Nowadays the phenomenon of hearing voices represents a very fertile and discussed field of research. In psychological and psychiatric fields, the phenomenon has been described as a normal phenomenon, but also as a prodromal stage and as a symptom of psychosis. Through a qualitative research methodology, the aim was to explore how family medicine physicians configure the phenomenon and its clinical and interactive implications. The present research involved 35 family medicine physicians as figures of primary importance in the approach toward people who start to hear voices. Semi-structured interviews have been used and they have been analyzed by the method of discourse analysis. The results show a remarkable difficulty in understanding the phenomenon in all its complexity and the tendency to consider it a symptom or a prodromal stage of psychopathology. Increasing the knowledge of doctors on the subject is necessary so that their evaluation and choice of intervention match the needs of each patient. We also discuss the importance of promoting the knowledge of the potential meanings taken on by the voices in the context of the personal and family background of the individual hearer, and of collaboration with other relevant professionals and services. Full article

Radical enactivism supports radical embodied cognition (REC), which is the idea that basic or fundamental cognition (perception and action) does not need to be understood in representational, contentful terms. REC departs from the idea that the mind can be naturalized through biological functions, but rejects the idea that mental content, which is understood as having a representational nature, can be naturalized. For REC, the natural origins of content (or NOC) is a program based on the following hypothesis: first, we depart from basic cognitive processes that are target-based and guided by an Ur-intentionality or directedness toward the world, and then sociality enters in the picture when language appears into the scene, allowing for establishing full-blown semantic content in which that content is about worldly states of affairs. Here, I am going to focus on the phenomenon of directedness since there are blind spots in this picture: as many authors claim, REC takes Ur-intentionality as the starting point, but there is simply no explanation to date of how this directedness or Ur-intentionality is established. Therefore, how could we account for Ur-intentionality? How does this kind of intentionality emerge? We believe that we can answer this question if we invoke the best scientific evidence from ecological perceptual learning especially in regard to the role of the environment and the information for perceiving affordances in our learning processes. This allows us to offer an answer to the question of how the most basic form of cognition (Ur-intentionality or directedness) emerges in nature. Full article

Lignocellulosic-based polymer composites have gained significant interest due to their ‘’green’’ character as a response to environmental concerns. A diverse array of lignocellulosic fibers is utilized, depending on fiber dimensions, chemical composition, moisture content, and the fiber–matrix interface. The aim of this study is to establish an alternative standardized methodology, aimed at comparatively estimating the performance of polymer composites through the examination of individual plant fibers. The fibers studied are ramie, hemp, flax, and kenaf, and HDPE-based corresponding composites were analyzed for their performance across various fiber-content levels (10, 20, and 30 wt.%). It was found that kenaf showcases the largest average fiber diameter, succeeded by hemp, ramie, and flax. Additionally, ramie and kenaf exhibit elevated levels of crystallinity, suggesting increased cellulose content, with kenaf having the lowest crystallinity index among the fibers compared. Based on Thermogravimetric analysis, ramie displays the lowest moisture content among the examined fibers, followed by hemp, flax, and ultimately kenaf, which is recorded to have the highest moisture content, while, similarly, ramie exhibits the lowest mass loss at the processing temperature of the corresponding composites. Composites containing fibers with smaller diameters and higher crystallinity indexes and lower moisture absorptions, such as ramie and hemp, demonstrate superior thermal stability and exhibit increased Young’s modulus values in their respective composites. However, poor interfacial adhesion affects mechanical performance across all composites. Understanding fiber morphology, inner structure, and thermal stability is important for developing new composite materials and optimizing their selection for various applications. Full article

A broadband Doherty power amplifier (DPA) always experiences an efficiency degradation between two efficiency peaks, especially at two side bands. In this study, the efficiency degradation was demonstrated to be caused caused by the in-phase power combining at the saturation power level. To solve this problem, current misalignment was introduced into the broadband DPA design. The carrier and peaking PA have different current phases when performing the power combination at the saturation power level. In this work, it was also demonstrated that the efficiency in the high-power region of a DPA can be improved by elaborately using misaligned current phases. A detailed analysis and the design procedure of a broadband DPA are presented in this paper. And a 1.5–2.45 GHz broadband DPA was implemented and measured. The fabricated DPA achieves a saturation output power of 42.7–44.9 dBm, a saturation drain efficiency (DE) of 62.7–74.1% and a gain of 10.2–13.9 dB over 1.5–2.45 GHz. Moreover, the fabricated DPA also achieves a 6 dB back-off DE of more than 49.1% in the frequency band of interest. Full article

