Based on a reflection on the tensions between play, education, and learning in early childhood, this article aims to identify and analyze the factors that limit or negatively condition the possibilities for play at school during the transition between Early Childhood Education and Primary Education in Chile. The study was conducted in four Chilean schools, with the Transition Levels of Chilean Early Childhood Education (children aged 4 and 5) and the first two levels of Primary Education (children aged 6 and 7). Based on an ethnographic approach, we combined 22 ethnographic observation days spread over two consecutive years and 59 interviews of various types with children, educators, and parents. The results show structural-material limitations on school play that mainly affect children in Primary Education. Beyond, factors associated with routines, indications, and statements governing functioning and participation in this level tend to limit or prevent play, often considered a "non-legitimate" activity. Conclusions highlight the potentialities that children's restricted or resisted play can present in terms of learning.

In order to foster a more sustainable and eco-friendly trajectory for the construction industry, while concurrently mitigating environmental pollution and energy inefficiency, it is imperative to cultivate an environmentally conscious building and urban environment. Under the background of carbon peak and carbon neutrality, green building evaluation system (GBRS) has become a research hotspot in the field of green building. This paper systematically summarizes the current research progress based on GBRS, focuses on the current weight and indicators setting, analyzes it with Cite Space software, and puts forward its future development direction. The results show that the weight setting method of green building evaluation system is determined by multidimensional and multi-method. From the perspective of environment, society and economy, the scope of indicators setting is expanding. The green building evaluation system will play a guiding role in green building design, and the evaluation process will continue to be optimized and developed in the direction of intelligence and automation.

This paper presents a study on optimization of Overcurrent relay (OCR) coordination protection scheme for Sustainable Standalone Hydrokinetic Renewable Energy (SHRE) distribution network at Batang Rajang river, located at Kapit Sarawak, Malaysia by turning river stream into power generation source. The purpose of the project is to develop rural electrification system for native long houses along the river. The research study is tested on a DigSILENT develop model of the SHRE distribution network and in accordance with all respectively unique parameters and relevant standards. Since this is a new standalone distribution system, an efficient and properly coordinated overcurrent protection system must be provided. Improper and miscoordination among OCRs result in maloperation of the protection system that can lead to false tripping and an unnecessary outage and power system instability. Thus, the objective of this work is to employ Genetic Algorithm (GA) technique in Matlab/Simulink for optimal overcurrent coordination and settings among all OCRs in the proposed distribution network in order to improve the speed of OCR tripping operation. The GA is used because the project is fast track and requiring the simplest method available. In this strategy, time dial setting (TDS) is optimized by using plug setting multiplier (PSM) as the constraint. The obtained results show a significant improvement of the relay operating time of 36.01% faster than that of conventional numerical technique during fault occurrence. Thus, an efficient and reliable overcurrent protection scheme has been achieved for the SHRE distribution network.

Disseminated or military tuberculosis (TB) is defined as the presence of at least two non-contiguous sites of Mycobacterium tuberculosis, occurring as a result of progressive primary infection, reactivation and spread of a latent focus or due to iatrogenic origin. Disseminated TB represents a life-threatening condition, especially in at-risk children and when the diagnosis and treatment are delayed. We report on a case of a 3-year old boy who presented with long-lasting unrecognised disseminated TB that was successfully managed in a low-resource setting.

The study focuses on solving urban challenges such as temperature reduction, urban stormwater management, noise reduction, air quality improvement, and CO2 concentrations reduction, and suggests terrestrial and freshwater habitat types (HTs) found in Europe, as innovative forms of nature-based solutions (NBS) for them. Establishment of native HTs in different urban environments to solve urban challenges would enhance biodiversity at different levels and integrate this aspect in urban planning. This contribution builds on the recognition that surfaces of vegetated terrain are the most versatile NBS in addressing the broadest range of environmental problems in urban areas and that the processes running within these green spaces offer the key to socio-ecological improvements of such areas. Employing narrative literature review, qualitative content analysis, and interdisciplinary expert discussion this paper defines why and how native HTs of unchanged nature can be implemented as NBS in the urban environment, indicate potential HTs for specific urban challenges and presents an approach to the inclusion of HTs as NBS into spatial planning documents at national, regional, and local levels. The proposed planning approach attributes added value to HT, and by linking the concepts of NBS and HT integrates them into urban planning.

