Macular edema (ME) remains a primary cause of visual deterioration in uveitis. Visual acuity (VA) can often be maintained using corticosteroid depot systems. This study evaluated the efficacy of a fluocinolone acetonide (FAc) intravitreal implant (ILUVIEN^®) in treating non-infectious uveitis using real-world data. This retrospective analysis included 135 eyes subdivided into responders and non-responders. Central retinal thickness (CRT), VA, and intraocular pressure (IOP) were followed over time. A significant decrease in CRT and an increase in VA were observed in all eyes throughout the follow-up period (p < 0.01). An IOP increase (p = 0.028) necessitated treatment in 43% of eyes by Month 6. Non-responders were older (p = 0.004) and had been treated with more dexamethasone (DEX) implants (p = 0.04); 89.3% had a defect in the external limiting membrane (ELM) and inner/outer segment (IS/OS) zone (p < 0.001). Immunomodulatory therapy had no impact on treatment response. Pars plana vitrectomy (PPV) patients had a mean CRT reduction of 47.55 µm and a reduced effect by Month 24 (p = 0.046) versus non-PPV patients. We conclude that the FAc implant achieves long-term control of CRT and improves VA. Increases in IOP were manageable. Eyes with a previous PPV showed milder results. Data showed a correlation between older age, a damaged ELM and IS/OS zone, frequent DEX inserts, and poorer outcome measures. Full article

This review highlights the role of postbiotics, which may provide an underappreciated avenue doe promising therapeutic alternatives. The discovery of natural compounds obtained from microorganisms needs to be investigated in the future in terms of their effects on various metabolic disorders and molecular pathways, as well as modulation of the immune system and intestinal microbiota in children and adults. However, further studies and efforts are needed to evaluate and describe new postbiotics. This review provides available knowledge that may assist future research in identifying new postbiotics and uncovering additional mechanisms to combat metabolic diseases. Full article

Thermal comfort and daylighting are vital components of dormitory environments. However, enhancing indoor lighting conditions may lead to increased annual energy consumption and decreased thermal comfort. Therefore, it is crucial to identify methods to reduce buildings’ energy costs while maintaining occupants’ thermal comfort and daylighting. Taking the dormitory building of Songyuan No. 2 at Shandong Jianzhu University of Architecture, which is located in a cold region, as an example, a field measurement analysis was conducted on the recessed balconies within the dormitory. The measured data were analyzed and utilized to simulate the annual energy consumption, thermal comfort predicted mean vote (PMV), and useful daylight illuminance (UDI) values of the dormitory units using the Grasshopper platform with the Ladybug and Honeybee plugins. The different depths of the balconies and window-to-wall ratios have a significant impact on the indoor physical environment and energy consumption, leading to the design of independent variables and the construction of a simplified parametric model. The simulation results underwent multi-objective optimization using genetic algorithm theory through the Octopus platform, resulting in a Pareto optimal solution set. Comparisons between the final-generation data and simulations of the original Song II dormitory unit indicate potential energy savings of up to 2.5%, with a 25% improvement in indoor thermal comfort satisfaction. Although there was no significant improvement in the UDI value, all the solution sets meet the minimum requirement of 300 lux specified by relevant regulations, according to the simulated average illuminance levels on the indoor work plane. Finally, the 60 optimal solution sets were further screened, filtering out sets deviating excessively from certain objectives, to identify 6 optimal solutions that are more balanced and exhibit a higher overall optimization rate. These findings offer detailed data references to assist in the design of dormitory buildings in cold regions. Full article

Breast cancer, when advancing to a metastatic stage, involves the liver, impacting over 50% of cases and significantly diminishing survival rates. Presently, a lack of tailored therapeutic protocols for breast cancer liver metastasis (BCLM) underscores the need for a deeper understanding of molecular patterns governing this complication. Therefore, by analyzing differentially expressed genes (DEGs) between primary breast tumors and BCLM lesions, we aimed to shed light on the diversities of this process. This research investigated breast cancer liver metastasis relapse by employing a comprehensive approach that integrated data filtering, gene ontology and KEGG pathway analysis, overall survival analysis, identification of the alteration in the DEGs, visualization of the protein–protein interaction network, Signor 2.0, identification of positively correlated genes, immune cell infiltration analysis, genetic alternation analysis, copy number variant analysis, gene-to-mRNA interaction, transcription factor analysis, molecular docking, and identification of potential treatment targets. This study’s integrative approach unveiled metabolic reprogramming, suggesting altered PCK1 and LPL expression as key in breast cancer metastasis recurrence. Full article

