This research aims to determine the similarities in groups of people to build a film recommender system for users. Users often have difficulty in finding suitable movies due to the increasing amount of movie information. The recommender system is very useful for helping customers choose a preferred movie with the existing features. In this study, the recommender system development is established by using several algorithms to obtain groupings, such as the K-Means algorithm, birch algorithm, mini-batch K-Means algorithm, mean-shift algorithm, affinity propagation algorithm, agglomerative clustering algorithm, and spectral clustering algorithm. We propose methods optimizing K so that each cluster may not significantly increase variance. We are limited to using groupings based on Genre and, Tags for movies. This research can discover better methods for evaluating clustering algorithms. To verify the quality of the recommender system, we adopted the mean square error (MSE), such as the Dunn Matrix and Cluster Validity Indices, and social network analysis (SNA), such as Degree Centrality, Closeness Centrality, and Betweenness Centrality. We also used Average Similarity, Computational Time, Association Rule with Apriori algorithm, and Clustering Performance Evaluation as evaluation measures to compare method performance of recommender systems using Silhouette Coefficient, Calinski-Harabaz Index, and Davies-Bouldin Index.

COVID-19 has created anxiety not only in individuals but also in health organizations, and countries worldwide. Not a single industry is left un-influenced and loss is being estimated in billions of dollars. The widespread of this pandemic disease has challenged researchers all over the world. Some of the researchers are working to invent its cure while, others are applying computing technologies to stop its spread, by analyzing and identifying patterns for prediction and forecasting. This is by no doubt the hottest area of research for the last 100 years. This survey has targeted the research published in computing sub-domains to combat the pandemic. The survey has clustered the scientific efforts into logical groups: surveillance, metrological effects, social media analytics, image processing and business and economy, analysis and modeling. It will serve as a leading source for the followings: researchers who want to identify what has been achieved in different computing sub-domains, those who need fresh authenticated datasets openly accessible for different research contexts and what are future directions in this area of research. The findings of analysis and modeling can be also useful for government agencies who want to set priorities and formulate policies.

In 2002, the Higher Learning Commission, a regional accrediting agency in the US, placed the community college in this study on academic probation for several criteria and many residents of the community believed that closing doors was the best option for addressing these concerns. This study is designed to ascertain data from external stakeholders of the community college regarding their current perceived value of the community college and suggestions about moving from the present to the future. The main question of the study is: What are external stakeholders’ perceptions of the value of the college to the service area? This qualitative approach is used consisting of interviews, focus groups, surveys, and document review to triangulate stakeholder perspectives. Participants included 176 high school seniors from different counties, four counselors, and four focus groups. The findings from the data are presented in this study are planned to be used by community college officials to incorporate into their strategic plans. They showed that the college needs to consider the value that it brings to the service area including economic benefits, specifically community support; accessibility; and cost of tuition.

Recent reports suggest that the clinical course of coronavirus disease 2019 (COVID-19) in previously healthy children is usually milder as compared to adults. However, children with comorbid conditions such as diabetes are at increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as well as morbidity and mortality due to COVID-19. Experience in adults with diabetes shows that they are prone to faster metabolic decompensation, develop diabetes-related complications, and have a poor prognosis when hospitalized with COVID-19. Data on children are limited. The aim of this mini-review is to discuss the possible risks to children and adolescents with diabetes during the current pandemic and the special considerations in management in those affected with COVID-19. The challenges for children who develop new-onset type 1 diabetes during the COVID-19 lockdown, especially in accessing healthcare, are also discussed.

