In Spain, the public National Health Service provides care to Spaniards and other residents and is tailored for a decentralized state of autonomies. Each Autonomous Community has legislative capacity in its organization and management. We study the case of the collaboration between private hospitals and the public health service in La Rioja, an Autonomous Community of Spain located in the North of the Iberian Peninsula, due to the importance that this relationship has in health systems, in general. We applied the case study method as a methodological tool in a long-term local study. The interpretation was carried out within a national context, which allows us to understand its meaning and the historical keys to hospital development in this region. Primary sources have been reviewed (mainly reports, catalogs, and censuses of hospitals from the Ministry of Health and the Government of La Rioja) and other secondary sources, located in archives, libraries, Institute of Rioja Studies, and Department of Health. The hospital system in La Rioja was characterized by a predominance of public beds compared with private ones, although there has been a growing trend in the number of private beds from 2013 onwards due to the incorporation of health and social care convalescent hospitals (two). La Rioja has been promoting public–private collaboration (seen as a strategic alliance) and focusing on agreements in the socio-health space, particularly using the management service agreement and the concession of work formulas. The development of the public health service in La Rioja, from 1986 to 2019, has been determined by a progressive lower dependence on specialized hospitals from other health services of neighboring Autonomous Communities and by a mixed public–private hospital system. Full article

In the context of the contemporary accelerated pace of life, emphasizing the importance of sleep quality is essential for enhancing overall well-being and health. Historically underestimated, recent studies highlight sleep’s vital importance for physical, mental, and emotional well-being. Chronic sleep deprivation is connected to numerous health problems such as cardiovascular disease, diabetes, and weakened immune response. Additionally, lack of sleep can worsen stress, depression, and anxiety, impairing daily life and overall quality of life. This study investigates the link between poor sleep quality and key factors affecting wellness, such as mental health and eating disorders. Through a cross-sectional analysis involving 407 participants, utilizing established measures including the Depression Anxiety Stress Scale (DASS-21), the Eating Disorder Examination Questionnaire Short (EDE-QS), and the single-item Sleep Quality Scale (SQS), data were collected and analyzed using SPSS v28 and R-Statistics. The findings reveal a significant correlation (p < 0.05) between DASS-21, EDE-QS, and SQS, indicating that individuals experiencing poor sleep quality exhibit higher levels of depression, anxiety, and stress. Furthermore, multinomial logistic regression analysis highlights low sleep quality as a risk factor for both mental health (OR: 1.071, 95% CI: 1.042, 1.102, p < 0.05, low vs. high sleep quality) and eating disorders (OR: 1.047, 95% CI: 1.004, 1.092, p < 0.05, low vs. high sleep quality). Overall, these results underscore the critical role of sleep quality in mental health and suggest that insomnia is a predictive factor for both poor mental well-being and disordered eating habits. The main contribution of this study is its identification of poor sleep quality as a common risk factor linking mental health issues and eating disorders, which emphasizes the need for integrated treatment strategies focusing on sleep improvement. Further research through randomized controlled trials is warranted to validate the findings of this cross-sectional study. Full article

Various drying temperatures impact the texture of pasta and cause different drying defects. These by-products could reflect techno-functional characteristics which are suitable for cereal products. This research addresses the influence of low (LT) and high (HT) drying pasta defects with two granulations on the theoretical and functional characteristics of hard dough biscuits. By shifting from a LT to HT drying temperature, a higher onset and peak temperature was found due to the higher mobility of starch molecules with increasing crystalline stability. The lowest transition enthalpy of biscuit formulation was also observed for higher incorporation of fine HT pasta regrinds. The algebraic model of dough with consistography determined the poor-extensible gluten and a high resistance with a greater value of P/L and P indices for LT regrinds. Scanning electron microscopy revealed a heavy and dense texture with immersed starch granules for additional fine regrinds while coarse samples caused swell granules with greater diameter. Moreover, fine HT regrinds reflected the lowest L* value for biscuit due to heat gradient tension with the hard milling process which leads to protein denaturation with decreasing nitrogenous. Full article