Barred galaxies often develop a box/peanut pseudobulge, but they can also host a nearly spherical classical bulge, which is known to gain rotation due to the bar. We aim to explore how the presence of gas impacts the rotation of classical bulges. We carried out a comprehensive set of hydrodynamical N-body simulations with different combinations of bulge masses and gas fractions. In these models, both massive bulges and high gas content tend to inhibit the formation of strong bars. For low-mass bulges, the resulting bar is stronger in cases of low gas content. In the stronger bar models, bulges acquire more angular momentum and thus display considerable rotational velocity. Such bulges also develop anisotropic velocity dispersions and become triaxial in shape. We found that the rotation of the bulge becomes less pronounced as the gas fraction is increased from 0 to 30%. These results indicate that the gas content has a significant effect on the dynamics of the classical bulge, because it influences bar strength. Particularly in the case of the low-mass bulges (10% bulge mass fraction), all of the measured rotational and structural properties of the classical bulge depend strongly and systematically on the gas content of the galaxy. Full article

Neem leaves have long been used in traditional medicine for promoting longevity. However, the precise mechanisms underlying their anti-aging effects remain elusive. In this study, we investigated the impact of neem leaf extract (NLE) extracted from a 50% ethanol solution on the chronological lifespan of Saccharomyces cerevisiae, revealing an extension in lifespan, heightened oxidative stress resistance, and a reduction in reactive oxygen species. To discern the active compounds in NLE, LC/MS and the GNPS platform were employed. The majority of identified active compounds were found to be flavonoids. Subsequently, compound-target pharmacological networks were constructed using the STP and STITCH platforms for both S. cerevisiae and Homo sapiens. GOMF and KEGG enrichment analyses of the predicted targets revealed that “oxidoreductase activity” was among the top enriched terms in both yeast and human cells. These suggested a potential regulation of oxidative stress response (OSR) by NLE. RNA-seq analysis of NLE-treated yeast corroborated the anti-oxidative effect, with “oxidoreductase activity” and “oxidation-reduction process” ranking high in enriched GO terms. Notably, CTT1, encoding catalase, emerged as the most significantly up-regulated gene within the “oxidoreductase activity” cluster. In a ctt1 null mutant, the enhanced oxidative stress resistance and extended lifespan induced by NLE were nullified. For human cells, NLE pretreatment demonstrated a decrease in reactive oxygen species levels and senescence-associated β-galactosidase activity in HeLa cells, indicative of anti-aging and anti-oxidative effects. This study unveils the anti-aging and anti-oxidative properties of NLE while delving into their mechanisms, providing novel insights for pharmacological interventions in aging using phytochemicals. Full article

The rapid development of miniaturized, high-frequency, and highly integrated microelectronic devices has brought about critical issues in electromagnetic compatibility and thermal management. In recent years, there has been significant interest in lightweight polymer-based composites that offer both electromagnetic interference (EMI) shielding and thermal conductivity. One promising approach involves constructing three-dimensional (3D) interconnection networks using functional fillers in the polymer matrix. These networks have been proven effective in enhancing the thermal and electrical conductivity of the composites. This mini-review focuses on the preparation and properties of 3D network-reinforced polymer composites, specifically those incorporating metal, carbon, ceramic, and hybrid networks. By comparing the effects of different filler types and distribution on the composite materials, the advantages of 3D interconnected conductive networks in polymer composites are highlighted. Additionally, this review addresses the challenges faced in the field of multifunctional thermal management and electromagnetic protection materials and provides insights into future development trends and application prospects of 3D structured composites. Full article

