Low Level Research Articles

Empowering Investors: Reducing Herd Bias through Financial Literacy and Self-reflective Thinking

Herd behavior, where investors mimic the trades of others rather than relying on their own information or analysis, is a widespread phenomenon that can lead to suboptimal investment decisions and market inefficiencies. Hence, understanding how to reduce this behavior is crucial for improving individual investment outcomes and sustainable market performance. Though the literature suggests that self-reflection and financial literacy have potential to mitigate herd bias, it is unclear as to how these two perspectives interact to minimize this irrational behavior. By drawing on insights from the adaptive market hypothesis, transformative learning theory, concept of bounded rationality and dual process theory, this study attempts to enhance the understanding of this phenomenon by introducing a conditional mediation model that promotes self-directed learning. It predicts that investors can reduce their herd bias through self-reflection on their past stock trading experiences, which they can practice by engaging intuitive logical thinking and strengthen further through their financial literacy. Since herding is generally predicted to be more prevalent in frontier stock markets, the study was conducted in a frontier market - the Colombo Stock Exchange. The data was obtained through a self-administered questionnaire from 253 active individual investors, and analyzed by applying the PROCESS procedure. The findings reveal the significance of self-reflection as a mediating variable across its antecedents, which provides strong evidence for its central role in reducing herd bias. Notably, the findings indicate that self-reflection has a stronger effect on reducing herd bias of investors with lower level of financial literacy. It implies that investors with low financial literacy are more susceptible to herd bias, and self-reflection facilitates them to recognize and minimize their herd bias. Accordingly, the study concludes that promoting self-reflection can empower individual investors to become more financially literate and thereby mitigate their herd bias.

The Mechanisms Underlying Religious Coping and Hopelessness: Role of Meaning in Life and Affectivity

AbstractReligion can fulfill both positive and negative functions in coping with stress. There is a lack of research regarding the mechanism underlying the link between religious coping and mental health. The purpose of this study was to verify how religious coping is related to mental health. Two indirect mechanisms were tested for finding meaning in life and emotional regulation. The study was conducted with 115 students from Poland. According to the results, both positive and negative religious coping were indirectly related to hopelessness through finding meaning in life and affectivity. More frequent use of negative religious coping was positively related to the intensity of negative affect and problems with finding meaning in life, which, in turn, led to a higher level of hopelessness. Meanwhile, more frequent use of positive religious coping was correlated with a greater intensity of positive effect and supported individuals in finding meaning in life. Finding meaning in life was related to a lower level of hopelessness, but positive affect was not correlated with hopelessness. The research confirmed the role played by finding meaning in life and affectivity within the mechanism underlying the link between religious coping and hopelessness. In conclusion, theoretical and practical implications are presented.

Functional difficulty among children in Malaysia – findings from the National Health and Morbidity Survey (NHMS) 2019

IntroductionData on child functioning and disability are important for public policy development which aimed at reducing child disability prevalence and strengthening the provision of appropriate and timely health care services. This study reports the prevalence of functional difficulty in Malaysian children aged 2–17 years and its associated sociodemographic factors and epilepsy.MethodsData on children aged 2–17 years (n = 4576) were generated from the National Health and Morbidity Survey (NHMS) 2019, a population-based cross-sectional survey. Functional difficulty in children was assessed using the United Nations Children’s Fund (UNICEF)/Washington Group on Disability Statistics (WG) Child Functioning Module (CFM). The questionnaires were administered to the parents or guardians of the children via face-to-face interviews. Functional difficulty, defined as having difficulty in at least one domain, was examined for its prevalence and associations with sociodemographic variables and the epilepsy variable in children using descriptive analysis and multiple logistic regression.ResultsThe overall prevalence of functional difficulty among children aged 2–17 years was 4.7%. Multiple logistic regression analysis revealed that older children, children from households whose heads of household had a lower education level and children who have epilepsy were significantly more likely to experience functional difficulty (p < 0.05). Children of Chinese ethnicity were less likely to experience functional difficulty compared to children of Malay ethnicity.ConclusionsThis study provides baseline findings on the prevalence of functional difficulty among children in Malaysia using nationally representative data. Although the prevalence was relatively low, the information is important for the planning of strategies to improve the development and well-being of children in Malaysia and for achieving the Sustainable Development Goals (SDGs).

