This paper presents a system developed for the assistance with a collaborative robot in hand-assisted laparoscopic surgery (HALS). The system includes a sensing glove with piezoresistive sensors which capture continuously the flexion degree of the surgeon's fingers. These data are analyzed using an algorithm that detects and recognize the selected movements. This information is sent as commands to the collaborative robot throughout the surgical operation. The bending patterns, speed and execution times of the movements are modelled in a pre-phase in which it will extract all the necessary information for later detection during the motion execution. The results obtained with 10 different volunteers show a high degree of accuracy and a low false discovery rate.

Multiple sensor nodes known as detection stations make the sensor networks; each node is light and portable. Every sensor node contains power source, microcomputer, transducer and transceiver. Power source provides power to each node. Micro-computer is used for storing and processing the output coming from the sensors. The transducer is used to generate the signals and the transceiver is used to receive and transmit data to the central computer. Eavesdropping gets facilitated with wireless communication, and it has many useful applications in military, homeland, hostile and uncontrolled environments. So it is prone to the high level of security. The process in which information is gathered to form a summarized type for analysis is known as data aggregation, as it is used to reduce the energy consumption in wireless sensor networks. The security issues have become crucial in data aggregation, especially when gets deployed in hostile and remote environment. In wireless sensor networks many secure aggregations have been proposed. It still faces some resource constrained that’s why new techniques are needed. In our survey we will discuss those approaches and their pros and cons.

Epistaxis, particularly in Hereditary Hemorrhagic Telangiectasia (HHT) patients, is a common otolaryngological emergency, often requiring complex management. A hierarchy of increasingly invasive interventions, from external compression of the nasal pyramid to nostril closure, is typically proposed and applied. We conducted a retrospective study on HHT patients to assess the effectiveness and longevity of invasive procedures postoperatively. Data were collected using the Epistaxis Severity Score (ESS) questionnaire. The primary focus was on changes in the frequency and intensity of epistaxis, while the secondary focus was on the overall quality of life. The study found that invasive procedures initially improved the frequency and intensity of epistaxis in HHT patients. However, within one to 9 months postoperatively, these benefits often diminished, with hemorrhagic symptoms recurring at similar or worsened levels. Facial trauma further negated the advantages of these procedures. The findings suggest a need for a gradual and increasingly invasive approach to managing epistaxis in HHT patients. Highly invasive procedures should be reserved for cases where less invasive methods fail, due to their limited temporal effectiveness and the risk of causing anatomical-functional changes in the rhino-sinus area, complicating future management of severe epistaxis.

High Education Institutions (HEI) play a key role in fostering sustainability since students will be future active society members. By providing them with the knowledge, skills, and mindset needed to address environmental challenges, they can contribute to increase sustainability in a long-term approach. With the effects of climate change strongly affecting water availability across planet, it is increasingly relevant to understand if higher education students are aware of this situation, to develop adequate measures to promote sustainable behaviors regarding water uses. This study aimed to assess students’ perceptions regarding water efficiency through a questionnaire submitted in 7 HEI in Portugal. Students recognized the importance of water with older students, women and science students demonstrating a greater awareness. Inspite of this 27% students do not know what the average water consumption in Portugal is and only 18% accurately reported the consumption range in Portugal. There is also a lack of knowledge (>50% students) if common water efficiency measures are applied in their HEI. The main information sources identified by the students were “social communication” and “internet/social media”, revealing that water efficiency knowledge transfer in high education can be improved.

This paper utilizes the 2020 financial data of A-share listed companies, both ST and non-ST, as the data sample. The model is constructed employing the Factor-Logistic fusion algorithm. Eight key indicator factors were selected from the frameworks of profitability, solvency, operating capacity, development potential, shareholder retained earnings, cash flow and asset growth. An independent indicator system was subsequently established to address the issue of collinearity among risk indicators. The results of model are presented in the form of probabilities, enhancing the interpretability of model. The weights of the features indicate the influence of different features on the final outcome. The model achieves a prediction accuracy of over 89%, with an AUC score exceeding 95%. Finally, by applying the principles of interval estimation theory in statistical hypothesis testing, the risk levels are categorized as A-level representing significant risk, B-level representing moderate risk, C-level representing minor risk and D-level representing no risk. This paper aims to provide a comprehensive definition of a universal financial risk management warning model for enterprises, applicable to all enterprises in China.