Efficient magnetic resonance imaging (MRI) segmentation, which is helpful for treatment planning, is essential for identifying brain tumors from detailed images. In recent years, various convolutional neural network (CNN) structures have been introduced for brain tumor segmentation tasks and have performed well. However, the downsampling blocks of most existing methods are typically used only for processing the variation in image sizes and lack sufficient capacity for further extraction features. We, therefore, propose SARFNet, a method based on UNet architecture, which consists of the proposed SL_iRF module and advanced AAM module. The SL_iRF downsampling module can extract feature information and prevent the loss of important information while reducing the image size. The AAM block, incorporated into the bottleneck layer, captures more contextual information. The Channel Attention Module (CAM) is introduced into skip connections to enhance the connections between channel features to improve accuracy and produce better feature expression. Ultimately, deep supervision is utilized in the decoder layer to avoid vanishing gradients and generate better feature representations. Many experiments were performed to validate the effectiveness of our model on the BraTS2018 dataset. SARFNet achieved Dice coefficient scores of 90.40, 85.54, and 82.15 for the whole tumor (WT), tumor core (TC), and enhancing tumor (ET), respectively. The results show that the proposed model achieves state-of-the-art performance compared with twelve or more benchmarks. Full article

The accurate identification of target imagery in the presence of sea fog is essential for the precise detection and comprehension of targets situated at sea. To overcome the issues encountered when applying traditional polarimetric dehazing methods to sea fog imagery, this paper proposes an improved polarimetric dehazing method. Initially, the methodology employs quartile-based selection on polarization difference images to ascertain atmospheric light at an infinite distance. Subsequently, the study describes a segmentation approach for sea–sky background images based on the degree of polarization. The results show that the image information entropy of the segmentation process improves by more than 6% compared to that of alternative methodologies, and the local contrast of the image is increased by more than 30% compared to that of the original foggy image. These outcomes confirm the effectiveness of the proposed dehazing methodology in addressing the challenges associated with sea fog imagery. Full article

Fog in mine air intake roadways is a non-negligible disaster that seriously reduces the visibility of the roadway, affects vehicle transportation and the safe passage of personnel, and jeopardizes the safe production of the mine. This paper applies both field testing and numerical simulation to explore fog formation conditions and the effects of inlet air temperature and humidity on the fog zone length within the Wangjialing Mine’s air intake roadway in Shanxi, China. First, based on the consideration of the relationship between the moisture gain of surrounding rock and the temperature with humidity of the air flow, the fog generation and distribution law model of the air intake roadway was established. Based on this model, the critical inlet air temperature and the critical inlet air relative humidity for fogging in the Wangjialing Mine air intake roadway were determined. In addition, we found that the fogging point inside the roadway shifted forward continuously with the increase in inlet air temperature and inlet air relative humidity, and the length of the fog zone expands parabolically in response to these rising conditions. Full article

In an attempt to reduce such decay induced by pathogenic causes, several studies investigated the effectiveness of nanoparticles (NPs) that play a vital role in saving food products, especially fruits. Current research delves into biogenic silver nanoparticles (using marine alga Turbinaria turbinata (Tt/Ag-NPs) and their characterization using FT-IR, TEM, EDS, and zeta potential. Some pathogenic fungi, which cause fruit spoilage, were isolated. We studied the impact of using Tt/Ag-NPs to protect against isolated fungi in vitro, and the influence of Tt/Ag-NPs as a coating of tomato fruit to protect against blue mold caused by Penicillium italicum (OR770486) over 17 days of storage time. Five treatments were examined: T1, healthy fruits were used as the positive control; T2, healthy fruits sprayed with Tt/Ag-NPs; T3, fruits infected with P. italicum followed by coating with Tt/Ag-NPs (pre-coating); T4, fruits coated with Tt/Ag-NPs followed by infection by P. italicum (post-coating); and T5, the negative control, fruits infected by P. italicum. The results displayed that Tt/Ag-NPs are crystalline, spherical in shape, with size ranges between 14.5 and 39.85 nm, and negative charges. Different concentrations of Tt/Ag-NPs possessed antifungal activities against Botrytis cinerea, Rhodotorula mucilaginosa, Penicillium expansum, Alternaria alternate, and Stemphylium vesicarium. After two days of tomatoes being infected with P. italicum, 55% of the fruits were spoilage. The tomato fruit coated with Tt/Ag-NPs delayed weight loss, increased titratable acidity (TA%), antioxidant%, and polyphenol contents, and decreased pH and total soluble solids (TSSs). There were no significant results between pre-coating and post-coating except in phenol contents increased in pre-coating. A particular focus is placed on the novel and promising approach of utilizing nanoparticles to combat foodborne pathogens and preserve commodities, with a spotlight on the application of nanoparticles in safeguarding tomatoes from decay. Full article

