Primary Research Question Research Articles

A new normal in primary care: the rapid normalization of a major eHealth program in public health centers.

This study aimed to contribute to a better understanding of the context, mechanisms and outcomes in the implementation process of an eHealth video consultation program in primary care. The study focused on how the program is normalized in the primary care setting. The primary research question for this study is "in what ways is the implementation of video consultation normalized in primary care?". The qualitative design and content analysis of primary data from the transcripts were based on in-depth interviews, complemented with free-text answers to open-ended survey questions and various documents. The study focuses on the large-scale implementation of the public eHealth program Närhälsan Online, which represents more than 100 health centers in Sweden's largest region of Västra Götaland. Multiagent perspectives on how the program is normalized were drawn from expressed perceptions by professions directly linked to both strategic and functional implementation, as well as administration and clinical operation. This study both confirms and enhances the field with a theoretical contribution in six ways to the reviewed previous research, as well as showing practical implications. It also provides multi-agent perspectives on the rapid normalization of the implementation program studied. In relation to the rapid progression of different initiatives in eHealth, this study contributes to perspectives on specific challenges as expressed by professions directly linked to both strategic and functional implementation as well as administration and clinical operation.

Radiological Spinopelvic Parameters Can Be Risk Factors for Early Total Hip Replacement After Spine Fusion.

Interest in the correlation between the spinopelvic complex and its radiographic parameters in early total hip arthroplasty has been increasing. This study investigated whether radiological spinopelvic parameters are risk factors for early total hip replacement (THR) within 1 year of spinal fusion surgery. The primary research question focused on identifying specific spinopelvic changes that may lead to early THR. We retrospectively analyzed patients who underwent lumbar spinal fusion between 2016 and 2021. The patients were divided into 2 groups: patients who underwent early THR (n = 35) and patients who did not (n = 213). Spinopelvic parameters, including pelvic incidence (PI), sacral slope (SS), pelvic tilt, lumbar lordosis, thoracolumbar kyphosis (TLK), sagittal vertical axis, and thoracic kyphosis (TK), were measured before and after surgery. The statistical analyses included inverse probability of treatment weighting, independent t tests, χ 2 tests, and logistic regression analyses. A total of 248 patients were included in the study. The pre- and postoperative TLK and TK angles were significantly smaller in the early THR group than in the late THR group. Increases in the PI and SS after surgery were significant risk factors. The use of interbody fusion techniques was associated with a higher rate of early THR. The difference in the PI minus lumbar lordosis before and after surgery was also significantly correlated with early THR. Abnormal spinopelvic parameters, especially reduced TLK and TK angles and increased PI and SS, are risk factors for early THR. Changes in spinopelvic parameters can lead to rapid hip joint destruction, which highlights the need for careful preoperative evaluation and postoperative monitoring of patients to prevent early THR.

Trigger warnings in medical student education: A scoping review.

Medicine is recognised as a challenging course where exposure to potentially distressing content is inevitable. Some educators provide students with warnings before they encounter potentially upsetting content-trigger warnings. In this scoping review, we mapped the existing literature seeking to better understand how trigger warnings are implemented in medical schools and how they are influencing education within them. Bibliographic databases were searched to identify relevant literature, including searching for grey literature. Articles were included if they focussed on medical school education and were written in English. Data analysis was undertaken using both quantitative and qualitative approaches (thematic analysis). Searching generated 1284 potential records for inclusion. Articles not related to the primary research question were excluded. Abstracts of the remaining 841 articles were screened, and ultimately, 12 articles met criteria for full-text review. Of these, there were three empirical research studies. Qualitative analysis identified five main themes: purpose, implementation, student distress, responsibility and problems with terminology. The use of trigger warnings within medical student education remains contentious. There is a lack of consensus as to their purpose and much diversity in how they are implemented. There was limited published empirical evidence to inform practice in this area.

