Hasil untuk "Hazardous substances and their disposal"

Ioannis Stefanakos, Roisin Bradley, Radu Calinescu et al.

Robotic and embodied-AI systems have the potential to improve accessibility and quality of care in clinical settings, but their deployment in close physical contact with vulnerable patients introduces significant safety risks. This paper presents a hazard management methodology for MammoBot, an assistive robotic system designed to support patients during X-ray mammography. To ensure safety from early development stages, we combine stakeholder-guided process modelling with Software Hazard Analysis and Resolution in Design (SHARD) and System-Theoretic Process Analysis (STPA). The robot-assisted workflow is defined collaboratively with clinicians, roboticists, and patient representatives to capture key human-robot interactions. SHARD is applied to identify technical and procedural deviations, while STPA is used to analyse unsafe control actions arising from user interaction. The results show that many hazards arise not from component failures, but from timing mismatches, premature actions, and misinterpretation of system state. These hazards are translated into refined and additional safety requirements that constrain system behaviour and reduce reliance on correct human timing or interpretation alone. The work demonstrates a structured and traceable approach to safety-driven design with potential applicability to assistive robotic systems in clinical environments.

Dinay Eloisa Durán-Sequeda, Aldo Ibarra-Rondón, Pedro Fragoso-Castilla

Pleurotus ostreatus has emerged as a promising model for heavy metal bioremediation. Given the known role of laccases in copper oxidation, it was hypothesized that higher laccase activity would correlate with increased copper removal. This study evaluated how the composition of the culture medium influences copper adsorption and its relationship with copper-induced laccase activity in this fungus. Fungal pellets were produced in two different media, and their morphological characteristics, laccase activity, and copper removal capacity were evaluated. The results show that, contrary to expectations, pellets with more complex morphology and higher laccase activity exhibited a maximum copper loading capacity approximately six-fold lower than those produced in media with lower laccase activity. Analysis of the pellets by SEM-EDX, FTIR, and confocal microscopy revealed some physicochemical differences. Pellets with higher copper loading capacity had higher fluorescence suggesting more cell wall polysaccharide content, but lower laccase activity. These results offer a possible link between copper removal and copper-induced laccase activity associated with compositional medium for fungal culture. This finding represents a novel approach to designing and optimizing fungal biotechnological solutions in heavy metal bioremediation.

Ameneh Marzban, payam emami

Dear Editor Obesity has emerged as one of the most pressing public health challenges of the 21st century. Its prevalence has escalated globally, affecting both high-income and low- to middle-income countries (Jiwani et al., 2019; Sanchez-Vaznaugh et al., 2019). The consequences of obesity extend beyond individual health, contributing to increased rates of cardiovascular disease, type 2 diabetes, respiratory complications, and certain cancers (Hamano et al., 2018). Moreover, the economic burden is staggering, with obesity-related healthcare costs accounting for a significant portion of national health expenditures estimated at 1.2% of GDP in the United States alone (Van Hulst et al., 2025). While genetic and behavioral factors are often cited in discussions of obesity, growing evidence points to the critical role of environmental determinants (Hamano et al., 2018). Among these, the spatial distribution of fast food restaurants has garnered increasing attention (Jiwani et al., 2019). Studies have consistently shown that individuals residing in close proximity to fast food outlets are more likely to exhibit unhealthy dietary patterns, including higher consumption of energy-dense, nutrient-poor foods and lower intake of fruits and vegetables (Gallego & López-Gil, 2024; Hamano et al., 2018; Van Hulst et al., 2025). This trend is particularly alarming among children and adolescents, whose exposure to fast food near schools and recreational areas correlates with increased intake of sugary beverages and processed snacks (Jia et al., 2021). The proliferation of fast food establishments reflects broader socioeconomic and cultural dynamics (Jia et al., 2021). In many urban settings—particularly in countries such as the United States and the United Kingdom—fast food restaurants are disproportionately concentrated in low-income neighborhoods, where access to fresh produce and healthy food options is limited. For example, in the UK, 29% of people living in the most deprived areas reside in neighborhoods with the highest concentration of fast food outlets, compared to only 11% in the least deprived areas (Sanchez-Vaznaugh et al., 2019). Similarly, a multi-country study across 68 nations found that food insecurity was significantly associated with increased fast-food consumption, especially in low- and middle-income countries (Smith et al., 2022). This imbalance in the food environment exacerbates health disparities and perpetuates cycles of poor nutrition and obesity (Gallego & López-Gil, 2024).Despite public health campaigns which aims at promoting healthier eating habits, the nutritional profile of fast food offerings has remained largely unchanged, and aggressive marketing strategies continue to target vulnerable populations (Gallego & López-Gil, 2024). To address this multifaceted issue, The authors recommend a comprehensive public health approach that includes both regulatory and educational interventions (Jiwani et al., 2019). Zoning policies should be implemented to restrict the establishment of fast food outlets near schools, parks, and residential zones (Van Hulst et al., 2025). Simultaneously, incentives should be provided to encourage the development of supermarkets and grocery stores offering affordable, nutritious food options. Community-based programs that promote food literacy and empower individuals to make healthier choices are also essential (Jiwani et al., 2019). Furthermore, longitudinal research is needed to examine the causal relationship between food environments and obesity outcomes. Such studies should account for confounding variables such as socioeconomic status, physical activity levels, and cultural dietary preferences. By deepening the understanding of these dynamics, policymakers can design targeted interventions that are both effective and equitable. In conclusion, the spatial accessibility of fast food is not merely a convenience; it is a determinant of public health. Tackling obesity requires a shift in how we conceptualize and regulate our food environments. Through coordinated efforts across urban planning, education, and health sectors, we can create communities that support healthier lifestyles and reduce the burden of obesity.

