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Background: Although the prescription of physical activity in clinical care has been advocated worldwide, in the Netherlands, "Exercise is Medicine" (E = M) is not yet routinely implemented in clinical care. Methods: A set of implementation strategies was pilot implemented to test its feasibility for use in routine care by clinicians in 2 departments of a university medical center. An extensive learning process evaluation was performed, using structured mixed methods methodology, in accordance with the Reach, Effect, Adoption, Implementation, and Maintenance framework. Results: From 5 implementation strategies employed (education, E = M tool embedded in the electronic medical records, lifestyle coach situated within the department, overviews of referral options, and project support), the presence of adequate project support was a strong facilitator of the implementation of E = M. Also, the presence of the lifestyle coach within the department seemed essential for referral rate. Although clinicians appreciated the E = M tool, barriers hampered its use in practice. Conclusions: Specific implementation strategies, tailored to the setting, are effective in facilitating the implementation of E = M with specific regard to education for clinicians on E = M, deployment of a lifestyle coach within a department, and project coordination. Care providers do see a future for lifestyle coaches who are structurally embedded in the hospital, to whom they can easily refer. [ABSTRACT FROM AUTHOR]

Objective: The goal of the present study was to determine whether using gamification with the flexibility of board game design to prepare aviation cadets for future flight training could reduce their fatigue and stress from work overload and thereby decrease risk of human error leading to accidents. Background: Cadets need to have fully acquired aviation knowledge so as be able to access it spontaneously in decision-making when operating an aircraft and performing multi-tasks. The current tight training schedule and the need to immediately apply newly learned knowledge add considerable stress to the fatigue resulting from highly demanding physical training. Method: A board game involving specific content, rules, and contexts and incorporating competition and collaboration was designed. Results: The results showed that the learning effect of the game group was at least the same as, if not better than, traditional self-study. Both groups of cadets could retrieve their learning after two months. The game group was significantly more positive in their responses to the flow survey and expressed being in favor of learning by playing board games in the interviews. Conclusion: The findings suggest the feasibility of adjusting the current pilot training program by adopting game-based learning of aviation knowledge at an early stage for future use. [ABSTRACT FROM AUTHOR]

AbstractDepression is the most prevalent mental disorder in the population worldwide. A systematic review of meaning-based psychotherapies (MBPs) for depression has shown their efficacy in improving depression. However, to date, all the studies on the efficacy of MBP have been carried out in English-speaking countries. The construction of meaning in life depends on cultural, social, and religious factors, and so it is necessary to adapt MBPs and verify their effectiveness in samples that speak languages other than English, such as Spanish. The aim of the study reported was to analyze the feasibility of MBPs in Spanish participants with depression. The sample was composed of 30 participants who met the DSM5 criteria for depressive disorders, 20 of whom completed MBP. Qualitative and quantitative outcomes were measured. The participants indicated that MBP was useful, that they were very satisfied with the intervention, and that they would highly recommend it to other people with depression. At the end of the treatment, there was a reduction in depression and anxiety and an increase of meaning in life. The change in depression was highly associated with the change in meaning in life. MBP is a feasible intervention for Spanish participants with depression. [ABSTRACT FROM AUTHOR]

Background: Though evidence-based research about system constellations (SCs) appears marginal, it is applied in many psychiatric, psychological, and psychotherapeutic institutions as well as in different contexts of organizational counseling. To date, only one randomized controlled trial (RCT) has been conducted to assess the short- to long-term efficacy of SCs, which entail clients meeting at the same location in person. This study is to investigate the feasibility of a RCT investigating SCs in virtual reality (VR), and to calculate the number of clients needed for a confirmatory RCT. Design: We will perform a prospective, monocentric, parallel-group, feasibility RCT with subsequent intervention. A total of 128 clients of 3-day group-based SC-VR seminars will be randomized to either the intervention group (IG; n = 64) or wait-list group (WLG; n = 64), which receives SCs in VR after 4 months. Feasibility and acceptability of the (1) research methodology and (2) intervention as well as the (3) estimation of effect sizes will be assessed using qualitative and quantitative data. Based on the model of a general mental health, the proposed primary outcome includes the SC-VR adherence, and the proposed secondary outcomes refer to psychological functioning (OQ-45.2), social system functioning (EXIS), psychological distress (FEP-2), motivational incongruence (INK-SF), and goal attainment (GAS). We plan to investigate the short-term efficacy at 2-week and 4-month follow-up within the RCT design (n = 128), and mid-term efficacy at 8- and 12-month follow-up for the intervention group (n = 64). Discussion: The study is expected to be the first study on the feasibility of SC-VR. We will reflect on successfully implemented study procedures, and we will provide recommendations for changes considering the design, rationale, analyses, and interpretation of the study results where they became necessary. The discussion will conclude with an evaluation whether a confirmatory RCT on SC-VR is worth the investment of future resources, including the calculated number of clients needed based on the efficacy trends derived from this feasibility study. Trial registration: ClinicalTrials.gov: ID = N CT05557890; date of registration: September 23, 2022; https://clinicaltrials.gov/ct2/show/NCT05557890. [ABSTRACT FROM AUTHOR]

In next-generation communication systems, Filter Bank Multicarrier with Offset Quadrature Amplitude Modulation (FBMC/OQAM) has emerged as a promising alternative to Orthogonal Frequency Division Multiplexing (OFDM), offering enhanced robustness in multipath channels. However, like OFDM, FBMC/OQAM is susceptible to Carrier Frequency Offset (CFO), which can cause inter-carrier interference and performance degradation. This paper proposes a novel solution to the critical challenge of joint CFO and channel estimation in multipath fading environments. We propose a novel estimator that leverages a strategically designed training sequence within each frame's header. This sequence, comprising pilot symbols and Zero-FBMC symbols (ZFBMC), significantly improves the accuracy of joint estimation. To reduce computational complexity, we introduce an iterative algorithm based on Taylor approximation for CFO estimation. Extensive simulations demonstrate that our proposed estimators asymptotically approach the Cramer-Rao bound (CRB) for both joint CFO and channel estimation. Moreover, in scenarios with perfect CFO synchronization, our channel estimation method achieves near-optimal performance. These results underscore the effectiveness of our approach in enhancing FBMC/OQAM system performance, paving the way for its implementation in future communication networks. [ABSTRACT FROM AUTHOR]

In developing countries, value chains for many crops are underdeveloped, leading to low producer prices and poor quality produce. Value chain research using secondary data is made difficult by selection problems, whereas experimental research is logistically very difficult and lacks external validity. With the intention of conducting a field experiment, we piloted an intervention connecting smallholder groundnut farmers in Ghana to a premium groundnut processor through aggregators. While we successfully delivered inputs and training to farmers, we failed in our attempts to link aggregators with downstream processors over two growing seasons. In this paper, we situate the challenges we faced in the broader literature on value chains and identify three problems that prevented us from establishing a value chain for high quality groundnuts: uncertainty, cash constraints, and trust. To help inform future research on this topic, we propose three specific interventions that could mitigate these problems. [ABSTRACT FROM AUTHOR]

