Search Results (231)

A particularly important activity carried out by railway infrastructure managers to maintain railway devices in full working order is the diagnostic process. It increases the level of railway safety. The diagnostic process involves collecting information about the equipment through inspections, tests, functional trials, parameter measurements, and analysis of the working environment, followed by comparing the obtained information with the required parameters or permissible conditions. This activity also enables the formulation of a technical diagnosis regarding the current ability of the devices to perform its intended functions, taking into account the impact of its technical condition on railway traffic safety. This is especially important in the case of railway traffic control devices, as these devices are largely responsible for ensuring railway traffic safety. The collection of data on the condition of railway traffic control devices in the form of Big Data sets and diagnostic inference is an effective factor in making operational decisions for such devices. It enables the acquisition of complete information about the actual course of the exploitation process and allows for obtaining reliable information necessary to manage this process, particularly in the areas of diagnostics forecasting of devices conditions, renewal, and organization of maintenance and repair facilities. To support this, a service data acquisition and analysis system for railway traffic control devices (SADEK) was developed. This system can serve as a software platform for maintenance needs in the railway sector. Full article

In the United States, ecosystems regularly experience wildfires and as fire seasons lengthen, fires are becoming a more important disturbance. While all types of disturbance have impacts on the carbon cycle, fires result in immediate emissions into the atmosphere. To assist managers in assessing wildland fire impacts, particularly on federally managed land, we developed estimates of area burned and related emissions for a 21-year period. These estimates are based on wildland fires defined by the interagency Monitoring Trends in Burn Severity database; emissions are simulated through the Wildland Fire Emissions Inventory System; and the classification of public land is performed according to the US Geological Survey’s Protected Areas Database of the United States. Wildland fires on federal land contributed 62 percent of all annual CO₂ emissions from wildfires in the United States between 2001 and 2021. During this period, emissions from the forest fire subset of wildland fires ranged from 328 Tg CO₂ in 2004 to 37 Tg CO₂ in 2001. While forest fires averaged 38 percent of burned area, they represent the majority—59 to 89 percent of annual emissions—relative to fires in all ecosystems, including non-forest. Wildland fire emissions on land belonging to the federal government accounted for 44 to 77 percent of total annual fire emissions for the entire United States. Land managed by three federal agencies—the Forest Service, the Bureau of Land Management, and the Fish and Wildlife Service—accounted for 93 percent of fire emissions from federal land over the course of the study period, but year-to-year contributions varied. Full article

The synergistic development of ecosystems and socioeconomic systems constitutes a critical foundation for achieving Sustainable Development Goals (SDGs). Large river basins characterized by ecological and socioeconomic spatial heterogeneity frequently present contradictions and conflicts in regional sustainable development, thereby impeding the realization of SDGs. This study employed the Yellow River Basin (YRB), a typical large sediment-laden river system, as a case study. Based on the secondary water resource zones, the spatial variability and temporal evolution of ecosystem service value (ESV), population (POP), GDP, nighttime light (NTL), and Human Development Index (HDI) were analyzed at the water resource partition scale. A consistent mode was applied to quantify the spatiotemporal consistency between ESV and socioeconomic indicators across water resource partitions. The results indicated that from 1980 to 2020, the ESV of the YRB increased from 1079.83 × 10⁹ to 1139.20 × 10⁹ yuan, with no notable spatial pattern variation. From upstream to downstream, the population density, GDP per unit area, and NTL per unit area displayed increasing trends along the river course, whereas the total population, GDP, and NTL initially increased and then declined. Temporally, the population fluctuated with an overall upward tendency, while GDP and NTL experienced significant growth. The spatial distribution and temporal evolution of HDI remained comparatively stable. The coefficients of variation for population, GDP, and NTL were significantly higher than those for ecosystem services and HDI. The study highlighted an overall lack of coordination between ESV and socioeconomic development in the YRB, with relatively stable spatial patterns. These findings could offer a theoretical reference for the formulation of policies to enhance the synergistic development of ecosystems and socioeconomic systems in the YRB. Full article