Niklas Köller, Dustin Roedder, Christian J. Linnartz et al.

Flow-electrode Capacitive Deionization (FCDI) is an innovative method for practical salt removal and recycling applications. Here, we report that FCDI facilitates the recovery of nitrate and fluoride salts from brines produced during the wastewater treatment process in a stainless steel pickling line. Laboratory-scale experiments with synthetic wastewaters were used to evaluate the influence of (a) the membrane thickness, (b) feed flow rates, and (c) applied voltage on the outlet concentrations and the average salt transfer rate. In continuous single-pass experiments, the flow rates of diluate and concentrate have the greatest influence on the resulting outlet concentrations in the FCDI process as they directly influence the residence time. The operating voltage of the FCDI process can be varied to increase the ratio of fluoride over nitrate for recycling.

Erika Maria Ricci, Miryam Perrucci, Marcello Locatelli et al.

Growing concerns over environmental pollution have led to increased emphasis on Green Chemistry and, more specifically, Green Analytical Chemistry (GAC). These frameworks advocate for the reduction of hazardous substances, minimization of waste, and consideration of the entire life cycle of analytical procedures—from production to disposal. Within this context, miniaturized analytical techniques have emerged as sustainable and efficient alternatives to conventional methods. Among these, capillary liquid chromatography (cLC), nano-liquid chromatography (nano-LC), and various modes of capillary electrophoresis (CE)—including micellar electrokinetic chromatography (MEKC), capillary isotachophoresis (CITP), capillary zone electrophoresis (CZE), capillary isoelectric focusing (CIEF), and capillary gel electrophoresis (CGE) have gained significant traction. Their advantages in terms of reduced solvent and sample consumption, enhanced resolution, and faster analysis times have made them particularly valuable in pharmaceutical and biomedical applications. One critical application area is the chiral separation of active pharmaceutical ingredients (APIs), which is increasingly vital in biotechnology, chemistry, agriculture, and especially the pharmaceutical industry. Electrokinetic chromatography (EKC) has proven to be an effective and versatile technique for this purpose, offering high resolution, flexibility, speed, and cost-efficiency. The growing availability of novel chiral selectors further enhances its appeal for the separation of enantiomeric drug compounds. This review provides an overview of recent advancements in miniaturized analytical techniques and highlights their applications in the biomedical and pharmaceutical sectors, with a particular focus on chiral separations using EKC.

Kshitija Shah, Vijaya Pandey, Himadri Bose et al.

