Search Results (21)

Background: The COVID-19 pandemic has caused widespread disruptions in oncology care, significantly affecting both the quality of life (QoL) and mental health of cancer patients. This study aimed to evaluate the long-term impacts of the pandemic on oncology patients, focusing on the periods before, during, and after the pandemic. Objective: The objective of this study was to assess the changes in QoL, illness acceptance, and mental health indicators, including the risk of depression, generalized anxiety, elevated stress levels, and post-traumatic stress disorder (PTSD) among oncology patients, comparing these factors across the pre-pandemic, pandemic, and post-pandemic periods. Material and Methods: This study included 2000 oncology patients, divided into three cohorts based on the time of assessment: pre-pandemic (2019, n = 600), during the pandemic (2020–2021, n = 800), and post-pandemic (2023, n = 600). This study included a balanced sample of 52% female and 48% male participants, with a mean age of 58 years (SD = 11.9), representing a wide range of cancer types including breast (25.7%), lung (20.9%), and colorectal cancer (14.8%). Additional demographics showed a mean BMI of 25.8, with varied educational levels, marital statuses, income levels, and lifestyle factors such as smoking and alcohol consumption. QoL was assessed using the EORTC QLQ-C30, while the Hospital Anxiety and Depression Scale (HADS) was used to measure depression and anxiety. The PTSD Checklist for DSM-5 (PCL-5) was used to evaluate PTSD symptoms, and stress levels were measured with the Perceived Stress Scale (PSS). Statistical analyses were conducted using ANOVA and chi-square tests to assess differences between the groups. Results: During the pandemic, the prevalence of depression symptoms rose significantly, from 15% pre-pandemic to 32% (p < 0.001), while the risk of generalized anxiety increased from 18% to 40% (p < 0.001). Stress levels also saw a sharp rise, with 45% of patients reporting elevated stress during the pandemic compared to 22% before (p < 0.001). The rate of PTSD symptoms increased from 10% pre-pandemic to 28% during the pandemic (p < 0.001). QoL scores dropped markedly, with the mean EORTC QLQ-C30 global health status score decreasing by 25% during the pandemic (p < 0.01). Illness acceptance declined, with 60% of patients reporting poor acceptance during the pandemic, compared to 35% before. In the post-pandemic period, a slight improvement was observed across all measures. Depression levels dropped to 28% (p < 0.05 compared to the pandemic period), and anxiety levels decreased to 35% (p < 0.05). Stress and PTSD symptoms also showed modest reductions, with 38% reporting elevated stress and 22% exhibiting PTSD symptoms (p < 0.05). However, these post-pandemic values remained significantly higher than pre-pandemic levels (p < 0.001). QoL improved marginally, with a 10% increase in the global health status score compared to the pandemic period, though it remained lower than pre-pandemic scores (p < 0.05). Conclusions: The COVID-19 pandemic had a profound impact on the mental health and QoL of oncology patients, with significant increases in depression, anxiety, stress, and PTSD symptoms, along with a decrease in QoL and illness acceptance. While post-pandemic recovery trends are apparent, the psychological burden remains elevated compared to pre-pandemic conditions. These findings highlight the need for continued mental health support and interventions for oncology patients, even after the immediate pandemic effects have subsided. Full article

During aerial combat, when an aircraft is facing an infrared air-to-air missile strike, infrared baiting technology is an important means of penetration, and the strategy of effective delivery of infrared bait is critical. To address this issue, this study proposes an improved deep deterministic policy gradient (DDPG) algorithm-based intelligent bait-dropping control method. Firstly, by modeling the relative motion between aircraft, bait, and incoming missiles, the Markov decision process of aircraft-bait-missile infrared effect was constructed with visual distance and line of sight angle as states. Then, the DDPG algorithm was improved by means of pre-training and classification sampling. Significantly, the infrared bait-dropping decision network was trained through interaction with the environment and iterative learning, which led to the development of the bait-dropping strategy. Finally, the corresponding environment was transferred to the Nvidia Jetson TX2 embedded platform for comparative testing. The simulation results showed that the convergence speed of this method was 46.3% faster than the traditional DDPG algorithm. More importantly, it was able to generate an effective bait-throwing strategy, enabling the aircraft to successfully evade the attack of the incoming missile. The strategy instruction generation time is only about 2.5 ms, giving it the ability to make online decisions. Full article

