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Breaking through local knowledge search limitations is essential for fostering interdisciplinary innovation. This paper investigates how High-speed Railway (HSR) facilitates these firms in integrating information technology (IT) knowledge from other cities into their innovation processes. By connecting cities through faster transportation, HSR diminishes the constraints of geographical proximity, enabling firms to bypass the traditional reliance on local knowledge clusters and access a broader pool of IT expertise. Utilizing a difference-in-differences (DID) approach, our results reveal that HSR enhances knowledge search scope by improving access to IT resources, increasing human capital mobility, and raising competitive awareness. Additionally, we identify heterogeneity in this effect based on factors such as the marketization level of a firm's location, the degree of digital infrastructure development, whether a firm is located in a provincial capital, and the specific industry sector. Our findings further demonstrate that the expansion of knowledge search scope due to HSR significantly boosts future firm performance. These findings highlight the critical role of transportation infrastructure, exemplified by HSR, in breaking down geographic barriers to interdisciplinary knowledge flows and fostering more dynamic innovation ecosystems. • High-speed railway (HSR) can facilitate the firms to incorporate IT knowledge from other cities into innovation. • Enlarged knowledge search scope brought about by the introduction of HSR significantly enhances future firm performance. • HSR expands knowledge search scope by increasing IT accessibility, human capital, and competition awareness. [ABSTRACT FROM AUTHOR]

Given the negative health impacts of climate change, clinicians have a fundamental responsibility to take an active role in mitigating the environmental impact of their practices. Inhaled anaesthetics are potent greenhouse gases, including nitrous oxide (N 2 O), with their long atmospheric lifetime, high global warming potential, and ozone-depleting properties. However, few clinicians realise that losses from central N 2 O supply systems account for the vast majority of overall N 2 O consumption in healthcare. Central N 2 O supply systems are standard in most facilities, compounding the impact of these under-recognised, unnecessary greenhouse gas emissions. We review the environmental impact of N 2 O in healthcare, offer N 2 O utilisation data from 47 hospitals in the USA, and provide clinician-targeted guidance for mitigating these widespread N 2 O emissions. Consistent with findings from the UK and Australia, data from two large US healthcare systems reveal significant nonclinical N 2 O losses of 47.2–99.8% of total procured N 2 O. As illustrated in one quaternary medical centre, the transition from central to portable supply systems reduced overall N 2 O consumption by 97.6%. To date, this mitigation initiative has been successfully implemented at over 25 hospitals in our system. Raising awareness of this considerable source of healthcare-specific N 2 O emissions empowers clinicians to spearhead facility-level engagement and action. As healthcare leaders, clinicians should advocate for decarbonisation of clinical practices and systems while ensuring high-quality patient care. [ABSTRACT FROM AUTHOR]

The diagnosis and management of malaria in non-endemic countries presents a continuing challenge. Plasmodium falciparum, which is capable of rapidly inducing severe and life-threatening multiorgan disease, is the species most frequently diagnosed in Europe and North America. To summarise the more relevant diagnostic findings and clinical features of malaria observed in non-endemic settings and to provide an update of the key management decision points using three illustrative clinical scenarios of uncomplicated and severe malaria. The discussion is based on a relevant literature search spanning the last 20 years. Recommendations are based on available clinical guidelines including those of the WHO, observational studies conducted in non-endemic settings, and, when available, extrapolation from randomised studies from malaria-endemic settings. The following topics are covered: diagnosis, including the use of molecular biology; clinical characteristics; management with a specific focus on complicated (severe) and uncomplicated malaria; and areas of resistance to available antimalarial drugs. Malaria imported to non-endemic settings, especially P. falciparum malaria, is sometimes initially overlooked and the delayed diagnosis is responsible for every year of preventable deaths. This review aims to raise awareness of malaria outside endemic countries and to provide clinicians with a practical guide for efficient diagnosis and targeted therapy for the different species involved. [ABSTRACT FROM AUTHOR]

The American Lung Association's "State of the Air" 2023 report reveals almost 36% of Americans live with unhealthy levels of air pollution. Studies link air pollution with acute respiratory symptoms and exacerbation of respiratory and cardiovascular diseases. Differential air pollution exposures between white and nonwhite communities are significant components of environmental injustices. Even during the coronavirus disease 2019 (COVID-19) lockdown, when the United States experienced significant decreases in polluting activities, these differences persisted. The American College of Preventive Medicine's Science and Translation Committee conducted a nonsystematic literature review to explore initiatives addressing air pollution as a key component of environmental justice, the state of the science regarding health impacts, and evidence supporting mitigations to reduce those impacts. We recommend advocacy for cleaner energy sources and increasing green space; and increasing research, surveillance, and education and training on linkages between air pollutants and health. We recommend preventive medicine physicians raise awareness about increased risks of cardiovascular disease, cancer, asthma, and reduced lung function with air pollution exposure. Preventive medicine physicians may also educate patients and other practitioners about exposures, and how "conventional" disease prevention strategies may have unintended consequences; and influence healthcare leaders to improve efficiency and reduce emissions. We also recommend physicians utilize social determinants of health Z-Codes to capture environmental factors. Private payers should incorporate pollution exposure data into social determinants of health risk adjustments for Medicare Advantage programs. Medicaid agencies should develop provider recommendations for pediatric populations, and states should finance in-home interventions for asthma. [ABSTRACT FROM AUTHOR]

Scientists are under increasing pressure to enhance public awareness of the societal implications of their research. This involves recontextualizing highly specialized knowledge into forms accessible to diverse audiences, varying in levels of expertise. While much research has focused on the reformulation of ideas for popularizing purposes, less emphasis has been placed on the pragmatic strategies involved in adapting expert knowledge for varied audiences in digital contexts. A pragmatic approach that leverages both verbal communication and digital tools could provide insights into these dissemination strategies. This study examines how digital research digests, which are concise versions of research articles, make scientific research accessible to non-experts. The study identifies two key sets of strategies: expert-oriented, which emphasize authority and credibility, and audience-oriented, which simplify complex ideas and relate them to everyday life. These strategies blend to form a unique narrative voice that balances authority with accessibility. The paper argues that effective digital dissemination should integrate both linguistic and pragmatic methods to successfully communicate complex information across different digital practices. • Pragmatic strategies help bridge knowledge asymmetries in digital scientific communication. • Expert-oriented strategies highlight credibility and research significance. • Audience-oriented strategies ensure comprehension and engagement. • Interaction of pragmatic strategies with metadiscourse enhances science communication. [ABSTRACT FROM AUTHOR]

Neurosurgeons may resort to caffeine, alcohol, and various drugs to maintain peak performance as they grapple with work demands and escalated stress. The prevalence of this controversial strategy remains largely unexplored. An anonymous survey of 23 questions formulated by our research group was distributed through personal contacts and neurosurgical societies. Inquiries revolved around the use of medications and other substances for job-related reasons. Data were analyzed via regression and descriptive statistics in python. In total, 215 neurosurgeons (43 residents) were included, with 213 disclosing their gender (94 females). Out of all, 9.3% were <30, 38.1% were 30–39, 44.6% were 40–59, and 7.9% were >60 years old. Most (70.7%) practiced in Europe, 18.6% in Asia, 6.5% in North and South America, and the rest in Africa or Australia. While 132 participants stated they consume caffeine to manage challenging schedules, drugs for cognitive and mood enhancement were utilized by 18 and 35 respectively. Alcohol was employed for stress relief by 28 with 4 reporting as heavy drinkers. Drugs posed a solution to sleep disorders for 82, and helped 8 others in strengthening their hand dexterity. Notably, 12 of those claiming drug use initiated it in medical school. Exercise, self-care activities, and relational support were the main alternatives sought. Ultimately, most responders recommended extending mental health assistance and raising awareness about drug use. Reflecting on our results on job-associated drug use by neurosurgeons, we propose the judicious use of pharmacological or nonpharmacological adjuncts, alongside the prioritization of neurosurgeons' well-being. [ABSTRACT FROM AUTHOR]