The differential expression of molecular markers identified in response to environmental contaminants offer insights into early-stage resilience pathways that may support biological remediation approaches. Per- and polyfluoroalkyl substances (PFAS) are chemically stable, persistent environmental pollutants, which are associated with multiple adverse health effects. While fungi possess oxidative enzymes with potential for PFAS biotransformation, the molecular basis of their tolerance and response remains poorly understood. This study investigated the proteomic response of Phanerochaete chrysosporium to 10 mg/L PFOA and an environmentally relevant concentration of a PFAS mixture. Although no measurable PFAS degradation was observed over a 25-day exposure period, significant differential protein expression of key stress-response proteins such as cytochrome P450s, glutathione S-transferases, heat shock proteins, peroxidases, and ABC transporters were noted, in both intra- and extracellular fractions. Functional enrichment revealed the activation of pathways related to posttranslational modification, protein turnover, membrane efflux mechanisms, catabolism, and signal transduction. Proteomic profiles were shaped more closely by exposure duration and localization than by compound identity. These findings highlight the early-stage adaptations and signaling mechanisms of wood-decaying fungi under PFAS stress, which precede observable chemical breakdown, and offer critical insights into fungal responses that may be leveraged for future monitoring and bioremediation strategies.

Haijun Li

Regular and rapid variation have been extensively studied in the literature and applied across various fields, particularly in extreme value theory. In this paper, we examine regular and rapid variation through the lens of generalized hazard rates, with a focus on the behavior of survival and density functions of random variables. Motivated by the von Mises condition, our hazard rate based framework offers a unified approach that spans from slow to rapid variation, providing in particular new insights into the relationship between hazard rate functions and the right tail decays of random variables.

Shuangping Han, Kai Song, Pengyu Zan et al.

In this work we introduce an innovative approach to single-molecule quantum coherence (SMQC)-based disposable micro-optical anti-counterfeiting labels. This method facilitates the editing and reading of anti-counterfeiting with single molecules used as the anti-counterfeiting information labels. The label is meticulously crafted through inkjet printing technology, while its authentication is achieved via frequency domain imaging. Through a validation process including experimental demonstration, numerical simulation, and neural network analysis, we demonstrate the feasibility of this approach, further validate the integrity of the miniature anti-counterfeiting information storage, and verify the signal extraction accuracy with the recognition accuracy of the labels is consistently above 99.995%. The combination of SMQC-based disposable micro-optical anti-counterfeiting technology is expected to enable more precise preparation of single-molecule-array chips, thus providing a crucial foundation for the advancement of high-tech and smart manufacturing industries.

Jasmine Li, Quanzhi Ye, Denis Vida et al.

The Taurid Complex is a large interplanetary system that contains comet 2P/Encke, several meteoroid streams, and possibly a number of near-Earth asteroids. The size and nature of the system has led to the speculation that it was formed through a large-scale cometary breakup. Numerical investigations have suggested that planetary dynamics can create a resonant region with a large number of objects concentrated in a small segment of the orbit, known as the Taurid swarm, which approaches the Earth in certain years and provides favorable conditions to study the Taurid Complex. Recent meteor observations confirmed the existence of the swarm for mm- to m-sized objects. Here we present a dedicated telescopic search for potentially hazardous asteroids and other macroscopic objects in the Taurid swarm using the Zwicky Transient Facility survey. We determine from our non-detection that there are no more than 9--14 $H\leq24$ (equivalent to a diameter of $D\gtrsim100$~m) objects in the swarm, suggesting that the Encke--Taurid progenitor was $\sim10$~km in size. A progenitor of such a size is compatible with the prediction of state-of-the-art Solar System dynamical models, which expects $\sim0.1$ $D>10$~km objects on Encke-like orbits at any given time.

J. A. Christen, F. J. Rubio

The hazard function is central to the formulation of commonly used survival regression models such as the proportional hazards and accelerated failure time models. However, these models rely on a shared baseline hazard, which, when specified parametrically, can only capture limited shapes. To overcome this limitation, we propose a general class of parametric survival regression models obtained by modelling the hazard function using autonomous systems of ordinary differential equations (ODEs). Covariate information is incorporated via transformed linear predictors on the parameters of the ODE system. Our framework capitalises on the interpretability of parameters in common ODE systems, enabling the identification of covariate values that produce qualitatively distinct hazard shapes associated with different attractors of the system of ODEs. This provides deeper insights into how covariates influence survival dynamics. We develop efficient Bayesian computational tools, including parallelised evaluation of the log-posterior, which facilitates integration with general-purpose Markov Chain Monte Carlo samplers. We also derive conditions for posterior asymptotic normality, enabling fast approximations of the posterior. A central contribution of our work lies in the case studies. We demonstrate the methodology using clinical trial data with crossing survival curves, and a study of cancer recurrence times where our approach reveals how the efficacy of interventions (treatments) on hazard and survival are influenced by patient characteristics.

