Issues related to obesity are no longer being discussed solely within the scope of public health, as they have overcome this barrier and entered the marketing context, promoting plus size fashion. This study aimed to understand how social responsibility through Instagram can be applied as a strategy to generate competitive advantage in the plus size segment. Applied research was conducted, with a descriptive objective, a problem addressed in a qualitative and quantitative way, using bibliographical research as technical procedures and a survey using an online form that had the Net Promoter Score (NPS) as a mechanism for analyzing the answers. The main results include the analysis of the dissonance between consumer thinking and attitude in relation to social responsibility, the noticeable facilitation of Instagram with regard to product offers, and the notable adherence of movements that encourage acceptance of one's own body.

Clearance of the pediatric cervical spine (CS) may pose a challenge following blunt trauma. Prior studies suggest that less than half of pediatric trauma centers (PTCs) have a written protocol for CS clearance. This study aimed to evaluate national practices for pediatric CS clearance in adult trauma centers (ATCs) and PTCs. Western Pediatric Cervical Spine Study members were queried for hospital demographics and current CS clearance practices. Data included trauma center verification level and the number of yearly trauma activations. Study members provided information about CS clearance and included a copy of their CS clearance protocol, if applicable. Standalone PTCs were defined as level I or level II PTCs not combined with ATCs. Sixty-six of 80 institutions queried responded. Of 66 responding institutions, 15 were combined PTC/ATC, 16 were ATC only, and 36 were standalone PTCs (level I PTC, 29; level I ATC, 14; level II PTC, 5; level II ATC, 2; level III ATC, 1). The median number of pediatric (younger than 18 years) trauma admissions at each TC per year was 644 (interquartile range, 315-1,215). For CS clearance, 74% (49 of 66) of TCs had a written protocol. Standalone PTCs were more likely to have a written protocol (97% vs. 57%, p < 0.001) and require a magnetic resonance imaging for CS clearance in the obtunded patient (97.0% vs. 56.0%, p < 0.001). Among sites that had written CS clearance protocols, there were no differences between standalone PTCs and nonstandalone PTCs in the proportion of sites that included Nexus criteria, Canadian CS Rule, Pediatric Emergency Care Applied Research Network, mechanism of injury, Glasgow Coma Scale, or obtunded status. There is variation among adult and pediatric TCs in the screening and clearance of the pediatric CS. Despite evidence suggesting the importance of protocols for evaluating the CS, approximately half of the nonstandalone PTCs do not have an established protocol. Observational/Case Series; Level III.

Greenfield manufacturing initiatives represent transformative opportunities for retailers seeking vertical integration advantages through comprehensive technology ecosystem implementation. This article examines the architectural design and deployment of end-to-end IT solutions specifically validated within a dairy manufacturing environment, focusing on integration challenges and strategic solutions across complex multi-vendor environments. The dairy sector presents unique integration challenges due to the high-volume, real-time data requirements of milk sourcing and critical cold-chain management necessities. The implementation centered on enterprise resource planning systems as foundational integration hubs, extended through specialized manufacturing execution, laboratory information management, and warehouse automation platforms following ISA-95 standard architectures. Key challenges addressed include multi-system orchestration complexity, high-volume transaction performance requirements, and cybersecurity considerations in operational technology convergence environments. The architectural framework established standardized templates enabling rapid facility replication while maintaining operational consistency across expanding manufacturing networks. Performance outcomes demonstrated quantifiable improvements, including 18% cycle time reduction, 99.2% inventory accuracy, and 15% distribution efficiency enhancement that exceeded industry benchmarks by 12-15%. The article contributes practical frameworks for practitioners navigating similar technological transformations in dairy manufacturing environments while establishing foundations for advanced analytics and Internet of Things integration capabilities. Research Classification: This article represents an Applied Research Case Study following Design Science Research methodology, examining real-world implementation of integrated manufacturing systems architecture in large-scale dairy processing environments.

A Proposed Intelligent Accounting and Auditing Framework for Reforming ESG Disclosure and Enhancing Sustainability Governance in the Egyptian Capital Market: A Comparative Applied Research

Trajectories of type 2 diabetes and cancer in 330 000 individuals with prediabetes: 20-year observational study in England.

Can cycles in research refine the research? Yes, cycles in research are essential for refining the research process and its findings. Research is not a linear, one-and-done process but an iterative and recursive cycle of continuous improvement. Each cycle or iteration builds upon the last, allowing researchers to refine their methods, test assumptions, and produce more accurate and reliable result. Then the initial cycle of the commutative diagram of the research method by fundaments that is isomorphic to a subtheory is such an affine subscheme, which is isomorphic to the spectrum of the ring of the studied research method. A corollary is obtained in the electronics and quantum field theory research.

