuring sp¹ hybridization, has unveiled exciting prospects for integrating them into cutting-edge technologies across diverse industries. To fully harness their potential, precise control over the growth process is necessary to obtain desired nanostructure and functionality. However, optimizing properties through traditional approaches has been challenging due to complex interactions. To address this, we implement a focused data-driven strategy for nanocarbon inverse design by leveraging a state-of-the-art data-driven nanocarbon genome approach (NCGA). By uncovering relationships between growth parameters and resultant traits, this serves as an expedient catalyst in engineering nanostructures with tailored attributes. We introduce an extensive array of technological approaches aimed at precisely controlling the growth process. These methods encompass stimulating and precisely adjusting synergistic effects, coordinating atomic vibrations at a collective level through the implementation of multilayer nano-interfaces, harnessing the potential of active screen plasma surface engineering, utilizing nano-patterning and allotropic phase transformations, incorporating heteroatom doping, and effectively directing self-assembly. These aim to unlock nanomaterials' latent potential and reveal novel neural pathways within the data-driven NCGA, enhancing its predictive capabilities. Specifically, triggering self-organization during growth can potentially unlock previously unexplored neural pathways. The data-driven NCGA offers a paradigm shift, accelerating discovery and design of nanocarbons with optimized, application-specific properties.

This study explores the complexities of risk communication practices in orthodontics, specifically examining the perspectives of orthodontists in Greece and Slovakia. Informed by the foundational importance of effective communication in health sciences, particularly in facilitating valid consent and shared decision-making, this research addresses gaps identified in the literature concerning the consistent communication of potential treatment risks based on demographic and cultural characteristics. The study identifies 15 potential critical risks with orthodontic treatment. These risks include root necrosis; temporary undesired changes to the occlusion; sleep difficulties; not achieving an ideal result; development of black triangles between teeth; taking additional X-rays; speech difficulties; using a protective splint during sports; duration of treatment; number of visits; transmission of infectious diseases; and swallowing orthodontic appliances. The questionnaire, distributed electronically to orthodontists in Greece (n=570) and Slovakia (n=210) from Sept. 2022 to Dec. 2022, aimed to assess risk communication practices, with consideration to country, gender, and degree-related variations. 168 valid questionnaires (91 from Slovakia and 77 from Greece) were obtained indicating significant disparities in the risks emphasized and preferred forms of consent. The Greek orthodontists focused more on the risks involved such as on relapse, root resorption, temporal occlusal changes, and failure of desired movement, while the Slovak practitioners tend to be interested more about sleeping difficulties, temporal occlusal changes and not achieving an ideal result. They also tend to obtain written or digital consent from patients or their parents/guardians more frequently than the Greek team. Male orthodontists discussed specific risks more frequently, including relapse and extractions, whereas females preferred written or digital consent. PhD-trained orthodontists prioritized certain risks, indicating the need for tailored approaches. This study underscores the dynamic nature of risk assessment in orthodontic practice, emphasizing its ethical and strategic dimensions. The findings advocate for tailored risk communication strategies, that recognize individual, contextual, and cultural factors and the need of an orthodontic informed consent protocol for tailored communication approach for patients to elevate the standard of care in European orthodontics. The reliance on digital tools reflects contemporary trends in enhancing patient understanding, thereby supporting ongoing innovation in orthodontic practices.

There is little understanding of patients' experiences and perceptions with satisfaction by health professionals such as medical and dental clinicians. Furthermore, patient satisfaction is not well understood. The objective of this article is to better understand patients' satisfaction with their medical and dental care. The methods of the current article are based on a narrative review of the literature strategy. Patient satisfaction's multidimensional nature has been established since the perceived reasons for satisfaction varied widely among patients. Many aspects of the treatment influence participant satisfaction at different stages of the intervention's process. An improved understanding of the basis for managing patients' expectations with information reiteratively and efficiently may ultimately reduce patients' potential for negative feelings toward the medical and dental treatment experience. The consumerist method may misrepresent the concept of satisfaction in health service.

The neural system has limited resources to interact with the environment, and this is where attention comes into play. Attention is a complex process that provides numerous benefits, but there has been a longstanding debate about the mechanisms involved in attentional orientation. Two widely proposed mechanisms are top-down and bottom-up, which relate to the organism's current behavioral goal and the salience of environmental stimuli, respectively. However, distinguishing between these mechanisms can be challenging in both behavioral and neural studies. This review introduces a new conceptualization in which both top-down and bottom-up mechanisms are viewed as aspects of the same process. This unified approach aims to prepare the organism to face stimuli and events based on its prior experiences, immediate (the current task that he/she is aware of), and innate (to be alive) demands.