Background: This practice guideline was developed by the Chronic Kidney Disease (CKD) Task Force, which was composed of clinical and methodological experts. The Saudi Arabian Ministry of Health and its Health Holding Company commissioned this guideline project to support the realization of the Vision 2030's healthcare transformation pillar. Methods: The guideline synthesis was guided by the GRADE-ADOLOPMENT methodology. Results: The final adoloped guideline addressed 12 clinical questions on blood pressure management in patients with CKD through a set of recommendations and performance measures. The recommendations included antihypertensive agents in children, non-renin angiotensin system inhibition (Non-RASi) vs RASi in adults, intensive vs standard blood pressure targets, early vs late assessment for kidney replacement therapy (KRT), late vs early preparation strategy for KRT, CKD symptoms during assessment for KRT or conservative management, initiation of KRT in patients with deteriorating CKD, choice of KRT modality or conservative management in certain CKD patient groups, changing or discontinuing KRT modalities, review frequency for KRT or conservative management, and Information, education and support. Conclusions: These conditional recommendations were based on low to very low certainty of evidence that highlights the need for high-quality randomized trials comparing different antihypertensive agents in patients with CKD.

This study examines the dynamics of failure development in marginalized communities, investigating the interplay of socioeconomic, environmental, and community engagement factors. The research aims to uncover underlying causes, provide policy recommendations, and elucidate the challenges faced by these communities. However, limitations include a restricted focus on marginalized areas, data limitations, and an exclusive emphasis on socioeconomic factors. The analysis reveals gaps in addressing political influences, limited coverage of success stories, and potential biases in the methodology. The conclusion emphasizes the transformative power of community-led initiatives to address challenges, foster inclusivity, and create sustainable change. These initiatives prioritize capacity building, social cohesion, economic development, and access to education and healthcare. Implications for policy and practice underscore the need for comprehensive interventions, collaboration, empowerment, and sustainable development. Future research directions include exploring the long-term impact of historical failures, intersectionality, the role of technology, mental health implications, and comparative analysis.

Pulmonary thromboembolism is a very common cardiovascular disease, with a still high mortality rate. Despite the clear guidelines, this disease still represents a great challenge both in diagnosis and treatment. Heterogeneous clinical picture, often without pathognomonic signs and symptoms, represents a huge differential diagnostic problem even for experienced doctors. The decision on the therapeutic regimen also represents a major dilemma in the group of patients who are hemodynamically stable at initial presentation and have signs of right ventricular (RV) dysfunction proven by echocardiography and positive biomarker values (pulmonary embolism of intermediate-high risk). Studies have shown conflicting results about the benefit of using fibrinolytic therapy in this group of patients until hemodynamic decompensation, due to the risk of major bleeding. The latest recommendations give preference to new oral anticoagulants (NOACs) compared to vitamin K antagonists (VKA), except for certain categories of patients (patients with antiphospholipid syndrome, mechanical valves, pregnancy). When using oral anticoagulant therapy, special attention should be paid to drug-drug interactions, which can lead to many complications, even to the death of the patient. Special population groups such as pregnant women, obese patients, patients with antiphospholipid syndrome and cancer represent a great therapeutic challenge in the application of anticoagulant therapy. In these patients, not only the effectiveness of the drugs must be taken into account, but great attention must be paid to their safety and possible side effects, which is why a multidisciplinary approach is emphasized in order to provide the best therapeutic option.

(1) As the craft beer industry continues to expand in Canada, understanding the regional differences between the Eastern and Western markets becomes pivotal for brewing ingredient companies seeking to penetrate or expand within these regions. This study aims to provide a comprehensive review of these two distinctive markets, focusing on economic, logistical, ingredient, and cultural differences. (2) The study primarily relies on secondary data from government, industry reports, and scholarly publications, providing a holistic view of the Canadian craft beer landscape. It further highlights the need to consider market distinctions between Canada and the United States. (3) Findings reveal that Western Canadian breweries, unlike their Eastern counterparts, operate under constrained storage space, prefer locally-sourced ingredients, and offer a distinct variety of beer styles catering to local tastes. The study further uncovers the regulatory and financial complexities of the Canadian market compared to the United States. (4) Based on these findings, this study provides strategic recommendations for brewing ingredient companies, emphasizing domestic logistics, local sourcing, product adaptation, educational support, and regulatory navigation, fostering success in the Canadian craft beer landscape.