Objective: Eating disorders are complex illnesses with high morbidity and mortality. Yet, there is promising evidence to support the effects of nutrition on the brain and behaviour. One proposed example is the use of tyrosine as an adjunct treatment in anorexia nervosa (AN). However, recruitment and retention in eating disorder clinical trials has posed difficulties for researchers. The aim of this study was to pilot test a parallel randomised controlled trial (RCT) of tyrosine supplementation to explore the feasibility of recruitment and retention, intervention adherence and data collection methods from the perspective of participants and researchers. Method: Feasibility was assessed using numbers participating, questionnaire completion in patients and parent/carers completing and declining participation, a researcher implementation record and clinical measures. Subjects included adolescents aged 12–17 years with AN. The study was conducted over a 12-week period, with the intervention group receiving 5 mg of L-tyrosine supplement and the control group receiving a placebo. Results: Recruitment targets were not met and recruitment to a full RCT based on the current study protocol and recruitment sites did not prove feasible. Of the 39 approached for RCT participation, seven were recruited to the RCT (18% response rate) despite extending recruitment periods, with 100% retained and analysed. Patients or parents/carers identified barriers to study participation including burden, the need to consume tyrosine as tablets, and the use of blood, urine and psychological testing. Blood tyrosine rose markedly for subjects in the intervention group. No side effects were reported or measured. Conclusions: This study offers a unique exploration of the feasibility of a tyrosine trial in anorexia nervosa and is of relevance to assist the success of future nutrition trials. Exploring the suitability of future study designs for nutrition intervention research is warranted. Plain English Summary: Eating disorders are serious mental illnesses and exploration of effective treatments are required as a priority. This study explored whether using of a dietary protein (tyrosine) in supplement form added to usual treatment appeared feasible and acceptable to study participants. Study components perceived as potential barriers included use of tyrosine capsules as well as physical and psychological testing. Exploring suitable future study designs for nutrition intervention research with people with an eating disorder and parents/carers is required. [ABSTRACT FROM AUTHOR]

Introduction: Reconciling economic development and emission reduction of polluting gases requires balancing long-term and short-term goals across various markets. As a new production cost, the price of carbon allowances is assumed to affect the supply and demand of carbon-intensive sectors. Therefore, this study examines the dynamic price spillover effects between China as the largest carbon emission market and the carbon-intensive building materials industry in a unified time-frequency framework. Methods: This study measures the dynamic overall and directional spillover effects of carbon and building materials markets in three frequency bands, considering eight carbon pilots and the national carbon market in China and four important building materials. Results: The empirical results show that the bi-directional spillover between carbon and the building materials market shows pronounced characteristics in the time-frequency domain, especially in the short-term frequency band of one day to one week, with strong connectivity. After the launch of the national carbon market, the information spillover from the building materials market to the carbon pilots become stronger. Both the carbon pilots and the national carbon market have significant short- and long-term impacts on the building materials market. In addition, there are differences in the impact of carbon markets on various types of carbon intensive building materials. Discussion: Compliance cycles in carbon markets are likely to induce sharp fluctuations in spillovers between the two markets. Therefore, balancing industrial development and stabilizing carbon prices requires a refined policy design that considers the diversified impacts of carbon markets on different industries at across frequencies. [ABSTRACT FROM AUTHOR]

Background: In the United States (US), transgender women of color experience cyclical, interlocking systems of structural and institutional oppression rooted in racism and transphobia, which fuel economic vulnerability. Together, cycles of intersecting racism, transphobia, and economic vulnerability create conditions that give rise to extreme HIV inequities among transgender women of color. Microeconomic interventions — designed to improve financial standing by increasing income generation and access to financial resources through entrepreneurship, cash transfers, and training — have the potential to address structural factors underlying HIV inequities. Over the past few years, several trans-led organizations, including the Trans Sistas of Color Project, have integrated microeconomic strategies, specifically emergency assistance, into their programming. The aim of the current study is to conduct a pilot randomized controlled trial (RCT) to evaluate the feasibility and acceptability of a definitive subsequent RCT and explore initial evidence of an enhanced microeconomic intervention to increase income generation and improve HIV prevention and care continua outcomes. Methods: This is a two-arm waitlist randomized controlled trial in which transgender women of color will be randomly allocated to either usual care that includes the Trans Sistas of Color Project's existing microeconomic interventions, which includes the following: (1) US $250 in emergency assistance and (2) peer support to obtain legal gender affirmation (i.e., legal name and gender markers on identification documents) or the enhanced microeconomic intervention that includes usual care and will be enhanced to include the following: (1) 12 weekly educational group sessions on economic empowerment (i.e., job acquisition, income generation through micro-business, and financial literacy) and HIV prevention and care, (2) employment-focused mentoring, and (3) an unconditional grant (US $1200) for use towards acquiring self-led or formal employment. Participants in each condition will complete a baseline survey prior to randomization, a follow-up survey immediately following intervention completion, and 3-month survey after intervention completion. Participants will also complete qualitative exit interviews within 1 month of intervention completion for both conditions. Discussion: This study will be one of the first US-based pilot randomized clinical trials that builds upon existing community-led solutions to economic vulnerability to address HIV inequities. Findings will provide the necessary groundwork to examine intervention effectiveness in a future large-scale trial. Trials registration: NCT06212544. Protocol version: September 25, 2024, version 2. [ABSTRACT FROM AUTHOR]

This pilot study assessed text messaging as an early intervention for preventing pressure ulcers (PrUs) in individuals with spinal cord injury (SCI) post-hospital discharge. Thirty-nine wheelchair-users discharged after acquiring a SCI, underwent randomisation into an intervention group (n = 20) with text messages and a control group (n = 19). All participants received standard post-discharge care and completed a skincare questionnaire before and 6-month after discharge. Primary outcomes included feasibility and acceptability of early intervention using text messaging, alongside performance, concordance, and attitudes toward skincare. Secondary outcomes measured perception and the incidence of PrUs. Baseline demographics were comparable between the intervention and control groups. Eight of 20 participants completed 6-month follow-up questionnaires in the intervention group, six participants completed the 6-month questionnaires in the control group,. Participants expressed high satisfaction with text messages, understanding of content, and increased confidence in preventing PrUs. At 6-month post-discharge, the intervention group showed improved prevention practices, heightened awareness of PrU risks, and increased perceived importance of prevention, which were not observed in the control group. However, there were no significant differences in PrU incidence, possibly due to the small sample size and short follow-up. The study demonstrates that using text messaging as an early intervention for PrU prevention in individuals with SCI is feasible and well-received. Preliminary results suggest a positive impact on participants' attitudes and practices, indicating the potential of text messaging to reduce PrU incidence. However, further research with larger samples and extended follow-up is crucial to validate these promising initial findings. • This is the first study evaluating feasibility of text messagings for PrU prevention in spinal cord injury patients. • Participants were highly satisfied with receiving and understanding text messages, recommending them for PrU prevention. • Participants receiving messages showed improved practices, awareness, and reduced barriers of PrU prevention post-discharge. • If future larger studies show significant results, this intervention could be a valuable tool in community healthcare. [ABSTRACT FROM AUTHOR]

