Implementation Of Effective Strategies Research Articles

Developing technological pedagogical content knowledge skills during teaching practicum

<span lang="EN-US">This study investigates the efforts of Indonesian pre-service teachers in developing their technological pedagogical content knowledge (TPACK) skills during teaching practicum, explores the obstacles they encounter in this process, and examines their responses to the challenges of TPACK skills development. Employing qualitative narrative inquiry as the research method, the study interviews five pre-service teachers from various study programs to gain insights into their experiences. The findings demonstrate that Indonesian pre-service teachers employ diverse strategies to enhance their TPACK skills, including observing experienced teachers, participating in workshops or online courses, reading relevant literature on TPACK, and consistently integrating TPACK into their teaching practice. However, they face obstacles such as a lack of confidence in their teaching abilities, limited time and resources for reflective practice, and inadequate self-awareness regarding their skills. To overcome these obstacles, they respond by collaborating with peers and mentors, engaging in reflective teaching practice, and setting goals for each practicum session. The study provides valuable insights for teacher training institutions (TTIs), educators, practitioners, and policymakers, facilitating the implementation of more effective strategies for integrating TPACK in future events.</span>

Analysing the drivers of smart city implementation using DEMATEL method

<p>Indian cities are becoming more and more populated, and the technological, environmental, social, political and economic infrastructure of those cities is deteriorating, necessitating the development of more innovative methods to enhance public utilities and services. The growth of smart cities encourages the creation of a stable, networked, and sustainable metropolitan structure. The “100 Smart Cities Mission” was started by the Indian government to encourage planned development. However, there is also a literature of criticisms on the used indicators by the smart city mission. A thorough investigation is necessary to identify the critical infrastructure, important resources, and development patterns for smart city planning. The purpose of my study is to achieve and move towards Smart City Mission goals in a holistic framework. This research paper proposes a weighted criteria to assess the eligibility factors identified from the literature studies of Smart City Mission, to analyze the complex relationships among the indicators, to develop a holistic approach and classify factors based on the drivers of dependence and implementation. The findings of this study shed light on the key drivers and barriers to the implementation of smart city initiatives. The DEMATEL method provided a valuable tool for analysing the complex interrelationships between different factors and identifying the most influential drivers. The results can guide policymakers, city managers, and other stakeholders in developing more effective strategies for smart city implementation. However, the study also highlights the need for further research to explore the context-specific factors that may affect the drivers of smart city implementation in different regions and cities. Overall, this study contributes to the growing body of literature on smart cities and provides practical insights for decision-makers seeking to promote sustainable and inclusive urban development.</p>

Teaching and Learning English in the Digital Era: Opportunities and Challenges

This paper examines the opportunities, challenges, and perspectives of teaching and learning English in the digital era. With the rapid advancement of technology and its integration into educational settings, English language instruction has experienced significant transformations. The paper explores the potential benefits of digital tools and platforms in language learning while also addressing the challenges in the digital language classroom. Based on a review of previous studies and a comprehensive analysis, it further discusses the evolving roles of teachers and learners in this digital landscape and presents strategies for effective implementation and utilization of technology in English language education. The findings offer to share expertise, disseminate the lessons learned, and recommend best practices collected from scholarship. Sustainable solutions to specific problems and perspectives to cope with future challenges have been proposed with the recommendation of effective systems such as Computer Assisted Language Learning (CALL), Mobile Phone Assisted Language Learning (MPALL) and other sophisticated tools that fit some specific situations.

Strategies for enhancing global supply chain resilience to climate change

This review paper addresses the critical need for enhancing resilience within global supply chains against climate change impacts. It systematically explores strategies for identifying and assessing risks, adapting supply chain practices, fostering collaborative efforts among stakeholders, and leveraging policy and regulatory support. The study highlights the financial, technological, and regulatory challenges impeding resilience implementation, emphasizing the exacerbating effect of global inequalities. Recommendations for businesses, policymakers, and international bodies are provided to facilitate the effective implementation of resilience strategies. The paper calls for future research focusing on empirical validation of these strategies, integrating long-term climate projections, and exploring social dimensions within supply chain resilience. This comprehensive approach aims to bolster global supply chains against climate-induced disruptions, contributing to sustainable economic stability and community well-being. Keywords: Climate Change, Global Supply Chains, Resilience Strategies, Risk Management, Collaboration, Policy Support.