Since its emergence, COVID-19 has caused a great impact in health and social terms. Governments and health authorities have attempted to minimize this impact by enforcing different mandates. Recent studies have addressed the relationship between various socioeconomic variables and compliance level to these interventions. However, little attention has been paid to what constitutes people's response and whether people behave differently when faced with different interventions. Data collected from different sources show very significant regional differences across the United States. In this paper, we attempted to shed light on the fact that a response may be different depending on the health system capacity and each individuals’ social status. For that, we analyzed the correlation between different societal variables (i.e. education, income levels, population density, etc.) along with healthcare capacity related variables (i.e. hospital occupancy rates, percentage of essential workers, etc.) with regards to people's level of compliance with three main governmental mandates in the United States: mobility restrictions, mask adoption, and vaccine participation. Our aim was to isolate the most influential variables impacting behavior in response to these policies. We found that there was a strong relationship between individuals' educational levels and political preferences with respect to compliance with each of these mandates.

Disease related malnutrition (DRM) is prevalent in hospitals and is associated with increased care needs, prolonged hospital stay, delayed rehabilitation and death. Nutrition care process related activities such as screening, assessment and treatment has been advocated by scientific societies and patient organizations but implementation is variable. We analyzed the cross-sectional nutritionDay database for prevalence of nutrition risk factors, care processes and outcome for medical patients. In 59126 medical patients included between 2006-2015 the prevalence of recent weight loss (45%), history of decreased eating (48%) and low actual eating (53%) was more prevalent than low BMI (8%). Each of these risk factors was associated with a large increase in 30 days hospital mortality. Nutrition care processes increases slightly with presence of risk factors but never done in more than 50% of patients. Only a third of patients not eating in hospital receive oral nutritional supplements or artificial nutrition. We suggest that political action should be taken to raise awareness and formal education on all aspects related to DRM for all stakeholders, to create and support responsibilities within hospitals, and to create adequate reimbursement schemes. Collection of routine and benchmarking data is crucial to tackle DRM.

Primary immune thrombocytopenia (ITP) is a complex autoimmune disease whose hallmark is a deregulation of cellular and humoral immunity leading to an increased destruction and a reduced production of platelets. The heterogeneity of presentation and clinical course hampers personalized approaches for diagnosis and management. In 2021, the Spanish ITP Group (GEPTI) of the Spanish Society of Hematology and Hemotherapy (SEHH) updated a consensus document which had been launched in 2011. The updated guidelines have been the reference for diagnosis and management of primary ITP in Spain ever since. Nevertheless, the emergence of new tools and strategies makes it advisable to review them again. For this reason, we have properly updated the main recommendations. Our aim is to provide a practical tool to enable the integral management of all the aspects concerning primary ITP management.

Background: Cervical cancer is the fourth most common cancer in women globally despite being a largely treatable and preventable malignancy. Developing countries account for over 80% of all new cases of cervical cancer. Women residing in low-resource settings such as those residing in slums have a higher risk of cervical cancer, and lower uptake of cervical cancer screening. Diverse barriers influence the uptake of cervical cancer screening among women in low-resource settings. Objectives: This qualitative study was carried out prior to a cervical cancer screening program and explored women’s knowledge about cervical cancer, and their perceived barriers and recommendations for the program.Method: Four focus group discussions (FGD) were conducted among 35 women between the ages of 21 – 65 years residing in two urban slums in Lagos, Nigeria. Each FGD was limited to 8-10 participants of women of similar ages. Voice recordings were transcribed verbatim and analysis was done using thematic analysis.Results: Most of the women were not aware of cervical cancer and none knew the symptoms or risk factors of cervical cancer. The participants felt that the cervical cancer screening program would be well accepted in the community, however, they expressed concerns about the cost of the screening test and the sex of the person performing the test. The recommendations proffered for a successful cervical cancer screening program include; reducing the cost of the test or providing the test free of charge, having people that speak the local language as part of the team, using female health care providers, using a private location within the community or nearby PHC, and publicizing the program with the use of SMS, phone calls, town crier, and health talks. It was recommended that organizing health education sessions would help improve women’s poorly perceived susceptibility to cervical cancer.Conclusion: Interventions to increase uptake of cervical cancer screening among women in low resource settings need to improve knowledge and understanding of cervical cancer and address the barriers to cervical cancer screening such as cost, distance, and as much as possible, sex of the healthcare provider should be considered.

