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Mental health disorders such as depression and anxiety are highly prevalent among ophthalmic patients, particularly those with progressive vision impairment. Despite the strong interconnection between mental health and vision-related disabilities, mental health support remains underintegrated into ophthalmic care. The economic burden of untreated mental health conditions in visually impaired patients is understudied, particularly in middle-income countries such as Turkey and Bulgaria.
Aims
This study aims to examine the economic impact of untreated mental health disorders among ophthalmic patients, focusing on financial burden, healthcare access disparities and quality of life outcomes. In addition, the study compares barriers to mental healthcare across ophthalmic conditions and between Turkey and Bulgaria.
Method
A qualitative study was conducted using structured surveys and in-depth interviews with 214 ophthalmic patients (107 in Turkey, 107 in Bulgaria). Mental health symptoms were assessed using the Patient Health Questionnaire-9 (for depression) and Generalized Anxiety Disorder-7 (for anxiety) scales. Thematic analysis was applied to qualitative responses.
Results
Over 50% of participants exhibited moderate-to-severe depression and anxiety, with diabetic retinopathy and retinal disease patients experiencing the highest distress levels. Financial barriers were more pronounced in Bulgaria, whereas long psychiatric wait times disproportionately affected retinal patients. Mental health stigma was higher in Bulgaria, limiting care access.
Conclusions
Findings underscore the urgent need for integrating mental health services into ophthalmic care. Policy interventions should focus on financial support, stigma reduction and improved interdisciplinary care models to enhance mental health outcomes for visually impaired individuals.
According to what I call the Probabilistic View, absence of evidence is evidence of absence when finding evidence is highly expected. However, this view fails to make sense of the practice of using absence of evidence in the paleosciences, where finding evidence is typically not highly expected. Using a case from paleogeology, I offer a novel account of when absence of evidence should be evidence of absence, which I call the Pragmatic View: Appeals to absence of evidence as evidence of absence are warranted because they offer a scaffold to investigate auxiliary hypotheses related to the hypothesis in question.
This study presents the design and evaluation of an autonomous landing system for rotary-wing unmanned aerial vehicles (UAVs) targeting moving platforms. The proposed system leverages the UAV’s onboard positional data and the moving platform’s position, velocity and orientation information to execute high-precision landings. By incorporating the GPS coordinates provided by the mobile platform, the operational envelope of the landing procedure is significantly extended. A Kalman filter is employed to fuse the platform’s GPS data with the UAV’s inertial orientation measurements, enabling accurate estimation of a dynamic rendezvous point along the platform’s trajectory. This facilitates the generation of an optimised landing trajectory that minimises path length and enhances energy efficiency.
A YOLOv8-based object detection model is integrated into the system to detect the landing pad in real time. The effectiveness of the proposed method is validated through scenario-based simulations designed to evaluate landing performance under variable altitudes, crosswind disturbances and limited visibility due to fog.
Across 30 independent runs, the proposed method reduced total autonomous landing time by 12% (191 ± 2.0 s → 168 ± 1.6 s, p < 0.001), halved the landing phase (22.9 ± 0.7 s → 11.1 ± 0.7 s), shortened the path by ≍152 m (2035 ± 6.8 m → 1883 ± 3.1 m), and lowered battery consumption from 5.0 ± 0.1% to 4.0 ± 0.1%. The system maintained successful landings under variable wind (up to 6 m/s) and fog with a 7 m detection range, achieving sub-meter touchdown accuracy (RMSE ≍ 0.15 m); at a 5 m detection limit, landings failed, indicating a robustness boundary.
Compared to existing literature, the developed system introduces a novel 3D trajectory planning approach involving altitude variations and dynamic target prediction. The framework is modular and compatible with various UAV and ground vehicle platforms, making it suitable for diverse mission profiles in both civilian and defense applications.