On penalized goal-reaching probability minimization under borrowing and short-selling constraints

Abstract We consider a robust optimal investment–reinsurance problem to minimize the goal-reaching probability that the value of the wealth process reaches a low barrier before a high goal for an ambiguity-averse insurer. The insurer invests its surplus in a constrained financial market, where the proportion of borrowed amount to the current wealth level is no more than a given constant, and short-selling is prohibited. We assume that the insurer purchases per-claim reinsurance to transfer its risk exposure to a reinsurer whose premium is computed according to the mean–variance premium principle. Using the stochastic control approach based on the Hamilton–Jacobi–Bellman equation, we derive robust optimal investment–reinsurance strategies and the corresponding value functions. We conclude that the behavior of borrowing typically occurs with a lower wealth level. Finally, numerical examples are given to illustrate our results.

Hemoglobin level and common mental disorder among school adolescent girls in Central Ethiopia: Structural Equation Model.

The prevalence of common mental disorder (CMD) and anemia is observed to be on the rise over time, adversely affecting the health and overall quality of life among adolescents. Extensive literature corroborates the significant impact of anemia on cognitive development, intelligence and developmental milestones. Nevertheless, the linkage between hemoglobin level and CMD emerging during adolescence remains relatively unexplored. Thus, the objective of this study was to investigate the association between hemoglobin level and CMD as well as the mediating factor among school adolescent girls residing in Central Ethiopia. A cross-sectional study design was conducted among adolescent girls attending schools in Silti Woreda, Central Ethiopia, comprising a total sample size of 516 individuals during the period from October 2-20, 2023. Hemoglobin level was adjusted for altitude, while CMD was evaluated utilising the summation score of a 20-item Self-Reporting Questionnaire. Data were analysed through fitting Structural Equation Model and the maximum likelihood estimation method. Goodness of fit was assessed using the χ2The -test statistic, Comparative Fit Index, Root Mean Square Error of Approximation, Standardised Root Mean Square Residual, Non-Normed Fit Index, Pclose and coefficient of determination (R2). The prevalence of CMD was 22.3% (95% CI: 18.6%-25.8%). Hemoglobin level (UTE = -0.73, CI: -0.93, -0.53) and experience of morbidity symptoms (UTE = 1.05; CI: 0.74, 1.38) were significantly associated with CMD. Furthermore, hemoglobin level is significantly influenced by morbidity frequency symptoms (UDE = -0.63, CI = -0.77, -0.49) and animal source food (ASF) (UDE = 0.09, CI = 0.01, 0.17). Hemoglobin level has been identified as a significant mediator of the experience of morbidity symptoms and ASF on CMD. However, household food insecurity and wealth index had no significant association with CMD. A significant proportion of adolescent girls face CMD, often linked to a lower hemoglobin level. Having a significant association with CMD, the hemoglobin level is found to mediate a significant effect of morbidity symptom experience and ASF on CMD. Hence, addressing early infection prevention, promoting ASF and treating anemia are promptly needed.

Consistent Egalitarianism or Heterogeneous Belief Patterns? Gender Ideologies in Contemporary East and West Germany

Abstract Studying gender ideologies is crucial for understanding the work and family related behaviors of women and men. This paper analyzes the gender ideologies of respondents living in East and West Germany, and whether these belief patterns differ by socio-demographic characteristics. To this end, latent class analysis is applied to eight gender role items from the FReDA 2021 survey. The results show the presence of a consistent and widespread egalitarian gender ideology in both regions, as well as a less prevalent traditional one in the West. Additionally, heterogeneous gender ideologies are to be found with egalitarian essentialism present in both regions, and intensive parenting only in the West. Respondents with a lower level of education and males have higher chances of holding non-egalitarian ideologies. The findings align with the literature on persisting East-West differences in gender ideology, and with research on the diversification of gender ideology.