Transport is a high-risk time for sheep, especially if the distances are long and sheep are fasted for a long time beforehand. Two experiments were conducted to compare transport durations of 1 hour (1 h) and 3 hours (3 h) and the effects of feeding before transport using Dorper × Mongolian sheep, which are typical of the region and may be tolerant of the high temperatures in the Inner Mongolian summer. Thirty 4-month-old male sheep were randomly divided into two treatment groups, with 15 sheep/treatment in each experiment, to evaluate the effects on blood biochemical indicators, stress hormone levels, rectal temperatures, and antioxidant status of lambs in summer. In Experiment 1, the levels of triglycerides and free fatty acids after 3 h transport were significantly lower than after 1 h transport (p < 0.05). The levels of thyroxine and malondialdehyde in blood were greater after 3 h transport than 1 h transport (p < 0.05). Creatine kinase levels after 3 h transport tended to be lower than after 1 h transport (p = 0.051). In Experiment 2, the levels of urea and superoxide dismutase in the group fasted pre-transport was significantly lower than those of the group fed pre-transport (p < 0.05). The serum cortisol level in the pre-transport fed group was higher compared to the group fed pre-transport (p = 0.04). Total antioxidant capacity in the pre-transport fasted group tended to be lower compared to that in the pre-transport fed group (p < 0.0001). We conclude that the reduction in nutritional status of sheep transported for longer and without feed pre-transport suggests that transporting sheep in hot conditions in northern China after fasting for a long period should be restricted. However, a decrease in the stress induced by transport following fasting is worthy of further study. Full article

Control design for the nonlinear cascaded system is challenging due to its complicated system dynamics and system uncertainty, both of which can be considered some kind of system nonlinearity. In this paper, we propose a novel nonlinearity approximation scheme with a simplified structure, where the system nonlinearity is approximated by a steady component and an alternating component using only local tracking errors. The nonlinearity of each subsystem is estimated independently. On this basis, a model-free adaptive control for a class of nonlinear cascaded systems is proposed. A squared-error correction procedure is introduced to regulate the weight coefficients of the approximation components, which makes the whole adaptive system stable even with the unmodeled uncertainties. The effectiveness of the proposed controller is validated on a flexible joint system through numerical simulations and experiments. Simulation and experimental results show that the proposed controller can achieve better control performance than the radial basis function network control. Due to its simplicity and robustness, this method is suitable for engineering applications. Full article

Lignanoids are an active ingredient exerting powerful antioxidant and anti-inflammatory effects in the treatment of many diseases. In order to improve the efficiency of the resource utilization of traditional Chinese medicine waste, Magnolia officinalis Rehder & E.H.Wilson residue (MOR) waste biomass was used as raw material in this study, and a series of deep eutectic solvents (ChUre, ChAce, ChPro, ChCit, ChOxa, ChMal, ChLac, ChLev, ChGly and ChEG) were selected to evaluate the extraction efficiency of lignanoids from MORs. The results showed that the best conditions for lignanoid extraction were a liquid–solid ratio of 40.50 mL/g, an HBD-HBA ratio of 2.06, a water percentage of 29.3%, an extract temperature of 337.65 K, and a time of 107 min. Under these conditions, the maximum lignanoid amount was 39.18 mg/g. In addition, the kinetics of the extraction process were investigated by mathematic modeling. In our antioxidant activity study, high antioxidant activity of the lignanoid extract was shown in scavenging four different types of free radicals (DPPH, ·OH, ABTS, and superoxide anions). At a concentration of 3 mg/mL, the total antioxidant capacity of the lignanoid extract was 1.795 U/mL, which was equal to 0.12 mg/mL of V_c solution. Furthermore, the antibacterial activity study found that the lignanoid extract exhibited good antibacterial effects against six tested pathogens. Among them, Staphylococcus aureus exerted the strongest antibacterial activity. Eventually, the correlation of the lignanoid extract with the biological activity and physicochemical properties of DESs is described using a heatmap, along with the evaluation of the in vitro hypoglycemic, in vitro hypolipidemic, immunomodulatory, and anti-inflammatory activity of the lignanoid extract. These findings can provide a theoretical foundation for the extraction of high-value components from waste biomass by deep eutectic solvents, as well as highlighting its specific significance in natural product development and utilization. Full article

