This paper reviews applications of machine learning (ML) predictive models in the diagnosis of chronic diseases. Chronic diseases (CDs) are responsible for a major portion of global health costs. Patients who suffer from these diseases need lifelong treatment. Nowadays, predictive models are frequently applied in the diagnosis and forecasting of these diseases. In this study, we reviewed the state-of-the-art approaches that encompass ML models in the primary diagnosis of CD. This analysis covers 453 papers published between 2015 and 2019, and our document search was conducted from PubMed (Medline), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) libraries. Ultimately, 22 studies were selected to present all modeling methods in a precise way that explains CD diagnosis and usage models of individual pathologies with associated strengths and limitations. Our outcomes suggest that there are no standard methods to determine the best approach in real-time clinical practice since each method has its advantages and disadvantages. Among the methods considered, support vector machines (SVM), logistic regression (LR), clustering were the most commonly used. These models are highly applicable in classification, and diagnosis of CD and are expected to become more important in medical practice in the near future. Artificial intelligence (AI) is defined as the technology that uses computer knowledge to represent intelligent behavior with nominal human involvement, and machine learning (ML) is considered as a subset of AI techniques. Usually, this kind of intelligence is commonly acknowledged as having begun with the innovation of robotics . With thThe applications of AI in medicine are developing quickly. In 2016, AI projects coupled with medicine drew in more speculation from the global economy than other projects . In mediIn general, ML is categorized as supervised   or unsupWith ML models, it can also be possible to improve quality of medical data, reduce fluctuations in patient rates, and save in medical costs. Therefore, these models are frequently used to investigate diagnostic analysis when compared with other conventional methods . To reduDue to the low-progress nature of CDs, it is important to make an early prediction and provide effective medication. Therefore, it is essential to propose a decision model which can help to diagnose chronic diseases and predict future patient outcomes. While there are many ways to approach this in the field of AI, the present study focuses distinctly on ML predictive models used in the diagnosis of CDs, which highlights the importance of this study. In this study, we conducted a systematic literature review of different state-of-art of predictive models, and our significant contribution in this paper is to develop comparative model analysis to propose model optimization. In comparison to the conventional data analysis techniques, this review article will able to find promising results that enhance the quality of patient data and analysis of specific items that are related to ML algorithms in medical care.The systematic literature search was conducted through the libraries of PubMed (Medline) and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Keywords like ‘chronic diseases’, ‘predictive models’, ‘ML in CD diagnosis’, and ‘model classifiers’ were used during the document search. The search was conducted in January 2020 and resulted in 453 documents. The documents were filtered based on its publication dates ranging from 2015 to 2019 to evaluate the latest literature on ML classifiers in CD prediction. The title and abstract of the individual articles were retrieved based on the mentioned search terms. Finally, a few of the items were found to be eligible to fulfill the research objectives. This research only describes predictive models used to perform CD diagnosis and does not concentrate on overall trends in AI medicine. Further article revision was conducted to filter the duplicates between the two databases. Moreover, the inclusion and exclusion criteria of our review were based on time, methodological quality and language. Reports and other studies published before 2015 were excluded as outside the limitations on the timeframe of this study. The inclusion criteria used in Pub Med and CINAHL are as follows: free full text, English, original papers and research outcomes. We excluded 276 items among the total search documents because of duplication. The remaining 177 were screened to match the methodologies related to the current research topic. Data evaluation was conducted in two phases. In the first phase, depending on the inclusion criteria, 55 documents were identified for extended revisions. In the second phase, two individual researchers (GB and GGS) were equally distributed for quality check. As discussed, the proposal of a precise model in CD diagnosis was considered as the main focus of this paper. Therefore, articles were extracted based on the authors’ information, the study design of sampling pattern and method types, and diagnostic criteria. The analysis of each article was individually revised and recorded.Quality assessment check was accomplished by the adoption of the Newcastle–Ottawa Scale (NOS), which is a renowned method in the assessment of study relevance and research interest . The quaFrom In , COPD paModel accuracy is defined as a percentage of true predictions from total predictions. From Despite the above results, it is still debatable matter on the existence of particular microbial profiles for distinct periodontal conditions. Studies conducted on the ML model development in classifying patient data based on bacterial species  have shoThe present study analyses the distinct prediction models of machine learning in the diagnosis of chronic diseases. Sometimes, it could be hard to propose the best learning method in disease predictions since it depends on dataset size and user access. Supervised machine learning (SML) approaches are followed in the highest number of studies, with the integration of easy and simple predictive modeling. The implementation of these models in clinical practice certainly can help to provide better health services and enhance specialist decision-making. It is rudimentary to confirm the different algorithms based on a specific problem, and review studies could help to analyze the performance and determine optimal machine learning models. Before machine learning, recommendations for practice in medicine development depended on individual studies. Therefore, it is affecting the data science because all this medical information is coming from different platforms and people. Due to contemporary trends in computational models, healthcare services are quickly transformed by having the ability to record large amounts of patient data. However, it is highly impossible to analyze huge medical records with human knowledge. On the other hand, with the evolvement of big data in biomedical and medicinal service networks, accurate analysis of medical data becomes possible that could improve patient care ; if therAging is one of the significant difficulties facing in the western world, meaning that lowering the weight of continuous infection and enhancing life span is necessary ,53. Few On the other hand, unsupervised ML deals with a deep learning model containing a medical data set that it can handle without having a clear direction regarding what and how to proceed. The neural network attempts automatic detection of structured data and performs key feature extraction. Depending on the pathology type, it can follow different patterns like clusters that involve a group of particular information . HoweverIt is also evident that SVM and LR models significantly implemented in the large number of studies to do CD diagnosis. Sixteen studies were adopted these models especially for hepatitis B, COPD, diabetes, and others. An SVM model is popular among others to identify COPD from the beginning, and it could be greatly assisted in the relationship between doctor and patient. Bayesian networks and NB models help to forecast the diagnosis of asthma problems. These models encompass old patient records to look up clinical symptoms and footing on Bayesian networks to present the relationship individual case and diagnose future possible symptoms. The KNN algorithm is associated with five studies for diagnosis, forecasting, and to critically follow the CD’s stages with the help of different primary and secondary data.The main limitation of the present study is most of the adopted literature on disease prediction or classification was adopted with supervised models, and it is important to adopt unsupervised (clustering) and deep learning  models as well in future works.The present study evaluated the studies associated with the diagnosis of chronic diseases. However, the implementation of correct methods or selection of the right models is a prerequisite to perform ideal decisions, as modern researchers are claiming that some ML models are compromised by enlarging contained datasets with malicious data that can have severe consequences. On the other hand, diagnosis limitations may lead to life-threatening attacks, and sometimes it might be a driving factor of fatality. In contrast, the wrong diagnosis prompts the skepticism in machine learning use, that can lead policy makers to avoid predictive model usage. Therefore, reviews on predictive models can provide evidence to propose excellent methods for the CDs diagnosis. In the future, AI techniques like ML, cognitive computing and deep learning may play a critical role in the interpretation of chronic diseases. However, researchers are progressively attracted by predictive model techniques in the advancement of health care. As new advancements in medical care are being established and are expanding the access to electronic data, this opens new doors to decision support and productivity improvements. These models are designed to emphasize the responsibility of patient care quality and cut down medical costs.