Applied Research Note: Validating Energy Systems for the Formulation of Laying Hen Diets

The impact of previous head trauma and history of cranial surgery on clinical findings in acute pediatric head injury.

Artificial intelligence made great changes in investment management Incorporating machine learning models into portfolio optimization to enhance the portfolios returns and decrease the risk. However, lacking in explanatory ability of decision making is also challenging to an investor who would like to understand how those automated processes work, to avoid losing too much. To solve this problem, this paper explains how we will use machine learning for portfolio allocation. This research uses SHAP (SHapley Additive exPlanations) to explain the outputs from a machine learning model. The model is trained on the results of a dynamic Markowitz portfolio optimization. CSI 300 market date is applied, the portfolio consists of 10 random stocks having over 1,000 trading days. conduct robustness analysis to see how different rolling windows would affect the explanation of the model. From the results, it is obvious that the framework can identify the drivers of portfolio weights and improve the transparency and understandability of the model.

This article explores the challenges of determining the effectiveness of various youth policy implementation modalities. It relies on empirical results obtained by the authors from the project "Youth in Interethnic Communications: Intolerance, Tolerance, Dialogue," which was conducted under the Fundamental and Applied Research Program "Ethnocultural Diversity of Russian Society and Strengthening All-Russian Identity". The article focuses on how reliable and comprehensive evaluations are by various youth policy actors and to the identified challenges in assessing the effectiveness of youth policy. The authors give an assessment the main reasons for the decline in the effectiveness of youth policy plans, programs, and projects at four stages using the RACE formula. The article grounds the necessity of a continuous system for assessing the effectiveness of plans, programs, projects, competitions, and other documents aimed at working with youth, based on recognized criteria and methods. The authors propose establishing a national network of youth policy research centers affiliated with leading universities. These centers would provide essential data and analysis for youth policy at all levels, addressing youth expectations and concerns across social, political, cultural, and economic spheres.

Sustainable agricultural principles guided the development of a machine designed for the application of organic fertilizers in fruit and vineyard plantations. Applied research was therefore conducted to design (using three-dimensional design software), construct, and test a machine with a capacity of 3 tons. The machine is capable of performing fertilization between tree rows, either across the entire inter-row width or in strips near the tree rows, ensuring efficient nutrient application directly to the root zone. The designed, constructed, and tested prototype features a ratchet mechanism driving the scraper conveyor, which delivers the manure to the rotors in the grinding and spreading section. This configuration prevents the spiral rotors from clogging and avoids conveyor chain breakage. Experimental research conducted under laboratory and field conditions demonstrated that the machine can distribute manure over a working width ranging from 960 to 1800 mm.

STUDY QUESTIONDoes a homozygous HFM1 mutation cause human embryonic developmental arrest by disrupting zygotic genome activation?SUMMARY ANSWERA pathogenic homozygous HFM1 mutation causes aberrant mRNA splicing and produces a protein that fails to localize to the nucleus, leading to widespread transcriptional dysregulation, failure of zygotic genome activation, and consequent embryonic arrest.WHAT IS KNOWN ALREADYHFM1 (Helicase 1) is a germ cell-specific gene that plays a pivotal role in meiotic recombination and DNA damage repair, and its mutations are linked to premature ovarian insufficiency. While HFM1 knockout mice exhibit fertility defects, the mechanism by which HFM1 mutations cause preimplantation embryonic arrest in humans, particularly its role in zygotic genome activation, remains unclear.STUDY DESIGN, SIZE, DURATIONThis was a case-based experimental study conducted from June to November 2024, involving a single infertile patient carrying a homozygous HFM1 mutation and experiencing recurrent embryonic arrest. Analyses included molecular characterization of patient embryos and functional validation in a mouse model.PARTICIPANTS/MATERIALS, SETTING, METHODSThe patient was recruited from the Reproductive Medicine Centre of the Affiliated Guangdong Second Provincial General Hospital of Jinan University. Whole-exome sequencing identified a homozygous HFM1 mutation. Minigene assays, RNA-seq, immunofluorescence, and confocal imaging were used to characterize the mutation’s impact on splicing, protein localization, and transcriptomic and epigenetic states. Functional rescue experiments were performed in mouse embryos.MAIN RESULTS AND THE ROLE OF CHANCEFunctional analysis confirmed that the HFM1 mutation disrupts normal mRNA splicing, leading to the production of a protein variant that is excluded from the nucleus. Transcriptomic and epigenetic profiling of arrested human embryos linked the abnormal localization of this protein to a failure in zygotic genome activation and aberrant retention of H3K27me3. The essential role of HFM1 was further verified in a mouse model, where embryonic defects induced by HFM1 knockdown were specifically rescued by wild-type HFM1 mRNA, but not by the mutant version.LIMITATIONS, REASONS FOR CAUTIONThe findings are based on a single clinical case and a limited number of embryos. Further studies with larger cohort studies are needed to validate the prevalence and pathogenicity of such mutations. Further mechanistic studies are also required to fully elucidate how HFM1 regulates gene expression and epigenetic remodeling.WIDER IMPLICATIONS OF THE FINDINGSThis study establishes that nuclear localization of HFM1 may be essential for ZGA and early embryogenesis in humans. It provides a mechanistic link between noncoding HFM1 variants, transcriptional dysregulation, epigenetic dysregulation, and embryonic arrest, expanding the genetic understanding of female infertility and informing future diagnostic approaches.STUDY FUNDING/COMPETING INTEREST(S)This study was supported by National Key R&D Program of China (2022YFC2702200), the National Natural Science Foundation of China (82271728), and the Key Basic and Applied Research Project of Guangdong Province (2023B1515120027). None of the authors have any competing interests.TRIAL REGISTRATION NUMBERn/a.