The aim of the work was to determine important parameters of the course of π-A isotherms, which can determine the HLB (hydrophilic-lipophilic balance) value of surfactant mixtures with selected structural features, such as a straight or branched hydrocarbon chain and a double bond, using RSM (response surface methodology) computational methods. Mixtures of surfactants derived from fatty acids and sorbitan with specific HLB values were evaluated by Langmuir trough. The resulting elasticity modules (ELM) and molecules surfaces (SAM) were evaluated via response surface methodology and respective equations were calculated. The π-A isotherm determined in a Langmuir trough and the ELM and SAM parameters determined on the basis of this isotherm may be useful for determining the HLB of a fixed surfactant mixture. The RSM method used, in which ELM and SAM were assumed as two independent variables, can be a useful technique for tracking the influence of individual molecular characteristics on the hydrophilic-lipophilic properties of mixtures of surfactant compounds. Changes in HLB as a dependent variable can be described as a function of ELM and SAM. Full article

Pulmonary oncological pathologies are an important public health problem and the association with other pulmonary lesions may pose difficulties in diagnosis and staging or require different treatment options. To address this complexity, we conducted a retrospective observational study at the Marius Nasta Institute of Pneumophthisiology, Bucharest, Romania. Our study focused on patients admitted in 2019 with non-small-cell lung carcinoma and associated pulmonary lesions identified through surgical resection specimens. Among the 314 included patients, multiple pulmonary nodules were observed on macroscopic examination, with 12% (N = 37) exhibiting nonmalignant etiologies upon microscopic examination. These findings underscore the challenge of preoperative staging. Patients with coexisting nonmalignant lesions were similar in age, smoking habits, and professional or environmental exposure by comparison with those who presented only malignant lesions. The presentation of coexisting malignant and nonmalignant lesions may pose difficulties in diagnosing and staging pulmonary cancer. Full article

This paper proposes a prescribed performance fault-tolerant control based on a fixed-time extended state observer (FXTESO) for a carrier-based unmanned aerial vehicle (UAV). First, the attitude motion model of the UAV is introduced. Secondly, the proposed FXTESO is designed to estimate the total disturbances including coupling, actuator faults and external disturbances. By using the barrier Lyapunov function (BLF), it is proved that under prescribed performance control (PPC), the attitude tracking error is stable within the prescribed range. The simulation results for tracking the desired attitude angle show that the average overshoot and stabilization time of PPC-FXTESO is $0.00455\mathrm{rad}$ and $6.2\mathrm{s}$. Comparatively, the average overshoots of BSC-ESO and BSC-FTESO are $0.035\mathrm{rad}$ and $0.027\mathrm{rad}$, with stabilization times of $14.97\mathrm{s}$ and $12.56\mathrm{s}$, respectively. Therefore, the control scheme proposed in this paper outperforms other control schemes. Full article

In emerging countries like Romania, research on food loss and waste remains relatively scarce. This is mainly because the phenomenon, along with its repercussions and ramifications, is inadequately understood by all stakeholders within the agri-food chain. Consumer behaviour, with a specific focus on sustainability and waste reduction, has undergone a noticeable transformation on a global scale. Researchers have been emphasising the imperative for effective awareness and education strategies in this respect. Diverse studies contribute valuable insights into household food behaviour, identifying possible drivers and suggesting counteractive techniques. This study poses inquiries about consumer feelings regarding the food waste phenomenon and perceptions of the Romanian agri-food chain, as well as the influence of education on their awareness and adoption of sustainable eating habits. The paper delineates the semi-structured interview-based methodology, shows results through word-cloud and sentiment analysis, and engages in discussions on consumer behaviour through four distinct clusters, concluding with limitations, managerial implications and outlining future research directions. The findings underscore the relevance of emotions and sentiments in understanding consumer behaviour, shedding light on the nuanced factors influencing food waste. Notably, the accuracy of interpretation is higher when drawn from interviews rather than online comments or reviews made by unknown individuals. This distinction increases the credibility of the insights gained from the qualitative study. By analysing consumer sentiments, the study aids in implementing strategies to improve customer satisfaction and reduce food waste, fostering a more sustainable and consumer-centric approach in the agri-food sector worldwide. Full article

