Herdsmen's access to credit funds plays an important supporting role in promoting the modern economic development of pastoral areas and broadening the channels for herders to increase their income. This paper studies the credit behavior of herdsmen from the perspective of emotional and psychological state identification to analyze the current credit behavior of herdsmen. Firstly, the internal mechanism of herdsmen's credit and emotional and psychological identification research content are analyzed. Secondly, a scheme of emotional and psychological state identification is proposed, and a corresponding survey of herdsmen is carried out according to the scheme. Finally, the Probit and Heckman models are introduced to analyze the credit behavior of herdsmen. The results show that herdsmen with high emotional and psychological scores strongly demand credit. They are likely to have access to credit and have a high level of credit. Herdsmen with low scores of emotional and psychological characteristics have low or no apparent demand for credit, and their credit availability is also low. The herdsmen with high emotional and psychological characteristics have a 71% higher probability of generating credit demand than herdsmen with low openness. Their likelihood of obtaining credit is also 33.47% higher than herdsmen with low emotional and psychological characteristics. They also have easy access to higher loan amounts. The results provide a reference for related research and analysis of herdsman's credit behavior and economic development. Credit is an important policy tool for addressing poverty in pastoral areas. It has played an important role in developing “agriculture, rural areas, and farmers” for a long time. The “separation of rural land ownership, contract rights, and management rights” and “socialized services” have been continuously promoted. Land and labor constraints are eased through the transformation of capital factors . TherefoBesides, information science can be organically combined with the research paradigm of psychology with the rapid development of modern information science and technology such as intelligent wearable sensing technology, virtual reality technology, computer network technology, data mining technology, and artificial intelligence technology. Traditional psychometric research methods and tools can be effectively improved . IntelliResearchers have also conducted a lot of studies in the corresponding field. Pang et al.  proposedP value evaluation method of emotional and psychological state based on feature layer fusion and an emotional and psychological state recognition method based on decision layer fusion are proposed.This paper is organized as follows. Firstly, the research background and significance of this subject are introduced, and the research process and research status related to this subject are analyzed. Then, the research on the universal intelligent psychological evaluation system is carried out. The psychological assessment system and technical architecture are analyzed and designed from the overall requirements of the system. Finally, research on the method of mental state identification based on multisource information fusion is conducted. In addition, three multisource information fusion strategies for the data layer, feature layer, and decision layer fusion are comprehensively compared. Then, a The innovation and contribution are the research on the key psychometric technology of multisource information fusion based on the intersection of psychology and information science. A set of the universal intelligent psychological evaluation systems is analyzed, designed, and implemented based on the traditional psychometric research paradigm, which provides a reference for different fields and institutions to realize the intelligentization of psychometric work. Meanwhile, an emotional and psychological state recognition method based on feature layer fusion and decision layer fusion is proposed. Finally, the microhouseholds of 200 herdsmen in three autonomous banners in XX district are investigated. The influence of herdsman's credit access is analyzed using herdsman's emotional and psychological state.Studies have indicated that changes in human emotional states can cause a combination of changes in physiology, facial expressions, speech, and body posture. The signals of these changes can independently represent a particular emotional stat. The multisource information fusion calculation method for emotional and psychological recognition can fully use the complementarity and redundancy between homogeneous or heterogeneous data, thereby improving the accuracy of emotional and psychological recognition. Therefore, the psychological characteristics to be measured are thoroughly and objectively displayed. Many scholars have gradually formed a good development trend . The genFrom The data feature layer fusion is further analyzed. Feature layer fusion refers to the feature extraction of multisource signals, respectively. Then, these multimodal features are formed into a joint feature vector according to a fusion algorithm. This vector is fed into the same classifier to output the recognition result . PhysiolFrom Decision layer fusion refers to the feature extraction of multisource signals, respectively. Then, they are input into the respective classifiers to get the classification results. The classification results are fused according to specific criteria to output the final recognition result . Physioln is located on the subject's lower limb. From In Feature layer fusion and decision layer fusion strategies are widely used in practice, so an emotional and psychological state recognition method based on the fusion of these two levels is proposed here .Sufficient economic resources are the core factor for individual development and even the realization of freedom. Still, the current economic and social credit constraints are severe, which limits the herdsmen's pursuit of freedom. Therefore, enhancing credit availability for herdsmen has always been a research focus in the financial field. The government has taken a series of measures to increase the monetary supply of herdsmen to deepen the development of herdsmen's financial inclusion, such as guiding financial institutions to carry out small loan business, giving herdsmen financial services tax incentives, and relaxing the access threshold of financial institutions . HoweverFrom P value based on the fusion of the feature layer is as follows according to the questioner's choice of the answer to the test question, the expression, and the fusion characteristics of various physiological and psychological signals. N factors, the question and answer records of the subjects are obtained after the intelligent question and answer session. Lie detection is combined with facial expression recognition when the subjects answer questions. If the expression conforms to the preset, the answer to the question is recorded as valid. The answer records are calculated according to the quantitative scoring rules of the scale to which the item belongs. The fractional value of N factors is obtained, denoted as a column vector A, as shown inAssuming that the scale used in the intelligent question and answer session contains t, the facial expression and M-type physiological data of the subjects within t are collected. The original facial expression data during this period is denoted as E. The feature extraction rule f is used to extract the expression feature value for the expression image with the most significant proportion of expressions in the original data, denoted as f(E). The M-type original physiological signals are represented as B1, B2, ⋯BM. The feature extraction algorithm fi corresponding to each physiological signal is used. Feature extraction is performed on B1, B2, ⋯BM to extract the eigenvalues of M-type physiological signals. The expression and physiological signal eigenvalues are concatenated into a joint eigenvector B(2) Assuming that the period when the animation game session induces a particular emotion is P. It is obtained according to(3) The combined eigenvectors obtained from the three psychometric steps are weighted and fused to get the fusion eigenvector The evaluation method of the emotional and psychological state The emotional and psychological state recognition of facial expressions is mainly analyzed. One frame of facial expression image in each video image in the database is selected as a key frame for facial expression emotional state recognition. These samples are divided into the training, validation, and test sets. A ConvNet network is used to train a facial expression-based emotional and physiological state recognition model. xi represents the input test sample. From This paper examines the analysis of personality traits based on an emotional and psychological state recognition scheme for herdsmen's credit behavior. The specific research is based on the identification of emotional and psychological states, the behavior analysis of herdsmen's demand for formal credit, availability of formal credit, and the amount of formal credit. Among them, the credit availability of herdsmen can be investigated in two stages. The first stage is whether the herdsmen obtain loans from formal financial institutions, usually represented by a zero to one dummy variable. The second stage is the quota received by farmers, which is generally expressed as a truncation variable greater than zero. Therefore, a Probit model is first constructed to test the influence of emotional and psychological states on herdsmen's formal credit demand and whether to obtain loans. The Probit model is demonstrated asYi∗ is a dummy variable. Y1∗ = 1 means the herdsmen have formal credit needs. If it is not one, there is no formal credit need. The controls are control variables. εi is the residual term.In Equation , Yi∗ is Then, a Heckman two-stage model is constructed to examine the influence of the emotional and psychological state on herdsmen's formal credit line. The first stage is the Probit model, which describes the possibility of farmers obtaining formal credit. The second stage describes the material availability of credit, which is how much credit is available. “Have a credit rating” and “Have informal credit” are identification variables. The first-stage equation is used to calculate the Nimirs ratio. It is added to the second-stage model as a control variable. If its coefficient is significantly nonzero, the selection of the Heckman two-stage model is effective. Stratified random sampling is adopted here. The data comes from the research group's household survey of 200 farmers in three