Objective – Analyze the city of Passo Fundo/RS from the perspective of more sustainable urban planning, evaluating indicators from NBRs ISO 37120, 37122 and 37123, and discussing strategies for energy efficiency, technologic Methodology – Applied research with a qualitative and descriptive approach, carried out based on a bibliographic review on sustainable cities, and based on a case study and documentary analysis of the indicators of NBRs ISO 37120, 37122, and 37123. Originality/Relevance – The study fills the research gap that relates international standards of urban sustainability to the context of medium-sized Brazilian municipalities, strengthening the academic and technical debate. Results – Potential for advancement was identified in public policies aimed at energy efficiency, technological innovation and urban resilience, as well as good practices in urban mobility with a focus on the population's quality of life. Theoretical/Methodological Contributions – The work reinforces the applicability of NBRs ISO 37120, 37122, and 37123 as diagnostic and planning tools for more sustainable city management. Social and Environmental Contributions – Benefits related to improving the efficiency of urban services and reducing environmental impacts are evident, seeking greater alignment of Passo Fundo with global sustainability goals.

Applied researchers often encounter situations where certain item response categories receive very few endorsements, resulting in sparse data. Collapsing categories may mitigate sparsity by increasing cell counts, yet the methodological consequences of this practice remain insufficiently explored. The current study examined the effects of response collapsing in Likert-type scale data through a simulation study under the confirmatory factor analysis model. Sparse response categories were collapsed to determine the impact on fit indices (i.e., chi-square, comparative fit index [CFI], Tucker-Lewis index [TLI], root mean square error of approximation [RMSEA], and standardized root mean square residual [SRMR]). Findings indicate that category collapsing has a significant impact when sparsity is severe, leading to reduced model rejections in both correctly specified and misspecified models. In addition, different fit indices exhibited varying sensitivities to data collapsing. Specifically, RMSEA was recommended for the correctly identified model, and TLI with a cut-off value of .95 was recommended for the misspecified models. The empirical analysis was aligned with the simulation results. These results provide valuable insights for researchers confronted with sparse data in applied measurement contexts.