LEADERSHIP STYLES AND PERFORMANCE OF ROAD PROJECTS UNDER KENYA RURAL ROADS AUTHORITY IN KENYA

Road infrastructure drives global economic growth by facilitating the movement of goods, services, and people, enhancing trade and regional integration; recent improvements in developing countries have reduced cost overruns, highlighting the importance of effective strategy implementation, stakeholder engagement, and sustainability considerations for project success. The aim of the study was to establish whether leadership styles influence the performance of road projects by Kenya Rural Roads Authority. The study sought to establish whether leadership styles influence the performance of road projects by Kenya Rural Roads Authority. The study employs multiple theories, including Resource-Based Theory, Agency Theory, and others, within a mixed-methods approach guided by pragmatism. Focused on 140 Development Road Projects by KeRRA, it includes 104 Strategy Implementation Officers, Contractors’ CEOs, and KeRRA officials. Data, gathered through questionnaires and interviews, underwent statistical analysis revealing a significant positive correlation (r = 0.508, p < 0.05) between leadership styles and project performance, using SPSS Version 27. The study suggests that project managers at the Kenya Rural Roads Authority demonstrate positive leadership qualities, such as agreeableness and visionary leadership, which are linked to timely completion of road construction projects, although challenges like resistance to change and laissez-faire leadership tendencies may impede project success. Recommendations include reinforcing and promoting positive leadership qualities among project managers at the Kenya Rural Roads Authority, focusing on aspects such as agreeableness, visionary leadership, and developmental leadership, while addressing challenges related to laissez-faire and resistance to change through training and support initiatives, and emphasizing the importance of directive leadership to improve project outcomes and ensure successful completion of road construction projects. KEY WORDS: Leadership Styles, Performance of Road Construction Projects, Kenya Rural Roads Authority

Multimorbidity patterns and trajectories in young and middle-aged adults: a large-scale population-based cohort study

IntroductionThe presence of multiple chronic conditions, also referred to as multimorbidity, is a common finding in adults. Epidemiologic research can help identify groups of individuals with similar clinical profiles who could benefit from similar interventions. Many cross-sectional studies have revealed the existence of different multimorbidity patterns. Most of these studies were focused on the older population. However, multimorbidity patterns begin to form at a young age and can evolve over time following distinct multimorbidity trajectories with different impact on health. In this study, we aimed to identify multimorbidity patterns and trajectories in adults 18–65 years old.MethodsWe conducted a retrospective longitudinal epidemiologic study in the EpiChron Cohort, which includes all inhabitants of Aragón (Spain) registered as users of the Spanish National Health System, linking, at the patient level, information from electronic health records from both primary and specialised care. We included all 293,923 patients 18–65 years old with multimorbidity in 2011. We used cluster analysis at baseline (2011) and in 2015 and 2019 to identify multimorbidity patterns at four and eight years of follow-up, and we then created alluvial plots to visualise multimorbidity trajectories. We performed age- and sex-adjusted logistic regression analysis to study the association of each pattern with four- and eight-year mortality.ResultsWe identified three multimorbidity patterns at baseline, named dyslipidaemia & endocrine-metabolic, hypertension & obesity, and unspecific. The hypertension & obesity pattern, found in one out of every four patients was associated with a higher likelihood of four- and eight-year mortality (age- and sex-adjusted odds ratio 1.11 and 1.16, respectively) compared to the unspecific pattern. Baseline patterns evolved into different patterns during the follow-up.DiscussionWell-known preventable cardiovascular risk factors were key elements in most patterns, highlighting the role of hypertension and obesity as risk factors for higher mortality. Two out of every three patients had a cardiovascular profile with chronic conditions like diabetes and obesity that are linked to low-grade systemic chronic inflammation. More studies are encouraged to better characterise the relatively large portion of the population with an unspecific disease pattern and to help design and implement effective and comprehensive strategies towards healthier ageing.

