A simple line of reasoning, based on the most fundamental concepts of thermodynamics, yields some intriguing results for a better understanding of the processes occurring in the observable Universe. Gravitational mass must be continuously generated within an expanding thermodynamic system for this system to remain closed. The Second Law is a direct consequence of this production of mass. Simple expressions for the entropy and temperature of the Universe were obtained and the results agree well with observable values. Furthermore, it is demonstrated that the conservation laws within the Universe are independent of its energy density. Based on the solution for the quantum state of the Universe, it is conjectured that the Second Law is incomplete and must be complemented to a conservation law, which takes into account the growth of the amount of information within the Universe. Once the Second Law is complemented to a conservation law, the importance of mass generation within the Universe becomes well pronounced – not only gravitational effects play the role of an organising force, but also the amount of mass within the Universe defines both the amount of information within the Universe and the level of the Universe’s complexity.

: 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.

Dental-implant-supported reconstructions provide comfort and improvements in prosthetic function, adaptation, and stability over conventional treatment options. The objective of this study was to evaluate the effect of multiple cleaning solutions on dentures and their influence on the deterioration and loss of retention of overdenture attachments in a 12-month clinical-use simulation. In this way, four different brands of retentive caps made of Teflon (OT Equator, Locator®, Kerator®, and Locator R-Tx®) were immersed in five different cleaning solutions (Kukident®, Benfix®, Corega®, and Protefix®), and tap water was used as the control group, in a simulation that lasted 12 months. Data were analyzed using two-way ANOVA and a Tukey HSD. Furthermore, a Levene Test and Shapiro–Wilk tests were performed to assess the validation of the ANOVA assumptions. The statistical analysis was performed using R version 4.2.2 software with the significance level set to p < 0.05. There were significant statistical differences between the different manufacturers on the retention forces of the attachment’s retentive caps. For the cleaning solution groups, different statistical results between Kukident® and Benfix® were observed. There were no significant statistical differences between Corega®, Protefix®, and tap water despite the fact that the retention forces decreased in all of them.

The COVID-19 pandemic has had a significant impact on all facets of life and has exacerbated many challenges faced by people living with tuberculosis (TB). This study aimed to assess the health-related quality of life (HRQoL) of TB patients in Guinea during the COVID-19 pandemic. A mixed-methods study was conducted using two validated psychometric tools to assess HRQoL and qualitative interviews among TB patients enrolled in treatment at three centers in Conakry, Guinea. Multinomial logistic regression was used to identify factors associated with the deterioration of HRQoL. We included 439 participants in the study, among whom 44% and 31% experienced pain and anxiety, respectively. We found that an increase in the number of household members and the distance from participants’ residence to the health centre were significantly associated with lower HRQoL. Qualitative interviews highlighted nutritional and financial concerns which were exacerbated during COVID-19 pandemic and beliefs that the Guinean Government’s assistance plan was insufficient. This study supports the implementation of specific relief plans for TB patients which includes nutritional and psychological support, especially those whose movements are limited by travel restrictions, impeding access to TB care, reducing work opportunities and exacerbating financial needs and stress.

As the first pilot ecological civilization zone in China, Fujian Province has an excellent ecological environment quality, and its ecological environment-related indices continue to be among the highest in the country. In order to investigate the causes of the excellent ecological quality in Fujian Province in the past 15 years, this paper selects MODIS images, land use data and provincial and municipal statistical yearbook data of Fujian province from 2005 to 2020 as data sources, evaluates the ecological system health of Fujian Province by remote-sensing ecological index (i.e. RSEI), constructs the land use intensity system of Fujian Province at the same time, and uses a coupled coordination model to analyze the coupling between RSEI and The coupled coordination model was used to analyze the coupling relationship between RSEI and land use intensity, and finally the spatial and temporal evolution of ecological health in Fujian Province from 2005 to 2020 was analyzed. The results show that the coupled coordination between land use intensity and ecosystem health in Fujian province showed a continuous increase between 2005 and 2020, especially in Ningde, where the increase was most significant, from 0.0993 to 0.963, this pattern of spatial distribution is lower in the south-eastern coastal region than in the north-western interior, higher in the south-western region than in the north-western region, and higher in the north-eastern region than in the south-eastern region. In terms of the type of role, the land use intensity of most cities in Fujian Province in 2005 played an obvious role in blocking the degree of ecosystem health, but as time changed, urban land use continued to be optimized and reached moderate or even high quality coordination with the quality of the ecological environment, but Xiamen City developed relatively slowly and its 2020 coupling degree value was 0.315, which was still in mild disorder. This study fills a gap in the research mechanism of the interaction between the degree of ecosystem health and land use intensity, and also provides a new perspective for the construction of ecological civilization and the assessment of the degree of ecosystem health in Fujian Province and the whole country.

Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and out-comes including disabling and life-threatening complications. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordina-tion, and psychosocial support for patients and their caregivers. This study examined factors as-sociated with hospital discharge to home health care and subsequent utilization of home health care among a cohort of Medicare beneficiaries with diabetes, age 50 and older, living in the United States. The cohort (n=786,758) was followed for 14 days after a diabetes-related index hospitalization, using linked Medicare administrative, claims, and assessment data (2014-2016). Multivariate logistic regression models included patient demographics, comorbidities, hospital length of stay, geographic region, neighborhood area deprivation, and rural/urban setting. In ful-ly adjusted models, hospital discharge to home health care was significantly less likely among Hispanic (OR 0.8, 95% CI 0.8-0.8) and American Indian (OR 0.8, CI 0.8-0.8) compared to white patients. Among those discharged to home health care, all racial/ethnic minority patients were less likely to receive services within 14-days. Further work should focus on eliminating systemic racism in home health care referral and systemic barriers to receiving home health care services.

Socioeconomic conditions and social attitudes are known to represent epidemiological determinants. Credible knowledge on socioeconomic driving factors of the COVID-19 epidemic is still incomplete. Based on a linear random effects regression, a predictive model is derived to estimate COVID-19 incidence in German rural districts from local socioeconomic factors and popularity of political parties in terms of their share of vote. Thereby, time series provided by Germany's public health institute (Robert Koch Institute) of weekly notified 7-day incidences per 100,000 inhabitants per district from the outset of the epidemic in 2020 up to December 1, 2021, have been used to construct the dependent variable. Local socioeconomic conditions including share of votes, retrieved from the Federal Statistical Office of Germany, have been used as potential risk factors. Popularity of the right-wing party Alternative for Germany (AfD) bears a considerable risk of increasing COVID-19 incidence both in terms of predicting the maximum incidences during three epidemic periods (alternatively, cumulative incidences over the periods are used to quantify the dependent variable) and in a time-continuous sense. Thus, districts with high AfD popularity rank on top in the time-average regarding COVID-19 incidence. The impact of the popularity of the Free Democrats (FDP) is markedly intermittent in the course of time showing two pronounced peaks in incidence but also occasional drops. A moderate risk emanates from popularities of the Green Party (GRÜNE) and the Christian Democratic Union (CDU/CSU) compared to the other parties with lowest risk level. Socioeconomic parameters like \emph{per capita} income, proportions of protection seekers and social benefit claimants, and educational level have negligible impact. To the contrary, incidence significantly increases with population density. In order to effectively combat the COVID-19 epidemic, public health policymakers are well advised to account for social attitudes and behavioural patterns reflected in local popularities of political parties, which are conceived as proper surrogates for these attitudes. Whilst causal relations between social attitudes and the presence of parties remain obscure, the political landscape in terms of share of votes constitutes at least viable predictive "markers" relevant for public health policy making.

Syncope and presyncope occurring during work can affect safety and impair occupational performance. Few data are available regarding the prevalence of these events among workers. The possible role of sleep quality, mental stress and metabolic disorders in promoting syncope, presyncope and falls in workers is unknown. In the present study, 741 workers (male 35.4%; mean age 47±11 years), employed in different companies, underwent clinical evaluation and blood tests and completed questionnaires to assess sleep quality, occupational distress and mental disorders. The occurrence of syncope, presyncope and unexplained falls during their working life was assessed by an ad hoc interview. The prevalence of syncope, presyncope and falls of unknown origin was 13.9%, 27.0%, and 10.3%, respectively. The occurrence of syncope was associated with an increased risk of occupational distress (adjusted Odds Ratio aOR: 1.62, Confidence Intervals at 95%: 1.05-2.52), low sleep quality (aOR: 1.79 CI 95%: 1.16-2.77) and poor mental health (aOR: 2.43 CI 95%: 1.52-3.87). Presyncope was strongly associated with occupational distress (aOR: 1.77 CI 95%: 1.25-2.49), low sleep quality (aOR: 2.95 CI 95%: 2.08-4.18) and poor mental health (aOR: 2.61 CI 95%: 1.78-3.84), while no significant relationship was found between syncope or presyncope and metabolic syndrome. These results suggest that occupational health promotion interventions aimed at improving sleep quality, reducing stressors and increasing worker resilience might reduce syncope and presyncope events in the working population.

Inequality of health service for different specialty categories not only occurs in different areas inequality of health service for different specialty categories in the world, but also happens in the online service platform. In the online health community (OHC), health service was often of inequality for different specialty categories, including both online views and medical consultation for offline registered service. Moreover, how the factor city-level impacts the inequality of health service in OHC is still unknown. We designed a causal inference study with data on distributions of serviced patients and online views in over 100 distinct specialty categories on one largest OHC in China. To derive the causal effect of the city-levels (two levels inducing 1 and 0) on the Gini coefficient, we matched the focus cases in cities of rich healthcare resources with the potential control cities. For the Gini coefficient of serviced patients in over 100 specialty categories, the average treatment effect of level-1 cities is 0.470, which is 0.029 higher than that of the matched group. Similarly, for the Gini coefficient of online views, the average treatment effect of Level-1 cities is 0.573, which is 0.016 higher than that of the matched group. For each of the specialty categories, we also estimated the average treatment effect the specialty category’s Gini coefficient ( ) with the balanced covariates. The results support the argument that the total Gini coefficient of all the doctors in OHC shows that the inequality of health service is still very serious. This study contributes to the development of the theoretically grounded understanding of the causal effect of city-level on the inequality of health service in an online to offline healthcare service setting.

This paper investigates whether currency risk is priced differently in the different sectors (industrial, financial, and basic materials) of equity markets in a sample of developed United States of America (USA) and developing economies (Brazil, India, Poland, and South Africa). The paper makes use of the following techniques: (i) Univariate Autoregressive Fractionally Integrated Moving Average and Exponential General Autoregressive Conditional Heteroskedastic (ARFIMA-EGARCH), (ii) the Markov-Switching method (MS), and (iii) the Canonical Vine Copulas (C-Vine) techniques. Using a sample of daily data made of the foreign exchange rate against the domestic currency and equity market sectors; our findings show that there is an asymmetry effect between equities markets and the foreign exchange rate: there is a heterogeneous, strong, and positive dependence between the two. Higher equities prices are associated with depreciation of local currencies, according to US dollar (USD) exchange rates. In addition, we find that the selected emerging economies are pricing a positive and considerable currency risk. The pricing of currency risk has a varied effect in both regimes representing the states of the economy. In fact, when currency risk pricing has a beneficial impact on certain sectors of the economy, investors predict better returns.

The COVID-19 appears as a catastrophic health risk with psychological, emotional, social and relational implications. From the early stages of the virus spread, the elderly population was identified as the most vulnerable and the health authorities have rightly focused on such frailest population. Conversely, less attention was paid to emotional and psychological dimension of children and adolescents. Actually, they were less at risk quoad vitam or quoad valetudinem, nevertheless they had to face a reality of anxiety, fears and uncertainties. The current study investigated state anxiety and emotion awareness in a healthy sample of older adolescents, 84 females and 64 males, aged 17 to 19, during the pandemic lockdown, using Self-rating Anxiety Scale and the Italian Emotion Awareness Questionnaire. An unexpected anxious phenomenology, impacting the anxiety ideo-affective domain, was found, while the somatic symptomatology appeared to be less severe. The highest anxiety symptom were the breathing difficulties. These findings supported the hypothesis that the COVID-19 pandemic may be a risk condition for an increased state anxiety in older adolescents and suggest the need to provide 1. an effective, empathic communication system with the direct participation of older adolescents, 2. a psychological counseling service for stress management of adolescents.