autonomous banners in XX District. The survey data is collected and organized, and the office software is used for scientific analysis and calculation of the collected data. The detailed information lays a solid foundation for the following research work. The questionnaire design adopted a multidimensional questionnaire. Each dimension contains three to six items, including one to four reverse scoring items. A total of 25 topics are designed around experience, cognition, practice, and active personality. The research is divided into two aspects. The first is the basic situation at the village level, the circulation of grasslands, and the economic environment. The second is the basic household information, pasture information, production and operation information, and credit insurance information at the household level.The reliability and validity of the questionnaire are analyzed. Reliability analysis is mainly used to measure whether the answer results of experimental samples are reliable. For example, the same object is measured multiple times. If the results of multiple measurements are close, the value of the result is considered credible. If the results of each measurement are different, the reliability is low. Validity analysis simply refers to the validity and accuracy of the questionnaire design. It is used to measure whether the design of the item is reasonable. Validity can be further divided into content validity, construct validity, and criterion validity. Content validity is usually a verbal description of the validity of the questionnaire. For example, references or authoritative sources are used to demonstrate the authority and validity of the questionnaire. Commonly used reliability coefficients include Cronbach's alpha coefficient, half coefficient, and sampling suitability measure Kaiser-Meyer-Olkin (KMO), which can be analyzed in the software Spssau. The value of the Cronbach's coefficient is 0.96 based on the reliability test of this questionnaire, and the half correlation coefficient is between 0.85 and 0.89, which shows that the reliability of the questionnaire is good. Based on the validity test, the KMO value reaches 0.92, indicating that the validity of the questionnaire is good.The sampling method of the survey is stratified random sampling. First, pure animal husbandry counties (autonomous flags) within each city (league) are divided into high and low groups according to their gross domestic product considering regional differences and data availability. One county (autonomous banner) is randomly selected from each group. Second, each county (autonomous banner) is randomly selected from two to three sample townships. Finally, one to two sample villages are drawn from each township. Home interviews are used to fill out the questionnaires. A total of 200 questionnaires are collected in this survey. A total of 196 valid questionnaires are obtained after invalid questionnaires are excluded, with an effective rate of 98%.In addition, the processing efficiency model using maximum likelihood estimation is selected to further study the influence of emotional and psychological positive state characteristics on farmers' formal credit behavior. The descriptive analysis of the respondents is shown in From Regression analysis is carried out on the influence of the survey variables on the credit behavior of farmers, and the specific results are shown in From The link between the positive emotional state and herdsmen's credit behaviors is further analyzed. It is used as the standard to take the average of all sample values of positive emotional and psychological characteristics. The ones above the standard value are set as the sample group of high emotional and psychological characteristics. Besides, the sample groups are set as training groups, and the differences between the groups are analyzed. The results are revealed in From From This paper studies the current herdsmen's credit behavior based on the emotional and psychological state identification scheme. A related identification research model is designed according to the current status of herdsmen's credit behavior and the action mechanism of the psychological identification program. The herdsmen's credit behavior is analyzed according to the survey data. The results show that herdsmen with high scores of emotional and psychological characteristics have strong demand for credit, are likely to obtain credit, and have high credit lines. Herdsmen with low scores of emotional and psychological characteristics have low or no obvious demand for credit, and their credit availability is also low. Moreover, the treatment effect model analyzes the influence of emotional and psychological characteristics scores on herdsmen's credit behavior. The study finds that herdsmen with high emotional and psychological characteristics have a 71% higher probability of generating credit demand than farmers with low openness. They are also 33.47% more likely to obtain credit than herdsmen with low emotional and psychological characteristics. They are also expected to obtain high loan amounts. The robustness test results indicate that the experimental results are in good agreement. The disadvantage is that the number of surveyed objects is relatively small, and the geographical area is limited. The research work on the key techniques of psychometrics done here has broad application prospects and practical significance. Although some achievements have been achieved, there is still a long way to go before the actual promotion and use. The follow-up research work can also be improved and perfected from the following aspects. Firstly, the universal intelligent psychological evaluation system can operate stably and reliably after systematic testing. This is in line with the expected demand design. Physiological and behavioral data of different groups can be easily collected through the promotion and use of the system. In the follow-up work, artificial intelligence algorithms such as deep learning can be added to the server to research various data aggregation and mining technologies. It will help build a group mental situational awareness model to serve all areas of society well.


The main objective of this research was to investigate the relationship between flexible working arrangements (FWA) and turnover intentions (TI), as well as the mediation effect of employee engagement (EE) in the relationship between flexible working arrangements and turnover intentions. The main research question is: what is the nature of the effect of flexible working arrangements on employees’ turnover intention, and the role of employee engagement in this relationship? The methodology of the paper consists of theoretical (literature review) and empirical parts (field research). The empirical research was performed on a sample of 514 highly educated employees from service sector organizations that operate in the Republic of Serbia. Sample collection lasted from January to October 2022, via Google Forms. The proposed relationships were tested by using the PLS-SEM method, with the application of the SmartPLS software. The main findings of the research are that there are direct positive effects of flexible work arrangements and employee engagement on turnover intentions, and that employee engagement has an indirect effect on the relationship between flexible work arrangements and turnover intentions. A partial mediation was found. Employees who are offered flexible work arrangements decrease their turnover intentions when they are more engaged at work. Modern organizations face various challenges such as increasingly strong competition, the rapid development of information and communication technologies, rapid globalization, enhanced digitalization, and economic, political, energy, health COVID-19 pandemic), and other crises. In such circumstances, organizations need to adapt their business patterns and find a strategy with the aim not only to survive but also to achieve a leadership position in the market ,3,4. Add pandemicThe main objective of this research is to examine the relationship between flexible work arrangements and turnover intentions, as well as the mediating effect of employee engagement. The sample was created using an electronic Google Forms questionnaire where employees in the positions of professional workers or managers belonging to the service sector in the territory of the Republic of Serbia had the opportunity to answer at any time. After collecting an adequate number of respondents (514 employees), the authors coded the data and then conducted a PLS-SEM analysis to determine the relationships between the observed variables. Flexible work arrangements represent an independent variable, while employee engagement and turnover intentions represent dependent variables. Moreover, it should be emphasized that employee engagement and turnover intentions represent employees’ attitudes, and the attitudes are significant predictors of the future behavior of employees . They reThe research consists of four parts, the first part refers to the theoretical background of the research, where the authors explain the research variables  and emphasize their importance for the research. This is followed by an overview of previous research in the area, and the development of hypotheses. The methodology of the research is presented in the second section. The authors present the questionnaires used, data analysis procedures, as well as the sample. The third part is related to the empirical part of the research, in which the authors used the SmartPLS and IBM SPSS Statistics programs for data processing and performed PLS-SEM analysis to test the proposed relationships. Finally, the authors provide conclusions regarding the entire research, theoretical and empirical implications, research limitations, and proposed suggestions for future research.Due to various internal and external factors that have a direct impact on business, modern organizations are using flexible work arrangements. Companies have modified the traditional way of organizing work and today there are different flexible work arrangements in usage, such as weekend work (employees can work during the weekend and/or can work in two shifts), shift work ), overtime , flexi-time , home-based work , teleworking , a compressed working week , job share (part-time employees can share a full-time job), part-time jobs (employees work less than the regular 40 h working week), fixed-term contracts (employees work under employment contracts with a fixed duration), temporary/casual work (employment is offered temporarily), annual hours contracts (a predetermined number of working