Perioperative management of antithrombotic therapy is a necessary preprocedural consideration for patients prescribed direct oral anticoagulants (DOACs), vitamin K antagonists, or antiplatelet medications. There is a lack of evidence-based guidelines to help inform decision-making in managing antiplatelet and anticoagulation medications in the perioperative period around brain tumor resection. The objective of this study was to provide an example of the heterogeneity in practice and raise awareness for the need to create standardized guidelines for managing these medications. A survey was sent to a list of over 800 international neurosurgeons who are members of the Neurosurgery Research Listserv. The survey comprised 70 questions assessing individual practices for managing thromboprophylaxis, antiplatelet medications, and anticoagulation in the perioperative period. The survey was sent via e-mail invitation between March 2021 and June 2021. A total of 72 surgeons responded to the survey. There was no difference in medication management preoperatively or postoperatively when comparing intra- and extra-axial tumor resections. Cessation of antiplatelet medications varied between 3 and 11 days while restart varied between 1 and 14 days. Preoperative management of vitamin K antagonists varied between indication for use (P < 0.001) while DOAC management did not. In our group of respondents, 90% started heparin products within 5 days of surgery, while the same fraction restarted DOAC within 14 days. Respondents demonstrated significant heterogeneity in their perioperative management of antiplatelet and anticoagulation medication in brain tumor resection. This may lead to an unacceptable level of heterogeneity in practice that has the potential to cause patient harm due to errors in medication management. [ABSTRACT FROM AUTHOR]

Malignant hyperthermia susceptibility (MHS) designates individuals at risk of developing a hypermetabolic reaction triggered by halogenated anaesthetics or the depolarising neuromuscular blocking agent suxamethonium. Over the past few decades, beyond the operating theatre, myopathic manifestations impacting daily life are increasingly recognised as a prevalent phenomenon in MHS patients. At the request of the European Malignant Hyperthermia Group, we reviewed the literature and gathered the opinion of experts to define MHS-related myopathy as a distinct phenotype expressed across the adult lifespan of MHS patients unrelated to anaesthetic exposure; this serves to raise awareness about non-anaesthetic manifestations, potential therapies, and management of MHS-related myopathy. We focused on the clinical presentation, biochemical and histopathological findings, and the impact on patient well-being. The spectrum of symptoms of MHS-related myopathy encompasses muscle cramps, stiffness, myalgias, rhabdomyolysis, and weakness, with a wide age range of onset mainly during adulthood. Histopathological analysis can reveal nonspecific abnormalities suggestive of RYR1 involvement, while metabolic profiling reflects altered energy metabolism in MHS muscle. Myopathic manifestations can significantly impact patient quality of life and lead to functional limitations and socio-economic burden. While currently available therapies can provide symptomatic relief, there is a need for further research into targeted treatments addressing the underlying pathophysiology. Counselling early after establishing the MHS diagnosis, followed by multidisciplinary management involving various medical specialties, is crucial to optimise patient care. [ABSTRACT FROM AUTHOR]

The emotional impact of surgical complications on urologists is a significant yet historically under-addressed issue. Traditionally, surgeons have been expected to cope with complications and their psychological effects in silence, perpetuating a culture of perfectionism and 'silent suffering.' This has left many unprepared to handle the emotional toll of adverse events during their training and early careers. Recognizing the gap in structured education on this matter, there is a growing movement to openly address and educate on the emotional consequences of surgical complications. This article underscores the importance of such educational initiatives in the mid-career phase, proposing strategies to promote surgeon health, and psychological safety. It advocates for utilizing Morbidity and Mortality conferences as platforms for peer support, learning from 'near miss' events, and encourages at least annual department-wide discussions to raise awareness and normalize the emotional challenges faced by surgeons. Furthermore, it highlights the role of formal peer support programs, acceptance and commitment therapy, and resilience training as vital tools for promoting surgeon well-being. Resources from various organizations, including the American Urological Association and the American Medical Association, are now available to facilitate these critical conversations. By integrating these resources and encouraging a culture of openness and support, the article suggests that the surgical community can better manage the inevitable emotional ramifications of complications, thereby fostering resilience and reducing burnout among surgeons. [ABSTRACT FROM AUTHOR]

The multi-soil-layering (MSL) systems is an emerging solution for environmentally-friendly and cost-effective treatment of decentralized rural domestic wastewater. However, the role of the seemingly simple permeable layer has been overlooked, potentially holding the breakthroughs or directions to addressing suboptimal nitrogen removal performance in MSL systems. In this paper, the mechanism among diverse substrates (zeolite, green zeolite and biological ceramsite) coupled microorganisms in different systems (activated bacterial powder and activated sludge) for rural domestic wastewater purification was investigated. The removal efficiencies performed by zeolite coupled with microorganisms within 3 days were 93.8% for COD, 97.1% for TP, and 98.8% for NH 4 +-N. Notably, activated sludge showed better nitrification and comprehensive performance than specialized nitrifying bacteria powder. Zeolite attained an impressive 89.4% NH 4 +-N desorption efficiency, with a substantive fraction of NH 4 +-N manifesting as exchanged ammonium. High-throughput 16S rRNA gene sequencing revealed that aerobic and parthenogenetic anaerobic bacteria dominated the reactor, with anaerobic bacteria conspicuously absent. And the heterotrophic nitrification-aerobic denitrification (HN-AD) process was significant, with the presence of denitrifying phosphorus-accumulating organisms (DPAOs) for simultaneous nitrogen and phosphorus removal. This study not only raises awareness about the importance of the permeable layer and enhances comprehension of the HN-AD mechanism in MSL systems, but also provides valuable insights for optimizing MSL system construction, operation, and rural domestic wastewater treatment. [ABSTRACT FROM AUTHOR]

• EDCs are ubiquitous in the environment and humans are constantly exposed to them. • EDCs can alter stem cell function in ways that can lead to health disturbances. • EDCs can alter the pluripotency, proliferation, and differentiation capacities of embryonic, adult, and cancer stem cells. • EDCs might induce modulation of gene expression, crucial for regulating stem cell self-renewal and differentiation. • EDCs can have long-term effects on stem cells, even after exposure has stopped. Endocrine-disrupting chemicals (EDCs) are compounds, either natural or man-made, that interfere with the normal functioning of the endocrine system. There is increasing evidence that exposure to EDCs can have profound adverse effects on reproduction, metabolic disorders, neurological alterations, and increased risk of hormone-dependent cancer. Stem cells (SCs) are integral to these pathological processes, and it is therefore crucial to understand how EDCs may influence SC functionality. This review examines the literature on different types of EDCs and their effects on various types of SCs, including embryonic, adult, and cancer SCs. Possible molecular mechanisms through which EDCs may influence the phenotype of SCs are also evaluated. Finally, the possible implications of these effects on human health are discussed. The available literature demonstrates that EDCs can influence the biology of SCs in a variety of ways, including by altering hormonal pathways, DNA damage, epigenetic changes, reactive oxygen species production and alterations in the gene expression patterns. These disruptions may lead to a variety of cell fates and diseases later in adulthood including increased risk of endocrine disorders, obesity, infertility, reproductive abnormalities, and cancer. Therefore, the review emphasizes the importance of raising broader awareness regarding the intricate impact of EDCs on human health. [Display omitted] [ABSTRACT FROM AUTHOR]

The integration of artificial intelligence (AI) into current research information systems (CRIS) is becoming increasingly prevalent, driven by the need for enhanced operational efficiency and data accessibility. While AI offers promising opportunities for improving CRIS functionalities, it also raises significant ethical challenges that must be addressed. This paper examines the ethical implications of AI implementation in CRIS, focusing on issues such as autonomy, discrimination, data protection, and user rights. Drawing on insights from machine, technology, digital, and robot ethics, the paper explores strategies for mitigating these challenges and fostering responsible AI use in CRIS. Additionally, it highlights the impact of AI technology on CRIS staff and emphasizes the importance of considering societal and personal effects alongside technological advancements. By raising awareness of ethical considerations and promoting ethical AI practices, this paper aims to contribute to the development and acceptance of AI technologies in CRIS, particularly in the light of forthcoming regulations such as the EU AI Act. [ABSTRACT FROM AUTHOR]