Vitamin C status is known to be associated with several demographic and lifestyle factors. These include gender, age, ethnicity, pregnancy/lactation, body weight, smoking status and dietary habits. In the present study, our aim was to interrogate the National Health and Nutrition Examination Survey (NHANES) 2017-2018 datasets to assess the impact of these factors on vitamin C dose-concentration relationships to establish if there are higher requirements for vitamin C in certain subpopulations and the possible extent of these additional requirements. The relevant data were extracted from the NHANES 2017-2018 datasets, the final cohort of which comprised 2828 non-supplementing adult males and females (aged 18 – 80+ years) with both vitamin C serum concentrations and dietary intake data available. The data was subsequently stratified by gender, age tertiles (≤36, 37-58, ≥59 years), ethnicity (non-Hispanic white, non-Hispanic black, and total Hispanic), socioeconomic tertiles (poverty income ratios: >3.0, 1.36 – 3.0, ≤1.35), weight tertiles (≤72, 72-91, ≥91 kg), BMI tertiles (≤26, 26-32, ≥32 kg/m2) and smoking status. Sigmoidal (four parameter logistic) curves with asymmetrical 95% confidence intervals were fitted to the dose-concentration data. We found that males required vitamin C intakes ~1.2-fold higher than females to reach ‘adequate’ serum concentrations of 50 µmol/L. Males had both higher body weight and a higher prevalence of smoking than females. Smokers required vitamin C intakes ~2.0-fold higher than non-smokers to reach adequate vitamin C concentrations. Relative to adults in the lighter weight tertile, adults in the heaver weight tertile required ~2.0-fold higher dietary intakes of vitamin C to reach adequate serum concentrations. We did not observe any impact of ethnicity or socioeconomic status on the vitamin C dose-concentration relationship, and although no significant difference between younger and older adults was observed at vitamin C intakes > 75 mg/day, at intakes < 75 mg/day, older adults had an attenuated serum response to vitamin C intake. In conclusion, certain demographic and lifestyle factors, specifically gender, smoking and body weight, have a significant impact on vitamin C requirements. Overall, the data indicate that the general population must consume ~110 mg/day of vitamin C to attain adequate serum concentrations, smokers require ~165 mg/day relative to non-smokers, and heavier people (100+ kg) require ~155 mg/day to reach the same vitamin C concentrations. These findings have important implications for global vitamin C dietary recommendations.

This scholarly investigation conducts a rigorous exploration of Bangladesh's textile sector spanning the years 2011 to 2022, centering its attention primarily on the development of an intricate econometric framework. The study unveils profound insights into the sector's growth trajectories, the intricate dynamics of global demand, the undulating fluctuations of interest rates, and other pivotal economic gauges. The core component of this research, the econometric model, adeptly prognosticates textile exports through the incorporation of multifarious variables, encompassing the count of garment establishments, the magnitude of the workforce, market penetration, worldwide demand patterns, currency exchange rates, and interest rate fluctuations. Notably, the model attains a lofty degree of explicative potency, with an R-squared coefficient approximating 0.756, thereby attesting to its remarkable capacity to elucidate variances in textile export values. These discoveries carry substantial consequences for policymakers and stakeholders within the industry, as they bestow upon them a potent instrument for judicious decision-making and strategic blueprinting within Bangladesh's textile domain. The model accentuates the paramount significance of global demand and market share, concurrently accentuating the latent repercussions posed by fluctuations in interest rates.This research provides valuable insights into promoting the industry's sustainable growth, diversification, and resilience in the face of economic challenges.