hours per year) . Flexible work arrangements bring mutual benefits for both employers and employees. Both parties agree when, where, and how employees will work with the aim of meeting the needs of the company . OrganizEmployee attitudes are significant predictors of future behavior , and repInvestigation of the direct relations between flexible work arrangements, employee engagement, and turnover intentions, as well as the role of employee engagement in the relationship between flexible work arrangements and turnover intentions has been the theme of much of the previous research. The main theoretical background for these relations can be found in the social exchange theory . The maiDrawing from the social exchange theory, employees who perceive flexible work arrangements positively, in terms of all the benefits that flexible work arrangements can bring to an employee, could feel more engaged at work. Employees who have the possibility to use flexible work arrangements achieve some greater autonomy and control over their job, and enhance their work–life balance, and they can feel a higher level of energy and mental resilience during work, a stronger involvement in their work, and experience a sense of significance, enthusiasm, inspiration, pride, and challenge, and higher concentration and preoccupation with work. The theoretical linkage between flexible work arrangements and employee engagement lies in the discretion afforded to employees as to how work is completed and how workers can achieve some mechanisms of control and autonomy . PreviouHypothesis 1 (H1).Flexible work arrangements are positively related to employee engagement.Regarding turnover intention, this attitude could be decreased because employees, when they have the opportunity to use flexible work arrangements, can have more control and autonomy regarding their business and private life, improve their work–life balance, and on that basis, feel more satisfied in the job and have a desire to stay in a specific company. If employees perceive flexible work arrangements as a positive business practice, it is expected that they will have positive work attitudes, such as job satisfaction, employee commitment, and engagement, and on that basis, that they will not try to avoid their work and leave their organization. The results of previous research ,30,31 prHypothesis 2 (H2).Flexible work arrangements are negatively related to turnover intentions.As well as direct relations, it is obvious that other attitudes of employees can have some indirect effects on FWAs-TI relations. This is tackled in the previous part of the research since the authors stated that employees usually feel a kind of satisfaction when they use different FWAs, and then estimate the desire to stay or leave the organization. However, satisfaction is not the only attitude that is related to a desire to stay in a company. Higher engagement at work leads to loyalty and a stronger attachment to an organization, and this results in lower levels of employee turnover intentions ,33,34. THypothesis 3 (H3).Employee engagement has a positive mediation effect in the relationship between flexible work arrangements and turnover intentions.Data collection was performed through an electronic Google Forms questionnaire, where professional workers and managers in the service sector could answer questions at any time. The questionnaire consists of four parts. The first part refers to the socio-demographic and organizational characteristics , and belonging to the public or private sector). The second part refers to the question about Flexible Work Arrangements where the employees had the opportunity to answer 11 questions see . FlexiblThe third part refers to Employee Engagement where the employees had the opportunity to answer 9 questions see . EmployeThe fourth part refers to Turnover Intentions where the employees had the opportunity to answer 4 questions see . TurnoveIf the questionnaire contains a reverse score at the end of the question, it means that the authors made the necessary changes before the analysis.After creating the electronic questionnaire, the authors moved on to the next step related to sample collection. The sample was made up from employees from the territory of the Republic of Serbia who belong to the service sector, work in positions such as professional workers or managers, and who are highly educated. Based on the data from the Statistical Office of the Republic of Serbia (2022), there were 2,848,800 employed persons in the Republic of Serbia. Because flexible work arrangements are offered to a greater extent to employees with higher education  and in hSample collection lasted from January to October 2022; during that time, a total of 582 responses were gathered. After the data check and preparation (exclusion of outliers and incomplete questionnaires), only 514 respondents who filled out the questionnaire were taken into account. The structure of the sample is shown in Based on the presented The authors used Partial Least Squares Structural Equation Modeling (PLS-SEM) to test the proposed model. PLS-SEM is a method based on the analysis of complex interrelated relationships between constructs and indicators  (p. 2). The study assessed the direct effects of flexible work arrangements on the dependent variables (employee engagement and turnover intentions) and indirect effects through the mediator (employee engagement). The authors first tested the formative higher-order construct flexible work arrangements.p-value. Multicollinearity analysis was also performed by the variance inflation factor (VIF).The formative construct in the model was tested by analyzing the outer weight as well as the significance through t-statistics and the p-values < 0.05). Formative construct flexible work arrangements consists of two variables, FWAs related to family issues and FWAs related to job issues.Based on the values in The multicollinearity was tested by the variance inflation factor (VIF). Based on the obtained results in To test reflective constructs in the model, the reflective indicator loadings, internal construct reliability, convergent validity, and discriminant validity were analyzed . RegardiDiscriminant validity was assessed by cross-loading indicators, the Fornell–Larcker Criterion, and heterotrait–monotrait, HTMT .Authors Grubor et al.  (p. 310)According to the Fornell–Larcker criterion, the square root of the AVE of a latent variable must have a higher value than all correlations with other latent variables . Table 9HTMT ratio values below 0.9 indicate that the defined components are sufficiently different from each other; it means that they describe different phenomena . The resBased on the data in p-values, and confidence intervals are calculated to assess the significance of the PLS-SEM results. The results obtained on the basis of the bootstrapping analysis are shown in the following table and graph on the basis of which we can check the proposed hypotheses [In order to test the observed relations , a bootstrapping analysis was performed. Subsamples are randomly drawn observations from the original data set (with replacement). The subsample is then used to estimate a PLS path model. The process is repeated until a large number of random subsamples (for example 5000) have been generated. Estimates from bootstrap subsamples are used when determining standard errors for PLS-SEM results. With this information, t-values, potheses .p = 0.000). Based on the presented results, hypothesis H1 is confirmed. Additionally, there is a negative statistically significant relationship between flexible work arrangements and turnover intentions , which confirms hypothesis H2. Finally, the author tested the mediating role of employee engagement in explaining the relationship between flexible work arrangements and turnover intentions. There is a partial mediation since the indirect effect of flexible work arrangements on turnover intentions through employee engagement is significant . Based on the presented results, hypothesis H3 is confirmed too. These relations are presented in The data in The present research reveals relations between the modern work design strategy, flexible work arrangements, employee engagement, and turnover intentions, as attitudes that have strong effects on employee behavior in a company. The research successfully confirmed all three hypotheses, i.e., flexible work arrangements have positive effects on employee engagement, and negative effects on turnover intentions, and employee engagement has a positive partial mediation effect in the relationship between flexible work arrangements and turnover intentions.The practical implications of the research are in the potential of flexible work arrangements to increase employee engagement and reduce turnover intentions in companies for their highly educated employees. Due to the insufficient number of researches dealing with the mediating role of employee engagement between flexible work arrangements and the turnover intentions, the authors decided to examine the given relations and determine the effects. Moreover, research is of great importance for almost all companies in modern business because there is a lack of talent and a high level of stress  at work,Regarding the theoretical implications, the present research is one of the first to deal with the themes of flexible work arrangements, employee engagement, and turnover intentions in the Serbian context, with this specific methodology (questionnaires and PLS-SEM). We tested and confirmed all questionnaires, which is important for future research and the reliability of the findings. Theoretical implications also lie in an increased understanding of the effects of employee engagement on the relationship between flexible work arrangements and turnover intentions, which is very important bearing in mind behavioral economics, where the psychological dimension of human behavior is found to be one of the most important factors for decision making . In thisThis study has potential limitations. One is related to the sample size. According to the data of the Republic Institute of Statistics in 2021, the average number of higher educated employees was 789,118. This sample consists of only 514 employees. Considering the size of the target population in the survey for the year 2021, and in accordance with the sample size formula developed by the authors Cochran (1977), we conclude that for the most commonly applied significance level of 5% and confidence interval of 95% , an appr


