With the continuous development of the global green finance market, accurately forecasting its trends has become a critical issue in financial research. Traditional time series forecasting methods are commonly used in this domain, but when applied to complex green finance data, they often suffer from low robustness, weak generalization ability, and difficulty in simultaneously capturing global trends and short-term fluctuations. To address these limitations, this paper proposes a task-oriented hybrid deep learning model, TranGRU, which combines Transformer and Gated Recurrent Unit (GRU) architectures for green finance market trend forecasting. The Transformer's global attention mechanism extracts long-term market dependencies, while the GRU's temporal memory capability captures short-term fluctuations, thereby enhancing the model's robustness and generalization in complex data environments. Experimental results indicate that TranGRU achieves comparatively better forecasting performance than several baseline models under the current experimental setting, particularly in terms of prediction error, convergence behavior, and directional consistency. The main contribution of this work lies not in introducing a fundamentally new sequence architecture, but in developing and systematically validating a multimodal forecasting framework tailored to the green finance context, where long-term policy signals and short-term market dynamics need to be modeled jointly. These findings provide empirical evidence that hybrid temporal modeling and multimodal feature fusion may be useful for short-horizon green finance market forecasting. The proposed framework may therefore serve as a supportive analytical tool for policy assessment and investment-related decision-making, while its broader applicability requires further validation across different markets and data conditions.

Energy security is a major issue in the 21st century, especially in the context of climate change and political conflicts. The shift to renewable energy has the potential to transform international dependency patterns, the geopolitical landscape, and the dynamics of energy trade. This upcoming change highlights the necessity of adopting a holistic approach to energy policy, one that incorporates the unique features of a renewable energy-dominated landscape characterized by growing electrification, digitalization, and decentralization. Conventional methods of ensuring energy security are already failing. The changing energy system necessitates a proactive approach to strengthen interdependencies and increase the system’s resilience so that it can adjust to broader economic, social, and political changes in addition to changes within the energy sector. Through the lenses of political and security considerations, this paper investigates the major public governance issues related to the advancement of renewable energy. To find structural obstacles influencing the implementation of renewable energy, the study uses a qualitative analytical methodology that combines systems analysis, institutional analysis, and comparative policy assessment. The implementation of long-term energy transition initiatives is frequently hampered by political short-termism, regulatory ambiguity, institutional fragmentation, and the influence of incumbent fossil-fuel interests. In order to ensure successful and socially acceptable renewable energy policies, the study also emphasizes the significance of robust regulatory frameworks, transparent governance institutions, and public participation.

ABSTRACT Despite globally rising inequality levels, consideration of this core aspect of social sustainability is largely missing from climate policy assessments. This way, climate policy risks becoming a missed opportunity for reducing inequalities, instead causing unequally distributed effects. This study responds to calls for greater coherence between social dimensions of sustainable development and climate action. We chart the state of play for inequality matters in climate policy, by examining if and how states propose interventions to address inequality in their Nationally Determined Contributions (NDCs) to the Paris Agreement. Following warnings that vested interests, faulty institutions, and power asymmetries inhibit effective implementation of inequality-mitigating actions related to climate policy, the study also maps the cross-country patterns of proposed inequality interventions to identify how inequalities are addressed by different types of states. The study shows that two thirds of states address inequality in their NDCs and that inequality considerations are especially prominent among countries with lower levels of human development and greater income inequality. We conclude that, while the viability of intervention proposals is uncertain at best, addressing inequalities in the NDCs can serve as a gateway to a more systematic incorporation of inequalities in the Paris Agreement.