Investigation of reporting bias in interrupted time series (ITS) studies: a study protocol

Background Interrupted time-series (ITS) studies are commonly used to examine the effects of interventions targeted at populations. Suppression of ITS studies or results within these studies, known as reporting bias, has the potential to bias the evidence-base on a particular topic, with potential consequences for healthcare decision-making. Therefore, we aim to determine whether there is evidence of reporting bias among ITS studies. Methods We will conduct a search for published protocols of ITS studies and reports of their results in PubMed, MEDLINE, and Embase up to December 31, 2022. We contact the authors of the ITS studies to seek information about their study, including submission status, data for unpublished results, and reasons for non-publication or non-reporting of certain outcomes. We will examine if there is evidence of publication bias by examining whether time-to-publication is influenced by the statistical significance of the study’s results for the primary research question using Cox proportional hazards regression. We will examine whether there is evidence of discrepancies in outcomes by comparing those specified in the protocols with those in the reports of results, and we will examine whether the statistical significance of an outcome’s result is associated with how completely that result is reported using multivariable logistic regression. Finally, we will examine discrepancies between protocols and reports of results in the methods by examining the data collection processes, model characteristics, and statistical analysis methods. Discrepancies will be summarized using descriptive statistics. Discussion These findings will inform systematic reviewers and policymakers about the extent of reporting biases and may inform the development of mechanisms to reduce such biases.

Large language models in patient education: a scoping review of applications in medicine.

Large Language Models (LLMs) are sophisticated algorithms that analyze and generate vast amounts of textual data, mimicking human communication. Notable LLMs include GPT-4o by Open AI, Claude 3.5 Sonnet by Anthropic, and Gemini by Google. This scoping review aims to synthesize the current applications and potential uses of LLMs in patient education and engagement. Following the PRISMA-ScR checklist and methodologies by Arksey, O'Malley, and Levac, we conducted a scoping review. We searched PubMed in June 2024, using keywords and MeSH terms related to LLMs and patient education. Two authors conducted the initial screening, and discrepancies were resolved by consensus. We employed thematic analysis to address our primary research question. The review identified 201 studies, predominantly from the United States (58.2%). Six themes emerged: generating patient education materials, interpreting medical information, providing lifestyle recommendations, supporting customized medication use, offering perioperative care instructions, and optimizing doctor-patient interaction. LLMs were found to provide accurate responses to patient queries, enhance existing educational materials, and translate medical information into patient-friendly language. However, challenges such as readability, accuracy, and potential biases were noted. LLMs demonstrate significant potential in patient education and engagement by creating accessible educational materials, interpreting complex medical information, and enhancing communication between patients and healthcare providers. Nonetheless, issues related to the accuracy and readability of LLM-generated content, as well as ethical concerns, require further research and development. Future studies should focus on improving LLMs and ensuring content reliability while addressing ethical considerations.

The relationship of tooth shade and skin tone and its influence on smile attractiveness in native South Indians: A web-based cross sectional survey

ObjectivesThis study aimed to investigate the influence of tooth shade and skin tone on smile attractiveness among native South Indians. The primary research question was whether there is a significant relationship between these variables and perceived smile attractiveness. Materials and methodsA web-based cross-sectional survey was conducted with approval from the Institutional Review Board of (Thai Moogambigai Dental College and Hospital, Chennai). Standardized smile photographs of two South Indian models (one male and one female) were digitally modified to display four different tooth shades and four different skin tones, resulting in 32 images. These images were incorporated into a Google Form along with a questionnaire and a Visual Analog Scale (VAS) for attractiveness rating. The survey was distributed to 1200 participants, including both dental professionals and the general population, with 1000 valid responses recorded. Statistical analysis was performed using IBM SPSS Statistics, employing parametric tests to evaluate the data. ResultsThe study found that lighter tooth shades were consistently rated higher in attractiveness for both genders. Lighter tooth shades such as FS1T1 and FS2T1 scored means of 6.88 and 7.27 respectively for females, while darker shades like FS1T4 scored lower with a mean of 4.95. Similarly, males showed a preference for lighter tooth shades with MS1T1 and MS2T1 scoring means of 5.57 and 5.78 respectively compared to darker shades like MS1T4 with a mean of 3.63. Significant differences were noted across age groups and genders, with younger participants and females showing a stronger preference for lighter tooth shades. ConclusionsThe study concludes that both tooth shade and skin tone significantly influence smile attractiveness, with a clear preference for lighter tooth shades among the surveyed population. These findings suggest the importance of considering these factors in aesthetic dental treatments to enhance patient satisfaction and achieve optimal results. Clinical relevanceThe results underscore the necessity for dental practitioners to take into account both tooth shade and skin tone when planning aesthetic dental treatments. This approach will help in achieving a more harmonious and natural appearance, ultimately improving patient satisfaction with the treatment outcomes. Future research should continue to explore the cultural and individual factors that contribute to these preferences in dental aesthetics.