Susceptibility to e-cigarette adoption among tobacco-naïve youths: a cross-sectional study in Shenzhen, China

BackgroundThe rise in e-cigarette use among youth is a significant global public health issue. It is important to identify those at increased risk and implement effective strategies to reduce e-cigarette popularity among the youth.ObjectiveThis study aims to identify predictors of e-cigarette uptake in youths with no prior tobacco use, considering individual, familial and the broader societal environmental factors.MethodsFor this investigation, a group of 2,487 tobacco-free youths was selected from 15 high schools in Shenzhen, China. Susceptibility to e-cigarettes was determined by assessing the possibility of future use and the openness to trying e-cigarettes if presented by friends. Both chi-square tests and logistic regression were applied to identify factors linked to susceptibility to e-cigarette use.ResultsAmong the respondents, 5.5% (n = 136) were found to be susceptible to e-cigarette use. The analysis revealed factors tied to this risk: perceptions of e-cigarettes, the impact of vaping peers, paternal parenting styles, the extent of social support, exposure to messages both for and against e-cigarettes use, and secondhand smoke (SHS) exposure. Youths who downplayed the addictive nature of e-cigarettes (aOR = 2.01; 95% CI: 1.14–3.55; p = 0.016), those with friends who engaged in vaping (aOR = 3.43–7.64; 95%CI: 2.36–20.42; p < 0.001), those experiencing over-protective or rejective maternal parenting (aOR = 1.68–3.01; 95%CI: 1.11–5.77; p = 0.001–0.014) or rejective paternal parenting (aOR = 3.63; 95%CI: 1.99–6.59; p < 0.001), those aware of e-cigarette advertisements (aOR = 1.82; 95%CI: 1.28–2.60; p = 0.001), and those exposed to SHS at home (aOR = 1.68; 95%CI: 1.17–2.41; p = 0.005) or at public places (aOR = 1.72–1.79; 95%CI: 1.21–2.57; p = 0.002–0.003) were more prone to e-cigarettes. In contrast, youths who believed using e-cigarettes reduces one’s attractiveness (aOR = 0.34; 95%CI: 0.16–0.72; p = 0.005) or perceived that vaping made social interactions less enjoyable (aOR = 0.26; 95%CI: 0.12–0.58; p = 0.001), those who benefited from high social support (aOR = 0.30–0.60; 95%CI: 0.17–0.97; p < 0.001), and those who noticed message about e-cigarettes’ adverse consequence (aOR = 0.54; 95%CI: 0.38–0.77; p = 0.001) were less likely to be inclined toward e-cigarette use.ConclusionThe propensity of the youth to e-cigarette usage is shaped by a multiple element. An all-encompassing strategy that addresses the individual, familial, and the broader societal aspects is imperative for the effective prevention of e-cigarette initiation among youth.

CSR in MSMEs: A Systematic Literature Review and Future Research Agenda

The purpose of this study was to conduct a systematic literature review on corporate social responsibility (CSR) in micro, small, and medium enterprises (MSMEs). MSMEs stand as pivotal contributors to economies worldwide, fuelling innovation and economic growth. As the business landscape evolves, the relevance of CSR practices among these enterprises becomes increasingly apparent. This study aims to collect, analyze, and synthesize findings that already exist in the literature on CSR practices among MSMEs, as well as formulate possible research directions for the future. This study seeks to bridge the knowledge gap by delving into CSR practices within MSMEs, examining both manufacturing and service sectors. It aims to identify the unique internal and external factors influencing the effective implementation and success of these CSR strategies. We will identify the specific challenges faced by MSMEs in adopting CSR, as well as analyze the benefits they can achieve through the implementation of CSR practices. The systematic literature review research methods are systematic steps to collect, analyze, and synthesize relevant literature on CSR among MSMEs. Research results emphasize the importance of CSR practices for MSMEs, acknowledge the limitations of existing research due to limited data and context-specific considerations, and highlight the theoretical and practical implications of such research for developing CSR strategies and guidelines for MSMEs. Provides a comprehensive overview of the complexities, challenges, and benefits associated with implementing CSR practices in MSMEs across various sectors and contexts. This research addresses the pressing need to understand the role of CSR in MSMEs. As these enterprises navigate the dynamic business landscape, equipping them with insights into effective CSR practices can bolster their contributions to sustainable development.

Effect of Mineral Composition and Particle Size on the Failure Characteristics and Mechanisms of Marble in the China Jinping Underground Laboratory.