The aim of this study is to experimentally capture the semantic, syntactic, and phonological properties of recursive compounds in English. We asked 22 native speakers of English to judge the semantic, syntactic, and phonological properties of 20 recursive compounds that are inherently ambiguous in interpretation (e.g., university entrance exam). We found variations among the participants in each of these three basic aspects. For semantic interpretation, there was a tendency among the participants to prefer left-branching interpretation (‘an exam for university entrance’) over right-branching interpretation (‘an entrance exam in a university’). Using a lexical integrity effect for the syntactic tests, it was found that certain recursive compounds allow for coordination inside. Phonologically, speaker variation was observed in whether and how recursive compounds were pronounced, with 16 participants obeying the Lexical Category Prominence Rule. Full article

Background and Objectives: Although nonsuicidal self-injury (NSSI), by definition, excludes suicidal intent, numerous studies show associations between NSSI and suicidal phenomena in clinical and outpatient adolescent samples. Given the growing interest in the relationship between NSSI and suicidal phenomena, the present study aimed to investigate the relationship between NSSI and suicidal beliefs in adolescent psychiatric inpatients. Materials and Methods: The study sample included 50 adolescent inpatients at a specialized facility, with a mean age of 15.44 ± 1.39, who fulfilled DSM-5 criteria for NSSI. For study purposes, we use the Ottawa Self-Injury Inventory (OSI) and Brief Suicide Cognitions Scale (B-SCS). Statistical data processing was performed in the R software 4.3.0 (R Core Team, Vienna, Austria). Results: Of all NSSI functions, the Internal ER function score was the highest (18.72 ± 7.08), followed by External ER (8.10 ± 3.11), Social Influence (5.88 ± 5.37), and Sensation Seeking (3.44 ± 2.98). The mean Craving (C) score was 14.06 ± 7.51. The mean value of the B-SCS score was 19.54 ± 5.24. It was found that the B-SCS score is significantly related to Internal ER (r = 0.441, p < 0.001) and Craving (r = 0.297, p = 0.036). The multivariable model shows that internal ER function and participants’ age are significantly related to the B-SCS score. Conclusion: Despite the limitations of the study, it is emphasized that cognitions occurring across the fluid suicidal belief system alone do not fully capture the complexity of suicide, but assessing the suicidal belief system in NSSI inpatient adolescents could nevertheless provide helpful information for identifying individuals who may have an elevated vulnerability to experiencing suicidal ideas and behaviors over time. Full article

Since the creation of the first parallel electrical power systems around the world, the rotor angle stability of synchronously operating generators has been one of the most crucial and challenging problems. In modern electricity networks, including in Kazakhstan, where renewable energy technologies are rapidly emerging, the issue of stability takes on even greater importance due to the technical shortcomings of inverter-based generation. In this framework, an analysis of rotor angle transient stability was carried out when replacing existing synchronous generators with doubly fed induction generators under a certain pre-emergency mode. A critical proportion of active power generation by DFIG units was identified at which transient stability can still be maintained due to the sufficient stored kinetic energy of the synchronous machines remaining in operation. In addition, two simple solutions were investigated to improve transient stability, such as an increased time of the automatic reclosure operation and the use of special load-shedding automation. Finally, this paper proposes a novel type of flexible smart-grid automation that is capable of monitoring the main operating parameters and issuing control actions depending on inertia, the availability of wind resources, and the load of the system as a whole. For this analysis, a real power system from the Mangystau region in Kazakhstan was considered, and the PowerWorld software 23 was used. Full article