Pediatric cervical spine injury (CSI) is a rare occurrence; however, CSI can result in significant disability and death. It is essential to determine the optimal CSI clinical prediction rule to risk stratify children with potential CSI after blunt trauma who require cervical spine imaging. To compare the test characteristics and projected imaging rates between 3 prospectively derived CSI clinical prediction rules: the Pediatric Emergency Care Applied Research Network CSI prediction rule (PECARN CSI rule), the National Emergency X-Radiography Utilization Study (NEXUS), and the Canadian Cervical Spine (c-spine) rule (CCR). This comparative effectiveness study was a planned secondary analysis of a prospective observational study enrolling from December 2018 to October 2021 in 18 PECARN emergency departments. Eligible participants were children up through age 17 years presenting after blunt trauma. Data were analyzed between March 2024 and January 2025. Enrollment in the primary study to develop and validate the PECARN CSI prediction rule. Test characteristics with 95% CIs (sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV]) and area under the curve (AUC) for the receiver operator curves (ROC) for the detection of CSI using each of the 3 rules. We also estimated the projected c-spine imaging rate (radiography or computed tomography [CT]) based on criteria for each of the 3 rules. There were 22 430 eligible children enrolled (median [IQR] age 8 [2.0-13.0] years; 13 068 male [58.3%]) and 433 (1.9%) had CSI. C-spine imaging was performed 12 768 children (56.9%): 8912 (39.7%) had radiography and 3856 (17.2%) were imaged with CT. The sensitivity of the 3 rules was: PECARN CSI rule, 93.3% (95% CI, 90.9%-95.7%); NEXUS, 85.7% (95% CI, 82.4%-89.0%); and CCR, 90.8% (95% CI, 88.0%-93.5%). The NPV of the 3 rules was: PECARN, 99.8% (95% CI, 99.7%-99.9%); NEXUS, 99.6% (95% CI, 99.5%-99.7%); and CCR, 99.7% (95% CI, 99.6%-99.8%). Strictly applying each rule resulted in projected CT imaging of 1549 children (6.9%) for PECARN, 2419 (10.8%) for NEXUS, and 2968 (13.2%) for CCR. In this comparative effectiveness study of CSI prediction rules in children, the PECARN CSI rule had the highest sensitivity and NPV for identifying children at risk for CSI after blunt trauma, with the lowest projected CT imaging rate.

In recent years, the application of various advanced technologies, such as digitization and informatization, has become the primary tool for innovation in education and teaching. For traditional single-chip microcomputer course teaching, it is necessary to emphasize the introduction and application of high-tech innovations in its path of innovative development. This course is a typical representative of multidisciplinary teaching, involving multiple disciplines such as electronic engineering, automation, and computer science. In response to issues faced in traditional teaching, such as rigid organization of teaching content that struggles to keep pace with technological advancements, resulting in a noticeable lag in knowledge transfer, and monotonous teaching methods that fail to precisely meet the diverse learning needs of students, analyzing the innovative applications of this course under the empowerment of AI technology holds significant practical relevance. In this regard, the study relies on AI technology empowerment to analyze the application paths for the deep integration of AI technology and single-chip microcomputer courses, constructing a new teaching model to provide references for enhancing teaching quality and stimulating students’ innovative potential.

The rapid growth of e-commerce has increased the demand for efficient order picking systems in large warehouses. To improve throughput performance, many facilities deploy autonomous mobile robots (AMRs) to assist human pickers. Warehouse throughput critically depends on the choice of human-robot collaboration policy. This study focuses on two popular policies: the swarm policy, in which pickers switch between AMRs while picking, and the system-directed policy, in which a picker completes an order with a single AMR. An analytical framework is developed to evaluate these policies. We model the swarm policy as a closed queuing network with a synchronization station, and we derive closed-form expressions for its steady-state probabilities and throughput given load-dependent service rates. The service rates of the network nodes are estimated by Monte Carlo simulation, accounting for stochastic travel times, varying order sizes, item allocation strategies, matching rules, and warehouse layouts. The analytical predictions are validated against detailed discrete-event simulations, with average relative errors below 2% in [Formula: see text] instances. The results indicate that the swarm policy generally provides higher throughput than the system-directed policy, with gains increasing in the AMR-to-picker count and speed ratios. The system-directed policy is more effective when AMR and picker speeds are similar, the orders are large, and there is a limited number of AMRs. Managerial insights are provided to guide policy choice. Funding: This research is part of the Sharehouse Project, which was cofinanced and supported by the Dutch Research Council NWO, the Dutch Ministry of I&amp;W, the Taskforce for Applied Research SIA, the Dutch Topsector Logistics, and TKI Dinalog [Project 439.18.452]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2024.0969 .

