Search Results (111)

One of the most important changes after the COVID-19 pandemic was the adoption of remote or hybrid work, which has become increasingly common in many sectors and industries. In this context, based on data from a questionnaire survey, this study aims to explore the perceptions and expectations of students from two Eastern European countries—Romania and Bulgaria—regarding working from home as an effect of the COVID-19 pandemic. To achieve this aim, this study is based on The Job Demands–Resources Theory and the Task–Technology Fit model, which provide an important theoretical framework in interpreting the results. The research employed a non-probability sampling method, with the final sample including 260 respondents from various bachelor’s, master’s, and doctoral programs from two universities, 115 from Romania and 145 from Bulgaria. Data analysis was performed using descriptives statistics, nonparametric correlation analysis, nonparametric tests, as well as multinomial logistic regression and a two-step cluster analysis. The empirical results showed that there are significant differences between the two countries in terms of several aspects related to working from home. We found that the national context influences how people perceive the advantages and disadvantages of working from home and what skills are most important in the post-pandemic labor market. However, respondents have similar expectations regarding future working arrangements, with the majority wanting a hybrid work style. Consequently, the COVID-19 pandemic has had a powerful effect on how people currently work, an effect that will also continue in the future. Full article

Remote First Nations communities in Australia experience ongoing energy insecurity due to geographic isolation, reliance on diesel, and uneven consumer protections relative to grid-connected households. This paper analyses evidence on electricity access, infrastructure and practical experience along with initiatives for improving existing infrastructure; highlights government policies, funding frameworks and regulation; demonstrates the benefits of community-led projects; provides geographic and demographic insights; and relevels key challenges along with pathways for effective solutions. Drawing on existing program experience, case studies and recent reforms (including First Nations–focused strategies and off-grid consumer-protection initiatives), this paper demonstrates that community energy systems featuring solar-battery systems can significantly improve reliability and affordability by reducing reliance on diesel generators and delivering tangible household benefits. The analyses reveal that there is an ongoing gap in protecting off-grid consumers. Hence, this work proposes a practical agenda to improve electricity supply systems for First Nations community energy systems through advanced community microgrids (including long-duration storage), intelligent energy management and monitoring systems, rights-aligned consumer mechanisms for customers with prepaid metering systems, fit-for-purpose regulation, innovative blended finance (e.g., Energy-as-a-Service and impact investment) and on-country workforce development. Overall, this paper contributes to a perspective for an integrated framework that couples technical performance with equity, cultural authority and energy sovereignty, offering a replicable pathway for reliable, affordable and clean electricity for remote First Nations communities. Full article

Amid the nationwide promotion of fitness and the rapid expansion of China’s sports industry, enhancing spectator satisfaction in sports consumption has become a crucial driver for the industry’s sustainable development. Based on the theory of mind-flow perception, this paper explores the influence of stadium intelligent design on race consumption satisfaction, focusing on the four dimensions of stadium intelligent application perception, personality design perception, digital development perception, and technology integration perception, introduces the mind-flow experience as a mediating variable to construct a theoretical model, and analyzes the questionnaire data of 641 spectators with structural equation modeling. The results show that each perception dimension of intelligent design of stadiums has a significant positive effect on consumer satisfaction. Among them, intelligent applications enhance convenience and interactivity, individual design stimulates emotional resonance and immersion, and digital development and technological convergence optimize the audience’s interactive experience through augmented reality, the Internet of Things, and other technologies. flow experience serves as a key mediator to transform functional attributes into emotional value and immersion experience, significantly enhancing satisfaction. This study contributes theoretical insights and managerial guidance for the integration of AI-driven design, human–technology interaction, and smart construction strategies in modern sports venues. The results have broader implications for enhancing digital user environments and optimizing the infrastructure for next-generation event-based urban development. Full article

To support the national goals of carbon peaking and carbon neutrality, this study proposes a household carbon emission prediction model based on Gene Expression Programming (GEP) for low-carbon retrofitting of aging residential areas in arid-cold regions. Focusing on 15 typical aging communities in Kundulun District, Baotou City, a 17-dimensional dataset encompassing building characteristics, demographic structure, and energy consumption patterns was collected through field surveys. Key influencing factors (e.g., electricity usage and heating energy consumption) were selected using Pearson correlation analysis and the Random Forest (RF) algorithm. Subsequently, a hybrid prediction model was constructed, with its parameters optimized by minimizing the root mean square error (RMSE) as the fitness function. Experimental results demonstrated that the model achieved an R² value of 0.81, reducing RMSE by 77.1% compared to conventional GEP models and by 60.4% compared to BP neural networks, while significantly improving stability. By combining data dimensionality reduction with adaptive evolutionary algorithms, this model overcomes the limitations of traditional methods in capturing complex nonlinear relationships. It provides a reliable tool for precision-based low-carbon retrofits in aging residential areas of arid-cold regions and offers a methodological advance for research on building carbon emission prediction driven by urban renewal. Full article