The purpose of this systematic review is to examine the various articles published in the field of neuropsychology of anxiety research in terms of publication type and volume, methodology, and subject matter. The significance of this topic derives from the clinical and functional consequences of cognitive symptoms. Generalized anxiety disorder refers to the cluster of clinical symptoms characterized by predominant anxious anticipation and difficulty controlling worry. In order for the review to be systematic and reproducible, a search of the PsycINFO, Scopus, PubMed, Elsevier databases and an analysis using the PRISMA method are suggested. After analyzing the research data, empirical studies evaluating the clinical neuropsychology of generalized anxiety disorder are discussed.

Since the end of 2019 and throughout 2020 the world has been devastated by the SARS COVID-19 pandemic. The sport world suddenly had to deal with a massive reorganization of events with important implications on the physical and psychological preparation of athletes and coaches. The purpose of this study was to explore how these changes impacted coaches’ and athletes’ goal setting strategies and their experience of goal adjustment. As part of a wider mixed-method project involving 2162 coaches and 1354 athletes, an online qualitative survey was used, and data collected were analyzed using reflexive thematic analysis. Findings highlighted three overarching themes, in response to goal adjustment: “Moving on toward new goals”, “Letting go of goals”, and “Trying to hold on”, with several themes and sub-themes identifying different nuances of athletes’ and coaches’ experience. The implications of such findings for the mental preparation of high-level athletes are discussed in two ways. Firstly, in light of existing literature on goal setting from an applied perspective; secondly, in the broader perspective of the sport culture and the application of our themes to other challenging moments that sport professionals might encounter.

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

The concept of Emotional Intelligence (EI) has gained prominence due to its substantial impact on a range of life outcomes, including academic performance. The present study aims to examine the relationship between Emotional Intelligence and academic accomplishment in the context of a school environment. Analyzing students' emotional skills and competencies makes it possible to uncover the potential of emotional intelligence (EI) in predicting their academic achievement. Additionally, the study emphasizes the importance of integrating emotional intelligence (EI) training within the educational curriculum. Developing students' emotional awareness, empathy, self-regulation, and social skills can yield notable academic benefits, cultivating an environment more favorable to learning. This systematic review examines the relationship between emotional intelligence and its impact on children and teachers by synthesizing several relevant research studies. This study encompasses a comprehensive review conducted from 2016 to 2023. A total of 64 publications were examined in this study, specifically chosen based on their relevance to the review's parameters. These articles were sourced from reputable academic databases, including Scopus, PsycINFO, PubMed, and WoS. The study revealed a correlation between the five dimensions of personality and emotional intelligence, creativity, resilience, the educational framework, and specific experimental programs about its education. The results mentioned above are of great significance, as they demonstrate that emotional intelligence (EI) is not solely a non-essential skill but a vital factor in education that can provide significant perspectives for students, educators, and politicians.

On the analyzed section of 2.4 km of the national road No. 50 of the Młodzieszyn bypass, it was carried out by a consortium of OAT and SAT companies in the period April-September 2019, under constant traffic in the field of repairing the concrete pavement by replacing slabs, levelling them and sealing expansion joints, roughening and roadside reinforcements.

In this paper we provide a highly selected review and synthesis on some of the recent and notable contribution to research in portfolio analysis. A unique perspective on this development in the literature is offered in this paper by judiciously identifying a few sample eigenvalues adjustment patterns in a portfolio that leads to an improvement in the out-of-sample portfolio Sharpe ratio when the population covariance matrix admits a high-dimensional factor model. These patterns unveil a key insight into a portfolio performance improvement and shed an important light on the effectiveness of a few recently introduced ”robust to estimation errors” covariance matrix estimation approaches, which were not originally designed with the goal to improve the out-of-sample portfolio performance.