Ziyue Liu, Michelle T. Bensi

Tropical cyclone-induced coastal hazards can significantly damage coastal infrastructure, and these risks may intensify under future climate change. As a result, there is increasing interest in conducting comprehensive assessments of coastal hazards-including storm surge, storm wind, storm rainfall, and their combined impacts-associated with tropical cyclone events. Risk assessments that overlook the compounding nature of these hazards may lead to ineffective or insufficient mitigation strategies. This study seeks to identify and evaluate the available data, models, and methodologies for assessing both individual and compound typhoon-induced hazards in South Korea. Particular effort is devoted to exploring how established approaches from the North Atlantic region can be adapted, integrated, and extended for application in the South Korean context. Multiple sites across South Korea are analyzed to illustrate the strengths and limitations of these methods.

Mary Lai O. Salvaña

A fundamental theoretical limitation undermines current disaster risk models: existing approaches suffer from two critical constraints. First, conventional damage prediction models remain predominantly deterministic, relying on fixed parameters established through expert judgment rather than learned from data. Second, probabilistic frameworks are fundamentally restricted by their underlying assumption of hazard independence, which directly contradicts the observed reality of cascading and compound disasters. By relying on fixed expert parameters and treating hazards as independent phenomena, these models dangerously misrepresent the true risk landscape. This work addresses this challenge by developing the Multi-Hazard Bayesian Hierarchical Model (MH-BHM), which reconceptualizes the classical risk equation beyond its deterministic origins. The model's core theoretical contribution lies in reformulating a classical risk formula as a fully probabilistic model that naturally accommodates hazard interactions through its hierarchical structure while preserving the traditional hazard-exposure-vulnerability framework. Using tropical cyclone damage data (1952-2020) from the Philippines as a test case, with out-of-sample validation on recent events (2020-2022), the model demonstrates significant empirical advantages. Key findings include a reduction in damage prediction error by 61% compared to a single-hazard model, and 80% compared to a benchmark deterministic model. This corresponds to an improvement in damage estimation accuracy of USD 0.8 billion and USD 2 billion, respectively. The improved accuracy enables more effective disaster risk management across multiple domains, from optimized insurance pricing and national resource allocation to local adaptation strategies, fundamentally improving society's capacity to prepare for and respond to disasters.

Yohannes Desalegn Wirtu

The use of cosmetic products is expanding globally, and with it, so is the range of chemical substances employed in their production. As a result, there is also a higher risk of intoxication, allergic reactions, prolonged chemical exposure, adverse effects, and indiscriminate use. Cosmetic products can contain more than 10,000 ingredients. Most users of synthetic cosmetics are unaware of the harmful effects if they even are. However, it is linked to many diseases like cancer, congenital disabilities, reproductive impairments, developmental systems, contact dermatitis, hair loss, lung damage, old age, skin diseases and reactions, allergies, and harm to human nails. Many beauty products also create a high demand for natural oils, leading to extensive and intensive cultivation, harming natural habitats through deforestation, and contaminating soil and water through pesticides and fertilizers. The adverse effects of hazardous substances in synthetic cosmetics extend beyond human health and influence ecosystems, air quality, and oceans. Thus, this review aims to assess the environmental and health impacts of cosmetics using published scientific articles. The study used a systematic review based on Scopus, Science Direct, Web databases, Scholar Google, and PubMed. The results of this review showed that the formulation of cosmetics until the disposal of their containers could adversely affect environmental and human health.

Afonso Henrique da Silva Júnior, Carlos Rafael Silva de Oliveira, Tarcisio Wolff Leal et al.

Organochlorine pesticides have been widely used in agriculture to control agricultural pests. Although effective in controlling pests, organochlorine pesticides present numerous hazards to ecosystems and human health due to their persistence in the environment, bioaccumulation, and toxicity. Scientific studies have shown that organochlorines may be associated with endocrine and neurological problems. Several strategies have been developed to apply treatment techniques to remove pesticides from various ecosystems, both aquatic and terrestrial. Physicochemical and biological methods have revealed other potentialities for remediation of aqueous environments contaminated with organochlorine pesticides. In addition, combined processes using different approaches have been highlighted as efficient alternatives to mitigate the impacts of agrochemicals on the environment, e.g., physical technique followed by a biological process. However, there are still numerous gaps that need to be explored and elucidated. Therefore, this review addressed the impacts of organochlorine pesticides on ecosystems and some treatment techniques used to remove agrochemicals from water. Furthermore, new findings, technological perspectives, and opportunities on this subject were presented and discussed.

