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Purpose – Stakeholder satisfaction relates closely to service quality and performance of educational organizations. Often, this relationship is addressed in literature through the lens of excellence models, such as the European Foundation for Quality Management (EFQM) model. Nevertheless, limited studies focus on the effect of the EFQM model enablers on stakeholder satisfaction and hardly any in vocational education. To fill this void, the aim of this paper is to investigate the relationship between EFQM enablers (leadership, human resources, processes) and stakeholder satisfaction under the different perspectives of teachers and students in Greek public vocational education. Design/methodology/approach – To address the research purpose, the authors used the case study methodology. The authors used mixed research methods, the focus group method and survey. Specifically, the focus group method used to distill the EFQM enablers related to the Greek context and to develop a questionnaire administered to teachers and students of a vocational education school. From September 2021 to June 2022, 90 teachers and 216 students participated in the survey. Findings – The partial least squares structural equation modeling (PLS-SEM) method was used for data analysis, indicating that leadership and human resources have a positive and significant relationship with the satisfaction of both students and teachers. However, results did not corroborate the relationship between processes and stakeholder satisfaction either from the student’s or the teacher’s perspective. Originality/value – This paper fills a gap in existing literature by exploring the impact of EFQM enablers on stakeholder satisfaction in vocational education and training (VET), from the perspectives of both teachers and students. The findings assist VET institutions in prioritizing areas for improvement and help companies to develop strategies that consider key stakeholders' needs.

Decarbonization of hard-to-abate industrial sectors, namely the extractive industries, has become an imperative, and thus, processes such as carbon capture and utilization (CCU) have been explored thoroughly and seem to be a promising solution. Carbon dioxide (CO2) catalytic hydrogenation employing green hydrogen (H2) to produce synthetic methanol (MeOH) aims to utilize industrial-captured carbon. A thermodynamic and kinetic analysis of a pilot scale methanol synthesis reactor was conducted by modeling the process using Aspen Plus V12 software. The methanol synthesis model consists mainly of a multi-tubular packed-bed reactor with a thermal oil heat recovery system, a product separator, and an internal recycle loop for optimal efficiency. The reactor has a 5 kg h−1 methanol production capacity, and its heat recovery system achieves an overall heat reduction of 64.1% and can retrieve 1.293 kWh per kg of methanol produced. The overall carbon conversion achieved is 80.6%. Valuable information concerning the design and profile of the reactor is provided in this study.

UNLABELLED: Functional enrichment is the process of identifying implicated functional terms from a given input list of genes or proteins. In this article, we present Flame (v2.0), a web tool which offers a combinatorial approach through merging and visualizing results from widely used functional enrichment applications while also allowing various flexible input options. In this version, Flame utilizes the aGOtool, g: Profiler, WebGestalt, and Enrichr pipelines and presents their outputs separately or in combination following a visual analytics approach. For intuitive representations and easier interpretation, it uses interactive plots such as parameterizable networks, heatmaps, barcharts, and scatter plots. Users can also: (i) handle multiple protein/gene lists and analyse union and intersection sets simultaneously through interactive UpSet plots, (ii) automatically extract genes and proteins from free text through text-mining and Named Entity Recognition (NER) techniques, (iii) upload single nucleotide polymorphisms (SNPs) and extract their relative genes, or (iv) analyse multiple lists of differentially expressed proteins/genes after selecting them interactively from a parameterizable volcano plot. Compared to the previous version of 197 supported organisms, Flame (v2.0) currently allows enrichment for 14 436 organisms. AVAILABILITY AND IMPLEMENTATION: Web Application: http://flame.pavlopouloslab.info. Code: https://github.com/PavlopoulosLab/Flame. Docker: https://hub.docker.com/r/pavlopouloslab/flame.