The paper presents the findings of research on companies in the early stage of development based on the concept of ensuring their sustainability. The starting point is attributes shaping a sustainable model of start-ups. A solution has been proposed and examined that identifies the factors dynamising a business model, which give the company the ability to make fast changes in the configuration of the business model, and that applies stabilizing factors based on the concept of the Triple Bottom Line. The research problem is a response to the phenomena of the bankruptcy of many start-ups that cannot find a way to survive in the long term. The business models of companies in the early stage of development should be designed taking into account the possibility of their dynamic and iterative changes when the earlier assumptions do not work when implemented in practice. A cognitive gap has been observed as the relevant literature does not propose a systemic solution to the problem of instability of the startups viewed from the perspective of the business model concept. The research problem, therefore, is to identify potential new methods to ensure the sustainability of young companies trying to combine aspects dynamising changes in business models, taking into account economic, environmental and social aspects. The findings of research on companies in the early stage of development show that when the methods of increasing the flexibility of the business model are applied and attention is drawn to environmental and social activities and a strong emphasis is put on financial performance, reflecting the expectations of shareholders, the concept of ensuring the sustainability of young companies from the point of view of sustainable business model attributes emerges.

The global focus on geopolymer binder production has increased due to the adoption of waste materials and industrial byproducts. Given the gradual decline of the availability of fly ash and ground granular blast furnace slag (GGBFS) resulting from the decarbonization process in electricity and steel productions, waste clay brick powder (WCBP), could be a viable substitute of these pozzolanic by-products. This research is dedicated to thoroughly investigate the techno-eco-efficiency performance of WCBP when utilized as a geopolymer precursor. The favorable mechanical characteristics exhibited by fly ash-GGBFS-WCBP-based geopolymer binder emphasize the importance of assessing its sustainability alongside its technical viability. The study employed life cycle analysis (LCA), following ISO 14040-44 standards, and using the Simapro software, to evaluate the environmental implications of the use of WCBP-based geopolymer mixtures. Human toxicity emerged as the primary impact. Moreover, the analysis of life cycle costs highlighted key financial factors, with around 65-70% attributed to alkaline activators of the total cost. The production of alkaline activators was identified as a critical point for both environmental impact and economic considerations due to energy consumption. While WCBP-rich samples exhibit a 1.7-0.7% higher environmental impact compared to the control mix (CM), their high mechanical strength and cost-effectiveness make them technologically and economically efficient geopolymer mixes. In conclusion, the portfolio analysis for techno-eco-efficiency affirms that mixes containing 40%, 30%, and 20% WCBP are more efficient than those using 10% and 0% WCBP, respectively.

Aquaculture by-products can be compromised an important liming material of increasing soil pH and soil fertility. The aim of this research was to assess the effect of mussel shells on soil pH, on organic matter and on soil nutrients. In this study a pot experiment was carried out at the De-partment of Ichthyology and Aquatic Environment (University of Thessaly, Greece). A acidic soil (pH 4.26) amended with 6 different proportions of mussel shell (0.0, 0.1, 0.3, 0.5, 1, 3 and 6%) in two different grain sizes (Fine powder (>1 mm) and Coarse powder (1-2 mm)), resulting in 13 treatments. According to the results, it was observed that pH, organic matter, Available P and Exchangeable K increased. Specifically, the highest pH values observed at 6% rate. Available P and Exchangeable K achieved the highest content at 6% Fine powder treatment, 46.2 and 190.1 mg kg-1, respectively. Similarly, organic matter had the highest value in 6% Fine powder pots (2.27%). Moreover, Total N concentration varied from 0.11 to 0.14 but no statistically significant different was noticed between the treatments. In conclusion, mussel shells can compose a promising liming material in the agriculture section.