The findings of this research showed that being overweight is a concerning issue even in a small-sized and lightly populated city such as Bandar-Turkmen, Iran. Most students (90%) did not perform the required minimum daily activity when commuting to school. Further, overweight could be found even among those students who walked more than one hour to commute to school. The contribution of walking to school to the MVPA of overweight students was found to be low on school days and throughout the year. Counterintuitively, the situation is even worse for nonoverweight students.  The population of overweight students was more active compared to nonoverweight students in general, although they still suffered from excess weight since walking distances were short and not all days were school days. Thus, encouraging students to walk to school is necessary, while it is not sufficient alone as a single measure. Moreover, we recommend that all students should perform extra PA at home, school, or other places, on both school days and all other days of the year. Children's dependence on motor vehicles has increased in recent decades , while tIt should be noted that obesity is spreading even among children as the dependence on motor vehicles increases. The World Health Organization (WHO) webpage reported that the number of children and adolescents aged 5–19 who were obese or overweight in 2016 was more than 340 million. Nearly 11% prevalence of obesity at primary school starting age placed Iran, the country under study, on a par with Western countries . More imAccording to Mozaffari and Nabaei, being overweight is due to inappropriate diet choices, unhealthy and sedentary lifestyles, and reduced physical activity (PA) . HoweverSome researchers have attempted to summarize and classify the broad effects of transportation, and walking as a healthy travel behavior, on the overall quality of life (QoL) . For exaVarious research studies have focused on reasons for the decline in active travels to school. For instance, socioeconomic variables such as higher car ownership , higher Some studies consider parents as a significant factor in the behavior of school travel . For exaThe WHO recommends that children and adolescents aged 5–19 years need to accumulate 60 minutes of moderate-to-vigorous PA (MVPA) each day . This rePromoting ACS has been the focal point of various research studies and public health policies over the years, if such initiatives significantly increase the MVPA of student populations –39. The Worldwide, a great number of studies have been conducted on the association between weight status and ACS –39. ReviAs shown in However, the target community of the current study included girls and boys of all 12 grades enrolled in both public and private schools.To examine whether overweight students have more dependence on motor vehiclesTo investigate if students accumulate the minimum PA in school tripsTo explore the association between the inadequacy of PA in walking trips and excess weightTo understand to what extent ACS contributes to the MVPA of overweight students on school days and all days of the yearThe objectives of the current research are as follows:This study is a cross-sectional evaluation of the differences in the travel patterns of overweight and normal-weight students. The study was aimed at assessing the health implications of walking to school in an Iranian setting. We employed a self-report questionnaire for use in school children aged 7–18 years.Since the context of the study has an influence on how students commute to school, the city under study, its transportation systems, the educational system, and the types of schools in Iran will be described in the next section.The present study focused on the city of Bandar-Turkmen, Golestan, located in Northeastern Iran. Bandar-Turkmen is a coastal city with a moderate and humid climate and an urban population of 53,970 in 2016 .Bandar-Turkmen lacks a regular bus system and shared taxis constitute the only active (para)-transit system. In Iran, the shared taxi system attracts a high modal share and operates similarly to regular bus services in that vehicles are only allowed to follow a specific predetermined path on the network. The service is provided with small-sized vehicles, and the main features are that vehicles only depart if full and that there are no intermediate boarding stops.School services in Iran are generally provided by minibuses, vans, cars, or taxis, while there are no school buses or minibuses. Additionally, the government does not fund school services, and thus, parents must pay all associated expenses. Hence, there is no distance threshold to be eligible for school services, and students are likely to utilize school services even if their homes are very close to the schools. In addition, the school office may arrange and schedule for minibus or van services if the number of students with the same travel route is high in a school. Otherwise, parents themselves are required to find appropriate shuttle services and reach an agreement with drivers on the prices and schedules.The educational system in Iran is divided into three main levels of primary, guidance, and high school. All children spend six years of their education at the primary level from the age of six to 12. Further, they attend guidance and high school from the ages of 13 to 15 and 16 to 18, respectively. Schools are single sex in Iran.The schools in Iran can be broadly classified into two groups, namely, public and private. Public schools are free schools and are administered by government. Private schools charge tuition fees and are administered by private parties. Private schools have higher educational quality than public schools .So far, active travel programs such as “Safe Route to School” , 42 and Originally, a Norwegian team consisting of researchers and experts in transportation and traffic psychology developed a questionnaire to collect information about the active travels of students , 78. TheFor the current study, we employed an English version of this questionnaire as a basis, which was then translated into Persian to be used in the present study. The questionnaire employed in the current study was named the active and safe travel to school questionnaire (ASTSQ). Regarding the translation of the ASTSQ into Persian and cultural adaptation, it should be explained that three transportation specialists and three physical activity specialists, who were fluent in both English and Persian, translated the English version of ASTSQ into Persian. Three English language experts then translated the resulting Persian translations into English. Then, by comparing the original English text and the Persian to English translation versions, the necessary corrections were made in the Persian translation. To evaluate the Persian version in terms of cultural phrases and concepts, the Persian questionnaires were sent to 10 faculty members specialized in transportation or physical activity of children and adolescents. They were asked to evaluate the ASTSQ questions and items based on the content validity index (CVI) and score them from one (completely unsatisfactory) to four (completely satisfactory) . If the The first part of the questionnaire included questions about the socioeconomic characteristics of the household, along with students', fathers', and mothers' travel habits. In the second part of the questionnaire, parents' attitudes toward walking, factors influencing the choice of travel mode, parents' risk assessment of walking, and concerns about active travels to school were investigated.d) and confidence level (α) were selected at 0.05 and 0.01, respectively, the required sample size was 788. Additionally, 1,500 questionnaires, 712 more than the required amount, were distributed among the students according to true population proportions, given that some students would probably not return the questionnaires or that parents would fail to answer the questions completely or fill out the questionnaires inappropriately.The sampling procedure of the current study was a combination of random clustered and stratified sampling techniques. Students were classified based on sex, educational level, and school type, with the number of students in each category following polynomial distribution. Thompson  providedTo select schools, researchers initially consulted with the education authorities of the city, who then, based on their past experiences, recommended inclusion of certain schools due to the close cooperation of their students with survey teams and a high participation rate in past surveys. Similarly, the authorities recommended that specific schools included students of all social classes from all areas, thus making them representative of the entire population of students in the city. A shorter list of schools was prepared from which schools to be included in the study were randomly selected.The locations of schools in the city of Bandar-Turkmen have generally not been planned with specific geographical or spatial patterns or rules in mind. Public schools can mostly be found in highly populated community areas, whereas private schools tend to be geographically spread around the city. These schools were selected from every area of the city to ensure that all urban regions were covered in terms of socioeconomic characteristics. Likewise, classes within these schools were randomly selected and the students of a class were all given the questionnaires to take home.The survey was conducted in a total of 23 out of 60 schools in the city, namely, 11, 6, and 6 elementary, guidance, and high schools out of 30, 14, and 16 schools, respectively, in December 2017.School teachers were instructed to ask the students to take the questionnaires home, have their parents, caretakers, or guardians fill them out, and bring them back to schools after three days. Predominantly, 96.3% of parents filled out the forms. The families of students also received written instructions regarding how to fill out the questionnaire. The questionnaire was only filled out for the student who took it home, and the information about other children or students in the household was not collected.Generally, if the school officials ask the families and students to participate in a survey or complete a questionnaire for a study, the families and students agree and cooperate. Therefore, no written consent was obtained from students and their families to participate in the survey. However, appropriate approvals from officials of the Bandar-Turkmen education bureau and schools were gained prior to the start of the survey. It is important to mention here that gaining approval or permission from an ethics committee for medical experiments or human research is not mandatory in Iran.The total number of enrolled