Carbon capture and utilization (CCU) has emerged in recent years as a promising decarbonization solution for hard-to-abate industries. Compared to carbon capture and storage (CCS), CCU aims not for the storage of carbon dioxide (CO2) but for its use in the production of synthetic fuels, such as synthetic methanol (MeOH). Synthetic MeOH is produced through CO2 hydrogenation, utilizing green hydrogen (H2). Efficient use of CO2 and H2 feedstocks is essential to maximize the carbon reduction potential and energy efficiency of the process. This study performed an optimization analysis on a small-scale, containerized, and portable CO2 hydrogenation unit with a 5 kg MeOH/h production capacity goal, focusing on carbon conversion efficiency (CCE), MeOH yield, H2 consumption, and MeOH purity. The analysis was conducted using Aspen Plus V12. A single-pass model was used first to evaluate an initial reactor design. The reactor was then re-designed according to the results of the gas hourly space velocity (GHSV). The model was then expanded to include a recycling loop and the final reactor design was validated, aiming to maximize overall efficiency. The effects of the operational parameters including the reactor inlet temperature, reactor pressure, thermal fluid temperature, and condensation temperature were examined. The model was then further expanded to include the MeOH distillation process, and the effect of the distillation temperature was examined. The final product of the analysis was a fully-defined and optimized unit, achieving an 87.97% CCE and an 84.99% MeOH yield, consuming 1.11 kg H2/h for the production of 5.01 kg MeOH/h of 99.86 wt% purity. This study can provide valuable information and guidelines for designing small-scale, containerized, and portable CO2 hydrogenation units, which can serve as alternative solutions to address issues of H2 production and transportation related to large-scale installations.

Objective To evaluate the possible association between thyroid function within the euthyroid range and musculoskeletal parameters as well as body composition in a sample of postmenopausal women.Methods This cross-sectional study included 96 postmenopausal women with serum thyroid-stimulating hormone (TSH) within the normal laboratory reference range. Fasting venous blood samples were obtained for biochemical/hormonal assessment. Bone status and body composition were measured using Dual Energy X-ray absorptiometry (DXA). Physical activity was quantified using the International Physical Activity Questionnaire (IPAQ) index.Results Serum TSH correlated with handgrip strength (HGS, r-coefficient = 0.233, p = .025), and total body bone mineral density (BMD) T-score values (r-coefficient = 0.321, p = .003). HGS measures were associated with BMD (r-coefficient = 0.415, p

Electric vehicles (EVs) have a growing market share in the US and several policies promote their ownership and use. EV drivers face significantly longer charging times at public charging stations, compared to internal combustion engine vehicle drivers. When charging stations are colocated with other land uses, such as shopping and recreational ones, EV drivers can plan their trips and turn their charging down time to a productive or enjoyable experience. This study examines the variety of businesses and premises located near public charging stations in Chicago, Illinois, and explores their pricing levels, which may influence the accessibility of charging stations for EV users from diverse socio-economic backgrounds. Our findings reveal that the businesses closest to charging stations predominantly include food establishments, shops, and tourism-related venues, with the majority falling into affordable pricing categories. These results suggest that public charging stations in Chicago are situated in areas with amenities that cater to a wide range of income levels, promoting equitable access to EV infrastructure. On the other hand, chargers are overwhelmingly placed in majority white neighborhoods. We highlight the importance of considering both amenities proximity and affordability in the assessment of public charging infrastructure to support a more inclusive and equitable transition to electric vehicles.

Available drugs have been used as an urgent attempt through clinical trials to minimize severe cases of hospitalizations with Coronavirus disease (COVID-19), however, there are limited data on common pharmacogenomics affecting concomitant medications response in patients with comorbidities. To identify the genomic determinants that influence COVID-19 susceptibility, we use a computational, statistical, and network biology approach to analyze relationships of ineffective concomitant medication with an adverse effect on patients. We statistically construct a pharmacogenetic/biomarker network with significant drug-gene interactions originating from gene-disease associations. Investigation of the predicted pharmacogenes encompassing the gene-disease-gene pharmacogenomics (PGx) network suggests that these genes could play a significant role in COVID-19 clinical manifestation due to their association with autoimmune, metabolic, neurological, cardiovascular, and degenerative disorders, some of which have been reported to be crucial comorbidities in a COVID-19 patient.

Critically ill neonates admitted to neonatal intensive care units require specialized pharmacological treatment due to various medical conditions. However, despite the decades of clinical use of some pharmacological agents, there are still significant knowledge gaps surrounding their everyday use. The wide variability of drugs used in neonates, and how they are used in different settings worldwide, precisely reflects this fact. A major factor contributing to this variability is the lack of adequate studies regarding the effectiveness and safety of medications administered to neonates, especially in those born preterm. This is mainly due to inherent difficulties in performing pharmacokinetic, pharmacodynamic, and clinical studies in this age group. In this review, we discuss the existing data on medications most commonly used in the respiratory and cardiovascular care of the sick neonate. Knowledge gaps and future perspectives are highlighted, as well.

