Detailed Questionnaire Research Articles

Challenges of Engineering Skillsets Essential for Driving Circularity of Smart Cities

This study aims to define specific transferable engineering capabilities needed for the implementation (design and practices) of circular economy (CE) within a smart city setting. We conducted a critical literature review of over 100 studies on the core values of CE and smart cities to investigate the knowledge gap in this topic and understand what specific skillset is employed by industry experts that can be harnessed on a wider scale, which can allow for the optimization of CE. There is a lack of research on the skillsets needed to implement a circular economy in any setting, and there are very few studies on circularity practices in a smart city setting. Primary data collection allows us to bridge this knowledge gap, yielding new findings that do not already exist concerning the skillset employed by experts in the field, which can positively impact the smart city settings in which a circular economy is implemented. We conducted a qualitative analysis based on expert interviews of 21 participants who have experience in the circular economy. This information will benefit the industry by informing businesses and councils about the key skillsets and capabilities to look out for when employing people to implement any aspect of circular practices in a smart city setting, with an emphasis on enhancing efficiency, achieving deliverables, and thinking systemically to address complex challenges they may face during the implementation. We also investigated the implementation of CE in smart cities to provide a well-rounded view of the different achievements and challenges faced during the process. This mainly focuses on the work of governance in smart circular cities, a factor that has many important implications and externalities in different sectors. This study describes the methodology adopted to formulate a detailed questionnaire for expert interviews with respect to the skill gap and capabilities necessary for working in the industry, the results of which aid discussions regarding the different challenges faced in CE implementation. Our findings reveal that background knowledge in engineering and sustainability is the most ‘highly critical’ hard skill according to the experts, while communication and stakeholder engagement are the essential soft skills required to ensure the success of a circular economy within smart city settings.

EVALUATING THE FINANCIAL PROBLEMS AND PROSPECTS OF MICRO AND SMALL-SCALE ENTERPRISES OF AHMEDABAD CITY

Micro, Small, and Medium Enterprises (MSMEs) are pivotal to economic growth, contributing significantly to employment and industrial development. Despite their importance, these enterprises frequently encounter financial challenges that hinder their growth and stability. This study explores the financial issues faced by MSMEs through a sample of 120 respondents from Ahmedabad city, using a detailed questionnaire to collect data. The research reveals that MSMEs, especially those in urban areas and engaged in manufacturing, face varied financial difficulties influenced by their business nature and ownership structure. Key findings highlight a predominant reliance on personal savings and informal financial sources, indicating gaps in formal financial support. The study's originality lies in its targeted analysis of different enterprise profiles and financial solutions, offering insights into improving financial assistance tailored to MSME needs. The results underscore the need for policy interventions and innovative financial products to better support these vital enterprises.

Remediating cognitive inflexibility in obsessive compulsive disorder and anorexia nervosa neither moderates nor mediates treatment effects: an exploratory study

ObjectiveObsessive compulsive disorder (OCD) and anorexia nervosa (AN) are conditions associated with poor cognitive flexibility, a factor considered to interfere with treatment, but research into the relationship between cognitive flexibility and treatment outcome is limited. This study explores whether baseline measures of cognitive flexibility predict outcomes in OCD and AN, evaluates whether changes in these measures contribute to treatment outcome, and evaluates the effectiveness of adjunctive cognitive remediation therapy (CRT) in improving cognitive flexibility.MethodsThis secondary analysis utilized linear mixed model analysis on data from a randomized controlled multicenter clinical trial involving adult participants with OCD (n=71) AND AN (n=61). Participants underwent 10 twice-weekly sessions of either CRT or a non-specific active control intervention (specialized attention therapy; SAT), followed by treatment as usual. Assessments using Yale-Brown Obsessive Compulsive Scale and the Eating Disorder Examination Questionnaire were conducted at baseline, post-CRT/SAT and at 6 and 12 months. Cognitive flexibility was evaluated through the Trail Making Test (TMT), the Color-Word Interference Test (CWIT) and the Detail and Flexibility Questionnaire (DFlex).ResultsLevels of cognitive flexibility at baseline did not predict or moderate treatment outcome, nor did change in cognitive flexibility (baseline post-CRT/SAT) mediate treatment outcome, with CRT providing no greater improvement in measures of cognitive flexibility than SAT.ConclusionsThis study failed to find any relationship between measures of cognitive flexibility and treatment outcome in OCD and AN, and thus questions hypothetical associations between measures of cognitive flexibility and mechanisms of change in patients with OCD and AN.