Abstract Background There is a lack of data support and scientific validation of the Exemption Approach policy for responding to the COVID-19 pandemic, in terms of protecting the health of flight crews and meeting the requirements for passenger and cargo transportation in emergencies, in terms of its safety and the circumstances that contribute to pilots’ symptoms of jet lag and the risk of fatigue. Methods To assess pilots’ sleep issues related to jet lag symptoms and fatigue, this study evaluated an example of risk management for flight crews on flights across time zones during the COVID-19 pandemic. To evaluate the crew’s sleep status, variations in sleep index changes between before and after the flights, variations in sleepiness levels, and data on sleep indexes recorded by ActiGraph bracelets were collected from 146 crew members before and after flights eastward or westward across time zones. Sleepiness levels predicted by applying the SAFE model were also determined. Results Whether flying east or west across time zones, the crew’s sleep indexes were relatively similar at the end of a flight during a layover. However, a comparison with the pre-flight period showed that the sleep indexes of the crew were slightly more disturbed after the eastward flight compared with those after the westward one. In addition, the SAFE model predicted a higher rate of change in crew mean sleepiness levels between before and after the flight for the eastward flight than for the westward one; however, the Karolinska Sleepiness Score (KSS) of the pilots on either eastward or westward flights did not exceed 5 (“not alert or sleepy”). Conclusion Flight crew adaptation to the Exemption Approach policy during the COVID-19 pandemic was assessed by evaluating the sleep problems of crews flying eastward or westward across time zones.

Abstract. Introduction. The problems of the Great Patriotic War, despite the many decades that have passed, still remain an important subject field of historical science. However, some aspects of activity of military units and even armies, specific conditions of their combat activity, character of military everyday life are not always reflected in the works of researchers of this historical period. To a full extent this can be attributed to the institutions of the military sanitary service of the period 1941-1945. Their participation in combat operations has not been investigated deeply enough, some aspects of medical support of the Red Army troops remain outside the scope of scientific interests of most historians. In particular, it concerns the work of sanitary aviation during the Great Patriotic War. In this article the object of research is the 5th separate sanitary aviation squadron (SSAS) as a whole military unit, which was on the fronts from January 1942 to July 1944. It is interesting because the personnel had to carry out combat missions over a fairly long period of time in different operational and tactical situations, in a variety of natural, climatic, geographical and meteorological conditions- on flat and mountainous terrain, over the sea, in frost and blizzard. Materials and Methods. The study is based on the analysis of several types of sources: award documents of the personnel of the 5th SSAS, combat orders and orders from the funds of the Central Archive of the Ministry of Defense of the Russian Federation, memoir literature and articles in the press. Scientific materials related to the problem under consideration are also used. Traditional methods of historical research are used in the course of the work. Analysis. The analysis showed that the squadron took part in the defense and liberation of the Crimea, the battle for the Caucasus, offensive operations to liberate Ukraine and Belarus. The questions of formation, combat path and peculiarities of the front everyday life of the flying and technical staff and medical personnel were subjected to analytical comprehension. Results. By the example of the 5th SSAS the general picture of the sanitary squadron work, typical for the sanitary aviation in general during the Great Patriotic War, is reconstructed. The organizational structure of the squadron and changes in the chain of command of the unit, staffing of the unit with personnel and materiel are specified, quantitative indicators of the combat work of the squadron are given, feats of flight and technical personnel and medical personnel are described.

Abstract Objective Eating disorders are complex illnesses with high morbidity and mortality. Yet, there is promising evidence to support the effects of nutrition on the brain and behaviour. One proposed example is the use of tyrosine as an adjunct treatment in anorexia nervosa (AN). However, recruitment and retention in eating disorder clinical trials has posed difficulties for researchers. The aim of this study was to pilot test a parallel randomised controlled trial (RCT) of tyrosine supplementation to explore the feasibility of recruitment and retention, intervention adherence and data collection methods from the perspective of participants and researchers. Method Feasibility was assessed using numbers participating, questionnaire completion in patients and parent/carers completing and declining participation, a researcher implementation record and clinical measures. Subjects included adolescents aged 12–17 years with AN. The study was conducted over a 12-week period, with the intervention group receiving 5 mg of L-tyrosine supplement and the control group receiving a placebo. Results Recruitment targets were not met and recruitment to a full RCT based on the current study protocol and recruitment sites did not prove feasible. Of the 39 approached for RCT participation, seven were recruited to the RCT (18% response rate) despite extending recruitment periods, with 100% retained and analysed. Patients or parents/carers identified barriers to study participation including burden, the need to consume tyrosine as tablets, and the use of blood, urine and psychological testing. Blood tyrosine rose markedly for subjects in the intervention group. No side effects were reported or measured. Conclusions This study offers a unique exploration of the feasibility of a tyrosine trial in anorexia nervosa and is of relevance to assist the success of future nutrition trials. Exploring the suitability of future study designs for nutrition intervention research is warranted.

Abstract Background In the United States (US), transgender women of color experience cyclical, interlocking systems of structural and institutional oppression rooted in racism and transphobia, which fuel economic vulnerability. Together, cycles of intersecting racism, transphobia, and economic vulnerability create conditions that give rise to extreme HIV inequities among transgender women of color. Microeconomic interventions — designed to improve financial standing by increasing income generation and access to financial resources through entrepreneurship, cash transfers, and training — have the potential to address structural factors underlying HIV inequities. Over the past few years, several trans-led organizations, including the Trans Sistas of Color Project, have integrated microeconomic strategies, specifically emergency assistance, into their programming. The aim of the current study is to conduct a pilot randomized controlled trial (RCT) to evaluate the feasibility and acceptability of a definitive subsequent RCT and explore initial evidence of an enhanced microeconomic intervention to increase income generation and improve HIV prevention and care continua outcomes. Methods This is a two-arm waitlist randomized controlled trial in which transgender women of color will be randomly allocated to either usual care that includes the Trans Sistas of Color Project’s existing microeconomic interventions, which includes the following: (1) US $250 in emergency assistance and (2) peer support to obtain legal gender affirmation (i.e., legal name and gender markers on identification documents) or the enhanced microeconomic intervention that includes usual care and will be enhanced to include the following: (1) 12 weekly educational group sessions on economic empowerment (i.e., job acquisition, income generation through micro-business, and financial literacy) and HIV prevention and care, (2) employment-focused mentoring, and (3) an unconditional grant (US $1200) for use towards acquiring self-led or formal employment. Participants in each condition will complete a baseline survey prior to randomization, a follow-up survey immediately following intervention completion, and 3-month survey after intervention completion. Participants will also complete qualitative exit interviews within 1 month of intervention completion for both conditions. Discussion This study will be one of the first US-based pilot randomized clinical trials that builds upon existing community-led solutions to economic vulnerability to address HIV inequities. Findings will provide the necessary groundwork to examine intervention effectiveness in a future large-scale trial. Trials registration NCT06212544. Protocol version September 25, 2024, version 2.