The Chronic Disease Self-Management Program (CDSMP) focuses on a health promotion perspective with a salutogenic approach, reinforcing the pillars of self-efficacy. The aim of this study was to assess the impact of the CDSMP on Self-perceived Health (SPH) in disadvantaged areas of Asturias, España. The study included vulnerable adults with experience of chronic diseases for over six months, along with their caregivers. The intervention consisted of a six-session workshop led by two trained peers. SPH was evaluated by administering the initial item of the SF-12 questionnaire at both baseline and six months post-intervention. To evaluate the variable “Change in SPH” [improvement; remained well; worsening/no improvement (reference category)], global and disaggregated by sex multivariate multinomial logistic regression models were applied. There were 332 participants (mean = 60.5 years; 33.6% were at risk of social vulnerability; 66.8% had low incomes). Among the participants, 22.9% reported an improvement in their SPH, without statistically significant sex-based differences, while 38.9% remained in good health. The global model showed age was linked to decreased “improvement” probability (RRRa = 0.96), and the “remaining well” likelihood drops with social risk (RRRa = 0.42). In men, the probability of “remaining well” decreased by having secondary/higher education (RRRa = 0.25) and increased by cohabitation (RRRa = 5.11). Women at social risk were less likely to report “remaining well” (RRRa = 0.36). In conclusion, six months after the intervention, 22.9% of the participants had improved SPH. Age consistently decreased the improvement in the different models. Full article

Background: Chronic hepatitis B affects close to 300 million people globally with 1.5 million new infections per year. It causes the highest numbers of cirrhosis and liver cancer diagnoses each year. In children, perinatal transmission and contact with infected blood or body fluids remain the main methods of transmission. There are increasing reports of breakthrough hepatitis B infections in fully vaccinated children born to hepatitis B-negative mothers, especially in low- and middle-income countries. Our study aimed to measure the adequacy of hepatitis B surface antibody levels among children and adolescents who received three rounds of hepatitis B vaccination during infancy and delivered to hepatitis B-negative mothers in Addis Ababa, Ethiopia. Method: This was a retrospective cohort study analyzing results of paired serology tests for hepatitis B surface antibody and antigen tests performed for children aged 1–18 years from July 2022 to June 2023. All recorded data were transferred to SPSS version 29.0. The prevalence of adequate hepatitis B surface antibody levels was determined and sub-group analysis conducted using descriptive statistics, frequencies and tables. The magnitude of association between different variables and vaccine-induced hepatitis B immunity was assessed using logistic regression. Statistically significant differences were taken at p < 0.05. Results: A total of 256 children were included in the study (mean age: 7.53 years). Six children (2.3%) had breakthrough hepatitis B infections. Overall, 37 children (14.4%) were categorized as having optimal hepatitis B surface antibody levels (vaccine-induced antibody titers of >10 IU/mL), while 219 (85.6%) had low titers of <10 IU/mL. Nearly all (97.4%) of the sub-group aged 10 years and above had below-par antibody levels, with adolescents (11–18 years) being ten times more likely to have low seroprotection than those aged less than 5 years. Conclusions: Our study showed markedly low vaccine-induced hepatitis B surface antibody levels among the study population, especially adolescents. The presence of breakthrough infections may suggest a genuine lack of response and not just a mere drop in antibody titers and thus could highlight a significant public health problem in Ethiopia. Further immunologic studies and a thorough analysis of vaccine storage and administration should be conducted to inform prevention programs. Full article

This study investigates the thermal performance of the ventilated mask wall used in the low-income neo-vernacular dwellings designed by André Ravéreau to cope with the warm desert climate conditions of M’zab Valley, Ghardaia, in southern Algeria. This device is a ventilated façade provided with an opaque external massive cladding. It is designed to be particularly efficient in hot climates, functioning simultaneously as a brise-soleil and a ventilated façade, compared with conventional façade systems. Based on a typical experiment conducted during the summertime (12–14 August), a residential unit in Sidi Abbaz selected as a case study was modeled and calibrated using EnergyPlus (v8.4) software, and then a dynamic simulation was performed in order to assess the efficiency of the ventilated mask wall as a cooling strategy. By means of the validated thermal model, various alternatives for the façade materials were investigated, and the thermal behavior of the current ventilated mask wall was compared with a 45 cm thick limestone façade wall, and a 30 cm thick hollow clay brick wall under the same conditions. Countless benefits were achieved by the application of the mask wall system, including a stable and less fluctuant inner surface temperature, and a reduction in the incoming summer heat flux. The improvements performed, in particular the time lag of 12 h and the related decrement factor of 0.28 indicate the effectiveness of this wall system, which enabled radiant temperature drops of more than 10 °C, and an air temperature decrease of about 6 °C, during the summer sunniest hours. The results demonstrate that this solution is suitable for buildings design applications to meet the objective of low-energy demand in warm desert climates. Full article

