Low back pain (LBP) is a common complaint among individuals engaged in physically demanding occupations, such as construction workers, luggage lifters, manual laborers, and drivers. One of the main problems facing modern healthcare is treating these people. The identification of distinct patient subgroups with non-specific LBP and the development of specialized, more effective therapies are of crucial significance to enhancing evaluation and treatment regimens. This case report describes the evaluation and management of non-specific LBP in a male construction worker who complained of severe low back discomfort. Enhancing the muscular endurance, strength, and flexibility of the back muscles and soft tissues is the main goal of exercise therapy, which is the key to the management of nonspecific LBP. This patient receives a four-week treatment regimen that includes movement control exercises and several advanced therapeutic modalities. The direction of movement control ensures the way patients sit when their back muscles contract. Back muscle activation rates are greater in the active extension group and lower in the flexion group. A comprehensive rehabilitation program that was effective for our patient, who was experiencing lower back discomfort. We assessed the efficacy of our outcome measures using a variety of outcomes, including the modified Oswestry disability index, visual analog scale, range of motion, Quebec back pain disability scale, and pressure biofeedback unit for muscle strength. In addition to a standard physiotherapy course, providing modern physiotherapeutic treatments was found to be more beneficial for enhancing the patient\'s overall health and quality of life.

The objective of microgrid operation is to supply the energy demanded by the loads at minimum cost. To achieve this goal, new tools are being proposed in the literature, such as the use of optimal schedulers in the field of multi-vector management systems. An optimal scheduler provides the hourly schedule of the flexible loads that exist in a microgrid to maximize the use of local renewable resources. This work aims to investigate the application in the context of five optimization algorithms in terms of energy and computation costs and to demonstrate how optimal schedulers can contribute significantly to reducing energy operating costs in new and real microgrid scenarios. The analysis of the algorithms is carried out through an experimental process on the existing installations at Port of Borg (Norway), which contains photovoltaic production and different types of flexible assets, such as cranes, electric vehicle charging stations, and electrical storage. Real data gathered at the port\'s premises is used to assess the energy cost reduction when the optimal scheduler is part of the energy management system, and the computations are performed in real time to apply the proposed schedule to the pilot. The results show how the use of optimal schedulers can reduce operation costs up to 17.2%, augmenting local energy production utilization, and that using two OS algorithms in cascade can also reduce the computation time.

Small angle neutron scattering is a powerful complementary technique in structural biology. It generally requires, or benefits from, deuteration to achieve its unique potentials. Molecular deuteration has become a mature expertise, with deuteration facilities located worldwide to support access to the technique for a wide breadth of structural biology and life sciences. The sorts of problems well answered by small angle scattering and deuteration involve large (>10Å) scale flexible movements, and this approach is best used where high-resolution methods (crystallography, NMR, cryo-EM) leave questions unanswered. This chapter introduces deuteration, reviewing biological deuteration of proteins, lipids and sterols, and then steps through the ever-expanding range of deuterated molecules being produced by chemical synthesis and enabling sophisticated experiments using physiologically relevant lipids. Case studies of recent successful use of deuteration may provide illustrative examples for strategies for future experiments. We discuss issues of nomenclature for synthesised molecules of novel labeling and make recommendations for their naming. We reflect on our experiences, with cost associated with achieving an arbitrary deuteration level, and on the benefits of experimental co-design by user scientist, deuteration scientist, and neutron scattering scientist working together. Although methods for biological and chemical deuteration are published in the public domain, we recommend that the best method to deuterate is to engage with a deuteration facility.

The management of anorexia nervosa (AN) remains complex with insufficient success rates. Based on clinical and empirical observations implicating neuropsychological difficulties in AN, cognitive remediation (CR) therapy appears to show positive effects. Nevertheless, these results remain subject to debate as some studies do not show this improvement, or in the case of positive improvements, a smaller effect size on cognitive performance. A possible explanation could lie in the cognitive tests used to assess CR. The aim of this study is to propose a new protocol for the evaluation of cognitive remediation for patients suffering from ED through the presentation of a case study.