Digitalised supply-chain traceability systems can offer wide prospects both for improving safety as well as enhancing perceived quality. However, the coupling between physical goods and information is often difficult for agri-food items. A solution could be the use of RFID (Radio Frequency IDentification) systems. Due to its wide reading range, Ultra-High Frequency (UHF) technology is already widely used in logistics and warehousing, mostly for the identification of batches of items. A growing interest is also emerging in Near Field Communication (NFC), as several smartphones embed an integrated NFC antenna. This paper deals with the automatic identification of meat products at item level, proposing and evaluating the adoption of different RFID technologies. Different UHF and NFC solutions are proposed, which benchmark tag performances in different configurations, including four meat types , by using a specifically designed test bench. As avoiding the application of two different tags could be advantageous, dual frequency devices (UHF and NFC) are also considered. Significant differences in tag performances, which also depend on meat type and packaging, are highlighted. The paper highlights that tag positioning should consider the geometry of the packaging and the relative positioning of tag, meat and reader antenna. It is well recognised that, especially for meat products, high consumer trust and the perceived good reputation of the food influence the customer’s buying experience, resulting in higher sales. Apart from mandatory traceability, which is governed by specific national laws, voluntary traceability is often adopted, with the goal being to share additional food attributes or more detailed traceability information that could reach the consumer through other information media. This is particularly attractive for new marketing strategies .Since meat traceability was introduced early in Europe to tackle the spread of diseases, mandatory data are collected in huge official databases , which contain the main traceability information of each single head . In Italy, the consumer is allowed to access part of this information  on the national registry website by typing the animal’s 14-letter code .Labelling rules are very strict. National and supranational beef producers, together with food authorities, often debate about the possibility of allowing the implementation of additional information on labels or sharing it by other means of communication .High quality meat producers could increase their income through a private certified information flux, which is costly to maintain nowadays, subject to a low degree of identification system standardisation and dependent on certification of trustworthiness by third parties. This situation causes the information flux on meat supply-chain traceability to be discontinuous and very costly, excluding a priori a great part of the possible stakeholders. To enhance the reliability of supply-chain traceability and its robustness against possible external inferences, the information about meat origin and processing could be guaranteed by blockchain technologies ,4,5. TheUltra-High Frequency (UHF) RFID technologies have been proposed for the food sector, e.g., fresh produce ,12, coldMeat supply-chain traceability is indeed complicated due to the huge amount of data required by regulations, by information privacy levels  and by the willingness of the stakeholder to transmit/acquire certain information that cannot be directly perceived by the senses (credence attributes). In Europe, the information that can be reported on printed labels is strictly regulated by Regulation (EU) No 1169/2011  and otheElectronic animal identification is currently mandatory for sheep and goats and well regulated for cattle in the European Union. It is allowed to be performed with Low Frequency (LF) ISO 11784 and 11785 standard passive tags ,23, whicWhile Electronic Product Code (EPC) communication standards in the UHF or HF band can be exploited for processing and logistics traceability, the end user could benefit from Near Field Communication (NFC) technology by using new generation mobile phones . NowadayThe labels, which are normally placed on the plastic wrapping, always report the mandatory animal data. For example, in Europe, it is strictly required to report animal code, birth date, birth country, slaughter plant code and slaughter plant country. Voluntary traceability data could be added without further requirements, e.g., age at slaughter, sex, meat category, breeding period in the country and breeding region. In Italy, other traceability and quality data  can be added on the packaging only if appropriately certified and under the strict control of the Ministry of Agriculture. Then, pictures and other marketing/selling information could be printed.An increasing quantity of fresh meat is sold cut and packed and is displayed on the shelves of self-service refrigerated cabinets. The most frequent type of meat packaging displayed in supermarkets consists of a tray overwrapped with plastic film or in vacuum packaging. In the first case, air (or a modified atmosphere) surrounds the meat cut, while in vacuum packaging the air is removed by negative pressure in sealed pouches. Therefore, the distance between the labels and the meat varies from approximately 100 microns (the thickness of a plastic film for vacuum pouches) to a few centimetres. While RFID technologies have been proposed and used in the food supply chain for some commodities, UHF RF identification of meat cuts at item level is not yet available.It is known that animal tissues and food composition could negatively affect high-frequency electromagnetic signal propagation ,28,29. MThis paper deals with the problem of the RFID identification of processed meat products  at item level, which is required in retail. With the aim of defining the possible criticalities of any stakeholder in meat cut identification, RFID system frameworks were envisaged to perform item-level identification at different points of the meat supply chain. In particular, systems operating in the UHF frequency band were considered in the cutting plants and refrigeration phase where item identification can be performed by fixed panels as well as by mobile Personal Digital Assistants (PDAs) similar to those already used in other warehousing applications, while NFC systems were considered for products to be detected on the shelves by user mobile phones. Dual frequency tags, already used in different sectors ,33,34 maThis paper analyses the criticalities in packed meat food RF identification and proposes possible solutions to enhance the reliability of RFID system integration for meat logistics and traceability based on experimental indices that are related to readability. The overall performances of the RF systems were tested on four different kinds of packed minced meat , by using two available RFID technologies (UHF or HF-NFC) and mixed-mode tags (UHF and HF-NFC) in order to avoid the use of two different identifiers.A series of experimental trials to evaluate the feasibility of automatic meat RF identification was conducted by considering two different meat packaging options: a) shrink bags or vacuum bags, with the film in direct contact or very close to the meat, and b) overwrapped trays, with the film applied to the tray, with a modified atmosphere or air between the film and the meat. With this aim in mind, two different test bench layouts were designed for UHF and HF readability testing, respectively. Dual Frequency (DF) tags were tested on both test benches to assess their performances in comparison with the Single Frequency (SF) tags.The paper is organised as follows: The three-dimensional layout of the designed test bench for the UHF RFID system performance assessment is shown in Pmin (dBm)) was evaluated by a custom C# software, [To determine the reading efficiency of the system, the minimum Transmitted Power Output (TPO) required to activate the tag ) was measured and recorded. Three repetitions were performed for each tag-meat-smartphone combination. For each meat type, the tested tag order was randomly scheduled to avoid any influence due to the different test duration.In the initial test configuration, the tag-to-smartphone distance was set to 100 mm in order to keep the tag outside the smartphone reading range. Then, the NXP Taginfo application was activated and set to continuous tag reading. The tag-to-smartphone distance was then progressively decreased by turning the screw system in 0.625 mm steps. When detection was obtained, the tag-to-smartphone distance  drastically influence tag readability, especially when the tag and the sample are very close ,31, the The experimental tests using the designed test benches were conducted with samples refrigerated at approximatively 4 °C to simulate the product temperature of chilled retail cabinets. It was therefore necessary to periodically cool the samples before each measurement.Pmin, acquired by means of the UHF test bench, was considered as the dependent variable and analysed by a linear model to evaluate the effects of the considered factors: meat type and tag model  as well as the distance between the tag and meat surface . Two-fold and three-fold interactions were considered in the model. In the case of the NFC tags, a three-way ANOVA  was used, evaluating the effects of the meat, tag and smartphone model categorical variables on the dependent variable Rmax. The mean values of the dependent variables (Pmin and Rmax) were evaluated by using the post-hoc Bonferroni test for p < 0.01. The R software (version 3.6.3) was used to process the data.The obtained An index accounting for the UHF tag’s performance, in terms of tag readability when attached to a food item, was obtained by measuring the amount of power needed during the interrogation phase in order to guarantee a feasible response from the tag at a given distance.In the carried-out experiments, the effects of meat proximity on tag performance were clearly observable. In particular, when the tag was in contact or very close (<2.5 mm) to the meat , the levIt can be noticed that contact with pork meat affects tag performance minimally, as in most cases the tags were also readable when they were laid directly on the patty’s surface . In the Pmin values at a distance in the range 2.50–18.75 mm were compared statistically. Values at shorter distances (<2.5 mm) were not compared as many tags were not readable in this interval. In the linear model, the meat type, tag and distance factors were considered in all combinations, in order to evaluate their effects on the dependent variable Pmin. The variance was explained by all of the three considered factors and factor interactions (coefficient of determination R2 = 0.999). The Pmin means by tag factor, grouped by means of the Bonferroni test at p < 0.01, are reported in To assess significant differences in tag performance, in terms of the minimum amount of power to be delivered to activate the tags, Tags UH 105 and UH 107, whose inlay shapes are very similar, proved to perform very well on the meat for the low power rates required for their detection. Compared to the Single Frequency tags, the activation of the Dual Frequency tags was possible only by emitting higher energy levels .Pmin means by meat factor, grouped by means of the Bonferroni test at p < 0.01, are reported in p < 0.01). The readability of the tag was significantly higher in proximity to pork or fatty beef, rather than chicken or lean beef.The Pmin mean values are reported for each meat type in the 0–18.75 mm distance range. It should be noted that, when the tag and the meat were almost in contact (<2.5 mm), tag readability was severely compromised. Indeed, the Pmin values were very high or even out of the reader’s TPO range (>33 dBm). Pmin mean