A key step in providing management/treatment options to men with suspected prostate cancer (PCa) is categorizing the risk for the presence of benign, low risk, intermediate risk, or high-risk disease. Our novel modality brings new evidence, based on the long-known hallmark characteristic of PCa – decreased Zinc (Zn), which is the most direct metabolic sign of malignancy and its aggressiveness. To date, this approach has not been adopted for clinical use for a number of reasons that are described in this article and which have been addressed by our approach: Zn has to be measured on fresh samples, prior to fixating in formalin, therefore samples have to be scanned during the biopsy session; as Zn depletion occurs in the glands, where the tumors develop, estimation of the glands’ levels in the scanned tissue along with their compactness, are essential for accurate diagnosis. Combined with the Zn depletion, this facilitates a reliable assessment of the disease aggressiveness. Data gathered in the clinical study described here indicate that in addition to improving the biopsy quality by real-time interactive guidance, a malignancy score can now be established for the entire prostate, allowing higher granularity personalized risk stratification and more decisive treatment decisions for all PCa patients.

Contactless charging is evolving fast in many domains and applications such as the electrical vehicles (EV). The principle consists of transferring energy between two systems without having any electrical connection between them. This power transfer can be realized by emitting a magnetic field for Inductive Power Transfer (IPT). In the automotive domain, the application of contactless charging to supply power to the vehicle while driving is one of the solutions envisaged to solve the limited autonomy range of EV and reduced its cost but the system must comply with existing standards (e.g., allocated frequency range and radiated electromagnetic emissions), as summarized in this paper.

Strengthening the analysis and risk assessment of the pig epidemic will help to better prevent and mitigate epidemic risks and promote high-quality development of the pig industry. Based on the systematic grasp of the situation of live pig epidemics, a risk assessment index system was constructed, and the spatial and temporal variation characteristics of the risk of pig epidemics in China were explored by the entropy method. In recent years, the overall trend in pig epidemics in time first increased and then decreased, and in space, the trend in the acceleration of the spread across the country continued to weaken. China still faces challenges, such as many types and a wide range of diseases, large total livestock breeding and weak epidemic prevention and control capacity, and a large risk of introduction of foreign animal epidemics. The spatial and temporal variation in the pig epidemic risk was obvious; there was one high-risk area, two higher-risk areas and 10 medium-risk areas in recent years, and the epidemic risk was highest in Beijing, Hainan, Liaoning, Tibet and Zhejiang. However, there were significant differences in the regional distribution of the risk of pig epidemics in different years. To further build a secure “defense system” for the high-quality development of the pig industry, it is recommended to improve the monitoring and early warning system of pig epidemic risk, perfect the pig epidemic prevention and control system, and strengthen the regional collaboration mechanism of epidemic prevention and control.

Data show that preschoolers consume few vegetables, fruits, whole grains, and nuts. We investigated whether a properly planned kindergarten menu can contribute to optimized daily intake of healthy foods. In this cross-sectional experimental study, we designed a 5-day prototype kindergarten menu with consistently followed dietary guidelines and randomly divided six invited kindergartens into a prototype group that received the prototype menu (PG, n=4) and a control group that used their regular menu (CG, n=2). From the participating kindergartens, we invited healthy 5-6-year-old children to participate. Outside of kindergarten, participants ate as usual. All completed a 7-day dietary record of foods consumed inside and outside of kindergarten. We used the Dietary Assessment Tool OPEN to analyze the average daily intake of seven food groups and compare it to the dietary guidelines. Fifty-seven participants completed the study, 40 from PG and 17 from CG. The average daily intake of vegetables (54% vs. 28%), whole grains (100% vs. 47%), and nuts (104% vs. 4%) was significantly higher (p<0.05) in participants from PG compared with guideline recommendations than in participants from CG. Average daily intake of fruits, meats, dairy products, and refined grains did not differ significantly between study groups. Only kindergarten diet made a significant contribution, as intake outside of kindergarten did not show significant differences. The study demonstrates the importance of a well-planned menu in kindergartens and can serve as a basis for future interventions aimed at improving the nutritional environment in childcare facilities.