Forest health tourism is an increasingly popular new form of tourism. Fujian Province, with its abundant forest resources, ranks among the top provinces in China in terms of forest coverage and holds significant development potential. The study focuses on 80 provincial-level forest health resorts in Fujian Province, China. Software such as the ArcGIS geographic information system is used to analyze the resorts’ nearest neighbor index, geographic concentration index, kernel density, etc., thus indicating their spatial distribution characteristics. Overlay analysis, correlation analysis, and fitting analysis are employed to explore the spatial distribution specificity and its influencing factors. The research results indicate that forest health resorts in the area exhibit an aggregated distribution with a higher overall concentration. They are influenced by factors such as the distribution of river systems, the accessibility of transportation, distance to central cities, and socio-economic conditions. The geographic concentration index (G) is 50.28 and the unevenness index (S) is 0.640, both indicating that the forest health resorts in Fujian Province demonstrate a distribution pattern of “overall dispersion with multiple core aggregations”. Based on the research findings, the article puts forward some policy insights. Taking into account the local geographical characteristics, it advocates for the rational development of forest health resort industry models suitable for the region. It suggests incorporating innovative ideas into the forest health resort industry in order to broaden development channels. Additionally, it emphasizes the importance of close collaboration between the government and the market for mutual development. Full article

Gulf Cooperation Council (GCC) countries have faced environmental challenges in recent decades. This study aims to identify the contribution of digitalization, industrialization, and financial development to the ecological footprint (EF) in GCC countries between 2000 and 2021. The empirical investigation involves estimating the STochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) model using the augmented mean group (AMG), common correlated effects mean group (CCEMG) and cross-sectionally augmented autoregressive distributed lag (CS-ARDL) estimators. The findings reveal the existence of long-term linkages between EF and the factors mentioned above. Furthermore, there is evidence that adopting digitalization and information and communication technologies (ICT) improves long-term environmental quality. In contrast, both industrialization and financial development exert detrimental effects on the environment. Finally, the JKS Granger non-causality test revealed that all variables, except financial development, predict environmental degradation in GCC countries. These findings can assist in formulating efficient strategies to reduce ecological degradation and achieve environmental sustainability in GCC countries. Full article

The Mediterranean diet is considered a healthy eating pattern. It has been shown to improve people’s quality of life. When a person suffers injuries, their quality of life suffers. This research aims to accomplish the following: (a) to study the differences in the effect of the health-related quality of life on injuries according to the degree of adherence to the Mediterranean diet, (b) to analyse the existing differences in the variables that make up the health-related quality of life according to the degree of adherence to the Mediterranean diet, and (c) to analyse the degree of adherence to the Mediterranean diet according to whether the participants have suffered any injury. The study was descriptive, cross-sectional, and exploratory in a sample of 556 physical education students. The PREDIMED questionnaire, the SF-36 questionnaire, and a self-administered questionnaire were used. The results showed that high adherence to the Mediterranean diet was associated with higher quality of life and lower injury rates. It was also observed that high adherence to the Mediterranean diet improved the effect of the quality of life on injuries. In conclusion, the Mediterranean diet is beneficial for the quality of life of young university students. Full article