values at the different tag-to-meat distances considering all the tags and all the meat types.In Pmin constantly decreases as a function of the tag-to-meat distance  turned out to be in the range 15–51.25 mm. The meat type factor did not have a statistically significant effect on the variable Rmax.The maximum scanning distance measured between the reading smartphone and the tags attached to the different meat patties  employed. In fact, DF tags with larger HF antenna loops  frequency bands. In this paper, the effects of meat proximity on the readability of RFID systems were assessed. Due to the high amount of energy required to activate the tag, low reading performances arose in the UHF frequency band when the tags were placed in contact with or very close to the meat . In someUHF tags require a certain amount of signal power to be activated and transmit the Electronic Product Code (EPC), which is related to the item’s traceability information. As shown by Barge et al. , who conThe use of samples of the same weight and shape made it possible to compare the effects of the meat type on tag readability. Among other factors, differences due to the meat type and the tags were assessed in controlled static conditions, which allowed the variability caused by the speed or by the EPC anti-collision algorithm to be reduced.High values were found in terms of the power needed for tag activation, also considering that, in experimental conditions, the distance between the item and the reader antenna was only 0.5 m, while, in some logistics applications, the distance might be larger. This could be the case in RFID gates or conveyor belts for multiple dynamic identification; in this context, the reading performance of the UHF system might be further reduced.In some cases  , who conBased on the reported results, some precautions will have to be adopted to improve tag readability, such as adopting plastic or carton trays that allow the meat parts to be maintained at a suitable distance from the tag. This can be obtained, for example, considering an appropriate distance between tag and meat as well as mutual orientation of the transponder with the reader antenna. In fact, especially in the case of chicken and lean beef, positioning the tag in proximity to the meat should be avoided, choosing instead, for example, a packaging solution where a layer of another material or atmosphere is interposed between the RFID identifier and the product.Due to the possibility of setting the distance between the tag and the meat sample, the designed UHF test bench allowed the effects of meat sample proximity on tag readability to be clearly highlighted. The designed HF tag test bench allowed the maximum reading distance between NFC tags attached to the meat patty surface and the smartphone to be defined.Further work should focus on the effects of different orientations and distances in UHF identification by means of circular and/or linear antennas that can be mounted at strategic points where identification is considered in warehousing and at points of sale  or used by operators (by means of PDAs).NFC tags were shown to be suitable for the scenario where the consumer uses a smartphone app to obtain information to access the digitalised supply chain. The large-scale use of tags could enhance product sales as shoppers, during their buying, are time-pressed; however, an eventual failure of the identification system could be fatal if smartphones are sought to influence the choice of picking one product over another. As different smartphone models determined significant differences in the maximum reading distances, further testing on more recent smartphone models could be performed in future research. The difference between the reading performances of the two smartphone models can probably be ascribed to better radio interfaces and/or different NFC antenna designs .The availability of Dual Frequency tags could be a good opportunity to use RFID both in logistics as well as for other proximity range applications such as at points of sale. From user-level access to the digital dataflow through a trusted identification system, each stakeholder can benefit from the given information. In particular, some non-perceivable quality attributes  could be guaranteed by a complete digitalisation of the meat supply chain. By means of smart technologies, the consumer is involved in an in-store selling engagement, enjoying a service that is similar to that offered by e-commerce, and post-buying access to the information they might not have enough time to consider while shopping. Moreover, retailers can have the advantage of tracing locations of customers during their buying path, cross-selling some suggested items based on marketing strategies.The adoption of UHF tags in the animal-origin supply chain has been considered for many years both for food ,38,39 asIn this paper, the weaknesses and advantages of using UHF and/or NFC systems to perform automatic identifications, which could be adopted in logistics as well as at points of sale, were assessed. The research showed that there are configurations in which tag reading performance would result to be too low to be applicable in real contexts. The distance between the transponder and the reader antenna resulted to be a critical parameter for a good performance of the UHF RFID system. The dimensions of the air gap that should be maintained were assessed and reported.For NFC applications, the effect of the distance between the tag and the meat as well as the performance of recent smartphone models could be further investigated.It was demonstrated that, in many cases, reliability problems in reading performances can be overcome by carefully choosing the tag model and its positioning. Tags could be integrated into food packaging, developing suitable solutions that can guarantee the relative positioning of the meat and the transponder during the handling of the product throughout the entire supply chain. When properly integrated, UHF technology can thus lead to successful applications. The results reported in this paper can be exploited by developers of sensors based on RFID technology for meat applications.Further experimentation should also assess the effects of other meat cuts or meat products  with different dielectric properties.


Anodorhynchus hyacinthinus), an emblematic species, have suffered declines due to many environmental factors. The Hyacinth Macaw Institute’s actions are showing positive outcomes for the conservation of A. hyacinthinus. However, environmental issues, such as fires and deforestation due to inefficient and unsustainable cattle ranching practices, are a threat to the biodiversity. Another major threat is the reckless use of pesticides. The objective of this manuscript is to describe the findings, in the Pantanal, of three dead hyacinth macaws and to investigate their cause of death and conservation implications. A necropsy was conducted on two individuals and biological samples were collected and sent to conduct toxicological exams to test for organophosphates, organochlorines, and carbomates. Compatible with other findings, results showed a highly dangerous level of organophosphate, 158.44 ppb. We describe for the first time, a rare, isolated but unusual mortality event associated with organophosphate pesticide poisoning of hyacinth macaws. Mortality reports for bees and other bird species on how the improper use of pesticides can potentially cause the contamination of food and water resources are discussed. These factors are antagonistic to long-term efforts to preserve wildlife and carry out other conservation efforts in Brazil’s southern Pantanal.The populations of hyacinth macaws ( Currently, as result of a successful conservation program in the southern Brazilian Pantanal of Mato Grosso do Sul, the wild population is estimated at approximately 6.500 individuals3.The Hyacinth Macaw Institute (HMI = Instituto Arara Azul) is part of a 30 year old conservation program in which, at the start of the project in 1987, it was estimated there were approximately 2500 wild hyacinth macaws4. A large portion of this ecosystem consists of private properties, whose main economic activities include extensive livestock production, tourism and fishing. Nevertheless, the Pantanal has one of the highest conservation practices in Brazil, where numerous threatened animal species can still be seen, such as jaguars, tapirs, giant anteaters and hyacinth macaws.The Pantanal, located in central South America, is one of the world’s largest continuous freshwater floodplains in the world. It supports a highly productive and diverse assemblage of neotropical flora and fauna, provides important regional and global ecosystem services, and as a result, it was designated by UNESCO as a Biosphere Reserve in 20027.The hyacinth macaw is specialized in its choice of food and nest site, and therefore it has experienced population declines due to habitat degradation, such as deforestation and forest fragmentation, and illegal wildlife trade6.The HMI has successfully reduced the number of macaw seizures for the illegal wildlife trade primarily due to environmental awareness programs that focuses on educating the local population, and the expansion of effective patrolling8 increase the mortality rate of juvenile birds.The long-term monitoring and continued research studies indicate numerous other factors that are also important threats to the hyacinth macaws. Besides deforestation, infrastructure (e.g. power lines) and pollutants 9.Crop protection products have been adapted to minimize impact on human and animal health. However, products are more diverse, with less residual impact, but they still cause significant damage, which can sometimes go undetected12.The use of pesticides can affect wildlife directly and indirectly. Some animals can be directly affected during pesticide application, because they consume the contaminated food and water, or by secondary poisoning from the residual pesticide effects on air, water and soil contamination. The residual effects of pesticides can promote behavioral changes in many organisms, and affect important developmental stages or aspects of their biological cycle, especially reproduction15.The increase in the release of pesticides in Brazil since 2019 is a serious concern, especially with the current knowledge of pesticide residual effects on the environment. Pesticide residue impact have affected several animal groups, especially bees, one of the most studied groups regarding the consequences and damages caused by synthetic or phytomolecular poisons17.The residual effects of organophosphates are small when compared to other pesticides such as organochlorines and carbamates. However organophosphates can reside in the environment for at least three years, and their high aqueous solubility allows them to be washed away quickly, increasing their contamination potential Our objective for this study was to describe the findings of the three dead hyacinth macaws encountered in the Pantanal, and investigate the cause of mortality and its conservation implications.In 2014 three hyacinth macaws were found by a landowner who is also a veterinarian, from a remote farm in the Pantanal of Rio Negro, Mato Grosso do Sul, Brazil. One of the individuals had recently died and was not sampled. Once the specimens were sent to HMI, necropsied individuals received identification numbers (ID 2014–02 and 2014–03). The state of the specimens in terms of organic and physiological condition was similar, but one was in a more advanced state of decomposition .Visceral organs such as the liver, spleen and stomach , were sent to a reference Toxicological Service Center for analysis—CEATOX of Biosciences at the Sao Paulo State University “17.Liver samples were analyzed for the identification and quantitative determination of