Real-time data processing and decision-making are increasingly crucial in various applications, driven by the continuous influx of data streams. Event-driven AI workflows within serverless computing environments offer a promising approach to handle these real-time demands efficiently. This paper presents a framework for simulating and analyzing the performance characteristics of such workflows. Our proposed approach utilizes simulated data with varying event rates and durations to investigate the impact on key performance metrics like latency, throughput, and resource utilization. This enables a comprehensive evaluation of the inherent trade-offs within event-driven AI systems. The key findings reveal a trade-off between latency and throughput. As the event rate increases, average processing latency generally increases while average throughput increases. Resource utilization remains relatively stable across different event rates in the simulated scenarios (e.g., 75.55\% at 2 events/second, 74.51\% at 10 events/second). This framework provides a valuable tool for understanding the performance characteristics of event-driven AI workflows and optimizing resource allocation strategies.

This work focuses on short-term forecasting of PV output power. The multilayer perception (MLP), convolutional neural networks (CNN), and k-nearest neighbour (kNN) neural networks have been used singly or in a hybrid (with other algorithms) to forecast solar PV power or global solar irradiance with good success. Their performances in forecasting PV power have been compared with other algorithms but not with themselves. The study aims to compare performance of a number of neural network algorithms in solar PV energy yield forecasting under different weather conditions. The performance of MLPNN, CNN and kNN are being compared using solar PV (hourly) energy yield data for Grahamstown, Eastern Cape, South Africa. The choice of location is part of the study parameters to provide insight into renewable energy power integration in specific areas in south Africa that may be prone to extreme weather conditions. The kNN algorithm was found to have RMSE value of 4.95% and MAE value of 2.74% at its worst performance, and RMSE value of 1.49% and MAE value of 0.85% at its best performance. It outperformed the others by a good margin and kNN could serve as a fast, easy, and accurate tool to forecast solar PV output power.

In reinforced concrete (RC) structures, splicing is required owing to the length limitations of rebars, insufficient lengths, and transportation issues. In particular, splices connect the rebar of RC structures such as walls, columns, beams, slabs, and joints. Lap splices are the most commonly used method worldwide because they do not require specific equipment or skilled workers. However, lap splices incur high construction costs because of the long splice lengths required for large-diameter rebars in megastructures, as well as issues pertaining to material supply, labor costs, constructability, and project duration. Additionally, approximately 15% more rebar is required because of the overlap. Energy saving for a sustainable built environment is possible if the disadvantage of lap splices, which generate high CO2 emissions due to the excessive use of rebar, are resolved. Hence, mechanical rebar couplers (MRCs) have been developed. However, despite their advantages, they have not been widely applied in construction sites owing to concerns regarding safety, quality, and constructability. Although various MRCs have been developed, most studies focus only on their structural performance. Therefore, a data-driven approach for selecting MRCs based on the reinforcing bar shape and structural characteristics is proposed in this study. Using a data-driven MRC selection algorithm, using the T-threaded coupler for one rebar over two floors resulted in 56% more efficient labor productivity, 15% shorter assembly time, 17% lower costs, and 26% lower CO2 emission. Using a developed algorithm, the appropriate MRC can easily and rapidly be selected for frequent design changes.

The modeling and prediction of crop seed yield can be a vital improvement in the precision agriculture industry as it provides reliable assessments of the effectiveness of agro-traits. Here, multiple machine learning (ML) techniques are established for predicting sesame (Sesamum indicum L.) seed yield (SSY) and incorporating agro-morphological features. Models utilized for coupled PCA-ML (Principal component analysis-Machine Learning) methods were compared with original ML models to evaluate predicted efficiency. The Gaussian process regression (GPR) and Radial basis function neural network (RBF-NN) models exhibited the most accurate SSY predictions with determination coefficients or R2 values of 0.99 and 0.91, respectively. The root-mean-square error (RMSE) for the ML models fluctuated between 0 to 0.30 t/ha (metric tons/hectare) for the varied modeling process phases. Estimation of sesame seed yield with coupled PCA-ML models improved performance accuracy. The K-fold process suggested the utilization of datasets with the lowest error rates to ensure the continued accuracy of GPR and RBF models. Sensitivity analysis revealed the capsule number per plant (CPP), seed number per capsule (SPC), and 1000-seed weight (TSW) were the most significant seed yield determinants.