Empowering and Influencing Factors of Intellectual and Spiritual Capital in Improving Organizational Performance at Tourism Institutions

This research aims to measure factors that influence intellectual and spiritual capital in increasing organizational performance at tourism institutions in Banda Aceh City through the variable organization. The methodology used is quantitative. Data was collected from respondents using a structured questionnaire with a Likert scale. Seventy-five questionnaires were distributed in all to the Banda Aceh City Tourism Institution. Sample selection utilized a disproportionate technique of stratified random sampling. The research data underwent descriptive, and structural equation modeling analysis using SPSS and SEM AMOS software. The analysis that was produced was: Research has demonstrated that intellectual capital has a substantial and favorable impact on the functioning of organizations, that is 0.000 &lt; 0.05 as the significant value; spiritual capital has a -0.070 direct effect on organizational performance; the coefficient of the indirect effect is 0.273, the mediation process has a substantial impact, and the effect of mediation has been proved to be significant, the coefficient for the indirect effect is 0.458, at the lower level for intellectual capital boot of 0.227, and the upper level for intellectual capital of 0.676, with a 95% confidence interval.

Dengzhan Shengmai capsule ameliorates cognitive impairment via inhibiting ER stress in APP/PS1 mice

Ethnopharmacological relevanceAlzheimer's disease (AD) is a common type of neurodegenerative disease with the β-amyloid plaques (Aβ) deposition. Previously, Dengzhan Shengmai capsule (DZSM) has been shown to reduce the pathology associated with AD, but the underlying mechanism is unclear. Aim of studyThis study investigated the potential mechanisms of DZSM against AD. Materials and methodsThe six-month-old wild-type male mice and APP/PS1 double transgenic male mice were administered 0.9 % saline or DZSM for 8 weeks by gavage. Open field test, new object recognition test, and Morris Water maze test were used to assess spatial learning and memory. Aβ plaques in brains were visualized using ThT staining. Nissl staining, TUNEL staining, and Western blot analyses were used to detect the neuronal function and apoptosis level. The superoxide dismutase (SOD), glutathione peroxidase assay kit (GSH-Px), and malondialdehyde (MDA) kits were performed to assess oxidative stress levels. Then, immunofluorescence and Western blot analysis were applied to evaluate ER stress pathway protein levels. Finally, HT22 cells were treated by Aβ1-42 with or without DZSM medicated serum. Cell viability was assessed using the CCK-8 assay, and Western blot analysis was applied to evaluate ER stress pathway protein levels. ResultsOpen filed test, new object recognition test and Morris Water maze test showed that DZSM restored cognitive disorders in APP/PS1 mice. Immunohistochemistry and Thioflavin T staining results indicated that DZSM reduced Aβ plaques in the brain. Deeper and denser Nissl bodies were found in APP/PS1 mice after DZSM administration. Besides, APP/PS1 mice treated with DZSM showed a lower level of TUNEL and Bax/Bcl-2 ratio. DZSM improved the acetylcholine (ACh), choline acetyltransferase (ChAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) activity while reducing acetylcholinesterase (AChE) and malondialdehyde (MDA) activity. In addition, the levels of ER stress pathway containing Phospho-PKR-like ER kinase (P-PERK), phosphorylate eukaryotic initiation factor 2 (P-eIF2α), activating transcription factor 4 (ATF4), glutamine-rich protein 1 (QRICH1), phosphorylate inositol-requiring protein 1α (P-IRE1α), the spliced form of X-box binding protein 1 (XBP1s), activating transcription factor-6 (ATF6) and C/EBP homologous binding protein (CHOP) were decreased by DZSM. CCK-8 results indicated that DZSM medicated serum played cytoprotective effects on Aβ1-42-induced HT22 cells. Western blot results suggested DZSM possibly inhibited ER stress pathways in Aβ1-42-induced HT22 cells. ConclusionThe potential protective mechanism of DZSM on cognitive impairment in AD might be related to ER stress pathways.

Systematic multiomics analysis and in vitro experiments suggest that ITGA5 could serve as a promising therapeutic target for ccRCC