The aim of this study was to evaluate the effect of starvation and refeeding on the growth and food intake of gilthead seabream (Sparus aurata) and seabass (Dicentrarchus labrax) and on the growth and nitrogen uptake of glasswort (Salicornia europaea) in a polyculture aquaponic system under 12 ppt salinity for 75 days. Nine small-scale autonomous aquaponic systems were used, each containing 10 gilthead seabreams (average weight of 6.33 ± 0.73 g and average length of 5.73 ± 0.72 cm) and 10 seabasses (5.82 ± 0.77 g and 6.35 ± 0.45 cm), as well as five glasswort plants. Three fish feeding treatments were performed, a control (A), in which fish were fed daily until satiation, and two fasting treatments for 4 (B) and 7 days (C). Fish growth performance was significantly lower (p

Glioblastoma is a highly aggressive brain tumor that has a poor prognosis despite various treatments like surgery, chemotherapy, and irradiation. However, a restricted ketogenic diet (RKD), which has been proven to be effective in treating drug-resistant epilepsy, could be a potential adjunct in the treatment of certain GBM cases. Our study aimed to highlight the existing knowledge, identify collaboration networks, and emphasize the ongoing research based on highly cited studies. During the literature search, we found 119 relevant articles written between 2010 and 2023. Among the top 20 most cited articles, there were seven laboratory and five clinical studies. The works of Olson LK, Chang HT, Schwartz KA, and Nikolai M from the Michigan State University, followed by Seyfried TN and Mukherjee P from Boston College, and Olieman JF, and Catsman-Berrevoets CE from the University Medical Center of Rotterdam, were significant contributions. The laboratory studies showed that RKD had a significant antitumor effect and could prolong survival in mouse glioblastoma models. The clinical studies verified the tolerability, efficacy, and safety of RKD in patients with GBM, but raised concerns about whether it could be used as a single therapy. The current research interest is focused on the efficacy of using RKD as an adjunct in selected chemotherapy regimens and demonstrates that it could provide GBM patients with better treatment options.

Background People who have had a stroke or a Transient Ischaemic Attack (TIA) can experience psychological and/or cognitive difficulties. The body of research for psychological and neuropsychological interventions after stroke is growing, however, published systematic reviews vary in scope and methodology, with different types and severity of strokes included, and at times, diverse conclusions drawn about the effectiveness of the interventions evaluated. In this umbrella review, we aim to systematically summarise the existing systematic reviews evaluating psychological interventions for mood and cognition post-stroke/TIA. Methods We will conduct this umbrella review according to the JBI Manual for Evidence Synthesis. The following databases will be searched from inception: Cochrane Database of Systematic Reviews, Database of Reviews of Effects (DARE), MEDLINE, Embase, CINAHL, PsycINFO, and Epistemonikos. Systematic reviews with or without meta-analysis published until the search date will be included. Reviews including psychological interventions addressing mood and/or cognition outcomes for any stroke type or severity will be screened for eligibility. A narrative synthesis, including content analysis, will be used. Each stage of the review will be processed by two independent reviewers and a third reviewer will be considered to resolve disagreements. The methodological quality of the included reviews will be assessed using AMSTAR 2. Discussion Existing systematic reviews provide varied evidence on the effectiveness of psychological interventions post-stroke/TIA. This umbrella review aims to summarise knowledge and evidence on different types of psychological and neuropsychological interventions targeting mood and cognition. Findings will highlight important knowledge gaps and help prioritise future research questions. Systematic Review Registration This protocol was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) on November 15, 2022; PROSPERO CRD42022375947.