students in the school year 2017–2018 was 10,719, of which 5,651 and 5,068 were boys and girls, respectively. Out of 1,500 distributed questionnaires, students returned a total of 1,072 questionnaires, constituting a response rate of 71.47%, three days after receiving them . HoweverSince some questionnaires were not returned in the same proportions as they were distributed, measures had to be taken to reflect the over- or underrepresentation of some groups. Accordingly, sample weights were applied in such a way that the proportions of students were similar in the sample and population in terms of sex, the educational level, and school type. The sum of sample weights was equal to 999 provided that the number of correctly completed questionnaires was 999 . Based oSince travel features such as mode and distance did not contribute to sample weighing, it may seem that sample weights are unnecessary for travel analysis and can be excluded from further consideration. However, given that the three sociodemographic variables of sex, educational level, and type of school may indirectly affect travel characteristics, sample weights were applied to implicitly capture the effects of variables on travel patterns.The frequency of travel modes and the travel distances were the two measures widely applied in this study. Parents were asked about how many times on school days of the week their children went to school and returned home by each mode of travel. Travel modes were divided into 12 classes in ASTSQ for the convenience of respondents. However, some similar travel modes were aggregated after the data collection process. The four final travel modes were classified as active, when the student went to school and returned home on foot; semiactive, with the student going to school in a motorized vehicle and returning home on foot or vice versa; service, whereby students commuted to school by school services in vehicles which were not owned by the student's family; and motorized where the student commuted to school purely by car, motorbike, taxi, and the like.The collected questionnaires showed that the changes in travel modes during school days of the week were small. Therefore, we assume that the travel mode is the same in all school days of the week.Although the current study primarily considered the inclusion of data from students who cycled to or from school, the focus shifted to walking trips because the prevalence of cycling among the students (and residents of the city) was extremely low, and walking was the dominant mode of active traveling. The home-to-school network distance stated by parents in the questionnaires was considered as a proxy for travel distance.2 kg/m2). In the questionnaires, parents were asked to report their children's heights and weights. To determine the weight status of students, Z-score graphs, as recommended by the WHO, were separately applied for boys and girls. Using these graphs, the Z-score and weight status of each student were determined based on their BMI and age. For example, the student's weight status was considered “normal” if the BMI and age were such that the Z-score of the student was between +1 and -2  was used to determine students' obesity or thinness. The BMI is defined as the body mass divided by height in meters squared  test was applied in the analysis of variance (ANOVA). Prior to ANOVA, Levene's homogeneity of variance test was performed to check whether the variances of travel distances were equal across weight groups. The test finding revealed that the variances of travel modes were equal at the The next section investigates whether walking to school can meet the minimum PA requirements recommended by health organizations. The WHO recommends that children and youth aged 5-19 should accumulate at least 60 minutes of MVPA each day . ConsideThe research team also evaluated whether students who had enough physical activity on school trips could be overweight. The nonparametric chi-square test was applied to represent the independence of weight status from the adequacy of students' walking distances. In this test, the expected counts of cells in the crosstab of the two nominal variables, i.e., weight status and sufficiency of walking variables, were obtained using an independence assumption, and then, chi-square test was carried out using expected and observed cell counts.The contribution of walking to school to the MVPA of students was computed. The students do not attend schools on many days of the year, and not all of them walk to school. School days only represent nearly 40% of all days of the year in Iran. Additionally, schools are closed more than four months in a year due to summer and New Year holidays, along with weekends. Therefore, the number of school days attended per year matters, as does active commuting prevalence. The contribution of walking to school to the MVPA of entire population of students was analyzed for school days and all days of the year.The influence of sex on students' overweight and travel patterns was also investigated.A logistic regression model was developed to obtain the relation between students' weight and other independent variables affecting it. The response variable was binary, indicating whether the student was overweight or not. In the current research, the number of collected data fields for each student was 130, all of which were considered for incorporation into the logistic model as independent variables. These included the socioeconomic status of the family, characteristics of student's school trips, travel patterns of parents, school features, parents' concerns and perceptions of risk and safety, traffic and geometric risk factors when walking on roads and streets, the importance of factors for parents in selecting travel modes of their children, and parents' attitudes toward walking and were collected and entered in the modeling.A forward likelihood ratio fitting was used to estimate the parameters. In this method, the variables are added to the model in an order that causes the most significant improvement in the likelihood ratio. The likelihood ratio was defined as the likelihood of the model with more variables (full model) over the likelihood of the model with fewer variables (reduced model).61.98% of students were of normal weight, while 21.76% and 10.33% were overweight and obese, respectively . Furtherp value = 0.73), and the same results were obtained when comparing the semiactive trips of the same two groups   .ρ = 0.039 and p = 0.001).Investigating the linkage between being overweight and modes of travel using Spearman's rho correlation coefficient demonstrated that there was no statistically significant correlation between these two variables , implying that being overweight was independent of the distances of active travels. As previously mentioned in Modal Shares by Weight Status, we found that being overweightness was irrelevant to travel modes.An association analysis further suggested an insignificant inverse correlation between weight status and the distances of active travels  of all students had enough PA when traveling to school. Most students did not perform the minimum daily activity needed when commuting to school and typical walking distances were not long enough.One may ask whether excess weight can be found among students who walk sufficiently. Based on the data in Of the students who did not walk sufficiently on school trips, 30% of them were also overweight, while the remaining students were not overweight. The comparison of column proportions in p value = 0.656). Accordingly, overweight was also found among students who walked sufficiently, and adequacy of walking distances was independent of weight status.The nonparametric chi-square test was applied to represent the independence of weight status from the adequacy of students' walking distances. The test finding in The contribution of walking to school to the MVPA of students was computed as the sum of the walking distances of students with a specific weight status divided by the should-walk distance of the same group . The sumBased on data in On a school day, a student who actively commutes to school will walk for an average of 33 minutes regardless of his/her weight status, and he/she performs 55.5% of the minimum MVPA on this trip. Students do not attend schools on many days of the year in Iran, and not all of them walk to school. An active commuter accumulates 13 minutes (22.2%) MVPA when averaged for all days of a year for individuals who walk to or from school. Given that around half of the students do not walk but travel to school by motorized modes, the contribution of walking trips to population MVPA for the entire year further reduces and accounts for only seven minutes a day (11.1%).α = 0.05 level. Overweight girls made fewer and shorter trips compared to overweight boys. In contrast to overweight boys, who walked longer distances than normal-weight boys, the overweight girls' distances of walking were shorter compared with normal-weight girls.Overweight and obesity prevalence were statistically similar between girls and boys at the In addition, 20% of all girls undertook the required daily PA when commuting to school, whereas this figure was 21% in boys. In overweight boys, 28.8% performed adequate PA during school trips, but the rest did not perform enough PA. However, only 3.5% of overweight girls performed the minimum PA on school trips.The regression model results and definition of independent variables are shown in α = 0.05 on being overweight. In The four variables of student grade, travel mode of student's father, importance of travel safety, and cost for parents were parameters that had a significant effect at In previous sections, it was concluded that overweight students do not have more dependence on motor vehicles, and students' being overweight is irrelevant to the mode of travel and walking distance. The logistic regression modeling led to the same result, and parameters such as travel mode, walking distance, and travel distances of students had no influence on overweight. Logistic regression also suggested that the way parents' attitudes toward the choice of travel mode affects overweight in their children is not clear.In the current study, around a third of students (32.09%) suffered from overweight, which is a concerning issue in Bandar-Turkmen. This is consistent with the findings of Nabavi et al., who demonstrated 33.1% obesity for students aged 7 to 12 years in Semnan, Iran . SimilarThe findings of the present study revealed that students' overweight was irrelevant to walking to school. Moreover, the amount of physical activity performed on school