Total joint arthroplasties (TJAs), including total knee (TKA) and total hip (THA), are common treatments for end-stage arthritis, significantly improving patients' quality of life (QoL). Clinical TJA registries play a critical role in monitoring implant performance, revision surgeries, postoperative complications, and long-term outcomes and patient-reported outcomes (PROs). However, the lack of a standardized data collection framework limits data integration, interoperability, and comparison across healthcare systems and studies. This study aims to establish a minimum data set (MDS) for the development of a TJA registry system. The proposed MDS represents the essential data elements needed to consistently capture key information related to TJA procedures. Establishing this MDS can facilitate greater agreement among stakeholders and support effective patient care, clinical research, and healthcare policy decisions. This mixed-method study was performed from December 2023 to March 2024 in two phases. Initially, an extensive literature review, along with the review of existing arthroplasty registries and patients' medical records, was conducted to identify potential administrative and clinical data elements. The extracted items were then organized into a researcher-developed checklist. In the second phase, a 17-member expert panel refined the data elements through a two-round Delphi survey. Clinical and administrative items were evaluated by orthopedic surgeons and other experts involved in arthroplasty care to ensure their clinical relevance and suitability for comprehensive TJA registry purposes. Data elements with ≥ 80% agreement were included in the final MDS. Finally, Quantitative validity was assessed using the content value index (CVI), Kappa, and content validity ratio (CVR). A total of 154 data elements related to the TJA procedures (TKA and THA) were identified by literature review. Following expert consensus, 136 data elements that capture preoperative, intraoperative, and postoperative data of the TJA procedures were accepted. Finally, 111 data elements were confirmed through CVI and CVR calculation. The finalized MDS supports standardized and interoperable data collection across healthcare settings. From a clinical perspective, the TJA-MDS may facilitate outcome monitoring, implant performance evaluation, identification of complications and revision trends, PROs assessment, evidence-based decision-making, multicenter research, quality improvement, and healthcare policy development related to TJA procedures.

Pathways to Impactful Water-Energy-Food+ Nexus Projects in Europe: Insights From a European Expert Survey.

To assess the impact of the individualised risk-based donor selection guidelines on deferral of blood donors at donation sessions in England. From June 2021, the 3-month deferral for sex between men was replaced by an individualised risk assessment known as FAIR (For the Assessment of Individualised Risk). Assessing the impact of deferral at donation informs donor and policy management. Data were obtained from the NHS Blood and Transplant donor management system for deferrals associated with FAIR deferral codes or injecting drug use after FAIR implementation, 14 June 2021 to 13 June 2023. Rates for each deferral category were estimated by age group, sex, ethnic group, and donor type. Pre-donation forms were reviewed for evidence of multiple deferrable behaviours, and return rates were calculated for temporarily deferred donors. Over 2 years, 286 donors were deferred on-session due to FAIR (9.0 donors per 100 000 donations made). Highest adjusted incidence rate ratios of deferral were seen in first-time, male, 17- to 24-year-old, and Mixed and Other ethnicity donors. Multiple FAIR deferrals were observed in 10 donors. Of 220 temporarily deferred donors, 56.8% returned to donate within 6 months. The impact of FAIR on donation session appears low, supported by good return rates. First-time, male, and younger donors were most affected. Multiple FAIR deferrals in a donor were rare, suggesting donors at higher risk were not attending to donate. Clarity on deferral application may aid donors and staff to defer appropriately. Further investigation is needed to determine levels of ineligible donation.

Lifestyle Medicine (LM) plays a critical role in the prevention, treatment, and even reversal of chronic diseases through evidence-based lifestyle interventions. Despite its importance, LM is not yet systematically embedded into family medicine residency training. Current approaches often focus narrowly on behavior change and lack an integrated curriculum framework. This study aimed to identify and reach expert consensus on the core learning objectives necessary for incorporating LM into family medicine specialty education in Turkey. A two-round electronic modified Delphi (E-Delphi) method was employed to gather consensus from a multidisciplinary expert panel. Fifteen participants-including family medicine academicians, practicing physicians, residents, and professionals in medical education, nutrition, and sports medicine-evaluated 114 learning objectives developed by a steering committee through literature review. A 5-point Likert scale was used for scoring, with consensus defined as ≥ 80% agreement, a median score ≥ 4, and an interquartile range (IQR) ≤ 1. In the first round, consensus was achieved for 107 objectives. In the second round, 96 learning objectives reached final consensus, covering eight core domains: introduction to LM, nutrition, physical activity, sleep health, stress management, substance use, sexual health, social relationships, and environmental exposures. Highest agreement was observed in nutrition and physical activity; objectives related to stress regulation, sleep assessment, and environmental policy received lower consensus, indicating areas needing further curricular clarification. The findings provide a foundational framework for curriculum development and may guide international efforts to integrate LM into postgraduate medical education.