BackgroundIntegrin alpha 5 (ITGA5) was previously confirmed to be related to prognosis in several cancer types; however, its function in clear cell renal cell carcinoma (ccRCC) and how this molecule regulates tumor progression and the tumor microenvironment (TME) remain to be elucidated.MethodsWe investigated the prognostic implications of ITGA5 with a machine learning model and evaluated biological behaviors of different levels of ITGA5 expression in vitro. Bioinformatic analysis was performed to explain the comprehensive effect of ITGA5 on the TME and drug sensitivity.ResultsWe constructed a machine learning model to elaborate the prognostic implication of ITGA5. As tumorigenesis of ccRCC was tightly relevant with several mutant genes, we investigated the correlation between ITGA5 expression and frequent mutations and found ITGA5 upregulation in VHL mutant ccRCC (P = 0.016). Through overexpressing, silencing, and blocking ITGA5, we verified the role of ITGA5 in promoting ccRCC adverse biological activities; and the potential functions of ITGA5 in ccRCC were bioinformatically demonstrated, summarizing as cell proliferation, migration, and angiogenesis. The localization of ITGA5 primarily in endothelia and macrophages further verified its magnitude in angiogenesis and aroused our excavation in ITGA5 regulation of immune infiltration landscape. Generally, ITGA5-high ccRCC presented an immunosuppressive TME by inducing a lower level of CD8 + T cell infiltration. For the last part we predicted drug sensitivity relevant to ITGA5 and concluded that a joint medication of ITGA5 inhibitors and VEGFR-target drugs (including sunitinib, axitinib, pazopanib, and motesanib) might be a promising therapeutic strategy.ConclusionOur findings clarified the adverse outcome induced by high expression of ITGA5 in ccRCC patients. In vitro experiments and bioinformatical analysis identified ITGA5 function as predominantly cell proliferation, migration, angiogenesis, and macrophage recruitment. Further, we predicted immune infiltration and medication sensitivity regulation by ITGA5 and proposed a joint use of ITGA5 inhibitors and anti-angiogenetic drugs as a potential potent therapeutic strategy.

BMI trajectories from birth to young adulthood associate with distinct cardiometabolic profiles.

Numerous studies have investigated links between body mass index (BMI) trajectories and cardiovascular risk, yet discrepancies in BMI measurement duration and timing of the cardiovascular-related outcome evaluation have led to inconsistent findings. We included participants from the Swedish birth cohort (BAMSE) and applied latent class mixture modeling to identify BMI trajectories using data of multiple BMI measures (≥ 4 times) from birth until 24-year follow-up (n = 3204). Subsequently, we analyzed the associations of BMI trajectories with lipids (n = 1974), blood pressure (n = 2022), HbA1c (n = 941), and blood leukocytes (n = 1973) using linear regression. We also investigated the circulating levels of 92 inflammation-related proteins (n = 1866) across BMI trajectories. Six distinct BMI groups were identified, denoted as increasing-persistent high (n = 74; 2.3%), high-accelerated increasing (n = 209; 6.5%), increasing-accelerated resolving (n = 142; 4.4%), normal-above normal (n = 721; 22.5%), stable normal (n = 1608; 50.2%), and decreasing-persistent low (n = 450; 14.1%) BMI groups. The increasing-persistent high and high-accelerated increasing BMI groups had higher levels of total cholesterol [mean difference (95% confidence intervals): 0.30 (0.04-0.56) and 0.16 (0.02-0.31) mmol/L], triglyceride, low-density lipoprotein, hemoglobin A1C [3.61 (2.17-5.54) and 1.18 (0.40-1.98) mmol/mol], and low-density lipoprotein/high-density lipoprotein ratios, but a lower level of high-density lipoprotein than the stable normal BMI group. These two groups also had higher leukocyte cell counts and higher circulating levels of 28 inflammation-related proteins. No increased cardiometabolic markers were observed in the increasing-accelerated resolving BMI group. Participants with persistently high or accelerated increasing BMI trajectories from birth to young adulthood have elevated levels of cardiometabolic risk markers at young adulthood than those with stable normal BMI. However, a raised BMI in childhood may not be inherently harmful to cardiometabolic health, provided it does not persist into adulthood.

Utility of First-Morning-Voided Urinary Total Luteinizing Hormone in Detecting the Onset of Central Puberty