Background/Objectives: High-intensity interval training (HIIT) can optimize recovery by complementing the low cardiovascular fitness intensities typically achieved in stroke rehabilitation programs. Skating exercise is an HIIT workout developed based on ice skating movements, and we investigated the effects of this exercise on the cardiorespiratory fitness of elderly patients with minor stroke. Methods: Participants aged 65 or older with a National Institutes of Health Stroke Scale score of 3 or lower were recruited. This study was designed as a randomized controlled trial, in which the intervention group engaged in skating exercises following HIIT, while the control group underwent moderate-intensity continuous training (MICT). Both groups of participants performed either HIIT or MICT for 20 min per day, four times a week, over three months. Results: A total of 34 elderly patients with minor stroke were recruited, with an average age of 70.7 years. For three months, no fall-down injuries or adverse cardiovascular or cerebrovascular events were reported among patients undergoing HIIT or MICT. Both the intervention and control groups showed significant increases in the measures of aerobic capacity after the intervention. However, the patients in the intervention group exhibited significantly greater improvements in peak oxygen uptake, ventilatory threshold, and peak MET (p = 0.005, p = 0.002, and p = 0.024, respectively). Additionally, the Berg Balance Scale (BBS) scores and the skeletal muscle mass index showed significantly greater enhancements in the intervention group compared to the control group (p = 0.032 and p = 0.032). Conclusions: In conclusion, skating exercise could be a safe and effective HIIT protocol for elderly people who have experienced a minor stroke. Full article

This study explores the governance and implementation of local labor market programs (LLMPs) in Swedish municipalities, analyzing the tension between national mandates and local policy practices. Drawing on institutional ethnography (IE), intersectionality, and emotional labor theories, we examine interviews with politicians and managers from eight municipalities. Politicians frame LLMPs as budget-driven initiatives, depoliticizing local labor market issues to comply with national policies like the January Agreement. This approach prioritizes efficiency, workfare models, and quick labor market entry, often sidelining individualized support. In contrast, managers describe their role as navigating policy constraints while addressing diverse local needs. They emphasize the challenges of aligning “one-size-fits-all” activation strategies with the realities of their participants, advocating for flexibility and adaptation within national frameworks. These contrasting perspectives reveal how LLMPs, although locally implemented, are shaped by textually mediated national policies, which influence local governance practices. Politicians focus on the need to meet national objectives, while managers struggle to reconcile these goals with participant-centered approaches. This study contributes to the understanding of how LLMPs operate within a governance framework that prioritizes efficiency over holistic support, highlighting the limitations of workfare-oriented policies and their implications for labor market integration. Full article

Background: Prehabilitation is increasingly being used in patients undergoing multimodality treatment for oesophagogastric cancer (OGC). Most studies to date have been small, single-centre trials. This collaborative study sought to assess the overall impact of prehabilitation on patient outcomes following OGC surgery. Methods: Data came from four prospective prehabilitation trials conducted in the UK or Ireland in patients undergoing multimodality treatment for OGC. The studies included three randomised and one non-randomised clinical trial, each comparing a prehabilitation intervention group to controls. The prehabilitation interventions included aerobic training delivered by exercise physiologists alongside dietetic input throughout the treatment pathway. The primary outcome was survival (all-cause and disease-specific mortality). Secondary outcomes were differences in complications, cardio-respiratory fitness (changes in VO_{2 peak} and anaerobic threshold (AT)), chemotherapy completion rates, hospital length of stay, changes in body mass index, tumour regression and complication rates of anastomotic leak and pneumonia. Cox and logistic regression analysis provided hazard ratios (HR) and odds ratios (OR), respectively, with 95% confidence intervals (CI), adjusted for confounders. Results: Among 165 patients included, 88 patients were in the prehabilitation group and 77 patients were in the control group. All-cause and disease-specific mortality were not improved by prehabilitation (HR 0.67 95% CI 0.21–2.12 and HR 0.82 95% CI 0.42–1.57, respectively). The prehabilitation group experienced fewer major complications (20% vs. 36%, p = 0.034; adjusted OR of 0.54; 95%CI 0.26–1.13). There was a mitigated decline in VO_2 peak following neo-adjuvant therapy (delta prehabilitation −1.07 mL/kg/min vs. control −2.74 mL/kg/min; p = 0.035) and chemotherapy completion rates were significantly higher following prehabilitation (90% vs. 73%; p = 0.016). Hospital length of stay (10 vs. 12 days, p = 0.402) and neoadjuvant chemotherapy response (Mandard 1–3 41% vs. 35%; p = 0.494) favoured prehabilitation, albeit not statistically significantly. Conclusion: Despite some limitations in terms of heterogeneity of study methodology, this study suggests a number of meaningful clinical benefits from prehabilitation before surgery for OGC patients. Current initiatives to agree on national standards for delivering prehabilitation and the results of ongoing trials will help to further refine this important intervention and expand the evidence base to support the widespread adoption and implementation of prehabilitation programs. Full article