• Virtual Reality is as a viable training method for low-voltage electrical safety. • VR training demonstrates overall effectiveness in reaction, learning, and duration. • Trainees react positively, notably for engagement, intention to use, and enjoyment. • VR facilitates learning; trainees retain substantial knowledge after four weeks. • Most trainees consider the 29- to 44-minute training duration appropriate. Introduction : The widespread use and inherent risks associated with low-voltage electrical equipment require all workers to understand its hazards and how to manage them. Despite being the most commonly used method for raising safety awareness, lecture-based training often proves ineffective. Virtual reality (VR) allows the user to be immersed in a virtual environment and actively participate in practical training while maintaining their safety, which can potentially result in engaging and effective training. This paper investigates the effectiveness of using immersive VR for low-voltage (LV) electrical safety training to understand the potential benefits of VR technology for industrial safety training applications. Method: A within-group experimental design was employed with 18 participants undertaking the LV VR training. The effectiveness of the training was evaluated by measuring participants' reactions, learning, and training duration. Participants' learning was measured before, immediately after, and four weeks after the training, whereas reaction and suitability of training duration were measured after the training. Results: Participants reported highly positive reactions to the LV VR training, particularly regarding their level of engagement, intention to use the system in the future, and enjoyment. Knowledge test scores significantly improved immediately after training with high effect sizes. Although scores decreased significantly four weeks after training, they remained significantly higher compared to before training. The training duration, ranging from 29 to 44 minutes was considered suitable for the training. Conclusions: LV VR training effectively elicited positive reactions from trainees and supporting trainees to acquire and retain safety information while maintaining appropriate training duration. Practical Implications: VR emerges as a viable alternative training method worth exploring for organizations seeking to improve their safety training programs. VR combines educational and entertainment values, facilitating enjoyable learning experiences. [ABSTRACT FROM AUTHOR]

It is unknown whether racial disparities in access to heart transplantation (HT) are amplified when coupled with substance use. We examined patients evaluated for HT over 8 years at an urban transplant center. We evaluated substance use and race/ethnicity as independent and interactive predictors of HT and left ventricular assist device (LVAD) implantation. Of 1,148 patients evaluated for HT, substance use was cited as an ineligibility factor in 151 (13%) patients, 16 (11%) of whom ultimately received HT. Significantly more non-Hispanic Black (NHB) patients were deemed ineligible due to substance use (n = 59, 19%) compared to other races/ethnicities (non-Hispanic white: n = 68, 12%; other race/ethnicity: n = 24, p = 0.002). No racial differences were observed in the likelihood of HT among patients initially excluded for substances, but more NHB patients ultimately received LVAD than the other racial groups. This study encourages greater awareness of the role of substance use and race in the HT evaluation. [ABSTRACT FROM AUTHOR]

Traumatic spinal cord injury (TSCI) is a devastating condition that may result to lifelong complications that affect patient outcome and quality of life. Because of the increasing incidence of TSCI, it is important to comprehend the extent of this condition in terms of demographics, mechanism, and degree of disability to raise awareness and develop strategies in approaching care for these patients. There is a lack of information regarding data on TSCI in Southeast Asia, especially in the Philippines. This study aims to describe the clinical characteristics and outcomes of patients with TSCI in a tertiary care hospital in the Philippines. This is a retrospective descriptive cohort study in individuals aged 18 years older who were admitted for TSCI in a Philippine tertiary care hospital between 2022 and 2023. Of 118 admitted patients, 100 patients were included in the study. The data were obtained from the review of patients' medical records. Demographics of TSCI, mechanism, presenting clinical characteristics, American Spinal Injury Association Impairment Scale (AIS) grade, radiographic findings, outcomes, and complications were analyzed. A total of 100 patients with TSCI were included in the study. The mean age of the patients was 43.4 ± 15.8 in years, with male patients being predominant, at 92%. The most common mechanism of injury was motor vehicular crash, at 68%, followed by fall, at 22%. Most patients, 38%, were graded AIS C, on admission. The most common level of injury was cervical, at 70%. The usual complications recorded were sacral ulcer 28%, and hospital-acquired pneumonia, 20%. TSCI is common in young adult male patients with motor vehicular crash as the mechanism of injury. Most patients in the study had incomplete spinal cord injury (AIS C), with the cervical region as the most common level. The recorded mean length of hospital stay was 1–2 weeks. The most common co-occurring extra spinal injury was traumatic brain injury. At discharge, most developed sacral ulcer and hospital-acquired pneumonia, with stable neurologic status. A multicenter prospective data collection with a larger population and inclusion of more variables are necessary to formulate a regression model and establish the factors that improve the outcomes of TSCI. [ABSTRACT FROM AUTHOR]

Modern species delimitation is challenged by past morphological descriptions, a mix of applied species concepts, missing tools for complex evolutionary processes and large multi-approach datasets, and nonstandardized data integration. The vision is to have less subjective and standardized species delimitation approaches based on modern integrative taxon-omics under a unified species concept, integrating the discovery of genetic entities with the fusion of automatically extracted information from multi-approach data to find natural taxonomic units. Artificial Intelligence (AI) approaches have been launched to tackle delimitation issues using classification/clustering methods based on supervised/unsupervised learning, although data fusion and problematic and unknown species represent active fields of research. AI can help accelerate the revision and unraveling of eukaryotic biodiversity on a scale not seen before. Although species are central units for biological research, recent findings in genomics are raising awareness that what we call species can be ill-founded entities due to solely morphology-based, regional species descriptions. This particularly applies to groups characterized by intricate evolutionary processes such as hybridization, polyploidy, or asexuality. Here, challenges of current integrative taxonomy (genetics/genomics + morphology + ecology, etc.) become apparent: different favored species concepts, lack of universal characters/markers, missing appropriate analytical tools for intricate evolutionary processes, and highly subjective ranking and fusion of datasets. Now, integrative taxonomy combined with artificial intelligence under a unified species concept can enable automated feature learning and data integration, and thus reduce subjectivity in species delimitation. This approach will likely accelerate revising and unraveling eukaryotic biodiversity. Although species are central units for biological research, recent findings in genomics are raising awareness that what we call species can be ill-founded entities due to solely morphology-based, regional species descriptions. This particularly applies to groups characterized by intricate evolutionary processes such as hybridization, polyploidy, or asexuality. Here, challenges of current integrative taxonomy (genetics/genomics +morphology +ecology, etc.) become apparent: different favored species concepts, lack of universal characters/markers, missing appropriate analytical tools for intricate evolutionary processes, and highly subjective ranking and fusion of datasets. Now, integrative taxon-omics combined with artificial intelligence under a unified species concept can enable automated feature learning and data integration, and thus reduce subjectivity in species delimitation. This approach will likely accelerate revising and unraveling eukaryotic biodiversity. [ABSTRACT FROM AUTHOR]

The hearing aid adoption rate among older adults in Japan is lower than that in other developed countries. Herein, a survey was conducted to identify this bottleneck and develop countermeasures. This study aimed to examine whether raising awareness of the relationship between hearing loss and dementia is significant for hearing tests and adopting hearing aids. A questionnaire was administered to participants aged 65 or older who visited a general hospital to determine the background factors (1) for a recent history of hearing tests, (2) for the desire to visit an otolaryngologist and have a hearing test, (3) for recognizing the hearing loss–dementia relationship, and (4) for adopting hearing aids. A total of 517 patients (mean age, 78.06; SD 6.97), representing 2.4% of the region's older-adult population, participated in the survey. A history of hearing tests within five years was significantly associated with recognizing the hearing loss–dementia relationship (adjusted OR 2.36, 95% CI 1.49–3.72). The desire to visit an otolaryngologist or have a hearing test was significantly associated with recognizing the hearing loss–dementia relationship (adjusted OR 1.70, 95% CI 1.02–2.85). Moreover, 39.3% were aware of the hearing loss–dementia relationship. The significant associated factors were being female (OR 2.50, 95% CI 1.64–3.81) and having interpersonal hobbies (OR 1.66, 95% CI 1.11–2.49). The significant background factors for adopting hearing aids were older age (OR 6.95, 95% CI 1.90–25.40), self-reported severe hearing impairment (OR 5.49, 95% CI 2.55–11.80), and living alone (OR 2.63, 95% CI 1.18–5.89). Recognizing the hearing loss–dementia relationship was not a significant factor. Raising awareness of the hearing loss–dementia relationship was not associated with adopting hearing aids for self-reported hearing impairments. However, it may be associated with otolaryngology visits and hearing tests. Thus, steps like hearing screening for older adults are also essential. [ABSTRACT FROM AUTHOR]