In this paper, we introduce ResNetMF, a groundbreaking approach that harnesses the power of residual network matrix factorization to revolutionize recommendation systems. ResNetMF integrates residual networks, renowned for their ability to capture intricate patterns and features, with matrix factorization techniques that excel in modelling user-item interactions. This fusion presents a novel solution that surpasses the limitations of traditional recommendation systems. Through comprehensive experimentation and evaluation of diverse datasets, ResNetMF demonstrates remarkable enhancements in recommendation accuracy and efficiency. By effectively capturing both linear and nonlinear relationships in user-item interactions, ResNetMF provides superior recommendation quality. The outcomes from experiments unequivocally highlight the superiority of ResNetMF over existing state-of-the-art recommendation approaches, thereby validating its innovative nature and underscoring its potential to shape the future of recommendation systems. Through the integration of the deep residual network, ResNetMF approach facilitates the training of neural networks, enabling them to explore the underlying data layers more comprehensively. Extensive experimentation and evaluation across various datasets provide compelling evidence for the superiority of ResNetMF. Moreover, the proposed method utilized natural language processing (NLP) techniques for targeted information dissemination in recommendation systems, emphasizing the importance of personalized and relevant recommendations for user satisfaction and engagement.

The article analyzes the transitional mode of movement of a passenger train caused by emergency braking by the driver. To study the possibility of derailment of passenger cars, a simulation model of the movement of a train consisting of a locomotive and twenty passenger cars was developed in the Universal Mechanism software environment, designed to study the dynamics and kinematics of mechanical systems, which include railway rolling stock. The developed model allows taking into account the longitudinal, transverse and vertical vibrations of all cars and locomotive. All bodies in the model are assumed to be absolutely rigid. The assumption of non-deformability of the bodies is based on the fact that the stiffness of the spring suspension and elastic connections is significantly less than the structural rigidity of the bogie frames and the bolster structure, and the frequency of elastic vibrations of these bodies is much higher than the frequency of their vibrations on the spring suspension. Passengers and cargo in a wagon are considered to be non-deformable and integral with the wagon body, similarly in the case of a locomotive body. Between the elements of the system, connections are involved that regulate certain relative movements of these elements.

In an era where dietary habits significantly impact health, technological interventions can offer personalized and accessible food choices. This paper introduces Chef Dalle, a recipe recommen-dation system that leverages multimodal human-computer interaction (HCI) techniques to pro-vide personalized cooking guidance. The application integrates voice-to-text conversion via Whisper, ingredient image recognition through GPT-Vision, and employs TF-IDF vectorization alongside cosine similarity for personalized recipe recommendations. These methods enable users to interact with the system using voice, text, or images, accommodating various dietary re-strictions and preferences. Furthermore, the utilization of DALL-E 3 for generating recipe images enhances user engagement. User feedback mechanisms allow for the refinement of future rec-ommendations, demonstrating the system's adaptability. Chef Dalle showcases potential appli-cations ranging from home kitchens to grocery stores and restaurant menu customization, ad-dresses accessibility, promoting healthier eating habits. This paper underscores the significance of multimodal HCI in enhancing culinary experiences, setting a precedent for future developments in the field.

Accelerating the construction of livestock powerhouses is of great significance to better enhance the ability to guarantee the supply of livestock products and improve the quality, efficiency and competitiveness of the livestock industry. This study constructed an evaluation index system to assess the level of China’s livestock powerhouse and then performed an in-depth analysis of the issues and challenges facing the construction of livestock powerhouses. The research results showed that the level of China’s livestock powerhouse ranked 5th in the world, and the livestock industry was transitioning from being a large livestock country to a powerhouse, while there was still a large gap in terms of reaching the goal of constructing livestock powerhouses. There were significant differences in the level of livestock powerhouses across different livestock industries; the layer industry was the world leader in China, whereas the pig, sheep and goat, and broiler industries were stronger, while the beef cattle and dairy industries were weaker. There are still many challenges to accelerating the construction of livestock powerhouses in terms of supply security, scientific and technological support, operation systems, industry and supply chain resilience, international trade, policy support, etc. It is recommended to improve the institutional mechanism for the construction of livestock powerhouses, promote a high level of self-reliance and self-improvement in livestock science and technology, build a modern livestock operation system, enhance the resilience and security level of the industrial and supply chain, and consolidate and expand international trade and cooperation.

