Search Results (526)

Background/Objectives: In many parts of the world, pharmacists hold the primary responsibility for providing safe and effective pharmacotherapy. A key aspect is the availability of appropriate medicines for each individual patient. When industrially manufactured medicines are unsuitable or unavailable, pharmacists can prepare tailor-made medicines. While this principle applies globally, practices vary between countries. In the Netherlands, the preparation of medicines in pharmacies is well-established and integrated into routine healthcare. This narrative review explores the role and significance of extemporaneous compounding, pharmacy preparations and related product care in the Netherlands. Methods: Pharmacists involved in pharmacy preparations across various professional sectors, including community and hospital pharmacies, central compounding facilities, academia, and the professional pharmacists’ organisation, provided detailed and expert insights based on the literature and policy documents while also sharing their critical perspectives. Results: We present arguments supporting the need for pharmacy preparations and examine their position and role in community and hospital pharmacies in the Netherlands. Additional topics are discussed, including the regulatory and legal framework, outsourcing, quality assurance, standardisation, education, and international context. Specific pharmacy preparation topics, often with a research component and a strong focus on product care, are highlighted, including paediatric dosage forms, swallowing difficulties and feeding tubes, hospital-at-home care, reconstitution of oncolytic drugs and biologicals, total parenteral nutrition (TPN), advanced therapy medicinal products (ATMPs), radiopharmaceuticals and optical tracers, clinical trial medication, robotisation in reconstitution, and patient-centric solid oral dosage forms. Conclusions: The widespread acceptance of pharmacy preparations in the Netherlands is the result of a unique combination of strict adherence to tailored regulations that ensure quality and safety, and patient-oriented flexibility in design, formulation, and production. This approach is further reinforced by the standardisation of a broad range of formulations and procedures across primary, secondary and tertiary care, as well as by continuous research-driven innovation to develop new medicines, formulations, and production methods. Full article

Designing optimal heritage tourism routes in secondary cities involves complex trade-offs between cultural richness, travel time, carbon emissions, spatial coherence, and group satisfaction. This study addresses the Personalized Group Trip Design Problem (PGTDP) under real-world constraints by proposing DRL–IMVO–GAN—a hybrid multi-objective optimization framework that integrates Deep Reinforcement Learning (DRL) for policy-guided initialization, an Improved Multiverse Optimizer (IMVO) for global search, and a Generative Adversarial Network (GAN) for local refinement and solution diversity. The model operates within a digital twin of Warin Chamrap’s old town, leveraging 92 POIs, congestion heatmaps, and behaviorally clustered tourist profiles. The proposed method was benchmarked against seven state-of-the-art techniques, including PSO + DRL, Genetic Algorithm with Multi-Neighborhood Search (Genetic + MNS), Dual-ACO, ALNS-ASP, and others. Results demonstrate that DRL–IMVO–GAN consistently dominates across key metrics. Under equal-objective weighting, it attained the highest heritage score (74.2), shortest travel time (21.3 min), and top satisfaction score (17.5 out of 18), along with the highest hypervolume (0.85) and Pareto Coverage Ratio (0.95). Beyond performance, the framework exhibits strong generalization in zero- and few-shot scenarios, adapting to unseen POIs, modified constraints, and new user profiles without retraining. These findings underscore the method’s robustness, behavioral coherence, and interpretability—positioning it as a scalable, intelligent decision-support tool for sustainable and user-centered cultural tourism planning in secondary cities. Full article

Despite extensive prevention strategies in Spain since the 1980s, gender-based violence, including among adolescents, remains prevalent, as observed in the Romance SUCC-ED Project (R&D&I Operating Programme ERDF Andalusia 2014–2020). This research study investigates the dimensions, meanings, relationships, and practices shaping the culture of romance in digital Andalusian adolescence (12–16 years) and its potential impact on school trajectories in Compulsory Secondary Education. Based on the premise that equality-focused relationship education is key to preventing gender violence, the study employs an ethnographic methodology with 12 Andalusian school case studies (4 out of them are located in rural areas) and 220 in-depth interviews (126 girls, 57.3%; 94 boys, 42.7%). This article aims to empirically explain gender violence in early adolescence by analysing the culture of romance as an explanatory factor. Findings reveal an interconnected model where dimensions (love, couple, sexuality, pornography, social networks, and cultural references), meanings (constructed by adolescents within each of them), relationships (partner), and practices (control and jealousy) reinforce romanticised femininity and dominant masculinity, thus explaining the high incidence of gender-based violence among students in the study. Full article