Type 2 diabetes mellitus (T2DM) patients suffer premature development of cardiovascular disease and commonly require cardiac revascularization using the autologous saphenous vein (SV). Smooth muscle cells (SMCs) are the principal cell type within the vascular wall and are dysfunctional in T2DM SV-SMCs, yet the mechanisms underpinning this are incompletely understood. The purpose of this study was to interrogate differential microRNA (miRNA) expression in SV-SMCs to enhance our understanding of T2DM SV-SMC phenotypic change. miRNA expression in primary human SV-SMCs from T2DM and non-diabetic (ND) donors was determined using an array (n = 6 each of ND and T2DM SV-SMCs). Differentially expressed miRNAs were ranked, and functional annotation of the 30 most differentially expressed miRNAs using DAVID and KEGG analysis revealed pathways related to SMC phenotype, including proliferation, migration, cytokine production and cell signaling. After selecting miRNAs known to be involved in SMC phenotypic regulation, miR-17, miR-29b-2, miR-31, miR-130b and miR-491 were further validated using qRT-PCR (n = 5 each of ND and T2DM SV-SMC), with miR-29b-2 subsequently being removed from further investigation. Potential mRNA targets were identified using mirDIP. Predicted target analysis highlighted likely dysregulation in transcription, epigenetic regulation, cell survival, intracellular signaling and cytoskeletal regulation, all of which are known to be dysfunctional in T2DM SV-SMCs. In conclusion, this paper identified four miRNAs that are dysregulated in T2DM SV-SMCs and are implicated in functional changes in the behavior of these cells. This provides a step forward in our understanding of the molecular and epigenetic regulation of vascular dysfunction in T2DM. Full article

This study explores the complexities of mission–state and church–state relations from a micro-level perspective, asking how the missionaries, teachers, and pupils at the Lutheran Middle School in Hunan Province negotiated conflicting claims on church membership and national citizenship. As historian Stephen R. Platt points out, Hunan is not a microcosm of modern China.. When dealing with nationalism in a Hunanese context, it is sometimes more accurate to speak of Hunanese nationalism rather than Chinese nationalism. This micro-level case study sheds light on the general trends of changing mission-state and church-state encounters, but it also emphasizes unexpected expressions of local Christianity in a context that has not so far been given much scholarly attention. Full article

Historical transmission and other controversies related to Sengzhao’s Things Do Not Shift have long been a subject of scholarly attention. However, his essay Emptiness of the Nonabsolute has been insufficiently studied, despite being traditionally deemed emblematic of the Chinese understanding of Mādhyamaka philosophy. The present study shows that this essay has also historically generated divisions and debates in the Chinese context. It finds that Emptiness of the Nonabsolute expresses the Mādhyamaka philosophy of emptiness in a distinctly Chinese manner by grounding itself in the principle of dependent origination, and by transforming issues of being and nonbeing and the name and the “thing-in-itself” into conditional emergence. Nevertheless, Sengzhao’s essay evoked the two markedly distinct construals of Buzhengukong 不真故空 and Bushizhenkong 不是真空 as Tathāgatagarbha and Buddha-nature philosophy within Chinese Buddhism. Bushizhenkong directly aligned Sengzhao’s ostensibly representative theory of Mādhyamaka emptiness in China with the doctrinal framework of Tathāgatagarbha and Buddha-nature, triggering almost a millennium-long period of discussions and controversies. Full article

Silk and silk derivatives have emerged as a possible alternative in surgical device development, offering mechanical strength, biocompatibility, and environmental sustainability. Through a systematic review following PRISMA guidelines, this study evaluated silk fibroin’s application across pre-clinical and clinical settings, focusing on its role as screws and plates for osteofixation. A comprehensive search yielded 245 studies, with 33 subjected to full-text review and 15 ultimately included for qualitative analysis. The findings underscore silk fibroin’s superior properties, including its tunable degradation rates and ability to be functionalized with therapeutic agents. In vivo and in vitro studies demonstrated its efficacy in enhancing bone healing, offering improved outcomes in osteofixation, particularly for craniofacial defects. Silk fibroin’s remarkable attributes in biodegradation and drug release capabilities underscore its potential to enhance patient care. Ultimately, silk fibroin’s integration into surgical practices promises a revolution in patient outcomes and environmental sustainability. Its versatility, coupled with the continuous progress in fabrication techniques, signals a promising horizon for its widespread acceptance in the medical field, potentially establishing a new benchmark in surgical treatment. Further research is expected to solidify the transition of silk products from basic science to patient care, paving the way for widespread use in various surgical applications. Full article