In addition to the subject-matter theoretical knowledge acquired during undergraduate and especially postgraduate studies future young scientists must also acquire the accompanying academic skills. This skillset will enable them to plan and conduct research in accordance with the scientific method, but also to present the results of that research in suitable forms. No result and no new knowledge derived from research is valuable in itself, as long as it is not presented to the scientific community and society as a whole. This dissemination is most often done through the peer-reviewed publishing in scientific journals. Hence acquiring the skill of writing scientific publications must be an integral part of education, eg. part of the acquired academic skills. However, currently that is not the case in all scientific environments and a significant number of (young) scientists and researchers do not possess all the necessary knowledge and skills to write academic articles, especially when it comes to the standard form and technical preparations. This skill-gap often results in a significant number of submitted papers to be rejected or sent back for resubmission even before they reach the Editor's desk. In an effort to provide an academic-writing-skill resource for young academics in the field, this article, points out the general principles of a well-written and prepared paper, indicates the most common errors and omissions, and suggests ways to prevent them. In addition, the article is considering the current state of academic skills in, primarily, less developed scientific environments. and the causes of such a state.

: Background: The aim of this study was to evaluate Phenylketonuria (PKU) patients’ oral health habits and the efficiency of tailored recommendations for PKU patients in Latvia on the correct management of oral hygiene. The-free amino acid formula can negatively impact PKU patient’s oral health as it contains a high amount of complex carbohydrates. Materials and methods: In this study with a one-month interval pre and post implementation of oral hygiene recommendations, two questionnaires regarding oral hygiene habits and knowledge were prepared and provided by trained medical personnel to be filled in for all diagnosed PKU patients in Latvia who were not lost to follow-up. Results: Based on the questionnaires among the PKU patients under 18 years of age, 27% cleaned their teeth once a day. However, 6% of patients did not engage in regular teeth brushing at all. Among PKU patients over and 18 years of age, 26% brushed their teeth only once a day. Additionally, a mere 39% of PKU patients ≥18 years of age and 17% < 18 years of age incorporated flossing into their oral hygiene routine. In total, 45% of PKU patients ≥18 years of age and 44% < 18 years of age visited a dentist once a year, but 40% ≥18 years of age and 39% <18 years of age visited a dentist less often than once per year. After reading the recommendations, a remarkable number of PKU patients < 18 years of age had improved their daily oral hygiene routine, including toothbrushing (25%) and flossing (23%). Conclusion: Given the unique dietary requirements and the implementation of these daily at-home oral health practices, motivation and regular reminders should result in better oral health of PKU patients and cooperation with clinicians.

The advent of social commerce (SC) has transformed the landscape of online consumer behavior, emphasizing the significance of customer-to-customer relations in shaping sustainable relation-ships with customers. This research investigated the intricate relationships between social com-merce dimensions, particularly suggestions and recommendations, forums and communities, and ratings and reviews, and their influence on customer-to-customer value co-creation (C2CVCC) and sustainable customer relationships (SCRs). A questionnaire was designed and administered to 635 respondents. We examined the psychometric properties of the measurements and subse-quently applied Partial Least Squares as a Structural Equation Modeling method (PLS-SEM) for hypothesis testing. The findings reveal that the dimensions of SC significantly impact C2CVCC, with ratings and reviews playing a pivotal role. Furthermore, C2CVCC emerges as a substantial mediator in the path between SC and SCRs. The empirical analysis showcases strong support for the proposed model, with robust path coefficients (β) and p-values confirming direct and indirect effects. These findings offer valuable insights for businesses seeking to leverage SC and customer interactions to enhance SCRs in the digital era. Understanding the dynamics of C2CVCC within the context of SC has become essential for marketers and businesses aiming to thrive in today's competitive online marketplace.