Enhancing Student Engagement in Learning Management Systems through Exploration of Avatars in Virtual Classrooms: A Systematic Review

The rise of online education has highlighted the crucial need to comprehend student participation in virtual learning environments. With the evolution of online learning platforms, understanding the impact of technological components, especially interactive avatars, on student engagement has become imperative. This study aims to investigate the influence of avatars on student participation in virtual classrooms. Specifically, it seeks to understand the impact of avatars on student interactions, engagement, and involvement within online learning environments. Three primary research questions guide the inquiry: the impact of avatars on student participation, the extent of technology-mediated interaction's effect on engagement, and the nuanced ways in which avatars contribute to or hinder student involvement. The study conducts a comprehensive review of existing literature, delving into the design, integration, and influence of avatars in virtual learning environments. It critically assesses technological advancements, focusing on interactive avatars, and their implications for student engagement. The methodology involves an in-depth analysis of scholarly works, educational platforms, and user experiences to gather valuable insights. The study uncovers the multifaceted impact of avatars in virtual classrooms. Interactive avatars significantly enhance student engagement and participation, fostering interactions between students and teachers as well as among peers. The customization and interactivity of avatars create a more immersive learning experience, positively influencing student involvement. Future research endeavours could explore the integration of avatars with emerging technologies like augmented reality and artificial intelligence, enhancing the depth and scope of virtual classroom interactions. Continued research in this area is essential for refining virtual learning environments and ensuring optimal student participation in the digital educational landscape.

Social services and healthcare personnel’s digital competence profiles: A Finnish cross-sectional study

BackgroundRecent research has highlighted the deficiencies and variations in the digital competences of social services and healthcare personnel. Yet there is a shortage of data regarding how the personnel use digital devices and solutions and their attitudes towards digitalisation. Hence, a systematic investigation into digital devices and solutions in healthcare is warranted. ObjectivesThis study aimed to analyse the similarities and differences in digital competences and organisational support among healthcare personnel, focusing on using digital applications and services. The primary research question was to investigate what kinds of digital competence profiles are identifiable through social services and healthcare personnel self-assessments. MethodsThe survey was conducted in the Wellbeing Services County of Central Finland at the end of 2023. It utilised validated self-assessment methods and garnered 643 responses from social services and healthcare professionals. Data analysis involved quantitative cluster analysis for grouping participants and qualitative content analysis for describing the clusters. ResultsThe study resulted in a final model of seven clusters that presented distinct digital competence profiles with relatively even sizes. These clusters represented the different aspects of digital usage among social services and healthcare professionals. They could be categorised into three overarching profiles: 1) Motivated digital experts, 2) Burdened digital users and 3) Frustrated survivors. Motivated digital experts comprised up almost half of the respondents (45.1%). Still, the findings also facilitated identifying of a small group of Frustrated survivors (7.5%) who represented burdened and stressed digital users. ConclusionsThe results indicate significant variances in digital competence profiles among employees. Social services and healthcare personnel perceive the opportunities and challenges associated with digital applications and services differently. Further detailed research into the disparities between digital competence profiles is necessary, particularly regarding the types of support that benefit different profiles the most.