Abstract The amount of illegal wildlife trade cases increases every year in Indonesia. This causes some unique Indonesian wildlife to become endangered or even extinct. Therefore, the purpose of this research is to raise public awareness to illegal wildlife trade issue by using a game as its media to reduce the number of cases of illegal wildlife trade in Indonesia. The game made in this research will be developed using the GDLC development method and 2021.3.11f1 version of Unity as its game engine. To evaluate the game that has been developed in this research, a comparation to other related games is conducted and resulted in the game that has been developed in this research is significantly better than other related games in Challenge, Learnability and Concentration aspects (p < 0.001). [ABSTRACT FROM AUTHOR]

Despite global efforts to improve surgical care access, many low- and middle-income countries, especially in neurosurgery, face significant shortages. The Gambia exemplifies this, with only 1 fully qualified neurosurgeon serving its population of 2.5 million people. This scarcity results in higher morbidity and mortality. We aim to document the history and current state of neurosurgery in the Gambia to raise awareness and promote neurosurgery development. The study reviews the Gambia's health care system, infrastructure, neurosurgical history, workforce, disease burden, and progress, with information derived from reference sources as well as author experience and interviews with key partners in Gambian health care. Neurosurgery in the Gambia began in the 1970s, facing constraints due to competing health care demands. Significant progress occurred much later in the early 2010s, marked by the initiation of Banjul Neuro Missions and the establishment of a dedicated neurosurgery unit. We report significant progress with neurosurgical interventions in the past few years showcasing the unit's dedication to advancing neurosurgical care in the Gambia. However, challenges persist, including a lack of trained neurosurgeons, equipment shortages such as ventilators and diagnostic imaging. Financial barriers for patients, particularly related to the costs of computer tomography scans, pose significant hurdles, impacting the timely diagnosis and intervention for neurological conditions. Neurosurgery in the Gambia is progressing, but challenges like equipment scarcity hinder further progress. We emphasize the need for addressing cost barriers, improving infrastructure, and fostering research. Engaging the government and international collaborations are vital for sustained development in Gambian neurosurgery. [ABSTRACT FROM AUTHOR]

Recent research underscores the vital role social media can play in enhancing mental health awareness and encouraging help-seeking behaviors among youth. Nevertheless, the inherent risks of social media highlight the need for the careful creation of safe, effective content. This editorial outlines our strategy of using crowdsourcing platforms to develop and refine video interventions before launching a targeted Instagram campaign featuring these evidence-based videos. This process ensures the content is both beneficial and secure prior to public exposure. We emphasize the necessity of such meticulous preparation in leveraging social media to foster a supportive environment for adolescents seeking mental health help. Our approach and ongoing adjustments offer guidance for future initiatives aimed at promoting the well-being of young digital users. [ABSTRACT FROM AUTHOR]

Pediatric and adolescent gynecology (PAG) is a unique subspecialty for which accessible educational resources and clinical exposure have historically been limited; surveys show that trainees in both obstetrics and gynecology and pediatrics agree. In 2014, the North American Society for Pediatric and Adolescent Gynecology (NASPAG) introduced PAG WebEd, an original and interactive online case-based curriculum designed to bridge this learning gap. As of 2023, there are 35 published PAG WebEd clinical cases with key learning points that present, test, and discuss a variety of current PAG topics. The NASPAG Resident Education Committee (REC) compiled and reviewed administrative data from the module platform to investigate trainee utilization and performance. The activity data and assessment scores for 161 registered users are included and reported in this article. This brief report highlights that a relatively small number of medical trainees use PAG WebEd and aims to raise awareness of this resource through publication. There is potential for many more users to benefit from this resource; its efficacy as an examination and clinical practice tool could also be measured. The NASPAG REC hopes to ultimately show, with increased utilization, that PAG WebEd deserves to be a key piece of PAG-focused medical education. For PAG WebEd information and faculty registration, as well as a link that allows faculty to submit new learners, please visit https://www.naspag.org/pagwebed-information. [ABSTRACT FROM AUTHOR]

It is widely acknowledged that patients with cancer commonly experience malnutrition, and some individuals may adopt specific dietary trends. This study investigated the prevalence of malnutrition and dietary trends among Algerian cancer outpatients undergoing chemotherapy. This cross-sectional, descriptive study was conducted from January to October 2023 with 71 cancer outpatients undergoing chemotherapy. Malnutrition risk was evaluated using the Malnutrition Screening Tool (MST). The questionnaire also collected the occurrence of nutrition impact symptoms, the avoidance of specific food groups, and the use of oral nutritional supplements and dietary supplements. Malnutrition risk was identified in 57.7% (41 cases) of participants. Nutrition impact symptoms were reported by 59.2% (42 cases) of patients. A total of 36 of the patients (50.7%) altered their eating habits by avoiding at least one food group. Among malnourished cancer outpatients, only five used oral nutritional supplements. Dietary supplements were used by 23.9% (27/71) of the patients after cancer diagnosis. Our findings underscore the necessity for a systematic malnutrition assessment in cancer patients. Qualified clinicians should provide nutritional awareness to enhance the quality of life for these patients. [ABSTRACT FROM AUTHOR]

• Vitamin D is one of the most widely used drugs. • Large use of vitamin D in prevention leads to therapeutic inappropriateness. • Governments must adopt policies without wasting public resources. At the Asl Napoli 3 SUD a local, regional and national level analysis of prescription and spending related to the prescription and dispensing of drugs intended to increase vitamin D levels in the human body was carried out. The Italian Pharmacy Regulatory Agency (AIFA) in late 2019 introduced a prescriptive note of appropriateness (note 96) to regulate the prescribing activity of a drug that is widely used on the Italian national population, significantly affecting spending by the National Health System (NHS). Despite this action there has been an increase in prescription and expenditure of calcifediol at all levels of analysis (national, regional and local) while regarding the remaining Anatomical Therapeutic Chemical (ATC) referring to drugs used as vitamin D supplement in the Campania Region and at the Asl Napoli 3 SUD there is a slower decrease in expenditure and prescription, sometimes even increasing and in countertendency to the Italian national average. For these reasons, the Campania Region instituted two executive decrees (DD 405/2021 and 91/2022) that led to a marked reduction in spending and prescription in 2022 even higher than in other Italian regional realities. This analysis aims to show how vitamin D prescription is widespread and often inappropriate, attested by wide regional variability. In addition, the main recommendations for the use of these drugs are highlighted in order to raise awareness among all healthcare professionals of the informed use of these molecules ensuring sustainability and governance. [ABSTRACT FROM AUTHOR]

Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease caused by the SFTS virus (SFTSV). The Miyazaki Prefecture has the highest number of SFTS cases in Japan and requires countermeasures for prevention. In this study, we aimed to conduct an epidemiological survey in Miyazaki Prefecture to determine the exposure conditions of SFTSV by measuring the seroprevalence among residents of Miyazaki and to evaluate the factors that influence the endemicity of SFTS. The survey was conducted between June 2014 and April 2019 in all 26 municipalities in Miyazaki Prefecture. SFTSV antibodies were detected using an enzyme-linked immunosorbent assay in the blood samples of 6013 residents (3184 men and 2829 women). A questionnaire-based survey of the living environment was also conducted. Multiple logistic regression analysis revealed that age and occupation were significant factors related to the proportion of participants with an optical density (OD) value > 0.2 and a seroprevalence of 0.9 % (54/6013). Seven seropositive individuals (0.1 %) with an OD value of >0.4 were identified (three men and four women, aged 54–69 years), and all were asymptomatic. One participant had a higher OD than the positive control. Although SFTS is endemic in Miyazaki Prefecture, Japan, its seroprevalence is relatively low. Since some risk areas in Miyazaki prefecture have been identified, it is important to enhance awareness of SFTS in residences and reduce contact with ticks, especially in high-risk areas. [ABSTRACT FROM AUTHOR]