Precise determination of the tectonothermal events at the Qinling-Qilian junction is extremely significant for understanding the tectonic evolution of the eastern branch of the Paleo-Tethys. The Banpo porphyry outcrops in the northern margin of the North Qinling were chosen as the research subject, and its formation and tectonic environment were analyzed using Zircon U-Pb age estimation and geochemical studies. The results indicated the final stage of the Triassic orogeny and the closure phase of the Paleo-Tethys. The weighted average values of 206Pb/238U ages of samples from 3 sites of the Banpo porphyry corresponded to 213.4 ±2.1 Ma (MSWD = 0.56), 213.0 ±1.6 Ma (MSWD = 0.92), and 213.2 ±4.4 Ma (MSWD = 1.6). This study revealed that the Banpo porphyry was formed during the Late Triassic (Norian). The porphyry with high SiO2 and high alkali is typical A-type granite, which belongs to the weak peraluminous shoshonite series. All the samples are rich in low rare earth elements. However, the heavy rare earth elements are low, especially Eu, which exhibits a seagull-type right-leaning partitioning curve. In addition, based on the regional geological data, it can be concluded that the Banpo porphyry was formed during the transition period from a post-orogenic environment to a non-orogenic environment. This study indicated the closure of the Paleo-Tethys-Mianxian-Lveyang Ocean by the Late Triassic as well as the completion of the collision between the North China and Yangtze Blocks along the Qinling orogenic belt.

This study proposes a novel flexible bus dispatching system where a fleet of fully automated modular bus units, together with conventional buses, serves the passenger demand. These modular bus units can either operate individually or combined (forming larger modular buses with a higher passenger capacity). This provides enormous flexibility to manage the service frequencies and vehicle allocation, reducing thereby the operating cost and improving passenger mobility. We develop an optimization model used to determine the optimal composition of bus units and the optimal service frequency at which the buses (both conventional and modular) are dispatched across each bus line. We explicitly account for the dynamics of traffic congestion and complex interactions between the modes at the network level based on the recently proposed three-dimensional macroscopic fundamental diagram (3D-MFD). To the best of our knowledge, this is the first application of the 3D-MFD and modular bus units for the frequency setting problem in the domain of bus operations. Numerical results show the improvements in the total system cost made by adapting the number of combined modular bus units and their dispatched frequencies to the evolution of both, the car and the passenger demand. A comparison with the commonly used approach that considers only the bus system (neglecting the complex multimodal interactions and congestion propagation) reveals the value of the proposed modeling framework.

Calcium carbonate cements have been synthesized by mixing amorphous calcium carbonate and vaterite powders with water to form a cement paste and study how mechanical strength is created during the setting reaction. In-situ XRD was used to monitor the transformation of ACC and vaterite phases into calcite and a rotational rheometer was used to monitor the strength evolution. There are two characteristic time scales of the strengthening of the cement paste. The short timescale of the order 1 hour is controlled by smoothening of the vaterite grains, allowing closer and therefore adhesive contacts between the grains. The long timescale of the order 10-50 hours is controlled by the phase transformation of vaterite into calcite. This transformation is, unlike in previous studies using stirred reactors, found to be mainly controlled by diffusion in the liquid phase. The evolution of shear strength with solid volume fraction is best explained by a fractal model of the paste structure.

Objectives: The purpose of this systematic review was to ascertain critical care nurses’ understanding and experiences of patient advocacy in adult critical care settings. The specific objectives were to identify how critical care nurses define patient advocacy, to explore the understanding and experiences of critical care nurses regarding patient advocacy, to explore critical care nurses’ role in patient advocacy, and to ascertain the barriers to encouraging advocacy in the critical care setting. Research design: Systematic literature search of CINAHL and Medline databases, Google Scholar, and Cochrane Database of Systematic Reviews, as well as grey literature search, was conducted. Search dates were restricted from January 2005 to 2015 in both CINAHL and Medline. Findings: 62 studies were identified, of which 6 qualitative research papers were included. Nurses gave varied definitions of patient advocacy, which were categorized into three themes: communication, protection, and doing. Nurses perceive advocacy as truly listening to patients and their families. Conclusion: For critical care nurses to be effective advocates, there must be support, collaboration, and improved working relationship between professional groups. Moreover, nurses must be empowered to be able to give power to patients and family.

Polyvinyl alcohol-engineering cementitious composites (PVA-ECC) has been widely applied in bridge deck repairing or widening, the common practice for doing this is that a portion of a bridge is left open to traffic while the closed portion is constructed, which expose the early age PVA-ECC to the vehicle-induced vibrations. However, whether vehicle-induced vibrations affect the tensile performance of early age PVA-ECC remains unknow. The purpose of this study was to conduct laboratory test programs on how much vehicle-induced vibrations during early ages affected the tensile performance of PVA-ECC. A self-improved device was used to simulate the vehicle-induced vibrations, and after vibrating with the designed variables, both a uniaxial tensile test and a grey correlation analysis were performed. The results indicated that: the effects of vehicle-induced vibrations on the tensile performance of early age PVA-ECC were significant, and they generally tended to be negative in this investigation. In particular, for all of the vibrated PVA-ECC specimens, the most negative age when vibrated occurred during the period between the initial set and the final set. We concluded that although vehicle-induced vibrations during the setting periods had no substantial effects on the inherent strain-hardening characteristics of PVA-ECC, the effects should not be ignored.