Low-dose computed tomography is being used for lung cancer screening in high-risk groups. Detecting lung cancer at an early stage improves the chance of optimal treatment and increases overall survival. This article compares segmentectomy vs. lobectomy as surgical options, in the case of stage I non-small cell lung carcinoma, ideally IA. To compare the 2 previously referred strategies, data were collected from articles (40 studies were reviewed), reviews, and systematic analyses in PubMed Central, as well as reviewing recent literature. Segmentectomy could be an equal alternative to lobectomy in early-stage NSCLC (tumour < 2 cm). It could be preferred for patients with a low cardiopulmonary reserve, who struggle to survive a lobectomy. As far as early-stage NSCLC is concerned, anatomic segmentectomy is an acceptable procedure in a selective group of patients. For better tumour and stage classification, a systematic lymph node dissection should be performed.

Background People who have had a stroke or a Transient Ischaemic Attack (TIA) can experience psychological and/or cognitive difficulties. The body of research for psychological and neuropsychological interventions after stroke is growing, however, published systematic reviews vary in scope and methodology, with different types and severity of strokes included, and at times, diverse conclusions drawn about the effectiveness of the interventions evaluated. In this umbrella review, we aim to systematically summarise the existing systematic reviews evaluating psychological interventions for mood and cognition post-stroke/TIA. Methods We will conduct this umbrella review according to the JBI Manual for Evidence Synthesis. The following databases will be searched from inception: Cochrane Database of Systematic Reviews, Database of Reviews of Effects (DARE), MEDLINE, Embase, CINAHL, PsycINFO, and Epistemonikos. Systematic reviews with or without meta-analysis published until the search date will be included. Reviews including psychological interventions addressing mood and/or cognition outcomes for any stroke type or severity will be screened for eligibility. A narrative synthesis, including content analysis, will be used. Each stage of the review will be processed by two independent reviewers and a third reviewer will be considered to resolve disagreements. The methodological quality of the included reviews will be assessed using AMSTAR 2. Discussion Existing systematic reviews provide varied evidence on the effectiveness of psychological interventions post-stroke/TIA. This umbrella review aims to summarise knowledge and evidence on different types of psychological and neuropsychological interventions targeting mood and cognition. Findings will highlight important knowledge gaps and help prioritise future research questions. Systematic Review Registration This protocol was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) on November 15, 2022; PROSPERO CRD42022375947.

Background People who have had a stroke or a Transient Ischaemic Attack (TIA) can experience psychological and/or cognitive difficulties. The body of research for psychological and neuropsychological interventions after stroke is growing, however, published systematic reviews vary in scope and methodology, with different types and severity of strokes included, and at times, diverse conclusions drawn about the effectiveness of the interventions evaluated. In this umbrella review, we aim to systematically summarise the existing systematic reviews evaluating psychological interventions for mood and cognition post-stroke/TIA. Methods We will conduct this umbrella review according to the JBI Manual for Evidence Synthesis. The following databases will be searched from inception: Cochrane Database of Systematic Reviews, Database of Reviews of Effects (DARE), MEDLINE, Embase, CINAHL, PsycINFO, and Epistemonikos. Systematic reviews with or without meta-analysis published until the search date will be included. Reviews including psychological interventions addressing mood and/or cognition outcomes for any stroke type or severity will be screened for eligibility. A narrative synthesis, including content analysis, will be used. Each stage of the review will be processed by two independent reviewers and a third reviewer will be considered to resolve disagreements. The methodological quality of the included reviews will be assessed using AMSTAR 2. Discussion Existing systematic reviews provide varied evidence on the effectiveness of psychological interventions post-stroke/TIA. This umbrella review aims to summarise knowledge and evidence on different types of psychological and neuropsychological interventions targeting mood and cognition. Findings will highlight important knowledge gaps and help prioritise future research questions. Systematic Review Registration This protocol was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) on November 15, 2022; PROSPERO CRD42022375947.

Necrotizing enterocolitis (NEC) is the most prevalent and potentially fatal intestinal injury mainly affecting premature infants, with significant long-term consequences for those who survive. This review explores the scale of the problem, highlighting advancements in epidemiology, the understanding of pathophysiology, and improvements in the prediction and diagnosis of this complex, multifactorial, and multifaced disease. Additionally, we focus on the potential role of metabolomics in distinguishing NEC from other conditions, which could allow for an earlier and more accurate classification of intestinal injuries in infants. By integrating metabolomic data with other diagnostic approaches, it is hoped to enhance our ability to predict outcomes and tailor treatments, ultimately improving care for affected infants.