BackgroundGlioblastoma (GBM) is a clinically challenging primary brain tumor with poor survival outcome despite surgical resection and intensive chemoradiation. The metabolic heterogeneity of GBM can become biomarkers for treatment response, resistance, and outcome prediction. The aim of the study is to investigate metabolic distinctions between primary and recurrent GBM tissue and patient plasma to establish feasibility for metabolic profiling.MethodsA single-center cohort study analyzed tissue and blood samples from 15 patients with GBM using untargeted metabolomic/lipidomic assays. Metabolomic, lipidomic, and biogenic amine analyses were conducted on GBM tissue and patient plasma at diagnosis and recurrence using untargeted mass spectrometry. The study utilized a small but longitudinally collected cohort to evaluate alteration in metabolites, lipids, and biogenic amines between specimens at diagnosis and recurrence.ResultsExploratory analysis revealed significant alteration in metabolites, lipids, and biogenic amines between diagnostic and recurrent states in both tumor and plasma specimens. Notable metabolites differed at recurrence, including N-alpha-methylhistamine, glycerol-3-phosphate, phosphocholine, and succinic acid in tissue, and indole-3-acetate, and urea in plasma. Principal component analysis revealed distinct metabolomic profiles between tumor tissue and patient plasma. Distinct metabolic profiles were observed in GBM tissue and patient plasma at recurrence, demonstrating the feasibility of using metabolomic methodologies for longitudinal studies. One patient exhibited a unique tumor resistance signature at diagnosis, possibly indicating a high-risk metabolomic phenotype.ConclusionsIn this small cohort, the findings suggest the potential of metabolomic signatures of GBM tissue and patient plasma for risk stratification, outcome prediction, and the development of novel adjuvant metabolic-targeting therapies. The findings suggest metabolic discrepancies at diagnosis and recurrence in tissue and plasma, highlighting potential implications for evaluation of clinical response. The identification of significant changes in metabolite abundance emphasizes the need for larger studies using targeted metabolomics to validate and further explore these profiles.

Abstract Background Flight attendants face various risk factors in their working environments, particularly occupational exposure to cosmic radiation. This study aimed to assess cancer risk among air transportation industry workers, including flight attendants, in Korea by constructing a cohort using national health registry-based data and analyzing cancer incidence risk. Methods We used the Korea National Health Insurance Service database from 2002 to 2021 to construct a cohort of 37,011 workers in the air transportation industry. Cancer incidence was defined using the tenth version of the International Classification of Diseases. We calculated the age- and sex-specific standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) by applying the cancer incidence rate of the general population between 2002 and 2019. Results Approximately 5% of the cohort developed cancer. Overall, the cancer incidence in the cohort was similar to or lower than that of the general population, with the SIRs for all cancers being lower. However, significantly higher SIRs were observed for nasopharyngeal cancer (SIR, 3.21; 95% CI, 1.71–5.48) and non-Hodgkin lymphoma (SIR, 1.57; 95% CI, 1.02–2.32) in male workers and breast and genital cancer (SIR, 1.51; 95% CI, 1.34–1.70) and thyroid cancer (SIR, 1.25; 95% CI, 1.05–1.47) in female workers. Conclusions The lower overall cancer incidence among air transportation industry workers observed in this study could indicate the “healthy worker effect”; however, the incidences of certain cancers were higher than those in the general population. Given that these workers are exposed to multiple occupational and lifestyle-related risk factors, including cosmic radiation, further studies are necessary to determine radiation-induced cancer risk while considering potential confounding factors.

The development of the shipping industry has put forward new requirements and challenges for its pilotage and services. To promote navigation development and ensure safe and efficient ship navigation, experiments have been conducted to combine geographical information systems (GIS) big data with neural systems, resulting in a proposed intelligent ship pilotage service method. This paper presents a novel approach to building a ship pilot system using GIS technology. The system is enhanced with the introduction of the Faster-RCNN model to improve its positioning function, and Gaussian distribution is employed to optimize the loss function. Finally, the system’s ship pilot service set time parameters are solved based on ship entry and exit scheduling to achieve intelligent navigation and services for ship piloting. The data showed that on the MarineT dataset, the research method (GIS big data positioning-neural network) achieved its maximum fitness value at 36 iterations of the system, with a value of 99.78. At the same time, when the system ran 66 times, the average absolute percentage error obtained by the research method infinitely approached 0. In addition, based on the AIS dataset, when the recall rate of the four algorithms was 0.800, the accuracy of the research method was 0.873, with the highest numerical value. Practical applications have shown that when the system iterated 51 times, the total waiting time for ship piloting in and out of the port quickly decreased to 177.92 hours, which is significantly better than manual scheduling time. The aforementioned findings suggest that the implemented system has the capability to considerably decrease piloting time, deliver cutting-edge technical aid for the current expansion of the shipping sector, and establish a stable basis for future intelligent shipping technology.

Kun Xu,1,2 Jiefan Zhang,1,2 Wei Ma,1,2 Yongyu Wang,1,2 Bo Chen,1,2 Ningyang Gao,1,2 Jian Pang,1,2 Hongsheng Zhan1,2 1Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People’s Republic of ChinaCorrespondence: Hongsheng Zhan; Jian Pang, Email shgsyjs@139.com; pangjian2004@gmail.comObjective: Shi’s Knee Daoyin (SKD) exercise is a treatment derived from Traditional Chinese exercise (TCE) specifically designed for lower limb health care. This study aimed to assess the feasibility of conducting a randomized controlled trial to explore the effectiveness of SKD exercise in treating knee osteoarthritis (KOA).Methods: Participants were randomized to receive Health Education (HE) or SKD exercise. The primary outcomes were feasibility and safety outcomes, including participant recruitment rate, retention rate, as well as adherence to intervention. The secondary outcomes included Visual Analogue Scale (VAS) scores for pain, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, the 20-Meter Walk Test (20-MWT) and the 5-times Chair-Stand Test (5-CST).Results: The results indicate that out of 89 individuals invited to participate in the study, 72 were eligible and agreed to participate, resulting in a recruitment rate of 80.9%. All participating patients completed the follow-up and were included in the analysis; no patients dropped out of the study due to adverse events. The secondary outcome measures showed that after twelve weeks of treatment, the VAS score, WOMAC total score, WOMAC pain score, WOMAC stiffness score, and WOMAC function score of patients in the HE group and SKD group all improved, but the improvement was more significant in the SKD group. The 20-MWT of SKD group after treatment was significantly shorter than before treatment (P< 0.001); There was no significant difference in 20-MWT between the HE group and baseline after treatment. The performance of the two groups of patients improved in 5-CST, but there was no statistical difference between the two groups after treatment (P=2.439).Conclusion: This study evaluated the feasibility and effectiveness of home-based SKD exercise intervention in alleviating symptoms in patients with symptomatic KOA, providing valuable information for designing an appropriate randomized controlled study.Keywords: knee osteoarthritis, pilot, exercise, randomized controlled trial