The 2019 Coronavirus pandemic which was initially referred to as 2019-nCoV, was first identified in Wuhan, China. Early response from the Chinese government included quarantine of infected persons, isolation and total lockdown of Wuhan province to prevent further spread. With the spread of the disease across national borders and declaration of the disease as a global pandemic, there has been a robust response by the international community to contain this deadly virus and prevent its further spread worldwide. Africa is not left out of this rampaging pandemic with documented cases in over 40 countries and still rising. Although extensive studies have been carried out on the novel SARS-CoV-2 on its pathogenesis, mode of infection and virulence but much is still unknown. However, potentially infectious samples are received routinely in the medical laboratory for analysis. This technical note reviews good laboratory practice (GLP) and processes across the different specialities of Medical Laboratory practice that should minimize the risk of infection to laboratory staff especially in resource-limited settings.

During the casting in a warmer tropical temperature, a setting time delay is required to maintain the workability of the concrete, commonly achieved by the addition of admixtures i.e. silica fume (SF), fly ash (FA), and Plastrocrete®. However, high sugar content Coca-Cola in niche conditions is proposed as an ingredient for delaying concrete setting time in combination with conventional admixtures. This research aims to compare the setting time of admixtures from Coca-Cola and Plastocrete® RT6 plus in concrete mixing with control data of concrete mixed with SF or FA. The second aim is to measure the compression strengths between combinations of Coca-Cola and Plastocrete® RT6 plus. Concretes were produced with admixtures of SF, FA, Plastocrete® RT6plus, or Coca-Cola. The concrete used to control was f'c20 and f'c 25, while other concrete mixes were produced with the addition of Coca-Cola at 0.15% from the weight of cement at variation of moisture treatments. The first method to produce concrete (f'c20+Plas0.23%+Cola0.15% and f'c25+Plas0.23%+Cola0.15%) did not employ water reduction. The second concrete productions (f'c25+Plas0.46%+Cola0.15% and f'c25+Plas0.46%+Cola0.15%) reduced the addition of water at 8.8% (v/w). The first concrete production method had a setting time 44% longer than control. The reduced water concrete in the second productions had a setting time 34% longer than control. Meanwhile, the Plastocrete® RT6 Plus admixture with the reduced water delayed the concrete setting time by 26% longer than control. The delayed setting time of Plastocrete® RT6 Plus admixture with reduction of water was shorter than in the treatment with Coca-Cola. The combination of the addition of Coca-Cola with Plastocrete® RT6 plus by reducing the amount of adding Coca-Cola to 0.10% with Plastocrete® RT6 plus can delay concrete setting time by 51% longer than normal concrete and increase concrete compressive strength by 13% higher than normal concrete. Mixing Coca-Cola with Plastocrete® RT6 plus not only provided an optimal delay effect on setting time but also significantly increase the compressive strength that was desired during the casting in warm tropical weather applied in building construction of Mulawarman University, Samarinda, Indonesia.

In this paper, we consider a manufacturer who produces and sells a kind of innovative product in the monopoly market environment. Because the life cycle of innovative product is usually shorter than its procurement lead time, one unique demand quantity (scenario) will occur in the selling season, thus there is only one chance for the manufacturer to determine both optimal production quantity and optimal sale price. Considering this one-time feature of such a decision problem, a price-setting newsvendor model for innovative products is proposed. Different to the existing price-setting newsvendor models, the proposed models determine the optimal production quantity and sale price based on some specific state (scenario) which is most applicable for the manufacturer. The theoretical analysis provides managerial insights into the manufacturers’ behaviors in a monopoly market of an innovative product and several phenomena in the luxury goods market are well explained.