In many countries, governments have implemented non-pharmaceutical techniques to limit COVID-19 transmission. Restricting human mobility is one of the most common interventions, including lockdown, travel restrictions, working from home, etc. However, due to the strong transmission ability of the virus variants, further rounds of interventions, including a strict lockdown, are not considered as effective as expected. The paper aims to understand how the lockdown policy and pandemics changed human mobility in the real scenario. Here we focus on understanding the mobility changes caused by compliance with restrictions and risk perceptions, using the mobility index from the Google report during three strict lockdown periods in Leeds, the largest city in the county of West Yorkshire, England from March 2020 to March 2021. The research proposed the time-varying z-scores and Principal Component Analysis (PCA) to simulate how local people dynamically process and perceive health risk based on multi-dimensional daily COVID-19 reports first. Further modelling highlights exponentially increasing policy non-compliance through the duration of lockdown, probably attributable to factors such as mental anxiety and economic pressures. Finally, the proposed nonlinear regression model examines the mobility changes caused by the population's dynamic risk perceptions and lockdown duration. The case study at Leeds fits data well and shows that the third lockdown policy took effect much slower than the first. At the same time, the negative impact of the epidemic on population mobility decayed 40% in the third lockdown period in contrast with the first lockdown. The risk perception estimation methods could reflect that the local population became increasingly accustomed to the COVID-19 situation, and local people rationally evaluated the risks of COVID in the third lockdown period. The results prove that simulated risk perceptions and policy decay could explain urban mobility behaviour during the mobility well during lockdown periods, which could be a reference for future decision-making processes.

This paper studied the natural convection heat transfer from two equal-sized cylinders of triangular cross-section confined in triangular enclosure. The inner cylinders have hot surfaces and the outer enclosure has a cold surfaces. The annular space between inner cylinders and the outer one was filled with incompressible Newtonian fluid. The work examined the behavior of fluid flow in the process of transferring heat energy. The work was achieved numerically using the commercial code ANSYS-CFX. The adopted initial conditions were selected for these ranges: Prantl number (Pr = 1 to 10³), Rayleigh number (Ra = 10³ to 10⁵). It was found that the increment of Ra number increases the rate of heat transfer. However, the effect of Pr number on heat transfer is almost negligible.

Forest planners have traditionally used expected growth and yield coefficients to predict future merchantable timber volumes. However, because climate change affects forest growth, the typical forest planning methods using expected value of forest growth can lead to sub-optimal harvest decisions. We proposed in this paper to formulate the harvest planning with growth uncertainty due to climate change problem as a multistage stochastic optimization problem and use sample average approximation (SAA) as a tool for finding the best set of forest units that should be harvested in the first period even though we have a limited knowledge of what future climate will be. The objective of the harvest planning model is to maximize the expected value of the net present value (NPV) considering the uncertainty in forest growth and thus in revenues from timber harvest. The proposed model was tested on a small forest with 89 stands and the numerical results showed that the approach allows to have superior solutions in terms of net present value and robustness in face of different climate scenarios compared to the approach using the expected growth and yield. The SAA methods requires to generate samples from the distribution of the random parameter. Our results suggested that a sampling scheme that focuses on generating high number of samples in distant future stages is favorable compared to having large sample sizes for the near future stages. Finally, we demonstrated that, depending on the level of forest growth change, ignoring this uncertainty can negatively affect forest resources sustainability.

We present a class of efficient parametric closure models for 1D stochastic Burgers equations. Casting it as statistical learning of the flow map, we derive the parametric form by representing the unresolved high wavenumber Fourier modes as functionals of the resolved variables’ trajectory. The reduced models are nonlinear autoregression (NAR) time series models, with coefficients estimated from data by least squares. The NAR models can accurately reproduce the energy spectrum, the invariant densities, and the autocorrelations. Taking advantage of the simplicity of the NAR models, we investigate maximal and optimal space-time reduction. Reduction in space dimension is unlimited, and NAR models with two Fourier modes can perform well. The NAR model’s stability limits time reduction, with a maximal time step smaller than that of the K-mode Galerkin system. We report a potential criterion for optimal space-time reduction: the NAR models achieve minimal relative error in the energy spectrum at the time step where the K-mode Galerkin system’s mean CFL number agrees with the full model’s.