Objectives To investigate the impact of electroacupuncture on cognitive function, quality of life (QoL), and depression severity in patients with major depressive disorder (MDD). Methods This double-blinded randomized controlled trial included 60 participants aged 18-55 with cognitive symptoms related to MDD at Thammasat University Hospital. Participants were divided into two groups: the electroacupuncture group combined with standard antidepressant treatment (EG; n=30) and the control group receiving standard care with placebo acupuncture (CG; n=30). The study assessed 1) executive functions using the Trail making test- B and Stroop Color and Word Test, 2) delayed recall, and 3) subjective cognitive complaint and Quality of life (QoL) using WHODAS 2.0. Depressive symptoms were measured using the Thai version of the Patient Health Questionnaire (PHQ-9). Baseline and post-intervention assessments were conducted over 10 weeks. Mann-Whitney U test analyzed treatment effects by comparing median differences between groups. Results Both groups exhibited similar demographics and cognitive traits. Cognitive improvement was observed in both groups at the endpoint. Intention-to-treat analysis revealed significantly higher median scores for subjective cognitive complaints in the EG compared to the CG (EG: Median = 5.5, CG: Median = 0.0, p=0.049). No serious side effects were identified from either electroacupuncture or placebo acupuncture. Conclusions Electroacupuncture improved subjective complaints in MDD patients with cognitive symptoms, but did not show effects on specific cognitive functions, QoL, or depressive symptoms. This study provides initial evidence supporting the potential of electroacupuncture in MDD patients with cognitive symptoms, suggesting opportunities for further research. Trial registration NCT06239740, February 2, 2024, ClinicalTrials.gov.

The aim of this pilot study was to explore whether executive functioning (EF) problems of children with severe congenital heart disease (CHD) could be improved through a personalized EF-training program. Eleven preschool-aged children (mean age = 62 months, SD = 6) received a standardized test battery. Eight children were eligible for training and six children participated in the training and posttest. Due to the small sample size, only effect sizes were analyzed. Clinically relevant improvements were found with large effect sizes. Findings indicate that a personalized EF-training program could be effective in improving EF of children with severe CHD. Further research is needed. [ABSTRACT FROM AUTHOR]

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Background: Flight attendants face various risk factors in their working environments, particularly occupational exposure to cosmic radiation. This study aimed to assess cancer risk among air transportation industry workers, including flight attendants, in Korea by constructing a cohort using national health registry-based data and analyzing cancer incidence risk. Methods: We used the Korea National Health Insurance Service database from 2002 to 2021 to construct a cohort of 37,011 workers in the air transportation industry. Cancer incidence was defined using the tenth version of the International Classification of Diseases. We calculated the age- and sex-specific standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) by applying the cancer incidence rate of the general population between 2002 and 2019. Results: Approximately 5% of the cohort developed cancer. Overall, the cancer incidence in the cohort was similar to or lower than that of the general population, with the SIRs for all cancers being lower. However, significantly higher SIRs were observed for nasopharyngeal cancer (SIR, 3.21; 95% CI, 1.71–5.48) and non-Hodgkin lymphoma (SIR, 1.57; 95% CI, 1.02–2.32) in male workers and breast and genital cancer (SIR, 1.51; 95% CI, 1.34–1.70) and thyroid cancer (SIR, 1.25; 95% CI, 1.05–1.47) in female workers. Conclusions: The lower overall cancer incidence among air transportation industry workers observed in this study could indicate the "healthy worker effect"; however, the incidences of certain cancers were higher than those in the general population. Given that these workers are exposed to multiple occupational and lifestyle-related risk factors, including cosmic radiation, further studies are necessary to determine radiation-induced cancer risk while considering potential confounding factors. [ABSTRACT FROM AUTHOR]

New roles have been developed to meet increased demands for children and young people's (CYP) mental health support. In 2017, Children's Wellbeing Practitioners (CWP) and Education Mental Health Practitioners (EMHP) psychological professions' training programmes were introduced. A new Children & Young People's Mental Health Practitioner (CYP-MHP) role has now been piloted with the aim of improving access to CYP mental health support through early intervention, providing psychoeducation, advice and signposting. This pilot provides a new service; CWP/EMHP require training and deliver therapy, whereas CYP-MHP provides a triage/assessment therapeutic service and does not require NHS-funded training. Outcomes of the pilot evaluation demonstrate a place for this role in primary care, where there existed a gap before. [ABSTRACT FROM AUTHOR]

Uplifted occurrences of fine-grained glaciogene marine sediments are found throughout the northern hemisphere. These sediments could be used to produce local construction materials, to rely less on imported construction materials from southern regions. In this study, a representative occurrence from Ilulissat, West Greenland, was investigated as a potential resource for local brick production. The study comprised three parts: (1) raw material characterization based on grain size distribution, major element chemistry, including total carbon, sulfur, and chloride concentrations, mineralogy, morphology, and Atterberg limits; (2) the production of test bricks at a Danish brickwork; and (3) testing of the bricks based on total shrinkage, water absorption, hygroscopic adsorption, open porosity, bulk density, compression strength, and mineralogy. The bricks produced proved to have excellent compression strength, low open porosity, and low water absorption. The shrinkage could be reduced by adding 10% chamotte to the marine sediment. Based on the investigated properties, this indicates that this type of clay is highly suitable as a resource for bricks. [ABSTRACT FROM AUTHOR]

Pilot tends to have a high prevalence of dyslipidemia. The present study aimed to identify key factors of pilot hyperlipidemia through thorough analysis of physical examination data, and to provide pilot-targeted health guidance to manage hyperlipidemia risks. The physical examination data of 1,253 pilot inpatients from January 2019 to June 2022, were evaluated and divided into two groups based on whether or not the pilot had hyperlipidemia. A total of three multivariate analysis models including logistic model, multilevel model and boosting propensity score were applied to find the risk factors of pilot hyperlipidemia. In the group of pilots with hyperlipidemia, four risk factors, including thrombin time, carbohydrate antigen 199, lymphocyte count and rheumatoid factor, were significantly different from pilots without hyperlipidemia, which might be positively associated with the incidence of hyperlipidemia. In future studies regarding pilots, whether hyperlipidemia is connected to abnormalities in thrombin time, carbohydrate antigen 199 and rheumatoid factor should be further explored. Based on the findings of the present study, pilot health management should be more refined and personalized, and attention should be paid to the risk factors of hyperlipidemia including diet and lifestyle. [ABSTRACT FROM AUTHOR]

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INTRODUCTION: Pilots are frequently exposed to thrombotic risk as a result of immobility from air travel. As hypoxemia is associated with secondary polycythemia, and polycythemia increases the risk of thrombosis, intermittent exposure to high-altitude hypoxic environments could escalate the risk of thrombosis in pilots. Our objectives were to find the prevalence of polycythemia in airplane pilots (primary outcome) and to assess associated risk factors of polycythemia (secondary outcome). METHODS: This study is a cross-sectional descriptive study. Data was collected from paper-based and computerized medical records of airplane pilots who applied for Class 1 Aviation Medical Certificate renewal at the Institute of Aviation Medicine, Royal Thai Air Force, Bangkok, Thailand, in 2018. The data was sampled by a simple random sampling technique. RESULTS: A total of 386 paper-based records were sampled. Of those, 29 (7.5%) of the pilots met polycythemia criteria. Spearman's correlation analysis showed a significant positive correlation between Body Mass Index (BMI) and hemoglobin (correlation coefficient = 0.127) and between BMI and hematocrit (correlation coefficient = 0.105). In multivariate logistic regression of each variable on polycythemia as defined by hemoglobin alone, piloting a non-pressurized aircraft was found to be an independent predictor of polycythemia (odds ratio = 4.3). DISCUSSION: The prevalence of polycythemia in airplane pilots was 7.5%. Operating a non-pressurized aircraft was a significant risk factor of polycythemia, and pilots with higher BMI were more likely to have increased red blood cell parameters. [ABSTRACT FROM AUTHOR]