Optimizing crop seeding rates on organic grain farms using on farm precision experimentation

Organic agriculture is often regarded as less damaging to the environment than conventional agriculture, though at the expense of lower yields. Field-specific precision agriculture may benefit organic production practices given the inherent need of organic farmers to understand spatiotemporal variation on large-scale fields. Here the primary research question is whether on-farm precision experimentation (OFPE) can be used as an adaptive management methodology to efficiently maximize farmer net returns using variable cover crop and cash crop seeding rates. Inputs of cash crop seed and previous-year green manure cover crop seed were experimentally varied on five different farms across the Northern Great Plains from 2019 to 2022. Experiments provided data to model the crop yield response, and subsequently net return, in response to input (seeding) rates plus a suite of other spatially explicit data from satellite sources. New, field-specific spatially explicit optimum input rates were generated to maximize net return including temporal variation in economic variables. Inputs were spatially optimized and using simulations it was found that the optimization strategies consistently out-performed other strategies by reducing inputs and increasing yields, particularly for non-tillering crops. By adopting site specific management, the average increase in net return for all fields was $50 ha−1. These results showed that precision agriculture technologies and remote sensing can be utilized to provide organic farmers powerful adaptive management tools with a focus on within-field spatial variability in response to primary input drivers of economic return. Continued OFPE for seeding rate optimization will allow quantification of temporal variability and subsequent probabilistic recommendations.

National schools of diplomatic training: divergences in the global epistemology of international relations

The proposition of establishing “global international relations” (Global IR) as an amalgamation of diverse national epistemologies in the field of international relations, potentially superseding the Western-centric paradigm, presents significant challenges. A critical inquiry emerges: Is it possible to form a discipline based on the polyphony of national approaches, despite the fact that the ontology of international relations has remained fundamentally unchanged since the mid-17th century? This study evaluates the thesis of extant national epistemologies in international relations by examining national traditions of diplomatic training. The primary research question is formulated as follows: What are the foundational approaches employed by leading states in the training of IR specialists, and can these approaches be considered reflective of national epistemologies regarding the nature of international relations? The research methodology involves a synthesis of findings from an examination of diplomatic training institutions across a diverse sample of countries. This sample encompasses Western nations (United Kingdom, Hungary, Poland, United States, Finland, France, and Germany), Asian countries (Vietnam, Indonesia, India, China, and the Republic of Korea), Middle Eastern states (Egypt, Iran, Saudi Arabia, and Turkey), African nations (Nigeria and South Africa), and Latin American countries (Brazil, Mexico, and Cuba). The article is structured in two principal sections. The theoretical section explores the hypothesis of “global international relations” within the context of existing literature and theoretical frameworks. The second section synthesizes the empirical findings from the study of national approaches to diplomatic training, testing the hypothesis of its correlation with national epistemologies in the field of international relations.

An Investigation of Cooperative Learning Strategies in Improving Students' Comprehension Skills in the Context of English as a Foreign Language (EFL)

The objective of this study was to enhance the reading comprehension abilities of EFL students by implementing cooperative learning strategies. The study aimed to address the following primary research question: What is the influence of cooperative learning on enhancing the reading comprehension skills of EFL students? The study included a total of 70 students from the first and second levels of the Department of English and Literature at the Ar Rass campus of Qassim University in Saudi Arabia. We conducted the study over a three-week period in two classes: the control group consisted of 35 female students (N = 35), while the experimental group also included 35 female students (N = 35). The experimental group received instruction through cooperative learning strategies, whereas the control group received instruction through a standard teacher-centered strategy. To address the fact-finding investigation of the study, we employed a pre- and post-test tool to assess reading comprehension skills. This test specifically aimed to identify the levels of literal and inferential comprehension. We employed the t-test to determine the statistical divergence between the average scores of the two groups. This study demonstrated the beneficial influence of cooperative learning approaches on the enhancement of reading comprehension skills among first- and second-level students in the Department of English and Literature. We strongly recommend cooperative learning practices to improve the reading skills of EFL learners.

Uncovering the Complexity of Perinatal Polysubstance Use Disclosure Patterns on X: Mixed Methods Study.