organophosphate  and organochlorines  using gas chromatography and a capillary column, coupled to an electron capture detector. The contents of the gizzard were analyzed to determine and identify the presence of carbamates  with liquid chromatography (HPLC) and an ultraviolet detectorThe toxicological data obtained by the experts' findings allowed reliable conclusions about the cause of death of necropsied animals. The information obtained is descriptive (case study).18. Externally we observed some bruises in different parts of the body of the two individuals which may have been due to ataxia caused by the toxic agent.Of the three investigated hyacinth macaws, one of the individuals had recently died and was not sampled. This particular specimen showed bodily fluid extravasation into its oral cavity and nose. The two other individuals were found alive but neurological symptoms were observed, and soon they died in the same manner, and sent to HMI. These occurrences are unusual, isolated and rare for hyacinth macaws. Results of the laboratory exams are shown in Table Internally there were very significant differences in their state of decomposition. Specimen 2014–02 showed 24 h more decay than the predicted time of death, and yet both had intact airbags and visceral organs. The color and texture of organs were used to determine the time difference between the two decomposing animals. Besides the differences of decomposition time, both lungs showed signs of hemorrhagic edema, leading to the likely cause of death being cardiac arrest . The analysis indicated organophosphate liver poisoning .The 1989 Pesticide Act regulated the use, production and inspection of chemicals and pesticides to minimize the risks and potential environmental contamination and poisoning of farmers and/or people, directly or indirectly exposed to these productsButeo swainsoni) specimens were found in the Argentinian Pampas23. Contamination of organochorines were reported between 2015 and 2017 in southern Brazil where researchers detected the presence of organochlorines in feathers of three raptor species  24. The samples were obtained from live animals and the concentrations of organochlorine were higher than reported from other species of raptors. Caracara plancus samples showed the highest concentrations of organochlorine probably because this species feeds mostly in urban and agricultural environments24.Evidence of organophosphate contamination was identified in the intestinal tracts of the Swainson’s hawks. In 1996, mortality reports of more than eight thousand Swainson’s hawk , fifteen 26.A compilation of a 36 year analysis (1976 – 2012) of mortality factors for wild birds in the USA, list organophosphate compounds as the most common factor for adult bird mortality. These compounds have been found in more than 100 species of wild birds27. The impact of pesticides on wild birds is also detected in other countries and continents, in which the diversity of birds decreases after the application of pesticides in a given area. Although most birds are susceptible to pesticide exposure, the symptoms and intensity of the effects will vary with the natural history of each species, and the behavior and physiology of each group25.The historical misuse of pesticides impacted Peregrine falcon reproduction and adult survival in North America and the British Isles, respectivelyEven though the pesticides used today have less residual effects and are safer, we must still be cautious that the established safety levels are in accordance with the criteria established for human metabolism, and medium to large size livestock or pets. For captive animals, ingested food and water are controlled and generally safe from contamination. However, for wildlife, resources are not necessarily controlled or monitored.28. Although birds have not been impacted as much as bees, they have adaptations that make them vulnerable and sensitive to pesticide contamination, and they have greater potential for exposure to all types of toxic agents. These adaptations include unique physiological patterns characterized by high metabolic rates, low weight and low body mass. These traits may be important for the future conservation of bird populations especially with the reduced restrictions of pesticide use in Brazil, including those banned for a long time in many countries in Europe, North America, and others.In 2020 in only four Brazilian states, more than five hundred million bees were found dead by beekeepers. The main cause for this mortality was the use of neonicotinoid and fipronil pesticides, which are very lethal, and the continued spraying across different environments is leading to the extermination of many bee populations. Bees are important pollinators and essential for food production sectors all over the world. According to United Nations Food and Agriculture Organization (FAO), 75% of plants consumed by humans are dependent on beesAnother feature of birds that makes them more susceptibility to poisoning is their thin integument and their preening behavior using their beak. This behavior causes chemicals on the feathers to come into contact with the integument and the digestive tract, which are high permeability tissues.29.Free-ranging wildlife is constantly exposed to pesticides and can serve as indicators for human and environmental health. However, most of the effects on wild fauna are not observed, especially regarding mortality in nature, and therefore does not get reportedIt is not easy to find dead small animals, especially birds in their natural environment. In the Pantanal, depending on the type of vegetation and especially the vast ecological interactions with other species of fauna, it is even more difficult to find. In reality, it is rare when a person finds a carcass before a crab-eating fox or caracara. In this study case, once the owner found the three macaws, the HMI was immediately notified. For this reason it was possible to identify the cause of death, and subsequently suggest appropriate management strategies to prevent future deaths.The toxicity of organophosphates and other pesticides indicate how potentially aggressive they are for the environment and wildlife. Therefore we recommend that the use of any organophosphate should not be applied in or adjacent environmental reserves and especially aquatic ecosystems such as the Pantanal.Supplementary Information[replace with the revised file]


In the last decade, 3D virtual models have been used for educational purposes in the health sciences, specifically for teaching human anatomy and pathology. These models provide an opportunity to didactically visualize key spatial relations that can be poorly understood when taught by traditional educational approaches. Caries lesion detection is a crucial process in dentistry that has been reported to be difficult to learn. One especially difficult aspect is linking clinical characteristics of the different severity stages with their histological features, which is fundamental for treatment decision-making.This project was designed to develop a virtual 3D digital model of caries lesion formation and progression to aid the detection of lesions at different severity stages as a potential complement to traditional lectures.Pedagogical planning, including identification of objectives, exploration of the degree of difficulty of caries diagnosis–associated topics perceived by dental students and lecturers, review of the literature regarding key concepts, and consultation of experts, was performed prior to constructing the model. An educational script strategy was created based on the topics to be addressed . Virtual 3D models were developed using the Virtual Man Project and refined using multiple 3D software applications. In the next phase, computer graphic modelling and previsualization were executed. After that, the video was revised and edited based on suggestions. Finally, explanatory subtitles were generated, the models were textured and rendered, and voiceovers in 3 languages were implemented.We developed a 6-minute virtual 3D dynamic video in 3 languages  intended for dentists and dental students to support teaching and learning of caries lesion detection. The videos were made available on YouTube; to date, they have received more than 100,000 views.Complementary pedagogical tools are valuable to support cariology education. This tool will be further tested in terms of utility and usability as well as user satisfaction in achieving the proposed objectives in specific contexts. Dental caries is one of the most prevalent chronic diseases worldwide . It is cDental caries are detected by recognizing the signs and symptoms involved in the abovementioned process . The impSeveral caries classification and detection methods have been developed to assess different stages of caries lesions . HoweverBased on this, the ICDAS Foundation designed an e-learning program to universalize and spread the use of their system . This fr3D animation models can show spatial and dynamical relationships from almost any angle; this can provide information that may be difficult to acquire using traditional static learning resources . In thisThus, the aim of the present project was to develop a digital, dynamic, and virtual 3D model of the formation, progression, and detection of caries lesions at different stages using the ICDAS at the Virtual Man Project Laboratory to complement traditional teaching resources.This descriptive study was developed in collaboration with the Discipline of Telemedicine (School of Medicine), the Teledentistry Centre, and the Department of Pediatric Dentistry (School of Dentistry) at the University of Sao Paulo, Brazil. The study was approved by the Ethics Committee of the Dental School (protocol 206.345/2013).This phase comprised the initial steps to develop a learning object oriented toward the detection of caries lesions based on their developmental stages and the differences among their clinical characteristics. In this phase, we discussed the objectives, the topics to approach, and the best methodologies for knowledge transmission. Firstly, a team of experienced lecturers and researchers in the area of cariology was formed to discuss the learning object purpose, key topics representing the minimum skills a dental student should develop in this field as a future dental practitioner, and the possibility of using technology to achieve the proposed goals. Sources such as the First Consensus Workshop on the Development of a European Curriculum in Cariology  and a stAs a second step in the previous study, we assessed the degrees of difficulty of caries detection–related learning topics perceived by dental students and lecturers . In thisFirst, images of clinical and histological caries lesions were acquired to include them in the learning object as complementary supports. To that end, an examiner trained in the ICDAS criteria selected a sample of human teeth (N=12) with different caries lesion severity stages on occlusal surfaces (scores 0-6) from the Human Teeth Bank of the Dental School, University of Sao Paulo. Clinical images of these lesions were then obtained with a digital camera  with a macro lens . Then, the teeth were fixed with the crown exposed to Eppendorf tubes using utility wax and transparent acrylic resin. Longitudinal sections (100 micrometers) were made at the center of each lesion using a cutting machine  with a diamond grinding disc (Extec 12205). The histological sections were analyzed under a stereomicroscope , and the images were captured and processed with a digital camera  and QWin Plus software (Leica). This material was saved in digital files until its inclusion in the learning object.A technological plan structure and interactive tele-education strategies were developed in partnership with a multidisciplinary team composed of cariology