High incidences of haemorrhagic fever with renal syndrome (HFRS) have been reported in the southern Republic of Korea (ROK). A distinct southern genotype of Orthohantavirus hantanense (HTNV) was identified in Apodemus agrarius chejuensis on Jeju Island. However, its association with HFRS cases in southern ROK remains elusive. We investigated the potential of the southern HTNV genotype as an etiological agent of HFRS. Samples from 22 patients with HFRS and 193 small mammals were collected in the southern ROK. The clinical characteristics of patients infected with the southern HTNV genotype were analysed. Amplicon-based MinION sequencing was employed for southern HTNV from patients and rodents, facilitating subsequent analyses involving phylogenetics and genetic reassortment. High-throughput sequencing of HTNV exhibited higher coverage with a cycle of threshold value below 32, acquiring nearly whole-genome sequences from six patients with HFRS and seven A. agrarius samples. The phylogenetic pattern of patient-derived HTNV demonstrated genetic clustering with HTNV from Apodemus species on Jeju Island and the southern Korean peninsula, revealing genetic reassortment in a single clinical sample between the M and S segments. These findings imply that the southern HTNV genotype has the potential to induce HFRS in humans. The phylogenetic inference demonstrates the diverse and dynamic characteristics of the southern HTNV tripartite genomes. Therefore, this study highlights the significance of active surveillance and amplicon sequencing for detecting orthohantavirus infections. It also raises awareness and caution for physicians regarding the emergence of a southern HTNV genotype as a cause of HFRS in the ROK. [ABSTRACT FROM AUTHOR]

This research aims to present priority actions to improve user experience and fashion consumer design. The Partial Least Square (PLS) technique was used to do this. One hundred thirteen responses were collected for the questionnaire, and an average composite reliability of 0.86 was obtained. The model explained Intention to Use by 37.4%, while Persuasion was explained by 27.9%. Persuasion was the variable that had the most significant impact on intention to use (26.88%), demonstrating that the more persuasive a website or application is, the more likely it is to be used. This is reflected in different segments, as evidenced by campaigns to raise awareness about AIDS and the use of condoms. In addition, usefulness proved to be a crucial factor in increasing persuasiveness (20.11%), indicating that the greater the utilitarian value of the app, the more persuasive it is. Credibility is also essential, influencing both persuasiveness (7.83%) and usefulness (10.16%), with credibility questions focused on verifying whether the honesty of information can influence purchase intent and increase the perception of usefulness and credibility of the website or app. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the leading cause of death worldwide, but prevalence estimates in former professional athletes are limited. HUDDLE (Heart Health: Understanding and Diagnosing Disease by Leveraging Echocardiograms) aimed to raise awareness and estimate the prevalence of CVD and associated risk factors among members of the National Football League (NFL) Alumni Association and their families through education and screening events. HUDDLE was a multicity, cross-sectional study of NFL alumni and family members aged 50 years and older. Subjects reported their health history and participated in CVD education and screening (blood pressure, electrocardiogram, and transthoracic echocardiogram [TTE] assessments). Phone follow-up by investigators occurred 30 days postscreening to review results and recommendations. This analysis focuses on former NFL athletes. Of 498 participants screened, 57.2% (N = 285) were former NFL players, the majority of whom were African American (67.6%). The prevalence of hypertension among NFL alumni was estimated to be 89.8%, though only 37.5% reported a history of hypertension. Of 285 evaluable participants, 61.8% had structural cardiac abnormalities by TTE. Multivariable analysis showed that hypertension was a significant predictor of clinically relevant structural abnormalities on TTE. HUDDLE identified a large discrepancy between participant self-awareness and actual prevalence of CVD and risk factors, highlighting a significant opportunity for population health interventions. Structural cardiac abnormalities were observed in most participants and were independently predicted by hypertension, affirming the role of TTE for CVD screening in this population aged older than 50 years. (Heart Health: Understanding and Diagnosing Disease by Leveraging Echocardiograms [HUDDLE]; NCT05009589) [Display omitted] [ABSTRACT FROM AUTHOR]

Management of acute shoulder dislocation in the emergency department (ED) is common. This study describes the rate, risk factors, and length of stay (LOS) associated with shoulder dislocation reduction failure in the ED. The study was a retrospective case–control study of patients 18 years and older presenting to the ED with acute shoulder dislocation who underwent attempted reduction. Patients with successful reduction on post-reduction first confirmatory imaging are compared with those requiring multiple attempts. Of 398 ED encounters when a shoulder reduction was attempted in the ED, 18.8% (75/398 [95% CI 15.2–22.9%]) required multiple reduction attempts. Patients with successful reduction on first confirmatory imaging were more commonly male (80.2% [95% CI 75.6–84.3%] vs. 68.0% [95% CI 56.8–77.8%]; p = 0.0220), discharged home from the ED (95.4% [95% CI 92.6–97.3%] vs. 84.0% [95% CI 74.4–91.0%]; p = 0.0004), reduced using a traction/countertraction technique (42.1% [95% CI 36.8–47.6%] vs. 29.3% [95% CI 19.9–40.4%]; p = 0.0415), and less likely to have a pre-reduction fracture (26.0% [95% CI 21.4–31.0%] vs. 45.3% [95% CI 34.4–56.7%]; p = 0.0010). Mean length of stay (LOS) for those with successful reduction on first confirmatory imaging was 2 hours and 8 minutes shorter than for those with more than one attempt (p < 0.001). The rate of failed first-pass reduction is higher than previously reported. Furthermore, the ED LOS was significantly longer in patients requiring multiple attempts. Knowledge of the failure rate and risk factors may raise physician awareness and guide future studies evaluating approaches for verification of reduction success. [ABSTRACT FROM AUTHOR]

Vascular neurosurgery has developed significantly in Nigeria, but its burden and challenges remain unclear. This study systematically reviewed vascular neurosurgical literature from Nigeria. Four research databases and gray literature sources were searched from 1962–2021. ROBINS-I tool was used to assess risk of bias. Descriptive, narrative, and statistical analyses were conducted on all variables. Where appropriate, paired t-tests and Chi-squared independence tests were used (α = 0.05). 56 articles were included and 3203 patients pooled for analysis. Risk of bias was moderate-high. Most articles were published over the last 20 years with retrospective cohort studies and case reports being the most common study designs. The cohort had a relatively even gender split and an average age of 49 years (±22). Cerebrovascular accidents accounted for over 85% of diagnoses, with most etiologies being traumatic. Headache and motor deficit were the most prevalent clinical features. X-ray and carotid angiography were the most commonly reported imaging modalities, closely followed by computed tomography (CT) and CT angiography. The top two radiological diagnoses were ischemic cerebrovascular disease and intracerebral hematoma. Aneurysmal clipping and hematoma evacuation were the most commonly reported treatment modalities. Outcome at last follow-up was favorable in 48%. The mortality rate was 6%. Post-treatment complications included chest infection and rebleeding. This study illustrates the epidemiological burden of neurovascular pathology (based on the available data in published literature) in Nigeria, and raises awareness amongst service providers and researchers of the attendant challenges and epochal trends seen within vascular neurosurgery in Nigeria. [ABSTRACT FROM AUTHOR]

To provide an overview of medication errors (MEs) in veterinary medicine, with a focus on the perianesthetic period; to compare MEs in veterinary medicine with human anesthesia practice, and to describe factors contributing to the risk of MEs and strategies for error reduction. PubMed and CAB abstracts; search terms: [("patient safety" or "medication error∗") AND veterin∗]. Human anesthesia is recognized as having a relatively high risk of MEs. In veterinary medicine, MEs were among the most commonly reported medical error. Predisposing factors for MEs in human and veterinary anesthesia include general (e.g. distraction, fatigue, workload, supervision) and specific factors (e.g. requirement for dose calculations when dosing for body mass, using several medications within a short time period and preparing syringes ahead of time). Data on MEs are most commonly collected in self-reporting systems, which very likely underestimate the true incidence, a problem acknowledged in human medicine. Case reports have described a variety of MEs in the perianesthetic period, including prescription, preparation and administration errors. Dogs and cats were the most frequently reported species, with MEs in cats more commonly associated with harmful outcomes compared with dogs. In addition to education and raising awareness, other strategies described for reducing the risk of MEs include behavioral, communication, identification, organizational, engineering and cognitive aids. [ABSTRACT FROM AUTHOR]