Background: Best Possible Medication History (BPMH) collected by clinical pharmacists is crucial for effective medication review but, in Italy, it is often left to the nursing staff. This study aims to compare the quality and accuracy of a clinical pharmacist-documented BPMH with the current standard practice of ward staff-collected BPMH at an Italian perioperative surgical setting. Methods: A 20-week prospective observational non-profit study was conducted in a major University hospital. The study comprised a feasibility, an observational, and an interventional phase. During the feasibility phase, 10 items for obtaining a correct BPMH were identified. The control group consisted of retrospectively analyzed BPMHs collected by the ward staff during the observational phase, while interventions included BPMHs collected by the clinical pharmacist during the third phase. Omissions between the two groups were compared. Results: 14 (2%) omissions were found in the intervention group, compared with 400 (57.4%) found in the controls (p<0.05); data collection was more complete when collected by pharmacists compared to the current modalities (98.0% versus 42.6%; p<0.05). Conclusions: The involvement of a pharmacist significantly reduced the number of omissions in perioperative surgical-collected BPMHs. This intervention holds the potential to decrease the risk of medication errors associated with inaccurate or incomplete BPMHs prior to surgical hospitalization.

Being hospitalized is a threatening and stressful experience for many children. From a psychological point of view, children may experience increased feelings of anxiety and fear that can negatively interfere with behavioral, cognitive, and emotional outcomes. To limit these impacts on children's well-being and mental health, interventions that could contribute to protecting the emotional domain of hospitalized children are welcomed. The present research reported a single-setting case study intervention to evaluate the impact of educational play-based activity with a CoderBot robot in a pediatric short-term recovery ward (N=61). The methodology included multiple sources of data (i.e., children, parents, nurses), observations on the field, and a sequential (quantitative-qualitative) mixed-method approach to data analysis. Results supported the idea that robot-based activities were associated with increased participant well-being (particularly positive emotions). The conclusions of this pilot study discuss the strengths, limitations, and further developments of using robots with hospitalized children.

Management of demand and capacity for airport operation is important. The effect of capacity setting on slot adjustment, maximum adjustment and flight delay has been extensively investigated and discussed in previous slot adjustment models. But its effect on characteristics of flight waves has not been studied deeply. At present, in order to resolve the problem that Linear Integer Programming (LIP) is limited in slot allocation due to its fast dimension growth and large memory consumption, the general practice is to optimize the slot application according to data-splitting technology. However, the relationship among data splitting method, capacity setting and characteristics of slot wave has not been investigated in detail, which limits the application of LIP in slot allocation. Through the detailed analysis and testing, we found that the waveform and amplitude of slot wave can be controlled and designed by appropriate virtual capacity settings, while the number of capacity constraints and the computing time is reduced by adopting appropriate data feeding method. Our research also provides clues for further research on the construction of the flight waves for airlines operating at specific airports in order to establish direct or indirect connectivity, and increase hit rate by using our approaches.

The ageing of workers is one of the most important issues for occupational health and safety in Europe. A number of intervention studies on health promotion for older workers were conducted in European workplaces between 2000 and 2015. This review gives an overview of these studies and considers perspectives for workplace health promotion.

E-scooters are a micromobility transportation option for completing short trips. In recent years, many ‎cities welcomed shared e-scooters in an effort to offer more mode choices, increase travelers' ‎convenience, and reduce automobile use in their service areas. However, a knowledge gap still remains ‎regarding the acceptability of shared e-scooters as a transportation option, which motivates additional ‎research on user and non-user preferences and attitudes toward e-scooter use. This study investigates ‎latent variables impacting the adoption of shared e-scooters in urban areas, focusing on mode choice ‎factors and attitudes towards e-scooter use and car use. The study utilizes machine learning (ML) ‎techniques and SHAP analysis to analyze survey data (N=1196) collected from travelers in Washington, ‎D.C., Miami, FL, and Los Angeles, CA, in 2021 and 2022. A comparative analysis is performed to develop ‎comprehensive demographic profiles of e-scooter users. The analysis reveals gender (male), age (25-39 ‎years age group), higher income, and educational background as the most relevant factors toward e-‎scooter use. Attitudinal variations among e-scooter users and non-users underscore the complexity of ‎perceptions toward e-scooter use, with significant differences in mode choice factors and attitudes ‎toward the use of e-scooters and private vehicles. Notably, educational background ranked as a significant ‎factor in Washington, D.C., and Miami, while Factor 3, derived from factor analysis and encompassing car ‎use attitudes and the utilization of technology, emerged as influential in Los Angeles. This research ‎contributes fresh insights into factors shaping e-scooter adoption, offering a foundation for informed ‎urban transportation planning and policymaking. The holistic approach showcased in this study enhances ‎understanding of shared micromobility and its implications for urban mobility.