Acinetobacter baumannii has developed multiple drug resistances, posing a significant threat to antibiotic efficacy. LysECD7, an endolysin derived from phages, could be a promising therapeutic agent against multi-drug resistance A. baumannii. In this study, in order to further enhance the antibacterial efficiency of the engineered LysECD7, a few lipopolysaccharide-interacting peptides (Li5, MSI594 and Li5-MSI) were genetically fused with LysECD7. Based on in vitro antibacterial activity, the fusion protein Lys-Li5-MSI was selected for further modifications aimed at extending its half-life. A cysteine residue was introduced into Lys-Li5-MSI through mutation (Lys-Li5-MSI^V12C), followed by conjugation with a C16 fatty acid chain via a protonation substitution reaction(V12C-C16). The pharmacokinetic profile of V12C-C16 exhibited a more favorable characteristic in comparison to Lys-Li5-MSI, thereby resulting in enhanced therapeutic efficacy against lethal A. baumannii infection in mice. The study provides valuable insights for the development of novel endolysin therapeutics and proposes an alternative therapeutic strategy for combating A. baumannii infections. Full article

Additive manufacturing (AM) or 3D printing of metals is gaining popularity due to its flexibility when fabricating parts with highly complex designs, as well as when simplifying manufacturing steps and optimizing process times. In this investigation, 17-4 PH stainless steel was additively manufactured using Laser Powder Bed Fusion (L-PBF), followed by functionalization through a DUPLEX treatment. This treatment involved a plasma-assisted nitriding process, followed by the deposition of an arc-PVD c-Al_0.7Cr_0.3N hard coating. The microstructural modifications resulting from plasma nitriding (such as the formation of Fe_2,3N and Fe₄N and the αN or expanded martensite phases) and the surface improvements with the c-Al_0.7Cr_0.3N coating on the 3D-printed 17-4 PH steel are evaluated in comparison to conventionally manufactured 17-4 PH steel. These microstructural characteristics are correlated with the mechanical response of the treated surfaces. As a result of the plasma nitriding process, the hardness of the 3D-printed 17-4 PH SS increased by approximately 260%. The wear, measured through dynamic and static scratch testing, was reduced by approximately 31%. This improvement was attributed to the modification of adhesive failure mechanisms, leading to a reduction in wear volume, improved coating adhesion, and enhanced scratch resistance. Full article

This article aims to introduce a set of hybrid matrix polynomials associated with $\lambda$-polynomials and explore their properties using a symbolic approach. The main outcomes of this study include the derivation of generating functions, series definitions, and differential equations for the newly introduced two-variable Hermite $\lambda$-matrix polynomials. Furthermore, we establish the quasi-monomiality property of these polynomials, derive summation formulae and integral representations, and examine the graphical representation and symmetric structure of their approximate zeros using computer-aided programs. Finally, this article concludes by introducing the idea of 1-variable Hermite $\lambda$ matrix polynomials and their structure of zeros using a computer-aided program. Full article

Background: Frailty leads to vulnerability to stress, impaired daily functioning, and an increased need for care. Frailty is considered reversible, and it is crucial to detect the risk of frailty early and investigate factors that may delay its progression. Objectives: To identify tests that can explain frailty risk and compare the situation of local residents with and without frailty support. Methods: Participants were recruited in two ways: through public advertisements in Akita City (open recruitment group) and through invites from frailty supporters in their immediate communities (community-based group). We examined the differences in frailty risk and oral, motor, and social functions between the two groups and identified factors associated with frailty risk in both groups. Results: The community-based group exhibited a lower risk of frailty than the open recruitment group despite having more older members on average. Additionally, the community-based group demonstrated better social functioning than the open-recruitment group. Furthermore, factors such as oral diadochokinesis (ODK), one-leg stand test (OLS), and grip strength (GS) showed significant association with frailty risk. Conclusion: The ODK, OLS, and GS were identified as factors explaining frailty risk, and Frailty Supporters may reduce the risk of frailty. Full article