The situation of rocky desertification in the southwestern part of China is very serious and has been included as one of three major ecological problems. In this study, using Landsat images as the data sources, we estimated the fractional vegetation coverage (FVC) in the Mengdong River Basin in the Hunan Province over the past 40 years, analyzed its spatio-temporal variation characteristics, and explored the driving mechanism (climate and anthropogenic) using the Mann–Kendall, Hurst index, and partial correlation methods. Specifically, the impact of ecological engineering on the recovery of vegetation cover in rocky desertification areas was analyzed and discussed in this study. The results demonstrate the following: (1) The changes in FVC in the study area before and after the rocky desertification management ecological project differed significantly, with a very small change in the rate of change in the mean value of FVC between 1987 and 1999 (<0.1%), while the FVC had a significant linear growth trend between 2000 and 2022 (>0.9%). (2) The Hurst index of FVC ranged from −0.233 to 2.476, with an average value of 0.864. The area with an H value greater than 0.75 accounted for 80.12%, indicating that the future trend in the vast majority of regions will develop in accordance with the current change trend. (3) The average partial correlation coefficients between FVC and precipitation and between FVC and temperature were −0.02 and 0.27, respectively, showing that FVC is more sensitive to temperature than precipitation. The combination of climate change and human activities is the main cause of FVC change. The contributions of climate change (precipitation and temperature) and human activities to FVC variation are about 30% and 70%, respectively. Ecological restoration projects have a significant positive effect on the recovery of vegetation in rocky desertification areas. The results of this study are intended to provide a scientific basis for analyzing the characteristics of vegetation restoration in existing rocky desertification areas and ecological management in future rocky desertification areas. Full article

A growing number of large data sets have created challenges for the oil and gas industry in predicting reservoir parameters and assessing well productivity through efficient and cost-effective techniques. The design of drilling plans for a high-pressure tight-sand reservoir requires accurate estimations of pore pressure (P_p) and reservoir parameters. The objective of this study is to predict and compare the P_p of Huizhou Sag, Pearl River Mouth Basin, China, using conventional techniques and machine learning (ML) algorithms. We investigated the characteristics of low-permeability reservoirs by observing well-logging data sets and cores and examining thin sections under a microscope. In the reservoir zone, the average hydrocarbon saturation is 55%, and the average effective porosity is 11%. The tight sandstone reservoirs consist of fine- to extremely fine-grained argillaceous feldspathic sandstone. The mean absolute error for reservoir property prediction is 1.3%, 2.2%, and 4.8%, respectively, for effective porosity, shale volume, and water saturation. Moreover, the ML algorithm was employed to cross-check the validity of the prediction of P_p. Combining conventional and ML techniques with the core data demonstrates a correlation coefficient (R²) of 0.9587, indicating that ML techniques are the most effective in testing well data. This study shows that ML can effectively predict P_p at subsequent depths in adjacent geologically similar locations. Compared to conventional methods, a substantial data set and ML algorithms improve the precision of P_p predictions. Full article

Oral cancer is the 16th most common malignant tumor worldwide. The risk of recurrence and mortality is high, and the survival rate is low over the following five years. Recent studies have shown that curcumin causes apoptosis in tumor cells by affecting F_oF₁-ATP synthase (ATP synthase) activity, which, in turn, hinders cell energy production, leading to a loss of cell viability. Additionally, irradiation of curcumin within cells can intensify its detrimental effects on cancer cell viability and proliferation (photodynamic therapy). We treated the OHSU-974 cell line, a model for human head and neck squamous cell carcinoma (HNSCC), and primary human fibroblasts. The treatment involved a 1 h exposure of cells to 0.1, 1.0, and 10 μM curcumin, followed or not by irradiation or the addition of the same concentration of pre-irradiated curcumin. Both instances involved a diode laser with a wavelength of 450 nm (0.25 W, 15 J, 60 s, 1 cm², continuous wave mode). The treatment with non-irradiated 1 and 10 µM curcumin caused ATP synthase inhibition and a consequent reduction in the oxygen consumption rate (OCR) and the ATP/AMP ratio, which was associated with a decrement in lipid peroxidation accumulation and a slight increase in glutathione reductase and catalase activity. By contrast, 60 s curcumin irradiation with 0.25 W—450 nm caused a further oxidative phosphorylation (OxPhos) metabolism impairment that induced an uncoupling between respiration and energy production, leading to increased oxidative damage, a cellular growth and viability reduction, and a cell cycle block in the G1 phase. These effects appeared to be more evident when the curcumin was irradiated after cell incubation. Since cells belonging to the HNSCC microenvironment support tumor development, curcumin’s effects have been analyzed on primary human fibroblasts, and a decrease in cell energy status has been observed with both irradiated and non-irradiated curcumin and an increase in oxidative lipid damage and a slowing of cell growth were observed when the curcumin was irradiated before or after cellular administration. Thus, although curcumin displays an anti-cancer role on OHSU-974 in its native form, photoactivation seems to enhance its effects, making it effective even at low dosages. Full article