SDG target 12.3 calls for halving food waste at retail, food service, and household by 2030. The food waste index for this purpose includes parts attached to food that are usually removed intentionally ("unavoidable food waste") and allows counting the conversion to animal feed and utilisation as biomaterial as means of reduction. In Japan, the "Food Waste Recycling Law" which has been in effect since 2001, promotes the recycling of food waste generated from businesses, designating feed conversion as top priority. On the other hand, based on the more recent "Food Loss Reduction Promotion Act" of 2019, the government is currently promoting the reduction of avoidable food waste, as to meet the SDG target. Based on statistical sources and interviews with Ministry officers, this paper explains the history and achievements of Japan's 23-year policy based on the Food Recycling Law, as well as the tension between the two legislations.

Currently, with the rapid growth of the population, the demand for metals has increased, especially for the manufacture of electronic devices such as cell phones, computer equipment, among others. Once these devices stop working, most are sent to landfills, which represents a danger since these wastes contain metals and other materials that must be properly managed to prevent them from having a negative effect on the environment and the human being. On the other hand, e-waste contains valuable metals such as copper, gold, and silver, the concentration of which in these materials makes it cost-effective to recover. This paper presents a review of the extraction and recovery of valuable metals from electronic waste by hydrometallurgical methods, as well as patents and industrial processes related to the management and treatment of this waste.

Rice cultivation is the main agricultural activity in Asia, and it results in an enormous amount of agricultural waste, that are usually disposed-off by burning, causing serious environmental health and climate problems. Pakistan is the tenth largest producer in the world and the fourth exporter of rice in the world. To date, there are no studies targeting Pakistan’s profile monitoring its contribution in open burning emissions from rice straw waste. This study presents the characterization of PCDD/Fs, PCBs and PAHs emissions from three samples of rice straw collected from the main rice cultivation regions of Pakistan (Punjab, Sindh and Azad Jammu and Kashmir) in relation to the role of metal-based agricultural additives. PCDD/Fs, PCBs and PAHs emissions were quantified using a fixed grid system biomass plant and measuring the macro-pollutants online and sampling the organic micro-pollutants and metals in isokinetic mode, followed by ISO and CEN standards methods. In addition, role of agrochemicals was monitored in terms of metal catalysis resulted in POPs emissions. This study provides the characterization of most relevant group of pollutants (metals, PCDD/Fs, PCBs and PAHs) as a result of agricultural waste combustion. The rice straw samples from AJK showed high values of organochlorine micro-pollutants compared to the values followed by samples from Punjab and Sindh, i.e., respectively, ∑PCDD/F (2594>1493>856 pg/Nm³) and ∑PCB (41>38>30 pg/Nm³). Whereas the organic micro-pollutants ∑PAH, indicators of incomplete combustion (PICs), were recorded high in the samples from Sindh followed by Punjab and AJK. This study supports the idea that the phenomena that lead to the formation of PCDD/F and PCB are influenced not only by poor combustion but also by the presence of metal catalysts or precursors in the burned fuel.

In recent years, the use of solid waste fillers to partially replace natural fillers in asphalt mixtures to produce high-performance asphalt mixtures has received widespread attention. However, differences in the material properties of solid waste fillers remain a problem for this recycling method. To address this issue, limestone powder in asphalt mixtures was replaced by three solid waste fillers (steel slag powder, tailings powder and calcium carbide slag powder) in this study. The chemical composition of the fillers was first characterized to assess the homogeneity of the material. Then, AC and SMA asphalt mixtures were designed and produced and characterized for wet stability. The results showed that asphalt mixtures with solid waste fillers were superior to LP asphalt mixtures in terms of resistance to water damage, and steel slag powder showed the best improvement in moisture stability of asphalt mixtures. The optimum substitution of solid waste filler for limestone filler was 25%. In addition, the moisture stability of asphalt mixture with limestone filler was significantly improved with the addition of anti-stripping agents. In contrast, the moisture stability of asphalt mixtures with solid waste filler was slightly improved. Solid waste fillers could be used in asphalt mixtures and have a similar function as the anti-stripping agent. In summary, the use of solid waste fillers to replace mineral fillers in asphalt mixtures is a reliable, value-added, recycling option.

