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Real users are expected to have 2-3× the nicotine dose measured at 1100 mL/min, which could confound epidemiological studies seeking to link nicotine delivery to product satisfaction and acceptability.Order increases, supply chain disruptions, changing customer behavior, store closures, and more that have been caused by the coronavirus epidemic (COVID-19) will undoubtedly affect the online commerce forms of business. The coronavirus pandemic has a significant impact on digitalization and customer experience and well-being in mobile commerce. Since the beginning of the coronavirus pandemic, online sales and the number of online shoppers using wireless internet-enabled devices have increased tremendously. The article develops, an experimental study that captures COVID-19 and digital commerce's impact in terms of customers' experience and well-being during the pandemic period. The study explores the synergy between technology evolution and the effects of the COVID-19 pandemic on customers' behavior based on survey data collection and the technology acceptance model (TAM). The results reveal that, for millennials, digital commerce seems to be the typical way of shopping and paying in the pandemic period since the oldest generations adopted in a smaller proportion the use of mobile devices for shopping and payments. Besides, retailers are confronted with great challenges raised by millennials' expectations. The result confirms four of the six hypotheses based on the technology acceptance model (TAM). As a result, it shows that the easiness of use, trust, mobility, and customer involvement influences the behavioral intention of the customer to use mobile commerce, and that usefulness and customization does not influence the behavioral intention.The aim of this follow-up study was to examine the predictive values of caregivers' affiliate stigma at baseline for depression in caregivers and internalizing and externalizing symptoms in children with attention-deficit/hyperactivity disorder (ADHD) 1 year later. The Study on Affiliate Stigma in Caregivers of Children with ADHD surveyed the levels of affiliate stigma and depression in 400 caregivers and the behavioral problems of their children with ADHD. The levels of the caregivers' depression and children's behavioral problems were assessed 1 year later. The associations of caregivers' affiliate stigma at baseline with depression in caregivers and internalizing and externalizing symptoms in children with ADHD at follow-up were examined using stepwise multiple regression. The results indicated that before caregivers' depression and children's behavioral problems at baseline were controlled, caregivers' affiliate stigma at baseline positively predicted caregivers' depression and all children's behavioral problems. After caregivers' depression and children's behavioral problems at baseline were controlled, caregivers' affiliate stigma at baseline still positively predicted children's affective and somatic problems. Parenting training and cognitive behavioral therapy should be provided to caregivers with intense affiliate stigma to prevent emotional problems and difficulties in managing their children's behavioral problems.Much of the literature on hospitalizations post-September 11, 2001 (9/11) focuses on adults but little is known about post-9/11 hospitalizations among children. Data for World Trade Center Health Registry enrollees who were under 18-years old on 9/11 were linked to New York State hospitalization data to identify hospitalizations from enrollment (2003-2004) to December 31, 2016. learn more Logistic regression was used to analyze factors associated with hospitalization. link2 Of the 3151 enrollees under age 18 on 9/11, 243 (7.7%) had at least one 9/11-related physical health hospitalization and 279 (8.9%) had at least one 9/11-related mental health hospitalization. Individuals of non-White race, those living in New York City Housing Authority housing, those exposed to the dust cloud on 9/11, and those with probable 9/11-related PTSD symptoms were more likely to be hospitalized for a 9/11-related physical health condition. Older age and having probable 9/11-related PTSD symptoms at baseline were associated with being hospitalized for a 9/11-related mental health condition. Dust cloud exposure on 9/11 and PTSD symptoms were associated with hospitalizations among those exposed to 9/11 as children. Racial minorities and children living in public housing were at greater risk of hospitalization. Continued monitoring of this population and understanding the interplay of socioeconomic factors and disaster exposure will be important to understanding the long-term effects of 9/11.Forests are critical ecosystems for environmental regulation and ecological security maintenance, especially at high altitudes that exhibit sensitivity to climate change and human activities. The Qinghai-Tibet Plateau-the world's largest water tower region-has been breeding many large rivers in Asia where forests play important roles in water regulation and water quality improvement. However, the vulnerability of these forest ecosystems at the regional scale is still largely unknown. Therefore, the aim of this research is to quantitatively assess the temporal-spatial variability of forest vulnerability on the Qinghai-Tibet Plateau to illustrate the capacity of forests to withstand disturbances. Geographic information system (GIS) and the spatial principal component analysis (SPCA) were used to develop a forest vulnerable index (FVI) to assess the vulnerability of forest ecosystems. This research incorporates 15 factors covering the natural context, environmental disturbances, and socioeconomic impact. Results indicate that the measure of vulnerability was unevenly distributed spatially across the study area, and the whole trend has intensified since 2000. The three factors that contribute the most to the vulnerability of natural contexts, environmental disturbances, and human impacts are slope aspect, landslides, and the distance to the farmland, respectively. The vulnerability is higher in forest areas with lower altitudes, steeper slopes, and southerly directions. These evaluation results can be helpful for forest management in high altitude water tower regions in the forms of forest conservation or restoration planning and implementation towards sustainable development goals.Alcohol consumption is a major public health problem facing universities. The objectives of the present study were to investigate alcohol consumption and the behaviors associated with it among Romanian university medical students, with particular reference to sex differences, behavioral consequences, and lifestyle patterns. We performed a cross-sectional study on 722 medical students (60.4% females; 39.6% males); the participants filled out a validated questionnaire containing the following items co-occurring with alcohol consumption smoking, illicit drug use, energy drink consumption, and other behavioral drinking consequences. Physical activity was estimated using the IPAQ questionnaire. We statistically analyzed the interrelation between alcohol consumption and target factors. The present study showed a high percentage of at-risk drinkers among male (15.0%) and female medical students (14.9%) in the studied group. Male students reported higher illicit drug use and physical activity than female students, but the at-risk female drinkers' group consumed more drugs than the low-risk female drinkers. Both male and female drinkers engaged in other risky behaviors correlated with drinking (e.g., smoking, low academic performance, and driving a car after drinking). Public health policies, strategies, and interventions should be initiated to reduce alcohol consumption and associated behaviors in medical students.Investigating causation is a primary goal in forensic/legal medicine, aiming to establish the connection between an unlawful/negligent act and an adverse outcome. In malpractice litigation involving a healthcare-associated infection due to a failure of infection prevention and control practices, the medicolegal causal analysis needs to quantify the individual causal probabilities to meet the evidentiary requirements of the court. In this paper, we present the investigation of the most probable cause of bacterial endocarditis in a patient who underwent an invasive procedure at a dental/oral surgical practice where an outbreak of bacterial endocarditis had already been identified by the state Department of Health. We assessed the probability that the patient's endocarditis was part of the outbreak versus that it was an unrelated sporadic infection using the INFERENCE (Integration of Forensic Epidemiology and the Rigorous Evaluation of Causation Elements) approach to medicolegal causation analysis. This paper describes the step-by-step application of the INFERENCE approach to demonstrate its utility in quantifying the probability of causation. The use of INFERENCE provides the court with an evidence-based, transparent, and reliable guide to determine liability, causation, and damages.