With the rapid development of society and technology, the physical health of university students has become a critical concern, influencing both individual well-being and the national talent pool. This study employs an improved K-means algorithm integrated with machine learning models to analyze university students’ fitness data and develop personalized health intervention strategies. The enhanced K-means algorithm overcomes the limitations of traditional clustering approaches, leading to improved clustering accuracy and stability. Machine learning models—including Random Forest, decision trees, Gradient Boosting Trees, and logistic regression—were utilized to validate the clustering outcomes and to identify key health indicators associated with different student groups. Based on the clustering and model analysis, targeted intervention programs are proposed, such as strength training for groups with low muscular explosiveness, endurance training for those with stamina deficiencies, and flexibility exercises for groups exhibiting limited mobility. This integrated analytical framework provides a scientifically grounded tool for comprehensive health assessments and offers actionable, data-driven recommendations for student health management. Future research will focus on optimizing algorithmic performance, enhancing data diversity, and broadening the application scope to further improve the effectiveness and feasibility of health interventions. Full article

Background: This cross-sectional study aims to clarify the relationship between coaches’ decisions and players’ relative age, biological maturation, and experience when identifying Under-14 (U14) players for the District and National Teams. Methods: A total of 360 male soccer players participating in the U14 national inter-association tournament, Lopes da Silva, were assessed. Birth dates were recorded, and players were categorized by birth quarter. Anthropometric measurements, fitness level (handgrip strength), and success indicators (performance evaluated by the coach, minutes played, and selection for the National Team) were documented, Maturation status was determined using bone age. Results: The majority of the sample was born in the 1st and 2nd quartiles regardless of maturation status. Morphological and functional differences between players born in different quartiles were no longer significant after controlling the effect of bone age. Late-maturing athletes played significantly fewer minutes. Among the players selected for the National Team, 89.9% were early or on-time maturers, and 92.9% were born in the first or second quartile of the year. While previous studies have shown reduced variability between bone and decimal age in the third and fourth quartiles, our findings indicate greater variability across all birth quartiles. Conclusions: Maturation status and relative age effect are crucial factors influencing coaches’ selection decisions. These findings highlight the need for a more equitable approach to talent identification, which should include track maturation bias avoiding the pursuit of short-term success and promoting long-term development programs for young soccer players. Undoubtedly, maturation status and relative age effect (RAE) play a significant role in a coach’s decision-making process. Full article

Background/Objectives: Primary healthcare (PHC) plays a central role in the promotion of universal healthcare coverage within the Brazilian health system. Nevertheless, inequalities across municipalities represent substantial barriers to achieving equity in access to health, particularly due to disparities in the quality of healthcare delivered to patients. Thus, the study aimed to investigate factors associated with perception of PHC quality among adult individuals using private and public facilities within the Brazilian health system. Methods: The empirical approach was based on quantitative analysis of cross-sectional data from five nationally representative surveys conducted by the Brazilian Institute for Geography and Statistics (Instituto Brasileiro de Geografia e Estatística, IBGE) in 1998, 2003, 2008, 2013, and 2019. Pairwise comparisons and marginal analyses allowed for the assessment of differences in patients’ perception of healthcare quality according to source of funding and type of healthcare quality. A logistic regression model was estimated to identify factors associated with the perception of good quality of care. Model discrimination, calibration, and goodness-of-fit were assessed to ensure the robustness of analyses. Results: The results indicate that patients’ satisfaction was positively associated with level of implementation of the national program based on payment for performance in public healthcare facilities, PMAQ-AB (OR = 3.376; p < 0.001), self-assessment of good health status (OR = 3.209; p < 0.001), and healthcare financed through health insurance (OR = 2.344; p < 0.001). Contrarily, receiving healthcare in a public facility (OR = 0.358; p < 0.001) was negatively associated with the evaluation of good quality. Conclusions: The findings showed that patients’ perception of quality of care presents significant associations with patients’ health characteristics, healthcare funding source, and implementation of the PMAQ-AB. Furthermore, patients generally perceived lower healthcare quality in public facilities. The study indicates the need for evidence-based decision-making in public policies of health, particularly regarding further advances in payment for performance programs designed to foster improvements in quality of care within public PHC facilities in Brazil. Full article