Tangri Shreya, Kumari Ruby, Kalra Preety

A significant class of water pollutants emerging as a threat to human and aquatic populations is Per-and-polyfluoroalkyl substances (PFAS). The primary concern linked to PFAS is that they exhibit bioaccumulation potential as their perfluorocarbon moieties do not break down or do so very slowly under natural conditions, which is why PFAS has often been termed “forever chemicals.” These chemicals are disposed off in aquatic bodies via improper disposal methods, and because PFAS are persistent, they accumulate or concentrate in the water environment. Subsequently, these chemicals hamper the aquatic population and further enter the human food chain via direct consumption of affected aquatic species and drinking water. In this study, a mathematical model has been developed to understand the alarming consequences of PFAS on human and aquatic populations and the various challenges being faced due to inadequate treatment and management of these chemicals. The model has been analyzed for stability at the equilibrium points. Numerical simulations have also been carried out to support the analytical findings. The analysis demonstrates that rising PFAS contamination is extremely hazardous to both aquatic and human populations and immediate control methods need to be devised to restrain their increasing levels in water.

Anna Magdalene Brun Hansen, Rikke Poulsen, Louise von Gersdorff Jørgensen et al.

Polyquaternium polymers are widely used in various applications, such as personal care products and wastewater treatment plants, and eventually end up in the aquatic environment. While polymers have been perceived of low toxicological concern due to their size, several studies have pointed towards water-soluble cationic polymers being toxic towards aquatic organisms – and that the toxicity largely is determined by the polymer charge density. The present study investigated the polyquaternium toxicological mechanism of action throughout lipidomic analysis and changes in immune-gene expression (qPCR) of zebrafish larvae exposed continuously to two water-soluble polymers; a high charge density polyquaternium-6 and a low charge density polyquaternium-10, for 5 and 12 days upon fertilization. The results showed that the investigated polyquaterniums cause both inflammatory responses and significant alterations of the zebrafish larvae lipidome. Depending on polyquaternium polymer and larvae development stage, the gene expression showed an inflammatory response (e.g. significant up-regulation of il8, il1β and tnfα) in the exposed zebrafish. Alterations of the lipidome were additionally observed, with severe depletion of lipids (e.g. lyso-glycerophosphocholines and ceramides) in the 12 days old larvae exposed to high charge density polymer. The findings furthermore support a hypothetical mechanism of action to be non-specific and lethality potentially to be narcosis-like driven.

Gijs A. Verdoes Kleijn, Teymoor Saifollahi, Rees Williams et al.

Current and upcoming large optical and near-infrared astronomical surveys have fundamental science as their primary drivers. To cater to those, these missions scan large fractions of the entire sky at multiple wavelengths and epochs. These aspects make these data sets also valuable for investigations into astronomical hazards for life on Earth. The Netherlands Research School for Astronomy (NOVA) is a partner in several optical / near-infrared surveys. In this paper we focus on the astronomical hazard value for two sets of those: the surveys with the OmegaCAM wide-field imager at the VST and with the Euclid Mission. For each of them we provide a brief overview of the astronomical survey hardware, the data and the information systems. We present first results related to the astronomical hazard investigations. We evaluate to what extent the existing functionality of the information systems covers the needs for the astronomical hazard investigations