This paper presents the design and analysis of the Triple band Circular Quarter Mode Substrate Integrated Waveguide (QMSIW) 1 × 2 MIMO antenna for sub-6 GHz 5 G wireless applications. The antenna operates at three distinct frequencies those are 3.57GHz, 4.41GHz and 5.43 GHz respectively. The 3.57 GHz used to operate for WiMAX, 5 G, and Fixed Wireless Access, the 4.41 GHz, is often used for specific satellite uplink/downlink operations, Radar Systems and the third one 5.43 GHz is used for Wi-Fi, DSRC, and WLAN systems. The proposed architectural design underwent simulation utilizing electromagnetic (EM) tools to the extract results, followed by antenna fabrication and measured results, it was observed that there is a close match between the simulation, measured results and validated results. The measured, simulation gain values are 5.092dBi,4.98dBi at 3.57 GHz, 4.51dBi,4.6dBi at 4.41 GHz and 3.075dBi,3.06dBi at 5.43 GHz frequency, while also demonstrating satisfactory isolation between the ports, quantified as being less than −15 dB. The characteristic parameters of the MIMO antenna, including a diversity-gain (DG) surpassing 9.95 dB (>9.95 dB), alongside an envelope-correlation-coefficient (ECC) of less than 0.0001, Mean effective gain (MEG) lies between − 3 dB to − 4 dB, among any two radiating elements at every operational frequency, indicate that the antenna has been meticulously designed.
Although it is far from uncharted territory, some contemporary thinkers have been pushing the idea that imagination plays a central role in perception; specifically, as that which explains the phenomenon of perceptual presence. I agree with this general idea. However, there is a tendency among thinkers to place the vague notion of mental imagery at the core of their understanding of what it is to imagine; and attempts to explain perceptual presence in imagistic terms are incompatible with the phenomenology. I will consider another view that attempts to explain perceptual presence in terms of our possession of a form of implicit bodily knowledge of the ways one can access the world. Although it does not encounter the same issues as the imagery view, I will argue that there is much more to the phenomenon of presence than can be accounted for on the access view. I will propose an alternative that can be attributed to Merleau-Ponty. This alternative involves both appeal to a form of bodily knowledge and an imaginative capacity for entertaining the possibility of being situated otherwise; that, when exercised, gives rise to the presence of objects in experience as the objects that they are.
This study aimed to develop a disaster triage training program designed to enhance knowledge, skills, and resilience for disasters among nurses.
Method
A randomized controlled trial was conducted at two government hospitals in Indonesia. One hundred and eight nurses were randomly assigned in equal numbers to the experimental and control groups. The experimental group received a 4-hour triage training focused on mass casualty incidents. Disaster triage knowledge, skills, and resilience were assessed at three time points: before, immediately after, and 1 month following the intervention. Generalized Estimating Equations were used to evaluate the effectiveness of the training program.
Results
The results of this study revealed that nurses in the experimental group showed significantly greater improvements in disaster triage knowledge, skills, and resilience compared to those in the control group at 2 post-test time points. In addition, feedback from trained nurses emphasized its relevance to local disaster scenarios, such as earthquakes and floods, and highlighted the value of hands-on practice and easily accessible learning materials.
Conclusions
The study demonstrates that disaster triage training can effectively enhance nurses’ preparedness for disasters. It is recommended that health care institutions integrate disaster-related content into regular on-the-job training programs for nurses and assess its effectiveness.
We develop a weakly nonlinear theory to revisit the water hammer phenomenon resulting from slow valve manoeuvres. The hydraulic head at the valve is known to be nonlinearly coupled with the flow velocity via a relation derived from Bernoulli’s principle, so that solutions have been so far obtained only via numerical models. The governing equations and boundary conditions indeed yield a nonlinear boundary-value problem, which is here solved using a perturbation approach, Laplace transform and complex analysis. We obtain space- and time-dependent analytical solutions in all of the pipe and validate our results by comparison with standard numerical methods (i.e. Allievi’s method) for determining the exact behaviour of the hydraulic head at the valve. Additionally, we derive algebraic practically relevant closed form expressions for predicting the maximum and minimum hydraulic head values during both valve closure and opening manoeuvres.