Patients with encephalitis following a viral infection are often thought to have a para infectious, inflammatory, or autoimmune cause for their presentation. These diagnoses usually result in treatments with immunosuppressant therapies which can have side effects. However, there is an increasing body of evidence demonstrating that patients can have a direct genetic cause mediating viral infection triggered encephalitis, where inflammation is a secondary response. These patients may benefit not from immunosuppressive therapies, but from protection from infection through dedicated immunisation programs and early antiviral therapies at times of infection. A small case series of paediatric neurology patients (n = 2) from a single institution with infection induced encephalitis and an underlying genetic cause, is presented. Patients with a confirmed genetic cause of infection induced encephalitis were identified and consented by their treating neurologist for inclusion in this case series. Ethics approval was gained for this case series and review of the surrounding literature. A case of both DBR1 and NUP214 genetic changes resulting in infection induced encephalitis is presented. This case series raises awareness of this rare group of disorders and provides clues to their identification. Features to prompt clinician consideration of such genetic conditions are also highlighted. Although rare, identification of these patients is important due to implications on treatment, prognosis, and family planning. • Patients can have a genetic cause of infection induced encephalitis. Such conditions risk mislabelling as autoimmune encephalitis. • Consideration for genetic causes of infection induced encephalitis should be given in cases where first presentation is in the first few years of life, when neurodevelopment was abnormal prior to encephalitis, in cases of recurrence, and when criteria for autoimmune encephalitis is not met. • Patients with genetic causes of infection induced encephalitis, may benefit not from immunosuppression but from protection against infection. [ABSTRACT FROM AUTHOR]

This study utilized a project assignment task within a master's course in project management to investigate the dynamics of learning, unlearning, and adaptation in project-based environments. The assignment aimed to enhance students' understanding of effective project management, raise awareness of associated challenges, and develop crucial soft skills. The students were to plan, develop, and deliver a diverse range of products, emphasizing user value. From 34 groups, five were selected to provide representative reflections on their experiences. This study finds that in project-based tasks, learning is specific to product requirements, while unlearning is broader, impacting mainly beliefs and practices. Unlearning occurs in two forms: permanent and temporary. Permanent unlearning involves discarding outdated beliefs to facilitate deeper learning, aligning with project management literature. Temporary unlearning, however, is about setting aside current practices that don't fit the project but may be useful elsewhere. The findings underscore the importance of continuous reflection in identifying areas where unlearning might be necessary. [ABSTRACT FROM AUTHOR]

Cybersecurity has a major impact on the healthcare sector, mainly due to the sensitive data and vital medical devices that, when an attack occurs, may compromise the life, safety, and well-being of the patients. However, those institutions fail on implementing correct system protection policies and providing adequate programs for cybersecurity training and raising cybersecurity awareness. Healthcare professionals develop their academic courses focusing on providing the best care for the patients, studying guidelines, treatment protocols, and diagnostic criteria. However, there are insufficient subjects dedicated to the development of digital literacy to match the requisites of the daily challenges of those professionals, with human error being the main cause of data breaches worldwide. So, developing training programs to face the cybersecurity day-to-day threats is mandatory. Broadly speaking, traditional training programs seem to fail on retaining students' motivation, engagement, and long-term knowledge acquisition, being time-consuming and challenging in scheduling and planning. To face this situation, new techniques, such as gamification, have emerged, with promising results on motivation and engagement, allowing the users to be the center of the training programs, matching the strategy to their levels of knowledge and preferences. This paper aims to identify the existing gamified approaches available, review the state-of-the-art related to gamification and cybersecurity training, and elaborates on how they can be successfully applied to training programs for healthcare professionals. [ABSTRACT FROM AUTHOR]

Understanding how individuals utilize and perceive digital mental health interventions may improve engagement and effectiveness. To support intervention improvement, participant feedback was obtained and app use patterns were examined for a randomized clinical trial evaluating a smartphone-based intervention for individuals with bipolar disorder. App use and coaching engagement were examined (n = 124). Feedback was obtained via exit questionnaires (week 16, n = 81) and exit interviews (week 48, n = 17). On average, over 48 weeks, participants used the app for 4.4 h and engaged with the coach for 3.9 h. Participants spent the most time monitoring target behaviors and receiving adaptive feedback and the least time viewing self-assessments and skills. Participants reported that the daily check in helped increase awareness of target behaviors but expressed frustration with repetitiveness of monitoring and feedback content. Participants liked personalizing their wellness plan, but its use did not facilitate skills practice. App use declined over time which participants attributed to clinical stability, content mastery, and time commitment. Participants found the coaching supportive and motivating for app use. App engagement based on viewing time may overestimate engagement. The delay between intervention delivery and the exit interviews and low exit interview participation may introduce bias. Utilization patterns and feedback suggest that digital mental health engagement and efficacy may benefit from adaptive personalization of targets monitored combined with adaptive monitoring and feedback to support skills practice and development. Increasing engagement with supports may also be beneficial. • App use predominantly involved monitoring using the daily and weekly check-ins. • Check-ins encouraged awareness around sleep, routine, early warning signs and symptoms. • App use declined due to clinical stability, content mastery, and time constraints. • Time spent with coaches was substantial and comparable to app use. • Suicidality and functional evaluation calls highlight the need for provider involvement. [ABSTRACT FROM AUTHOR]

Cardiometabolic diseases (CMDs) increases the risk of cognitive decline, but the extent to which this can be offset by adherence to an active integrated lifestyle is unknown. This prospective study used the baseline and 2-year follow-up data of 2537 dementia-free elderly ≥60 from PINDEC Project. Lifestyle factors (including physical exercise, social interaction, leisure activities, sleep quality, smoking, and alcohol consumption) were collected and the integrated score was calculated. Participants were divided into three groups based on integrated score tertiles (inactive, ≤3 score; intermediate, 4 score; and active, ≥5). Logistic regression was used in data analysis. 35.2 % participants had 5–6 healthy components, while only 5.4 % had all 6 healthy lifestyles. The multiadjusted odds ratios (ORs, 95 % confidence interval) of early cognitive decline was 1.223 (0.799–1.871) and 1.832 (1.140–2.943) for participants with only one CMD and any two or more CMDs, respectively. An inverse dose-response relationship was found between lifestyle scores and early cognitive decline (P trend = 0.017). In participants with active lifestyle, the OR for early cognitive decline comparing the CMDs status of any two or more CMDs vs. CMDs-free was 0.778 (95%CI: 0.302–2.007). Participants with inactive lifestyle and any two or more CMDs had a near 3.4-fold increased risk of early cognitive decline than those without CMDs who had intermediate to active lifestyle (OR = 3.422, 95%CI: 1.764–6.638). Our research lacks information about nutrition. A dose–response relationship exists between CMDs status and risk of early cognitive decline. However, adherence to an active integrated lifestyle may mitigate this risk. • Lifestyle played a moderating roleon the association between CMDs status and early cognitive decline among older adults. • The association between CMDs status and early cognitive decline was attenuated in older adults with active lifestyle. • Medical staff should focus on raising awareness of the importance of brain-health-related healthy lifestyles in older adults. [ABSTRACT FROM AUTHOR]

Diabetes has evolved into a significant health concern, witnessing a rapid surge in diagnoses and fatalities. Organisations are trying to raise awareness of the dangers associated with this disease, creating prevention programmes, and reinforcing the need to adopt healthier lifestyles. Yet, there remains a scarcity of proposals and outcomes, prompting contemplation on how technology can enhance hospitals' capabilities in patient and treatment management, particularly through the early identification of individuals with potential diabetes. This article presents a study on the implementation of predictive models to improve the detection of diabetic patients, highlighting the tasks performed between feature engineering, model complexity and interpretability in the context of predictive performance, offering perspectives on future work and how it relates to the implementation of these models in clinical contexts. [ABSTRACT FROM AUTHOR]

Herein we developed an education game based on a spreadsheet- activity and virtual reality (VR) for teaching the fundamentals of gasification and combustion. The game could be used as a valuable resource to motivate students at the undergraduate and senior high school level to consider economic and environmental assessment including sustainability concerns as they design a hypothetical chemical product or process. The proposed game is intended to be incorporated into any sustainability course design or chemical engineering course. The game is suitable for both chemistry majors and non-chemistry majors as it introduces fundamental energy changes in chemical reactions and design principles. Additionally, the game can be adapted for high school outreach activities. The game is freely available and encourages students to think critically while considering several factors in making key industrial decisions about a product or process. Factors considered include the water availability, socioeconomic impact, environmental impact, and proximity of technological location to infrastructures. The game is designed to raise awareness about hydrogen as an energy carrier, including its economic aspects and its wide range of industrial applications. It could also be used as a means of recruiting students into chemical sciences and engineering degree programs. • An education game based on spreadsheet- activity and virtual reality (VR) was developed. • The game could be used to teach economic and environmental assessment of hydrogen production. • The proposed game is intended to be incorporated into any sustainability course • Game encourages students to think critically while considering several factors in making key industrial decisions [ABSTRACT FROM AUTHOR]