Background/Objectives: Miscarriage is a common pregnancy complication that significantly impacts individuals’ health due to its physical and psychological effects. This study aimed to investigate the association between periodontal health and hematological parameters in women who experienced miscarriage before the 20th week of gestation, and to assess the potential predictive value of these parameters for miscarriage risk by comparing them with those of women with an uncomplicated pregnancy course. Methods: This study was a prospective case–control and cross-sectional study. It included a total of 82 participants, comprising 41 women with miscarriage and 41 healthy pregnant controls. The periodontal examinations included measurements of the Gingival Index (GI), Plaque Index (PI), Probing Depth (PD), Clinical Attachment Loss (CAL), and Simplified Calculus Index (SCI). Additionally, complete blood counts (CBCs) were obtained from all participants. Appropriate statistical analyses, including non-parametric, correlation, logistic regression, and ROC analyses, were conducted, with the significance level set at p < 0.05. Results: The primary outcome measure was CAL as an indicator of periodontal disease severity and its association with miscarriage risk. Additional outcomes included Plateletcrit (PCT), the Platelet Count (PLT), and the Neutrophil-to-Lymphocyte Ratio (NLR) to evaluate systemic inflammatory responses and their correlations with periodontal parameters. CAL was significantly elevated in the miscarriage group (p < 0.001) and emerged as the strongest predictor of miscarriage risk (OR = 0.0537, p < 0.001, AUC = 0.8691). PCT was significantly higher in the miscarriage group (p = 0.017) and positively correlated with the GI (p = 0.041), suggesting a link between systemic inflammation and periodontal health. Conclusions: Considering this study’s limitations, CAL was the strongest predictor of miscarriage, while PLT and PCT had some discriminative power. Collaboration between obstetricians and dentists can facilitate early diagnosis and intervention by promoting routine oral health check-ups before and during pregnancy. Additionally, integrating oral health assessments into prenatal care and developing public health policies could enhance access to dental services during both preconception and pregnancy periods. Full article

Anorexia Nervosa (AN) is a psychiatric illness with serious medical and physiological implications. Anorexia Nervosa is characterised by significant disruptions in weight, growth and physical health resulting from disordered behaviours such as food restriction, purging and inappropriate exercise. The illness is associated with substantial physical, psychological, social and economic burdens affecting all areas of functioning. Typically emerging in adolescence, AN can have a chronic course and high risk of mortality, with evidence suggesting that approximately 10% of individuals diagnosed with AN will die from medical complications or completed suicide. Whilst inpatient treatment reduces mortality risks through nutritional and weight restoration, outpatient treatment is the preferred level of intervention. In the case of adolescents, family-based treatment (FBT) is the recommended and most researched outpatient model for medically stable adolescents. However, access to FBT is limited, and there are several barriers that exist to receiving care from trained clinicians. This review provides a literature update on studies reporting the real-world access challenges for FBT, with particular attention paid to non-research settings. The review also highlights how digitally delivered treatment, specifically telehealth, has been used to increase access to FBT and examines the preliminary outcomes of telehealth-delivered FBT, which appear comparable to traditional in-person care. Despite these promising findings, provider, intervention and systemic factors have challenged the delivery of traditional in-person and telehealth FBT in real-world settings. Critical areas for future research include the need to understand the impact of potential confounders and what adaptions may be required to increase model feasibility in community settings, where access to specialist services is often limited and access challenges are most felt. Full article

Approximately two decades after the approval of POCP, and following an assessment of the need for an accounting system that meets the demands of proper planning, accountability, and financial control, the SNC-AP was introduced. This system, regulated by 27 Public Accounting Standards, has faced challenges in its implementation. Therefore, it is relevant to analyze how managers of Portuguese higher education institutions (HEIs) perceive this issue. The objective of this research is to determine whether HEI managers use management control tools, which management control models are adopted, and the difficulties encountered in their implementation. To achieve this, a qualitative empirical study was conducted through semi-structured interviews with 12 administrators and financial directors from Portuguese higher education institutions (HEIs). The results show that management accounting is complex and challenging to implement. Portuguese HEIs are still in the early stages of adopting these tools, with progress limited to defining activities and cost centers. Conditions have not yet been established to calculate, for example, the cost per course, student, project, or service, as outlined in NCP27 of the SNC-AP. Full article