Seroprevalence, incidence estimates, and environmental risk factors for dengue, chikungunya, and Zika infection amongst children living in informal urban settlements in Indonesia and Fiji

BackgroundThe burden of Aedes aegypti-transmitted viruses such as dengue, chikungunya, and Zika are increasing globally, fueled by urbanization and climate change, with some of the highest current rates of transmission in Asia. Local factors in the built environment have the potential to exacerbate or mitigate transmission.MethodsIn 24 informal urban settlements in Makassar, Indonesia and Suva, Fiji, we tested children under 5 years old for evidence of prior infection with dengue, chikungunya, and Zika viruses by IgG serology. We used a catalytic model using seroprevalence and mean age to estimate annual incidence of dengue in each country. We also conducted detailed questionnaires to evaluate environmental risk factors for a positive serology result. Dengue risk factors were evaluated for children by univariate and multivariable logistic regression accounting for settlement as a fixed effect. Trash and flooding were additionally evaluated as dengue risk factors at the settlement level by univariate linear regression.ResultsIn Fiji and Indonesia respectively, 46% and 33% of children under 5 years old were seropositive for dengue, 3% and 3% for chikungunya, and 9% and 2% for Zika. In Indonesia, children living in a household where trash is routinely collected and removed were significantly less likely to be dengue seropositive in both unadjusted and adjusted models [adjusted model: OR 0.3 (95% CI: 0.1–0.8)]. In Indonesia, settlements with a higher proportion of households reporting flooding also had lower dengue rates (slope = 0.44; p-value: <0.05).ConclusionsHousehold trash collection and community flood management are important targets for interventions to mitigate the increasing risk of Aedes aegypti-transmitted viruses.

Risk Factors for Symptoms in Patients With Heterotopic Gastric Mucosa in the Upper Esophagus.

Goal: This study is aimed at comparing the clinical characteristics and histological types of symptomatic and asymptomatic patients with heterotopic gastric mucosa in the upper esophagus (HGMUE) and exploring the factors influencing the occurrence and severity of laryngopharyngeal reflux (LPR) symptoms in these patients. Background: HGMUE is a potential cause of LPR symptoms. Study: This retrospective analysis evaluated 70 patients with HGMUE using a detailed questionnaire. Clinical, histological, high-resolution manometry, and 24-h pH impedance monitoring data were compared between symptomatic (n = 49) and asymptomatic (n = 21) patients. Results: The diameter of HGMUE was significantly larger in the symptomatic group (p < 0.05), and the incidence of LPR symptoms increased with larger diameter grades; male patients were more likely to have LPR symptoms. The incidence of LPR symptoms varied significantly across histological classifications, being highest in patients with the fundic type (χ 2 = 6.64, p < 0.05). Binary logistic regression analysis identified sex and histological type as risk factors for LPR symptoms, with odds ratios of 8.996 (95% confidence interval (CI): 1.350-59.962) and 8.493 (95% CI: 1.486-48.522), respectively. The mean nocturnal baseline impedance (MNBI) in the upper esophagus was significantly lower in the symptomatic group (1676.82 ± 739.09 Ω vs. 2441.01 ± 604.11 Ω; p < 0.05). Clinical and demographic characteristics did not significantly affect the severity of LPR symptoms. Conclusion: The diameter, histological type, and sex of patients are risk factors for the occurrence of LPR symptoms in patients with HGMUE. More attention should be paid to patients with these factors. The MNBI is an effective indicator of the symptoms and treatment.

Association Between Self-Reported Lactose Intolerance, Additional Environmental Factors, and Bone Mineral Density in Young Adults.