experts, digital designers, journalists, and tele-education strategists. This phase was carried out at the Virtual Man Project Laboratory using dual Pentium 4 graphic workstations (Xeon HT) with 4 gigabytes of RAM, a professional video board, tablets, the 3D Studio Max program , and Photoshop and After Effects software .Before graphical production, a descriptive lecture regarding the caries process and the ICDAS criteria on occlusal surfaces was given to the team members who were not familiar with cariology. Concept descriptions as well as clinical and histological images of caries lesions were shown. Then, an educational script strategy was created to define the sequence in which the topics would appear in the video, emphasizing the most difficult topics .Sequence of topicsPresentationDental structures Dental enamel structure, microscopic viewDentine structure, microscopic viewPlaque stagnation areasDemineralization processCaries lesion formationICDAS scores ICDAS scores CreditsGraphical computer models  of the clinical and histological images and a preview video were promptly generated. A group of experts in the field of cariology who were not involved in the video production reviewed this first version of the video. After that, the video was edited to correct some theoretical and technical inconsistencies. Then, a new version was produced that incorporated all the suggestions; after the team’s approval, this video was rendered and textured. To achieve this, an image synthesis process was performed to generate photorealistic images  from the developed 3D models using computer programs. By this process, a silent 6-minute video was created using the Virtual Man Project .After the graphic design phase was complete, voiceovers were recorded to be played over the video to narrate the dynamic illustrations in an understandable way. Scripts in 3 languages  were written and revised by native experts. After that, the scripts were adjusted and synchronized with the times and sequences in the video. We engaged a native-speaking narrator from the United Kingdom, Mexico, and Brazil. Each of the 3 narrators received a brief explanation about the video and its objectives together with the script. They were then taken into a recording studio and provided with instructions on how to record the voiceovers. Voice volume and speed tests were performed. Later, the narrator read the script while the voiceover was recorded. If the narrator made mistakes, they were required to start over from the previous paragraph. Repetitions were made when necessary. Finally, the recordings of the scripts were edited and incorporated into the body of the video. The final versions, a 6-minute video in each language, were sent to the scientific board for revision. Minimal corrections and additions were performed at this point .Using the process described in the Methods section, a 6-minute dynamic video was produced in 3 languages  showing the dental structures, biofilm stagnation areas, caries lesion formation, demineralization process, caries lesion progression, and severity stages of caries lesions on occlusal surfaces according to the ICDAS . This prInterest is increasing in developing educational resources using information and communication technology to improve students’ understanding of human body processes . The devThis project represents an improvement in educational infographics, as it may facilitate and accelerate understanding related to a specific matter . The VirPart of the pedagogical planning for the development of this learning object was based on the findings of a previous study . Those fWe consider that this tool may have an impact on the theoretical understanding of caries lesion formation and progression and therefore may improve students´ knowledge and grades. This is supported by a study in which students who accessed virtual tools scored higher on assessments than students who did not . This toAs mentioned, the ICDAS e-learning program is an interactive resource that supports training in the use of the ICDAS criteria for dental education, examination protocols, and scoring systems  using stOne of our main goals is the dissemination of the produced tool. Open access is an ideal aspect of this process, and the first version of the video is already available on YouTube. However, additional steps should be performed to test the characteristics of the learning material as well as to address copyright issues; these steps are currently in progress. In the phase described in this paper, the authors created a learning object in 3 different languages: English, Spanish, and Brazilian Portuguese. This can be seen as an advantage in terms of dissemination, as these 3 languages have some of the largest populations of first-language speakers in the world .As a next step to fully address the efficacy of the current learning object, the authors will test this tool in a student population in different contexts and countries. This testing will be conducted to validate and assess the potential benefits, obstacles, and user acceptability of the learning object as a novel pedagogical resource in the area of cariology. Therefore, we will perform a multicenter randomized study involving dental students from different countries with the aim of evaluating the impact of the 3D virtual model as a learning object on the training and teaching of undergraduate dental students to detect caries lesions using the ICDAS; the results of this study will be discussed in a future paper.We produced a 6-minute virtual 3D video intended for dentists and dental students to support teaching and learning of the caries detection process. We suggest that complementary pedagogical tools, such as the one described here, are valuable to complement education in cariology. This learning object will be further tested in terms of utility and usability as well as user satisfaction in achieving the proposed objectives in specific contexts.


Environmental regulations (ERs) that can stimulate technological innovation (TI) are the key to enabling a win-win strategy that benefits both economic development and environmental protection. This study seeks to analyze the impacts of ERs on TI. Previous literature highlighted that the black box of TI can be decomposed into technology investment and technology transformation, but empirical studies on such a decomposition have largely been ignored. Moreover, a detailed discussion of the links between ERs and the decomposed components of TI has not been conducted in developing countries such as China. Our study attempts to address these research gaps by (i) decomposing TI using a novel data envelopment analysis (DEA) procedure and further analyzing the impacts of ERs on the decomposed components of TI and (ii) applying this novel methodology to Chinese context. Accordingly, this study is conducted in two stages. First, a novel application of the slack-based measure Network DEA model is developed to uncover the black box of TI using Chinese data in order to estimate the overall efficiency of technological innovation (TIE) and to decompose it into the efficiency of technology investment (TVE) and the efficiency of technology transformation (TTE). Second, a random effect Tobit model is applied to (i) investigate both the linear and nonlinear impacts of ERs on TIE in all sectors and (ii) examine whether the impacts of ERs on TVE and TTE in different subprocesses are heterogeneous or not. Our results have showed the benefits of decomposing TI: while technology transformation in China closely follows the trend of TI, the trend of technology investment is somewhat different. The estimation results further indicate that the impacts of ERs on TIE are nonlinear. Besides, ERs have heterogeneous impacts on the decomposed components of TI. The impacts of ERs on TVE are nonlinear, whereas the impacts of ERs on TTE are statistically insignificant. Academics and governments have been paying increased attention to the balance between economic development and environmental protection ,2. ChinaHowever, from a theoretical perspective, it remains unclear whether ERs can address environmental issues effectively or not and whether ERs enable a win-win strategy between economic growth and environmental protection . TraditiThe impacts of ERs on TI have been widely studied for several decades ,15, and First, a comprehensive literature survey shows that most of previous studies treat TI as a single production process ,20. In rSecond, when investigating the impacts of ERs on TI, the majority of extant studies generally employ a single indicator, such as research and development (R&D) investment and the number of patents, to capture TI . HoweverThird, as highlighted earlier, the influence of ERs on TI has been widely examined for several decades. However, the existing studies fail to examine whether or not the impacts of ERs on different subprocesses of TI are heterogeneous . As we dOverall, the purposes of this study are to (i) estimate the overall efficiency of TI along with the efficiencies of two subprocesses of TI (TVE and TTE), (ii) explore both the linear and nonlinear ERs–TI links and (iii) explore whether the impacts of ERs on different subprocesses of TI are heterogeneous or not. By doing so, several contributions have been made. First, we open the black box by decomposing the whole process of TI into two different subprocesses rather than treating it as a single process. This can help identify the inefficient subprocess of TI. Second, we use multiple indicators instead of a single indicator to capture TI, and we employ a novel application of a Network SBM DEA model to measure the overall efficiency of TI and the efficiencies of its subprocesses. Third, we further open the black box by exploring whether the impacts of ERs on different subprocesses of TI are heterogeneous or not, which can provide a new perspective for understanding the link between ERs and TI. Finally, the novel examination of the impacts of ERs on TIE, TVE and TTE in the Chinese context is another contribution of this paper. The literature review section is divided into four sections. The first section focuses on Chinese context on regulations and innovation. China is a vast country with a number of environmental regulations and innovation regimes. To resolve the environmental problems caused by economic development, the Chinese government has made great efforts in environmental governance of industrial pollution. The government has established a sound environmental governance system with multiple actors implementing multiple environmental policy instruments that target polluting industries (or firms) . BesidesTI plays a crucial role in the coordinated development between economic development and environmental protection ,13. HencTI is usually treated as a single production process in the existing literature ,20. UndeThe direct linear link between ERs and TI has been a constant focus among scholars, especially in the early literature. Most conclusions support the Porter Hypothesis and suggest that ERs can stimulate TI.A positive link between ERs and TI has been found in different countries, including India ,29, ChilIn addition to the positive link, some scholars also prove that the link can be negative, as the compliance costs of ERs can crowd out the expenditure on TI ,47. HencSome scholars also look beneath the surface and investigate some other factors that may affect the focal link. The results provide evidence for a more complex and uncertain relationship between ERs and TI, as the focal link can be affected by the organization’s structural flexibility and production process flexibility , the levIn addition, some scholars also distinguish ERs and innovation into different types and further demonstrate that the relationships between different kinds of ERs and TI ,55,56 anSince there have