can be isolated from stool in 3% of healthy adults and in at least 10% of asymptomatic hospitalized patients.

, the most common cause of hospital-acquired infectious diarrhea in the developed world, has re-emerged in recent years with increasing incidence and severity. In an effort to reduce the spread of the pathogen, published recommendations suggest isolation and contact precautions for patients suffering from

infection (CDI). However, asymptomatic colonized patients are not targeted by infection control policies, and active surveillance for colonization is not routinely performed. Moreover, given the current changes in the epidemiology of CDI, particularly the emergence of new virulent strains either in the hospital or community settings, there is a need for identification of factors associated with colonization by

and CDI. Methods and analysis We are carrying out a prospective, observational, cohort study in Edouard Herriot Hospital, Hospices Civils de Lyon, a 900-bed university hospital in Lyital institutional review board (Comité de protection des personnes et Comission Nationale de l'Informatique et des Libertés; N° 00009118). Dissemination The results of this study will be disseminated by presenting the findings locally at each participating ward, as well as national and international scientific meetings. Findings will be shared with interested national societies crafting guidelines in CDI.(1) Background Considerable prevalence in Poland and serious health consequences of prenatal alcohol exposure indicated the need to develop national guidelines for the diagnosis of fetal alcohol spectrum disorders (FASDs). link3 It was assumed that the guidelines must be in line with international standards but adjusted to the Polish context. (2) Methods Work on recommendations was carried out by an interdisciplinary team of Polish specialists. Its first stage was to assess the usefulness in our country of the U.S. and Canadian guidelines. In the second stage, after several rounds of discussions, a consensus was achieved. (3) Results The Polish guidelines for diagnosing FASD cover the following issues 1. distinguished diagnostic categories; 2. diagnostic procedure; 3. assessment of prenatal exposure to alcohol; 4. assessment of sentinel facial dysmorphias; 5. assessment of body weight, height, and head circumference; 6. neurodevelopmental assessment. An important element of the recommendation is appendices containing practical tools that are useful in the diagnostic procedure.