Reducing nitrogen excretion in dairy cattle is a critical factor for improving the environmental sustainability of the livestock industry. This research aimed to estimate the genetic parameters over time for the milk urea nitrogen (MUN) trait in Iranian Holstein dairy cattle. Data from 347,639 test-day records of 52,219 first-parity Iranian Holstein dairy cows (spanning 2018 to 2023), were sourced from the Iranian National Animal Breeding Center. A single-trait random regression test-day animal model was used for the genetic evaluation of MUN. Three orders of Legendre orthogonal polynomials (ranging from 1 to 3) were tested to fit the fixed curve, additive genetic effects, and permanent environmental effects. Based on the AIC, BIC, and residual variances to compare the models, the third order was considered as the appropriate order for this dataset. The average heritability and repeatability of the MUN trait were estimated to be 0.027 and 0.081, respectively. The average estimates for additive genetic variance, permanent environmental variance, and phenotypic variance were 0.14, 0.28, and 5.17, respectively. The genetic trend analysis revealed that the MUN trait exhibited fluctuations across birth years (2016–2021), with an overall negative trend. Importantly, the average MUN levels remained within the desirable range of 13–16 mg/dL for Iranian Holstein cows across calving years from 2019 to 2023. Despite the low heritability estimates, the genetic parameters obtained in this study are valuable for improving MUN in Iranian dairy cattle. These findings provide critical insights for designing effective breeding programs aimed at reducing nitrogen excretion and promoting environmental sustainability in the dairy industry. Full article

Background: Resection is considered the standard of care for patients with localized esophageal cancer who are “physiologically fit”. Patients who do not meet this standard are considered contraindicated to receive surgery. We hypothesized that among patients with non-metastatic esophageal cancer, the consideration of contraindication status would vary based on clinical and demographic factors and would vary between institutions. Methods: We identified patients with non-metastatic gastric and esophageal cancer in the National Cancer Database (NCDB) from 2004 to 2018. Patients were categorized into three groups based on surgical treatment: surgical resection (including endoscopic mucosal resection), resection contraindicated, and refusal of resection based on the coding of the “reason for no surgery” data element. Demographic, clinical, and institutional characteristics were compared between the groups using bivariate and multivariate techniques to identify factors associated with contraindicated status. A subgroup analysis of cT1N0M0 patients was also used to assess every institution in the NCDB’s observed–expected ratio for contraindication status. Results: In total, 144,591 patients with non-metastatic disease met inclusion criteria: 124,972 (86%) underwent resection, 13,793 (10%) were contraindicated for resection, and 5826 (4%) refused resection. Contraindication was associated with age, non-Hispanic Black race, socioeconomic status, Charlson–Deyo score, insurance type, institution characteristics, clinical T-stage, and clinical N-stage. There were 9459 patients who were cT1N0M0 and had no co-morbidities. In this cohort, there were more than 1000-fold differences between individual programs regarding observed–expected ratio of contraindication status when adjusting for clinical and demographic characteristics. Conclusions: Variation in the assessment of contraindication status varies dramatically between institutions. Underserved minorities, including age, race, and insurance type, are risk factors for being considered contraindicated. These findings highlight the disparities that exist regarding surgical care of non-metastatic esophageal cancer in the United States. Full article