Introduction: Early morning basal serum luteinizing hormone (S-LH) ≥0.3 IU/L is a specific marker for the onset of central puberty. In this study, we aimed to investigate the sensitivity and specificity of the first-morning-voided (FMV) total urinary LH (U-LH) to replace this marker. Methods: We re-analyzed our previously published data set of 297 children (145 boys and 152 girls, aged 5–15 years, across Tanner stages 1 through 5) using receiver operating characteristic (ROC) analysis and determined cutoff values for FMV total U-LH in predicting early morning S-LH concentration at or above 0.3 IU/L. We also determined S-LH and serum follicle-stimulating hormone (S-FSH) concentrations in girls at different stages of sexual maturation. Results: ROC analysis showed that FMV total U-LH levels of 0.60 and 0.63 IU/L in girls and boys, respectively, predicted early morning S-LH levels of 0.3 IU/L or higher with 97.4% sensitivity and 90.6% specificity. Higher cutoff levels for U-LH (0.78 IU/L for boys and 0.79 IU/L for girls) yielded 94.7% specificity at the expense of a relatively lower level of sensitivity (94.1%). The areas under the curve were 0.98 in boys and 0.99 in girls, respectively. Additionally, the increase in FMV total U-LH (or S-LH) levels identified the activation of central pubertal development at the mean age of 10.3 (10.3) in boys and 10.5 (10.6) in girls. The S-FSH concentrations of the six biochemically prepubertal girls with thelarche, ranging between 2.3 and 2.7 IU/L, were significantly higher than those measured in biochemically and clinically prepubertal girls of the same 10–12-year-old age group and significantly lower than those measured in both biochemically and clinically pubertal girls (p = 0.039 and p = 0.018, respectively). Conclusions: A FMV total U-LH concentration of 0.6 IU/L or above reliably reflects pubertal morning S-LH levels and is effective in detecting the onset of central puberty, which occurs at similar ages in both sexes. Concurrent S-FSH or noninvasive FMV U-FSH determinations may be useful in the differential diagnosis of isolated thelarche.

Rapid Zooplankton Assessment: Evaluating a Tool for Ecosystem‐Based Fisheries Management in the Large Marine Ecosystems of Alaska

ABSTRACTEcosystem‐based fisheries management (EBFM) remains an aspirational goal for management throughout the world. One of the primary limitations of EBFM is the incorporation of basic lower trophic level information, particularly for zooplankton, despite the importance of zooplankton to fish. The generation of zooplankton abundance estimates requires significant time and expertise to generate. The rapid zooplankton assessment (RZA) is introduced as a tool whereby nontaxonomic experts may produce rapid zooplankton counts shipboard that can be applied to management in near real time. Zooplankton are rapidly counted shipboard and placed into three broad groups of zooplankton relevant to higher trophic levels: large copepods (&gt; 2 mm), small copepods (&lt; 2 mm), and euphausiids. A Bayesian, hierarchical linear regression modeling approach was used to validate the relationship between RZA abundances and laboratory‐processed abundances to ensure the rapid method is a reliable indicator. Additional factors likely to impact the accuracy of the RZA abundance predictions were added to the initial regression model: RZA sorter, survey, season, and large marine ecosystem (Bering Sea, Chukchi/Beaufort Sea, and Gulf of Alaska). We tested models that included the random effect of sorter nested within survey, which improved fits for both large copepods (Bayes R2 = 0.80) and euphausiids (Bayes R2 = 0.84). These factors also improved the fit for small copepods when the fixed effect of season was also included (Bayes R2 = 0.65). Additional RZA data were used to predict laboratory‐processed abundances for each zooplankton category and the results were consistent with model training data: large copepods (Bayes R2 = 0.80), small copepods (Bayes R2 = 0.64), and euphausiids (Bayes R2 = 0.88). The Bayesian models were therefore able to predict laboratory‐processed abundances with an associated error when accounting for these fixed and random effects. To demonstrate the utility of zooplankton data in management, zooplankton time series from the Bering Sea shelf were shown to vary in relation to warm and cold conditions. This variability impacted commercially important fish, notably Walleye Pollock (Gadus chalcogrammus), and these time series were used by managers using a risk table approach. The RZA method provides a rapid zooplankton population estimation in near real time that can be applied to the management process quickly, thus helping to fill a gap in EBFM.

