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Tuktuk, as a generalized connotation, serves as a widely used vehicle for urban transportation, adapted from Thailand by the Philippines. The creation of the electric-typed public vehicle has now been recognized as one of the modalities of public transportations, the etuktuk. This study investigated the factors influencing passengers’ intention to use etuktuks as a mode of transportation in the Philippines by integrating the Theory of Planned Behavior with higher-order SERVQUAL dimensions. The objective was to understand how service qualities, attitudes, subjective norms, and perceived behavioral control impact passenger satisfaction and intention to use etuktuks. Data were collected from 501 respondents who had used etuktuks and were analyzed using partial least square structural equation modeling. The findings revealed that assurance, empathy, reliability, tangibility, and responsiveness significantly affected passenger satisfaction and intentions, with assurance being the most influential factor. Conversely, tangibles, such as the physical attributes of the etuktuk, were the least significant in shaping passenger preferences. Notably, a negative significant effect was observed between service quality and behavioral intention, indicating that while passengers are generally satisfied with etuktuk services, they may opt for alternative transportation options when available. These results highlight the need for improvements in etuktuk services, particularly in enhancing comfort, safety, and accessibility. Such improvements are crucial for encouraging wider adoption of etuktuks and fostering cleaner, more sustainable urban environments. By addressing the identified service quality issues and leveraging the research findings, stakeholders can better support the transition to more environmentally friendly and efficient transportation options.

The internet and digital technologies pose new specific challenges to competent authorities, whose activity fields are limited to their own jurisdictions. Consequently, these authorities must operate a system of controls adapted to online sites and e-sales, and official control must be strengthened. To address these challenges and protect consumers from misleading practices that can lead to the consumption of unsafe food, it is necessary to adapt official controls to new distance-selling techniques. The food inspection scheme as conceived in the European legal system cannot be easily applied to online food sales. To this purpose, the competent authorities need to equip themselves to guarantee effective control and compliance with the European Union laws regarding food sold online. It emerged that there are different levels of non-compliance with online food: the non-registration of the food business operator (registrant) and the non-compliance with the obligations as the law prescribes (obligations on food hygiene, electronic commerce, and information to consumers about the food). The focus of this survey on the distance sale of dairy products in Modena Local Competent Authority territory is on the pattern suggested by the Food Standards Agency in 2016. This analysis is based on two different phases. The first one is the study of the websites, and the second one is the physical visit to the address of the online food business. This survey shows how to collect the first phase's data and organize the official controls.

Effective evaluation of technological and operational approaches to reduce entrainment of marine organisms at cooling water intake structures (CWIS) requires accurate organism-sensing systems. Current detection methods lead to large temporal data gaps, require tedious manual analysis, and are fatal to organisms. Here, we describe integrating deep learning with a non-lethal, non-intrusive imaging method--digital holography--to rapidly detect fish larvae. Laboratory experiments demonstrated that the instrument could successfully image fish larvae at flow rates exceeding ranges seen in CWIS. Holograms of two fish larvae species, in the presence of bubbles and detritus, were collected to build a large database for training a lightweight convolutional neural network. The model achieves 97% extraction accuracy in quantifying larvae, and distinguishing them from other particles, including detritus and bubbles, when applied to a dataset of manually classified images, exceeding previous metrics for non-lethal, accurate, and real-time detection. These results demonstrate the potential of in situ holographic imaging for monitoring endangered larval fish species at power plant intake structures, and for high-fidelity, real-time applications in monitoring aquatic ichthyoplankton. Key words: digital inline holography, deep learning, real-time detection, ichthyoplankton, endangered species, Introduction In coastal regions, cooling water intake structures (CWIS; e.g., steam-generating electric facilities) in power plants could harm aquatic species and affect their behavior (Kennish 1992; Maes et al. 2004). [...]

Treatment of the disorders affecting skull base and craniovertebral junction (С1-С2, C1-C3) associated with craniovertebral instability is an unresolved issue of modern neurosurgery. Patients are often denied surgical care due to the disorder complexity, and treatment is limited to conservative methods (cervical collar, halo apparatus) that are palliative in nature. Patients with craniovertebral pathology have been considered to be radically inoperable until recently. Advanced methods for treatment of patients with various disorders affecting skull base and craniovertebral junction are used and developed in the Burdenko Neurosurgical Center.