This study examines the relationship between self-reported lactose intolerance (LI), environmental factors, and their effects on bone mineral density (BMD) in young adults from Slovakia. We assessed 985 adults aged 18-30 years, with an average age of 21.61 ± 2.32 years, who were enrolled in this pilot cross-sectional study during the period 2019-2023. Individual environmental factors (smoking status, alcohol consumption, physical activity, milk and milk product intake, and calcium intake) and self-reported LI were assessed using a detailed questionnaire. BMD was analyzed using the QUS device (Sunlight MiniOmni), and total weight was measured with the InBody 770 bioimpedance analyzer. Linear regression analysis showed the independent influence of age, total weight, and the presence of LI on the speed of sound in meters per second (SOS; m/s) and Z-score parameters in women (p < 0.05), whereas in men, age and smoking status were significant predictors of SOS (p < 0.05), and age and LI status significantly influenced the Z-score (p < 0.05). In the present study of young Slovak adults, the presence of self-reported LI and smoking had a negative effect on BMD, resulting in lower BMD in the radius.

Prevalence of indoor air pollutants from First Nation homes in North Central British Columbia, Canada

ABSTRACT Poor indoor air quality poses significant health risks. This study addresses the gap in knowledge regarding the prevalence of indoor air pollutants in remote and rural First Nation communities in north-central British Columbia, Canada. Dust samples from 75 homes were collected and analysed for house dust mites, pet allergens, mould antigens, and bacterial endotoxins. Indoor air quality parameters, including carbon monoxide, carbon dioxide, particulate matter, temperature, and humidity, were measured. A detailed questionnaire on household characteristics and potential pollutant sources was administered. Homes exhibited exposure to multiple pollutants, with wood stove smoke identified as a primary source. Felis domesticus (cat allergen) and Canis familiaris (dog allergen) were prevalent, with detectable levels in 64% and 60% of homes, respectively. Bacterial endotoxins were present in all households. One-third of homes exceeded recommended thresholds for 3 or more pollutants. This study provides critical insights into the prevalence and magnitude of indoor air pollutants, contributing to a broader initiative to characterise respiratory health in First Nations communities. While many homes in First Nations communities had acceptable air quality, one-third of homes exceeded thresholds for 3 or more pollutants. The results can guide ongoing community efforts to address housing concerns and advocate for increased federal funding.

Healthcare Services and its Impact on Women's Health: A Study of Chitral District

The present study was about healthcare services and their impacts on women's health. This study explored the problem faced by women in accessing healthcare services, and the reasons for their poor health. The research was carried out in the Istangol Valley of District Chitral by married women. The primary objective of this research was to unveil the major health problems of women and how healthcare facilities affect women's health in their daily lives. This study was conducted under a quantitative research design by using social survey method. Data was collected through a detailed questionnaire. A sample size of 103 respondents was selected from the targeted population through simple random sampling. The researcher then analyzed the data by employing a statistical package for social science (SPSS). Through the results, the researcher found that the unavailability of female specialties was a major reason that became a hurdle for women to access healthcare services. The situation of the poor basic health of women showed the failure of health ministries/departments to provide basic healthcare in rural areas. It is recommended that the government take action to upgrade facilities, supply infrastructure, and hire physicians to address women's health concerns in rural regions in order to enhance the health of women there. It is also suggested that non-governmental organizations should spread awareness about healthy diets and the importance of better health.

Head Above Water: The Inspiring Journey of The Swimmers (2022): A Survey on Audience Perception for the MigraMedia Project

This survey investigates how audiences perceive The Swimmers, a biographical drama about two sisters escaping war-torn Syria and their journey as refugees. The study focuses on people with migration backgrounds or experiences, with the goal of understanding how the film relates to their personal stories and how it affects public perception of migration. The participants were asked to fill a detailed questionnaire related to the film’s most memorable or frightening parts, particularly those that depicted the interplay of vulnerability and resilience. This emotional paradox is crucial to The Swimmers, highlighting the fragility and fortitude of the human spirit in the face of enormous adversity. It also investigates how the characters’ unique experiences and personal problems are depicted, focussing on universal themes such as hope, family, and survival. Participants were urged to think on the realism of these portrayals and the consequences of relocation, focussing on how these topics related to their own experiences or knowledge on migration. The film’s narrative offers a nuanced view of refugees, in contrast to the reductive and frequently one-sided portrayals found in the mainstream media, which can marginalise people by presenting them as numbers or political debating points. On the other side, it also highlights how The Swimmers reclaim agency for individuals affected by migration, giving a more empathic and humane perspective. The study also looks at how media portrayals, such as this film, might challenge common preconceptions, promote solidarity, and inspire optimism. By engaging audiences on a deeply personal level, The Swimmers crosses cultural differences, encourages understanding, and highlights the resilience and legacy of migrants worldwide.