In South Korea, demolition waste (DW) management has become increasingly significant owing to the rising number of old buildings. Effective DW management requires an efficient approach that accurately quantifies and predicts the generation of DW (DWG) of various types, which necessitates access to the required information or technology capable of achieving this. Hence, we developed an artificial intelligence-based model that predicts the generation of ten DW types, specifically from buildings in redevelopment areas. We used an artificial neural network algorithm with < 10 neurons in the hidden layer to derive individual input variables and optimal hyperparameters for each DW type. All DWG prediction models achieved an average validation and test prediction performance (R²) of 0.970 and 0.952, respectively, with their ratios of percent deviation ≥ 2.5, ver-ifying them as excellent models. Moreover, a Shapley additive explanations analysis revealed that DWG was most impacted by the floor area for all the DW types, with a positive correlation with DWG. Conversely, other factors showed either a positive or negative correlation with DWG de-pending on the DW type. The study findings will enable demolition companies and local gov-ernments in making informed decisions for efficient DW management and resource allocation by accurately predicting the generation of various types of DW.

Millions of tons of wool waste are produced yearly by textile industries, which may become a serious environmental hazard in the near future. Given this concern, it is crucial to explore strategies to reduce the amount of wool waste generated worldwide and adopt more sustainable practices for dissolving and regenerating wool keratin (WK) from textile waste. Most traditional methods involve the use of expensive, toxic, harmful, and poorly biodegradable compounds. To overcome these limitations and facilitate the reuse of wool waste through a cascade valorization strategy, researchers have started testing the use of deep eutectic solvents (DES) as a more sus-tainable and eco-friendlier alternative for WK dissolution and regeneration. In this study, the potential of two different DES mixtures, Choline chloride (ChCl): Urea and L-Cysteine (L-Cys): Lactic acid (LA), was explored for dissolving wool waste. Subsequently, the obtained gels based on DES-WK were blended with polyvinyl alcohol (PVA) in different ratios to produce nanofibers using the electrospinning technique. The effect of pH and the properties of the electrospinning solutions, namely electrical conductivity and viscosity, on the morphology of the gel solutions were evaluated. Moreover, the morphological features of the produced gel-based electrospun PVA/DES-WK nanofibrous membranes were analyzed using scanning electron mi-croscopy (SEM). Additionally, the PVA/L-Cys: LA DES-WK, which proved to be the most effective DES mixture for fabricating WK gel-based nanofibers, were characterized through Fourier transform infrared spectroscopy (FTIR) and tensile tests. Furthermore, their antioxidant and an-timicrobial abilities were evaluated. The results obtained revealed that this approach to valorize textile waste offers a unique avenue for the development of sustainable functional materials with potential applications in various biomedical and industrial fields.

Since the process of waste recycling generates dust and flammable gas during fragmentation, there is always a risk of fire resulting therefrom, and fire does, in fact, frequently occur. However, research on disaster management at recycling facilities deals only with the problem of processing systems from a technical point of view, but it does not suggest concrete alternatives from a management point of view. Therefore, in this study, we analyzed the influence of the disaster response network of a waste recycling center at the organizational level based on the concept of the cognitive accuracy of a network when considering administrative aspects. Through this analysis, we confirmed that factors affecting the influence of the network exist, such that the entire network and the networks of different levels of position are different. We suggest that this can be improved by deploying members who perform formal tasks at the center of the network so that everyone can agree political approach.

Peat is the main type of peloid used in Polish cosmetic/healing spa facilities. Depending on treatment and origin, peat waste can be contaminated microbiologically, and as result, it has to be incinerated in medical waste incineration plants without energy recovery (local law). Such a situation leads to peat waste management costs increase. Therefore in this work, we checked the possibility of peat waste upcycling to carbonized solid fuel (CSF) using torrefaction. Torrefaction is a thermal treatment process that removes microbiological contamination and improves the fuel properties of peat waste. In work torrefaction conditions (temperature and time) on CSF quality were tested. Parallelly, peat decomposition kinetics using TGA, and torrefaction kinetics with lifetime prediction using macro-TGA were determined. Furthermore, torrefaction theoretical mass and energy balance were determined. The results of the tested peat were compared with reference material (wood), and as result, obtained data can be used to adjust currently used wood torrefaction technologies for peat torrefaction. The results show that torrefaction can improve the high heating value of peat waste from 19.0 MJ x kg-1 to 21.3 MJ x kg-1, peat main decomposition takes place at 200-550 °C following second reaction order (n=2), with an activation energy of 33.34 kJ x mol-1 and pre-exponential factor of 4.40 x 10-1 s-1. Moreover, DSC analysis revealed that peat torrefaction required slightly more energy than wood torrefaction, and macro TGA showed that peat torrefaction has lower torrefaction constant reaction rates (k) than wood 1.05 x 10-5 - 3.15 x 10-5 vs 1.43 x 10-5 - 7.25 x 10-5 s-1.