BackgroundSeizures are one of the most common reasons for emergency medical services (EMS) activation for children, and current EMS practice results in underdosing and delayed delivery of anti-seizure medication. A prehospital evidence-based guideline recommends using intranasal or intramuscular midazolam as first-line treatment for pediatric seizures. Despite attempts to implement these guidelines, one-third of children having a paramedic-witnessed seizure have ongoing seizures on emergency department (ED) arrival; this may be due to inadequate or delayed midazolam dosing. Replacing the error-prone, sequential calculations with age-based midazolam dosing may be simpler, faster, and more effective without compromising safety. The objective of this manuscript is to describe the methodology of the Pediatric Dose Optimization for Seizures in EMS (PediDOSE) study, a clinical trial designed to compare the effectiveness and safety of an EMS protocol with four age-based categories for midazolam dosing relative to the current weight-based dosing.MethodsWe are conducting a large EMS-based stepped wedge trial in the Pediatric Emergency Care Applied Research Network (PECARN) by implementing midazolam dosing based on four age categories in seizure protocols in EMS systems in 20 cities. We believe that this implementation will stop more seizures before ED arrival without increasing respiratory failure rates. The primary aim of this study is to compare the effectiveness of age-based EMS midazolam dosing compared to the current weight-based dosing on seizure cessation upon ED arrival. The secondary aim is to determine the frequency of respiratory failure in children after the implementation of EMS midazolam dosing based on these age categories.ConclusionIf this study demonstrates that an EMS patient care protocol with age-based midazolam dosing is safe and more effective than current practice, the potential impact of this study is a paradigm shift in the treatment of pediatric seizures that can be easily implemented in EMS systems across the country. Beyond seizures, the concept of age-based dosing may also be applicable to other commonly encountered pediatric prehospital conditions for which medication may be indicated.

Fever in the first month of life is often the only sign of life-threatening invasive bacterial infection, specifically bacteremia or bacterial meningitis. Most international guidelines recommend routine lumbar punctures for all febrile infants 28 days or younger to rule out bacterial meningitis. Clinical prediction rules may allow for select testing, but limited information exists on their performance to identify infants at low risk for invasive bacterial infections. To evaluate the diagnostic accuracy of the updated Pediatric Emergency Care Applied Research Network (PECARN) prediction rule for identifying febrile infants 28 days or younger with bacteremia or bacterial meningitis. This pooled analysis of 4 published prospective cohort studies from pediatric emergency departments across 6 countries within the global Pediatric Emergency Research Network included previously healthy, non-ill-appearing, full-term (≥37 weeks' gestation) infants aged 28 days or younger with a temperature greater than or equal to 38.0 °C who underwent urine, blood, and serum testing. Infants were classified as low risk if they had a negative urinalysis/dipstick test result, serum procalcitonin less than or equal to 0.5 ng/mL, and blood absolute neutrophil count less than or equal to 4000/mm3. Meta-analytic methods were applied to assess diagnostic accuracy (sensitivity, specificity, and positive and negative predictive values) of the PECARN rule for detection of infants with invasive bacterial infections (bacteremia or bacterial meningitis). Among 1537 infants 28 days or younger (905 male, 1324 hospitalized, 1080 with lumbar punctures), 69 (4.5%) had invasive bacterial infections, including 11 (0.7%) with bacterial meningitis. Overall, 632 (41.1%) met low-risk criteria. The prediction rule had a sensitivity of 94.2% (95% CI, 85.6%-97.8%), specificity of 41.6% (95% CI, 36.7%-46.7%), positive predictive value of 6.9% (95% CI, 4.8%-9.9%), and negative predictive value of 99.4% (95% CI, 98.1%-99.8%) for invasive bacterial infections. In a secondary analysis of 2531 infants from the 2 US-based cohorts from which the rule was originally derived and the 4 validation cohorts, 96 (3.8%) had invasive bacterial infections, 22 (0.9%) had bacterial meningitis, and 1079 (42.6%) were classified as low risk; rule performance was similar. No infants with bacterial meningitis were misclassified in the primary or secondary analyses. The updated PECARN rule had high sensitivity but lower specificity for identifying febrile infants 28 days or younger with invasive bacterial infections in this study, with no missed cases of bacterial meningitis. These results may support shared decision-making regarding select vs routine use of lumbar puncture among infants classified as being at low risk of invasive bacterial infections.

This community service initiative took place at Pondok An Nahdloh, an Islamic boarding institution in Selangor, Malaysia, particularly serving the educational requirements of children of Indonesian migrant workers. Despite the integration of religious and general language training, students encounter difficulties in acquiring derivational and inflectional morphemes due to linguistic interference, inconsistent pedagogical approaches, and restricted access to resources. To address these issues, the project applied a multilingual and contextualized teaching approach that incorporated contrastive analysis, translanguaging strategies, and the use of familiar cultural and religious contexts. Materials suitable for various age groups were created, comprising interactive games, organized exercises, and digital resources like flashcards, quizzes, and augmented reality experiences. Furthermore, capacity-building workshops were conducted for educators and community people to guarantee sustainability. The project results indicated higher student skill in morpheme application, heightened motivation for language acquisition, and improved teacher effectiveness in providing consistent instruction. This approach cultivated a sustainable language learning environment, enhanced community engagement, and advanced the overall empowerment of the pesantren.