The Role of Nursing Educational Program in Improving Nutritional Status among Patients with Heart Failure

Background: Heart failure (HF) is characterized by cardiac dysfunction, fluid retention, and subsequent exercise intolerance, significantly impacting patients’ quality of life. Nutrition plays a pivotal role in managing HF, as dietary modifications can alleviate symptoms and improve clinical outcomes. Foods are categorized based on their nutritional density, which is critical for optimizing health in HF patients. Nurses play a key role in healthcare by providing education, empowering patients to make informed decisions, and enhancing healthcare efficiency through structured interventions. Methods: From (August 2 to February 8, 2024), 200 patients with HF were treated in the Sulaimani Cardiac Hospital in Sulaimani City using a quasi-experimental technique. The participants were divided into two groups: Intervention (100) and control (100). They completed a detailed questionnaire that included demographics, medical data, and a variety of examinations. The interventional group had exclusive access to the nutrition education program. Data were collected through direct interviews and processed with the Statistical Package for the Social Sciences, version (26). Results: The average age of the respondents was (68.3 ± 11.2) years. At first, both groups comprised (100) patients, however, the intervention group dropped to (94) and the control group to (90) owing to fatalities. The nutrition education program resulted in significant differences between the groups in high-density lipoprotein and cholesterol levels, blood electrolytes, waist-hip ratios, and hospitalization rates. Conclusions and recommendations: The intervention group showed greater improvements in nutritional status than the control group. A 12-week educational program improved eating habits, reduced hypertension, diabetes, cholesterol levels, and body weight, and increased awareness of healthier food alternatives. This demonstrates that such programs can enhance quality of life, and dietary habits, and perhaps reduce death rates in the intervention group compared to the control group.

The cow GUTBIOME CY study: investigating the composition of the cattle gut microbiome in health and infectious disease transmission in cyprus

BackgroundRecent evidence suggests that the lower gut microbiome of ruminants presents roles in their health and environment, including the development of the mucosal immune system, milk production efficiency and quality and subsequent methane emissions. However, there are proportionately fewer studies on this complex microbial community in cattle and region-focus studies are non- existent.MethodsHerein, we present the research protocol of the GUTBIOME CY project pertaining to determine the composition of the lower gut microbiome in dairy cows situated in 37 farms across five districts of the island of Cyprus. Detailed questionnaires on animal husbandry and farming practices will be gathered from each farm. Faecal, milk (individual and bulk) and water samples will also be collected from cows and their offspring. Samples will be analysed using a combination of molecular biology and bioinformatics pipelines to define microbiome profiles and antimicrobial resistance (AMR). Information collected from the questionnaires will be used to test for associations between animal husbandry or farming practices and microbiome components and AMR.DiscussionCollected samples will establish the first dairy cattle biobank in the country for contributing substantially towards scientific advancements in microbiome research and providing insights to all stakeholders, tailored to the unique agricultural context of Cyprus.

Factors Affecting Organic Farming Cultivation and Their Role in Achieving Sustainable Development Goals (SDG)