In this paper, optimum parameters of Tuned Mass Dampers (TMD) are considered to control the responses of 10-story shear building under harmonic loading and 22 set of seismic records of FEMA-P695. The criterion used to obtain the optimum parameters is to select mass ratio, the frequency (tuning) and damping ratio that would result in smallest lateral displacements. State-space equations of motion are presented to compute the structural responses by developing a MATLAB file. A 10-story shear building is presented as a case study to assess the effects of TMDs on the multi-story structures. The results indicate that using TMD can reduce structural responses up to the average 20% under earthquake excitation and up to 90% under harmonic loadings. TMDs are not always effective under any type of ground motion; therefore, being aware of the given location is significant to design TMDs properly.

In cosmology, the cosmic curvature $K$ and the cosmological constant $\Lambda$ are two most important parameters, whose values have strong influence on the behavior of the universe. By analyzing the energy-momentum tensor and equations of state of ideal gas, scalar, spinor and vector potential in detail, we find that the total mass density of all matter is always positive, and the initial total pressure is negative. Under these conditions, by qualitatively analyzing the global behavior of the dynamical equation of cosmological model, we get the following results: (i) $K= 1$, namely, the global spatial structure of the universe should be a 3-dimensional sphere $S^3$. (ii) $0\le\Lambda < 10 ^ {-24} {\rm ly} ^ {-2}$, the cosmological constant should be zero or an infinitesimal. (iii) $a(t)>0$, the initial singularity of the universe is unreachable, and the evolution of universe should be cyclic in time. This means that the initial Big Bang is impossible at all. Since the matter components considered are quite complete and the proof is very elementary and strict, these logical conclusions should be quite reliable. Obviously, these conclusions will be much helpful to correct some popular misconceptions and bring great convenience to further research other problems in cosmology such as property of dark matter and dark energy.

The purpose of work is to quantify the changes of the organism functional reserves during the successive phases of the human health Space-Time Continuum (STC) on the basis of postulates of reliability complex systems theory. The study is devoted to the problem of age-related human involution, which is evaluated not from the causal, but from the kinetic point of view. The analysis of 10 most important basic life support systems of human body — cardiovascular (CVS), respiratory (RS), nervous (NS), digestive (DS), endocrine (ES), immune (IS), excretory (EXS), brain (BS), musculo-skeletal (MSS), hematopoietic (HS) was carried out. Based on this analysis two levels of ensuring the reliability of organism’s work were revealed: sequential and parallel. The system of logical equations for reduced sequential system is: Ys1 = CVS ∧ RS ∧ BS, where ∧ is the notation for the conjunctions of set elements. The system of logical equations for the reduced parallel system is: Ys2 = NS ∨ DS ∨ ES ∨ IS ∨ HS ∨ EXS ∨ MSS ,where ∨ is the disjunction of the scheme elements. Visualization of human STC changes the concept of the kinetics of age-related changes in the organism and the role of determinants of health as a stable factor accompanying a uniform, smooth transition from the most pronounced functions of the body to their gradual extinction. For human STC is formulated the following regularity kinetics of involutionary processes: after 30 years of age in the human body morphological changes regress in arithmetic progression, and the functions of organs in a geometric one. Assumption of health as a state redundancy of functions is suggested.

Suicide is an important public health problem, fundamentally affecting the younger population and responding to multiple biological, psychological, and social causes. The objective of this study was to characterize changes suicide mortality, suicide methods and years of potential life lost during 2005 and 2019 in Paraguay. This observational, descriptive study used data from the Vital Statistics Information Subsystem of the Ministry of Public Health and Social Welfare. The average mortality rate from suicide was 4.9 per 100,000 inhabitants, with an increase from 4.2 between 200-2009 to 5.8 during 2014 and 2019. Suicide was more common in men (75%) than in women. In men, the highest mortality rate was observed among the 20-24 years-old whereas in women the age most affected were the 15–19-year-old age group. The most used method for suicide was strangulation. The most frequent places of suicide occurrence were at home (73%). The seasonality of suicide occurrence showed a slight increase in the spring-summer months compared with autumn winter (53% vs 47%). The rate of potential years of life lost statistically significantly increased from2005 to 2019. Public health measures need to be implemented to investigate the underlying reasons and to implement interventions in the population to decrease suicide mortality in Paraguay.

Detecting human head movement during sleep is important as it can help doctor to access some physical or mental health problems like infantile eczema, calcium deficiency, insomnia, anxiety disorder and even Parkinson’s disease, and provide useful clues for scientific diagnosing. To obtain the information of sleep head movement, current solutions either use the camera or require the user to wear intrusive sensors to collect the image or motion data. However, the vision-based schemes depend on the environmental light conditions and also bring privacy concerns. Some people including the elderly and infant may be reluctant to wear wearable devices during sleep. In this paper, we propose a novel system called Wi-Senser to address the issues mentioned above. Our Wi-Senser directly reuses the existing WiFi infrastructure and exploits the fine-grained channel state information (CSI) of WiFi signals to capture the minute human head movement during sleep without attaching any sensors to the human body. We design and implement our system with just one commercial off-the-shelf (COTS) router and one laptop equipped with Intel 5300 network interface card (NIC). We evaluate the performance of Wi-Senser with 6 volunteers (4 adults and 2 children). Extensive experiments demonstrate that Wi-Senser can achieve a 98.5% accuracy for head movement detection during sleep. Wi-Senser provides a new solution for achieving noninvasive, continuous and accurate human minute movement detection without any additional cost.

This empirical research is part of a larger project beginning in 2020 and ongoing until 2023 exploring the impact of the COVID-19 pandemic on young caregivers aged 5-25 years and their families in Canada. Utilizing the social determinants of health as a conceptual framework, this case study emphasizes the voices of professionals offering services to young caregiver clients during the pandemic, and explores their perspectives on the impact of the pandemic on young caregivers and their families. Across three (3) different organizations offering programs and services to young caregiver clients in Ontario, six (6) individual interviews were conducted with directors/program managers and four (4) group interviews were conducted with thirteen (13) staff members who worked directly with young caregivers and their families. Nineteen (19) service providers participated in total. The results of this study highlight five (5) primary themes that emerged through data analysis: i) the role of service providers, ii) the impact of the COVID-19 pandemic on organizations and service providers supporting young caregivers and their families, iii) barriers for service users, iv) helpful resources for service providers and organizations, and v) resources needed/preferred by service providers and organization. The pandemic significantly impacted young caregivers and their families, as reported by professionals, and organizations working with young caregivers and their families were tasked with addressing increased service demands and adapting service delivery to follow public health guidelines.

Although renal denervation (RDN) protects against hypertension, hypertrophy, and heart failure (HF), it is not clear whether RDN preserves ejection fraction (EF) during heart failure (HFpEF). To test this hypothesis, we simulated chronic congestive cardiopulmonary heart failure (CHF) by creating aorta-vena cava fistula (AVF) in C57BL/6J wild type (WT) mice. There are four ways to create experimental CHF: (1) myocardial infarction (MI) which is basically ligating coronary by instrumenting and injuring the heart; (2) trans-aortic constriction (TAC), although it mimics systematic hypertension but TAC again constricts aorta on top of the heart and exposes the heart; (3) acquired CHF such as by dietary factors, diabetes/salt diets etc. but it is multifactorial, and finally (4) AVF, which is the only one wherein AVF is created ~1cm below the kidney where the aorta and vena cava share the common middle-wall. By creating fistula, the red blood enters vena cava without an injury to the heart. This model mimics CHF such as during aging where with age the preload keeps increasing than the aging heart can pump out due to the weakened cardiac myocytes. This also involves the right ventricle to lung to left ventricle flow, thus creating congestion. The heart in AVF goes to transition from preserved to reduced EF (i.e., HFpEF to HFrEF). In fact, there are more models of volume overload, such as the pacing-induced and mitral valve regurgitation but these are also injurious models. Our lab is one of the original labs in creating and studying the AVF phenotype. The RDN was created by treating the cleaned bilateral renal artery. After 6 weeks, blood, heart, and renal samples were analyzed for exosome, cardiac regeneration markers and renal cortex proteinases. Cardiac function was analyzed by echocardiogram (ECHO). Fibrosis was analyzed with trichrome staining. The results suggested that there was robust increase in exosomes’ level in AVF blood, suggesting compensatory systemic response during AVF-CHF. During AVF there was no change in cardiac eNOS, Wnt1 and β-catenin, however; during RDN there was robust increase in eNOS, Wnt1 and β-catenin compared to the sham group. As expected in HFpEF there was perivascular fibrosis, hypertrophy and pEF. Interestingly, increased levels of eNOS suggested that despite fibrosis, the NO generation was higher that most likely contributed to pEF during HF. The RDN intervention revealed an increase in renal cortical caspase 8 and a decrease in caspase 9. Since caspase 8 is protective and caspase 9 is apoptotic, we suggest that RDN protects against renal stresses, and apoptosis. Our findings also suggest that RDN is cardioprotective during HFpEF via the preservation of eNOS and accompanied endocardial-endothelial function.

Aim: The aim of this study was to assess the performance of the SF-36 health survey (SF-36) in a sample of subjects with physical disabilities. Material and Methods: 305 patients recruited using the convenient sampling method from September 2019 to March 2020 in Kermanshah, Iran. Another similar 300 patients were selected to assess the confirmatory factor analysis (CFA). Results: The Cronbach’s α ranged from 0.70 to 0.93, and intra-class correlation coefficients from 0.71 to 0.88; and with the no ceiling and floor effect for two main subscales. Convergent validity was supported by moderate to good correlation between SF-36 subscales and Moorong self-efficacy subscales (r= 0.25- 0.53). The SF-36 divergently validated with HADS total score and subscales (r= -0.24- -0.65), concurrently validated with its subscales (r=0.49- 0.88), and physically discriminated between persons with different level of disability (t-test: p<0.001). Factorial analysis identified seven factors, confirmed with second-order in another 300 samples (chi-square (χ2/df) = 2.61(p < .001); RMSEA = 0.07 (90% CI = 0.07–0.08); AGFI=0.75; GFI = 0.78; CFI= 0.85; and NFI = 0.78). Conclusions: the SF-36 is a reliable and valid tool in physical disables. However, SF-36 shows insufficient eight-factor validity. Future studies should focus on evaluating other psychometric properties, such as sensitivity to change in subjects with physical disabilities.

Health information and communication are key elements that allow patients and family members to make decisions about end-of-life process and guarantee a death with dignity. Objective: To understand carers’ experiences regarding health information and communication during the illness and death of family members. Methods: This qualitative study was conducted in Andalusia based on the paradigm of hermeneutic phenomenology. Participants were carers who had accompanied a family member at the end of life for over 2 months and less than 2 years. Five nominal groups and 5 discussion groups were established, and 41 in-depth interviews with 123 participants were conducted. Atlas.ti 7.0 software was used to analyse the discourses. Results: Four dimensions of the dying process emerged: differences in carers’ perceptions of information and communication, a conspiracy of silence, consequences of the absence or presence of information, and the need for a culture change. Conclusions: Poor management of health information and communication at the end of life suffering and discomfort patients and their families. The culture of denying and avoiding death is still present today. A change in education about death would better enable health professionals to care for patients at the end of life.

OBJETIVE: This study analyses the views of four groups of healthcare professionals who may play a role in the management of suicidal behaviour. The goal was to identify key factors for suicide prevention in different areas of the healthcare system. METHODOLOGY: Qualitative research was conducted using focus groups made up of different healthcare professionals who participated in the identification, management and prevention of suicidal behaviour. Professionals included were primary care physicians, psychologists, psychiatrists and emergency physicians. RESULTS: ‘Suicide’ was amongst the most relevant terms that came up in discussions most of the times it appeared associated with words such as ‘risk’, ‘danger’ or ‘harm’. In the analysis by categories, the four groups of professionals agreed that interventions in at-risk behaviours are first in importance. Prevention was the second main concern with greater significance among psychiatrists. DISCUSSION: Primary care professionals claim for more time to address patients at risk for suicide and an easier access to and communication with the mental health network. Emergency care professionals have a lack of awareness of their role in the detection of risk for suicide in patients who seek attention at emergency care facilities for reasons of general somatic issues. Mental health care professionals are in high demand in case of self-harm but they would like to receive specific training in dealing with g suicidal behaviour.