Correlates of Socio Demographic Factors with Utilization of ICT Gadgets by Rural Students

Aims: This study investigates the utilization of ICT gadgets by rural students, focusing on usage patterns and their correlation with socio-demographic factors. As the demand and usage of ICT is increased, it is necessary to identify the ICT gadgets used by rural students and their extent of utilization so they may not be lag behind as urban population increasing the digital divide. Study Design: The research design was descriptive correlational research in nature. Research targeted two government senior secondary schools, one each from the villages of Niyana and Bhiwani Rohilla. A total of 100 students from grades 9 to 12 participated in the study who were willing and interested to participate. Place and Duration of the Study: The study was conducted in the Hisar district of Haryana state. The collection of data was done through the self-constructed questionnaire in the month of May, 2022 by the researcher itself. Duration of the study was 6 months. Methodology: Utilization was the usage of the ICT gadgets to reveal which types of ICT gadgets were being utilized by the respondents and which were not utilized. The developed questionnaire was used to discover the most utilized ICT gadgets by the respondents. For calculating, Level of Utilization of ICT gadgets, an excel sheet was made with the responses of the students given on the self-developed questionnaire on the usage of number of gadgets (0-15). For Comparison of School-I and School-II, Significance of the Difference was used. Correlation between Socio-Demographic profile of the respondents and utilization of ICT gadgets by School-I and School-II was also analyzed with P=.05. Results: It was revealed that all students in School-I utilized smartphones and televisions, with most displaying a medium level of usage. In contrast, students in School-II exhibited a lower level of ICT gadget utilization, despite similar access to smartphones and televisions. The t-score analysis revealed a significant difference in usage levels between the two schools. Smartphones were the most utilized devices for a variety of purposes, including academics, entertainment, and online transactions, while laptops were the least used gadgets. The study also found a positive correlation between education level and ICT gadget usage, suggesting that students with higher education engage more with ICT tools. A negative correlation was observed between distance from urban centers and ICT usage, indicating that students farther from cities face greater challenges in accessing technology. The results of the research will be beneficial for government and policymakers to formulate programs to enhance the utilization of ICT gadgets by rural students of India to overcome digital gap. Conclusion: These findings emphasize the influence of socio-demographic factors on ICT usage and highlight the need for targeted interventions to enhance technology access and utilization in rural education.

Comparing two Peanut Desensitization Protocols in pre-school children: a Real-World Clinical Practice.

Peanut allergy is the main food allergy in childhood and poses significant health concerns. This study aimed to critically evaluate the effectiveness and safety of Oral Immune Therapy (OIT) using crushed peanuts versus peanut puffs. Children with an allergist diagnosed peanut allergy based on a history of an IgE-mediated reaction and a positive skin prick test for peanuts were recruited at the Montreal Children's Hospital and the Children's Clinic located in Montreal. Based on age and personal preference, initial doses of peanut were given in either puff (Bamba) or crushed peanut form. Patients continued the same dose for 2-5 weeks at home, filled out a symptom diary, and returned to the clinic for up-dosing until maintenance was reached (2 teaspoons of peanut butter). A continuation ratio regression model was used to evaluate the effect of the allergen type on the severity of anaphylactic and allergic reactions during OIT while adjusting for potential confounders. Between October 2020 and June 2023, 191 children (59.6% male; median age 1.95 years) were recruited. Most patients (75.1%) had eczema, and 12.7% had asthma. Oral desensitization was performed using one of two strategies according to the allergist: Crushed peanut (n=60 (31.4%)( and peanut puff (n=131 (68.6%)). Of the participants, the consumption of puff lowered reaction severity by a factor of 3.39 (95% CI, 1.4 to 8.22), in comparison to crushed peanuts. Older age markedly elevates the adjusted odds of reacting to a particular severity level as compared to a lower level by 1.19 (95% CI, 1.04 to 1.37). Modified peanut desensitization using peanut puffs has shown potential in reducing the severity of allergic reactions in younger children. Older children may experience a higher risk of severe reactions, indicating the need for age-specific approaches to desensitization protocols.

Pandemic COVID-19 as a challenge for telemedicine in the Czech Republic.

The COVID-19 Pandemic contributed to accelerating the process of using information and communication technologies and digital technologies in healthcare management and delivery within healthcare systems. At that time, the Czech healthcare system faced the same problems as other European systems and struggled with a temporary limitation of direct provision of healthcare services. It was solved by switching to telemedicine. The Czech healthcare system used telemedicine to a minimal extent until then. Despite adopting the law on healthcare digitisation, it is still one of the countries with a lower level of digitisation of healthcare processes. The article presents the results of an exploratory expert investigation focused on the implementation and development of telemedicine in the Czech Republic. The conducted research aimed to identify problems related to the implementation of telemedicine in practice, place them in the broader framework of the healthcare system and structure them, propose possible solutions, and identify the future challenges of telemedicine in the Czech Republic. We based our study on the results of a three-phase QUAL-QUAN-QUAL research. Data collection in the first phase took the form of individual semi-structured interviews with patients (25) with practical experience in the field of telemedicine, followed by the second quantitative phase of the questionnaire survey with patients (650). The third qualitative phase included semi-structured interviews with experts (17) with practical experience in telemedicine. The introduction and expansion of telemedicine require several fundamental changes. These include adjustments to the legislative environment and changes to the technological infrastructure, organisation of care and work. Several barriers have been identified at the healthcare system level, healthcare providers, healthcare professionals and patients.