This study evaluates the association between smoking rates and mortality from circulatory system diseases (CSD) after implementing a series of smoking bans in Macao (China). (1) Background: Macao phased in strict total smoking bans since 2012. During the past decade, smoking rates among Macao women have dropped by half. CSD mortalities in Macao also show a declining trend. (2) Method: Grey relational analysis (GRA) models were adopted to rank the importance of some key factors, such as income per capita, physician density, and smoking rates. Additionally, regressions were performed with the bootstrapping method. (3) Results: Overall, smoking rate was ranked as the most important factor affecting CSD mortality among the Macao population. It consistently remains the primary factor among Macao’s female population. Each year, on average 5 CSD-caused deaths were avoided among every 100,000 women, equivalent to about 11.45% of the mean annual CSD mortality. (4) Conclusions: After the implementation of smoking bans in Macao, the decrease in smoking rate among women plays a primary role in the reduction in CSD mortality. To avoid excess CSD mortality due to smoking, Macao needs to continue to promote smoking cessation among the male population. Full article

The importance of tourism in the Azores’ economy has been increasing over the years. In order to respond to higher tourist demand, new accommodation establishments and restaurants started activity in the region, creating new jobs and wealth. This trend of economic expansion has been slowed down, possibly reversed, since the COVID-19 pandemic and the various strategies adopted by the government to decrease the infection rate, which led to the arrival of fewer tourists. To assess the pandemic impact after the first lockdown on the economy of São Miguel, the biggest and most visited island of the Azores, surveys were designed for the tourism accommodation and restaurant sectors, both influenced by tourism activity. The main aim was to estimate the mean income drop in the 2020 tourism high season, in percentage, compared to the homologous pre-pandemic 2019 period. The results highlight an adverse impact on those sectors, with the greatest mean income drop being estimated for the local accommodation sector ($78.7\pm 3.6\%$), followed by the traditional hotel sector ($74.7\pm 4.6\%$) and the restaurant sector ($58.5\pm 6.5\%$). Moreover, an almost 60% drop in the mean occupancy rate during the 2020 tourism high season, compared to 2019, was estimated for the tourism accommodation sector. Full article

Tea (Camellia sinensis L.), as one of the most important cash crops in China, plays an important role in increasing farmers’ incomes and guaranteeing a high quality of life. Tea production has been greatly influenced by both climate change and economic development in China. However, without a scientific understanding of the interaction mechanism of climate change and the impetus from rapid economic development on tea production practices in China, it is difficult to take adaptive actions to meet the climate change challenges for the tea industry. In this paper, we firstly assessed the potential impacts of climate change on tea climate suitability by empirical formula calculation using meteorological data; then, the effects from the additional climatic stress due to warming on tea production were detected with the annual statistical tea yield record on a municipal level. The contribution of socioeconomic development to the tea industry was evaluated with the comparison of the movement of China’s national economy’s and tea industry’s gravity center during the period of 1987–2017. Finally, a conceptual adaptation framework was built to demonstrate the interaction mechanisms between climate change, tea production, and the economic development. The results showed that there was a negative impact of climate change on tea production in mainland China, with the percentage of high tea climate suitability (>0.9) areas dropping by 45% to 32%, while opportunities of enlarging the tea cultivating area emerged in the north tea production region where the tea climate suitability increased. We found that the tea planting area expanded northwards from 33° N in 1987 to 35° N in 2017 to take advantage of the favorable climatic resources due to warming, and tea planting decreased at an altitude of 100–400 m while increasing to higher altitude of 400–2000 m to avoid hot temperature damage and seek the optimum environment in high mountainous areas for tea production. In addition, the tea production moved westward along the longitude, decreasing obviously at 117–121° E while increasing significantly at 98–104° E and 107–110° E. Meanwhile, the tea production gravity center showed a westward movement consistent with the national economic gravity center moving trend, which means that tea industry development was driven by multiple socioeconomic factors and climatic forcings. A conceptual framework was built in this paper, aiming to show a robust adaptation mechanism for the tea system to maximize the benefits and minimize the damages from the altered climatic resources under rapid economic development in mainland China. The results in this study would help deepen the understanding of the adaptation process and practices for tea production in mainland China. Full article