Antibiotic, analgesic sedative, and antiseizure medications are among the most commonly used medications in preterm/sick neonates, who are at high risk of nosocomial infections, central nervous system complications, and are exposed to numerous painful/stressful procedures. These severe and potentially life-threatening complications may have serious short- and long-term consequences and should be prevented and/or promptly treated. The reported variability in the medications used in neonates indicates the lack of adequate neonatal studies regarding their effectiveness and safety. Important obstacles contributing to inadequate studies in preterm/sick infants include difficulties in obtaining parental consent, physicians’ unwillingness to recruit preterm infants, the off-label use of many medications in neonates, and other scientific and ethical concerns. This review is an update on the use of antimicrobials (antifungals), analgesics (sedatives), and antiseizure medications in neonates, focusing on current evidence or knowledge gaps regarding their pharmacokinetics, indications, safety, dosage, and evidence-based guidelines for their optimal use in neonates. We also address the effects of early antibiotic use on the intestinal microbiome and its association with long-term immune-related diseases, obesity, and neurodevelopment (ND). Recommendations for empirical treatment and the emergence of pathogen resistance to antimicrobials and antifungals are also presented. Finally, future perspectives on the prevention, modification, or reversal of antibiotic resistance are discussed.

This article provides novel fundamental tools for the open-source design and documentation of benchmark network models. The procedure for model development is motivated and described in detail in all its different phases: after an initial discussion on the relevance of open-source benchmark models, particularly in the context of an interoperable power system, the general conceptual framework for model documentation, based on the holistic test description and PreCISE paradigms, is presented. Building up on this theoretical basis, the procedure for model development is structured according to a testing-oriented approach, providing clear examples on how to map and translate the proposed conceptual framework into a practical and complete model description. Finally, to demonstrate the applicability and usefulness of the proposed method, a complete example of model documentation for a developed low-voltage network is described and validated in simulation. The complete model description is publicly available online as a guide and reference for the proposed model documentation procedure.

The present article is based on a small-scale research that took place with the students in the Department of Computer Science and Biomedical Informatics in 2014 and three years later with the students of the same Department and the Department of Computer Science, as well. Students who have enrolled in the Educational science-Pedagogy module, that the Department offers, were asked if the module was beneficial in a Department purely technical (Faculty of Science) and if this theoretical module assisted them in their academic life and generally. Various views are listed reflecting students' perspective of the module Educational science-Pedagogy and come to the conclusion that we present; no module is useless.

Stevia rebaudiana Bertoni, a no-calorie natural sweetener, contains a plethora of polyphenols that exert antioxidant properties with potential medicinal significance. Due to the variety of functional groups, polyphenols exhibit varying solubility depending on the nature of the extraction solvents (water, organic, or their mixtures, defined further on as hydroalcoholic extracts). In the present study, we performed a systematic review, following PRISMA guidelines, and meta-analysis, synthesizing all available data from 45 articles encompassing 250 different studies. Our results showed that the total phenolic content (TPC) of hydroalcoholic and aqueous extracts presents higher values (64.77 and 63.73 mg GAE/g) compared to organic extracts (33.39). Total flavonoid content (TFC) was also higher in aqueous and hydroalcoholic extracts; meta-regression analysis revealed that outcomes in different measuring units (mg QE/g, mg CE/g, and mg RUE/g) do not present statistically significant differences and can be synthesized in meta-analysis. Using meta-regression analysis, we showed that outcomes from the chemical-based ABTS, FRAP, and ORAC antioxidant assays for the same extract type can be combined in meta-analysis because they do not differ statistically significantly. Meta-analysis of ABTS, FRAP, and ORAC assays outcomes revealed that the antioxidant activity profile of various extract types follows that of their phenolic and flavonoid content. Using regression meta-analysis, we also presented that outcomes from SOD, CAT, and POX enzymatic antioxidant assays are independent of the assay type (p-value = 0.905) and can be combined. Our study constitutes the first effort to quantitatively and statistically synthesize the research results of individual studies using all methods measuring the antioxidant activity of stevia leaf extracts. Our results, in light of evidence-based practice, uncover the need for a broadly accepted, unified, methodological strategy to perform antioxidant tests, and offer documentation that the use of ethanol:water 1:1 mixtures or pure water can more efficiently extract stevia antioxidant compounds.