An understanding of bird movement and habitat use in breeding and non-breeding areas is critical for the conservation of migratory birds. Latham’s Snipe Gallinago hardwickii breeds in Japan and Russia then migrates more than 6,000 km to its non-breeding sites in Australia. It is at risk because it favours areas under pressure from urban development. We investigated the movement patterns of Latham’s Snipe at a key non-breeding site – Jerrabomberra Wetlands, in Canberra, Australia. We tracked 32 Latham’s Snipe using GPS telemetry devices in the 2022/3 and 2023/4 seasons. The tracked birds remained at Jerrabomberra Wetlands for their non-breeding season and formed distinctive and predictable patterns of roosting and foraging. The distance range between roosting and foraging sites was similar across both the 2022/3 and 2023/4 seasons, with 75% of birds travelling less than 2.5 km and the majority of birds travelling <6 km. Approximately one third (31%) of birds travelled up to 30 km overnight before returning to the wetlands, and two birds (6%) travelled up to 140 km for up to three days. Home range sizes averaged 19 ha and did not significantly differ among individuals in either season. The relatively small size of the home ranges and short foraging trip distances suggest that conservation of non-breeding habitat in urbanised areas can be achieved through the protection of small areas, providing the habitat is suitable. However, individuals varied in their use of the broader landscape and therefore their susceptibility to threats may vary. From an urban planning perspective, habitat protection should prioritise roost sites while ensuring a diversity of foraging habitat within 6 km.
Modern monetary theory (MMT) argues that all governments that issue their own currency have the same fiscal and monetary policy space. This paper argues against this position. For MMT’s assumptions to be valid, MMT must abstract from the gravitational force of the US dollar that stems from it being backed by a mass of securities – an influence transmitted through international investment flows. Once the dollar’s gravitational force is recognised, it becomes clear that the huge size disparity separating the US financial market from those of other markets, and most notably those of the emerging market economies (EMEs), translates into an equally huge disparity regarding fiscal and monetary policy capacities. The strategic implications of recognising this disparity are that EME governments should, where possible, join their financial markets into regional blocs of sufficient size to give their regional currencies enough backing mass to allow them to resist the gravitational pull of the dollar. Only by pooling their currency sovereignty can EME governments retain some scope for pursuing macroeconomic policies independently of those pursued by the US government. Without doing so, if EME governments in countries with small financial markets follow MMT’s advice to retain their local currencies, this will condemn these currencies to entrapment in the dollar’s gravitational field and possibly outright dollar colonisation.
To co-design a systems approach aimed at promoting wide scale adoption of whole-school approaches to food in UK primary schools to improve school food environments, food provision and dietary intake in children.
Design:
A systems framework (Action Scales Model) was used to guide the co-design of the systems approach. The process involved identifying leverage points within the UK primary school food system that, if influenced, could alter the way in which the system functions. Actions were then agreed upon to influence those leverage points.
Setting:
Co-design workshops were held online between September 2021 and February 2022.
Participants:
Members of the co-design team comprised 12 school stakeholders (headteachers, school food improvement officers, catering leads, representatives of UK school food organisations, and a dietician) and a team of researchers with expertise in school food, systems thinking and intervention development. Our partnership board included decision makers and advocates of the whole-school approach to food in England and Northern Ireland.
Results:
Identified leverage points included the priorities of headteachers, who are instrumental in instigating whole-school approach to food adoption. Direction from local and national policy makers was also identified. Actions to influence these leverage points included providing direct support to schools (through an online resource) and encouraging policy makers to monitor adoption of the approach.
Conclusion:
The methods described here can be replicated by others to promote adoption of whole-school approaches to food in other contexts and contribute to the growing literature on developing systems wide approaches to promote adoption of public health initiatives.