The radiation shielding abilities of waste marbles with different concentrations of WO₃ (tungsten oxide) nanoparticles were investigated. Four marbles were prepared with 0, 0.05, 0.1, and 0.2 WO₃ nanoparticles. The study aims to investigate the effect of the WO₃ concentration, the density, and the particle size of the waste marble samples. The linear attenuation coefficient (LAC) of the S1 sample, the sample with no WO₃, was determined theoretically and experimentally, and the results demonstrated that they were close enough together to adequately determine the LAC of the other samples. Additionally, the samples with nano-WO₃, rather than micro-WO₃, were found to have a greater LAC, showing that decreasing the particle size of the sample improves their shielding ability. Samples with greater WO₃ content also had higher LAC values. The LAC of the marbles was also evaluated at a wide energy range (0.015–15 MeV) to examine the shielding properties of the samples for a wide range of applications, and an inverse trend between LAC and energy was observed. The radiation protection efficiency (RPE) of the marbles demonstrated that the marbles absorb almost all incoming photons at low energies. As energy increases, the efficiency of the samples naturally drops, as the photons are able to penetrate through them with greater ease. High energy dependence was found when calculating the half-value layers (HVL) of the samples. When comparing the LAC and mean free paths (MFP) of the marbles, an inverse relationship was observed. Furthermore, the samples with nano-WO₃ had a smaller MFP than those with micro-WO₃, meaning that decreasing the particle size of the samples improves their radiation shielding ability. The Z_eff of the micro-WO₃ samples was also determined and the values followed three distinctive trends depending on the energy range of the incoming photons. Full article

There are three income categories for Malaysians: the top 20% (T20), the middle 40% (M40), and the bottom 40% (B40). The government has extended B40′s access to higher education to eliminate socioeconomic disparities and improve their lives. The number of students enrolled in bachelor’s degree programmes at universities has risen annually. However, not all students who enrolled graduated. Machine learning approaches have been widely used and improved in education. However, research studies related to unsupervised learning in education are generally lacking. Therefore, this study proposes a clustering-based approach for classifying B40 students based on their performance in higher education institutions (HEIs). This study developed three unsupervised models (k-means, BIRCH, and DBSCAN) based on the data of B40 students. Several data pre-processing tasks and feature selection have been conducted on the raw dataset to ensure the quality of the training data. Each model is optimized using different tuning parameters. The observational results have shown that the optimized k-means on Model B (KMoB) achieved the highest performance among all the models. KMoB produced five clusters of B40 students based on their performance. With KMoB, this study may assist the government in reducing HEI drop-out rates, increasing graduation rates, and eventually boosting students’ socioeconomic status. Full article

Hydropower plant operation reorganizes the temporal and spatial distribution of water resources to promote the comprehensive utilization of water resources in the basin. However, a lot of uncertainties were brought to light concerning cascade hydropower plant operation with the introduction of the stochastic process of incoming runoff. Therefore, it is of guiding significance for the practice operation to investigate the stochastic operation of cascade hydropower plants while considering runoff uncertainty. The runoff simulation model was constructed by taking the cascade hydropower plants in the lower reaches of the Lancang River as the research object, and combining their data with the copula joint function and Gibbs method, and a Markov chain was adopted to construct the transfer matrix of runoff between adjacent months. With consideration for the uncertainty of inflow runoff, the stochastic optimal operation model of cascade hydropower plants was constructed and solved by the SDP algorithm. The results showed that 71.12% of the simulated monthly inflow of 5000 groups in the Nuozhadu hydropower plant drop into the reasonable range. Due to the insufficiency of measured runoff, there were too many 0 values in the derived transfer probability, but after the simulated runoff series were introduced, the results significantly improved. Taking the transfer probability matrix of simulated runoff as the input of the stochastic optimal operation model of the cascade hydropower plants, the operation diagram containing the future-period incoming water information was obtained, which could directly provide a reference for the optimal operation of the Nuozhadu hydropower plant. In addition, taking the incoming runoff process in a normal year as the standard, the annual mean power generation based on stochastic dynamic programming was similar to that based on dynamic programming (respectively 305.97 × 10⁸ $\mathrm{k}\mathrm{W}\cdot \mathrm{h}$ and 306.91 × 10⁸ $\mathrm{k}\mathrm{W}\cdot \mathrm{h}$), which proved that the operation diagram constructed in this study was reasonable. Full article