Human-centered artificial intelligence (HCAI) needs to be able to adapt to anticipated user behavior. We argue that the anticipation capabilities required for HCAI adaptation can be modeled best with the help of a cognitive architecture. This paper introduces an ACT-R cognitive model that uses instance-based learning to observe and learn situations and actions in the form of mental models. These mental models enable the anticipation of the behavior of individual users. The model is applied to a use case of automation surprise in commercial aviation to test how anticipation can best be modeled for cockpit applications. Empirical data from a flight simulator study including behavioral, neurophysiological and eye-tracking measures from 13 pilots were used to evaluate the model. Results show that the accuracy of the model is significantly higher than chance, demonstrating that combining context information, user state data and a cognitive model can enable HCAI adaptation based on anticipated user behavior. [ABSTRACT FROM AUTHOR]

Background. Civil aviation comprises airlines/charters and general aviation (GA). Currently, airlines are experiencing a pilot shortage, partly reflecting scheduled retirements mandatory for airline (but not GA) pilots aged 65 years, fueling a debate as to whether the retirement age should be increased. Herein, using 16–40 years-of-age aviators as a reference, we determined whether GA pilots aged 60+ years (i) incurred an elevated accident rate, employing, for the first time, age-tiered flight time as a measure of risk exposure and (ii) carried an excess risk for cognitive deficiency-related fatal accidents. Methods. Airplane accidents (2002–2016) involving Class 3 medical certificated pilots were per the National Transportation Safety Board (NTSB) databases. Age-tiered pilot risk exposure represented a summation of flight hours per Class 3 medical applications. Cognitive decline measures were per NTSB field codes. Statistical analyses employed Chi-Square, Mann–Whitney, logistic regression, and binomial tests. Results. Using flight hours as the denominator, the fatal accident rate for older pilots (41–80 years) was unchanged compared with aviators aged 16–40 years. In the logistic regression, no cognitive deficiency measure was predictive (p = 0.11, p = 0.15) for pilots aged 61+ years who were involved in fatal accidents. Conclusion. These findings question the necessity of an automatic disqualification of air transport pilots at 65 years of age. [ABSTRACT FROM AUTHOR]

A service evaluation was conducted to explore staff perception of the role of assistant psychologists (APs) working in a Crisis Resolution and Home Treatment Team (CRHTT). Four APs were employed on a pilot scheme and embedded in four CRHTTs across Hywel Dda University Health Board (HDUHB). Using a mixed-methods survey, data were collected from staff working with these CRHTTs (N = 26). Quantitative results reported that the participants perceived the contribution of the AP as 'very valuable' to both the team and its patients. Qualitative results identified two overarching themes (Additional Value and Additional Expectations) and five themes (with subthemes): (1) A Stepping Stone; (2) A Different Perspective; (3) More is Needed; (4) Clarifying the Remit; and (5) The Impact on Discharge. Integrative analysis indicated that there is a need to improve staff understanding of the role and its remit. Further evaluation and research is needed to ensure greater understanding and clarification of the role. [ABSTRACT FROM AUTHOR]

Background: This paper outlines a pilot of a new memory aide for breastfeeding conducted in the Northeast of England and North Cumbria between April and August 2023. The United Kingdom has some of the lowest rates of breastfeeding, particularly in the Northeast of England, and as such more needs to be done to support mothers to breastfeed for as long as they would like to. Good support from health professionals can be effective in influencing decisions to breastfeed as well as helping to ensure initiation and continuation of breastfeeding but there is evidence to suggest that professionals and students do not always feel adequately trained and it is here, where memory aides may have value. Methods: Key breastfeeding practitioners and educators were brought together to select one of two memory aides for principles of attachment for effective breastfeeding. The selected memory aide, LATCHS, was piloted with 57 participants with a key role in promotion and support of breastfeeding in the Northeast of England and North Cumbria. Results: Participants conveyed mixed views about the proposed memory aide with more experienced staff reporting more favourable opinions than student midwives and early years practitioners. Experienced staff felt the new memory aide would complement an early memory aide, CHINS, which focused on principles of positioning. Discussion: Findings of the pilot indicate there is a role for a mnemonic to help practitioners understand, recall, and retain theory around attachment for effective breastfeeding and that memory aides can play an important role in complementing existing approaches to education and practice. The participants felt the proposed memory aide had some limitations and suggested important ways for it to be improved, particularly in adding an E to reflect the expecting wording. This produced the final memory aide: LATCHES. Conclusion: Using data from the pilot, the memory aide was refined, and the final version LATCHES agreed for wider dissemination. Future research is needed to understand the value of LATCHES on the wider breastfeeding workforce and whether any future improvements can be made to enhance its utility. [ABSTRACT FROM AUTHOR]

Background: Now affecting one in six couples in Canada, infertility is defined as a lack of conception after 12 or more months of regular, unprotected heterosexual intercourse. Infertility is associated with immense psychological burden, particularly for individuals assigned female at birth. Yet existing psychological interventions are not specialized to this population and have been shown to be only marginally effective at relieving distress related to infertility. Thus, a new online self-directed psychological intervention was co-created with a panel of women experiencing infertility, and ultimately consisted of six 10-min video modules addressing the cognitive, emotional, and interpersonal aspects of infertility-related distress. Methods: In the current study, 21 women experiencing reduced quality of life related to infertility were recruited to participate in a one-arm pre-post pilot testing the feasibility, acceptability, and preliminary efficacy of the program. Participant adherence and retention were monitored, and participants rated the credibility of the program and the helpfulness of each module as well as provided feedback on the content and format of the program. Pre-to-post changes in fertility quality of life, anxious symptoms, depressive symptoms, and relationship satisfaction were examined. Results: The program modules were highly rated by participants, with average helpfulness ratings ranging from 7.5 to 8.2/10. Two participants became pregnant and therefore stopped prematurely, 79% of the remaining participants completed all six modules, and participants reported completing 52.8 (SD = 82.0) min of homework per week. Participants perceived the intervention as highly credible and generally approved of the format, length, and speed; however, 68% of participants had recommendations for additional content to be included in the intervention. While relationship satisfaction did not change significantly over time, large pre-to-post improvements in fertility quality of life, depression, and anxiety were observed (p <.001; Cohen's ds = 0.9–1.3). Conclusions: This self-directed intervention was well received and has the potential to be highly effective in reducing infertility-related distress, informing future development and optimization. Trial registration: ClinicalTrials.gov, NCT05103982. [ABSTRACT FROM AUTHOR]