Traditional diets are culturally accepted and adapted to local environments, but globalisation has shifted towards unhealthy, unsustainable eating habits. This study aims to assess the literature on the effects of traditional, place-based diets on health and sustainability and examines the suitability of common tools used to evaluate them.
Design:
A systematic search was conducted using the PRISMA 2020 guidelines across seven databases (CINAHL, Cochrane Library, MEDLINE, Scopus, Web of Science, PubMed and Google Scholar), and the protocol was registered with PROSPERO (CRD42023445750). The inclusion criteria were traditional place-based diets, studies examining the nutritional, health benefits and sustainability impacts of traditional food consumption, published in English, with no date restriction.
Results:
Eleven studies from Spain, Romania, Portugal, Mexico, Chile, Japan, Uganda and India met the criteria. Assessment tools included carbon footprints (via LCA), nitrogen footprints, NRF9.3, Nutri-Score and EAT-Lancet; some incorporated qualitative methods. Mediterranean, Atlantic and Japanese diets aligned well with health and sustainability, whereas meat-heavy or nutrient-deficient patterns raised concerns. Most studies relied on standardised tools and secondary datasets, with limited use of region-specific environmental data or qualitative insights. Only one intervention study was identified.
Conclusions:
Traditional diets show promise as culturally appropriate models for sustainable and healthy eating. Current tools designed around standardised, reductionist frameworks often fail to capture the complexity of traditional food systems, including local practices, preparation methods and cultural meaning. To better assess traditional diets, future research should develop regionally adapted indicators and integrate quantitative measures with qualitative insights from local communities.
Research on the effects of textually enhanced (TE) subtitles on vocabulary acquisition through audiovisual input has yielded mixed results, primarily focusing on short viewing interventions. This study investigates the impact of TE on vocabulary meaning recall among 22 international students with limited knowledge of L3 Dutch. Participants watched an entire season of a comedy TV series in L2 English, accompanied by L3 Dutch subtitles as it would be broadcast on television. Using a within-subjects design, we assessed learning outcomes for 16 enhanced target words, 16 unenhanced target words, and 16 filler words absent from the subtitles. Two eye-tracking sessions were employed to measure participants’ attention to both enhanced and unenhanced target words during the first and last episodes, addressing the limitations of previous studies that only included a single eye-tracking session and could not capture shifts in processing at pre- and posttest. The findings reveal that TE significantly increases fixations on enhanced words compared to unenhanced ones, with this difference remaining significant over the duration of the intervention, resulting in greater learning gains. Overall, the results highlight the potential of TE to facilitate vocabulary acquisition through subtitled audiovisual input.
Sitotroga cerealella (Olivier) (Lepidoptera: Gelechiidae) is one of the most serious pests of rice. The variations in phytoconstituents of rice cultivars (Miniket, Cottondora Sannalu, Gobindobhog, Swarna, and Tulaipanji) that led to differences in population growth of S. cerealella were studied. Fitness of the moth was approximated in terms of mean generation time (Tc), net reproductive rate (NRR or R0), intrinsic rate of population increase (rm), etc. Considering potential fecundity (Pf), growth rates, mortality coefficient (MC), and expected population size in the second generation (PF2), we classified the susceptibility of the rice cultivars to S. cerealella in the order as M > C > G > S > T. This was despite the higher concentrations of all the tested primary metabolites (PMs) in C and T. The least susceptibility of T and lower susceptibility of C than M can be attributed to their higher levels of secondary metabolites (SMs). M was highly susceptible due to its lowest SM content and sufficient levels of PMs. Now, G and S contained lower amounts of SMs, but they were moderately susceptible owing to the lower PM content. This emphasises the role of SMs, such as phenols, flavonoids, tannins, saponins, alkaloids, phytates, and oxalates, in determining the susceptibility of crop cultivars. Although none of the rice cultivars were entirely resistant, it can be stated that Miniket requires more protection measures against S. cerealella during storage than the others.