been no consistent conclusions, scholars have further investigated the potential nonlinear link. The ever-increasing stringency of ERs can increase the compliance costs ,60. AccoAccording to the Porter Hypothesis, well-designed ERs can stimulate TI, which can help in achieving a win-win strategy between economic development and environmental protection ,11. HoweIn sum, the link between ERs and TI can be either U-shaped or inverted U-shaped on the basis of different theories, which proves the possibility of the nonlinear link.DEA is a well-known methodology for estimating the relative efficiency of decision making units (DMUs) via a series of inputs and outputs ,69. GeneIn the existing literature, TI is usually measured with a single indicator, like R&D investment or the number of patents. However, TI can be better captured with multiple indicators ,70. HencScholars also developed some new methodologies after the traditional DEA was proposed. When scholars examine the effects of ERs on TI, they also use the newly developed methodologies to evaluate the efficiency of TI. Feng et al.  measure As mentioned above, TI should be decomposed into different subprocesses. Hence, DEA is not suitable, as it treats a DMU as a single production process that transforms inputs into outputs . InsteadOverall, numerous studies have been conducted and no consensus has yet been reached. A systematic review of the literature indicates that decomposing TI into different subprocesses is more suitable, even though most scholars treat TI as a single process ,16,20. AWe employed multiple research methods to conduct our analyses. For decomposing TI, we used a Network SBM DEA model. This is described in Following Li et al.  and ChenTo operationalize the decomposition outlined in Our first objective was to estimate TIE, TVE and TTE of Chinese two-digit industrial sectors. The first two digits of the code represents the industrial sector to which the business belongs. From the total of 41 two-digit Chinese industrial sectors we included the 36 sectors described in Statistics on Science and Technology Activities of Industrial Enterprises and China Industry Statistical Yearbook. Following Chen et al. , Li et aWe employed MaxDEA 8 Ultra to evaluate the efficiency. While we do not show the annual efficiency score of each sector in this article, they are available upon request. The evaluation results of all sectors’ annual average TIE, TVE and TTE scores are displayed in To further explore the impacts of ERs, we continued to use the sector-level data over the period of 2005 to 2015. We carried out three different analyses to understand the impacts of ERs on (i) TI (without decomposition), for which the dependent variable is TIE; (ii) TVE; and (iii) TTE. All dependent variables were measured by the Network SBM DEA model described in Scholars have adopted many different methods to measure ERs. The costs and expenditures of pollution abatement or pollutant discharge fees are frequently used methods ,57,58,73China Industry Statistical Yearbook and China Statistical Yearbook on Environment [Following Ye and Wang , Yuan etironment .China Industry Statistical Yearbook.We also incorporated a couple of control variables to ensure the quality of the empirical results according to extant literature. Given that the range of the efficiency score was from 0 to 1, the random-effect Tobit model was used to conduct the analyses. The Tobit model can deal with a censored dependent variable . To test the linear impacts of ERs, we constructed Model 1. Considering that it may take some time for ERs to exert their impacts on TI, ERs were lagged by one year ,74. MoreTo test the nonlinear effects of ERs, we constructed Model 2. Compared with Model 1, we incorporated the quadratic term of ERs into the model. To reduce the potential threat of multi-collinearity, we centered the quadratic term before incorporating it into the models . We alsoThe other estimations of this study were conducted in the STATA 14.0 software. p = n.s.), whereas the correlation coefficient between ERs and TTE was also insignificant but positive . Conversely, ERs were significantly correlated with TVE . Although TIE, TVE and TTE were all significantly correlated with each other, they were dependent variables in separate models. We also examined the values of variance inflation factors (VIF) to check for problems with multi-collinearity. For all the regressions below, the maximum value of VIF was 3.87. Generally, if the values of VIF are under 10, multi-collinearity can be avoided . Hence, p = n.s.). However, the nonlinear impacts of ERs on TIE are significant, as the coefficient of (ERst−1)2 is significantly positive . Together, the results prove that the impacts of ERs on TIE are nonlinear rather than linear.p = n.s.), and the nonlinear regression results also present a neutral type . It can be concluded that the effects of ERs on TTE are not statistically significant. Taken together, the results support that ERs have heterogeneous impacts on different subprocesses of TI.In terms of the influence of ERs on the decomposed components of TI, the empirical results are different. Similar to the results of the influence of ERs on TIE, the impacts of ERs on TVE are also nonlinear. However, for the linear impacts of ERs on TTE, the regression results show a neutral type . Hence, the stringency of ERs should be improved continuously so that ERs can be beneficial to TI.Our results prove that ERs do not have linear impacts on TIE, TVE and TTE and the impacts of ERs on TIE are further from linear effects. The findings are consistent with some prior studies. Yuan et al.  show thaIn addition, we open the black box by providing interesting results showing that ERs have heterogeneous impacts on different subprocesses of TI. The results strongly prove the need for the decomposition of TI and provide a novel perspective for understanding the effects of ERs on TI. The impacts of ERs on TVE and TTE changing from nonlinear to neutral suggests that the current intensity of ERs has different effects on technology investment and technology transformation. Under the same intensity of ERs, ERs can exert significant impacts on technology investment but exert insignificant impacts on technology transformation. Hence, to exert ERs’ significant and positive effects on technology transformation rather than only on technology investment, the stringency of ERs should be increased. Only when the intensity of ERs is strong enough can ERs have significant impacts on both technology investment and technology transformation. We also present a new finding showing that technology investment can be more sensitive than technology transformation as a response to ERs. A change in the increasing of the intensity of ERs may be able to exert their positive impacts on technology investment but not on technology transformation. Why should the intensity of ERs should be increased so that ERs can exert their significant impacts on technology transformation compared with technology investment? The reasons may lie in that technology investment and technology transformation represent different environmental strategies that firms adopt. When firms mainly focus on technology investment, they may respond to ERs sensitively but reactively. An increase in the intensity of ERs may quickly result in greater expenditure on technology investment . ConversAs mentioned earlier, sectors attach more emphasis on technology investment rather than technology transformation in present-day China see . Hence, Our findings can help to deepen the understanding of the Porter Hypothesis. When firms engage more in technology transformation and not only in technology investment, the Porter Hypothesis can be better supported. When firms give priority to technology transformation, they start to adopt proactive rather than reactive environmental strategies so that TI can fully exert its positive effect on performance. When ERs are able to promote technology transformation, the win-win situations that benefit both the environment and the economy can be achieved more easily.To address environmental problems, the Chinese government has promulgated and enacted a series of policies aimed to improve the stringency of ERs and encourage firms to invest more in TI. To fully achieve the win-win strategy between economic development and environmental protection, drawing on our findings, we can propose some valuable implications for policy-makers. On one hand, the government needs to improve the intensity of ERs until the intensity can surpass the turning point so that ERs can start to exert positive effects on TI. On the other hand, under a certain intensity of ERs, ERs may exert their positive impacts on technology investment but not on technology transformation. Hence, the stringency of ERs should be increased so that ERs can exert positive impacts on technology transformation. In this way, ERs can exert positive impacts on two different components of TI. All in all, when the government improves the intensity of ERs, ERs can not only exert their positive impacts on all sectors, but also exert their positive impacts on different subprocesses of TI. Determining whether ERs can stimulate TI or not is the key for enabling a win-win strategy benefiting both economic development and environmental protection. In this study, we innovatively employ a Network SBM DEA model to estimate not only TIE but also TVE and TTE via dividing TI into two different subprocesses (technology investment and technology transformation). We further examine the linear and nonlinear links between ERs and TIE and examine whether ERs have varying impacts on TVE and TTE in order to help open the black box and see the heterogeneous impacts of ERs on different subprocesses of TI.The data needed for the research questions come from different Chinese statistical yearbooks, and 36 sectors from 2005 to 2015 are included in our analyses. The evaluation results show that there is an overall increase in TIE, TVE and TTE. The importance of decomposing TI has been revealed, as it has been shown that the patterns of changes in TVE and TTE are different in China during the research period. The results further suggest that the impacts of ERs on TIE are nonlinear rather than linear. Besides, ERs have varying impacts on TVE and TTE. The impacts of ERs on TVE are nonlinear, whereas the impacts of ERs on TTE are statistically insignificant. On the basis of our results, we conclude that the intensity of ERs should be increased so that ERs can exert positive effects on technology transformation. This study enriches the existing studies in three aspects. First, we divide TI into two different subprocesses, rather than treating it as a single process, in order to open the black box and identify the inefficient subprocess of TI. Second, the majority of previous studies use a single indicator to represent TI and then investigate the impacts of ERs on TI. Instead, we use multiple indicators and innovatively use the evaluation results via the Network SBM DEA model to capture TI. Third, our study enhances the prior studies by analyzing the heterogeneous impacts of ERs on different subprocesses of TI in order to further open the black box and provide a novel perspective for understanding the effect of ERs on TI. Finally, the novel examination of the impacts of ERs on TIE, TVE and TTE in Chinese context is another contribution of this paper.Despite of the contributions mentioned above, this study has some limitations as well. We believe future research can overcome these limitations. First, for the measurement of ERs, we could not include the operating costs of industrial waste solid treatment due to the unavailability of data. Future studies can consider these costs when available. Second, some scholars have proved that different types of ERs can exert varying influence on TI ,55. Howe