New Zealand hill country sheep and beef farms contain land of various slope classes. The steepest slopes have the lowest pasture productivity and livestock carrying capacity and are the most vulnerable to soil mass movements. A potential management option for these areas of a farm is the planting of native shrubs which are browsable and provide erosion control, biodiversity, and a source of carbon credits. A bioeconomic whole farm model was developed by adding a native shrub sub-model to an existing hill country sheep and beef enterprise model to assess the impacts on feed supply, flock dynamics, and farm economics of converting 10% (56.4 hectares) of the entire farm, focusing on the steep slope areas, to native shrubs over a 50-year period. Two native shrub planting rates of 10% and 20% per year of the allocated area were compared to the status quo of no (0%) native shrub plantings. Mean annual feed supply dropped by 6.6% and 7.1% causing a reduction in flock size by 10.9% and 11.6% for the 10% and 20% planting rates, respectively, relative to 0% native shrub over the 50 years. Native shrub expenses exceeded carbon income for both planting rates and, together with reduced income from sheep flock, resulted in lower mean annual discounted total sheep enterprise cash operating surplus for the 10% (New Zealand Dollar (NZD) 20,522) and 20% (NZD 19,532) planting scenarios compared to 0% native shrubs (NZD 22,270). All planting scenarios had positive Net Present Value (NPV) and was highest for the 0% native shrubs compared to planting rates. Break-even carbon price was higher than the modelled carbon price (NZD 32/ New Zealand Emission Unit (NZU)) for both planting rates. Combined, this data indicates planting native shrubs on 10% of the farm at the modelled planting rates and carbon price would result in a reduction in farm sheep enterprise income. It can be concluded from the study that a higher carbon price above the break-even can make native shrubs attractive in the farming system. Full article

Winter irrigation is an effective means of salt leaching, but the long-term effect on salinity is unclear. In 2008–2019, three different soil types of farmlands were selected as the study area by drip irrigation under film mulch combined with periodic winter irrigation in the non-growth period. The salinity of 0–150 cm as well as the survival rate and yield of cotton in the non-growth and growth periods were monitored, respectively. The mass fraction of soil salt decreased rapidly under winter irrigation, and then, the salt content in each observation layer increased with years of cultivation. After 10 years of application, the soil salt content basically stabilized at a low level. In 2008, the salinity of the 0–150 cm observation layer of loamy clay, loam, and sandy loam varied within 6–60, 10–65, and 4–22 g·kg⁻¹; after four winter irrigations in 2019, corresponding values dropped below 5.74, 3, and 4.76 g·kg⁻¹, respectively. The salinity returns rate of the different observation layers all exceeded 40%. The desalination rate of the different soils after four winter irrigations all exceeded 63.52%. Cotton survival rate and yield in different soils were directly proportional to each other. After the second winter irrigation, the survival rates on the different soils all exceeded 60%. The results of this study can provide technical support for the sustainable development of different types of soil, farmers’ income increase, and salinization land improvement. Full article

Children’s career exploration is a critical aspect of career development. Through it, children explore the interplay between their different life roles, including those related to work (in a broad sense), learning, and education. Through career exploration, children can (re)construct the emotions derived from the interactions between personal and contextual factors by giving meaning to life experiences. This process involves cognitive and affective activities. Evidence suggests that children from low-income contexts are more likely to drop out of school and show lower educational aspirations. Providing career exploration interventions introduces an intentional learning that allows children to develop a higher level of career awareness and increase their aspirations for the future. The sample analyzed consisted of students between 6 and 8 years old from a low-income school in Seville (Spain). The data collection methods used have been those of collaborative ethnography (e.g., unstructured interviews, student productions, and photographs). Co-analysis was the chosen method for systematizing the information used in this research. Our results have revealed a system of influences which plays an important role in the different contexts and emotions that the children derive from their interactions with different spaces and socialization agents. In short, through career exploration, children mobilize exploratory behaviors, providing emotional responses. Collaborative ethnography has been shown to be a valid process for research on career exploration as social and emotional learning. Full article

Ecovillages aim to foster community around sustainable practices and encourage low-impact lifestyles. This article explores the strategies employed by two ecovillages to scale up their practices through physical expansion and the consequence for the maintenance of said practices. The ecovillages under study are Hurdal in Norway and Findhorn in Scotland. The study employed a multi-method approach: document study, participant observation, and interviews with ecovillage residents. The ecovillages applied different strategies to gain access to economic resources for expansion. Hurdal ecovillage sold its land to a private developer while Findhorn chose a different path: raising funds within the community, accessing public funds, and adopting low-cost building designs. The study finds that collaborating with investors and developers results in expensive housing that excludes low-income individuals and attracts well-off house buyers with mainstream values. Both ecovillages dropped introductory courses that aimed to equip new members with the necessary skills for shared practices and establish a common ground. These two consequences led to a weakening of competences for shared practices as private property took precedence. Prioritizing affordable infrastructure and accessing local (community and public) financial resources opens up paths for expansion that can maintain the necessary skills and meaning for community living. Full article