trips was very low. Thus, programs and interventions for PA promotion should encourage students and their families to increase their children's PA not only when commuting to school but also at other times and places and on all days of the year.As previously mentioned in Average Travel Distances by Mode of Transport, the average walking distances of overweight students were like those of nonoverweight students. However, the measure for collective walking of students revealed that overweight students walk more than their normal-weight peers. This demonstrates that applying measures of individual walking would lead to misleading data. It was better to apply indicators that consider overall population walking. In the current study, the individual perspective resulted in an underestimation of the MVPA of overweight students.The contribution of walking to school to the MVPA levels of overweight students was larger compared to nonoverweight students. However, the amount of contribution of walking to school to the MVPA of overweight students was low both on school days and throughout the year. The situation is even worse for nonoverweight students.Although parental attitudes toward selecting travel modes were found to be significant for their children's overweight , the devIt is widely believed that overweight students are less active than their nonoverweight counterparts . HoweverMeasuring the energy expenditure of obese boys at home, school, and outside home, Waxman and Stunkard concluded that there was no significant difference in calorie expenditure between obese and nonobese boys at home and that obese boys had greater energy consumption than nonobese ones outside home and school . This isHatami et al. confirmed that dietary factors including higher energy intake and consumption of low rates of fruits and vegetables were the main determinants of overweight and obesity among Iranian students . TherefoLowry et al. remarked that combining PA with a reduced fat and calorie diet should receive greater attention to achieve a healthier weight . Wu et aThe authors speculate that two solutions could be effective in achieving a healthy weight and increasing the physical activity of students. But these solutions and their impact on body weight status need to be investigated for an Iranian setting.The first solution is to encourage families to increase their children's PA not only when commuting to school but also at other times and places and on all days of the year. In line with this recommendation, the future researches need to measure the daily physical activity of students and they should not focus only on active trips to school. Students who travel to school via motorized modes may perform PA at home, parks, play grounds, gyms, etc. Therefore, measuring the physical activity throughout the day is recommended.The second solution is to implement diet-plus-exercise intervention among the school students. Current study only analyzed the PA of students when commuting to school, and it did not evaluate the diet and nutritional status of the school students. To the best of our knowledge, other local studies have not examined the effectiveness of diet-plus-exercise interventions yet. The local researches studied the diet and exercise interventions for weight control separately. But since the previous experience in other countries show that diet-plus-exercise interventions were more successful than diet-only programs, the authors speculate the diet-plus-exercise intervention will also be more effective than diet-only interventions for weight loss in an Iranian context. But, this needs to be confirmed for an Iranian setting by further studies.The data required for this research were collected using a self-report questionnaire. One of the limitations of the current study was that parents report the height and weight of their school children. Many studies warn about the parents' perceptions of their school children's weight status , 92. AdoThe current study focused on the health implications of doing physical activity during school trips. But some students who commute to school by motor vehicles may perform physical activities at home or school, or in other places like playgrounds, parks, or gyms. So, adopting a holistic approach and measuring the physical activity throughout the day is recommended. It is also strongly suggested to quantify the students' physical activity on weekends or other holidays in a year when students do not go to school.The research team relied on association analysis using cross-sectional data. But instead of conducting association analyses and developing logistic regression models, exploring the cause-and-effect relations between overweight and other factors would be more helpful. For this purpose, we recommend developing structural equation models (SEMs). SEMs show the complex interaction system between the overweight and other explanatory variables and the cause-and-effect relationship between them via a system of equations. In this equation system, a network of cause-and-effect relationship is established. Extracting this set of relationships between all variables is more robust and helpful than understanding the association between two variables or a regression function among a limited number of variables. The other reason for suggesting structural equations is that even though numerous variables were tried for inclusion in the logistic regression models, a few of them entered the model, which may be due to not capturing the systematic relation between variables.This study was defined to investigate the attachment of overweight students to motor vehicles on school trips. For this purpose, the prevalence of active trips and the distance traveled by different means of travel was compared between the overweight and nonoverweight students. This article also appraised what percentage of students perform the minimum amount of PA recommended by the WHO. Exploring the linkage between the inadequacy of PA in walking trips and excess weight was another goal of the study. The contribution of walking to school to the MVPA of students on school days and all days of the year was also examined.Neither overweight students nor their parents were more attached to motor vehicles in school trips. Walking trips were not less prevalent among overweight students and the average walking distances of overweight students were not shorter than those of nonoverweight students. Being overweight was not associated with travel modes or distances.Only 10% of students walked more than one hour on school days, thus performing the minimum required activity when commuting to school. The remaining students would have to perform physical activities at home or school or other places like playgrounds to satisfy this requirement. Although some students walked more than 60 minutes and 3.6 km or more every school day, they were still overweight.The contribution of walking to school to population MVPA throughout the year was extremely low, probably because of short and inadequate walking distances and the fact that not many days are considered as school days. The contribution of walking to school to the MVPA of overweight students was possibly more than that of nonoverweight students. Parents' attitudes toward the safety and cost of their children's travel mode did affect overweight, but it is not clear how exactly.It is recommended that local health and transportation policymakers should not only rely on developing walking trips. Instead, they should implement programs to encourage students to build healthy eating habits, alongside finding ways for PA promotion.


Molecular animations play an increasing role in scientific visualisation and science communication. They engage viewers through non-fictional, documentary type storytelling and aim at advancing the audience. Every scene of a molecular animation is to be designed to secure clarity. To achieve this, knowledge on design principles from various design fields is essential. The relevant principles help to draw attention, guide the eye, establish relationships, convey dynamics and/or trigger a reaction. The tools of general graphic design are used to compose a signature frame, those of cinematic storytelling and user interface design to choreograph the relative movement of characters and cameras. Clarity in a scientific visualisation is reached by simplification and abstraction where the choice of the adequate representation is of great importance. A large set of illustration styles is available to chose the appropriate detail level but they are constrained by the availability of experimental data. For a high-quality molecular animation, data from different sources can be integrated, even filling the structural gaps to show a complete picture of the native biological situation. For maintaining scientific authenticity it is good practice to mark use of artistic licence which ensures transparency and accountability. The design of motion requires knowledge from molecule kinetics and kinematics. With biological macromolecules, four types of motion are most relevant: thermal motion, small and large conformational changes and Brownian motion. The principles of dynamic realism should be respected as well as the circumstances given in the crowded cellular environment. Ultimately, consistent complexity is proposed as overarching principle for the production of molecular animations and should be achieved between communication objective and abstraction/simplification, audience expertise and scientific complexity, experiment and representation, characters and environment as well as structure and motion representation. Modern technology makes video an easily accessible and therefore omnipresent medium in our lives and therefore also in the fields of knowledge and communication where it unfolds its full potential in the form of molecular animations. Molecular animation can be described as motion design for biological macromolecules. Since these nano-scale characters are not directly visible to the human eye, we need to draw on an array of visualisation methods to communicate them. Combining scientific illustration with motion gives us the opportunity to visualise the dynamics of the molecular system.Molecular animations can be used in science communication, education and research  and 2015In 2008 Gael McGill announced “Molecular Movies … Coming to a Lecture near You” , describThis perspective article formulates a number of guidelines with relevance for molecular animations based on knowledge and literature from the main fields design, scientific visualisation, molecular kinetics/kinematics and cinematography/storytelling. It may contribute