The aim of this discussion is to raise awareness on the danger of leaders being overtaxed when expectations are excessive; not compatible and do not correspond to leader's nature, or even when there is an excessive expectation of performance. The laboratory situation of a overwintering in Antarctica is suitable for approaching such a topic. An extensive analysis of relevant publications of the last decades on demands on station managers and general psychosocial influencing factors in such an environment clarifies a discrepancy in the scientific canon. Although such influences can affect all over-winterers, they are not considered in the description of expectations for station managers. The perception of this neglected aspect should not only be considered in the future design of expectations in ICE-regions and spaceflight, but provides a transfer to the everyday world, whether leaders are not also confronted here with expectations that are often too extensive and not individualized. • The laboratory situation of wintering in Antarctica is suitable for approaching possible excessive demands on managers. • The extensive analysis of relevant publications of the last decades on demands on station managers and general psychosocial influencing factors in such an environment illustrates a discrepancy in the scientific canon. • When expectations are excessive, incompatible and do not correspond to the nature of the manager, there is a risk of overstrain. [ABSTRACT FROM AUTHOR]

Antipsychotics (APs) are among the most widely prescribed medications, and have been shown to cause cognitive decline. But previous studies on their effects on dementia risk are controversial and scarce. We aimed to examine the relationships of APs exposure with the risk of dementia. Data were obtained from a prospective cohort of 415,100 UK Biobank (UKB) participants. We investigated the effects of APs exposure and their various classes on dementia risk by using multivariable Cox proportional hazard models and further the dose-response effects of oral APs. After a mean follow-up of 8.64 years, 5235 (1.3 %) participants developed all-cause dementia (ACD), among whom 2313 (0.6 %) developed Alzheimer's disease (AD), and 1213 (0.3 %) developed vascular dementia (VaD). Exposure to any APs conferred increased risks of ACD (HR: 1.33, 95 % CI = 1.17–1.51, P < 0.001) and VaD (HR: 1.90, 95 % CI = 1.51–2.40, P < 0.001), but not AD (HR: 1.22, 95 % CI = 1.00–1.48, P = 0.051). Cumulative dose-response relationships of oral APs with the risks of ACD and VaD were observed (P for trend, P < 0.05). Our study is observational and does not show evidence of causality. Since there are relatively few cases of dementia in the UKB, APs exposure may be higher than estimated in our study. APs exposure increased the risk of developing dementia. Dose-response relationships were found between oral APs and dementia risk. Efforts to raise awareness of doctors and patients about this potential drug-related risk are critical to reducing APs use. • Exposure to any antipsychotics (APs) conferred increased risks of dementia. • Cumulative dose-response relationships between oral APs and dementia risk existed. • Both typical and atypical APs increased dementia risk with different effect sizes. • The results were robust across a range of sensitivity analyses. [ABSTRACT FROM AUTHOR]

Augmented Reality (AR) and Virtual Reality (VR) technologies have significantly progressed in recent years, revolutionizing a diverse set of industries, mainly the industrial metaverse in cultural heritage and the cultural and creative sectors. In the context of social manufacturing, there's a pronounced need for platforms that foster collaboration. This paper introduces a collaborative AR/VR platform for social manufacturing, emphasizing the need for a co-creation environment. This platform supports real-time customized fabrication of 3D objects through rapid manufacturing within an AR/VR-based collaborative framework, further enhancing shared awareness in social manufacturing endeavors. The platform provides a robust toolkit for AR/VR applications that enables real-time interaction with virtual entities and seamless integration with the backend databases of online marketplaces. Designed to be universally adaptable, the toolkit is indifferent to the type of database it interacts with, and can function on a wide range of platforms including Web VR, Mobile AR, and HoloLens AR. A use case involving a reference chair model demonstrates the toolkit's capabilities, highlighting its potential to transform experiences within AR/VR landscapes. By offering a seamless fusion of digital content within physical environments, this AR/VR toolkit signifies a considerable advancement towards the intersection of digital and physical realities, paving the way of immersive experiences. [ABSTRACT FROM AUTHOR]

• It is important to involve alpha generation in the conservation of urban heritage as they will be the next generation responsible for its preservation. • The use of augmented reality based on serious game and GPS-guided applications has proven to be effective for heritage conservations. • This research describes a serious game based on the use of GPS-guided augmented reality in a renaissance village. It is important to involve young people in the conservation of urban heritage as they will be the next generation responsible for its preservation. The use of Augmented Reality (AR) based on Serious Game (SG) and GPS-guided applications has proven to be effective for heritage revitalisation. However, there are currently only a few applications that combine GPS AR and SG for urban heritage enhancement, and these are generally aimed at adult tourists rather than the young people of the alpha generation. This research describes a serious game based on the use of GPS-guided augmented reality in the Renaissance village of Caldana, Italy, to raise awareness of the importance of urban heritage and to stimulate its visit by the alpha generation. The application consists of a treasure hunt that children have to solve by meeting and listening in augmented reality to historical characters who built the Renaissance village at specific points of interest, following a route with increasing levels of difficulty. The application was tested using a questionnaire with a sample of 79 children. The results provide useful indications for the development of augmented reality applications to increase the awareness and attitudes of the alpha generation towards knowledge and conservation of urban heritage. [Display omitted] [ABSTRACT FROM AUTHOR]

• Carboxylic acids (CAs) have powerful antimicrobial properties, specially at low pH. • Owing to their safety record, CAs are used by industry to assure safe food consumption. • The use of some CAs as antiseptics is done but still in a limited form. • CAs can be more explored as anti-infectious agents. Carboxylic organic acids are intermediates of central carbon metabolic pathways (e.g. acetic, propionic, citric, and lactic acid) long known to have potent antimicrobial potential, mainly at acidic pHs. The food industry has been leveraging those properties for years, using many of these acids as preservatives to inhibit the growth of pathogenic and/or spoilage fungal and bacterial species. A few of these molecules (the most prominent being acetic acid) have been used as antiseptics since Hippocratic medicine, mainly to treat infected wounds in patients with burns. With the growth of antibiotic therapy, the use of carboxylic acids (and other chemical antiseptics) in clinical settings lost relevance; however, with the continuous emergence of multi-antibiotic/antifungal resistant strains, the search for alternatives has intensified. This prospective article raises awareness of the potential of carboxylic acids to control infections in clinical settings, considering not only their previous exploitation in this context (which we overview) but also the positive experience of their safe use in food preservation. At a time of great concern with antimicrobial resistance and the slow arrival of new antimicrobial therapeutics to the market, further exploration of organic acids as anti-infective molecules may pave the way to more sustainable prophylactic and therapeutic approaches. [ABSTRACT FROM AUTHOR]

The skill of reflective writing and emotional drivers of behavior is enhanced by boosting the awareness of one's feelings and emotions. Individuals having characteristic activity of reflection have more emotional quotient (EQ). EQ has more significance than intelligence quotient in personal and professional life. This study is conducted to analyze the impact of reflective writing skills on components of EQ among first-year MBBS students and to find out the impact of reflective writing between components of EQ and different levels of reflective writing skills among first-year MBBS students. An observational-analytical study was carried out for EQ self-assessment and reflections of first-year MBBS students. A paired t-test was used to check the difference between different segments of EQ. Analysis of reflections was done by modifying the REFLECT rubric method. There was a significant difference in the motivation component between pre and post-test (p-value = 0.013), whereas no significant difference was observed in other components, viz. self-awareness, empathy, self-control, self-confidence, and social competency. The average total scores among EQ domains compared were more at the level of reflection than habitual and introspection levels. Along with intelligence quotient, EQ is critical for students' overall development. The average total scores of EQ were higher among the students who had a higher level of reflection. Developing reflective writing skills had an impact on the motivation component of the EQ of the students within a short duration. [ABSTRACT FROM AUTHOR]