Objectives: The paper aims to explore the factors which influence the organic farming cultivation in India and how they lead towards attainment of SDG. Theoretical Framework: This paper has adopted Theory of Planned Behavior to identify the factors which influence the organic farming and define their relationship with SDG. Method: The paper attempts to explore the factors which influence the organic farming intention among the farmers. It further explores the relationship between intention for organic farming and adoption of organic farming. The data was captured through detailed questionnaire which was captured through 347 respondents. The data analysis was performed with the help of SPSS 29 and AMOS 29 The mediating role of motivation was also explored using process Macro 4.2. Results &amp; Discussions: The findings revealed that environment and cost influence the organic farming intention while attitude and perception had no effect on organic farming intention. Adoption of organic farming shared a positive relationship with organic farming intention The Cultivation of organic products lead to attainment of following goals No Poverty (SDG 1), zero Hunger (SDG2), Good Health and Well Being (SDG3) and Responsible Consumption and Production (SDG 12). Research Implications: The study reveals that there is a need to raise the awareness level among the farmers regarding the role of organic farming, its environmental impacts and health benefits associated with it. The findings underscore the importance of implementing additional training and awareness programs targeted at novice and less-experienced farmers. Such initiatives aim to familiarize them with diverse aspects of marketing, economics, and social factors associated with organic farming.

Health-Related Quality of Life among Patients with Ventricular Assist Devices in Saudi Arabia

Background: End-stage heart failure patients awaiting heart transplant often require Ventricular Assisted Devices (VAD) to support systemic and pulmonary circulation and to improve ventricular function, symptoms, and Health-Related Quality of Life (HRQoL). This study evaluates the health-related quality of life in patients with VAD and was conducted at the Cardio Ventricular Assisted Devices Clinic at King Faisal Specialist Hospital and Research Centre, Riyadh. Methods: This retrospective cohort study design included all eligible VAD patients who were still attending the cardio ventricular assisted devices clinic at KFSHRC, Riyadh. Each study participant was assigned a detailed questionnaire to assess and evaluate HRQoL outcomes measured in physical limitations, emotional stress, sexual activity, and social function from the date of device insertion to the time of data collection. Data were analyzed using the Statistical Package for Social Studies (SPSS 22; IBM Corp., New York, NY, USA). Results: Between February 2016 until June 2020, 26 patients were eligible for the study. The patients' support scores were moderate to high, indicating a positive effect on their HRQoL, with a mean score of 57.69 in emotional activity, a mean score of 34.07 in physical activity, and a mean score of 83.17 in social activity. The study's results show that the level of HRQoL varies among patients with VADs. Conclusion: Participating patients with VAD reported excellent health-related quality of life in all domains, with moderate to high support scores indicating a positive effect on their HRQoL. There is currently a lack of study on HRQoL in patients with VADs in Saudi Arabia. Therefore, this study may provide a baseline understanding of current challenges in the care of heart failure patients with VAD awaiting a heart transplant.

Effects of Beverage Consumption, Light Exercise, and Sleeping Hours on Salivary Flow Rate, Buffering Capacity, and Albumin Level in Young Adults

Background: Salivary characteristics play a crucial role in maintaining oral health and can be affected by various lifestyle factors. There is very little research to cover the influence of individuals lifestyle behavior on the salivary biomarkers. This research paper aims to explore the influence of popular drinks, light exercise, and sleeping hours on salivary flow rate, buffering capacity, and salivary albumin level in young adults. Materials and methods: The study involved 92 participants aged 18-25 years who were completed a detailed questionnaire on their dietary habits, physical activity, and sleep patterns. Saliva samples were collected and analyzed to determine the salivary flow rate, buffering capacity, and albumin level. Unstimulated whole saliva was collected from participants, and flow rate was noted down during collection of the sample. pH was assessed with a digital pH meter and buffering capacity was estimated using Ericsson method. Salivary albumin was estimated using the Bromocresol green method. Kolmogorov-Smirnov, Pearson correlation, Spearman’s rank correlation, Mann-Whitney U and t-test were used for statistical analysis. Results: The results showed nonsignificant correlations between salivary parameters and the lifestyle factors studied. However, significant correlations were observed between body mass index and light exercise, and consumption of water and water-milk. Also, a significant correlation was obtained between gender and salivary buffering capacity. Conclusion: Combination of lifestyle factors could influence salivary characteristics in young adults. Further research with larger number of participants is needed to elucidate the complex interplay between lifestyle behaviors and oral health biomarkers.