ABSTRACT This study examined physical education teachers’ perceptions of opportunities and challenges in implementing model-based practices (MBP) following a 25-hour continuous professional development (CPD) course. Through qualitative analysis of focus group data collected at three time points, nine in-service PE teachers navigated conceptual, pedagogical, cultural, and political dilemmas when integrating student-centred models into practice. Thematic analysis revealed that whilst CPD stimulated teachers’ curiosity and motivation to experiment with new instructional strategies, the absence of continuous mentorship and collaborative learning structures significantly limited sustained implementation. Teachers faced persistent systemic barriers, including institutional resistance and grade-focused assessment cultures. Notably, implementation challenges affected experienced educators as much as early-career teachers. Findings suggest that meaningful MBP adoption requires restructured professional development combining initial intensive training with ongoing mentorship and collaborative reflection within professional learning communities, supported by conducive school cultures and assessment policies.

The US adopted an individual donor assessment (IDA) policy in 2023 to evaluate blood donor risk, potentially resulting in more eligible donors and first-time donors (FTDs). FTDs are associated with higher transfusion-transmissible infectious disease (TTID) risk. Thus, we compared FTD demographics, characteristics, and return behavior during the first 2 years of the IDA compared to the previous 2 years during the 3-month deferral (3MD) policy. FTD donation data from the transfusion-transmissible infections monitoring system (TTIMS) during the initial 2 years of IDA were compared to the preceding 2 years (3MD). Descriptive statistics were used to assess changes in FTD demographics, donation characteristics, state of residence, and return behavior during the IDA policy compared to the 3MD policy. There were slightly over 4 million donations from FTDs during the entire study period, with a 6% increase overall during the IDA period, led mostly by male FTDs (14% increase). Increases were observed in most other demographic/characteristic groups except for a few (female, aged 16-24, or other procedure types). There was a higher absolute number of returning donors and subsequent donations from the FTDs during the IDA period compared to the previous period. The Northeastern US states were found to have the highest increase in FTDs. There were variable increases in FTDs among most demographic and characteristic groups post-implementation of the IDA policy, notably among men. Although attributability to the new policy is unclear, blood availability may increase with such policies. Continued monitoring will ensure blood safety during donor policy changes.

Advancing stakeholder analysis: Power and participation in health technology assessment policy development in the United Arab Emirates.

BackgroundThere is currently no national approach to physical health and activity management for individuals under forensic mental healthcare.AimsThis study aims to document the physical health and activity management of in-patients under forensic mental healthcare across Australia, physical activity opportunities and how data are recorded. It also explores staff perspectives on physical health and activity needs of forensic in-patients.MethodForensic hospital staff with expertise in managing the physical health and activity of in-patients were invited to participate in a mixed-methods study.ResultsTwenty-two surveys were completed and 64 staff members participated in 17 focus groups. Eight themes were identified: (a) lack of a standardised approach to physical health and activity; (b) inconsistent monitoring and documentation; (c) importance of general practitioners and multidisciplinary teams; (d) need for structured, adaptable programmes and engaged staff; (e) challenges related to patients, staff, ethics and infrastructure; (f) gaps in education, engagement and awareness; (g) need to balance nutrition and eating autonomy; and (h) importance of developing and implementing interventions.ConclusionsForensic hospitals in Australia lack a standardised approach to physical health and activity management, with inconsistent monitoring. Physical activity interventions require engaged staff, resources and flexibility, yet ethical and logistical barriers complicate implementation. Solutions include investing in specialised staff, scheduling physical activity into patients’ routines and integrating information technology systems. Comprehensive policies for assessment, monitoring, nutrition, physical activity and interventions are important for improving in-patient forensic mental healthcare, and key performance indicators should be developed.