According to the Morbidity and Mortality Weekly Report, polysubstance use among pregnant women is prevalent, with 38.2% of those who consume alcohol also engaging in the use of one or more additional substances. However, the underlying mechanisms, contexts, and experiences of polysubstance use are unclear. Organic information is abundant on social media such as X (formerly Twitter). Traditional quantitative and qualitative methods, as well as natural language processing techniques, can be jointly used to derive insights into public opinions, sentiments, and clinical and public health policy implications. Based on perinatal polysubstance use (PPU) data that we extracted on X from May 1, 2019, to October 31, 2021, we proposed two primary research questions: (1) What is the overall trend and sentiment of PPU discussions on X? (2) Are there any distinct patterns in the discussion trends of PPU-related tweets? If so, what are the implications for perinatal care and associated public health policies? We used X's application programming interface to extract >6 million raw tweets worldwide containing ≥2 prenatal health- and substance-related keywords provided by our clinical team. After removing all non-English-language tweets, non-US tweets, and US tweets without disclosed geolocations, we obtained 4848 PPU-related US tweets. We then evaluated them using a mixed methods approach. The quantitative analysis applied frequency, trend analysis, and several natural language processing techniques such as sentiment analysis to derive statistics to preview the corpus. To further understand semantics and clinical insights among these tweets, we conducted an in-depth thematic content analysis with a random sample of 500 PPU-related tweets with a satisfying κ score of 0.7748 for intercoder reliability. Our quantitative analysis indicates the overall trends, bigram and trigram patterns, and negative sentiments were more dominant in PPU tweets (2490/4848, 51.36%) than in the non-PPU sample (1323/4848, 27.29%). Paired polysubstance use (4134/4848, 85.27%) was the most common, with the combination alcohol and drugs identified as the most mentioned. From the qualitative analysis, we identified 3 main themes: nonsubstance, single substance, and polysubstance, and 4 subthemes to contextualize the rationale of underlying PPU behaviors: lifestyle, perceptions of others' drug use, legal implications, and public health. This study identified underexplored, emerging, and important topics related to perinatal PPU, with significant stigmas and legal ramifications discussed on X. Overall, public sentiments on PPU were mixed, encompassing negative (2490/4848, 51.36%), positive (1884/4848, 38.86%), and neutral (474/4848, 9.78%) sentiments. The leading substances in PPU were alcohol and drugs, and the normalization of PPU discussed on X is becoming more prevalent. Thus, this study provides valuable insights to further understand the complexity of PPU and its implications for public health practitioners and policy makers to provide proper access and support to individuals with PPU.

Strategic public value(s) governance: A systematic literature review and framework for analysis

AbstractThis article offers evidence‐based understanding of public value creation in multi‐actor collaborations by presenting the results of a systematic literature review of empirical studies published within the public administration field. Specifically, it focuses on two primary research questions: How do multi‐actor collaborations generate public value(s)? What types of public value(s) are created by these collaborative endeavors? Our results shed light on 12 strategic governance components for enacting public value(s) governance (PVsG) in multi‐actor collaborations, including six key public values to be considered for discerning and assessing processes of public value generation. We contribute to theory and practice by providing a unifying framework to PVsG which updates the public value strategic triangle combining Moore's managerial action‐focused approach with Bozeman's policy or societally oriented public values approach.

Integrating Art into STEAM Education: An Interview-Based Study of Interdisciplinary Art Educators

Extensive research has shown that students proficient in Science, Technology, Engineering, and Mathematics (STEM) subjects are more likely to succeed later in life. However, by adding the arts to the STEM curriculum (creating STEAM) and providing educators with a more interdisciplinary framework, students can be better prepared to understand and solve global problems and engage more effectively in social activities. This study employs a narrative approach to collect data and interpret results through interviews with three interdisciplinary art educators. The primary research question is: What is the self-perception of interdisciplinary art educators? By exploring how these educators integrate their specific fields into the arts to develop unique, comprehensive curricula, the study aims to highlight their role. Currently, the arts are viewed as optional rather than essential in education. Therefore, to create a truly effective, comprehensive, and engaging interdisciplinary educational system that benefits students, it is crucial to conduct in-depth interviews and research with interdisciplinary art educators, demonstrating that the arts are a vital component of all core curricula.