THE SOUK OF EL KHROUB: AN ECONOMIC AND SOCIAL PILLAR IN RESPONSE TO RECENT COMMERCIAL TRANSFORMATIONS

At the heart of El Khroub’s urban dynamics, the traditional market (souk) continues to play a significant economic and social role, despite facing recent urban transformations and the challenges posed by contemporary development types. Over a six-month period, encompassing 52 working days of the souk (Thursdays and Fridays), we conducted an in-depth sociological survey using a detailed questionnaire with a representative sample of 400 individuals. The sample was selected using the Krejcie and Morgan method, combined with the quota sampling method (Moser &amp; Kalton, 1971), to ensure that our sample reflected the diversity of stakeholders involved in the souk. The population was divided into four main strata: merchants, long-time visitors of the souk, local government members, and buyers. In addition to this survey, we conducted direct interviews with officials involved in the management of the souk, such as the municipal treasury officer and the current lessee of the souk, while also consulting the relevant specifications. This thorough assessment allowed us to fully understand the socio-economic characteristics and dynamics of this market. Thus, although initially centered on livestock trade, the souk of El Khroub has lost much of its former vitality ; it remains a crucial economic hub for local businesses and an essential social gathering point, despite the lack of relevant initiatives from municipal services to invigorate it and restore its former prominence. This paper highlights the critical importance of the El Khroub souk as an economic and social space, which requires the implementation of a strategy that would ensure its prosperity and ability to face current economic challenges. Therefore, we present a scenario to address these issues.

The Impact of Alpha-s1 Casein Hydrolysate On Chronic Insomnia: A Randomized, Double-Blind Controlled Trial

BackgroundAlpha-s1 casein hydrolysate (ACH; Lactium®) is recognized as a supplementary treatment to enhance sleep quality. However, limited studies utilizing objective sleep assessment tools have resulted in a lack of substantial validation. This study aimed to assess the effects of ACH on both subjective sleep assessments and objective polysomnography (PSG) recordings in a hospital-based cohort of Taiwanese individuals with chronic insomnia. MethodsIn this 4-week randomized, double-blind, placebo-controlled trial, 36 participants diagnosed with chronic insomnia were enrolled and randomly assigned to either the ACH or placebo groups. Initially, participants in the ACH group received 600 mg of ACH daily, which was reduced to 300 mg for the latter two weeks; the placebo group received maltodextrin capsules throughout the study. The study utilized polysomnography (PSG), along with detailed sleep questionnaires including the Insomnia Severity Index (ISI), Global Sleep Disorders Score (GSDS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression Scale (HADS), to assess improvements in sleep quality and related health markers. The efficacy of the intervention was assessed through measures of sleep efficiency, stage distribution, and psychological well-being, comparing results from before to after the treatment phase. ResultsThe study demonstrated that ACH treatment notably enhanced sleep quality, evidenced by significant improvements in ISI, GSDS, PSQI, ESS, and HADS scores at both week 2 and 4 (all p-values < 0.05) compared with baseline scores. When compared to the placebo group, the ACH group experienced a marked reduction in GSDS scores over time (p = 0.045). Furthermore, PSG data revealed a significant decrease in sleep onset latency from baseline in the ACH group compared to the placebo group (p = 0.012; -7.7 ± 16.0 minutes vs. 6.1 ± 17.7 minutes for ACH and placebo groups, respectively). These results indicate that ACH treatment effectively improved sleep initiation and overall sleep quality. ConclusionACH Supplementation significantly improved sleep quality, particularly by reducing GSDS scores and sleep onset latency, demonstrating its potential as an effective intervention for chronic insomnia. Future studies with larger samples and exploration of long-term effects are needed to confirm these results.

Effect of electroacupuncture on discomfort in patients undergoing colonoscopy: protocol for a multicentre, randomised, controlled clinical trial

IntroductionColonoscopy is currently the most commonly used and effective method for early detection, diagnosis and treatment of tumours of the colon and rectum. However, similar to other invasive procedures, it...

Nationwide Survey on Incidence and Management of Recurrent Respiratory Papillomatosis in Japan.