In the absence of standardized measures, researchers have struggled to define meaningful use of telehealth (care received via video or telephone). We evaluated a novel Telehealth Engagement Measure (TEM) that quantifies an individual's telehealth use, including telephone (TEM-t) and video (TEM-v), as a percentage of total care received. In a retrospective cohort in the Veterans Health Administration (VHA), we identified 716,373 Veterans with at least three primary care visits between May 1, 2022 and April 31, 2023. We calculated the predicted annual TEM, TEM-t, and TEM-v stratified by age, gender, race/ethnicity, rurality, drive time, and Charlson Comorbidity Index, adjusting for patient demographics. The mean unadjusted TEM was 21.7%, TEM-t was 15.1%, and TEM-v was 6.6%. The predicted annual TEM decreased with higher age until age 80 (15.1% (95% CI 14.7,15.5)). This was driven by reduced video care utilization, which peaked at 11.2% (95% CI 10.7,11.8) among Veterans aged 20 and declined after age 50 (6.5%, 95% CI 6.2, 6.8). A higher drive-time to VHA was associated with a higher TEM, while Veterans with higher comorbidity were associated with a higher TEM-t. The TEM reflects the distribution of a person's care across different modalities The measure can be applied in research and clinical settings and can be leveraged to examine the longitudinal impact of telehealth on a host of outcomes. The TEM is a novel, proportions-based measure that can be used to assess telehealth utilization at various levels in a health care system.

Global review of assessments of online video gaming policies affecting young people: Loot boxes, age ratings, gameplay time restrictions, and beyond.

ObjectiveTo provide an overview of the status of artificial intelligence (AI) governance for health in the World Health Organization (WHO) European Region.MethodsThe WHO Regional Office for Europe developed a cross-sectional survey on AI governance and adoption. The survey was available to all 53 Member States between June 2024 and March 2025. Responses were analysed at the regional and subregional level.FindingsOf the 50 Member States responding to the survey, 8% (4/50) have a health-specific AI strategy and 14% (7) are developing one. Regionally, 33 Member States have implemented cross-sectoral AI strategies and 8 (16%) are developing them. Of these Member States, almost half each have assigned implementation and oversight responsibilities to existing single or multiple government agencies. Nearly half the Member States (23) reported ongoing assessments of laws and policies on AI systems and a fifth (10) have developed new health-specific AI laws. Only 14 Member States have issued guidelines to address the ethical implications of using AI in health or across sectors. Less than 10% (4) of Member States have developed liability standards for AI or guidance on the application of existing liability standards. Overall, 33 (66%) Member States have adopted health data strategies, 33 (66%) have health data hubs and (68%) have health data authorities supporting data access and control.ConclusionIn the WHO European Region, governance of AI in health care is underdeveloped. Adaptive legal and policy mechanisms are needed to respond effectively to the complex and evolving challenges of AI integration in health systems.

Stability study of 17 clinical immunoassays analytes in serum and plasma samples within an automated storage and retrieval module: Assessment of add-on testing policies.

Social sustainability remains the least consistently defined and measured pillar of urban development, limiting comparability across studies and constraining evidence-based policy. This paper addressed this gap through a systematic analysis of twenty academic frameworks, consolidating 365 extracted metrics into a Holistic Social Sustainability Assessment Framework (HSSF) comprising 147 specialized metrics organized across four domains and seventeen subdomains. Using HSSF as a benchmark, the frameworks were evaluated along two complementary dimensions: spread and density. The findings revealed pronounced fragmentation, with 84% of the specialized metrics appearing in only one or two tools, indicating limited consensus on the core components of social sustainability. Methodologically, the field relied heavily on subjective inputs, with approximately 85% of the metrics classified as subjective, while only 5% were objective and verifiable. Although several frameworks appeared comprehensive at the domain level ten out of twenty covered all four domains coverage was consistently weak at the subdomain level, where no framework exceeded 60% coverage and substantial portions remained unmeasured, with zero-metric subdomains ranging from 41% to 88%. Metric density was similarly uneven, with detailed assessment concentrated in a small number of attributes, while entire domains were omitted in up to half of the reviewed frameworks. These results indicate that existing tools frequently operationalize divergent constructs and are therefore not directly comparable. The HSSF, together with the proposed diagnostic coverage-analysis approach, provides a foundation for developing a more standardized, balanced, and globally applicable set of social sustainability metrics capable of supporting robust assessment and evidence-informed urban policy.