Serious adverse events reporting in recent randomised clinical trials in intensive care medicine - A methodological study protocol.

Serious adverse events (SAEs) are common in intensive care unit (ICU) patients. Reporting of SAEs in randomised clinical trials (RCTs) varies why underreporting is likely. We aim to describe the reporting of SAEs from 2020 onwards and to illustrate the recent reporting of SAEs published in major medical journals. We will conduct a methodological study assessing pharmacological interventions in RCTs including adult ICU patients. We will search 10 general medical and critical care journals in PubMed. We will include all RCTs published from 2020 onwards. The primary research question is how many RCTs report SAEs in the primary publication. Secondary research questions include how SAEs are reported in the primary publication either as (1) proportion of patients experiencing one or more SAE, (2) all single events occurred, or (3) both strategies combined. We will assess the association between the proportion of patients with reported SAEs and the following trial characteristics: multicentred versus single-centre RCTs, industry-sponsored versus academic-sponsored, published trial protocol versus unpublished work, blinding, trials sample size, and RCTs focusing on COVID-19 patients versus other populations. The outlined methodological study will provide important information on the reporting of SAEs in recent drug trials in adult ICU patients.

Distal blocking screw augmentation in ulnar intramedullary nail fixation of adult forearm diaphyseal fractures.

This study aimed to evaluate the effect of distal blocking screws on the stability and healing of ulnar diaphyseal fractures treated with intramedullary (IM) nails. The primary research question was whether the addition of distal blocking screws enhanced fracture stabilization and promoted faster healing than the standard IM nailing techniques. This retrospective study reviewed medical records of 30 patients with ulnar diaphyseal fractures treated from February 2018 to September 2023. The patients were divided into two groups: those treated using IM nails alone (n = 17) and those treated with using IM nails with distal blocking screws (n = 13). The surgical time, medullary canal space, fracture healing time, and complications were assessed. Functional outcomes were evaluated using the Grace and Eversmann rating system, the DASH scores, and the VAS scores. The addition of distal blocking screws resulted in a slightly longer surgical time (56min vs 47min). However, the group with distal blocking screws had smaller medullary canal space and showed significantly faster fracture healing times (2.3 months vs 3.9 months; p = .036). There were no reported complications of nonunion, nerve injury, or infection in the distal blocking screw group, whereas the IM nail-only group had one case of nonunion (5.7%). The use of distal blocking screws in conjunction with IM nails for ulnar diaphyseal fractures improves fracture stability and promotes faster healing.

Reiterating the Need for Trauma-Informed and Anti-Oppressive Spaces for Disclosure of Sexual Violence: Learning from Those Who Have Lived Through It

The social movements of #metoo and #notokay illuminated the extent of sexual violence. By providing a safe platform the movement enabled victims/survivors opportunity to share their own experiences of victimization, often in a delayed disclosure, years after the violence occurred. With new disclosures of sexual violence, also comes a growing awareness of the lasting impact and the requirement to take steps to improve responses to sexual violence across the social and clinical spectrum to address and respond to victims/survivors’ holistic needs. The primary research question is, what is the retrospective life experience of individuals marginalized by gender who encounter sexual violence in post-secondary education? The authors of this manuscript used trauma- informed qualitative individual interviews with a feminist perspective to explore the retrospective experience of 10 victim/survivors, a decade or more after their experience of sexual violence. The inquiry discovered the themes of recognizing the wrong, the internal struggle, forging new relationships, and the lasting trauma of sexual violence. Learning from those that lived it legitimizes victims/survivors’ experiences and deepens clinical knowledge of these impacts and associated needs.

Enhancing pediatric attention-deficit hyperactivity disorder treatment: exploring the gut microbiota effects of French maritime pine bark extract and methylphenidate intervention.