to a theoretical basis for the field of scientific and especially molecular animation.Molecular animation is understood here as the visualisation of the structure and dynamic of macromolecular biomolecules and their substrates within the context of the living cell, at the molecular nano-scale. Molecular animation therefore can be seen as a subspace of data visualisation  and medical illustration/animation, that includes the biological mesoscale , methods (rising action), results (climax), analysis  and discussion (resolution) . In an aThe cinematic genre of molecular animations is best described as non-fictional documentary. Documentary storytellers must not invent and cannot make compromises when it comes to the facts. Instead, they need to be guided by and find the story in the material itself . The stoContextualised in the wider field of data visualisation, a molecular animation belongs to one of seven genres of narrative visualisation: film/video/animation. The narrative structure tactics is strongly author-driven. As such, an animation is characterised by linear ordering of scenes, heavy use of labels, headlines and annotations (messaging) and a lack of interactivity . The autAny story can be characterised by the three act structure that goes back to Aristotle’s Poetics  and FigMany molecular animation concepts include a storyboard with illustrated signature frames, the narration and possibly animatics for the timing. The more complex a topic and an animation are, the more important a storyboard becomes. Every signature frame, the transitions between them and the relative movement within a scene need to be designed to achieve the specific communication objective of that scene. Technically, this can be achieved by keyframe interpolation, particle or molecular dynamics with defined starting points and dynamic field parameters.The signature frames are individual images that represent important situations of the story. The molecular animator should be able to create a clear design for them and therefore have a good knowledge on design principles from various fields, most importantly graphic design, motion design, user interface design and cinematography/film. The design principles can be categorised into five  areas: draw attention, guide the eye, establish relationships, convey dynamics and create emotion /reaction. The methodology for the selection of principles relevant for molecular animations is described in the Supplement, including a visualisation of the principles in An animation is created by moving from signature frame to signature frame and includes the relative movement of characters and camera view. Characters may enter, stay in or leave the frame. Or they can move with the camera relative to other characters or the environment. Also, camera movement can be combined with character movement. The techniques and principles of non-dialogue cinematic storytelling  help to The motion lessons of interface design  support timing and spacing, easing, mass and weight, squash and stretch, follow through and overlapping, secondary action, arcs, solid drawing, anticipation, exaggeration, staging and appeal. With the help of those principles, natural movements are recreated based on material properties, following the laws of classical physics and building on every-day-life experience in the macro world. An experience that does not exist in the nano-world of atoms and molecules. Here, movement is determined by random collisions, diffusion gradients and thermal motion. So, with the exception of the more general principles staging and appeal, those for the design of motion need to be set aside for the animations of molecules.It needs to be mentioned, that the well known set of “Disney animation principles”  does notClarity is the overall goal of any design process and it is therefore also important for scientific visualisation in general. It is often reached by simplification (displaying fewer items) and abstraction (using simpler forms of an item), or both in combination. Clarity avoids clutter in the frame while unburdening the perceptual system of the viewer. However, it needs to be carefully balanced with the addition of more complex detail in order to advance the audience. In fact, in the nano-world of macromolecules, there is always a certain level of abstraction involved in scientific visualisations which automatically leaves room for interpretation . A taxonThe visualisation of a biological macromolecule (molecular graphics) can range from very simple to very complex. Illustrative and abstract representations include 1D formats (letter codes), 2D formats  and 3D formats . 3D-surface abstractions include beads representations  and coarse approximation. 3D atomistic surface models show more detail and include convolution surface models , molecular skin surfaces, ligand excluded surfaces, solvent excluded surfaces and solvent accessible surfaces. 3D atomistic space filling models are characterised by each atom being represented by a sphere with a radius based on the Van der Waals radii. 3D atomistic bond-centric models include hyperballs, licorice and ball-and-stick representations or even quantum mechanical models. Please see Choosing the adequate representation can be challenging and depends on several factors like the actual, specific communication objective, the experimental data available, the topical context, the target audience expertise level, and others. To avoid misconceptions, it is recommended to avoid causing superficial understanding due to over-simplification and abstraction. A depiction may be taken literally and not interpreted according to underlaying scientific knowledge. Whole biological concepts can be basically understood like this, but actual insight may not go beyond the simplicity of the representation explaining it . Mixed rAt the same time it should also be avoided to imply more knowledge than the data actually provides. The quality and resolution of the available experimental data restricts the level of structural detail shown in a scientific visualisation or animation. However, that does not keep us from integrating data from all kinds of resources or even models, predictions or hypotheses . Even wiThe design of motion requires biophysical knowledge from molecule kinetics and kinematics. For biological macromolecules four types of motion are most relevant: thermal motion, small and large conformational changes  and Brownian motion (with a molecule as one unit), see visualisations in Thermal motion is observed for any atom in a molecule and has a very high frequency, dependent on the temperature. The higher the temperature, the stronger the positional dislocation. It can often be neglected in an animation, especially when other, lower frequency motions are shown. It remains relevant in very complex and highly detailed animations, where visualising the movement of individual atoms or even quantum mechanical detail  increases the accuracy of the representation.Small conformational changes are based on the rotational freedom of a bond between two atoms, e.g., the rotation between peptide bonds see . AccumulBiological macromolecules and especially proteins often have domains, subdomains or other structural motifs  that show a certain rigidity within themselves while flexible loops between them are responsible for movements of those substructures relative to each other. Flexible loops themselves also may undergo large conformational changes to fulfil a function. Many biological processes depend on this type of large conformational changes. They are often visualised by the intrinsic movement of surface representations, but also ribbon-type cartoons.When macromolecules in a cellular environment move as one unit, they usually do so by random collision with other molecules, caused by their thermal motion and often described as random walk. Collisions create an external force that is not directional, so the movement of the macromolecule is random and not caused by long-range attracting forces between two reaction partners. This provides a challenge for a molecular animator, who needs to find a balance between the visualisation of the non-directional nature of the random motion and the actual approach of reaction partners within the timeframe of the scene. The motion-equivalent to structural detail in a representation is called dynamic realism by Jantzen . Both, sIn a crowded cellular environment, the set of principles described by In systems of high dynamics such as the nano-world of biological macromolecules, the medium of video can play out its strength. Compared to explanatory text, an animation can often be more efficient and intuitive. Compared to a diagram or illustration it can be more accurate and detailed. Consequently, an animation used in research and education should reflect the comprehensive knowledge of a system. Only then the complexity of the system can be communicated realistically and used for the development and evaluation of hypotheses. Failure to reflect the complexity leads to the misconception that a complex system is indeed simple and also to flawed future experiment design. As a consequence, it is recommended to use 2D sketches and cartoon style shading when little is known about a system and a 3D animation for established mechanisms .The main determinant for the complexity of a molecular animation is the complexity of the actual communication objective, the point that needs to come across, the focus of attention. The communication objective of a particular scene can be very specific and is usually related to one of these two categories (or a combination of both): a) the properties of the components - structure, chemical and physical properties, relation towards each other, etc.; and b) the dynamic of the system, the changes over time. The complexity of a communication objective is then directly associated to the complexity of the main element. The principle of consistent complexity  should be avoided. This is an issue for mixed representations. A more gradual change of the level of detail helps to avoid visual breaks. The environment should have less complexity than the characters, but may well become the focus of attention for another communication objective and have its complexity increased for another scene.The complexity of the structure representation needs to be matched with the one of the motion representation . While the complexity of a structure representation is easily understood as the level of detail, the complexity of a motion is less well intuitive. We need to look at the different motion types in order to relate the complexity of a representation with the complexity of a motion.