Capacity Optimization of Wind–Solar–Storage Multi-Power Microgrid Based on Two-Layer Model and an Improved Snake Optimization Algorithm

A two-layer optimization model and an improved snake optimization algorithm (ISOA) are proposed to solve the capacity optimization problem of wind–solar–storage multi-power microgrids in the whole life cycle. In the upper optimization model, the wind–solar–storage capacity optimization model is established. It takes wind–solar power supply and storage capacity as decision variables and the construction cost of the whole life cycle as the objective function. At the lower level, the optimal scheduling model is established, considering the output characteristics of various types of power supplies and energy storage, microgrid sales, and purchases of power as constraints. At the same time, the model considers constraints, such as the power balance, the operating state of the energy storage system, the power sales and purchases, and the network fluctuations, to ensure the system operates efficiently. Taking a microgrid in South China as an application scenario, the model is solved and the optimal capacity allocation scheme of the microgrid is obtained. Meanwhile, the demand response mechanism and the influence of planning years are introduced to further optimize the configuration scheme, and the impact of different rigid–flexible load ratios and various planning horizons on microgrid capacity optimization is analyzed, respectively, by a numerical example. The comparison shows that the ISOA has better optimization performance in solving the proposed two-layer model.

Convolutional Neural Network-Based Deep Learning Methods for Skeletal Growth Prediction in Dental Patients

This study aimed to predict the skeletal growth maturation using convolutional neural network-based deep learning methods using cervical vertebral maturation and the lower 2nd molar calcification level so that skeletal maturation can be detected from orthopantomography using multiclass classification. About 1200 cephalometric radiographs and 1200 OPGs were selected from patients seeking treatment in dental centers. The level of skeletal maturation was detected by CNN using the multiclass classification method, and each image was identified as a cervical vertebral maturation index (CVMI); meanwhile, the chronological age was estimated from the level of the 2nd molar calcification. The model’s final result demonstrates a high degree of accuracy with which each stage and gender can be predicted. Cervical vertebral maturation reported high accuracy in males (98%), while females showed high accuracy of 2nd molar calcification. CNN multiclass classification is an accurate method to detect the level of maturation, whether from cervical maturation or the calcification of the lower 2nd molar, and the calcification level of the lower 2nd molar is a reliable method to trust in the growth level, so the traditional OPG is enough for this purpose.

Mercury Speciation and Stable Isotopes in Emperor Penguins: First Evidence for Biochemical Demethylation of Methylmercury to Mercury-Dithiolate and Mercury-Tetraselenolate Complexes

Apex marine predators, such as toothed whales and large petrels and albatrosses, ingest mercury (Hg) primarily in the form of methylmercury (MeHg) via prey consumption, which they detoxify as tiemannite (HgSe). However, it remains unclear how lower trophic level marine predators, termed mesopredators, with elevated Hg concentrations detoxify MeHg and what chemical species are formed. To address this need, we used high energy-resolution X-ray absorption near edge structure spectroscopy paired with nitrogen (N) and Hg stable isotopes to identify the chemical forms of Hg, Hg sources, and species-specific δ202Hg isotopic values in emperor penguin, a mesopredator feeding primarily on Antarctic silverfish. The penguin liver contains variable proportions of MeHg and two main inorganic Hg complexes (IHg), Hg-dithiolate (Hg(SR)2) and Hg-tetraselenolate (Hg(Sec)4), each characterized by specific isotopic values (δ202MeHg = 0.3 ± 0.2‰, δ202Hg(SR)2 = −1.6 ± 0.2‰, δ202Hg(Sec)4 = −2.0 ± 0.1‰). Using δ15N as a tracer of food source, we show that Hg(SR)2 is likely not obtained through dietary intake, but rather is present as a biochemical demethylation product. Furthermore, on average, female penguins transferred Hg to the egg strictly as MeHg in the egg albumen but as mixtures of MeHg and IHg in the membrane (89% and 11%, respectively) and yolk (32% MeHg and 68% Hg(Sec)4). Despite IHg species in eggs, MeHg is still the main species quantitatively transferred by the mother to the chick because of the disproportionate mass of the MeHg-rich albumen compared to the yolk. This work highlights the transformation of MeHg to Hg(SR)2 during demethylation for the first time in multicellular organisms, but further work is needed to understand the formation of Hg(SR)2 in the presence of relatively abundant Se biomolecules in lower trophic level predator species.