Background and Objectives: On 6 February 2023, two catastrophic earthquakes struck southeastern Türkiye, affecting over 13 million individuals and causing widespread destruction. While the physical damage was immediate, the psychological consequences—particularly posttraumatic stress disorder (PTSD) and depression—have proven long-lasting. This study aimed to evaluate the severity and course of PTSD symptoms among survivors and to examine the effectiveness of a telepsychiatry-based mental health intervention in a post-disaster setting. Materials and Methods: This naturalistic, observational study included 153 adult participants from the affected regions who underwent at least two telepsychiatry sessions between the first and sixth month post-disaster. Initial screening was conducted using the General Health Questionnaire (GHQ-12), and individuals scoring ≥ 13 were further assessed with the PTSD Checklist—Civilian Version (PCL-C) and the Beck Depression Inventory (BDI). Follow-up evaluations and pharmacological or psychoeducational interventions were offered as clinically indicated. Results: At the one-month follow-up, 94.4% of participants met the threshold for PTSD symptoms (PCL-C > 22) and 77.6% had severe depressive symptoms (BDI > 30). By the sixth month, PTSD symptoms had significantly decreased (mean PCL-C score reduced from 42.47 ± 12.22 to 33.02 ± 12.23, p < 0.001). Greater symptom reduction was associated with higher educational attainment and perceived social support, while prior trauma predicted poorer outcomes. Depression severity emerged as the strongest predictor of chronic PTSD. Conclusions: This study highlights the psychological burden following the 2023 earthquakes in Türkiye and demonstrates the feasibility and potential effectiveness of telepsychiatry in disaster mental health care. Integrating digital mental health services into disaster response systems may help reach vulnerable populations and improve long-term psychological recovery. Full article

Social changes have significantly impacted the educational system at various levels, for example, through legislative reforms, and have consequently guided the teaching–learning process. One of the emerging methodologies is Service-Learning (SL), which directly affects student competence and promotes habits related to physical activity and health. The present quasi-experimental study examined the impact of an SL program on secondary school students (n = 112). The aim of the 16-session SL program, which was part of the Physical Education course, was to improve the physical condition and health of 18 sedentary older adults. The influence of this program on motivation, the prosocial climate, and the importance that the students attribute to the subject of Physical Education was assessed. The most significant results were found to be those related to the School Prosocial Climate linked to empathy (p < 0.05) and the motivational variable of Intrinsic Motivation for Stimulating Experiences (p < 0.01). In conclusion, it was determined that the implementation of a methodology based on SL has positive effects on students’ empathy and intrinsic motivation. Full article

Clinical documentation, particularly the hospital discharge report (HDR), is essential for ensuring continuity of care, yet its preparation is time-consuming and places a considerable clinical and administrative burden on healthcare professionals. Recent advancements in Generative Artificial Intelligence (GenAI) and the use of prompt engineering in large language models (LLMs) offer opportunities to automate parts of this process, improving efficiency and documentation quality while reducing administrative workload. This study aims to design a digital system based on LLMs capable of automatically generating HDRs using information from clinical course notes and emergency care reports. The system was developed through iterative cycles, integrating various instruction flows and evaluating five different LLMs combined with prompt engineering strategies and agent-based architectures. Throughout the development, more than 60 discharge reports were generated and assessed, leading to continuous system refinement. In the production phase, 40 pneumology discharge reports were produced, receiving positive feedback from physicians, with an average score of 2.9 out of 4, indicating the system’s usefulness, with only minor edits needed in most cases. The ongoing expansion of the system to additional services and its integration within a hospital electronic system highlights the potential of LLMs, when combined with effective prompt engineering and agent-based architectures, to generate high-quality medical content and provide meaningful support to healthcare professionals. Hospital discharge reports (HDRs) are pivotal for continuity of care but consume substantial clinician time. Generative AI systems based on large language models (LLMs) could streamline this process, provided they deliver accurate, multilingual, and workflow-compatible outputs. We pursued a three-stage, design-science approach. Proof-of-concept: five state-of-the-art LLMs were benchmarked with multi-agent prompting to produce sample HDRs and define the optimal agent structure. Prototype: 60 HDRs spanning six specialties were generated and compared with clinician originals using ROUGE with average scores compatible with specialized news summarizing models in Spanish and Catalan (lower scores). A qualitative audit of 27 HDR pairs showed recurrent divergences in medication dose (56%) and social context (52%). Pilot deployment: The AI-HDR service was embedded in the hospital’s electronic health record. In the pilot, 47 HDRs were autogenerated in real-world settings and reviewed by attending physicians. Missing information and factual errors were flagged in 53% and 47% of drafts, respectively, while written assessments diminished the importance of these errors. An LLM-driven, agent-orchestrated pipeline can safely draft real-world HDRs, cutting administrative overhead while achieving clinician-acceptable quality, not without errors that require human supervision. Future work should refine specialty-specific prompts to curb omissions, add temporal consistency checks to prevent outdated data propagation, and validate time savings and clinical impact in multi-center trials. Full article