Cognitive models of psychopathology were applied to inform the relationships between paranoid cognitions, perceptions of workplace bullying, and intentions of workplace deviance in UK and French teachers. Sixty-six UK teachers and 50 French teachers were asked to fill in an online survey comprised of the Green Paranoia Thought Scales, Negative Acts Questionnaire, Depression, Anxiety and Stress scales, and Workplace Deviance Scale. The variables in this study were conceptualized as cognitions and not as facts because the study used self-report questionnaires of paranoid ideation, workplace bullying, and workplace deviance. Mann-Whitney tests showed that UK teachers report significantly more perceptions of work-related bullying and intentions of workplace deviance than French teachers. However, there was no statistically significant difference between UK and French teachers for the report of paranoid ideation. Mediation analyses showed that paranoia impacted on intentions of workplace deviance but perceptions of workplace bullying and negative affect did not mediate this association in UK and French teachers. Culturally tailored psycho-social interventions should be implemented targeting teachers' paranoid thinking and workplace bullying in order to deter teachers from engaging in workplace deviance and to promote their well-being. Research on applying clinical cognitive and behavioral models , 2 to orAlthough some effort has been done in the past to study the prevalence of paranoia and its associations with both perceptions of workplace bullying and workplace deviance in samples of workers mostly from Anglo-saxonic countries, e.g., the UK , 8, therThis study will address those issues and will use a cognitive and behavioral framework of cognitions, affect, and behavior , 2 and aWorkplace bullying is defined by Einarsen, Hoel, Zapf, and Cooper [, page 11Previous research has found that more than 20% of both UK and French teachers have reported having received threats of physical violence. In France, more than 10% of teachers reported physical violence from non-colleagues. In the UK, prevalence rates for reported workplace bullying of teachers were higher than 10% and 15%, and the most common types of bullying were physical violence from colleagues and general bullying, respectively .In France, a study by Gilbert and Vercambre-Jacquot 2016) showed that the perpetrator(s) of the bullying of French teachers may depend on the students' teaching grades and social background. In basic education , perpetrators are most often the parents, while in secondary school and high school, perpetrators are most often the students themselves . Also, F16 showedWorkplace bullying has also been found not only to be linked to teachers' poor mental health  but alsoIndeed, teachers' workplace deviant behaviors may affect the students' learning progression and well-being, and the quality of teachers' relationships with other colleagues and with the school management, impacting negatively, as well on the well-being of teachers. Therefore, detection of deviant behaviors in schools is critical to prevent such behaviors and to take necessary counter-measures. In spite of this, previous research on this important topic has failed to explain what are the reasons behind the perceptions and report of workplace bullying and of workplace deviance by teachers. This study will aim to address this lacuna by drawing on cognitive models of psychopathology and bullying in the workplace.According to classic cognitive and behavioral models of psychopathology , 22 thatAs such, we would expect under the cognitive and behavioral models of psychopathology and bullying , 2, 22 tMoreover and according to Chan and McAllister's  model ofIt is possible that in time, the vicious circle between paranoid thinking, perceptions of workplace bullying and negative affect/mood and intentions of workplace deviance may predispose the onset of psychiatric disorders like psychosis and or major depression , 23, 24.It is important to note that in the model see Figure 1This is proposed because first, there is clinical/genetic research on paranoia that has shown that paranoia may not be as influenced by negative experiences as to be expected  and as such, has a strong genetic component , 26. SecIn conclusion, there is research that seemed to suggest that on the one hand, paranoia may not be as influenced by negative experiences like workplace bullying as previously thought, and on the other hand, paranoia is capable of influencing other negative context-dependent cognitions and behavior independently of the exposure to context-dependent negative events that are thought to prompt them and of the presence of negative affect. As such, we propose a model that looks specifically at the uni-directional influence of paranoia on intentions of workplace deviance that is either direct or indirect through the influence of perceptions of workplace bullying and or of negative affect.Also, workplace bullying and negative affect were proposed as possible mediators of the influence of paranoia on intentions of workplace deviance because on the one hand, it was found in samples of UK workers that paranoia is likely to interact with perceptions of abuse in the workplace to explain intentions of workplace deviance that in its turn, works as retaliation against the perceived abuse in the workplace through the lens of paranoia . On the H1. It is expected that UK teachers would show statistically significantly more work-related bullying than French teachers and that they would also show statistically significantly more intentions of workplace deviance than French teachers.H2. Drawing on the cognitive and behavioral model of abusive supervision through the lens of paranoia , we expeH3. Drawing on the previous cognitive and behavioral models and research on the effects of sub-clinical paranoia on cognition and behavior , we expeIn total, 50 French and 66 UK teachers were included in the present study. The inclusion criteria were to be currently working as a teacher for the past 6 months and teaching different teaching grades ranging from elementary to high school levels excluding university. Teachers that had managerial and supervisory roles were excluded from the analyses. The recruitment of teachers in the UK was made by contacting the headmasters of public schools and specialized schools in Nottingham and then asking for permission to advertise the study to teachers by distributing fliers with the link to the online qualtrics survey hosted at Nottingham Trent University in the UK and by advertising the study in the schools' webpage dedicated to teachers only. Teachers were told in both samples that the study was about negative experiences at school and workplace performance of teachers to avoid socially desirable responses.Regarding the French sample, recruitment of participants was made through four methods: by sending an invitation email to participate in this study through social networks, especially groups and associations of teachers; through the websites of teacher associations  among others and through contacts by telephone and email to the secretariats of some French educational institutions. Acquaintances were also requested to diffuse the invitation email to their colleagues working in schools in France. Participants in the French study completed an online survey hosted at Epsyline, the online questionnaire service of the Epsylon Research Laboratory. In both studies, the first page of the survey contained a brief introduction to the study, followed by socio-demographic questions. Those questions were then followed by mental health questions that then were followed by the battery of the questionnaires used in this study. No identifying data was requested in both UK and French studies and both online surveys asked for teachers' consent by asking them to click “yes” to continue to the online survey. Moreover, participants in both studies were allowed to drop out at any time by just closing the web browser. They were also fully debriefed at the end and the study took approximately 30 minutes to complete. All data were anonymized by the qualtrics and or Epsylon software that generated a random number for the participants' data. The studies also followed the British Psychological Society's code of ethics for internet research and the code of ethics of the World Medical Association (Declaration of Helsinki) and were approved by the Ethics Research Committees of Nottingham Trent University's Department of Psychology in the UK and the Laboratory of Epsylon in France.Green Paranoia Thoughts Scale (GPTS) (Paranoia was measured by the e (GPTS) . The GPTe (GPTS) . The orie (GPTS) . In thisNegative Acts Questionnaire-Revised (NAQ)   which ined (NAQ) .Workplace Deviance Scale (WD)  . This scale (WD) . Consistale (WD)  the scalDepression, Anxiety and Stress Scale (DASS-21) was also employed to measure negative affect and mood including depression, anxiety, and stress in the French sample. Each item is scored on a 4-point scale . Higher scores indicate greater levels of negative affect and mood. It was initially developed and validated by Parkitny and McAuley . Exploratory data analyses revealed that the data distributions were not normal. We tried to deal with the non-normal distributions by using transformations. The methods employed did not result in normal data distributions. Consequently, we chose to perform non-parametric analyses. Comparisons between the two samples (UK vs. French samples of teachers) were performed using Mann-Whitney analyses. Moreover, correlations between the different variables employed in this study were analysed using Spearman's Rho correlations for each sample. Benjamini and Hochberg's  false diA power analysis performed with G* power package was conducted to examine the strength of the differences between the uneven groups. It was observed for a sample of 116 individuals a power sensitivity of 99% for the two samples' comparisons for work-related bullying and workplace deviance and its dimensions, which enabled us to reject the null hypothesis and hence to support hypothesis 1. We used the SPSS macro developed by Hayes  to test The samples' characteristics concerning the socio-demographic variables and the report of mental disorders are presented in N = 116) are presented in The means and sds for the key variables for the total sample of teachers . In contrast to this, the French teachers identified evenly the perpetrators of workplace bullying as being their immediate superiors (N = 3), colleagues (N = 3), and students (N = 3).Concerning the report of workplace bullying in the past 6 months (item 23 of the NAQ)  68% of Uq = 0.015), UK teachers showed statistically significantly more work-related bullying and more intentions of workplace deviance and more specifically, organizational deviance than French teachers , as well as for the workplace deviance score. After applying Benjamini and Hochberg's  correctehers see Table 3.M = 29.24, SD = 16.51 for the UK's and M = 31.36, SD = 14.47 for the French's ideas of reference and M = 25.56, SD = 14.64 for the UK's and M = 26.52, SD = 17.74 for the French's ideas of persecution of paranoia). Concerning the prevalence of paranoid thoughts of the GPTS, ranging from the more common thoughts concerning ideas of reference to ideas of persecution of different levels of threat including a conspiracy, UK teachers showed a M = 1.71, SD = 1.26 for the thought “People definitely laughed at me behind my back” and 12% of UK teachers fully agree that they thought that people laughed behind their back. Similarly to the UK teachers, French teachers showed a M = 1.76, SD = 1.38 for “People definitely laughed at me behind my back” and 10% of French teachers acknowledged completely having this thought. Relatively