The deformation characteristics of the surrounding rock in tunnel groups are considered critical for the design of support structures and the assurance of the long-term safety of deep-buried diversion tunnels. The deformation behavior of surrounding rock in tunnel groups was investigated to guide structural support design. Field tests and numerical simulations were performed to analyze the distribution of ground stress and the ground reaction curve under varying conditions, including rock type, tunnel spacing, and burial depth. A solid unit–structural unit coupled simulation approach was adopted to derive the two-liner support characteristic curve and to examine the propagation behavior of concrete cracks. The influences of surrounding rock strength, reinforcement ratio, and secondary lining thickness on the bearing capacity of the secondary lining were systematically evaluated. The following findings were obtained: (1) The tunnel group effect was found to be negligible when the spacing (D) was ≥65 m and the burial depth was 1600 m. (2) Both P_0.3 and P_max of the secondary lining increased linearly with reinforcement ratio and thickness. (3) For surrounding rock of grade III (IV), 95% u_lim and 90% u_lim were found to be optimal support timings, with secondary lining forces remaining well below the cracking stress during construction. (4) For surrounding rock of grade V in tunnels with a burial depth of 200 m, 90% u_lim is recommended as the initial support timing. Support timings for tunnels with burial depths between 400 m and 800 m are 40 cm, 50 cm, and 60 cm, respectively. Design parameters should be adjusted based on grouting effects and monitoring data. Additional reinforcement is recommended for tunnels with burial depths between 1000 m and 2000 m to improve bearing capacity, with measures to enhance impermeability and reduce external water pressure. These findings contribute to the safe and reliable design of support structures for deep-buried diversion tunnels, providing technical support for design optimization and long-term operation. Full article

Physical challenges such as illness, injury, and disability significantly alter women’s relationships with their bodies, disrupting established notions of functionality and self-worth. This study re-examines the Holistic Model of Positive Body Image and Outdoor Physical Activity through secondary analysis focusing on women with illness, injury, and disability. From the original sample of N = 553 female participants, open-ended survey responses were identified from n = 84 participants (15.2%) who self-disclosed as having illness, injury, or disability to examine how outdoor settings facilitate positive body image. Through reflexive thematic analysis, the study revealed three key mechanisms: (1) personalized redefinition of functionality transcending standardized metrics, (2) therapeutic engagement with natural environments fostering embodied acceptance, and (3) cyclical reinforcement between physical capability and psychological wellbeing. The findings confirm the model’s utility while indicating necessary adaptations to address the fluctuating nature of body functionality. The adapted model emphasizes how outdoor recreational activities create contexts for reimagining body-self relationships across the spectrum of physical experiences—from temporary recovery to ongoing adaptation of persistent conditions—with implications for rehabilitation professionals, outdoor educators, and healthcare providers. Full article

Background: More than three years have elapsed since the onset of the full-scale invasion of Ukraine by the Russian Federation, displacing millions of Ukrainians. While preserving cultural identity in the host country is important for gaining resilience among refugees, we found no studies about how cultural identity influences health care experiences during resettlement. Objective: This study explores how cultural identity shapes health care experiences among Ukrainian refugees during resettlement in the United States. Methods: We conducted an interpretive description study using focus groups to elicit the perspectives of Ukrainian refugees who resettled in North Carolina after 24 February 2022. Twelve Ukrainian women participated in one of four focus groups. Thematic content analysis was employed for case comparison, and themes were inductively derived. Results: Two themes were identified: troubled health care partnerships and imprecise notions of preventive practices. Troubled partnerships represented a lack of trust between refugees and U.S. clinicians and the health care system. Imprecise notions of preventive practices represented mistaken beliefs about prevention. Conclusions: This study adds to the science on refugee health in two ways. First, newly arrived refugees often maintain strong ties to their homeland, which shapes their health care decisions and reinforces their cultural identity. Second, despite being well educated, some refugees held misconceptions about preventive health care, highlighting the need for clinicians to provide clear guidance on primary and secondary prevention practices. Findings may help guide clinicians in delivering culturally sensitive care to refugee populations. Full article