The description of various loading types within the frame of viscoelasticity, such as creep–recovery and stress relaxation in a wide time scale, by means of the same model and similar model parameters is always an interesting topic. In the present work, a viscoelastic model that was analyzed in previous works has been utilized to describe the main standard loading types of viscoelasticity with the same set of model parameters. The relaxation function of this model includes a distribution function followed by the energy barriers that need to be overcome by the molecular domains when a stress field is applied. This distribution function attains a decisive role in the analysis and it was shown that it can be determined on the basis of the loss modulus master curve experimental results. Thereafter, requiring no additional parameters, the creep compliance, the relaxation modulus of poly-lactic acid (PLA) in a wide time scale, as well as creep–recovery at various stresses could be predicted. It was also found that by employing the distribution function associated with the PLA matrix, the creep–recovery experimental data of PLA/hybrid nanocomposites could subsequently be predicted. Therefore, the proposed analysis was shown to be a useful method to predict the material’s viscoelastic response.

The non-minimal coupling of scalar fields to gravity has been claimed to violate energy conditions, leading to exotic phenomena such as traversable wormholes, even in classical theories. In this work we adopt the view that the non-minimal coupling can be viewed as part of an effective field theory (EFT) in which the field value is controlled by the theory's cutoff. Under this assumption, the average null energy condition, whose violation is necessary to allow traversable wormholes, is obeyed both classically and in the context of quantum field theory. In addition, we establish a type of "smeared" null energy condition in the non-minimally coupled theory, showing that the null energy averaged over a region of spacetime obeys a state dependent bound, in that it depends on the allowed field range. We finally motivate our EFT assumption by considering when the gravity plus matter path integral remains semi-classically controlled.

Pain in early life may seriously impact neonatal outcomes. This study aimed to evaluate whether the perceptions of physicians working in neonatal intensive care units (NICUs) of the short-term adverse outcomes associated with neonatal pain have changed over a 20-year period. Self-administered questionnaires were distributed to 117 and 145 neonatologists, pediatricians, and fellows working in level III NICUs in 2000 (T1) and 2019 (T2), respectively. The questionnaire consisted of four domains, including the central nervous, cardiovascular, and respiratory systems, as well as “other systems” (metabolic/endocrine system, growth, and general condition), with 21 total items overall. Although the proportion of positive (correct) responses to the total and system-specific domain scores was significantly higher at T2 than T1, the knowledge of certain short-term adverse outcomes was suboptimal even at T2. Adjustment for cofactors confirmed the independent association of the survey time-point with the total and system-specific domain scores. Moreover, NICU type was an independent significant factor associated with the adjusted total and central nervous system scores, while young doctors had a better knowledge of adverse cardiovascular effects. Conclusions: The perceptions of NICU physicians concerning the short-term outcomes associated with neonatal pain have significantly improved over the past 20 years, although remaining knowledge gaps mandate ongoing efforts to achieve an improvement in neonatal care.

Anti-hypotensive treatment, which includes dopamine, dobutamine, epinephrine, norepinephrine, milrinone, vasopressin, terlipressin, levosimendan, and glucocorticoids, is a long-established intervention in neonates with arterial hypotension (AH). However, there are still gaps in knowledge and issues that need clarification. The main questions and challenges that neonatologists face relate to the reference ranges of arterial blood pressure in presumably healthy neonates in relation to gestational and postnatal age; the arterial blood pressure level that potentially affects perfusion of critical organs; the incorporation of targeted echocardiography and near-infrared spectroscopy for assessing heart function and cerebral perfusion in clinical practice; the indication, timing, and choice of medication for each individual patient; the limited randomized clinical trials in neonates with sometimes conflicting results; and the sparse data regarding the potential effect of early hypotension or anti-hypotensive medications on long-term neurodevelopment. In this review, after a short review of AH definitions used in neonates and existing data on pathophysiology of AH, we discuss currently available data on pharmacokinetic and hemodynamic effects, as well as the effectiveness and safety of anti-hypotensive medications in neonates. In addition, data on the comparisons between anti-hypotensive medications and current suggestions for the main indications of each medication are discussed.