In deep underground engineering, the deformation, failure characteristics, and mechanism of surrounding rock under the influence of grain sizes and mineral compositions are not clear. Based on CJPL-II variously colored marbles, the differences in grain size and mineral composition of the marble were analyzed by thin-section analysis and XRD tests, and the effect of intermediate principal stress on the mechanical properties of marble was investigated. Both SEM and microfracture analysis were coupled to reveal the failure mechanisms. The results highlight that the crack initiation strength, damage strength, peak strength, and elasticity modulus of Jinping marble exhibit an increasing trend with an increase in intermediate principal stress, while the peak strain initially increases and subsequently decreases. Moreover, this study established negative correlations between marble strength, brittleness characteristics, and fracture angle with grain size, whereas positive correlations were identified with the content of quartz, sodium feldspar, and the magnitude of the intermediate principal stress. The microcrack density in marble was found to increase with larger grain sizes and decrease with elevated quartz and sodium feldspar content, as well as with increasing intermediate principal stress. Notably, as the intermediate principal stress intensifies and grain size diminishes, the transgranular tensile failure of marble becomes more conspicuous. These research findings contribute to the effective implementation of disaster prevention and control strategies.

Using Progress Feedback to Enhance Treatment Outcomes: A Narrative Review.

We face increasing demand for greater access to effective routine mental health services, including telehealth. However, treatment outcomes in routine clinical practice are only about half the size of those reported in controlled trials. Progress feedback, defined as the ongoing monitoring of patients' treatment response with standardized measures, is an evidence-based practice that continues to be under-utilized in routine care. The aim of the current review is to provide a summary of the current evidence base for the use of progress feedback, its mechanisms of action and considerations for successful implementation. We reviewed ten available meta-analyses, which report small to medium overall effect sizes. The results suggest that adding feedback to a wide range of psychological and psychiatric interventions (ranging from primary care to hospitalization and crisis care) tends to enhance the effectiveness of these interventions. The strongest evidence is for patients with common mental health problems compared to those with very severe disorders. Effect sizes for not-on-track cases, a subgroup of cases that are not progressing well, are found to be somewhat stronger, especially when clinical support tools are added to the feedback. Systematic reviews and recent studies suggest potential mechanisms of action for progress feedback include focusing the clinician's attention, altering clinician expectations, providing new information, and enhancing patient-centered communication. Promising approaches to strengthen progress feedback interventions include advanced systems with signaling technology, clinical problem-solving tools, and a broader spectrum of outcome and progress measures. An overview of methodological and implementation challenges is provided, as well as suggestions for addressing these issues in future studies. We conclude that while feedback has modest effects, it is a small and affordable intervention that can potentially improve outcomes in psychological interventions. Further research into mechanisms of action and effective implementation strategies is needed.

Food-web construction and ecological effects of implementing non-traditional biomanipulation in eutrophic reservoirs in North-central China

ABSTRACT This study was undertaken to elucidate the food web structure and interspecific interactions in the lakes and reservoirs undergoing eutrophication and to assess the efficacy of lake-wide non-traditional biomanipulation (direct predation of cyanobacteria by proliferating planktivorous fish) for bloom management. Analyses of aquatic organisms and stable isotopes of basic food sources and consumers were performed for Zhangze Reservoir in North-central China. Additionally, an improved scheme based on plankton changes and interspecific interactions is proposed on this basis. Compared with other widely-studied eutrophic reservoirs, the δ 15N value of each component of the food web in Zhangze Reservoir was higher, the food chain was relatively long and the δ 13C range of fish consumers was narrower. Planktivorous fish consumed phytoplankton as their primary food source. However, the phytoplankton biomass and the percentage of cyanobacteria increased, and eutrophication did not improve. The findings concerning the composition of consumers and their food sources in Zhangze Reservoir indicate the urgent need to change the fish structure to optimise the structure of plankton community and mitigate phytoplankton overgrowth. The study findings provide a basis for the implementation of effective eutrophication management strategies in lakes and reservoirs where planktivorous fish are prevalent.

Computer vision syndrome and ergonomic risk factors among workers of the Commercial Bank of Ethiopia in Addis Ababa, Ethiopia: an institutional-based cross-sectional study.