To investigate the incidence, laryngeal distribution, management, and postoperative clinical course of patients with newly diagnosed adult-onset recurrent respiratory papillomatosis (RRP) in Japan. An initial brief questionnaire was sent to 782 institutions, including all 101 core and 627 collaborating institutions providing board certification programs accredited by the Japanese Society of Otorhinolaryngology-Head and Neck Surgery. A detailed questionnaire regarding patient age, sex, Derkay's score, surgery, and postoperative clinical course was sent to 196 institutions caring for patients with either newly or previously diagnosed RRP. A total of 186 patients with newly diagnosed adult-onset RRP from 78 institutions were identified during the present study period (2018-2019), suggesting an annual incidence of 0.20 per 100,000 population in Japan. The true vocal folds were the most frequently affected subsites in the larynx, followed by the false vocal folds, anterior commissure, and laryngeal surface of the epiglottis. The use of cold instruments was the most preferred surgical approach, followed by the carbon dioxide laser and microdebrider. A significant difference in recurrence-free period after the initial surgery was observed between patients with lesions in a single region and those with lesions in multiple regions (p = 0.001). Here, we estimated the annual incidence of adult-onset RRP for the first time in Japan. To the best of our knowledge, the present study is the largest to identify the laryngeal distribution of lesions, as well as postoperative outcomes after initial surgery in newly diagnosed adult-onset RRP patients. 4 Laryngoscope, 2024.

Contributions of internal and external factors to bilingual development: Evidence from Kurdish-English adolescents

Aims: This study examined the role of internal and external factors in bilingual language outcomes in a societal/first language (L1) and minority/foreign language (FL) context. Methodology: Participants were 98 Kurdish-English adolescents, living in the Kurdistan Region of Iraq. The data collected through a detailed questionnaire and a battery of standardized and researcher-developed measures. Data and analysis: Data were analyzed using backward regression and hierarchical regression models. Findings: Richness of the Kurdish and English environment contributed to language outcomes, of which parental Kurdish proficiency, Kurdish input from media, and paternal English proficiency were the best predictors of greater Kurdish morphosyntactic knowledge and faster lexical access ability in Kurdish and English. Cognitive and age factors predicted language outcomes, of which nonverbal analytic reasoning and older age of English exposure were the best predictors of greater English morphosyntactic knowledge and larger vocabulary size in both languages. As two different sets, external factors outweighed internal factors in terms of vocabulary size and lexical access abilities in both languages as well as Kurdish morphosyntax. The contribution of two sets was alike for English morphosyntax. Conclusions: Sensitivity to variation in individual difference factors varies depending on the linguistic domains. External factors are more essential for bilingual development, but at the same time, the role of internal factors in dual language learning should not be underestimated. Originality: With valuable insights offered by previous research, this study contributes to the field of bilingual development through examining a large number of individual difference factors in one of the most under-studied bilingual populations.

Quantitative study on objective indicators for assessing motion sickness susceptibility based on Vestibulo-Ocular Reflex experiments

Motion sickness (MS) is a common physiological response that often occurs when individuals are exposed to environments with repeated acceleration stimuli. MS results from a mismatch between the vestibular system and visual and proprioceptive inputs. As a crucial organ for sensing acceleration stimuli, the vestibular system is closely related to the onset of MS. However, the complex pathogenesis of MS has led to its diagnosis primarily relying on subjective questionnaires, with a lack of objective indicators for evaluation. To identify objective indicators for evaluating MS, we conducted rotating chair stop experiments based on the principle of vestibulo-ocular reflex with 65 volunteers, obtaining their nystagmus slow-phase velocity and related time constants. Additionally, we conducted detailed MS questionnaires with these volunteers to assess their MS susceptibility. Through correlation analysis, we explored whether the nystagmus slow-phase velocity and related time constants significantly correlated with the MS questionnaire scores. The results showed significant positive correlations between the maximal nystagmus slow-phase velocity, cupula time constant, velocity storage time constant, and the nystagmus duration with the MS questionnaire scores in the 65 volunteers. These results indicated that these nystagmus parameters could serve as objective indicators for assessing MS susceptibility. Using K-Means clustering analysis, we classified MS susceptibility into categories I, II, III, and IV, and conducted K-Means clustering analysis on the corresponding nystagmus slow-phase velocity, cupula time constant, velocity storage time constant, and nystagmus duration. The magnitude and range of these indicators at different levels was quantified, offering objective and quantitative indicators for the clinical diagnosis of MS.