Background/aim: Sexual harassment has become a serious social and public health problem in adolescence, causing adverse effects on mental health. Nevertheless, some behaviours arise that, due to their characteristics, might be misinterpreted as sexual harassment. A field study, a survey with a non-probabilistic accidental sampling, was designed in order to estimate the prevalence of sexual harassment victimization in the Spanish adolescent population, as well as to quantify the harms. Method: 1028 Spanish adolescents, 54.3% females and 45.7% males, aged 13-17 years (M = 15.21, SD = 1.03), responded to a diagnostic measure of sexual harassment victimization and an inventory measure of internalizing and externalizing Mental Health Problems (MHPs). Results: The results showed a significant prevalence of diagnosed sexual harassment victimization of school-aged adolescents, 24.1%, 95% [.215, 267], with adverse effects on internalizing and externalizing MHPs. As for the internalizing MHPs, the results showed moderate adverse effects on depression, anxiety, somatic burns, posttraumatic symptoms, and obsessive-compulsive symptoms; and mild adverse effects on social anxiety. With regard to externalizing MHPs, the results revealed moderate adverse effects on hyperactivity-impulsivity, anger control and antisocial behaviour; and mild adverse effects on attention problems, aggression and defiant behaviour. In addition, it was corroborated that sexual harassment victimization affects adolescent females to a greater extent, with the effect being significantly greater in internalizing than in externalizing MHPs. Conclusions: The results obtained are discussed and future lines of research and intervention are proposed to promote the implementation of prevention and intervention programs that address this phenomenon and, in turn, improve the physical, psychological, and social well-being of adolescents.

Jabulile Ndlovu1 and Kebogile Mokwena1, 2 1 Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa 2 Research Chair in Substance abuse and population Mental Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa Corresponding author: jabulilendlovu5@gmail.com Abstract An estimated 6% of the world population has serious mental illness, with one in four families having a member with some form of psychiatric disorder, who are mostly cared for by their relatives within a family setting. Although caregiving in a home setting is reported to be associated with significant mental distress, the burden of such distress is rarely measured. The purpose of this study was to quantify the burden of care among family caregivers of relatives with serious mental disorders, as well as to explore possible association between the caregiver burden of care and a range of caregiver and Mental Health Care User (MHCU) variables in a rural district in Kwa-Zulu Natal, South Africa. The Zarit Burden Interview (ZBI) scale was used to collect data from 357 caregivers, and STATA 14 was used to analyze data. The ages of the sample ranged from 18 to 65, with a mean of 50.29, and the majority (86%) were female and unemployed (83%). The ZBI scores ranged from 8 to 85, with a mean of 41.59. The majority (91%) tested positive for caregiver burden of care, which ranged from mild to severe. Using the Pearson Chi-square test of association (p=0.05), variables that were significantly associated with the burden of care were clinically related (caregiver self-reported depression, MHCU diagnosis, recent relapse of the MHCU), socio-economic (caregiver family monthly income, MHCU disability grant status and MHCU employment status) and socio-demographic (MHCU gender and MHCU level of education). The prevalence of burden of care is high and severe, and scarcity of resources in families and communities contribute to the high burden of care in these rural communities.

Background. There are scant data about the effectiveness of high flow nasal cannula (HFNC) oxygen therapy in patients hospitalized with severe acute respiratory failure (ARF) in non-intensive medical wards, particularly regarding the effect on arterial oxygenation compared to conventional oxygen therapy (COT) and non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP). Methods. In a retrospective observational study, oxygenation parameters were measured before and immediately after HFNC initiation in 37 consecutive patients hospitalized in a geriatric ward in 2017. Results. HFNC was used as escalation therapy for untreatable hypoxia after failure of NIV/CPAP (n=18) or COT (n=19). Twenty-two patients died, 2 were transferred to the intensive care unit, while 13 were discharged alive. A “do not intubate” status was identified in 17 of the 22 deceased patients. Partial pressure of oxygen (pO2, p< 0.0001), oxygen saturation (SO2, p< 0.0001), pO2/fraction of inspired oxygen ratio (p=0.004) and peripheral SO2 measured by pulse oximetry (p< 0.0001) significantly increased soon after HFNC application. Oxygenation improvements were greater after escalation from NIV/CPAP and in patients discharged alive. Conclusion. HFNC significantly improved oxygenation in severe ARF after failure of COT or NIV/CPAP and may be particularly suitable for older patients hospitalized in non-intensive medical wards.