Computer vision syndrome (CVS) is the most pressing public health concern that affects vision and reduces quality of life and productivity, particularly in developing countries. Most of the previous studies conducted in Ethiopia focus on the knowledge and personal risk factors of bank workers. Moreover, ergonomic workstation design was not objectively assessed, which could hinder the implementation of effective intervention strategies. Therefore, this study aimed to determine CVS and ergonomic factors among commercial bank workers in Addis Ababa, Ethiopia. An institutional-based cross-sectional study was carried out among 466 study participants from May 26 to July 24, 2022. A multistage sampling technique was applied to select the study participants. Data were collected via a standardized tool of CVS (CVS-Q). Besides, workstation ergonomics were pertinently assessed. The collected data was entered into EpiData version 3.1 and exported to SPSS version 26 for data analysis and cleaning. Multivariable logistics regression analysis was performed to identify factors associated with CVS. The variables with a p-value < 0.05 were considered statistically significant factors. Prevalence of CVS was 75.3% (95% CI: 71.2-79.2%). Blurred vision, eye redness, and headache, 59.8%, 53.7%, and 50.7%, respectively, were frequently reported symptoms. Glare (AOR = 4.45: 95% CI: 2.45-8.08), 20-20-20 principle (AOR = 1.98, 95% CI: 1.06-3.67), wearing non-prescription eyeglasses (AOR = 4.17; 95% CI: 1.92-9.06), and poor workstation (AOR = 7.39; 95% CI: 4.05-13.49) was significantly associated with CVS. The prevalence of CVS was found to be high. Glare at work, ignoring the 20-20-20 principle, wearing non-prescription eyeglasses, and poor workstation ergonomic design were independent predictors of CVS. Therefore, comprehensive interventional activities like adhering to the 20-20-20 principle, avoiding the use of non-prescription glasses, minimizing glare, and improving workstation ergonomic setup are essential to prevent CVS.

First insights into the spatio-temporal ecology of sympatric large carnivores in Niokolo-Koba National Park, Senegal

Abstract Large carnivores play a crucial role in their native ecosystems, but their populations are rapidly declining across the African continent. West Africa is no exception, with large protected areas often forming the last strongholds for these species. Little is known about the population status and ecology of large carnivores in the region, hampering the design and implementation of effective conservation strategies. We conducted a camera-trap survey during the dry season in Niokolo-Koba National Park, the largest terrestrial protected area in Senegal and the second largest in West Africa, to investigate the spatio-temporal ecology of the four large carnivores inhabiting the Park: the spotted hyaena Crocuta crocuta, leopard Panthera pardus, West African lion Panthera leo leo and African wild dog Lycaon pictus. Spotted hyaenas and leopards had the widest spatial distribution and highest probability of site use. Spotted hyaena site use was positively associated with leopard relative abundance index and negatively associated with normalized difference vegetation index, whereas only distance to the nearest road influenced leopard site use. Distance to the Gambian River was the most important covariate positively affecting site use by lions. African wild dog site use was negatively associated with the relative abundance indices of lions and leopards. Lions, spotted hyaenas and leopards showed strong overlap in their activity patterns. By providing new information on the ecology of large carnivores in West Africa, including where they range and which habitats are critical for their survival, our study will facilitate conservation planning. Our findings lay the foundations for future research to conserve these threatened species in West Africa effectively and to guide ranger patrol efforts, which are key for their long-term survival.

GERIATRIC ASPECTS OF THE ORGANIZATION OF MEDICAL-SOCIAL, PALLIATIVE AND HOSPICE CARE IN THE CONDITIONS OF THE WAR: COMBINATION OF MEDICAL, PSYCHOLOGICAL AND SOCIAL PROBLEMS

The aim of the study is to characterize, from the point of view of geriatric aspects, the current problems of the organization of medico-social, palliative and hospice care (PHC) and social services for palliative care in the war conditions based on multidisciplinary, interagency and inter-sectoral approaches, as well as a combination of medical, psychological and social problems. Materials and methods. The research materials were scientific literary sources and regulatory documents. A pilot survey of 200 people was conducted to study the psychological state and psychological support needs of the elderly and internally displaced persons (IDPs). The survey results of 3,705 client’s questionnaires of the “Vseturbota” Project were also evaluated, of which 63.6 % are people aged 67-84 years, 26.4 % are 85–101 years old. The following research methods were used in the work: bibliosemantic, sociological, system approach and system analysis. Results and discussion. After February 24, 2022, IDPs will experience significant difficulties, suffer from reduced income, increased dependence on humanitarian aid, do not feel safe and protected. All these are reflected in their psychological state. It was found that among respondents aged ≥75 years had the most people with medium (57.1 %) and low (25.0 %) levels of anxiety, 71.4 % had a low level of mood. 32.17 % of the “Vseturbota” Project clients needed additional consultation with a family doctor, 3.83 % needed consultation with a psychologist, and 3.35 % with other specialists. Most often, they needed help around the house (26.02 %), buying medicines/foodstuff (22.43 %), 34.97 % needed information, and 13.36 % needed psychological counseling. An important condition for providing geriatric patients, including IDPs, with affordable, high-quality and effective PHC is the creation of a system and service of ambulatory/mobile and inpatient PHC facilities and medico-social care. Conclusions. The military aggression of the Russian Federation caused considerable suffering to the population of Ukraine. The state of anxiety and fear has a negative impact not only on the psycho-emotional, but also on the physical sphere of the elderly, which necessitates the implementation of psychological services and effective strategies for overcoming stress and distress, which requires the development and implementation of mechanisms for interagency coordination and cooperation, involving and training of multidisciplinary teams’ specialists and volunteers, effective advocacy activities, etc.