Chinese-speaking parents are argued to use less cognitive mental-state-talk than their English-speaking counterparts due to their goals in socializing their children to follow an interdependence script. To extend this research, we investigated bilingual Mandarin-English Singaporean mothers who associate different functions for each language as prescribed by their government: English for school and Mandarin for in-group contexts. English and Mandarin maternal mental-state-talk from bilingual Mandarin-English mothers with their toddlers was examined. Mothers produced more cognitive terms in English than in Mandarin and more desire terms in Mandarin than in English. We show that mental-state-talk differs between bilingual parents’ languages, suggesting that mothers adjust their mental-state-talk to reflect each language’s function.

The article examines church architecture in modern Russia. The historical processes of the development of church architecture are analyzed and systematized not only from the point of view of formal stylistic but also global significance. For this purpose, for the first time, a wide range of sources containing information on the sacred component of church art and on the monuments of temple architecture was studied. At the same time, many fragments of sources were first translated into English. The article uses historical and retrospective research methods that allowed to study the theoretical legacy of the modern period in the history of Russia and at the same time to generalize the place of Russian church architecture in the general context of European architectural development.

This article presents a review of resources for batteries with a specific focus on sustainability aspects related to raw materials, electrode and electrolyte chemistries suitable for the automobile industry. We emphasize the importance of prioritizing sustainability in battery technology evolution, which is expected to shift towards earth-abundant materials. One notable advancement in this direction is the utilization of glass solid-state electrolytes, known for their high ionic conductivity, low electronic conductivity, and high dielectric constant. However, our review suggests that further research should explore synthesis methods to modify anisotropic properties, enhancing the performance of solid-state electrolytes, particularly in facilitating the flow of ions.

Accurate and efficient determination of excited-state polarizabilities (α) is an open problem both experimentally and computationally. Following our previous work, [Phys. Chem. Chem. Phys. 2023, 25, 2131−2141], where one can employ simple ground-state density-based functions from the information-theoretic approach (ITA) to accurately and efficiently predict the macromolecular polarizabilities, we aim to predict the lowest excited-state polarizabilities in this work. The philosophy is to use density-based functions to depict the excited-state polarizabilities. As a proof-of-principle application, employing 2-(2′-hydroxyphenyl)benzimidazole and its derivatives as model systems, we have verified that either with the ground-state (S0) or excited-state (S1) densities as input, ITA quantities can be strongly correlated with the excited-state polarizabilities. When the transition densities are considered, both S0 and S1 polarizabilities are in good relationships with some ITA quantities. Furthermore, excitation and emission energies can be predicted based on multivariant linear regression equations of ITA quantities.

The purpose of this paper is to build a new bridge between category theory and a generalized probability theory known as noncommutative probability or quantum probability, which was originated as a mathematical framework for quantum theory, in terms of states as linear functional defined on category algebras. We clarify that category algebras can be considered as generalized matrix algebras and that the notions of state on category as linear functional defined on category algebra turns out to be a conceptual generalization of probability measures on sets as discrete categories. Moreover, by establishing a generalization of famous GNS (Gelfand-Naimark-Segal) construction, we obtain a representation of category algebras of †-categories on certain generalized Hilbert spaces which we call semi-Hilbert modules over rigs.

Organisms in the wild have cryptic life stages that are sensitive to changing environmental conditions and can be difficult to survey. In this study, I used mark-recapture methods to repeatedly survey Anaea aidea (Nymphalidae) caterpillars in nature, then modeled caterpillar demography as a hidden Markov process to assess if temporal variability in temperature and density influence the survival and growth of A. aidea over time. Individual encounter histories result from the joint likelihood of being alive and observed in a particular stage, and I included hidden states by separating demography and observations into parallel and independent processes. I constructed a demographic matrix containing the probabilities of all possible fates for each stage, including hidden states, e.g., eggs and pupae. I observed both dead and live caterpillars with high probability. Peak caterpillar abundance attracted multiple predators, and survival of fifth instars declined as per capita predation rate increased through spring. A time lag between predator and prey abundance was likely the cause of improved fifth instar survival estimated at high density. Growth rates showed an increase with temperature, but the most likely model did not include temperature. This work illustrates how state-space models can include unobservable stages and hidden state processes to evaluate how environmental factors influence vital rates of cryptic life stages in the wild.

This study assessed health inequality trends and the degree of maternal healthcare services utilization in the DRC, using two consecutive Demographic and Health Surveys, 2007 and 2013-2014. First, we assessed the changes in the magnitude of inequality in the utilization of MHCS using logistics and regressions. Second, we analyzed the distribution of inequality in each MHCS utilization variable using the Gini coefficient and the Lorenz curve. Third, we used the Wagstaff two groups concentration indices comparison method to assess health inequality trends. Finally, we fitted the concentration curves to estimate the inequality in the utilization of MHCS to the economic condition of women. Women were less likely to have their first ANC visit within the first trimester, less likely to receive checkups during ANC visits, and less likely to attend more ANC visits when living in eastern DRC compared to western DRC. Women in rural areas were less likely to have their last birth by C-section, and less likely to receive PNC than women in urban areas. Women with middle, richer, and richest wealth indexes were more likely to complete more ANC visits, more likely to deliver by C-section, most likely to receive PNC, and more likely to receive ANC than those with lower wealth indexes. Over time, inequality in the utilization of MHCS decreased for ANC and PNC but increased for the delivery by C-sections. These findings suggest that innovative strategies are still needed to improve the utilization of MHC services among poorer, rural, and underserved women in post-conflict DRC.

(1) Aims: To analyse the relationship between demographic and clinical characteristics and particular kinds of suicidal behaviour and its relationship with a nurse-led suicide prevention program. (2) Methods: A 5-year cross-sectional study design. Study performed in the region of Osona (Catalonia) during 2013-2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt and completed suicide. (3) Results: The sample included 753 patients ─ of whom 53 died by suicide─ and encompassed 931 suicidal behaviour episodes. Men represented 38.4% of the sample but 81.1% of deaths by suicide. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. 66.4% of the individuals were engaged in the nurse-led Suicidal Behaviour Case Management Program, of which 0.8% (n=4) died by suicide. (4) Conclusion: The main risk factors were female sex for suicidal behaviour, and male sex and older age for suicide. Mental disorders, widowhood and retirement were also associated with suicide. A high proportion of patients was engaged to the nurse-led suicide prevention program with a low proportion of suicides.

The world is currently experiencing the fourth industrial revolution driven by the newest wave of digitisation in the manufacturing sector. The term Industry 4.0 (I4.0) represents at the same time: a paradigm shift in industrial production, a generic designation for sets of strategic initiatives to boost national industries, a technical term to relate to new emerging business assets, processes and services, and a brand to mark a very particular historical and social period. I4.0 is also referred to as Industrie 4.0 the New Industrial France, the Industrial Internet, the Fourth Industrial Revolution and the digital economy. These terms are used interchangeably in this text. The aim of this article is to discuss major developments in this space in relation to the integration of new developments of IoT and cyber physical systems in the digital economy, to better understand cyber risks and economic value and risk impact. The objective of the paper is to map the current evolution and its associated cyber risks for the digital economy sector and to discuss the future developments in the Industrial Internet of Things and Industry 4.0.

Quasi-bound state in the continuum (QBIC) can effectively enhance the interaction of terahertz (THz) wave with matters due to the tunable high-Q property, which has a strong potential application in detection of low-concentration biological samples in the THz band. In this paper, a novel THz metamaterial sensor with a double-chain separated resonant cavity structure based on QBIC is designed and fabricated. The process of excitation of the QBIC mode is verified and the structural parameters are optimized after considering the ohmic loss by simulations. The simulated refractive index sensitivity of the sensor is up to 544 GHz/RIU, much higher than those of recently reported THz metamaterial sensors. Sensing sensitivity of the proposed metamaterial sensor is confirmed in experiment by detecting low-concentration lithium citrate (LC) and bovine serum albumin (BSA) solutions. The limits of detection (LoDs) are obtained to be 0.0025 mg/mL (12 μM) for LC and 0.03125 mg/mL (0.47 μM) for BSA, respectively, both of which excel over most of reported results in previous studies. These results indicate that the proposed THz metamaterial sensor has excellent sensing performances and can well be applied to the detection of low concentration biological samples.

With a reduction in the mortality rate of burn patients, patient length of stay (LOS) is increasingly adopted as an outcome measure. Some studies have attempted to identify factors that explain a burn patient's expected LOS. However, few have investigated the association between LOS and a patient's mental and socioeconomic status. There is anecdotal evidence for links between these factors and uncovering these will aid in better addressing the specific physical and emotional needs of burn patients, and facilitate the planning of scarce hospital resources. Here, we employ machine learning (clustering) and statistical models (regression) to investigate whether a segmentation by socioeconomic/mental status can improve the performance and interpretability of an upstream predictive model, relative to a unitary model derived for the full adult population of patients. Although we found no significant difference in the performance of the unitary model and segment-specific models, the interpretation of the segment-specific models reveals a reduced impact of burn severity in LOS prediction with increasing adverse socioeconomic and mental status. Furthermore, the models for the socioeconomic segments highlight an increased influence of living circumstances and source of injury on LOS. These findings suggest that, in addition to ensuring that the physical needs of patients are met, management of their mental status is crucial for delivering an effective care plan.

Recent astronomical observations with respect to measurements in distant supernovas, cosmic microwave background and weak gravitational lensing confirm that the Universe is undergoing a phase of accelerated expansion and it has been proposed that this cosmological behavior is caused by a hypothetical dark energy which has a strong negative pressure that allows explain the expanding universe. Several theoretical ideas and models related dark the energy includes the cosmological constant, quintessence, Chaplygin gas, braneworld and tachyonic scalar fields. In this paper, we have obtained new relativistic stellar configurations considering an anisotropic fluid distribution with a charge distribution which could represents a potential model of a dark energy star. In order to investigate the effect of a quadratic equation of state in this anisotropic model we specify particular forms for the gravitational potential that allow solving the Einstein-Maxwell field equations. For these new solutions we checked that the radial pressure, metric coefficients, energy density, anisotropy factor, charge density , mass function are well defined and are regular in the interior of the star. The solutions found can be used in the development of dark energy stars models satisfying all physical acceptability conditions but the causality condition and strong energy condition are violated. We expect that these models have multiple applications in astrophysics and cosmology.

Synthetic chalcomenite-type cupric selenite CuSeO₃∙2H₂O has been studied at room temperature under compression up to pressures of 8 GPa by means of single-crystal X-ray diffraction, Raman spectroscopy, and density-functional theory. According to X-ray diffraction, the orthorhombic phase undergoes an isostructural phase transition at 4.0(5) GPa with the thermodynamic character being first-order. This conclusion is supported by Raman spectroscopy studies which have detected the phase transition at 4.5(2) GPa and by the first-principles computing simulations. The structure solution at different pressures has provided information on the change with pressure of unit-cell parameters as well as on the bond and polyhedral compressibility. A Birch-Murnaghan equation of state has been fitted to the unit-cell volume data. We found that chalcomenite is highly compressible with a bulk modulus of 42 – 49 GPa. The possible mechanism driving changes in the crystal structure is discussed, being the behavior of CuSeO₃∙2H₂O mainly dominated by the large compressibility of the coordination polyhedron of Cu. On top of that, an assignation of Raman modes is proposed based upon density-functional theory and the pressure dependence of Raman modes discussed. Finally, the pressure dependence of phonon frequencies is also reported.

Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization. Of these patients, 26.6% were discharged to home health care. To evaluate the association between timing of home health care initiation and 30-day rehospitalizations, multivariate logistic regression models including patient demographics, clinical, geographic variables, and neighborhood socio-economic variables were used. Inverse probability-weighted propensity scores were incorporated into the analysis to account for potential confounding between the timing of home health care initiation and the outcome in the cohort. Compared to patients who received home health care within the recommended first two days, patients who received delayed services (3-7 days after discharge) had higher odds of rehospitalization (OR 1.28, 95% CI 1.25-1.32). Among patients who received late services (8-14 days after discharge), the odds of rehospitalization were four times greater than for patients receiving services within 2 days (OR 4.12, 95% CI 3.97-4.28). Timely initiation of home health care following diabetes-related hospitalizations is one strategy to improve outcomes.