Background and Objectives: Integrated health services are health services that are managed and delivered in a way that ensures patients receive a continuum of health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation, and palliative care services at different levels and sites of care within the health system, and according to their needs, throughout their life course. Assessing the effectiveness of their implementation, the perspective of the process participant—the patient—is examined. There are three main types of patient-reported measures: PROM, PREM and HLS. PREM (patient-reported experience measure) is a tool that allows the objective measurement of the patient’s experience related to healthcare services, for instance, the timeliness of visits or receiving recommendations. The aim of this study was to evaluate the coordinated care experienced by patients (PREMs) before and after the introduction of coordinated care, using the JOP-POP tool as a key measure. Materials and Methods: This longitudinal study was conducted in two stages. The first stage concerned the joining of the coordinated care program by the entity in which the study was conducted; the study was repeated six months after joining coordinated care (CC). At each stage of the study, the study group included 40 patients. The Shapiro–Wilk test was used to verify the normality of the distribution of quantitative variables. For statistical analysis, the Wilcoxon test for paired samples was used to compare two ordinal dependent variables. For independent variables, the Mann–Whitney and the Kruskal–Wallis ANOVA by ranks tests were used, with a post hoc test of multiple comparisons of mean ranks. Results: A statistically significant relationship (p = 0.00157) was observed between the number of chronic diseases and health status assessment before inclusion in coordinated care. The patients’ responses showed statistically significant improvement 6 months after the introduction of coordinated care (CC). The improvement in assessment was related to the time physicians spent with patients. The greatest improvement over 6 months was achieved in coordination of care and the smallest improvement was noted in the approach to the patient. Conclusions: The JOP-POP tool may be useful in future studies to assess patients’ experiences with implementing coordinated care. Full article

Background and Objectives: Low back pain (LBP) is a highly prevalent musculoskeletal condition that frequently recurs, leading to increased healthcare utilization and socioeconomic burden. While short-term management strategies are well-documented, long-term recurrence patterns remain insufficiently studied. This study aims to describe the long-term recurrence patterns and healthcare utilization associated with LBP in a nationwide cohort over a 17-year period. Materials and Methods: This descriptive, retrospective longitudinal cohort study utilized data from the Korean National Health Insurance Service (NHIS) database (2002–2018). We included 3,086,665 patients who sought medical care for LBP (ICD-10 code M54.5) at least once in 2010. Patients with a history of disability rating assessments were excluded. The primary outcomes included the number of LBP episodes, episode duration, recurrence patterns, and changes in healthcare utilization. We assessed the number of healthcare visits per episode and the interval between episodes over time. Results: Among the study population, 79.4% experienced recurrent LBP, with an average of 5.0 ± 4.9 episodes per patient. Recurrence rates increased with each episode. In addition, episode duration lengthened, and intervals between episodes shortened. Healthcare utilization also increased, with patients requiring more visits per episode over time. The demographic and socioeconomic characteristics of the LBP patients in our sample were also described. Conclusions: In this population-based sample, LBP follows a progressive course, with increasing episode frequency, prolonged duration, and escalating healthcare utilization over time. These findings highlight the need for early intensive management and long-term follow-up strategies to mitigate the growing burden of recurrent LBP on individuals and healthcare systems. Full article

Accurately evaluating postgraduate education satisfaction is crucial for improving higher education quality and optimizing management practices. Traditional methods often fail to capture the complex behavioral interactions among influencing factors. In this study, an innovative satisfaction indicator system framework is proposed that integrates a two-stage feature optimization method and the Tree Augmented Naive Bayes (TAN) model. The framework is designed to assess key satisfaction drivers across seven dimensions: course quality, research projects, mentor guidance, mentor’s role, faculty management, academic enhancement, and quality development. Using data from 8903 valid responses, Confirmatory Factor Analysis (CFA) was conducted to validate the framework’s reliability. The two-stage feature optimization method, including statistical pre-screening and XGBoost-based recursive feature selection, refined 49 features to 29 core indicators. The TAN model was used to construct a causal network, revealing the dynamic relationships between factors shaping satisfaction. The model outperformed four common machine learning algorithms, achieving an AUC value of 91.01%. The Birnbaum importance metric was employed to quantify the contribution of each feature, revealing the critical roles of academic resilience, academic aspirations, dedication and service spirit, creative ability, academic standards, and independent academic research ability. This study offers management recommendations, including enhancing academic support, mentorship, and interdisciplinary learning. Its findings provide data-driven insights for optimizing key indicators and improving postgraduate education satisfaction, contributing to behavioral sciences by linking satisfaction to outcomes and practices. Full article