Geospatial mapping of public sentiment and infodemic on human papillomavirus vaccination in India: An indication to formulation of strategies for effective implementation

ABSTRACT The implementation of Human Papillomavirus (HPV) vaccination is crucial for eliminating cervical cancer in India. The infodemic, characterised by misleading information, could hinder the successful implementation of the initiative. Misinformation related to the HPV vaccine, such as rumours, has been reported and circulated, contributing to an alarming pattern of vaccine hesitancy observed on social media. This study aimed to identify the public sentiment towards HPV vaccination based on the ‘Behavioral and Social Drivers (BeSD)’ framework through geospatial, content and sentiment analysis. A total of 1,487 tweets were extracted. After preprocessing, 1010 tweets were identified for sentiment and content analysis. The sentiments expressed towards the HPV vaccine are mixed, with a generally positive outlook on the vaccines. Within the population, there is a pervasive proliferation of misinformation, primarily focusing on vaccine safety and efficacy, contentious subjects, ethical considerations, and a prevalent sense of uncertainty in selecting the appropriate vaccine. These observations are crucial for developing targeted strategies to address public concerns and enhance vaccination rates. The insights gained from these results will guide policymakers, healthcare practitioners, and public health organisations to implement evidence-based interventions, thereby countering vaccine hesitancy and improving public health outcomes.

Good Practices and Initiatives for the Control and Elimination of Hepatitis B in the World: A Scoping Review.

Hepatitis B virus (HBV) infection remains a significant global public health challenge, leading to considerable morbidity and mortality. Implementationof effective strategies and novel initiatives is necessary to control and eliminate HBV. To identify the key approaches and actions used worldwide for HBV control and elimination, we conducted a comprehensive scoping review. We searched various sources, including PubMed, Scopus, Web of Science, Google Scholar, the official websites of the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), and relevant articles and reports published in the past decade. Our inclusion criteria focused on studies that reported on strategies for HBV control and elimination, provided evidence of their effectiveness, and assessed their impact on public health outcomes. We included 16 articles in our review, which highlighted a range of strategies, such as universal HBV vaccination, prevention of mother-to-child transmission, mass screening programs, and treatment of chronically infected individuals. These strategies have shown promising results in reducing HBV transmission rate, improving health outcomes, and making progress towardHBV elimination. Moreover, several challenges, including limited access to care, low awareness, stigma, and funding constraints, hinder the effectiveness of elimination programs. The findings underscore the importance of sustained efforts and investment in comprehensive strategies for HBV control and elimination. It is crucial to address barriers to care and enhance public awareness to achieve the goal of eliminating HBV as a public health threat by 2030.

The Impact of Telerehabilitation on Physical Therapy Services in Rural Communities

Telerehabilitation is a transformative approach to physical therapy, revolutionizing the accessibility of healthcare in rural communities through the strategic use of Telecommunications technology. This novel approach has the potential to significantly enhance the efficacy of healthcare delivery, particularly considering the critical challenges posed by geographical isolation and resource scarcity. This paper explores the multifaceted benefits of Telerehabilitation, including increased access to care and reduced costs, alongside the challenges of technological barriers and privacy considerations. It provides a comprehensive overview of Telerehabilitation’s impact on rural healthcare, emphasizing its capacity to optimize patient outcomes and proposing strategies for effective implementation. The findings of this study suggest that the use of technology to deliver telecare is a key means of delivering equitable healthcare to underserved populations, a promising way to improve access to rural physiotherapy services address the challenge of telehealth resources, and promote the long-term sustainability of rural Telerehabilitation practices.