Investigating the Implementation of English as the Medium of Instruction Policy at the Lower Primary Level: A Case of Nyabihu District in Rwanda

This study investigated the implementation and effectiveness of the English as the Medium of Instruction (EMI) policy in Rwanda's lower primary education system, specifically from primary one to primary three. The introduction provides a context for Rwanda's language-in-education policy, which mandates English as the primary instructional language. The study aimed to assess whether this policy is followed in practice and to identify challenges and pedagogical practices associated with its implementation. The theoretical framework was based on Krashen's comprehensible input hypothesis, emphasizing the importance of using the target language in classroom interactions to aid language acquisition. The research design adopted was a qualitative case study focusing on Nyabihu District, involving a study population of lower primary school teachers and students. Purposive sampling was the method employed in order to use a small population to gain a thorough understanding of the case. Teachers with at least two years of experience in the classroom were used in the study. The researcher needed teachers who were familiar with the language policy of instruction in Rwandan schools and had firsthand experience with the phenomenon, so this was necessary. The study involved 75 participants in total, including 25 teachers and 50 students or pupils. Data were collected through classroom observations, interviews, and analysis of policy documents. Data analysis revealed a significant gap between the theoretical policy and actual classroom practices. Despite the policy, teachers frequently used both Kinyarwanda (L1) and English (L2) in their instruction due to students' limited English proficiency. The study identified several challenges, including lack of policy enforcement, the monolingual nature of classrooms, and teachers' preference for using the Rwandan language. Common pedagogical practices included safe talk, code-switching, simultaneous use of both languages, and translation. Key findings indicated that the EMI policy is not strictly adhered to in practice, and several factors hinder its effective implementation. The study recommends stricter policy enforcement, improvements in English language instruction, increased use of L1 as the medium of instruction, and the creation of an English-friendly learning environment to enhance English usage at the lower primary level. The study's findings provide valuable insights for educators and policymakers, highlighting the need for practical solutions to address the challenges of implementing EMI in Rwanda's lower primary education system.

Pharmacokinetic study of iptacopan and its two acyl glucuronide metabolites in monkey plasma by liquid chromatography combined with electrospray ionization tandem mass spectrometry.

In this study, a simple and sensitive liquid chromatography tandem mass spectrometric method was developed and validated for the determination of iptacopan and two acyl glucuronidation metabolites in monkey plasma. The plasma sample was precipitated with acetonitrile and then separated on an Acquity UPLC BEH C18 column (2.1 × 100 mm, 1.7 μm) using 0.1% formic acid and 5 mM ammonium acetate in water and acetonitrile as the mobile phase. The mass spectrometry (MS) detection was performed in positive multiple reactions monitoring (MRM) mode with precursor-to-production transitions. The developed assay was validated over the range of 1-2000 ng/mL for three analytes with correlation coefficient (r) more than 0.99. The validation parameters including accuracy, precision, carryover effect, matrix effect, recovery, and stability were all within the acceptable limits. The validated method has been applied to investigate the pharmacokinetics of iptacopan and its two acyl glucuronidation metabolites in monkey plasma. After intravenous administration, iptacopan showed low clearance (2.75 mL/min/kg) in monkey plasma. After oral administration, the bioavailability was 55.43%. The exposure (AUC0-t) of direct acyl glucuronide (AG) of iptacopan accounts for 9.73% of the iptacopan plasma exposure. The AUC0-t of AG of dealkylated metabolite of iptacopan was present at a lower level, accounting for 0.5% of the iptacopan plasma exposure.