In response to the limited accuracy of current three-dimensional (3D) object detection algorithms for small objects, this paper presents a multi-sensor 3D small object detection method based on LiDAR and a camera. Firstly, the LiDAR point cloud is projected onto the image plane to obtain a depth image. Subsequently, we propose a cascaded image fusion module comprising multi-level pooling layers and multi-level convolution layers. This module extracts features from both the camera image and the depth image, addressing the issue of insufficient depth information in the image feature. Considering the non-uniform distribution characteristics of the LiDAR point cloud, we introduce a multi-scale voxel fusion module composed of three sets of VFE (voxel feature encoder) layers. This module partitions the point cloud into grids of different sizes to improve detection ability for small objects. Finally, the multi-level fused point features are associated with the corresponding scale’s initial voxel features to obtain the fused multi-scale voxel features, and the final detection results are obtained based on this feature. To evaluate the effectiveness of this method, experiments are conducted on the KITTI dataset, achieving a 3D AP (average precision) of 73.81% for the hard level of cars and 48.03% for the hard level of persons. The experimental results demonstrate that this method can effectively achieve 3D detection of small objects. Full article

Seed dormancy and germination play pivotal roles in the agronomic traits of plants, and the degree of dormancy intuitively affects the yield and quality of crops in agricultural production. Seed priming is a pre-sowing seed treatment that enhances and accelerates germination, leading to improved seedling establishment. Seed priming technologies, which are designed to partially activate germination, while preventing full seed germination, have exerted a profound impact on agricultural production. Conventional seed priming relies on external priming agents, which often yield unstable results. What works for one variety might not be effective for another. Therefore, it is necessary to explore the internal factors within the metabolic pathways that influence seed physiology and germination. This review unveils the underlying mechanisms of seed metabolism and germination, the factors affecting seed dormancy and germination, as well as the current seed priming technologies that can result in stable and better germination. Full article

The environmental impact caused by the intensive exploitation of fossil fuels to generate heat and electricity has already reached a critical level. Also, as the industrial sector is the largest energy consumer, mainly in the form of heat, it has then become compulsive to implement the use of renewable solar heat in industrial processes, such as those found in the food processing and beverages industries, which do not require high temperatures. Consequently, this study examines the viability of supplying heat as hot water at 80 °C and saturated steam at 160 °C to a medium-sized brewery factory through a hybrid solar plant composed of flat plate and parabolic trough collectors and sensible thermal energy storage. The study was conducted numerically using the meteorological conditions of a city different from that where the factory is located because it benefits from higher insolation levels. The mean annual solar fractions achieved were 49.9% for hot water production and 37.3% for steam generation, at a levelized cost of heat of 0.032 USD/kWh, which can be considered competitive if compared against the values reported in other similar solar projects. Also, the decrease in fossil fuel consumption allowed an annual reduction of 252 tons of carbon dioxide emissions. Full article

The constant use of alcoholic beverages can deregulate serotonin levels, affecting neurotransmitters and triggering symptoms of anxiety. In this context, the objective of this work was to evaluate the anxiolytic potential and possible action mechanisms of the natural compound amentoflavone against the deleterious effects caused by alcohol withdrawal on the behavior of adult zebrafish (aZF). The experiments showed that amentoflavone did not change locomotion and did not cause toxicity in aZF during up to 96 h of analysis, with a median lethal concentration (LC₅₀) greater than 1.0 mg/mL. The reversal of anxiety by pretreatment with granisetron suggested that the anxiolytic effect of amentoflavone is dependent on serotonergic 5-HT_3A/3B receptors. Furthermore, amentoflavone reversed anxiety due to flumazenil pretreatment, suggesting a dependence on the GABA_A receptor. The three concentrations of amentoflavone tested were effective in treating anxiety resulting from alcohol withdrawal. In silico analysis validated the in vivo results, supporting the idea that the interaction of amentoflavone with the protein occurs in a more stable manner than reference compounds. Amid growing interest in natural alternatives to treat anxiety disorders, amentoflavone is a potential candidate for a new anxiolytic compound that acts specifically on the 5HT_3A/3B and GABAergic serotonergic pathways. Full article