Abstract Background Providing relevant knowledge to empower all pregnant women diagnosed and nondiagnosed with tuberculosis (TB) is essential worldwide. Proper dissemination of health information for pregnant women could assist in preventing TB complications amongst women and babies. The study aimed to describe the sources of knowledge that empower pregnant women diagnosed with TB and improve their quality of life in Limpopo Province, South Africa. Methodology The study followed a qualitative, exploratory and descriptive research design. The study was conducted in 12 selected primary healthcare facilities in three crisis districts. Thirty‐five pregnant women with TB disease were purposively selected, and face‐to‐face interviews were conducted to generate data, which were analysed using the thematic approach. Measures to ensure trustworthiness and ethical standards were adhered to. Results The findings of this study revealed that healthcare workers, community stakeholders, and TB ambassadors are the primary sources of knowledge dissemination for capacitating women diagnosed with TB. Conclusion Most pregnant women lacked knowledge regarding TB ambassadors as sources of information for empowering women, community awareness campaigns, and Google searches as sources of information sharing. All stakeholders need to work together, considering the patients' charter for TB care that sets out the right for respect and information sharing. The emphasis of this study was on developing a comprehensive educational intervention that could assist in improving the quality of TB services offered to pregnant women.

Rapid urbanization has exerted pressure for development on public transportation infrastructure. The rise in population has driven consumers to seek efficient, cost-effective, and environmentally sustainable transportation. The objective of this study was to assess the determinants influencing consumers’ behavioral intention and acceptance of utilizing electric public transportation. The integrated UTAUT2 and sustainable theory of planned behavior underwent a higher-order construct using partial least squares structural equation modeling analysis to thoroughly evaluate key factors influencing the intention to accept electric public transportation. The study utilized a 55-item questionnaire distributed to 438 respondents. The findings indicated that the domains of UTAUT2 had the most significant effect, with hedonic motivation as the predominant variable, followed by effort expectancy and performance expectancy. This study indicated hedonic motivation as the primary factor influencing the intention to use electric public transportation, followed by effort expectancy. This study highlights the importance of ensuring user-friendly and convenient experience in the design and delivery of electric public transportation services. Substantial implications, both theoretical and practical, are also posited. Considering the impactful variables, this study deduced that the government, transportation sectors, and electric vehicle developers should place increased emphasis on enhancing customers’ intention to accept and use public transport in a sustainable manner.

This study evaluated the effectiveness of the reverse repurchase (RRP) rate as the main monetary policy instrument of the Bangko Sentral ng Pilipinas in affecting selected monetary policy indicators, particularly output gap, inflation, and nominal exchange rate, through a modified New Keynesian monetary policy model using vector autoregression (VAR). The results showed that changes in the RRP rate affects output gap, inflation, and nominal exchange rate, albeit not statistically significant. In addition, the “price puzzle” was seen in the results. This pertains to an increase in inflation after monetary policy contraction which is in contrast with the standard monetary policy theory.

Tuktuk, as a generalized connotation, serves as a widely used vehicle for urban transportation, adapted from Thailand by the Philippines. The creation of the electric-typed public vehicle has now been recognized as one of the modalities of public transportations, the etuktuk. This study investigated the factors influencing passengers' intention to use etuktuks as a mode of transportation in the Philippines by integrating the Theory of Planned Behavior with higher-order SERVQUAL dimensions. The objective was to understand how service qualities, attitudes, subjective norms, and perceived behavioral control impact passenger satisfaction and intention to use etuktuks. Data were collected from 501 respondents who had used etuktuks and were analyzed using partial least square structural equation modeling. The findings revealed that assurance, empathy, reliability, tangibility, and responsiveness significantly affected passenger satisfaction and intentions, with assurance being the most influential factor. Conversely, tangibles, such as the physical attributes of the etuktuk, were the least significant in shaping passenger preferences. Notably, a negative significant effect was observed between service quality and behavioral intention, indicating that while passengers are generally satisfied with etuktuk services, they may opt for alternative transportation options when available. These results highlight the need for improvements in etuktuk services, particularly in enhancing comfort, safety, and accessibility. Such improvements are crucial for encouraging wider adoption of etuktuks and fostering cleaner, more sustainable urban environments. By addressing the identified service quality issues and leveraging the research findings, stakeholders can better support the transition to more environmentally friendly and efficient transportation options. [ABSTRACT FROM AUTHOR]

ObjectiveTo provide estimates on the regional and national burden of tracheal, bronchus, and lung (TBL) cancer and its attributable risk factors from 1990 to 2019 in the North Africa and Middle East (NAME) region.Methods and materialsThe Global Burden of Disease (GBD) 2019 data were used. Disability-adjusted life years (DALYs), death, incidence, and prevalence rates were categorized by sex and age groups in the NAME region, in 21 countries, from 1990 to 2019. Decomposition analysis was performed to calculate the proportion of responsible factors in the emergence of new cases. Data are presented as point estimates with their 95% uncertainty intervals (UIs).ResultsIn the NAME region, TBL cancer caused 15,396 and 57,114 deaths in women and men, respectively, in 2019. The age-standardized incidence rate (ASIR) increased by 0.7% (95% UI -20.6 to 24.1) and reached 16.8 per 100,000 (14.9 to 19.0) in 2019. All the age-standardized indices had a decreasing trend in men and an increasing trend in women from 1990 to 2019. Turkey (34.9 per 100,000 [27.6 to 43.5]) and Sudan (8.0 per 100,000 [5.2 to 12.5]) had the highest and lowest age-standardized prevalence rates (ASPRs) in 2019, respectively. The highest and lowest absolute slopes of change in ASPR, from 1990 to 2019, were seen in Bahrain (-50.0% (-63.6 to -31.7)) and the United Arab Emirates (-1.2% (-34.1 to 53.8)), respectively. The number of deaths attributable to risk factors was 58,816 (51,709 to 67,323) in 2019 and increased by 136.5%. Decomposition analysis showed that population growth and age structure change positively contributed to new incident cases. More than 80% of DALYs could be decreased by controlling risk factors, particularly tobacco use.ConclusionThe incidence, prevalence, and DALY rates of TBL cancer increased, and the death rate remained unchanged from 1990 to 2019. All the indices and contribution of risk factors decreased in men but increased in women. Tobacco is still the leading risk factor. Early diagnosis and tobacco cessation policies should be improved.