Fault line detection timely and accurately when single-phase-to-earth fault occurs in resonant grounding system is still a focus of research. This paper presents a new approach for fault detection based on data fusion and it has non-artificial setting. Firstly, the fault criterion for interphase difference energy ratio and time-frequency correlation coefficient of each line is proposed. Subsequently, the paper establish a coordinate system with the interphase difference energy ratio as X axis and the time-frequency correlation coefficient as Y axis, and it uses the Euclidean distance algorithm to get the characteristic distance of each line by fusing two-dimensional information. Finally, comparing the sound distance and the fault distance of each line to discriminate the fault line. Electromagnetic Transients Program (EMTP) simulation results and adaptability analysis have confirmed the effectiveness and reliability of the proposed scheme.

Background: The proven efficacy of mTOR inhibitors (mTORI), tyrosine kinase inhibitors (TKI) or immune checkpoint inhibitors (ICI) therapies in metastatic renal cell carcinoma (RCC), suggested that these agents should be investigated as adjuvant therapy with the aim of eliminating any residual undetectable microscopic disease after curative resection. Our study aimed to compare the efficacy of these treatments through the application of an innovative method that reconstructs individual patient data. Methods: Nine phase III studies describing different treatment options for adjuvant RCC were selected. Individual patient data were reconstructed from Kaplan–Meier (KM) curves through the “IPDfromKM method”. Disease-free survival (DFS) were compared among combination treatments and control arm (placebo). Results were summarized as multi-treatment KM curves. Standard statistical testing was used, including hazard ratio and likelihood ratio tests for heterogeneity. Results: In the overall population, this study showed that two ICIs (pembrolizumab and nivolumab plus ipilimumab) and one TKI (sunitinib) showed superiority over placebo, whereas both TKI and mTORI did not. As we assessed DFS as the primary endpoint for the adjuvant comparison, the overall survival benefit remains unknown.. Conclusion: This novel approach to investigating survival has allowed us to conduct all of the indirect head-to-head comparisons between these agents in a context where no "real" comparative trials have been conducted.

Repetitive transcranial magnetic stimulation (rTMS) with intensive occupational therapy improves upper limb motor paralysis and activities of daily living after stroke; however, amount of improvement according to paralysis severity remains unverified. Target activities for daily living using patients’ upper limb functions can be established by predicting the amount of change after treatment for each severity level of upper limb motor paralysis and further aid practice planning. This study estimated post-treatment score changes for each severity level of motor paralysis (no, poor, limited, notable, and full) stratified according to Action Research Arm Test (ARAT) scores before combined rTMS and intensive occupational therapy. Severity of motor paralysis was the fixed factor for analysis of covariance, delta (post-pre) of the scores was the dependent variable. Ordinal logistic regression analysis was used to compare changes in ARAT subscores in patients, divided according to paralysis severity before treatment. A multicenter retrospective cohort dataset analyzed 907 patients with stroke hemiplegia. Largest treatment-related changes in scores were observed in the Limited recovery group for upper limb motor paralysis and Full recovery group for quality-of-life activities using paralyzed upper limb. These results will help predict treatment effects and determine exercises and goal movements for occupational therapy after rTMS.

Through a partnership with three Federally Qualified Health Centers (FQHCs), the local health department in Los Angeles County implemented a produce prescription program (PPR) to increase fresh fruit and vegetable purchases among patients with diabetes or prediabetes. The PPR, which began in 2020, provided eligible patients with a $40 voucher every month for 6 months to promote the purchase of fresh produce at large chain grocery stores. This qualitative assessment describes staff experiences with the PPR, documenting the facilitators and barriers they encountered while implementing the program. Fifteen clinic staff (i.e., PPR implementers) were interviewed for this assessment. Thematic analysis and coding were conducted using the ATLAS.ti software; the coding was carried out by two separate coders. Interviewees discussed the importance of having preexisting partnerships and programs to support the PPR at their clinic site. Hidden costs related to implementing the program included a large and unexpected amount of staff time devoted to enrolling patients into the program. Collecting quality data and having limited expertise to rigorously evaluate the program were other challenges. Because patients often share their food with their family, the monthly $40 incentive was generally not enough to support their needs; interviewees suggested giving a higher inventive amount to those with a larger household. Future PPR efforts and similar food incentive programs should consider these and other facilitators and barriers to implementation and sustainability, especially when making adjustments to these programs to improve services and access to food resources.