The region of the Arab Gulf is marching ahead very fast toward digitalization in ways prompted by initiatives, such as Saudi Vision 2030 and the UAE’s strategy for Smart Government. Thus, both underscore the boundless movement toward the inclusion of advanced technologies into accounting practices, such as Business Intelligence and Enterprise Resource Planning systems. While these technologies enhance efficiency and facilitate informed decision-making, they also render financial data vulnerable to cybersecurity threats, such as phishing, ransomware, and insider attacks. This paper investigates the impact of cybersecurity practices, ethical accountability, regulatory frameworks, and emerging technologies on the adoption of and trust in digital accounting systems in the GCC region. A quantitative research approach was followed, wherein the responses from a randomly selected sample of 324 professionals representing the GCC nations were collected. The empirical analysis was completed using Partial Least Squares Structural Equation Modeling. Strong cybersecurity measures, AI-driven threat detection mechanisms, and custom-fit employee training programs facilitate the adoption of and faith in digital accounting information systems considerably. Ethical accountability acts as the partial mediator of those effects, and supportive regulatory frameworks enhance cybersecurity strategy effectiveness. This study examines the development of integrated cybersecurity strategies with respect to technology, ethics, and regulations. It makes several major recommendations, calling for bringing the GCC countries’ regulatory frameworks into line with international standards; encouraging workforce training programs; and utilizing AI-powered technologies for proactive threat detection and management. These findings can arm stakeholders with a holistic pathway toward developing secure, resilient, and future-oriented digital accounting infrastructures across the region. Full article

Background: Whether colorectal cancer (CRC) screening with a fecal immunochemical test (FIT) reduces mortality remains unclear. In South Korea, CRC screening with a FIT for individuals aged ≥ 50 years has been part of the Korean National Cancer Screening Program (KNCSP) since 2004. The aim of this study was to evaluate the effectiveness of the KNCSP in reducing CRC-specific mortality. Methods: We conducted a nested case-control study using cohort-based data derived from the KNCSP database. The cohort included 5,944,540 colorectal cancer-free individuals aged ≥ 50 years as of 2004. Individuals who died after CRC diagnosis were defined as cases (n = 29,992) and their sociodemographic characteristics were matched to those of the selected controls. The effects of screening exposure, frequency, and time interval on CRC-specific mortality were analyzed according to age group. Conditional logistic regression analysis was performed. Results: Compared with individuals who had never been screened, those who had ever been screened showed an OR of 0.74 (95% CI, 0.71–0.76) for CRC-specific mortality. CRC-specific mortality decreased as the number of screenings increased. Similar results were observed for those aged 50–79 years; however, the results for those aged 75–79 years were not statistically significant. Moreover, those aged ≥ 80 years had the opposite results. Conclusions: CRC mass screening using FIT is effective for individuals aged 50–74 years; therefore, this study suggests that countries considering introducing national CRC screening implement FIT for those within this age range. Full article

Objective: We examined the effects of eight weeks of single-mode resistance, repeated sprint training, and the combination of the two programs on selected measures of physical fitness (muscle power, speed, and body composition), hematological parameters, and plasma volume variations in highly trained soccer players. Sixty male soccer players from the Tunisian national Ligue were randomly allocated to a resistance training group (RTG), a repeated sprint training group (RSTG), a combined resistance and repeated sprint training group (CTG), or an active control group (CG, soccer training only). The training volumes were similar between groups. Before and after training, we examined body composition, squat jump (SJ), countermovement jump (CMJ), sprint 30 m (S30), repeated-sprint sequences (RSSs), hematocrit, hemoglobin, mean hemoglobin concentration (MHC), and plasma volume. Significant group-by-time interactions were recorded for the RSS indices, SJ, and S30 (p < 0.039], 0.1< ηp² < 0.49]), as well as the hematological parameters (p = 0.0001–0.045, 0.11 < ηp² < 0.46). In terms of physical fitness, using post hoc tests, the CTG showed significantly greater gains compared to the RSTG, RTG, and the CG on the best time index of the RSSs (p = 0.008; d = 4.1), SJ (p = 0.004; d = 4.18) and 30 m linear sprint time (p = 0.008; d = 3.84). Body fat percentage also decreased significantly in the CTG compared to all other groups (p < 0.005, 0.21 < d< 0.35). Regarding hematological parameters (i.e., hemoglobin and hematocrit), the CTG, RSTG, and RTG showed significant decreases (p < 0.05) in their hemoglobin and hematocrit values compared to the CG (p < 0.05, 0.11 < d< 2.22]). Eight weeks of combined training compared to single-mode training was found to be more effective in improving fitness measures in highly trained soccer players. However, there appeared to be no consensus regarding the effect of single and combined repeated-sprint and resistance training on the hematological system. Full article