Fatemeh Zare Bidoki, Zohreh Arefmanesh, Jamal Barzegari Khaneghah

Background: auditors are required to make judgments in various fields, and their cognitive limitations lead to the deviation of their judgments. Goal orientation, which comes from the motivation of each person, as well as self-efficacy as another cognitive factor, can affect the way auditors’ judge. Therefore, this research examines the relationship between goal orientation and auditors' judgment performance, emphasizing the mediating role of self-efficacy. Methods: The statistical population of this research is auditors working in auditing institutes in Yazd and Isfahan provinces in 2021. In order to collect data, the auditors' standard performance questionnaires of Susetyo, Elliot and McGregor's goal orientation questionnaire and Bell and Kozlowski's self-efficacy questionnaire were used. Results: The results of the structural equation modeling test in Amos software showed that out of the four dimensions of goal orientation, two dimensions of performance approach goal and mastery approach goal had a positive and significant relationship with auditors' self-efficacy and judgment performance (P < 0.05). The two dimensions of mastery avoidance goal and performance avoidance goal had a negative and significant relationship with self-efficacy and the auditors' judgment performance (P < 0.05). While self-efficacy had a positive and significant relationship with the auditors' judgment performance (β = 0.786, P = 0.000). Moreover, self-efficacy played a mediating role between the three dimensions of goal orientation, i.e. performance approach goal (β = 0.685, P = 0.033), performance avoidance goal (β = -0.671, P = 0.002), and mastery avoidance goal (β = -0.139, P = 0.014), with the auditors' judgment performance. Moreover, self-efficacy played a mediating role between the three dimensions of goal orientation, i.e. performance approach goal, performance avoidance goal and mastery avoidance goal, with the auditors' judgment performance. Conclusion: According to the research findings, it is important to pay attention to the auditors' psychological factors because these factors affect the auditors' judgment. This research helps companies and their audit committee to pay special attention to the psychological characteristics of auditors, including their goal orientation and self-efficacy in selecting an auditor.

Farzana Rashid Brownia, Shah Ehsan Habib

Background: Bangladesh has one of South Asia’s highest rates of child marriage, making female adolescents vulnerable to reproductive health risks. Shornokishoree (SK) Network has been implementing a mobilization program in Bangladesh using a variety of community engagement approaches. The main objective is to raise awareness among adolescents in secondary schools, bringing together as many stakeholders as possible. This paper aims to examine the effectiveness of the Network’s interventions and to determine changes in adolescents’ knowledge, attitudes and practices to prevent child marriage.    Methods: 630 participants were recruited from 35 secondary schools across eight divisions of Bangladesh. This study adopted a quasi-experimental design and consisted of a sample for intervention (308) and control group (322). The intervention group consisted of the participants who attended awareness sessions regarding early marriage and reproductive health issues. The study was conducted using stratified random sampling technique. Data were collected through a structured questionnaire and analyzed using SPSS version 23. Chi-square and z-tests were performed to assess the program’s effectiveness including associated factors. Results: The study shows that knowledge about child marriage remained significantly lower (p < 0.01) for the control group compared to the intervention group. Nearly one-third (27.9%) of the experimental group rejected the assumption that women’s marriageability begins with puberty. 38.4% of the participants in the  control group were unaware of the consequences of adolescent pregnancy compared to 8.1% of the intervention group (p < 0.01). Additionally, 29.9% of the control group had a very limited understanding of the child mortality and maternal death issues compared to 6.8% of the intervention group (p < 0.01). Conclusion: The study concluded that the awareness program has been very useful in improving knowledge about child marriage among adolescents, creating an impact on child marriage prevention.

Majid Heydari, Mohammad Nouri, Amir Maziar Niaei

Background: Cancer leads to fear and anxiety and reduces mental health in patients soon after its diagnosis. Hence, it is imperative to examine therapeutic steps toward promoting the psychological conditions of these patients. The aim of this study is to determine the effectiveness of positive psychotherapy (PPT) on the psychological well-being and hope of cancer patients undergoing chemotherapy. Methods: The study was a single-blind clinical trial with a pretest-posttest design with experimental and control groups. The statistical population included all patients referring to Taleghani Hospital of Tehran in 2020. Thirty patients were selected by purposeful sampling and randomly assigned into two experimental and control groups. The experimental group learned PPT in six sessions held once a week and the control group received no intervention. Demographic forms, Ryff's psychological well-being scale (RPWBS-18), and Snyder’s hope scale (SHS-12) were used to collect data, which were analyzed by the Chi-square and ANCOVA tests run in the SPSS-20 software. Results: The results showed that PPT enhanced psychological well-being (F = 9.29) and hope (F = 8.28) among patients with cancer (P<0.01). Moreover, the effect size of the PPT was 29% for psychological well-being and 27% for hope. Conclusion: The PPT is effective in promoting the psychological health of cancer patients. Thus, this cost-effective therapy can be used in healthcare centers to promote the psychological health of these patients.