Over a three-year R&D project, the perception of mobile phone use in Spanish secondary schools shifted from initial tolerance to increasingly prohibitive policies. Drawing on the Actor–Network Theory, this study examines how mobile phones—alongside institutional discourses and school and family concerns—acted as dynamic actants, shaping public and political responses. The research adopted a qualitative design combining policy and media document analysis, nine semi-structured interviews with key stakeholders, ten regional case studies, and twelve focus groups. The study concluded with a public multiplier event that engaged the broader educational community. The Madrid region, among the first to adopt a restrictive stance, contributed two school-based case studies and three focus groups with teachers, students, and families. Findings suggest that the turn toward prohibition was motivated less by pedagogical evidence than by cultural anxieties, consistent with what it conceptualizes as a techno-pessimistic shock. This shift mirrors the historical patterns of societal reaction to disruption and technological saturation. Rather than reinforcing binary framings of promotion versus prohibition, such moments invite critical reflection. The study argues for nuanced, evidence-based, and multilevel governance strategies to address the complex role of mobile technologies in education. Full article

This article examines the strategies employed by Mexican secondary school students to understand unfamiliar academic vocabulary and the relationship between these strategies and their reading proficiency. Within the broader Latin American context—where low reading comprehension levels remain prevalent—the study focused on a sample of 40 first-year secondary students, categorized according to their reading level. Using two instruments, the research identified the vocabulary learning strategies used by students and assessed their effectiveness in deriving word meaning. Findings indicate that while students across reading levels use similar strategies, those with higher reading proficiency more frequently and effectively apply complex strategies such as contextual abstraction, retrieving textual information, rereading the text, and full morphological analysis. Morphological analysis proved to be the most effective strategy, provided students possessed the metalinguistic skills necessary to decompose and reconstruct word meaning from all morphemes. The study concludes that the successful use of vocabulary strategies is closely linked to students’ reading proficiency, and that reading comprehension and academic vocabulary knowledge are mutually reinforcing. These findings highlight the importance of explicitly teaching academic vocabulary in school settings as a means to enhance students’ reading performance. Full article

This article analyzes the role of dance and the arts in European and national educational policy agendas and maps the provision of dance in upper-secondary schools in the district of Porto, Portugal. To understand the role of dance in educational policies, we conducted a document analysis of regulations and decree-laws inspired by Stephen Ball’s policy cycle approach. To explore how these policies materialize in educational contexts, a mapping approach was conducted in upper-secondary schools within the district of Porto, Portugal. Results show that, at the public education policy level, although there is no specific debate about dance, the arts are gradually being included in the educational agendas, but still in a scarce way and with a more instrumental approach. At the institutional level, access to dance in education is not sufficiently democratized, reinforcing social and territorial inequalities. Despite its local scope, the study contributes to the broader international debate on equity in access to education with the arts, mainly dance. It offers insights from Southern Europe—a region often underrepresented in global research—which can inform research and policy development aimed at more inclusive educational systems. Full article

The ongoing threat of antimicrobial-resistant pathogens has intensified the need for new antimicrobial agents, making the discovery of novel natural products crucial. This study focuses on the isolation and characterization of a novel Streptomyces species from the Anjar region in Lebanon, an area rich in microbial diversity that is largely unexplored for its biotechnological potential. Soil samples were collected and processed, leading to the isolation of Streptomyces strain ANJ10. Comprehensive morphological, physiological, and genomic analyses were conducted, including whole-genome sequencing (WGS) to identify biosynthetic gene clusters (BGCs) and broth microdilution (BMD) assays to evaluate antimicrobial activity. The ANJ10 genome revealed 42 BGCs, significantly more than the average number in Streptomyces species, suggesting a high potential for secondary metabolite production. Phylogenetic analysis confirmed ANJ10 as a novel species, and BMD assays demonstrated its strong antimicrobial activity against several gram-negative pathogens, specifically, Acinetobacter baumannii. These findings underscore the potential of this strain as a significant source of new antimicrobial compounds, reinforcing the importance of exploring underexploited environments like Lebanon for microbial bioprospecting. Full article

Frequency instability poses a significant challenge to the overall stability of islanded microgrid systems. Deep reinforcement learning (DRL)-based intelligent control strategies are drawing considerable attention for their ability to operate without the need for previous system dynamics information and the capacity for autonomous learning. This paper proposes an intelligent frequency secondary compensation solution that divides the traditional secondary frequency control into two layers. The first layer is based on a PID controller and the second layer is an intelligent controller based on DRL. To address the typically extensive training durations associated with DRL controllers, this paper integrates transfer learning, which significantly expedites the training process. This scheme improves control accuracy and reduces computational redundancy. Simulation tests are executed on an islanded microgrid with four distributed generators and an IEEE 13-bus system is utilized for further validation. Finally, the proposed method is validated on the OPAL-RT real-time test platform. The results demonstrate the superior performance of the proposed method. Full article