Micron-scale zero-valent iron (ZVI)-based material has been applied for hexavalent chromium (Cr(VI)) decontamination in wastewater treatment and groundwater remediation, but the passivation problem has limited its field application. In this study, we combined aluminum chloride solution with ZVI (pcZVI-AlCl₃) to enhance Cr(VI) removal behavior under aerobic conditions. The optimal pre-corrosion conditions were found to be 2.5 g/L ZVI, 0.5 mM AlCl₃, and a 4 h preconditioning period. Different kinds of techniques were applied to detect the properties of preconditioned ZVI and corrosion products. The ⁵⁷Fe Mössbauer spectra showed that proportions of ZVI, Fe₃O₄, and FeOOH in pcZVI-AlCl₃ were 49.22%, 34.03%, and 16.76%, respectively. The formation of Al(OH)₃ in the corrosion products improved its pH_pzc (point of zero charge) for Cr(VI) adsorption. Continuous-flow experiments showed its great potential for Cr(VI) removal in field applications. The ZVI and corrosion products showed a synergistic effect in enhancing electron transfer for Cr(VI) removal. The mechanisms underlying Cr(VI) removal by pcZVI-AlCl₃ included adsorption, reduction, and precipitation, and the contribution of adsorption was less. This work provides a new strategy for ZVI pre-corrosion to improve its longevity and enhance Cr(VI) removal. Full article

Geopolymer materials, considered to be an alternative to Portland cement-based concretes, can be produced from various types of waste aluminosilicate raw materials. This article presents the results of research related to the use of diatomite as an additive in geopolymers. The results of testing geopolymer composites with 1%, 3%, and 5% additions of diatomite with a grain size of 0–0.063 mm after and without thermal treatment were presented. This article presents the physical properties of the diatomite additive, the morphology of diatomite particles SEMs, thermal analysis, and compressive strength test results. In this research, diatomite was treated as a substitute for both fly ash and metakaolin (replaced in amounts of 1 and 3%) and as a substitute for sand introduced as a filler (in this case, 5% of diatomite was added). As a result of this research, it was found that the addition of diatomite instead of the main geopolymerization precursors in amounts of 1 and 3% had a negative impact on the strength properties of geopolymers, as the compressive strength was reduced by up to 28%. The introduction of crushed diatomite instead of sand in an amount of 5% contributed to an increase in strength of up to 24%. Full article

Background: Individuals with metabolic syndrome exhibit simultaneously pro-thrombotic and pro-inflammatory conditions which more probably can lead to cardiovascular diseases progression, type 2 diabetes mellitus, and some types of cancer. The present scoping review is aimed at highlighting the association between cancer risk, inflammation, and metabolic syndrome. Methods: A search strategy was performed, mixing keywords and MeSH terms, such as “Cancer Risk”, “Inflammation”, “Metabolic Syndrome”, “Oncogenesis”, and “Oxidative Stress”, and matching them through Boolean operators. A total of 20 manuscripts were screened for the present study. Among the selected papers, we identified some associations with breast cancer, colorectal cancer, esophageal adenocarcinoma, hepatocellular carcinoma (HCC), and cancer in general. Conclusions: Cancer and its related progression may also depend also on a latent chronic inflammatory condition associated with other concomitant conditions, including type 2 diabetes mellitus, metabolic syndrome, and obesity. Therefore, prevention may potentially help individuals to protect themselves from cancer. Full article

 Educational institutions and educators are significant in children’s lives, and they have a crucial role in implementing policies, practices, and sexual education to enhance children’s safety. Such policies and practices should be based on the voices of CSA survivors. This study explored child sexual abuse (CSA) survivors’ viewpoints on their past experiences with educators and the educational system. A qualitative thematic approach was used to analyze 61 written testimonies collected in 2020–2021 by the Israeli Independent Public Inquiry on CSA. Two interrelated themes arose: 1) CSA survivors’ retrospective perspectives of educators and the educational system’s responses to signs of their CSA, described as ranging from abusive to life-saving. Specifically, they shared three types of responses: a) harmful and hurtful; b) dismissive and ignoring; and c) accepting and attending. 2) The second theme described the survivors’ messages to educators to promote constructive change. The survivors conveyed expectations that educators should play a central role in CSA prevention, detection, and intervention and, specifically, the need for educators to receive professional training, provide beneficial sexual education, and identify and respond to CSA. The findings promoted moving beyond individual-level interventions to focus on improving educational institutional and organizational cultures related to CSA in both national and international contexts. Full article