IntroductionThe ability of electronic differential diagnosis (DDx) tools to generate accurate diagnoses has been well established in simulation and primary care clinical environments. However, the use of such tools has not been well studied in the emergency department (ED). We aimed to characterize the use and perceptions of a DDx tool among emergency medicine (EM) clinicians who were newly provided with access to such a tool.MethodsWe performed a pilot study investigating the utilization of a DDx tool by clinicians in an ED setting shortly after the tool was introduced. After six months of use, retrospective data were analyzed to characterize the use of the tool among ED clinicians. The clinicians were also surveyed on their perceptions of the use of the tool in the ED setting.ResultsThere were 224 total queries, which were regarding 107 unique patients. The most searched symptoms were related to constitutional, dermatologic, and gastrointestinal complaints whereas symptoms related to toxicology and trauma were less commonly searched. Survey respondents rated the tool favorably, and when not used, reported reasons including forgetting that the tool was available for use, not feeling the need to use the tool, and disruption to workflow.ConclusionsElectronic DDx tools may have some utility in assisting ED clinicians in generating a DDx, however, clinician adoption and workflow integration are barriers to their utility. This article was previously presented as a poster at the 2022 American Academy of Emergency Medicine (AAEM) Annual Scientific Assembly on April 26, 2022.BackgroundThe ability of differential diagnosis (DDx) tools to generate an accurate DDx compared to gold standard diagnoses has been demonstrated in several retrospective chart reviews and case series from primary care settings ,2. HowevImportanceDDx tools generate a list of potential diagnoses based on patient history, symptoms, physical findings, and diagnostic data entered by the clinician which may enhance human-generated differentials. Typically, the DDx generated by a diagnosis tool will be much more extensive than that of the clinician, as the tool is not constrained by education, experiential, physiologic, environmental, and recall limitations experienced by human clinicians. Due to the high acuity of patients and lack of follow-up experienced by ED providers, quick and accurate diagnosis is particularly important in this setting to avoid errors that can increase mortality and length of hospital stays -7. DDx tGoals of this investigationThis pilot study aimed to evaluate the utility of a DDx tool newly introduced to an ED setting through analysis of DDx tool clinical usage and a survey of the ED clinicians' perceptions of the tool. The primary outcome of the study was to characterize the usage of the tool by emergency medicine (EM) clinicians based on the findings of the data retrieved from the DDx tool database. The secondary outcome was to assess the clinicians' perceptions of the DDx tool based on the results of a survey.We conducted a mixed-methods analysis, which included both prospective observational data collection and a survey of one ED's experience using a newly introduced DDx-generating tool. The study was conducted at Beaumont Hospital, a high-volume, academic medical center in suburban Detroit, MI, USA with a three-year EM residency training program. The ED serviced an annual volume of approximately 110,000 patients during the study period. Exemption status was granted by the hospital's Institutional Review Board.The ED provided access to the DDx tool  to all clinicians working in the department, including attending physicians, resident physicians, and advanced practice clinicians (APCs) in May 2020. The authors had no relationship with the tool company and the sole role of the tool company in the study was to provide de-identified usage data. There was a three-month introductory period during which the clinicians were familiarized with the tool. The study period included the following six months of tool usage in the department. A link to the tool was installed on all desktop computers in the ED and the clinicians were also given access to a mobile format of the tool for use on their personal mobile devices.The tool uses patient data elements entered by the clinician such as demographics, signs and symptoms, travel history, laboratory data, and imaging data to generate a list of most likely diagnoses. There is no limit on the number of patient data elements that can be entered for a diagnosis query, and more information entered can result in a more specific DDx. Before the initial rollout of the tool, EM clinicians were educated on how to access and use the tool with detailed usage instructions sent out via email as well as a walk-through of the application by one of the study authors at a monthly educational conference with faculty members and residents present. Clinicians were encouraged to use the DDx tool on diagnostically challenging cases. The clinicians were encouraged to re-query the DDx tool as the patient course progressed and more information was collected. The EM clinicians were subsequently sent monthly email reminders of the availability of the tool to encourage continued use.At the end of the six-month study period, de-identified usage data was provided to the researchers from the DDx tool database for analysis. The search data included the following information: patient age, patient sex, patient pregnancy status, travel history, search query text, and diagnosis output results.In addition to the usage data collected from the DDx tool database, EM clinicians were requested to complete an anonymous survey sent by email and conducted through REDCap (Research Electronic Data Capture), a secure web-based application designed to support data capture for research studies, to further assess their usage and perception of the tool . The surUsage data of the DDx tool included 224 total queries over the six-month study period. Usage dropped in the first three months and then did not drop further in the subsequent three months. Most searches were performed in Month 5 of the study period Figure . A revieThe mean number of patient data elements entered per search was 4.1 with a standard deviation of 3.07. The range of data elements entered was between 1 and 20. The average number of queries carried out per patient was 2.1 with a maximum of 12. A total of 34.6% of searches used lab or radiologic data in the query.The results of the data provided by the DDx tool database revealed that the cases most commonly searched by clinicians involved dermatologic, gastrointestinal, and constitutional data elements. The least commonly searched data elements were related to toxicology and trauma Figure .The survey was sent to 120 ED clinicians, including 28 APCs, 42 attending physicians, and 50 resident physicians. Of the 32 clinicians who responded to the survey, only seven reported using the DDx tool. The most commonly reported reasons for not using the tool were forgetting that the tool was available for use, perception of low utility, and disruption to workflow.The ED is a hospital setting where clinicians must rapidly evaluate, diagnose, and treat potentially critically ill patients, often with confusing or little information on the patient's history. An electronic DDx tool may have the potential to be of benefit in supporting accurate diagnosis in the ED by providing an extensive DDx which would be otherwise difficult for the typical ED clinician to generate from memory and experience. However, most current published research on the use of DDx tools is from non-clinical and primary care office-based settings and it is unclear if the benefits seen in those studies translate to the ED given the unique challenges of the setting ,2. CurreED clinicians in our study entered an average of 4.1 data elements per patient into the DDx tool. Clinicians often also re-queried the tool on the same patient as they obtained more data. Notably, clinicians input data on laboratory or radiologic findings in only one-third of patients, which potentially limited the DDx tool's output. Given that the DDx tool places no limit on the number of data elements that can be input, education of EM clinicians on the tool's capacity to assess large numbers of data elements, including laboratory and radiologic data, may increase the tool's utility in the ED.EM clinicians in our study utilized the DDx tool most frequently for patient presentations involving constitutional, dermatologic, and gastroenterological symptoms. This likely reflects diagnostic uncertainty experienced by the clinicians due to the large variety of potential diagnoses that a patient presenting with these symptom complexes could have. However, it is possible that existing tools that are specific to dermatologic cases and which allow visual input may be more useful for dermatologic presentations.For presentations relating to toxicology and trauma, the DDx tool was rarely used. In the case of toxicologic presentations, it is frequently known what the exposure was, eliminating diagnostic uncertainty. Furthermore, EM clinicians in the United States have the resources of Poison Control Centers to assist in their evaluation of complex toxicologic cases and may not utilize a DDx tool in this setting. Trauma patients are managed by the protocols taught in Advanced Trauma Life Support courses, which direct the diagnostic evaluation through standardized physical exams and diagnostic studies, and therefore make the DDx tool less useful in the trauma setting.Despite encouragement and multiple reminders from the study team to the ED staff to maximize EM provider utilization of the DDx tool, the tool was used by a relatively low number of clinicians during the study period. The reasons cited for not using the tool included forgetting that the tool was available for use, disruption to workflow, and perception of low utility. The hesitance to use the tool among clinicians due to a perceived lack of need is consistent with studies that have shown that the diagnostic confidence of clinicians is independent of both the difficulty of the case and the accuracy of their diagnosis . AdditioOur study had several limitations. First, it was conducted at a single tertiary-care, academic ED, and the results may not be applicable to smaller centers or to non-academic environments. Also, in our ED, clinicians utilized the DDx tool on a voluntary basis. Had tool usage been required or automated, a better understanding of the DDx tool’s abilities could be more fully understood. Due to the low response to the survey, it is unclear if the tool has more utility for APCs, EM residents, or seasoned EM physicians. Additionally, usage data from the DDx tool database was de-identified which limited the ability to analyze usage by individuals who did not respond to the survey or ascertain the exact number of unique clinicians who used the tool. Finally, as already noted, self-reported usage of the tool by survey respondents was exceptionally low, limiting the ability to subjectively characterize tool usage.In summary, this pilot study found that DDx tools may have some utility in the ED setting, particularly for cases involving dermatologic, gastrointestinal, and constitutional complaints. However, clinician adoption and integration of DDx tools into clinicians' workflow are barriers to their use. Further research is needed to investigate methods to reduce these limitations before the utility of DDx tools in this setting can be fully elucidated.