Waste from fish cutting (heads, swim bladders, fins, skin, bones) is a high-value technological raw material for obtaining substances and products based on them with a wide range of properties. The possibility of using waste from cutting fish of the Gadidae family: the Alaska pollock (Gadus chalcogrammus) and the Pacific cod (Gadus macrocephalus), processed in the coastal zone, is scientifically substantiated. In this work, a technology has been developed for processing accumulated waste from fish cutting in order to obtain fish gelatin, which is characterized by high protein content (more than 80.0%) and a full set of essential and nonessential amino acids. We studied the quality of fish gelatin obtained from wastes from cutting the fish of the Gadidae family. The possibility of using fish gelatin as a component of fish products is shown; the dose of its introduction into the fish products is substantiated. The data obtained made it possible to recommend the use of fish processing waste products as a gelling component and a source of amino acids in multicomponent food systems.

New materials are obtained by transforming fly ash wastes into a valuable composite, with tandem adsorption and photodegradation properties. Mild hydrothermal synthesis, from titanium dioxide, Platinum nanoparticles and zeolite materials obtained from a waste, fly ash, as support, was involved in the composite preparation. The Platinum nanoparticles extended the photocatalytic activity of the composite in Visible range (Eg = 2.1 eV). The efficiency of tandem adsorption and photocatalytic activity of the new composite were evaluated to 80.70% for Bemacid Blau and 93.89% for Bemacid Rot, after 360 min, the irradiation time, with H2O2 addition.

This article attempts to identify factors impacting on the quantity of municipal waste in Polish 2478 communes (LAU-2), taking into account the variability of particular determinants influence depending on their regional diversification. The analysis covers the years 2005-2018. The dependent variable is the volume of municipal waste in kg per capita, whereas the group of determinants include: economic and human development, uncontrolled dumping sites, population density, population at the working age, migration, tourism, urbanization, dwellings and housing, retail sales, entities, education and investments in waste management; The geographically weighted regression with spatial error term (GWR-SEM) was employed in this study. The model enabled not only the specification of the waste production determinants, but also the analysis of the variability in the strength and direction of dependencies occurring between the examined variables in individual communes. The results proved that the higher the level of education the less waste is generated (in the north-central Poland); the business entities and working-age population are crucial for the waste quantity in communes of eastern Poland; the factors most considerably as to regional range affecting the waste quantity are urban and business development; as to strength–higher education and the share of working age individuals;

In the European Union, the demand for polyurethane is continually growing. In 2017, the estimated production value of polyurethane was 700,400T, of which 27.3% is taken to landfill, which causes an environmental problem. In this paper the behaviour of various polyurethane foams from the waste of different types of industries will be analysed with the aim of assessing their potential use in construction materials. In order to this, the wastes were chemically tested by means of CHNS, TGA, and leaching tests. They were tested microstructurally by means of SEM. The processing parameters of the waste was calculated after finding out its granulometry and its physical properties i.e. density and water absorption capacity. In addition, the possibility of incorporating these wastes in plaster matrices was studied by determining its rendering in an operational context, finding out its mechanical resistance to flexion and compression at 7 days, its reaction to fire as well as its weight per unit of area and its thermal behaviour. The results show that in all cases, the waste is inert and does not undergo leaching. The generation process of the waste determines the foam’s microstructure in addition to its physical-chemical properties that directly affect building materials in which they are included, thus offering different ways in which they can be applied.