OBJECTIVE: Flexibility is essential for healthcare organizations to anticipate the increasing internal and external dynamics. Mental healthcare organizations in the Netherlands face major policy reforms made by the government, increasing involvement from municipalities and gradual replacement of clinical care with outpatient care. Top management plays an important strategic role in creating this flexibility because they make important choices, give direction and structure the organization. To create flexibility, managers have to deal with complexity and paradoxes. In this study, the authors aim to contribute to the knowledge on how healthcare managers can create flexibility in their organizations.
METHODS: This is a qualitative empirical field study. In total, 21 managers of mental healthcare organizations participated in open in-depth interviews. The authors explored flexibility on three perspectives: organizational direction, structure and operations. The COVID-19 pandemic has provided an opportunity to explore flexibility. The authors asked participants to reflect on their organization\'s response to the pandemic.
RESULTS: Most mental healthcare organizations create flexibility in an implicit way. Flexibility and resilience are closely linked mechanisms. Flexibility ensures a quick response while resilience provides the counterforce and rebound needed to adapt. Adaption ensures that healthcare professionals learn from their experiences and do not return completely to the way things were done before. The primary urge to survive ensured rapid and adequate responses to the COVID-19 pandemic. Whether this is a manifestation of flexibility remains difficult to conclude.
CONCLUSIONS: The complexity theory offers some guidance in creating a flexible organization without losing consistency. Flexibility and resilience are closely linked mechanisms that antagonize and protect each other. With this insight, managers in mental healthcare can utilize the qualities and balance them without falling into the various pitfalls.
CONCLUSIONS: In this research, the authors are concerned with flexibility as a proactive attitude and capacity of organizations. By looking at the response of organizations to the COVID-19 crisis, the authors find out that responding to a disaster out of survival instinct is something else than flexibility. There is an interesting relationship between flexibility, resilience and adaptability, and they can balance each other.

Control of preventive chemotherapy-targeted neglected tropical diseases (PC-NTDs) relies on strengthened health systems. Efficient health information systems provide an impetus to achieving the sustainable development goal aimed at ending PC-NTD epidemics. However, there is limited assessment of surveillance system functions linked to PC-NTDs and hinged on optimum performance of surveillance system attributes. The study aimed to evaluate surveillance system attributes based on healthcare workers\' perceptions in relation to PC-NTDs endemic in Kenya.
A cross-sectional health facility survey was used to purposively sample respondents involved in disease surveillance activities. Consenting respondents completed a self-administered questionnaire that assessed their perceptions on surveillance system attributes on a five-point likert scale. Frequency distributions for each point in the likert scale were analysed to determine health workers\' overall perceptions. Data was analysed using descriptive statistics and estimated median values with corresponding interquartile ranges used to summarise reporting rates. Factor analysis identified variables measuring specific latent attributes. Pearson\'s chi-square and Fisher\'s exact tests examined associations between categorical variables. Thematic analysis was performed for questionnaire open-ended responses.
Most (88%) respondents worked in public health facilities with 71% stationed in second-tier facilities. Regarding PC-NTDs, respondents perceived the surveillance system to be simple (55%), acceptable (50%), stable (41%), flexible (41%), useful (51%) and to provide quality data (25%). Facility locality, facility type, respondents\' education level and years of work experience were associated with perceived opinion on acceptability (p = 0.046; p = 0.049; p = 0.032 and p = 0.032) and stability (p = 0.030; p = 0.022; p = 0.015 and p = 0.024) respectively. Median monthly reporting timeliness and completeness rates for facilities were 75 (58.3, 83.3) and 83.3 (58.3, 100) respectively. Higher-level facilities met reporting timeliness (p < 0.001) and completeness (p < 0.001) thresholds compared to lower-level facilities.
Health personnel had lower perceptions on the stability, flexibility and data quality of the surveillance system considering PC-NTDs. Reporting timeliness and completeness rates decreased in 2017 compared to previous surveillance periods. Strengthening all surveillance functions would influence health workers\' perceptions and improve surveillance system overall performance with regard to PC-NTDs.

Prey morphology and size are known to influence a predator\'s decision to attack and consume particular prey; however, studies that evaluate both traits simultaneously are uncommon. Here, we first described the trophic niche in the mygalomorph spider Paratropis sp. These spiders have a narrow trophic niche and feed mainly on sympatric species such as larvae of lepidopterans and of beetles such as carabids, passalids and scarabeids. Second, we evaluated the effect of prey taxon and size on acceptance and immobilization duration, and built an ethogram of the predator\'s behaviors. For each prey taxa, we offered large (approximately same size than the spider) and small larvae (approximately half of the size of the spider) of the aforementioned prey. We classified carabid beetle larvae as the most dangerous prey because of their sharp mandibles and predatory habits, followed by scarabeid larvae; lepidopteran and passalids larvae were considered to be non-dangerous prey. We did not find a significant effect of prey taxon or size on spiders\' acceptance. Prey size did not affect the time invested on each behavioral category, but prey taxon did. Moreover, although spiders used a similar strategy for capturing prey, they spent more time biting carabid larvae than other prey. Our results suggest that, at least in our study area, prey that are dangerous or the predator\'s size do not seem to affect Paratropis sp. acceptance per se, but can cause the predator to change the time budget allocated to each behavior.