Spatial Data Infrastructures (SDI) support the harvesting, curating, storage, and sharing of data along with providing access to development, analytic, and visualization tools that enable the building of innovative applications to address broad or specific challenges. SDIs can be especially powerful in bringing together data and tools supporting a particular theme – and this paper discusses and demonstrates the value of an SDI focused on Health. Many potential benefits of a Health SDI are proposed, and the case of supporting emergency response efforts is developed in detail. Leveraging a Health SDI, a Health Risk Index was created that provides emergency response personnel (both Emergency Operations Managers and Emergency Medical Responders) key insights into the unique health risks the impacted population faces due to the disaster. In order to establish the Health Risk Index, datasets from multiple national and global sources representing health data and social data that influences health outcomes – typically called social determinants of health – are harvested, merged, and republished to support further efforts at advancing the Health Risk Index. Visualizations of the Health Risk Index at the global, national, and sub-national levels down to the address level are presented along with demonstrations of its use.

In this study, a numerical simulation of fluid flow through railway ballast in the time domain is presented, providing a model for unsteady-state flow. It is demonstrated that the position of the free surface with respect to time can also be used to solve the steady flow case. The effect of ballast fouling is included in the model to capture the realistic behavior of railway ballast, which is critical to understanding the impact of flooding. A thorough comparison with a range of previous studies, including theoretical and experimental approaches, is made and very close agreement is obtained. The significant impact of ballast fouling on fluid flow and its potential consequences for railway infrastructure are highlighted by the simulation. Valuable insights into the behavior of water flow through porous media and its relevance to railway ballast management are offered by this study.

The redefined vacuum approach, which is frequently employed in the many-body perturbation theory, proved to be a powerful tool for formula derivation. Here, we elaborate this approach within the bound-state QED perturbation theory. In addition to general formulation, we consider the particular example of a single particle (electron or vacancy) excitation with respect to the redefined vacuum. Starting with simple one-electron QED diagrams, we deduce first- and second-order many-electron contributions: screened self-energy, screened vacuum polarization, one-photon exchange, and two-photon exchange. The redefined vacuum approach provides a straightforward and streamlined derivation and facilitates its application to any electronic configuration. Moreover, based on the gauge invariance of the one-electron diagrams, we can identify various gauge-invariant subsets within derived many-electron QED contributions.

This article examines the impact of some system parameters on an industrial system composed of two dissimilar parallel units with one repairman. The active unit may fail due to essential factors like aging or deteriorating, or exterior phenomena such as Poisson shocks that occur at various time periods. Whenever the value of a shock is larger than the specified threshold of the active unit, the active unit will fail. The article assumes that the repairman has the right to take any of two decisions at the beginning of the system operation: either a takes a vacation if the two units work in a normal way, or stay in the system to monitor the system until the first system failure. In case of having a failure in any of the two units during the absence of the repairman, the failing unit will have to wait until the repairman is called back to work. We suppose that the value of every shock is assumed to be i.i.d. with some known distribution. The length of the repairman’s vacation, repair time, and recall time are arbitrary distributions. Various reliability measures have been calculated by the supplementary variable technique and the Markov’s vector process theory. At last, numerical computation and graphical analysis have been given for a particular case to validate the derived indices.

This paper builds upon a theory of emerging-state actors using ISIS as a case study. This paper seeks to apply the theory in analyzing intervention & containment policies to use against emerging-state actors, using ISIS as the case study. Two baseline scenarios are used for evaluation – one replicating the historical foreign intervention against ISIS and a counter-factual where no foreign intervention occurred. Eleven contemporary military policies were tested against these baseline in isolation, combination, at different timing windows and under hypothetical “best case” conditions as well as operationally constrained. Insights of these tests include the influence of ethnographic envelopes, timing windows. Finally, a policy based on emerging-state actor theory is tested performing substantially better across primary measures than other policies or the historical baseline. This is compared against a falsified-policy designed to disprove that emerging-state actor theory contributed to the benefits. This paper’s contributions are a practical application of system dynamics simulations and systems-thinking to current problems, generate insights into the dynamics of emerging-state actors and intervention strategies, and demonstrate utility for future application of the underlying simulation in other scenarios involving non-state actor irregular conflict including terrorism, insurgents, or emerging-state actors.

It is widely recognized that public health interventions benefit from community engagement and leadership, yet there are challenges to evaluating complex, community-led interventions assuming hierarchies of evidence derived from laboratory experimentation and clinical trials. Particular challenges include, first, inconsistency of the intervention across sites; and second, absence of researcher control over the sampling frame and methodology. This report highlights these challenges as they played out in the evaluation of a community-organized health project in South London. The project aimed to benefit maternal mental health, health literacy and social capital, and especially to engage local populations known to have reduced contact with statutory services. We evaluated the project using two studies with different designs, sampling frames and methodologies. In one the sampling frame and methodology were under community control, permitting comparison of change in outcomes from before to after participation in the project. In the other, the sampling frame and methodology were under researcher control, permitting a case-control design. The two evaluations led to different results however: participants in the community-controlled study showed benefits, while participants in the researcher-controlled study did not. The principal conclusions are that while there are severe challenges to evaluating a community-led health intervention using a controlled design, measurement of pre-/post-participation changes in well-defined health outcomes should typically be a minimum evaluation requirement, and confidence in attributing causation of any positive changes to participation can be increased by use of interventions in the project and in the engagement process itself that have a credible theoretical and empirical basis.

In this ‘New Normal' post-COVID-19 modern world, people's health is becoming increasingly important to track. An advanced technology that uses sensory instruments to track and record critical parameters and communicates with others is the need of the time. It's difficult to keep track of all of the medical parameters and post-operative data of people with non-communicable diseases like diabetes and heart disease on a continuous basis. The system discussed here to be designed for patients who are confined to their homes, particularly when going out and being exposed to the outer world is prohibited. This paper proposed a groundbreaking health management system based on the Internet of Things (IoT) for accessing patient medical parameters in both local and remote areas. When a person's wellbeing becomes urgent, this initiative seeks to send an emergency alert to family members or loved ones. A cloud server records data from the patient's temperature sensor and pulse sensor; the data is analyzed using support vector machine algorithms to identify irregular conditions, and an emergency message is sent to the rest of the family via a mobile application, as well as a warning message to the nearest hospital.

(1) Background: “Zero-dose” (ZD) refers to a child not receiving any doses of the pentavalent (diphtheria-tetanus-pertussis-Haemophilus influenzae type b (Hib)-Hepatitis B) vaccine in the routine national immunization schedule. These children are vulnerable to vaccine-preventable diseases (VPDs), and are often already disadvantaged due to poverty, conflict, and lack of access to basic health services. The Luambo health district (HD) is one of the 26 HDs in the Kasai Central Province and has the largest number of ZD children. This study was conducted to examine the factors associated with ZD status in the Luambo HD; (2) Methods: We conducted a mixed study of children aged 12-23 months in the Luambo HD in the Kasai Central Province; (3) Results: A total of 445 children aged 12-23 months were included in the study, including 89 cases and 356 controls. Correlates of zero dose (ZD) status in children aged 12-23 months were mothers who were not receiving Antenatal Care (ANC), of not knowing any VPD, the fact of the children being born in Angola and the fact of the children being born at home. In addition, the perceptions of children’s parents influenced child immunization; (4) Conclusions: Missing ANC services during pregnancy leads to home delivery with consequences being lack of knowledge on childhood’s VPD and subsequently children not being vaccinated.

The cancer burden is increasing worldwide with contrasting national patterns. Therefore, providing national estimations is necessary to understand and control this health issue. Herein, we comparatively describe incidence, mortality, and disability-adjusted lived years (DALYs) due to 29 groups of cancer in Mexico from 1990 to 2019 by sex and age. Using public data from the Global Burden of Disease Study 2019, we assessed the national burden of cancer using counts and crude and age-standardized rates per 100,000 people with 95% uncertainty intervals for 2019 and their trends using the annual percentage of change from 1990 to 2019. In 2019, cancer caused 222,060 incident cases, 105,591 deaths, and 2,86,054 DALYs in the general population. Nonmelanoma skin cancer, prostate cancer, and breast cancer had the highest incidence, and six groups of cancer (lung, colorectal, stomach, prostate, breast, and pancreatic) caused 53% of the deaths in 2019. From 1990 to 2019, incidence and mortality showed an increasing trend that varied between 10% and 436% among the groups of cancer, whereas the crude and age-standardized rates showed cancer-specific sex disparities. Our results demonstrate a substantial growth of the national burden of cancer with sex-specific patterns of change. These results may guide national efforts toward reducing health loss due to cancer.

This study aims to identify factors associated with anxiety levels of adults living in Singapore before the pandemic and during the COVID-19 outbreak. Data were collected using a cross-sectional web-based survey conducted from July to November 2020 accruing 264 eligible participants. Ordered logistic regression was used to assess Generalized Anxiety Disorder-7 (GAD-7), ranked as minimal (0-4), mild (5-9), moderate (10-14), and severe (15-21) before the pandemic and during the pandemic. About 74% of participants were female, 50% were aged 25-34, and 50% were married. The GAD-7 level went up from pre-pandemic for both moderate (from 12.5% to 16%) and severe GAD (from 2% to 11%). Alcohol consumption (AOR 1.79, 95% CI 1.04-3.06), loneliness (AOR 1.28, 95% CI 1.05-1.54), and difficulty in switching off social media (AOR 2.21, 95% CI 1.29-3.79) predicted increased GAD-7 levels. The quality of life (AOR 0.84, 95% CI 0.79-0.90) was significantly associated with decreased GAD-7 levels. The results heighten the awareness that early initiation of mental health support is crucial for the population in addition to the various financial support measures provided by the government as they are adapting to live with the COVID-19 pandemic.

Background: Perinatal anxiety and related disorders are common (20%), distressing and impairing. Fear of childbirth (FoB) is a common type of perinatal anxiety associated with negative mental health, obstetrical, childbirth and child outcomes. Screening can facilitate treatment access for those most in need. Objectives: The purpose of this research was to evaluate the accuracy of the Childbirth Fear Questionnaire (CFQ) and the Wijma Delivery Expectations Questionnaire (W-DEQ) of FoB as screening tools for specific phobia, FoB. Methods: A total of 659 English-speaking pregnant women living in Canada and over the age of 18 were recruited to the study. Participants completed an online survey of demographic, current pregnancy, and reproductive history information, as well as the CFQ and the W-DEQ, and a telephone interview to assess specific phobia FoB. Results: Symptoms meeting full and subclinical diagnostic criteria for specific phobia, FoB were reported by 3.3% and 7.1% of participants, respectively. The W-DEQ met or exceeded the criteria for a “good enough” screening tool across several analyses, whereas the CFQ only met these criteria in one analysis, and came close in three others. Conclusions: The W-DEQ demonstrated high performance as a screening tool for specific phobia, FoB, with accuracy superior to that of the CFQ. Additional research, to ensure the stability of these findings, is needed.

In the ongoing Covid-19 pandemic, if a preventive restriction (PR), intended to arrest the transmission of the virus, is effective we expect a decrease in the rate of transmission. If an effective PR is lifted or relaxed, the rate may show some increase. We test this expectation in the history of PR imposition and relaxation in all countries based on available public database. We found marginal or no negative correlation between standing stringency index of PR and change in slope of the local curve. A change in stringency index was significantly negatively correlated with change in slope, but change in stringency of PRs could explain only 6.1 percent of the variance in rates of transmission. The distribution of slope changes after imposing versus after relaxing PRs was highly overlapping with only a tail consisting of 4.5 % PR impositions being clearly non-overlapping with PR relaxation. Non-parametrically, only 9.4% of PR impositions were associated with a reduction in the slope above the expectation of a null hypothesis. In brief, globally, preventive restrictions have played a very small role in the pandemic process over the one year period. This feedback needs to be considered in making policy for disease prevention in the further course of the pandemic as well as in any future threats of respiratory disease epidemics.

Understanding tourist behaviour during and after major tourism crises is essential to help destinations recover. The COVID-19 pandemic, a period of uncertainty and risk, makes it relevant to assess factors that influence travel intentions. There has been little research on tourist behaviour during health crises and, in particular, on perceived health risk and uncertainty effects on travel intentions. This study was carried out during the first months of the pandemic in Brazil and aims to investigate the role of health risk perception and intolerance of uncertainty on travel intentions for 2020 and 2021. We applied an online survey to 1,150 Brazilian participants from March to May of 2020. Our findings indicate that perceived COVID-19 severity, perceived probability of contracting it, and expected pandemic duration are significant predictors of travel intentions for both years. This paper sheds new light on tourist behaviour in the context of global health crises.