Non-Intrusive Load Monitoring (NILM), which provides sufficient load for the energy consumption of an entire building, has become crucial in improving the operation of energy systems. Although NILM can decompose overall energy consumption into individual electrical sub-loads, it struggles to estimate thermal-driven sub-loads such as occupants. Previous studies proposed Non-Intrusive Thermal Load Monitoring (NITLM), which disaggregates the overall thermal load into sub-loads; however, these studies evaluated only a single building. The results change for other buildings due to individual building factors, such as floor area, location, and occupancy patterns; thus, it is necessary to analyze how these factors affect the accuracy of disaggregation for accurate monitoring. In this paper, we conduct a fundamental evaluation of NITLM in various realistic office buildings to accurately disaggregate the overall thermal load into sub-loads, focusing on occupant thermal load. Through experiments, we introduce NITLM with deep learning models and evaluate these models using thermal load datasets. These thermal load datasets are generated by a building energy simulation, and its inputs for the simulation were derived from realistic data like HVAC on/off data. Such fundamental evaluation has not been done before, but insights obtained from the comparison of learning models are necessary and useful for improving learning models. Our experimental results shed light on the deep learning-based NITLM models for building-level efficient energy management systems. Full article

The well-known inspection paradox or waiting time paradox states that, in a renewal process, the inspection interval is stochastically larger than a common interarrival time having a distribution function F, where the inspection interval is given by the particular interarrival time containing the specified time point of process inspection. The inspection paradox may also be expressed in terms of expectations, where the order is strict, in general. A renewal process can be utilized to describe the arrivals of vehicles, customers, or claims, for example. As the inspection time may also be considered a random variable T with a left-continuous distribution function G independent of the renewal process, the question arises as to whether the inspection paradox inevitably occurs in this general situation, apart from in some marginal cases with respect to F and G. For a random inspection time T, it is seen that non-trivial choices lead to non-occurrence of the paradox. In this paper, a complete characterization of the non-occurrence of the inspection paradox is given with respect to G. Several examples and related assertions are shown, including the deterministic time situation. Full article

The safety and sustainability of urban underground spaces have become crucial considerations in development projects. Seepage and cyclic loads are the principal reasons for the instability and failure of old underground space structures. This study investigates the variations in physical fields of underground spaces in cities under the coupling disturbance of seepage and cyclic loads, focusing on underground civil air defense engineering in Beijing as a case study. Different seepage conditions and the effects of seepage–cyclic load coupling were simulated using the numerical calculation software Plaxis 3D V20. The results show that change in groundwater can affect the deformation of underground space, and the severity is related to the quantity and intersection state of tunnels, the location of rivers above, and the strength of materials. The coupling effect of seepage–cyclic load on urban underground space structures is more serious than that of a single percolation. Decrease in material strength and high traffic loads are the principal reasons for the failure of underground structures. A 30% decrease in material strength causes the displacement to increase almost 1.5 times, and maximum displacement under different traffic loads can vary by 3 times. This study holds significant implications for the design, maintenance, and engineering management of underground spaces, emphasizing the importance of sustainable practices in urban development and infrastructure. Full article

This study advances the understanding of the Preferred Habitat Model’s capacity to shed light on the inter-market transfer of mean returns and the diffusion of price volatility in Pakistani investment markets. It examines the extent to which returns in one market exert a systematic influence on returns across others under the potential sway of interest rate policy shifts, USD exchange rate volatility, and domestic inflation trends. Employing a methodological arsenal that includes the GARCH process, enhanced by Dynamic Conditional Correlations (DCC), as well as the Markov Switching Model, this research assesses the propagation of mean returns and volatility across markets. The analysis uncovers significant linkages between monetary policy and stock market indices, underscoring the profound impact of monetary policy on cross-market performance transmission. These insights are pivotal for regulators overseeing the nuanced interaction between monetary policy and market performance. They are crucial for local and international investors interested in developing economies, especially in Pakistan’s markets. Full article