The aim of this present study is to investigate the influence of three learning contexts on the development of motor creativity of young footballers (8-9 years old). In team sport, creativity is a fundamental issue because it allows players to adapt in an environment of high social uncertainty. To carry out this work, we suggest a method for assessing motor creativity into ecological situations based on the analysis of praxical communications. Creativity originates from an interaction between divergence and convergence. In our case, the number of communications (fluidity) and the diversity of updated communications (flexibility) are our divergence indicators. Convergence, understood as the ability to make good decisions, is assessed by two expert judges (R > 0.90). Sixty boys\' football players (M = 8.67; SD = 0.3) coming from three football clubs participated in this research. The study lasted 2 years. Each year, a team of 10 players from each club participated in the research twice a week for 32 weeks (8 months), these groups attended different training sessions: (a) the control group (n = 20) followed a classical learning; (b) the decoding group (n = 20) attended training focused on learning the praxemes of football; (c) the traditional sporting games group (n = 20) followed a training session that was jointly focused on praxemes and the practice of traditional sporting games. The motor creativity of players and groups was assessed both at the beginning and at the end of the year during football matches. Compared to the control group, in the post-test, the group with the highest fluidity is the decoding group (p < 0.001) and the one with the highest fluidity is the traditional sporting games group. The latter group is also the one with the best convergence (p < 0.001). The results showed that traditional games can help develop players\' creative abilities. This research invites us to investigate the complementarity between the different offered training.

With the Industry 4.0 paradigm comes the convergence of the Internet Technologies and Operational Technologies, and concepts, such as Industrial Internet of Things (IIoT), cloud manufacturing, Cyber-Physical Systems (CPS), and so on. These concepts bring industries into the big data era and allow for them to have access to potentially useful information in order to optimise the Overall Equipment Effectiveness (OEE); however, most European industries still rely on the Computer-Integrated Manufacturing (CIM) model, where the production systems run as independent systems (i.e., without any communication with the upper levels). Those production systems are controlled by a Programmable Logic Controller, in which a static and rigid program is implemented. This program is static and rigid in a sense that the programmed routines cannot evolve over the time unless a human modifies it. However, to go further in terms of flexibility, we are convinced that it requires moving away from the aforementioned old-fashioned and rigid automation to a ML-based automation, i.e., where the control itself is based on the decisions that were taken by ML algorithms. In order to verify this, we applied a time series classification method on a scale model of a factory using real industrial controllers, and widened the variety of parts the production line has to treat. This study shows that satisfactory results can be obtained only at the expense of the human expertise (i.e., in the industrial process and in the ML process).

OBJECTIVE: Study whether male adult judokas with and without low back pain (LBP) have different hip-spine flexibility.
METHODS: Cross-sectional.
METHODS: Judo training centres.
METHODS: Judokas with (n = 29) and without (n = 33) LBP.
METHODS: Range of motion (ROM) (passive and active rotations) of hips, lumbar spine (flexion-extension) and fingertip-to-floor distance (FTFD).
RESULTS: The non-dominant hips of judokas with LBP had 6.8 ± 1.2° (ES:1.45, p < 0.001) lower passive and 8.0 ± 1.3° (ES:1.55, p < 0.001) lower active internal rotation. Dominant hips of judokas with LBP had 5.1 ± 1.6° (ES: 0.81, p = 0.002) lower active internal rotation and 8.8 ± 2.9° (ES:0.79, p = 0.003) lower active total rotation. The LBP group showed 8.0 ± 2.8° (ES: 0.73, p = 0.006) lower flexion and 6.0 ± 2.2° (ES: 0.69, p = 0.009) lower extension of the lumbar spine. The FTFD in the LBP group was 7.3 ± 2.6 cm (ES: 0.72, p = 0.007) lower. The multi-level regression analyses showed passive (OR 1.54, 95%CI 1.18-2.00, p = 0.001) and active (OR 1.47, 95%CI 1.16-1.87, p = 0.001) hip internal rotation of the non-dominant leg and lumbar spinal flexion (OR 1.11, 95%CI 1.03-1.20, p = 0.006) and extension (OR 1.16, 95%CI 1.01-1.33, p = 0.035) were related to LBP.
CONCLUSIONS: Lower hip internal rotation of the non-dominant leg (passive and active) and lower lumbar flexibility are significantly related to LBP in male adult judokas.