Health locus of control is the set of beliefs a person has about his or her personal influence on health. The current study aimed at identifying types of locus of control in parents of leukemia children and possible association with depressive symptomatology and current life perception. 104 parents were recruited at the Haematology-Oncologic Clinic of Padua post 1 month from the leukemia diagnosis. Participants were Caucasian with a mean age of 37.28 years (SD=5.89), mostly mothers (87.5%) and with a mean of 12.16 years of education (SD=3.82). After signing the informed consent, they filled in the Ladder of Life questionnaire, the BSI-18 and the Parents Health Locus Of Control (PHLOC). Paired-samples t-test (t= -14.42; df=103; p=0.0001) showed that parents of leukemia children were more inclined to have an external locus of control than an internal one. Hierarchical regression analysis model (R2=0.34; F=4.32; p=0.0001) identified health professional influence (ß= -0.28; p=0.004), current life perception (ß= -0.3; p=0.013) and future life perception (ß= -0.26; p=0.012) as significantly predictors on Parental depression. Improving trust in the medical staff care and parental life perceptions could be a preventive program to cope with parental depression symptomatology.

Electronic-health applications rely on large computer networks to facilitate patients' information access and to communicate various types of medical data. To examine the effectiveness of these networks, the traffic parameters need to be analysed. Due to quantity of the information carrying packets, examining each packet's transmission parameters individually is not practical, especially when a real time operation is needed. Sampling allows a subset of packets that accurately represents the original traffic to be formed. In this study an adaptive sampling method based on regression and fuzzy inference system was developed. It dynamically updates the number of packets sampled by responding to the traffic variations. Its performance was found to be superior to the conventional non-adaptive sampling methods.

This article explores the crucial task of estimating State of Charge (SOC) in Hybrid Electric Vehicles (HEVs) and examines the applicability of various regression models for this purpose. We delve into the strengths and limitations of Linear Regression, Support Vector Regression (SVR), and Neural Network Regression (NNR) in the context of SOC estimation. Linear regression provides a simple and interpretable baseline, SVR extends this to nonlinear relationships, while NNR emerges as a powerful tool with adaptive capabilities. The choice of model depends on factors such as data characteristics, interpretability, and computational resources. As the field evolves, the article advocates for a nuanced approach, possibly incorporating hybrid models, to achieve robust and accurate SOC estimation, contributing to the ongoing enhancement of HEV efficiency and sustainability.

Quantum computing arrives. Preceded by Mādhava of Sangamagrāma and other Hindu mathematicians, around 1,500 CE, and our previous work, we show at least 4 quantum properties that are indeed universal in some number systems; here we use them to enable quantum computing. Using the sets B={0,1}, B^n, N, Z, Q, and Q*, one has +4 quantum properties that one can trust, as archetypes of easy communication to friends and foes, to ignoranti or cognoscenti, and for quantum consciousness. Therefore, this work applies to computer calculations, apps in cell phones, algebra, atoms, mathematics, physics, and the human mind.

We present a new vision on the double-slit experiment (DSE), that does not use any waves or the so-called wave-particle duality. It is based on particles, viewed as localized vibrations. Rather than being illogical, or mysterious, the approach reproduces logically the interference patterns observed externally, using the well-known ``amplification of stimulated emission'' (ASE). The conservation of particle number is not observed. Different particles can present ASE with in-phase or counter-phase behavior, making the patterns observed for electrons, other particles, even atoms. The Law of the Excluded Middle (LEM) is not broken illogically in two-states macroscopically, but broken naturally in three or more states, microscopically, using ASE. Any particle supporting ASE, in-phase or counter-phase, can enter a DSE, and provide an external interference pattern. Frequency plays a role, while amplitude is not considered. This work is important in quantum computing, possibly saving cost, time, and welcoming more participants.

It was recently studied how to achieve the optimal degrees of freedom (DoF) in a multi-antenna full-duplex system with partial channel state information (CSI). In this paper, we revisit the DoF of a multiple-antenna full-duplex system using opportunistic transmission under the partial CSI, in which a full-duplex base station having M transmit antennas and M receive antennas supports a set of half-duplex mobile stations (MSs) having a single antenna each. Assuming no self-interference, we present a new hybrid opportunistic scheduling method that achieves the optimal sum DoF under an improved user scaling law. It is shown that the optimal sum DoF of 2M is asymptotically achievable provided that the number of MSs scales faster than SNR^M, where SNR denotes the signal-to-noise ratio. This result reveals that in our full-duplex system, better performance on the user scaling law can be obtained without extra CSI, compared to the prior work that showed the required user scaling condition (i.e., the minimum number of MSs for guaranteeing the optimal DoF) of SNR^2M−1.

The enormous growth in the penetration of electric vehicles (EVs), has laid the path to advancements in the charging infrastructure. Connectivity between charging stations is an essential prerequisite for future EV adoption to alleviate users’ “range anxiety”. The existing charging stations fail to adopt power provision allocation and scheduling management. To improve the existing charging infrastructure data based on real-time information and availability of reserves at charging stations could be uploaded to the users to help them locate the nearest charging station for an EV. This research article focuses on an a interactive user application developed through SQL and PHP platform to allocate the charging slots based on estimated battery parameters, which uses data communication with charging stations to receive the slot availability information. The proposed server-based real-time forecast charging infrastructure avoids waiting times and its scheduling management efficiently prevents the EV from halting on road due to battery drain out. The proposed model is implemented using a low-cost microcontroller and the system etiquette tested.

The primary goal of this review is to provide a comprehensive overview of the state-of-the-art in solid-state batteries (SSBs), with a focus on recent advancements in solid electrolytes and anodes. The paper begins with a background on the evolution from liquid electrolyte lithium-ion batteries to advanced SSBs, highlighting their enhanced safety and energy density. It addresses the increasing demand for efficient, safe energy storage in applications like electric vehicles and portable electronics. A major part of the paper analyzes solid electrolytes, key to SSB technology. It classifies solid electrolytes as polymer-based, oxide-based, and sulfide-based, discussing their distinct properties and application suitability. The review also covers advancements in anode materials for SSBs, exploring materials like lithium metal, silicon, and intermetallic compounds, focusing on their capacity, durability, and compatibility with solid electrolytes. It addresses challenges in integrating these anode materials, like interface stability and lithium dendrite growth. This review includes a discussion on the latest analytical techniques, experimental studies, and computational models to understand and improve the anode-solid electrolyte interface. These are crucial for tackling interfacial resistance and ensuring SSBs' long-term stability and efficiency. Concluding, the paper suggests future research and development directions, highlighting SSBs' potential in revolutionizing energy storage technologies. This review serves as a vital resource for academics, researchers, and industry professionals in advanced battery technology development. It offers a detailed overview of materials and technologies shaping SSBs' future, providing insights into current challenges and potential solutions in this rapidly evolving field.

The species composition of vultures and their interactions on carcasses of various stages of decomposition is not well understood yet it potentially affects their food acquisition and survival. We collected data from six carcasses between June and December 2021 using camera traps that were set on carcasses undergoing various decomposition states in Sinamatella Camp of Hwange National Park, Zimbabwe. Of interest were the cases in which each vulture species was dominating in interactions which gave it an advantage in terms of food acquisition. Four vulture species were observed (White-backed, White-headed, Lappet-faced and Hooded Vultures). Vulture abundances were greatest on fresh carcasses and least on dry ones. Although dominance behaviors by the White-backed and White-headed Vultures were recorded over all other vulture species, there were no records of the Lappet-faced dominating other vultures. In addition, the Hooded Vultures were mostly dominating non-vulture avian species on advanced decay carcasses. Our results demonstrate how various species may be prone to intense competition that may further place them at disadvantageous positions if food sources decline, more so under climatic shifts and various anthropogenic pressures.

The concept of “hyperferritinemic syndrome” defines a complex pathophysiological and clinical entity, characterized by a systemic hyperinflammatory state, generally associated with elevated levels of proinflammatory cytokines (hypercytokinemia) and high serum levels of ferritin (hyperferritinemia), traditionally recognized as an iron-binding plasma protein involved in the storage of iron in a biologically available form for different physiological cellular processes. Recent studies have shown that ferritin has other important functions as well, operating both as a proinflammatory mediator and as a immunosupressive agent, its elevated levels in the serum being detected in various conditions associated with inflammatory states, such as infectious diseases, autoimmune and autoinflammatory disorders and, in some cases, in malignancies. Catastrophic antiphospholipid syndrome (cAPS), systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease (AOSD) and acquired forms of hemophagocytic lymphohistiocytosis (HLH), which includes macrophage activation syndrome (MAS), have been associated with hyperinflammatory states and dramatic elevations of serum ferritin, generating hyperferritinemic syndromes. Severe forms of coronavirus disease-2019 (COVID-19), in which MAS may frequently develop, has also been linked to the development of a hyperferritinemic syndrome. This review offers several insights into the physiological and pathophysiological roles of ferritin in several (hyper-)inflammatory diseases, but also into the causal entities, the underlying pathophysiological mechanisms, clinical manifestations and diagnostic features of somewhat obscure, yet potentially fatal pathological conditions, reunited under the concept of hyperferritinemic syndromes.

The validity of our universe as a three-dimensional space (3+1 in relativity) is considered a fundamental fact in physics. In this study, we show that our observed world is thus the output of a prior fundamental operator referred to as an organizer. The organizer is an expansion of projecting operators. It is been shown that identical weighted projecting operators, which are associated with identical particles, generate subspaces of entangled states, whereas groups of unequal weighted coefficients are responsible for finite-size subspaces that are associated with unidentical particles. Considering 3D-subspaces as evidence of the coefficients’ arrangement in our universe, we implement our formalism to describe the implacable vectors, location, momentum, and force within each 3D subspace. By implementing the Heisenberg relation, we drive both the classical and quantum expressions for the laws of motion.

Quantum mechanics introduces the concept of an observer who selects a measuring device and reads the outputs. This measurement process is irreversible. Lately, scholars on quantum collapse phenomena have presented a quantum-like formalism describing the measurement results as an interpretation of the measured object. Note that an observer must read the interpretation results after the interpretation process. Therefore, we propose that the definition of the concept of life should be expanded based on the following concept: A living system decreases entropy, measured results are interpreted, and an internal observer reads the commentary.

Mathematical models across the applied sciences often utilize a standard methodological representation called a state variable formulation more commonly referred to as state space form. Recent research in unmanned underwater vehicle motor turbine blade thermal modeling for fatigue-life is generalized here permitting the proposed novel state space from to be applied to electrodynamics, motion mechanics, and many other disciplines. Proposed here is a very compact form inherently representing time variance, with a convenient presentation of dynamic variables applicable to all proper transfer functions, where all the distinct, real poles, zeros and gain of the transfer function appear as explicit components in the state space. The resulting manifestation simplifies utilization of the state space methods broadly across the applied sciences.

Schizophrenia is widely seen as a disorder of dysconnectivity. Neuroimaging studies have examined both structural and functional connectivity in the disorder, but these modalities have rarely been integrated directly. We scanned 29 patients with schizophrenia and 25 healthy control subjects and acquired resting state fMRI and diffusion tensor imaging. The Functional and Tractographic Connectivity Analysis Toolbox (FATCAT) was used to estimate functional and structural connectivity of the default mode network. Correlations between modalities were investigated, and multimodal connectivity scores (MCS) were created using principal components analysis. Nine of 28 possible region pairs showed consistent (>80%) tracts across participants. Correlations between modalities were found among those with schizophrenia for the prefrontal cortex, posterior cingulate, and lateral temporal lobes with frontal and parietal regions, consistent with frontotemporoparietal network involvement in the disorder. In patients, MCS values correlated with several aspects of the Positive and Negative Syndrome Scale, positively with those involving inwardly directed psychopathology, and negatively with those involving external psychopathology. In this preliminary sample, we found FATCAT to be a useful toolbox to directly integrate and examine connectivity between imaging modalities. A consideration of conjoint structural and functional connectivity can provide important information about the network mechanisms of schizophrenia.