to the more clinical thoughts of paranoia, UK teachers showed a M = 1.72, SD = 1.25 for the thought “I have definitely been persecuted” whereas French teachers showed a slightly lower mean for this thought . This meant that both UK and French teachers tend to somewhat agree to having the thought of being persecuted. Moreover, 8% of UK teachers and 12% of French teachers completely acknowledged being persecuted. Finally, concerning the more severe thought of a conspiracy, UK teachers showed a M = 1.53, SD = 1.07 and French teachers showed a M = 1.40, SD = 1.42 for the thought “I was convinced there was a conspiracy against me”, suggesting as expected, that thoughts of a conspiracy are less endorsed by individuals. Moreover, only 5% of UK teachers and 8% of French teachers fully acknowledge having the thought of a conspiracy against them.Echoing previous findings with an UK non-clinical population , the meaq = 0.023) was applied for the French sample of teachers only because p-values for the UK sample of teachers were all < 0.0001, therefore no corrections were applied for the correlations with this sample. Additional correlations were performed between DASS-21 negative affect/mood dimensions  and the other continuous variables for the French sample only. DASS -21 depression was significantly positively associated with both paranoia , and intentions of workplace deviance . DASS- 21 depression was also moderately positively associated with the physical intimidation dimension of workplace bullying . DASS-21 anxiety was significantly positively associated with paranoia  and DASS-21 stress was significantly positively associated with intentions of workplace deviance  Finally, the DASS-21 total score was significantly positively associated with paranoia  and with intentions of workplace deviance .Spearman Rho's correlation coefficients are presented in β = .45, p = .001; R2 = .76, p = .001) and with intentions of workplace deviance , nevertheless, workplace bullying was not statistically associated with intentions of workplace deviance . Consequently, the indirect effect of paranoid thinking on intentions of workplace deviance through workplace bullying was not statistically significant .Following the results of correlations for both samples, one mediation model was tested for the UK sample using intentions of workplace deviance as a dependent variable, paranoid thinking measured by the GTPS  as an inβ = .09, p = .04; R2 = .08, p = .04). Nevertheless, neither negative affect/mood  nor paranoid thinking  were significantly associated with intentions of workplace deviance . Consequently, the indirect effect of paranoid thinking through negative affect/mood on intentions of workplace deviance although being statistically significant .Regarding the French sample, paranoid thinking was entered as an independent variable and intentions of workplace deviance as a dependent variable. Since workplace bullying was neither associated with negative affect/mood nor with intentions of workplace deviance, we could not enter this variable as a mediator in the model as we did for the UK sample. Instead, we entered the variable of negative affect/mood as a mediator since correlations showed that this variable was associated with intentions of workplace deviance in the French sample of teachers. Therefore, we decided to move forward with the testing of the mediation effect of negative affect/mood. Results showed that paranoid thinking was statistically significantly associated with negative affect/mood . However. the means for ideas of reference and of persecution of both UK and French teachers are slightly higher than the means observed in the UK non-clinical sample but not the clinical sample in the original study that validated the GPTS . Those results suggest that both UK and French teachers tend to have paranoid thoughts and as such, those thoughts should be assessed more deeply in the future with larger national samples.Second, paranoid thoughts of the GPTS  are relathe GPTS  .Teachers in France besides having the usual teaching responsibilities are also expected to educate students on various social and moral topics such as, on how to behave in a social group and not to steal . TherefoIn addition to those results, our results also supported hypothesis 2 and suggested as previously found in the literature, that paranoid thinking is associated with perceptions of workplace bullying   and withIn support of Garety, Kuipers, Fowler, Freeman and Bebbington  model ofWhen examining the mediation models for both cross-cultural samples of teachers it was observed in the UK sample that although paranoid thinking had a direct effect on the variance of intentions of workplace deviance, perceptions of workplace bullying (in spite of being associated with intentions of workplace deviance as well) did not act as a mediator for the paranoia's effect on the variance of intentions of workplace deviance. This partially supports our hypothesis 3 that hypothesised direct and indirect effects of paranoia thinking on the variance of intentions of workplace deviance and this result suggested instead that paranoid thinking by itself is sufficient to impact on the variance of intentions of workplace deviance. This result also partially supports the cognitive and behavioral model of paranoia by Garety Kuipers, Fowler, Freeman and Bebbington  because Nevertheless, the fact that the study found a direct effect of paranoia on the variance of intentions of workplace deviance without workplace bullying for the UK sample of teachers supports the notion in clinical psychology that paranoid tendencies are relatively stable and have a strong genetic component and that they are not easily influenced and shaped by negative events  . For exaMoreover, research has shown the prevalence of a paranoid personality type in non-clinical populations, which might have more explanatory power than environmental factors such as, the experience of bullying . In suppResults of the mediation analysis for the French showed that negative affect did not mediate the impact of paranoia on intentions to engage in workplace deviance, and this also partially supports hypothesis 3. This result meant that perceptions of workplace bullying did not act as a mediator for both UK and French samples. Likewise, negative affect did not mediate the association between paranoid thinking and intentions of workplace deviance in the French sample.This result may be explained due to the weaker relationships between paranoid thinking and intentions of workplace deviance in the French sample of teachers that may have been caused by the small sample size of the French sample that led to a lack of statistical power in the model. However, this result also fits with the literature on paranoia that argued that paranoid thinking is associated with negative affect and mood and with worry .Our resuTherefore, the mediation results of the French sample of teachers partially support the cognitive model for persecutory delusions proposed by Garety, Kuipers, Fowler, Freeman, and Bebbington  that proUnder the light of Chan and McAllister's  model itPrevious research also found that ruminating on the paranoid thoughts might also cause more negative affect  and consThere are several limitations with this study. Firstly, the sample sizes were rather small and most of the teachers were from the public sector and female. However, the samples of our study do represent national samples since for both UK and French national samples there are more females than males in the teaching profession. Nevertheless, it is suggested that future studies in this area should have larger sample sizes and should include more diversified samples of teachers, including teachers from the public and private sectors. Ideally, research should be done with more cross-cultural samples to provide a holistic picture to the issue of workplace deviance in teachers. Secondly, the samples were of convenience, which means that a self-selection bias might have been present. Thirdly, we used self-report measures of bullying and of workplace deviance. Although we conceptualized workplace bullying as perceptions of bullying and workplace deviance as intentions of deviance  it is argued that in the future and in contrast to most research that has been done up until now, studies should try to have observational measures for workplace bullying and deviance. Fourthly, clearly there were concerns of social desirability regarding the report of workplace-related issues and thoughts by the French teachers. Indeed, by using self-report questionnaires to measure those issues and thoughts, not only they fail to fully and vividly capture the experiences of bullying and associated paranoid thougths and workplace deviant behaviors but there might have been social desirability biases in the reporting of behaviors, bullying, negative affect/mood and of paranoia . As suchFinally, there are potential confounders like career adaptability, affective investment, organizational and peer support that are directly related to the workplace environment and as such, might have influenced teachers' responses in this study. For example, career adaptability has been found to be essential for strategic career development, enabling adjusting to adverse work environments . TherefoThe results of this study suggest important practical recommendations. A psycho-social intervention should be devised for teachers with the intent of promoting their positive mental health and positive behaviors in schools but this needs to be tailored according to the cultural context. This intervention should integrate components of cognitive and behavioral therapy (CBT) tailored to address workplace contexts/issues , 8. CBT Our results showed that UK teachers tend to report more work-related bullying and intentions to engage in workplace deviance than French teachers. More importantly, results suggested that paranoid thinking not only is rather common in UK and French teachers but is also associated with perceptions of workplace bullying and intentions to engage in workplace deviance. Moreover, our results showed that neither negative affect nor workplace bullying mediate the association between paranoid thinking and intentions to engage in workplace deviance in both French and UK teachers. This supported previous research with UK workers that found that their supervisory-related paranoia had an impact on their poor well-being and intentions to engage in workplace deviance . Future The datasets generated for this study are available on request to the corresponding author.https://www.bps.org.uk/news-and-policy/ethics-guidelines-internet-mediated-research-2017 and the code of ethics of the Declaration of Helsinki as it can be read in text under Participants.The studies involving human participants were reviewed and approved by the Department of Psychology at Nottingham Ethics Research Committee and Laboratoire Epsylon Ethics research Committee in France. The patients/participants provided their written informed consent to participate in this study. The study was conducted under the guidelines of the British Psychological Society for internet mediated research, see here: All authors were involved in setting up the research. BL was involved in setting up the research in the UK whereas CB, SR, and VM were involved in setting up the research in France. BL was in charge of formulating the research questions and writing pieces of the introduction, method, results for the UK sample and the general discussion. CB was in charge of writing pieces of the introduction, the method, and the results for the French sample. SR and VM were in charge of writing pieces of the introduction for the French sample.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.The handling editor declared a past collaboration with one of the authors SR.