BackgroundSex work is a global driver of the HIV epidemic, and the risk of acquiring HIV is 13 times higher for female sex workers (FSWs) compared to the general population. The enrollment and retention of FSWs in HIV care is a challenge and has been a major contributing factor to increased new HIV infections.MethodsWe conducted a qualitative study among 30 FSWs and 21 healthcare workers (HCWs) working in antiretroviral therapy (ART) clinics at the selected three primary health facilities in Mbarara City, Southwestern Uganda. The study participants were enrolled by both purposive and snowball sampling techniques. We obtained informed consent from all the participants, and data were collected using in-depth interviews and thematically analyzed.ResultsThree themes emerged as facilitators toward enrollment and retention of FSWs into HIV care, namely, (1) good health living, (2) receptive HCWs and availability of health services, and (3) community outreach services and peer support. The barriers are summarized into four major themes: (1) stigma, community discrimination, and beliefs; (2) social obstacles; (3) adverse effects of ART; and (4) inadequate services at the health facilities.ConclusionFSWs are challenged by unsupportive environments and communities where they live and work, which hinders their enrollment and retention in HIV care. Creating awareness of the utilization of HIV care services and extending such services to hotspot communities could enhance the response of HIV-positive FSWs to ART.

ObjectivesSubvalvular aortic stenosis (SAS) can occur as discrete or tunnel-like obstruction of the left ventricular outflow tract and as progressive disease often leads to aortic valve regurgitation. We report our 30-year single-center experience after surgical repair of SAS.MethodsA retrospective chart review of all patients aged < 18 years, who underwent surgical repair of SAS from May 1985 to April 2020, was conducted. Mortality was cross-checked with the national health insurance database (93.8% complete mortality follow-up in April 2020). Survival and competing risks analysis were used to analyze the primary endpoints survival and incidence of reoperations.ResultsFrom May 1985 until April 2020 103 patients (median age 5.5 years) underwent surgical repair of SAS. Survival was 90.8% at 10 years and 88.7% at 20 and 30 years. Age < 1 year at time of surgery, Shone’s complex, mitral stenosis and concomitant mitral valve surgery were associated with mortality. The cumulative incidence of reoperation for SAS was 21.6% at 10 years, 28.2% at 20 and 30 years. The incidence of reoperation for SAS did not differ between the myectomy, membrane resection and combined myectomy and membrane resection groups. The cumulative incidence of reoperation on the aortic valve was 13.5% at 20 years.ConclusionRecurrence rate of SAS is not to be neglected, though surgical repair of subaortic stenosis has good long-term results. Patients who needed a combined membrane resection and septal myectomy are not more prone to recurrence than patients who underwent solitaire myectomy or membrane resection.

Abstract Background The choice of aortic valve replacement needs to be decided in an interdisciplinary approach and together with the patients and their families regarding the need for re-operation and risks accompanying anticoagulation. We report long-term outcomes after different AVR options. Methods A chart review of patients aged

Abstract Background Neonates and small infants with congenital cardiac disease undergoing cardiac surgery represent major challenges facing paediatric anaesthesia and perioperative medicine. Aims. We here aimed to investigate the success rates in performing ultrasound (US) guided central venous catheter insertion (CVC) in neonates and small infants undergoing cardiac surgery, and to evaluate the practicability and feasibility of thereby using a novel wireless US transducer (WUST). Methods Thirty neonates and small infants with a maximum body weight of 10 kg and need for CVC before cardiac surgery were included in this observational trial and were subdivided into two groups according to their weight:

This study used a qualitative approach to analyze ideal images of educational leadership among administrators in Mexico City and South Texas. Looking at educational leadership from a cross-cultural perspective revealed issues that are hidden when working in just one culture. Though both groups indicated that participation, clear communication, planned change, and attention to values were components of their best leadership experiences, there were subtle differences in how they discussed each dimension.