Multi-Attribute Task Battery (MATB) is a computerized flight simulator for aviation-related tasks, suitable for non-pilots and available in many versions, including open source. MATB requires the individual or simultaneous execution of 4 sub-tasks: systemmonitoring (SYSMON), tracking (TRACK), communications (COMM), and resourcemanagement (RESMAN). Fully customizable, the design of test duration, number of sub-tasks used, event rates, response times and overlap, create different levels of mental load. MATB can be combined with an additional auditory attention (Oddball) task, or with physiological constraints (i.e., sleep loss, exercise, hypoxia). We aimed to assess the main characteristics of MATB design for assessing the response to different workload levels. We identified and reviewed 19 articles for which the effects of low and high workload were analyzed. Although MATB has shown promise in detecting performance degradation due to increase workload, studies have yielded conflicting or unclear results regarding MATB configurations. Increased event rates, number of sub-tasks (multitasking), and overlap are associated with increased perceived workload score (ex. NASA-TLX), decreased performance (especially tracking), and neurophysiological responses, while no effect of time-on-task is observed. The median duration used for the test is 20 min (range 12--60) with a level duration of 10 min (range 4--15). To assess mental workload, the median number of stimuli is respectively 3 events/min (range 0.6--17.2) for low, and 23.5 events/min (range 9--65) for high workload level. In this review, we give some recommendations for standardization of MATB design, configuration, description and training, in order to improve reproducibility and comparison between studies, a challenge for the future researches, as human-machine interaction and digital influx increase for pilots. We also open the discussion on the possible use of MATB in the context of aeronautical/operational constraints in order to assess the effects combined with changes in mental workload levels. Thus, with appropriate levels of difficulty, MATB can be used as a suitable simulation tool to study the effects of changes on the mental workload of aircraft pilots, during different operational and physiological constraints. [ABSTRACT FROM AUTHOR]

In this pilot study, we report on the feasibility, acceptability and potential impact of 'Who, When, How to Share', a new disclosure decision-making programme for autistic adults. We evaluated this programme using pre-post mixed-methods surveys that included questions about participants' experiences of the programme and four psychosocial outcome measures. While 32 autistic adults completed the pre-programme survey and enrolled into the programme, there was high attrition, with only 19 autistic adults completing the programme and post-programme survey. We found that it was feasible to deliver the programme in a guided self-help format, although a minority of participants (who completed the programme or provided reasons for withdrawing from the programme) found it challenging to work through the programme independently and within the study time frame. High levels of satisfaction and positive qualitative feedback also suggested that the programme was acceptable to autistic adults. Participants provided useful recommendations for improvement, such as more interactive elements to enhance engagement. The programme showed potential to improve decisional conflict, disclosure-related distress, stigma-related stress and internalised stigma among autistic adults, though further evaluation of the impact of the programme is needed. 'Who, When, How to Share' is a new programme that aims to support autistic adults in making decisions around sharing their autistic identity with others. The programme involves working through a self-help guide independently over 3 weeks with optional peer support. We wanted to find out if autistic adults would join the programme and find it useful. Thirty-two autistic adults took part in the programme and 19 of them completed it. Most participants who completed the programme liked the programme and found it helpful, but some felt that they needed more time and support to complete it. They suggested that the programme would be more accessible if it was more interactive, such as including videos and other ways to gain feedback on their progress. Surveys filled in by participants before and after the programme suggested that they became more confident and less stressed about sharing their autistic identity with others, but some felt they still needed to build more confidence in order to handle negative attitudes from others. More work is needed to improve and test the programme further. [ABSTRACT FROM AUTHOR]

As the speed of the communication system increases, there exist two kinds of fading simultaneously in the wireless channels, namely time-frequency double-selective fading. In this case, delay expansion and doppler shift will affect the channel, resulting in inter-carrier interference and inter-symbol crosstalk, which will affect the channel estimation performance of generalized frequency division multiplexing communication technology. This paper first analyzes the effects of time-selective fading and frequency-selective fading on transmitted signals. Then, a complex exponential basis extension model (CE-BEM) suitable for dual selective channels was selected, and the mean square error (MSE) was used to evaluate the CE-BEM model. The function order Q of GFDM channel estimation simulation was determined by the relationship between the number of sampling points in the transmission block and different order functions. Finally, the least square (LS) channel estimation algorithm and the least mean square error (MMSE) are used to complete the channel estimation of the GFDM communication system. The performance of channel estimation is improved by changing the way of pilot insertion, and the performance of channel estimation is measured by mean square error (MSE) when the characteristics of pilot insertion are changed. [ABSTRACT FROM AUTHOR]

Objectives To investigate the impact of electroacupuncture on cognitive function, quality of life (QoL), and depression severity in patients with major depressive disorder (MDD). Methods This double-blinded randomized controlled trial included 60 participants aged 18-55 with cognitive symptoms related to MDD at Thammasat University Hospital. Participants were divided into two groups: the electroacupuncture group combined with standard antidepressant treatment (EG; n=30) and the control group receiving standard care with placebo acupuncture (CG; n=30). The study assessed 1) executive functions using the Trail making test- B and Stroop Color and Word Test, 2) delayed recall, and 3) subjective cognitive complaint and Quality of life (QoL) using WHODAS 2.0. Depressive symptoms were measured using the Thai version of the Patient Health Questionnaire (PHQ-9). Baseline and post-intervention assessments were conducted over 10 weeks. Mann-Whitney U test analyzed treatment effects by comparing median differences between groups. Results Both groups exhibited similar demographics and cognitive traits. Cognitive improvement was observed in both groups at the endpoint. Intention-to-treat analysis revealed significantly higher median scores for subjective cognitive complaints in the EG compared to the CG (EG: Median = 5.5, CG: Median = 0.0, p=0.049). No serious side effects were identified from either electroacupuncture or placebo acupuncture. Conclusions Electroacupuncture improved subjective complaints in MDD patients with cognitive symptoms, but did not show effects on specific cognitive functions, QoL, or depressive symptoms. This study provides initial evidence supporting the potential of electroacupuncture in MDD patients with cognitive symptoms, suggesting opportunities for further research. Trial registration NCT06239740, February 2, 2024, ClinicalTrials.gov.

Jelen tanulmány célja, hogy egyrészt bemutassa az Ovi-Sport Program kialakulását, lényegét és legfontosabb elemeit, másrészt egy empirikus alapú, pilot jellegű kérdőíves vizsgálat segítségével felmérje néhány debreceni óvoda óvodapedagógusának (n=52) véleményét a Programról. Cél, hogy a megkérdezett óvodapedagógusok válaszainak segítségével rámutassunk azokra a pontokra, amelyekben megmutatkozik a Program erősségeire és hiányosságaira. A kutatás kérdései arra irányultak, hogy megismerjük, hogy a megkérdezettek milyen céllal használják a gyakorlatban az Ovi-Sport pályát, módszertanilag felkészültek-e az Ovi-Sport Program széleskörű megvalósításához, valamint miket látnak a legfőbb erősségeknek és gyengeségeknek a Program működését illetően. Az eredményeket alapján elmondható, hogy az óvodapedagógusok összességében pozitívnak ítélik meg az Ovi-Sport Program meglétét. A megkérdezettek a pozitív visszaigazolások mellett azokra a pontokra is rámutattak, amelyeket további átgondolásra, fejlesztésre javasolnak például, hogy a Programban rendelkezésre álló módszertani segédletek nem elégségesek, azok mindenképpen bővítésre, átdolgozásra szorulnak. Mindemellett a megkérdezett pedagógusok igényelnék a további szakmai továbbképzéseket és külső szakemberek bevonását, segítségét.