Trace element composition and dietary exposure to Mn, Se, Mo, Cr, Co, Ni, and Li in the Cuban diet: Evidence from a Total Diet Study.

Preventing incisional hernia after ileostomy closure: Budget impact analysis of prophylactic biosynthetic mesh use in Italy.

Teachers’ conceptions of assessment shape how they interpret and respond to assessment policies. Multiple inventories have been developed to capture how teachers understand assessment from diverse theoretical perspectives. However, it remains unclear whether these inventories capture the same constructs with different terminology or reflect different constructs. To address this issue, this study compared four inventories in China: Chinese Teachers’ Conceptions of Assessment (C-TCoA, 2011), Chinese Approaches to Classroom Assessment Inventory (C-ACAI, 2022), Science Teachers’ Assessment Conceptions Questionnaire (STACQ, 2017), and Teacher Formative Assessment Literacy Scale (TFALS, 2022). Using a chained survey design ( N = 1041), data were analysed with confirmatory factor analysis, multitrait–multimethod correlations, and structural equation modelling. Results showed partial factorial validity and construct overlap. Improvement and accountability were the most consistent dimensions, whereas irrelevance remained independent. These findings suggest similar constructs may be labelled differently across inventories, indicating possible confusion in the field. • Four assessment conception inventories compared using MTMM and SEM in China. • Improvement emerged as the most stable shared construct. • Accountability showed partial overlap across inventories. • Irrelevance functioned as a distinct independent construct. • Findings reveal jingle–jangle fallacy across assessment conception inventories.

Advances in blood donor screening have supported the shortening of deferral intervals and incorporation of individual risk assessment. This study investigated the potential impacts of comparing 3‑ and 6‑month deferral periods for men who have sex with men and introducing a behaviour‑based individual risk assessment policy in Hong Kong, particularly on donor eligibility and blood safety. A cross-sectional study was conducted in March 2024, recruiting individuals who had successfully donated blood in October 2023 in Hong Kong. Participants completed a survey on transfusion-transmissible infection risk-related deferrable behaviours, as described in the pre-donation screening questionnaire, and the United States Food and Drug Administration-proposed individual risk assessment items within 6 months before donation. Bivariable and multivariable (backward) logistic regression analyses were performed to identify factors associated with non-compliance. Presumptive non-compliance rates were calculated based on the timing of the most recent reported risk behaviour. Of 2268 responses received, 1720 (median age=46 years; 50.8% male) were analysed. The non-compliance rate under the prevailing 6-month deferral policy was 4.01% (95% confidence interval [95% CI]=3.16%-5.02%). Non-compliant donors were more likely to be male (adjusted odds ratio [aOR]=2.049, 95% CI=1.216-3.451) and to perceive themselves as healthy (aOR=1.248, 95% CI=1.024-1.521), but less likely to believe in personal responsibility for blood safety (aOR=0.846, 95% CI=0.766-0.935). Presumptive non-compliance rates were 2.79% for 3-month deferral under the prevailing policy and 2.27% for 3-month deferral incorporating individual risk assessment. Of the five individuals who would have been deferred for male-to-male sexual activities under the prevailing policy with a 3-month deferral period, two would have become eligible under individual risk assessment. Shortening deferral intervals had modest effects on donor compliance. Incorporating individual risk assessment could improve identification of potential donors with higher-risk sexual behaviours while moderately expanding the donor pool.