The decision made by machine learning is mostly based on historical data that is used to train them. It raises the awareness that discrimination in machine learning should be eliminated because it may contain societal bias. The financial industry uses credit scoring as a reference to reflect the customer risk profile. To achieve fairness in the model, this paper tries to: (1) assess bias and (2) improve fairness in machine learning models with three bias mitigation methodologies. This study depicts that there is a trade-off between improving fairness and preserving performance. Implementing post-processing methods, for example, Grid Search performs best. [ABSTRACT FROM AUTHOR]

Psychotic disorders have a strong negative impact on multiple aspects of daily life, including people's financial situation. This exploratory study examines the level of financial dissatisfaction and its correlates in a large cohort of people with psychotic disorders. Data from the first assessments of people with psychotic disorders (n = 5271) who were included in the Pharmacotherapy Monitoring and Outcome Survey (PHAMOUS; 2006–2020), which is conducted in the northern Netherlands, were used. The Manchester Short Assessment of Quality of Life (MANSA) was used to measure financial dissatisfaction. In addition, sociodemographic and psychiatric characteristics, substance use and global and social functioning were assessed. One-fifth to one-third of people with psychotic disorders report financial dissatisfaction, fluctuating over the year in which they were assessed. These proportions are considerably higher than in the general population. Cannabis and other substance use were associated with higher levels of financial dissatisfaction (small to medium effect). The other significant associations showed (very) small effect sizes. Therefore, we conclude that financial dissatisfaction in people with psychotic disorders appears to be relatively independent of other demographic and psychiatric characteristics, and global and social functioning. These findings are an important first step for increasing knowledge on financial dissatisfaction among people with psychotic disorders. The findings can also contribute to raising awareness about the topic for healthcare professionals working in this field. [ABSTRACT FROM AUTHOR]

Understanding the distribution of the willingness-to-pay (WTP) to reduce travel time or other unpleasant travel attributes experienced by travellers is crucial to making well-informed choices about infrastructure investments and the pricing of services. Given multimodality, heavy tails, and the impact of averaging errors in the classical parametric distribution-based analysis of WTP, this study compares WTP distributions across six distinct datasets using a range of model specifications, including multinomial logit (MNL), mixed logit (MMNL) and nonparametric logit mixed logit (LML). The models are estimated directly in willingness-to-pay space, highlighting that WTP is not uniformly distributed with a high likelihood of having a multi-modal distribution across the population. The findings confirm the intuition on the presence of negative WTP for some undesirable travel attributes. This study raises awareness among transport researchers, modellers, and authorities about using the correct WTP distributions in practice. It adds some empirical evidence regarding the true underlying WTP distribution of various travel attributes to the transport literature. • Willingness to pay (WTP) distributions for various travel attributes across six datasets are empirically investigated. • Multinomial logit, mixed logit, and non-parametric logit mixed logit (LML) models are estimated in WTP space. • The estimated flexible WTP distributions generally differ from the parametric distributions assumed in mixed logit model. • The estimated flexible WTP distributions reveal multimodality and showcase individuals with negative WTP values. • Among users, the percentage with WTP values above the mean varies across travel attributes, typically staying below 50%. [ABSTRACT FROM AUTHOR]

Phlebotomine sand flies (Diptera: Phlebotominae) are vectors of human and animal pathogens, including Leishmania species protozoan parasites and viruses of the genus Phlebovirus. In Europe, visceral zoonotic leishmaniasis caused by Leishmania infantum , a deadly disease when left untreated, is endemic in southern countries, and dogs are the main reservoir hosts for human infection. Most phleboviruses cause asymptomatic infections or flu-like syndromes in humans, but Toscana phlebovirus can cause meningitis and encephalitis. These diseases are likely to re-emerge, posing a growing threat to public and animal health. Potential triggers include the movement of humans and dogs, increasing numbers of immunosuppressive conditions, climate change and other human-mediated environmental changes. An overview of the main epidemiological characteristics of the pathogens transmitted by sand flies in Europe and the potential triggers involved in their emergence and re-emergence are reviewed here. There is a need to implement mandatory notification of human and canine leishmaniases and human phleboviruses and coordinated epidemiological surveillance programmes at a European level, and to raise awareness among healthcare professionals and citizens about sand fly-borne diseases, following a One Health approach. [Display omitted] [ABSTRACT FROM AUTHOR]

Growing awareness of the need to enhance environmental performance resonates across various industrial sectors. However, efforts toward sustainability remain inadequate, especially given the pressing issue of Climate Change. To address this, this paper introduces a novel preliminary approach grounded in Lean Thinking principles, featuring a structured three-step process enhanced with visual tools. Step one involves pinpointing the green sustainability measures and their deployment locations, facilitating the identification of urgent actions. Step two delves into identifying potential barriers that could hinder measure adoption, resulting in a refined set of implementable actions for greater improvements. Finally, in the third step, we select and prioritize the most viable measures, accounting for case-specific factors like costs and their impact on environmental performance. This study culminates in a real-world application within a luxury plywood production company, illustrating the framework's ability to align environmental objectives with economic success by avoiding unprofitable choices. [ABSTRACT FROM AUTHOR]

The introduction of the Euro 7 emission standard is expected to significantly change the typology of the European passenger car. This study analyzes the environmental impact resulting from future trends in fleet composition and proposes an innovative vehicle classification system focused on raising consumer awareness of the importance of their choices with regard to key attributes such as body type, engine power and vehicle weight. A sensitivity analysis of the fleet's greenhouse gas emissions to deviations in their composition is carried out, considering the preferences expressed by the consumers in 2022 and the vehicle's specifications reported by the automotive industry on European digital platforms embodying Industry 4.0 principles. The findings show that internal combustion fleet emissions are expected to rise 0.30% per 1% increase in engine power and 0.44% to 0.69% per 1% increase in weight, according to the Worldwide Harmonised Light Vehicle Test Procedure (WLTP). The plug-in electric vehicle (PHEV) segment is the fastest growing in terms of market share. This trend will continue in the future, as this is the segment best suited to comply with the emissions targets imposed on manufacturers. Another relevant conclusion is that the environmental impact of PHEV vehicles is potentially very negative if the drivers' charging habits do not reflect the manufacturer's design intention. Thus, the development of consumer environmental awareness tools is urgent. This is the study's main motivation: to develop a tool in the scope of the Industry 4.0 while promoting the emergent concept of Industry 5.0, sustainability based and human-centered. [ABSTRACT FROM AUTHOR]

Abnormal movements are intrinsic to some forms of endogenous psychoses. Spontaneous dyskinesias are observed in drug-naïve first-episode patients and at-risk subjects. However, recent descriptions of spontaneous dyskinesias may actually represent the rediscovery of a more complex phenomenon, 'parakinesia' which was described and documented in extensive cinematographic recordings and long-term observations by German and French neuropsychiatrists decades before the introduction of antipsychotics. With the emergence of drug induced movement disorders, the description of parakinesia has been refined to emphasize the features enabling differential diagnosis with tardive dyskinesia. Unfortunately, parakinesia was largely neglected by mainstream psychiatry to the point of being almost absent from the English-language literature. With the renewed interest in motor phenomena intrinsic to SSD, it was timely not only to raise awareness of parakinesia, but also to propose a scientifically usable definition for this phenomenon. Therefore, we conducted a Delphi consensus exercise with clinicians familiar with the concept of parakinesia. The original concept was separated into hyperkinetic parakinesia (HPk) as dyskinetic-like expressive movements and parakinetic psychomotricity (PPM), i.e., patient's departing from the patient's normal motion style. HPk prevails on the upper part of the face and body, resembling expressive and reactive gestures that not only occur inappropriately but also appear distorted. Abnormal movements vary in intensity depending on the level of psychomotor arousal and are thus abated by antipsychotics. HPk frequently co-occurs with PPM, in which gestures and mimics lose their naturalness and become awkward, disharmonious, stiff, mannered, and bizarre. Patients are never spontaneously aware of HPk or PPM, and the movements are never experienced as self-dystonic or self-alien. HPk and PPM are highly specific to endogenous psychoses, in which they are acquired and progressive, giving them prognostic value. Their differential diagnoses and correspondences with current international concepts are discussed. [ABSTRACT FROM AUTHOR]