Analytical solutions for radiation dominated phase of Quasi Steady State Cosmology in Friedmann-Robertson-Walkar models are obtained. We find that matter density is positive in all the cases (k = 0,-1,1). The nature of Hubble parameter (H) in [0,2] is discussed. The deceleration parameter (q) is marginally less than zero indicating accelerating universe. The scale factor (S) is graphically shown with time. The model represents oscillating universe between the above mentioned limits. Because of bounce in QSSC, the maximum density phase is still matter dominated. The models represent singularity free model. We also find that the models have event horizon i.e. no observer beyond the proper distance rH can communicate each other in FRW mdels for radiation dominated phase in the frame work of QSSC. The FRW models are special classes of Bianchi type I, V, IX space-times with zero, negative and positive curvatures respectively. Initially i.e. at  = 0, the model represents steady model. We have tried to show how a good fit can be obtained to the observations in the framework of QSSC during radiation dominated phase.

The principal aim of a spectral observer is twofold: the reconstruction of a signal of time via state estimation and the decomposition of such a signal into the frequencies that make it up. A spectral observer can be catalogued as an online algorithm for time-frequency analysis because is a method that can compute on the fly the Fourier transform (FT) of a signal, without having the entire signal available from the start. In this regard, this paper presents a novel spectral observer with an adjustable constant gain for reconstructing a given signal by means of the recursive identification of the coefficients of a Fourier series. The reconstruction or estimation of a signal in the context of this work means to find the coefficients of a linear combination of sines a cosines that fits a signal such that it can be reproduced. The design procedure of the spectral observer is presented along with the following applications: (1) the reconstruction of a simple periodical signal, (2) the approximation of both a square and a triangular signal, (3) the edge detection in signals by using the Fourier coefficients, (4) the fitting of the historical Bitcoin market data from 2014-12-01 to 2018-01-08 and (5) the estimation of a input force acting upon a Duffing oscillator. To round out this paper, we present a detailed discussion about the results of the applications as well as a comparative analysis of the proposed spectral observer vis-à-vis the Short Time Fourier Transform (STFT), which is a well-known method for time-frequency analysis.

This is the first study to provide a systematic monetary benefit matrix, including greenhouse gas (GHG) emissions reduction benefits and air pollution reduction health co-benefits, for a change in on-the-road transport to low-carbon types. The benefit transfer method is employed to estimate the social cost of carbon and the health co-benefits via impact pathway analysis in Taiwan. Specifically, the total emissions reduction benefits from changing all internal combustion vehicles to either hybrid electric vehicles, plug-in hybrid electric vehicles, or electric vehicles would generate an average of US$760 million from GHG emissions reduction and US$2,091 million from health co-benefits based on air pollution reduction, for a total benefit of US$2,851 million annually. For a change from combustion scooters to light- or heavy-duty electric scooters, the average GHG emissions reduction benefits would be US$96.02 million, and the health co-benefits from air pollution reduction would be US$1,008.83 million, for total benefits of US$1,104.85 million annually.

Telemedicine is the use of Information and Communication Technology (ICT) for clinical health care from a distance. The exchange of radiographic images and electronic patient health information/records (ePHI/R) for diagnostic purposes has the risk of confidentiality, ownership identity, and authenticity. In this paper, a data hiding technique for ePHI/R is proposed. The color information in the cover image is used for key generation, and stego-images are produced with ideal case. As a result, the whole stego-system is perfectly secure. This method includes the features of watermarking and steganography techniques. The method is applied to radiographic images. For the radiographic images, this method resembles watermarking, which is an ePHI/R data system. Experiments show promising results for the application of this method to radiographic images in ePHI/R for both transmission and storage purpose.

Changing the symmetry of spin from SU(2) to the quaternion group, $Q_8$, has many ramifications. In this paper we first summarize the properties of Q-spin and then discuss some of those resulting changes.

The purpose of this study is to examine the relationship between the institutional investors which can affect financial performance for corporate sustainability on the income smoothing. Therefore, this study focus on the connection between the nature of stock rights and income smoothing in China. For this study, hypotheses were established on the relationship each state-controlled companies, income smoothing, and information equilibrium of individual investors, and empirical analysis was conducted through related variables. The analysis results are summarized in three categories as follows. First, this research finds that state-controlled firms (CONTs) prefer income smoothing activities compared to non-state-controlled firms for the long-term sustainable development of firms using data from 2011 to 2019. Second, this study found out that Institutional investors support the behavior of CONTs to smooth their earnings because this behavior is seen as an attempt by CONTs to convey valuable private information to other investors. Third, we was able to discover that institutional investors' monitoring effect is predominantly driven by pressure-resistant institutional investors. This research complements the lack of empirical research on income smoothing and enable to give a guideline that the type of stock rights is a critical key determinant of participation in income smoothing activities for stable growth and sustainability in the future.

Abstract: Background: In contrast to conventional definitions, the contemporary conceptualization of adulthood emphasizes psychological characteristics over sociodemographic milestones. Concurrently, there is a growing proposition that individuals' perceptions of adulthood exert a substantial influence on the mental well-being of adolescents and adults. However, empirical examination of this hypothesis has been notably limited to date. Method: This study applied some adulthood markers, and multiple mental health indices (including Well-being, Optimism, Alexithymia, Satisfaction with life, Goldberg's index of mental health, Dark triad, and dimensional personality disorders) to a community sample comprising 1772 individuals in Spain, spanning ages from 16 to 93 years. Results: The findings support the overarching hypothesis, as perceptions of adulthood exhibit significant associations with almost all measured mental health indices, especially with those conforming a factor of Negative emotions. These associations persist even after accounting for age and socioeconomic status, and in alignment with the psychological paradigm of adulthood, they demonstrate stability across different age cohorts. Conclusions: The study establishes that such perceptions of adulthood represent a modifiable factor contributing to positive mental health. The implications of these findings for the formulation of public policies aimed at promoting mental health in the context of adulthood are deliberated, as well as a number of future studies.

The late diagnosis of Type 2 Diabetes Mellitus can occur due to lack of access to the primary health care system and the non-manifestation of symptoms. Faced with this problem, this work presents the creation of a mobile application, called DiabetesCheck, for predicting the risk of Type 2 Diabetes Mellitus. A mathematical model is used, which classifies the risk of Type 2 Diabetes Mellitus for a group of patients with intervention and for a comparative group, using Fuzzy Classification and Decision Trees. The proposed application allows the health professional to monitor patients through the history stored in a database, allowing a representation of the evolution of patients and indication of medications. Therefore, this proposal aims to carry out the diagnosis in the initial phase of the disease and help in the prescription of more effective treatments and in the proposition of public policy strategies in epidemiology and screening.

Background: Valid questionnaires to assess dogs’ health-related quality of life (HRQoL) in veterinary practice can improve canine health outcomes and communications between veterinarians and dog caretakers. The Canine HRQoL Questionnaire (HRQoL-Q) and the Human-Canine Bond Questionnaire (HCBQ) were developed and validated to fulfill this need. Methods: A literature review, interviews with veterinarians, and focus groups with caretakers were conducted to generate questionnaire items to develop draft questionnaires, piloted with caretakers to establish content validity. Measurement properties were evaluated using data from a prospective survey study (N = 327). Results: Draft Canine HRQoL-Q and HCBQ measures were developed, including a domain structure, items, recall period, and scale/response options. Refinements were made via iterative cognitive interviews with caretakers. When no additional revisions were indicated and content validity established, the questionnaires were psychometrically tested. Ceiling effects were observed for all items, and factor analyses indicated that pre-specified domains are appropriate. Internal consistency was demonstrated for the HCBQ (α = 0.79–0.86) and all but the canine HRQoL-Q social functioning domain (α = 0.60)). Test-retest reliability for the canine HRQoL-Q was generally moderate-to-good (intraclass correlation coefficients [ICCs] &gt; 0.79). Test-retest reliability for the HCBQ was moderate (ICCs: 0.70–0.79), except the trust domain (ICC: 0.58). Known-groups validity was demonstrated by significant differences (p &lt; 0.05) in scores by health/bonding groups. Convergent validity was supported (r &gt; 0.40) between all domains and the total score for both questionnaires. Conclusions: The Canine HRQoL-Q and the HCBQ are valid, reliable measures of canine HRQoL for use in veterinary clinics and appear to measure related but distinct concepts that contribute to canine health and wellness.

Historically, Physalis physalis massive stranding events have been infrequent and poorly documented. However, their occurrence can have significant impacts on human health and the stability of coastal ecosystems. In this study we analyze the largest P. physalis stranding event historically recorded affected Cuba’s northwestern coast in December 2022. We counted all colonies during the massive event along ~ 3 km coast, within a 5 m stripe. Density, dimorphic form (left/right-handed), and colony size were quantified using 0.25 m2 quadrat placed every 50 m, 10 m from shoreline. Eighty-five people were stung, with 38 having strong allergic reactions, resulting in a health risk. Over ten thousand colonies were recorded, with the highest mean colony density (29.3 per m2) ever reported. The massive stranding coincided with the lowest Arctic Oscillation index (-2.59) in the past 11 years during December, likely linked to climate change. This led to the emergence of northeasterly winds reaching speeds of up to 24 km/h. Wind direction and speed, coupled with the dominance of left-handed colonies (71.4%), suggest the Sargasso Sea as the possible source of the bloom. The high prevalence of juvenile P. physalis colonies (68 %) likely aligns with the autumn breeding season in the northern hemisphere. The potential causes of P. physalis blooms are still poorly understood. Systematic monitoring of the distribution and abundance of this species should be a research priority considering the potential risk to human health and that the blooms could become more frequent and affect other areas in the Atlantic, given climate change and increasing eutrophication of the oceans.

The accelerated pace with which new diagnostic possibilities are produced and the budget re-strictions of the healthcare sector require that the decision-making process of acquiring new technologies becomes systematic in nature. There are some methodologies such as the Health Technology Assessment (HTA) that encompasses technological domains, clinical effectiveness, patient safety, organizational and financial aspects, among others. However, these methods do not contemplate the learning curve (LC) which is a differential factor in operator-dependent technologies. An assessment model was conceived based on the assessment domains of the AdHopHTA project with the addition of LC. The model was validated and calibrated through System Dynamics (SD) and using as case study the assessment of Point-of-care Ultrasound (POCUS) equipment in dengue screening. The model helped identify the influence of the LC and patient demand on the income and costs for the healthcare system regarding dengue screening as well as the cost-benefit indicator. The control charts LC-CUSUM and CUSUM are graphic tools to intuitively assess the learning curve which can be used for real-time monitoring once students reach a certain skill level.

Objective: To investigate the correlation between engagement and quality of life at work in nursing professionals, from a public hospital in the interior of the state of São Paulo, Brazil, at the beginning of the Covid-19 pandemic. Methods: Cross-sectional, descriptive, and correlational study, with nursing professionals, conducted between December 2020 and January 2021. We used the Brazilian versions of the Utrecht Work Engagement Scale and the Walton Model scale. Results: The nursing professionals obtained a strong and positive correlation (r≥0.70) between the social integration domain of QWL and vigor dimension of work engagement (r=0.88; p=<0.001); moderate positive correlation (r≥0.40≤0.69) between QWL working conditions and vigor (r=0.40; p=<0.001), dedication (r=0.40; p=<0.001) and overall score (r=0.41; p=<0.001) of the work engagement. The correlations were positive and weak (r≤0.39) for the other domains of QWL and dimensions of work engagement. Conclusion: Professionals with satisfactory levels of quality of life tended to have higher levels of engagement at work. Professionals were strongly engaged and satisfied with their quality of life at work at the beginning of the Covid-19 pandemic.

As of now, anthropogenic habitat injury via dissemination of manufactured chemicals is injuring the world’s ecosystems, but doctors have yet to recognize its consequences to humans. Recognition of overt toxicity due to chronic low-dose exposure will open the door to diagnosis, sequential elimination studies, and prescriptions for preventive cure that represent a first step in preventing escalating chronic diseases. This paper offers a diagnostic construct for such use: chronic ambient poisoning. Incorporating it into clinical practice can reduce misdiagnosis of gastro- and near-toxicity that doctors and patients presently suppress rather than remove, and reduce patient co-dependence with proton-pump inhibitors, anxiolytics, and antidepressants—and the thriving “alternative” health industry. This diagnostic elephant-in-the-room is presently missed for reasons of habit (when an ailment is not recognized, it cannot be included in the differential diagnosis) and of poor conduct and interpretation of non-clinical research studies that are taken to mean an absence of evidence is evidence of absence. Moreover, modern methods fail when: the exposure comprises a “daily cocktail” of poisons acting additively, interactively, and cumulatively over a lifetime; when there is no normal, unexposed comparison group; and when absence of a robust etiopathogenetic model disallows inapt statistics. Only patient-led, consultant-informed sequential elimination studies can “peel the onion” of toxicity and its recognition and “preventive cure”. Clinical use of the chronic ambient poisoning diagnosis can thus open the door to stemming and reversing anthropogenic epidemics.