Background: Central serous chorioretinopathy (CSC) is a disqualifying condition for pilots because of the importance of good vision to their jobs. The objective of this study was to evaluate the clinical diagnosis, treatment, and aviation medical assessment principles for CSC in military pilots. Methods: The clinical data and aviation medical assessments of 15 pilots with CSC who were admitted to the Air Force Medical Center between January 2003 and December 2021 were analyzed, and three typical cases were reported. The relevant literature evaluation was conducted on 32 non-pilot patients with CSC. Results: The mean age of the 15 pilots was 37.47 ± 4.21 years, and they were all male. Fourteen were affected in a single eye (4 in the right eye and 10 in the left eye), while one was affected in both eyes. Two pilots were nonsmokers and did not consume alcohol; one was a smoker; four pilots consumed alcohol on a regular basis; and eight pilots were smokers and consumed alcohol on a regular basis. The mean best-corrected visual acuity (BCVA) increased from 0.83 ± 0.33 at the initial visit to 0.95 ± 0.44 at the final visit. The non-pilot group included 32 patients, 29 of whom were male and 3 of whom were female, with a mean age of 37.16 ± 10.02 years. Thirty-one patients had single-eye involvement (17 of the right eye and 14 of the left eye), while one patient had involvement of both eyes. Seventeen patients were nonsmokers and did not consume alcohol; two were smokers; four consumed alcohol on a regular basis; and nine were smokers and consumed alcohol on a regular basis. The mean BCVA increased from 0.64 ± 0.28 at the first visit to 0.90 ± 0.30 at the final visit. Patients in the pilot group had a high recurrence rate, which was associated with a low final BCVA and led to their disqualification from flying. Conclusion: Pilot and non-pilot patients did not differ significantly in terms of CSC clinical data. Chronic and recurrent CSC can be a vision-threatening disease; therefore, pilots must receive accurate and timely diagnosis.

The Kenyan government implemented a Universal Health Coverage (UHC) pilot project in four (out of 47) counties in 2019 to address supply-side gaps and remove user fees at county referral hospitals. The objective of this study was to examine the UHC pilot implementation experience using a mixed-methods cross-sectional study in the four UHC pilot counties (Isiolo, Kisumu, Machakos, and Nyeri). We conducted exit interviews (n = 316) with health facility clients, in-depth interviews (n = 134) with national and county-level health sector stakeholders, focus group discussions (n = 22) with community members, and document reviews. We used a thematic analysis approach to analyze the qualitative data and descriptive analysis for the quantitative data. The UHC pilot resulted in increased utilization of healthcare services due to removal of user fees at the point of care and increased availability of essential health commodities. Design and implementation challenges included: a lack of clarity about the relationship between the UHC pilot and existing health financing arrangements, a poorly defined benefit package, funding flow challenges, limited healthcare provider autonomy, and inadequate health facility infrastructure. There were also persistent challenges with the procurement and supply of healthcare commodities and with accountability mechanisms between the Ministry of Health and county health departments. The study underscores the need for whole-system approaches to healthcare reform in order to ensure that the capacity to implement reforms is strengthened, and to align new reforms with existing system features.

Background: Cardiac rehabilitation is a beneficial multidisciplinary treatment of exercise promotion, patient education, risk factor management, and psychosocial counseling for people with coronary heart disease (CHD) that is underutilized due to substantial disparities in access, referral, and participation. Empirical studies suggest that cardiac telerehabilitation (CTR) have safety and efficacy comparable to traditional in-person cardiac rehabilitation, however, older adults are under-reported with effectiveness, feasibility, and usability remains unclear. Methods: The study randomized 43 older adults (84 % males) to the 12-week CTR intervention or standard of care. Guided by Social Cognitive Theory, participants received individualized in-person assessment and e-coaching sessions, followed by CTR usage at home. Data were collected at baseline (T0), six-week (T1), and 12-week (T2). Results: Participants in the CTR intervention group showed significant improvement in daily steps (T1: β = 4126.58, p = 0.001; T2: β = 5285, p = 0.01) and health-promoting lifestyle profile (T1: β = 23.26, p

The article discusses the importance of managing health conditions, specifically diabetes, in pilots and air traffic control officers to ensure safe aviation operations. The study compares the use of Continuous Glucose Monitoring (CGM) and Self-Monitoring of Blood Glucose (SMBG) in pilots with diabetes, highlighting the benefits of CGM in terms of efficiency and user satisfaction. Pilots generally prefer CGM over SMBG due to its convenience and accuracy, potentially improving glucose management and preventing incapacitation during flights. The study suggests that CGMs hold promise in enhancing diabetes management in aviation, despite the need for calibration and frequent replacements. [Extracted from the article]

Background Glioblastoma (GBM) is a clinically challenging primary brain tumor with poor survival outcome despite surgical resection and intensive chemoradiation. The metabolic heterogeneity of GBM can become biomarkers for treatment response, resistance, and outcome prediction. The aim of the study is to investigate metabolic distinctions between primary and recurrent GBM tissue and patient plasma to establish feasibility for metabolic profiling. Methods A single-center cohort study analyzed tissue and blood samples from 15 patients with GBM using untargeted metabolomic/lipidomic assays. Metabolomic, lipidomic, and biogenic amine analyses were conducted on GBM tissue and patient plasma at diagnosis and recurrence using untargeted mass spectrometry. The study utilized a small but longitudinally collected cohort to evaluate alteration in metabolites, lipids, and biogenic amines between specimens at diagnosis and recurrence. Results Exploratory analysis revealed significant alteration in metabolites, lipids, and biogenic amines between diagnostic and recurrent states in both tumor and plasma specimens. Notable metabolites differed at recurrence, including N-alpha-methylhistamine, glycerol-3-phosphate, phosphocholine, and succinic acid in tissue, and indole-3-acetate, and urea in plasma. Principal component analysis revealed distinct metabolomic profiles between tumor tissue and patient plasma. Distinct metabolic profiles were observed in GBM tissue and patient plasma at recurrence, demonstrating the feasibility of using metabolomic methodologies for longitudinal studies. One patient exhibited a unique tumor resistance signature at diagnosis, possibly indicating a high-risk metabolomic phenotype. Conclusions In this small cohort, the findings suggest the potential of metabolomic signatures of GBM tissue and patient plasma for risk stratification, outcome prediction, and the development of novel adjuvant metabolic-targeting therapies. The findings suggest metabolic discrepancies at diagnosis and recurrence in tissue and plasma, highlighting potential implications for evaluation of clinical response. The identification of significant changes in metabolite abundance emphasizes the need for larger studies using targeted metabolomics to validate and further explore these profiles.