I employ autoethnography to undertake a broader scholarly inquiry on intergenerational relationships and transnational care shaped by global migration and aging. Specifically, I reflect on the dynamics of my relationship with my mother, beginning with my departure from my home and spanning a period of 40 years, 8 in China and 34 outside China. In doing so, I contemplate theoretical models of intergenerational solidarity, ambivalence, and role ambiguity. I also challenge cultural assumptions of filial piety. The geographical distance, passage of time, and acculturation process have profoundly influenced my perception of filial piety, which differs markedly from my mother’s. However, this divergence in consensual solidarity—marked by variations in attitudes, beliefs, and values—does not translate into weakened affectual solidarity, characterized by positive sentiments and emotions. Furthermore, aided by advancements in transportation and social media technology, I have been able to extend crucial emotional and some “instrumental” care to my mother, along with financial support if needed, despite limited hands-on care. Nevertheless, I must negotiate my care for my mother and navigate a delicate balance in coordinating my care efforts with those of my non-migrant siblings. Full article

The visitor economy is responsible for a substantial percentage of the global carbon footprint. The mechanisms used to decarbonize it are insufficient, and the industry is relying on carbon trading with substandard credits that allow businesses to outsource the responsibility to decarbonize. We aim to transform carbon markets, help finance climate investments, and support decarbonization strategies. We identify and define the problem, outline the components and their interactions, and develop a conceptual model to transform carbon markets. The new, blockchain-based Carbon Tokenomics Model rolls out a decentralized database to store, trade, and manage carbon credits, with the goal of enabling sustainable climate finance investment. We outline the criteria needed for an industry-wide carbon calculator. We explain the process needed to increase rigor in climate investments in the visitor economy and introduce a delegated Proof of Commitment consensus mechanism. Our inclusive and transparent model illustrates how to reduce transaction costs and how to build consumer and industry trust, generating much-needed investments for decarbonization. Full article

Identifying the potential pollution sources of surface water pollutants is essential for the management and protection of regional water environments in drinking water source areas. In this study, absolute principal component score-multiple linear regression (APCS-MLR) and positive matrix factorization (PMF) models were applied to assess water quality and identify the potential pollution sources affecting the surface water quality of Xin’an River Basin. For this purpose, a 10-year (2011–2020) dataset of eight water quality indicators (including pH, EC, DO, COD, NH₃-N, TN, TP, and FC) covering eight monitoring stations and 7248 monthly observations was used. The results indicated that Pukou section had the worst water quality among the eight monitoring stations, and TN was the most serious water quality index. Both the APCS-MLR and PMF models identified agricultural nonpoint source pollution, urban nonpoint source pollution and rural domestic pollution, and meteorological factors. The sum of these three sources was very close, accounting for 60% and 58%, respectively. The APCS-MLR results demonstrated that for EC, COD, and NH₃-N, the major pollution sources were urban nonpoint sources and rural domestic pollution. The major contamination source of TN was agricultural nonpoint source pollution (30.4%). Meanwhile, the major pollution sources of pH, DO, TP, and FC were unidentified factors. The PMF model identified five potential sources, and pH and DO were affected by meteorological factors. NH₃-N and TP were influenced mainly by agricultural nonpoint source pollution. Atmospheric deposition was the major pollution source (87.9%) of TN. FC was mostly derived from livestock and poultry breeding (88.3%). EC and COD were mostly affected by urban nonpoint sources and rural domestic pollution. Therefore, receptor models can help managers identify the major sources of pollution in watersheds, but the major factors affecting different pollutants need to be supplemented by other methods. Full article