Rapid methods for assessing the fatigue properties of materials have been developed, among which the self-heating method stands out as particularly promising. This approach analyzes the thermal signal of the specimen when subjected to cyclic loading. In this research, the self-heating method was utilized for the first time with laser powder bed fusion (LPBF) of NiTi alloys, examining two specific loading conditions: loading ratios of 0.1 and 10. A thorough examination of the material self-heating behavior was conducted. For comparative purposes, conventional fatigue tests were also conducted, alongside interrupted fatigue tests designed to highlight the underlying mechanisms involved in high cycle fatigue and potentially self-heating behavior. The investigation revealed several key mechanisms at play, including intra-grain misorientation, the emergence and growth of persistent slip bands, and the formation of stress-induced martensite. These findings not only deepen our understanding of the fatigue behavior of LPBF NiTi alloys but also highlight the self-heating method potential as a tool for studying material fatigue. Full article

Congestion not only represents a cardinal sign of heart failure (HF) but is also now recognized as the primary cause of hospital admissions, rehospitalization, and mortality among patients with acute heart failure (AHF). Congestion can manifest through various HF phenotypes in acute settings: volume overload, volume redistribution, or both. Recognizing the congestion phenotype is paramount, as it implies different therapeutic strategies for decongestion. Among patients with AHF, achieving complete decongestion is challenging, as more than half still experience residual congestion at discharge. Residual congestion is one of the strongest predictors of future cardiovascular events and poor outcomes. Through this review, we try to provide a better understanding of the congestion phenomenon among patients with AHF by highlighting insights into the pathophysiological mechanisms behind congestion and new diagnostic and management tools to achieve and maintain efficient decongestion. Full article

In the United States, patients with chronic conditions experience disparities in health outcomes across the care continuum. Among patients with multiple sclerosis, diabetic retinopathy, and lung cancer, there is a lack of evidence summarizing interventions to improve care and decrease these disparities. The aim of this rapid literature review was to identify interventions among patients with these chronic conditions to improve health and reduce disparities in screening, diagnosis, access to treatment and specialists, adherence, and retention in care. Using structured search terms in PubMed and Web of Science, we completed a rapid review of studies published in the prior five years conducted in the United States on our subject of focus. We screened the retrieved articles for inclusion and extracted data using a standard spreadsheet. The data were synthesized across clinical conditions and summarized. Screening was the most common point in the care continuum with documented interventions. Most studies we identified addressed interventions for patients with lung cancer, with half as many studies identified for patients with diabetic retinopathy, and few studies identified for patients with multiple sclerosis. Almost two-thirds of the studies focused on patients who identify as Black, Indigenous, or people of color. Interventions with evidence evaluating implementation in multiple conditions included telemedicine, mobile clinics, and insurance subsidies, or expansion. Despite documented disparities and a focus on health equity, a paucity of evidence exists on interventions that improve health outcomes among patients who are medically underserved with multiple sclerosis, diabetic retinopathy, and lung cancer. Full article

Streptococcus suis (S. suis) is a zoonotic pathogen with a global distribution, which causes serious diseases in both humans and animals and economic losses in the swine industry. As antibiotic resistance increases, there is an urgent imperative to explore novel antibacterial alternatives. In the present study, we selected the anticancer drug 5-fluorouracil (5-FU) approved by the Food and Drug Administration (FDA) as a candidate drug to treat S. suis infections. The results showed that various pathogens, especially S. suis, are more sensitive to 5-FU. Moreover, the cytotoxicity of 5-FU is relatively low. Extensive in vitro assays demonstrated the pronounced bacteriostatic and bactericidal efficacy of 5-FU against susceptible and multidrug-resistant S. suis strains. Its mechanisms of action include damage to the bacterial cell walls and membranes, resulting in the leakage of intracellular components, and the inhibition of thymidylate synthase (TS), leading to a depletion of deoxythymidine triphosphate (dTTP) pools, ultimately causing thymine-less death and lethal DNA damage in bacteria. Gene-knockout experiments further showed that 5-FU played a role by inhibiting the thyA gene-encoding thymidine synthase. Finally, we determined that S. suis infections can be alleviated by 5-FU in the mouse infection model. This study emphasizes the antibacterial potential of 5-FU against S. suis and provides evidence for its targeting of bacterial membrane damage and DNA damage. In summary, 5-FU can control S. suis infection and is expected to become a new alternative to antibiotics. Full article