The service-learning (SL) approach has shown effectiveness in fulfilling both academic and community-oriented objectives. This paper focuses on a specific case study for a Cartography, Remote Sensing, and Geographical Information Systems (GIS) course for Environmental Sciences undergraduate students. The main goals for implementing SL practice were (1) to enhance students’ GIS knowledge and to develop cross-cutting skills by working with real-world problems; (2) to share with society the knowledge acquired by students and ensure that it is valued; and (3) to prompt reflection on urban waste issues among students. The activity consisted of analyzing the waste containers along the 1 km riverbanks in León (Spain) and elaborating a proposal for the location of new rubbish bins to deliver to a City Council’s environmental technician. The results showed an improvement in students’ GIS management skills to solve environmental problems compared to those from the previous 3 years and a satisfactory response from environmental professionals with delivering the results. Together, an increase in students discussing urban waste was observed during the sessions. Projects like this not only teach technical skills but also provide a deeper understanding of data collection and implementation processes in environmental issues, which are closely aligned with professional experiences, and awareness of the practical application of the knowledge acquired. Full article

This article examines the relationship between implementing sustainable development measures and financial risk in the context of global companies and the recycling economy. This study uses statistics from Forbes, TIME, and Statista on 50 global companies that actively embrace sustainable development and recycling-economy practices across various industries. As a result, we have compiled a Structural Equation Model (SEM), with the help of which we established that growth in the activity of their implementing the measures of sustainable development and the recycling economy by each 1 point leads to a reduction in the risk of a shortfall in global companies’ profit by USD 0.0741 billion and the risk of ousting global companies from the market by USD 1.8374 billion. It has also been revealed that a reduction in the risk of the shortfall in profit by each USD 1 billion is accompanied by an increase in the activity of global companies’ implementing the measures of sustainable development and the recycling economy by 0.3433 points, and a reduction in the risk of market displacement by each USD 1 billion is accompanied by a growth in this activity by 0.0073 points. The theoretical novelty of the research consists of substantiating the differences in the consequences of the development of the recycling economy for financial risks of companies from different sectors. Practical implications of the proposed recommendations for companies in different industries are that the authors’ recommendations for the development of the recycling economy will allow for systemic reduction in financial risks in the sectors “Automotive Industry & Suppliers”, “Banking, Insurance & Financial Services”, “Chemicals, Drugs & Biotechnology”, and “Retail, Wholesale & Consumer Goods”. We have also revealed the threat of growth of all financial risks in the course of the development of the recycling economy in the sphere “Transportation, Logistics & Aviation”. In “Electronics, Hardware & Equipment” and “Manufacturing & Industrial Production”, the implications are differentiated among financial risks, which require flexibility and care during the development of the recycling economy. We find that global companies’ implementation of sustainable development measures, recycling economy practices, and financial risks are mutually dependent organizational phenomena. Moreover, the risk to profits and market displacement manifest differently among global industries. Our conclusions support expediency in implementing sustainable development and recycling-economy measures to reduce the financial risks to global companies. Further, we propose practical recommendations for companies from different sectors of the world economy. Full article

This paper describes the development of the Climate-Friendly, Healthy, Efficient Food Service (CHEF) curriculum at the City University of New York (CUNY). The program addresses a critical gap between growing industry demand for sustainability-trained workers and limited community college culinary education in these areas. Through collaborative design with industry partners, public agencies, and non-profit organizations, we created four core courses covering sustainable food service operations, culinary practices, food systems, and nutrition. The curriculum offers two implementation pathways: a 100 h continuing education credential and an Associate of Applied Science degree concentration. Industry partners have committed to supporting the program through internships and recognition of the credential in hiring decisions. This model demonstrates the feasibility of integrating comprehensive sustainability education into community college culinary programs while enhancing graduates’ career prospects in the expanding sustainable food service sector. Full article