The aim of this study was to determine whether a rowing training program improved the quantity and quality of physical activity and quality of life in female breast cancer survivors (stage I - 4.35%; II - 30.43%; III - 52.17%; and IV - 8.7%) diagnosed 6.57 ± 5.02 years previously, who had undergone a subsequent intervention (preservation 53.52%; total mastectomy 39.13% and double mastectomy 4.35%) and had a current mean age of 53.70 ± 7.88 years. The participants (N = 30) engaged in a 12-week training program, each week comprising three sessions and each session lasting 60-90 minutes. An anthropometric evaluation was performed before and after the program. The short form of the International Physical Activity Questionnaire (IPAQ-SF) and the Short Form 36 Health Survey (SF-36) were also administered. The results showed statistically significant improvements in levels of physical activity and in the dimensions of quality of life. We can conclude that a 12-week rowing training program tailored to women who have had breast cancer increases physical activity levels, leading to improved health status and quality of life.

The aim of the article is to determine the predictors of mental health among Polish society. Research was conducted after the first wave of the pandemic. Due to such an approach, it was possible to determine whether secondary effects of the pandemic have impact on mental health, apart from socio-demographic and psychological factors. In order to gather the research material, the CAWI on-line survey method was applied and carried out within the framework of the Ariadna Research Panel on the sample of 1079 Poles aged 15 and over. The FCV-19S scale, which is used to measure the fear of COVID-19 was applied in the measurement. It is a verified diagnostic instrument used to measure mental health in a lot of countries. The results of a hierarchical regression analysis have shown that the factors which increase the level of fear of COVID-19 are demographic, social and psychological features as well as attitudes towards the pandemic. The results of research indicate the significance of social context in the analysis and explanation of the effects of disasters and cataclysms.

The aim of this study was to determine whether a rowing training program improved the quantity and quality of physical activity and quality of life in female breast cancer survivors (stage I - 4.35%; II - 30.43%; III - 52.17%; and IV - 8.7%) diagnosed 6.57 ± 5.02 years previously, who had undergone a subsequent intervention (preservation 53.52%; total mastectomy 39.13% and double mastectomy 4.35%) and had a current mean age of 53.70 ± 7.88 years. The participants (N = 30) engaged in a 12-week training program, each week comprising three sessions and each session lasting 60-90 minutes. An anthropometric evaluation was performed before and after the program. The short form of the International Physical Activity Questionnaire (IPAQ-SF) and the Short Form 36 Health Survey (SF-36) were also administered. The results showed statistically significant improvements in levels of physical activity and in the dimensions of quality of life. We can conclude that a 12-week rowing training program tailored to women who have had breast cancer increases physical activity levels, leading to improved health status and quality of life.

Overweight and obesity adversely affect health-related quality of life (HRQOL) through day-to-day impairments of both mental and physical functioning. It is assumed that polyphenols within the Mediterranean diet may contribute to improve HRQOL. This investigation aimed at studying the effects of a polyphenol-rich ingredient on HRQOL in overweight and obese but otherwise healthy individuals. A randomized, double-blind, placebo-controlled study including 72 volunteers was conducted. Subjects were randomly assigned to receive for a 16-week period either 900 mg/day of the supplement or a placebo. Dietary recommendations were individually determined, and intakes were recorded; daily physical mobility was monitored. Improvement of HRQOL was set as the primary outcome and assessed at baseline and at the end of the investigation, using the Short-Form 36 (SF-36) Health survey. Body composition was analyzed using dual-energy X-ray absorptiometry (DXA). Physical activity level was calculated using International Physical Activity Questionnaire (IPAQ). After 16 weeks, despite there was no adherence to the Mediterranean Diet Serving Score (MDSS), supplemented individuals experienced significant HRQOL improvement (+5.3%; P=0.001), including enhanced perceived physical (+11.2%; P=0.002) and mental health (+4.1%; P=0.021) components; bodily pain, vitality, and general health, being the greatest contributors. Besides, body fat mass significantly decreased (-1.2 kg; P=0.033), mainly within trunk area (-1.0 kg; P=0.002). Engagement in physical activity significantly increased (+1308 Met-min/week; P=0.050). Hence, chronic supplementation with a nutritional diversity and dose of a Mediterranean diet-inspired polyphenol-rich ingredient resulted in a significant amelioration in both perceived physical and mental health, concomitant with the improvement of body composition, in healthy subjects with excessive adiposity.

Monitoring the dynamic responses of bridge structures has received considerable attention. It is important to synchronously measure both the quasi-static and dynamic displacements of bridge structures. However, the traditional accelerometer method cannot capture the quasi-static displacement component, although it can detect the dynamic displacement component. To this end, a novel composite instrument of a smartstation was proposed to monitor vibration displacements of footbridges. Full-scale experiments were conducted on a footbridge to validate the feasibility of the composite instrument-based monitoring method. A Chebyshev filter and wavelet algorithms were developed to process the composite instrument measurements. It was concluded that the measurement noise of the composite instrument was mainly distributed in a frequency range of 0–0.1 Hz. In two case studies with displacement peaks of 5.7–10.0 mm and 1.3– 2.5 mm, the composite instrument accurately identified the quasi-static and dynamic displacements. The composite instrument will be a potential tool for monitoring structural dynamics because of its enhanced overall performance.

This study aimed to assess the psychological effects of being processed by the justice system, either as a plaintiff or as a defendant. The sample consisted of 360 subjects, 32.8% defendants and 52.2% plaintiffs, residents in the Autonomous Community of Galicia (NW Spain). A lot of psychological test were administered. The results indicated significant differences between plaintiffs and defendants. The former were more pessimistic about the future, used poor strategies for protecting health, and had less empathy. In contrast, defendants had a more negative outlook on life, and in general more psychosomatic symptomology. Thus, both defendants and plaintiffs suffered health problems. Moreover, the group with the longest exposure to litigation had the worst deteriorated health. In conclusion, defendants were more pessimistic about the future, used poor strategies for protecting their own health, and showed less empathy. Likewise, plaintiffs had a more negative outlook on life, and on the whole presented more psychosomatic symptomology. Thus, both defendants and plaintiffs presented health problems. Moreover, the comparison between litigants and non-litigants showed health was more deteriorated in the former, but only in a few specific variables.

The aim of the study is to assess enjoyment and intensity of physical exercise while practicing physical activity (PA) in immersive virtual reality (IVR) using innovative training devices (omni-directional Omni treadmill and Icaros Pro flight simulator). The study also contains the results of subjective research on the usefulness of such a form of PA in the opinion of users. In total, 61 adults (10 women and 50 men) took part in the study. To assess the enjoyment level (EL) Interest/Enjoyment subscale of Intrinsic Motivation Inventory (IMI) was used. Exercise intensity was assessed during 10-minute sessions of active video games (AVGs) in IVR based on heart rate (HR). The average enjoyment level during physical exercise in IVR on the tested training devices was relatively high (Omni 5.74 points, Icaros 5.60 points). In the opinion of the majority of participants, AVGs on IVR training devices constitute a sufficiently useful form of movement to meet the needs of PA practiced in free time, and they can even replace some of the classic forms of movement. Intensity of PA during games on training devices was at the level recommended for health benefits for 92% (Omni) and 84% (Icaros Pro) of its duration. Based on the conducted research, it can be assumed that AVGs in IVR using a multi-directional treadmill and a flight simulator can be an effective tool for increasing participation in health-oriented PA.

The devastating growth in the worldwide frequency of neurocognitive disorders and its allied difficulties such as decline in memory, spatial competency, and ability to focus poses a significant psychological public health problem. Inhibitor of Differentiation (ID) proteins are members of a family of helix-loop-helix (HLH) transcription factors. ID proteins have been demonstrated to be involved in neurodevelopmental & depressive diseases and thus may influence neurocognitive deficiencies due to environmental exposure. Previously, it has been demonstrated that environmental factors such as estrogenic endocrine disruptors (EEDs) have played an essential role in the influence of various neurocognitive disorders such as Alzheimer’s, Dementia, and Parkinson’s disease. Based on this increasing number of reports, we consider the impact of these environmental pollutants on ID proteins. Better understanding of how these ID proteins by which EED exposure can affect neurocognitive disorders in populations will prospectively deliver valuable information in the impediment and regulation of these diseases linked with environmental factor exposure.

A unified critical state model has been developed for both clean sand and silty sand using the modified Cam-clay model (MCC). The main feature of the proposed model is a new critical state line equation in the e-ln(p) plane that is capable of handling both straight and curved test results. With this feature, the error in calculating plastic volumetric strain is eliminated in theory. Another crucial feature of the model is the transformed stress tensor based on the SMP (spatially mobilized plane) criterion, which takes into account the proper shear yield and failure of soil under three-dimensional stresses. Additionally, the proposed model applies the intergranular void ratio with the fines influence factor for silty sand. Only eight soil parameters are required for clean sand, and a total number of twelve soil parameters are needed for silty sand.

Considering the negative impacts of climate changes along with the rapid increase in population in Islamic dominated states, e.g., the Middle East, water tension among upstream and downstream states is increasing. Despite the importance of water management in Islamic culture, the role of religion has been under-valued and under-emphasized by the scholars. The paper has sought to compare and contrast Islamic water management principles (IWMP) with international water law principles (IWLP). The findings from this analysis show not only that IWMP are in conformity with IWLP, but that in many cases, IWMP can be more effective. For instance, where international water accords between riparian states of a shared river basin are poorly developed and lack enforcement mechanisms under IWLP, those upstream states can abuse their geographical locations depriving those downstream-ers. In contrast, IWMPs stress the equitable and reasonable use of water resources among upstream and downstream users of a shared watercourse. Moreover, although IWLPs emphasize the conservation and preservation of ecosystems and the environment at the basin level, the inter-basin states especially those upstream can pose significant harm to the ecosystems. On the other side, Islam as the religion of peace, has placed much emphasis on the preservation of nature. For example, the verse, “.... And waste not by excess, for Allah loves not the wasters” [Quran, 7:31], illustrates the importance of the sustainable use of water and the environment. It is argued that if Islamic Water Management Principles are incorporated into the management instrument of Islamic States, the issue of equitable and sustainable use of water among Muslim-dominated riparian states (e.g., Iran, Afghanistan, etc.) will be solved.

This paper seeks to explain the rapid growth of the Islamic State of Iraq & Syria (ISIS) and approach the question of “what is” the Islamic State? The paper offers several contributions. First is the proposal of a dynamic hypothesis that ISIS is an emerging-state actor and differs notably from traditional non-state actors and insurgencies. The theory consists of both a causal loop diagram and key propositions. A detailed system dynamics simulation (E-SAM) was constructed to test the theory. The propositions of emerging-state actor theory are constructed as synthetic experiments within the simulation and confirm evidence of emerging-state actor behavior. E-SAM’s novelty is its combination of combat simulation with endogenous geospatial feedback, ethnographic behavior in choosing sides in conflict, and details internal simulation of key actor mechanisms such as financing, recruiting and governance. E-SAM can be loaded with scenarios to simulate non-state actors in different geospatial domains: ISIS in Libya, Boko Haram in Nigeria, Taliban in Afghanistan and even expatriated ISIS fighters returning to pursue new conflicts such as in Indonesia.

Abstract: Early life gut microbiota have been increasingly recognized as major contributors to short and/or long-term human health and diseases. Numerous studies have demonstrated that human gut microbial colonization begins at birth but continues to develop a succession of taxonomic abundances for two to three years until the gut microbiota reaches adult-like diversity and proportions. Several factors, including gestational age (GA), delivery mode, birth weight, feeding types, antibiotic exposure, maternal microbiome and diet influence the diversity, abundance and function of the early life gut microbiota. Gut microbial life is essential for assisting with the digestion of food substances to release nutrients, exerting control over pathogens, stimulating or modulating the immune system and influencing many systems such as the liver, brain, and endocrine system. Microbial metabolites play multiple roles in these interactions. Furthermore, studies provide evidence supporting that imbalances of the gut microbiota in early life, referred to as dysbiosis, are associated with specific childhood or adult disease outcomes, such as asthma, atopic dermatitis, diabetes, allergic diseases, obesity, cardiovascular diseases (CVD) and neurological disorders. These findings support that the human gut microbiota may play a fundamental role in the risk of acquiring diseases that may be programmed during the early life stage. In fact, it is critical to explore the role of the human gut microbiota in early life. In this review, we summarize the general understanding of the colonization and development of the gut microbiota in early life, highlighting the recent findings regarding the relationship between the gut microbiota composition and their metabolites, and immune functions, which could significantly influence long-term health and disease. We then review known pathophysiological interactions of the early gut microbiome with a number of well characterized diseases and pose potential etiological mechanisms.