Background: Extracorporeal shock wave lithotripsy (ESWL) is a common treatment for pancreatic stones in chronic pancreatitis. In contrast, peroral pancreatoscopy-guided lithotripsy (POPS-L) remains underexplored, with limited comparative studies to ESWL. This study compared the treatment outcomes of disposable POPS-L tools and ESWL for pancreatic stones. Methods: A retrospective analysis was conducted on 66 patients who had undergone pancreatic stone treatment at three institutions between 2006 and 2022. The treatment outcomes of POPS-L and ESWL were compared. Results: This study included 19 and 47 patients who had undergone POPS-L and ESWL, respectively. In a comparison between POPS-L and ESWL, the stone clearance rates were 78.9% vs. 70.2% (p = 0.55), while the procedure-related complication rates were 21% vs. 6.3% (p = 0.09). The median total session counts were 1 vs. 5 (p < 0.01). The cumulative stone recurrence rates were comparable in both groups. Multivariate analysis revealed no significant factors influencing the stone clearance rates, and the choice between POPS-L and ESWL did not affect the stone clearance rates. Conclusions: POPS-L and ESWL exhibited comparable treatment outcomes in terms of stone clearance, complications, and recurrence rates. Furthermore, POPS-L is advantageous due to the need for fewer sessions to achieve pancreatic stone clearance. Full article

In 3D microsphere tracking, unlike in-plane motion that can be measured directly by a microscope, axial displacements are resolved by optical interference or a diffraction model. As a result, the axial results are affected by the environmental noise. The immunity to environmental noise increases with measurement accuracy and the signal-to-noise ratio (SNR). In compound digital holography microscopy (CDHM)-based measurements, precise identification of the tracking marker is critical to ensuring measurement precision. The reconstruction centering method (RCM) was proposed to suppress the drawbacks caused by installation errors and, at the same time, improve the correct identification of the tracking marker. The reconstructed center is considered to be the center of the microsphere, rather than the center of imaging in conventional digital holographic microscopy. This method was verified by simulation of rays tracing through microspheres and axial moving experiments. The axial displacements of silica microspheres with diameters of 5 μm and 10 μm were tested by CDHM in combination with the RCM. As a result, the SNR of the proposed method was improved by around 30%. In addition, the method was successfully applied to axial displacement measurements of overlapped microspheres with a resolution of 2 nm. Full article

Research into innovative techniques in food technology is developing dynamically. This is indicated by the significant increase in the number of scientific studies in this field. The aim of this work was to provide a comprehensive, in-depth analysis of the available scientific evidence on new techniques used in food that not only increase efficiency but also enable the creation of products with desirable sensory and nutritional characteristics. Research on techniques including cold plasma, high-pressure processing, ultrasound, pulsed electric fields, sous vide, and microwave heating aims to provide innovative methods of food processing, in the context of meeting growing consumer expectations and optimizing production processes in the food industry. Compared to traditional food processing methods, innovative techniques can provide more efficient solutions in the processing of products. Research on alternative non-thermal methods in food technology suggests their possible benefits, including enhancing sensory and nutritional quality, minimizing environmental impact, and increasing production efficiency, which are a significant challenge in the modern food industry. Despite the many benefits, it is worthwhile to continue research to further improve modern food technologies. Full article

The modalities of schooling and the educational measures for students with special educational needs (SENs) are postulated as important aspects within the field of study of inclusive education. The general objective of this research is to analyse the processes, through the voice of their peers, for the inclusion of students with SENs enrolled in specialised classrooms (SCs) in mainstream centres in Spain when they attend mainstream classrooms (MCs). The design of the research is mixed (QUAN-Qual), non-experimental, and descriptive. The participants in the quantitative phase were 2649 peers from MCs that have students enrolled in the SCs, and the participants in the qualitative phase were 57 students from MCs. A questionnaire designed ad hoc was used for collecting the quantitative information and discussion groups for the qualitative information. This study shows the barriers and facilitators towards the inclusion of students in the SU within mainstream centres or classrooms. Among the facilitators which stand out is the wish of classmates from mainstream classrooms to share times, spaces, and activities with their classmates with SENs from the SU. Among the barriers highlighted by a large number of students in the MCs are the fact that they do not participate in group activities with their peers with SENs and that the latter do not usually participate in common activities developed at the centre (like celebrations or excursions). Full article