Unveiling the circular procurement Nexus: A hierarchical examination of barriers, interrelationships, and strategic insights

The integration of circularity into various functions, including procurement, is essential and is embraced by organizations for sustainable and profitable operations. Existing studies have explored circular procurement (CP) and its influencing factors. However, existing literature calls for a deeper examination of these factors to provide a smooth implementation guide for practitioners and to foster a comprehensive understanding of cause-and-effect relationships for future research by scholars. As a result, this study aims to investigate the interrelationship between CP barriers. Firstly, this study explores barriers through a thorough review of relevant literature with input from academic and industrial experts. Utilizing a classical triple-level framework, the work identifies and categorizes 21 barriers. Secondly, the study employs interpretive structural modeling (ISM) to examine the contextual relationships among the barriers. Thirdly, these barriers are classified into different categories using the MICMAC technique, based on their driving and dependence power. The research findings develop a hierarchical model of barriers, offering insights into which barriers are the most crucial and need immediate attention and how different barriers could influence each other. The study's unique contributions lie in its identification of hierarchical relationships between barriers and its categorization (independent, linkage, and dependent), contributing to tailored strategies for effective CP implementation.

Characterizing the antigenic evolution of pandemic influenza A (H1N1) pdm09 from 2009 to 2023.

The H1N1pdm09 virus has been a persistent threat to public health since the 2009 pandemic. Particularly, since the relaxation of COVID-19 pandemic mitigation measures, the influenza virus and SARS-CoV-2 have been concurrently prevalent worldwide. To determine the antigenic evolution pattern of H1N1pdm09 and develop preventive countermeasures, we collected influenza sequence data and immunological data to establish a new antigenic evolution analysis framework. A machine learning model (XGBoost, accuracy = 0.86, area under the receiver operating characteristic curve = 0.89) was constructed using epitopes, physicochemical properties, receptor binding sites, and glycosylation sites as features to predict the antigenic similarity relationships between influenza strains. An antigenic correlation network was constructed, and the Markov clustering algorithm was used to identify antigenic clusters. Subsequently, the antigenic evolution pattern of H1N1pdm09 was analyzed at the global and regional scales across three continents. We found that H1N1pdm09 evolved into around five antigenic clusters between 2009 and 2023 and that their antigenic evolution trajectories were characterized by cocirculation of multiple clusters, low-level persistence of former dominant clusters, and local heterogeneity of cluster circulations. Furthermore, compared with the seasonal H1N1 virus, the potential cluster-transition determining sites of H1N1pdm09 were restricted to epitopes Sa and Sb. This study demonstrated the effectiveness of machine learning methods for characterizing antigenic evolution of viruses, developed a specific model to rapidly identify H1N1pdm09 antigenic variants, and elucidated their evolutionary patterns. Our findings may provide valuable support for the implementation of effective surveillance strategies and targeted prevention efforts to mitigate the impact of H1N1pdm09.

Rising testicular cancer incidence in Spain despite declining mortality: an age-period-cohort analysis

BackgroundTesticular cancer, primarily affecting young men, has seen an alarming rise globally. This study delves into incidence and mortality trends in Spain from 1990 to 2019 using the Global Burden of Disease (GBD) database and the Age-Period-Cohort (A-P-C) model. MethodsWe analyzed GBD data on testicular cancer cases and deaths in Spain, calculating age-standardized rates (ASIR and ASMR) and employing Joinpoint regression to identify significant shifts. The A-P-C model further dissected the effects of age, period, and birth cohort on these trends. ResultsA striking doubling in testicular cancer incidence was observed, from 3.09 to 5.40 per 100,000 men (1.9% annual increase), while mortality rates remained stable and even decreased in younger age groups (0.34 to 0.26 per 100,000, 0.8% annual decrease). Joinpoint analysis revealed four distinct periods of increasing incidence, with a recent slowdown. The A-P-C model highlighted a consistent rise in incidence risk with each successive generation born after 1935, contrasting with a progressive decline in mortality risk across cohorts, particularly marked for those born since the 1960s. ConclusionWhile mortality rates are encouraging, Spain reflects the global trend of escalating testicular cancer incidence. The A-P-C analysis suggests a generational influence, but the underlying causes remain elusive. Further research is crucial to understand these trends and implement effective prevention strategies to combat this growing health concern.