Supporting the implementation of school food and nutrition policies (SFNPs) is an international priority to encourage healthier eating among children and youth. Schools are an important intervention setting to promote childhood nutrition, and many jurisdictions have adopted policies, guidelines, and programs to modify the school nutrition environment and promote healthier eating. The purpose of this study was to explore the association between perceived adequacy and capacity for SFNP implementation on food availability and policy adherence in the province of Nova Scotia (NS), Canada, one of the first regions in Canada to launch a comprehensive SFNP. A cross sectional online survey was conducted in 2014-15 to provide a current-state of policy implementation and adherence. Adequacy and capacity for food policy implementation was used to assess policy adherence through the availability of prohibited ‘minimum’ nutrition foods. An exploratory factor analysis was conducted on a selected of available foods and ‘slow’ and ‘quick’ service food composition measures were dichotomized for food availability. Schools with above perceived average adequacy and capacity for policy implementation had more than three times (3.62) greater odds of adhering to a lunch policy, while schools that adhered to a snack and lunch policy had 52% and 82% lower odds of serving quick service foods, respectively. This study identified the need for appropriate adequacy and capacity for policy implementation to ensure policy adherence and improve the school food environment. These findings highlight the potential of SFNPs to have a positive impact on childhood nutrition, but adequately supporting their implementation is critical to ensure their impact.

The aims of this study are to determine the oral health status of a rare sample of 19th-century migrant settlers to South Australia, how oral conditions may have influenced their general health, and how the oral health of this group compares with contemporaneous samples in Australia, New Zealand, and Britain. Dentitions of 18 adults and 22 subadults were investigated using non-destructive methods (micro-CT, macroscopic, radiographic). Extensive carious lesions were identified in 17 adults and 4 subadults, from this group 1 subadult and 16 adults had antemortem tooth loss. Sixteen adults showed evidence of periodontal disease. Enamel hypoplastic (EH) defects were identified in 14 adults and 9 subadults. Many individuals with dental defects also had skeletal signs of co-morbidities. South Australian individuals had the same percentage of carious lesions as the British sample (53%), more than other historic Australian samples, but less than a contemporary New Zealand sample. Over 50% of individuals from all the historic cemeteries had EH defects suggesting systemic health insults during dental development were common during the 19th century. The overall oral health of the South Australian settlers was poor but, in some categories, (tooth wear, periapical abscess, periodontal disease), better than the other historic samples.

This paper describes an entropy equation that can be used for measuring energy. It originated from measuring economy in AI models, where the assumption would be that any organic system makes use of energy efficiency to form its structures. Looking at clustering and cohesion resulted in the equation E = (mean * variance). It was apparent however, that it was a very generic type of equation and it could be adjusted so that distance represents mean. This new version was applied to the domain of physics and the universe, when the equation can support the idea that work is done through the energy released by the 'change' in entropy. A comparison with Einstein's relativity equation is made and also the audacious suggestion that a black hole has only potential energy inside, which converts to kinetic energy after a Big Bang, for example. From that suggestion, a universal theory about state change can be made.

Based on the dynamic strength variation mechanism of concrete under complex loading conditions, two approaches were devised: numerical testing and CT scanning, guided by the principle of minimizing energy dissipation. A methodology for calculating concrete's failure area and measuring its strength was developed. The analysis delves into the mechanisms behind failure patterns and variations in concrete specimen strength, focusing on crack initiation, development, and the resultant failure surface formed by crack propagation, along with the stress distribution in concrete specimens subjected to diverse loading conditions. Through evaluating the strength and computed failure area of concrete specimens, it is evident that the loading method influences both the strength and failure area of concrete specimens. In general, a larger failure area correlates with a higher measured strength.

Partially state-owned firms are common in both developed and developing countries and contribute around 10% of the world's GDP. This has led to a rich literature exploring various aspects of competition between such “mixed”-ownership firms. This paper contributes to the existing literature by studying the effects of mixed ownership on the intensity of competition in oligopoly markets. Our findings indicate that state ownership exerts an anti-competitive influence, with a higher state ownership share resulting in less aggressive behavior by firms in the product market. This result implies that industries with a higher proportion of state ownership yield lower total surplus. Further, when considering factors such as taxes, soft budget constraints, and weak property rights, the anti-competitive effects of state ownership are accentuated.

In recent times, there has been significant enthusiasm for the development of all solid state batteries. This interest stems from a dual focus on safety—addressing concerns related to toxic and flammable organic liquid electrolytes—and the pursuit of high energy density. \cite{SCHNELL2018160,Zheng2018}. While liquid electrolyte batteries constitute for now the vast majority of commercial cells, solid electrolyte batteries show great promise. In parallel with experimental research, computational models \cite{GrazioliEtAlCM2016} clarify the several fundamental physics \cite{LiMonroeARCBM2020} that take place throughout battery operations. We review some classical models, emphasizing the conceptual advancements documented in the most recent works.

Bridges enable communications and transportation of goods nationally and internationally, underpinning economic and social activities, thus they are pylons of our prosperity and mobility. Bridges worldwide are constantly subjected to physical wear, ageing, deterioration, hazards, environmental influences, and increased loading. Loss of performance and functionality of bridge structures would have a crucial impact on overall infrastructural resilience and would cause significant negative economic and social consequences. Monitoring their behaviour for different loading conditions relies on accurate estimations of the stress-strain state of various critical components and remaining capacities. These activities are of high importance for better planning lifespan prolongation, that is the extension of their service life and prevention of unforeseen collapses, in line with sustainability principles of well-informed maintenance. In many cases, access to the structure is limited or even impossible, which causes the need for the deployment of remote and contactless methods. One such innovative technique, which has recently attracted attention in scientific and practical applications is the digital image correlation (DIC). DIC is a contactless approach applicable for long-term measurements, which enables obtaining the full field of strains and deformations. Although the DIC approach has been widely used in world engineering practice for monitoring bridges and has proved to be a reliable and accurate method, there is a lack of systematic integral review on previous practical applications, revealing limitations and perspectives. This is the main motivation and novelty of this study, which will describe selected case studies, in which DIC was used on real full-scale bridge structures and propose improvements for the method.

This review provides an extensive overview of the developments in the field of polymer science, focusing on the solid-state modification (SSM) of thermoplastic materials. The background of the study places thermoplastics within the context of their increased use over the past century, highlighting their versatility in various applications and the associated environmental and health concerns due to certain additives. The methods section delves into the specifics of SSM, a technique that involves the incorporation of monomers or oligomers into the amorphous phase of polymers through multiple exchange reactions, distinguishing it from traditional melt polymer modification methods. The results section outlines the unique aspects of SSM and its increasing recognition for its potential to enhance material performance in areas such as catalysts and composites. It also discusses the application of SSM in modifying different thermoplastic polymers, highlighting various studies demonstrating the method's effectiveness in altering polymer properties. Finally, this work emphasizes SSM's importance in environmental sustainability and its potential in the recycling and upcycling of plastic materials. It acknowledges the challenges and future perspectives in the field, particularly regarding the scalability of SSM techniques for industrial applications and their role in advancing a circular economy in the polymer industry.

There is a continuous interest in cannabinoids like Δ9-tetrahydro cannabinol (Δ9-THC) and cannabidiol (CBD). A patent of Webster et al., described the conversion of CBD to either D8-THC or D9-THC, depending on the acid catalyst applied. The use of para-toluene sulfonic acid (pTSA) led to the formation of D8-THC, while boron trifluoride etherate (BF3·Et2O) yielded mainly D9-THC. The enormous difference in product selectivity between these two catalysts was investigated with Molecular Modeling. It was found that pTSA leads to fast isomerization of Δ9-CBD to Δ8-CBD and subsequent ring closure to Δ8-THC. BF3·Et2O catalysis leads to the formation of tertiary carbenium ions in the Transition States which yield D9-THC and some iso D8-THC. Under dry conditions in refluxing toluene, it was found that pTSA is predominantly present as a dimer, and only a small fraction is available as monomeric catalyst. Applying the computationally derived activation barriers in Transition State theory yielded reaction rates predicting amounts of cannabinoids that are in close agreement with the experimental findings.

Karate is a martial art that originated in Japan It is characterized by its diverse techniques, including punches, kicks, strikes, and open hand techniques. Generally, karate practitioners shall execute techniques fast, with an impactful finishing towards the target. The present study aims to examine the effectiveness of customized gym sessions in enhancing the athletes’ general performance with a duration of 3-months’time. A total of 7 tests were monitored, i.e., anthropometric measurement, sit and reach test, stork balance stand test, T-test, counter movement jump, 20m sprint, and Yo-Yo endurance test. 4 male amateur athletes (state representative) that has practiced karate for at least 6 years, with at least 5 days training per week, were selected. The age ranges from 15 to 20 years old. The athletes were requested to have a proper rest (at least 7 hours sleeping time) five days before the actual test day. The results show that all athletes have at least maintained or improved stork balance for both legs. The balance improvement ranges from 0% up to 134.69%. However, both the T-test and 20m sprint test demonstrated a negative outcome. The time consumed to complete 20m is increased, which deteriorated the linear speed capability by 1.89% up to 8.93%. Also, 3 out of 4 athletes show that the T-test performance does not provide a satisfactory achievement. The agility of athletes was found to drop by 3.58% up to 10.60%. Interestingly, the athletes’ stamina was found to improve based on the VO2 max prediction and Yo-Yo test. The enhancement of VO2 max prediction and Yo-Yo test recorded as 0% - 7.53% and 9.09% - 20%, respectively. So far, there is no clear indicator on the flexibility of the athletes’ spine and length of the hamstring muscles, based on the sit and reach test. Short-term gym sessions with a duration of 3 months might improve the strength and body balance of athletes. However, the impact on the responsiveness and agility of athletes did not show any significant breakthrough. In future study, it is recommended that a large sample of participants should be included in the analysis.

This paper proposes a metaphysical framework for distinguishing between human and machine intelligence. By drawing an analogy from Kant’s incongruent counterparts, it posits two identical deterministic worlds -- one comprising a human agent and the other comprising a machine agent. These agents exhibit different types of information processing mechanisms despite their apparent sameness in a causal sense. By postulating the distinctiveness of human over machine intelligence, this paper resolves what it refers to as “the vantage point problem” – namely, how to legitimize a determinist’s assertion of determinism by placing the determinist within the universe.

As the global community shifts away from fossil fuels towards more environmentally friendly energy alternatives, there is an escalating demand for sophisticated energy storage solutions. Solid-State Batteries (SSBs) have emerged as a promising advancement, presenting a superior substitute to conventional lithium-ion batteries. This review provides an in-depth examination of SSBs, emphasizing their enhanced energy density, safety, and longevity. We evaluate conventional cathode materials, including lithium cobalt oxide (LiCoO2), lithium manganese oxide (LiMn2O4), and lithium iron phosphate (LiFePO4). Additionally, we introduce emerging materials such as sulfides, oxides, and air-based cathodes, discussing their benefits, limitations, and their congruence with solid electrolytes. Special attention is devoted to the structural fine-tuning of cathode ma-terials, investigating approaches like nanostructuring, surface coatings, and composite strategies to counteract issues such as restricted conductivity and structural volatility. The review critically analyzes the electrical and thermal properties of these materials, which are essential for battery safety and efficacy. Moreover, we present a comparative assessment of cathode materials based on performance indicators and identify prevailing research voids and hurdles in the commerciali-zation of SSB cathodes. Concluding, we suggest prospective research directions and innovations, underscoring the revolutionary potential of SSB technologies in paving the way for a sustainable energy horizon.

The fact that quantum gravity does not admit a co-variant vacuum state has far-reaching consequences for all physics. It points out that space could not be empty, and we return to the notion of an ether . Such a concept requires a preferred reference frame for, e.g., universe expansion and black holes. Here, we intend to discuss vacuum and quantum gravity from three essential viewpoints: universe expansion, black holes existence, and quantum decoherence.