The pathogenesis of Attention-Deficit Hyperactivity Disorder (ADHD) is thought to be multifactorial, with a potential role for the bidirectional communication between the gut microbiome and brain development and function. Since the "golden-standard" medication therapy with methylphenidate (MPH) is linked to multiple adverse effects, there is a need for alternative treatment options such as dietary polyphenols. These secondary plant metabolites exert antioxidant and anti-inflammatory effects, but much less is known about their impact on the gut microbiota. Since polyphenols are believed to modulate gut microbial composition, interventions might be advantageous in ADHD therapy. Therefore, intervention studies with polyphenols in ADHD therapy investigating the gut microbial composition are highly relevant. Besides the primary research questions addressed previously, this study explored a potential prebiotic effect of the polyphenol-rich French Maritime Pine Bark Extract (PBE) compared to MPH and a placebo in pediatric ADHD patients by studying their impact on the gut microbiota via amplicon sequencing of the full length 16S rRNA gene ribosomal subunit (V1-V9). One interesting finding was the high relative abundance of Bifidobacteria among all patients in our study cohort. Moreover, our study has identified that treatment (placebo, MPH and PBE) explains 3.94% of the variation in distribution of microbial taxa (adjusted p-value of 0.011). Our small sample size (placebo: n = 10; PBE: n = 13 and MPH: n = 14) did not allow to observe clear prebiotic effects in the patients treated with PBE. Notwithstanding this limitation, subtle changes were noticeable and some limited compositional changes could be observed. doi: 10.1186/S13063-017-1879-6.

An Examination of Cyber Security Solutions in Public and Private IaaS Infrastructures

The digital transformation is a dynamic process that unfolds within the data and information cycle, aimed at maximizing the efficiency businesses derive from data and information. For the structuring and sustenance of this process require information processing resources, typically sourced from cloud computing infrastructures. In this context, the aim of this study is to scrutinize the cyber security measures provided by both public and private IaaS infrastructures, aiding businesses in their selection process for digital transformation. To address the objectives of this research, a mixed-methods approach was adopted, integrating both qualitative and quantitative research techniques. The study is structured around two primary research questions. The first research question (RQ1) seeks to delineate the cyber security measures in Amazon AWS EC2, Google Cloud CE, and Proxmox VE IaaS (Internet as a Service) infrastructures. The second research question (RQ2) aims to identify the similarities and differences in cyber security measures across these infrastructures. Additionally, to verify the findings derived from (RQ1) ensure the credibility of the study, and to experimentally examine cyber security measures within these infrastructures, the study adopts an experimental research method from quantitative analysis techniques and the hypothesis (H0) " The findings obtained as a result of RQ1 are confirmed in AWS EC2 and Google Cloud CE IaaS infrastructures" is tested. As a result of the experimental research, hypothesis H0 was accepted. A review of existing literature, there has been encountered no research that concurrently examines, compares, and experimentally verifies the cybersecurity measures across both public and private IaaS infrastructures. Therefore, this study can be considered to make an original contribution to the existing body of knowledge by addressing an important gap in the literature on the comparative and experimental evaluation of cyber security practices in public and private IaaS infrastructures.

Spatiotemporal Changes in Air Pollution within the Studied Road Segment

Environmental protection is a pivotal element of sustainable development, both essential and indispensable in the construction of smart, green cities. Road transport contributes significantly to atmospheric pollution, accounting for as much as 25% of annual emissions within the European Union (EU). To combat the adverse effects of road transport, the EU has set targets to reduce greenhouse gas emissions from both passenger and commercial vehicles. Consequently, sustainable air pollution management has become a focal point for numerous researchers. This study continues the investigation into the distribution of air pollutants along a specific highway segment in Poland. The article addresses two primary research questions: first, the temporal and spatial variations in air pollution adjacent to a major highway in Poland, and second, whether emission levels exhibit significant annual differences and if there is a correlation between pollutant concentrations and the distance from the roadway. The findings offer valuable data on one of the principal substances polluting the air along EU transportation routes. Moreover, the analysis provides recommendations for future road infrastructure renovation projects and strategies to protect the public from harmful traffic-related pollutants, thereby supporting the development of green cities in accordance with sustainable development principles.