This paper is a case study of supporting students in developing their Generative Artificial Intelligence (GAI) literacy as well as guiding them to use it ethically, appropriately, and responsibly in their studies. As part of the study, a law coursework assignment was designed utilising a four-step Problem, AI, Interaction, Reflection (PAIR) framework that included a problem-solving task that required the students to use GAI tools. The students were asked to use one or two GAI tools of their choice early in their assessment preparation to research and were given a set questionnaire to reflect on their experience. They were instructed to apply Gibbs’ or Rolfe’s reflective cycles to write about their experience in the reflective part of the assessment. This study found that a GAI-enabled assessment reinforced students’ understanding of the importance of academic integrity, enhanced their research skills, and helped them understand complex legal issues and terminologies. It also found that the students did not rely on GAI outputs but evaluated and critiqued them for their accuracy and depth referring to primary and secondary legal sources—a process that enhanced their critical thinking and problem-solving skills. Full article

Introducing and compacting lignocellulosic biomass in aluminum structures, though recommendable in terms of higher sustainability, the potential use of agro-waste and significant weight reduction, still represents a challenge. This is due to the variability of biomass performance and to its limited compatibility with the metal. Another question may concern possible moisture penetration in the structure, which may reduce environmental resistance and result in local degradation, such as wear or even corrosion. Despite these limitations, this hybridization enjoys increasing success. Two forms are possibly available for this: introduction into metal matrix composites (MMCs), normally in the form of char from biomass combustion, or laminate reinforcement as the core for fiber metal laminates (FMLs). These two cases are treated alongside each other in this review, first because they may represent two combined options for recycling the same biomass into high-profile structures, aimed primarily at the aerospace industry. Moreover, as discussed above, the effect on the aluminum alloy can be compared and the forces to which they are subjected might be of a similar type, most particularly in terms of their hardness and impact. Both cases considered, MMCs and FMLs involved over time many lignocellulosic residues, starting from the most classical bast species, i.e., flax, hemp, sisal, kenaf, etc., and extending also to less diffuse ones, especially in view of the introduction of biomass as secondary, or residual, raw materials. Full article

To enhance the economic and safety aspects of tunnel structural design, this study optimizes the mix proportion of steel fiber-reinforced concrete (SFRC). It investigates the stress characteristics and support parameters of SFRC secondary lining structures via small-scale model tests and finite element analysis. The research focuses on the cracking process, deformation, and stress characteristics of SFRC linings under various loads. Compared with conventional reinforced concrete tunnels, SFRC tunnels show a significant increase in lining stiffness and load capacity, with a 20% reduction in reinforcement yielding load. When the damage factor is 0.43, the addition of steel fibers increases compressive stress by 22.18%. Using ABAQUS, simulations of SFRC linings with thicknesses ranging from 400 mm to 600 mm and reinforcement ratios of 0% to 0.28% were conducted. The results indicate that a 450 mm thick SFRC lining matches the mechanical performance of a 600 mm thick conventional reinforced concrete lining. Notably, an SFRC lining with a 0.20% circumferential reinforcement ratio equals a conventional lining with a 0.28% reinforcement ratio in overall mechanical performance. Full article

The modern workplace grapples with a human energy crisis, characterized by chronic exhaustion, disengagement, and emotional depletion among employees. Traditional well-being initiatives often fail to address this systemic challenge, particularly in industrial contexts. This study introduces the Human Energy Management System (HEMS), a strategic framework to develop, implement, and refine strategies for optimizing workforce energy. Grounded in Industry 5.0’s human-centric, resilient, and sustainable principles, HEMS integrates enterprise risk management (ERM), design thinking, and the Plan-Do-Check-Act (PDCA) cycle. Employing a qualitative Design Science Research (DSR) methodology, the study reframes human energy depletion as an organizational risk, providing a proactive, empathetic, and iterative approach to mitigate workplace stressors. The HEMS framework is developed and evaluated through theoretical modeling, literature benchmarking, and secondary case studies, rather than empirical testing, aligning with DSR’s focus on conceptual validation. Findings suggest HEMS offers a robust tool to operationalize human energy reinforcement strategies in industrial settings. Consistent with the European Union’s vision for human-centric industrial transformation, HEMS enables organizations to foster a resilient, engaged, and thriving workforce in both stable and challenging times. Full article