There is a systematic exclusion of gender-based violence, safe abortion, reproductive cancers, infertility services, comprehensive sexuality education, sexuality services, and STI’s other than HIV in essential health packages in LMICs. To accelerate progress on sexual reproductive health (SRH), the Guttmacher–Lancet Commission proposed the adoption of these interventions into an essential health package of SRH services that should be universally available. In this commentary, we use a healthcare priority-setting processes lens to review the importance of these services for universal health coverage. We isolate inherent challenges in social value judgments for terminal, process and content evidence for their healthcare priority-setting. We then advance promising emerging practical examples from low to middle-income countries on evidence-informed decision-making processes. We recommend capacity development through regional support, generating equity and efficiency evidence and strengthening political and publicly acceptable processes to institutionalise and operationalise evidence-informed decision-making.

Examining the similarity of event environments or surroundings, more precisely settings, provides additional insight in analyzing event sequences as it provides information about the context and potential common factors that may have influenced them. This article proposes a new similarity measure for event setting sequences, which involve the space and time in which events occur. While similarity measures for spatiotemporal event sequences have been studied, the settings and setting sequences have not yet been studied. While modeling event setting sequences we consider spatial and temporal scales to define the bounds of the setting and incorporates dynamic variables alongside static variables. Using a matrix-based representation and an extended Jaccard index we developed new similarity measures that allow for the use of all variable data types. We successfully used these similarity measures coupled with other multivariate statistical analysis approaches in a case study involving setting sequences and pollution event sequences associated with the same monitoring stations, which validate the hypothesis that more similar spatial-temporal settings or setting sequences may generate more similar events or event sequences. In conclusion, these similarity measures have many potential real-world applications, and offer researchers a powerful tool for understanding different factors and their dynamics corresponding to occurrences of spatiotemporal event sequences.

Growing evidence suggests that healthcare provider advice may increase tobacco cessation, reduce alcohol use, and improve the adoption of desirable lifestyle behaviors among patients. However, how brief interventions and other provider-patient interactions can shape cumulative adoption of multiple modifiable behaviors is less well studied for diabetes prevention and control. Using weighted internet panel survey data from a large socio-demographically diverse urban population in the United States (n=1,003), the present study describes differences in group characteristics among those who had been “ever diagnosed” with prediabetes/diabetes versus those who had not. It also examines the associations between the cumulative adoption of lifestyle behaviors and each of the following: a) lifetime prediabetes/diabetes diagnosis; b) brief lifestyle intervention exposure (i.e., received provider advice/encouragement); and c) recent provider-patient communication about diabetes. There were several group differences in “ever diagnosed” prediabetes/diabetes status by age, employment status, health status, nutrition knowledge, blood pressure/hypertension diagnosis, and diabetes-related health behaviors (p<0.05). Each of the three provider-patient interactions of interest were positively associated with a higher cumulative sum of adopted modifiable lifestyle behaviors for diabetes prevention and management. Results suggest that provider advice/provider-patient interactions of any type can have a salutary impact on whether individuals with prediabetes or type 2 diabetes will engage in recommended lifestyle behavior modifications.

We describe a vision for a national-scale heavy mineral (HM) map generated through automated mineralogical identification and quantification of HMs contained in floodplain sediments from large catchments covering most of Australia. The composition of the sediments reflects the dominant rock types in each catchment, with the generally resistant HMs largely preserving the mineralogical fingerprint of their host protoliths through the weathering-transport-deposition cycle. Heavy mineral presence/absence, absolute and relative abundance, and co-occurrence are metrics useful to map, discover and interpret catchment lithotype(s), geodynamic setting, magmatism, metamorphic grade, alteration or mineralization. Underpinning this vision is a pilot project, focusing on a subset of the national sediment sample archive, which is used to demonstrate the feasibility of the larger, national-scale project. We preview a bespoke, cloud-based mineral network analysis (MNA) tool to visualize, explore and discover relationships between HMs as well as between them and geological setting or mineral deposits. We envisage that the Heavy Mineral Map of Australia and MNA tool will contribute significantly to mineral prospectivity analysis and modeling here, particularly for technology critical elements and their host minerals, which are central to the global economy transitioning to a more sustainable, decarbonized paradigm.