The application of thermoelectric generators (TEG) on the nozzle of an aviation jet engine was studied by finite element TEG-simulations. Against the background of system-level requirements of the reference aircraft this work reports the resulting requirements on the TEG design with respect to applied thermoelectric (TE) element lengths and fill factors (F) within the TE modules in order to maintain a positive effect on the specific fuel consumption. Assuming a virtual optimized TE material and varying the convective heat transfer coefficients at the nozzle surfaces this work reports the achievable power output. System-level requirement on the gravimetric power density (> 100 Wkg-1) can only be met for F ≤ 21%. Extrapolating TEG coverage to the full nozzle surface, the power output reaches 1.65 kW per engine. Assessment of further potential is demonstrated by a parametric study on the fill factor, convective heat transfer coefficients, and materials performance. This study confirms a feasible design range for TEG installation on the aircraft nozzle with a positive impact on the fuel consumption. This application translates into a reduction of operational costs, allowing for an economically efficient installation of TEG in consideration of the cost-specific power output of modern thermoelectric materials.

Economic theory states that incineration and landfill taxation can effectively diminish the environmental impacts of pollution and resource use by reducing their associated pollutants while stimulating the reuse and recycling of materials, and therefore, fostering a circular economy. The aim of this research is to assess the economic and environmental effects of these taxes in Spain under different scenarios with a detailed dynamic computable general equilibrium (CGE) model, as there are no studies analyzing this in detail. We focus on the economic impact on GDP and sectorial production and the environmental impact on different categories: global warming potential, marine eutrophication potential, photochemical ozone formation potential, particulate matter, human toxicity (cancer and noncancer), ecotoxicity, and depletion of fossil resources. We find in all scenarios that these taxes have a limited economic impact while reducing all of the environmental impact categories analyzed. The study reinforces the theory that policy makers need to impose taxes on landfill and incineration to reinforce the circularity of the economy and reduce environmental burdens, but also demonstrates that they can improve their design without additional costs.

To enhance industrial competitiveness and increase productivity, every country has strived to create a smart factory by introducing technologies such as Internet of Things, big data and artificial intelligence into production line and build cyber-physical system for the purpose of promoting manufacturing efficiency. For mission assignment, production line management or manufacturing field analysis, the location information of employee, machine and material is very essential. To promote manufacturing efficiency, of course, the location information became more important. A Bluetooth low energy (BLE) positioning system for the manufacturing is developed in this research. A "Tag tracking" mechanism is addressed and adopted, which uses Beacon to catch the location information and a BLE receiver is also used to receive the broadcasting information from Beacon. The position information from the BLE receiver will be compared with the data in the database for calculating the location of the target. The status of the target may also be obtained by using the data from the BLE receiver. Comparing with the mobile device, this method can reduce energy consumption and make the maintenance simple and easy. In the real applications, the target may not be limited to human. The "Regional label positioning technology" is also investigated in this research. Defining a suitable zone location and arranging BLE receiver location, and positioning analysis theory are the key factors included in this developed technology. The developed system will be tested for real industry applications. The test results show that the feasibility of this technology.

Fiscal control and monitoring of public management are issues of great importance and relevance, as they focus on preventing and mitigating corruption, thus benefiting governments in their management and performance, and thus citizens. Given the large amount of data involved in the management and functioning of a government, it is pertinent to apply data analysis methods to contribute to fiscal control. This paper aims to investigate data management for this purpose, starting with a bibliometric study to demonstrate the relevance and pertinence of the current study. It examines existing data collection techniques that may facilitate such control, data storage considering its nature and the possibilities that contribute to this end, and data processing through techniques that allow obtaining adequate information for further analysis and decision making. The necessary architecture and interoperability between systems is also discussed, as the existence of large amounts and types of data in governments makes it crucial to promote these practices for accurate and truthful analysis. Finally, data visualization is addressed since this topic is highly relevant as it allows for the identification of anomalies, where proper visualization promotes appropriate analysis and thus informed decision making. This work is useful for modern audit and fiscal control entities, since data capture, storage, processing, interoperability, and visualization are crucial elements that collectively enhance the ability to supervise public expenditure effectively, ensuring that public funds are managed with the highest standards of transparency, accountability, and efficiency.

There is currently an exponential growth in the electric vehicle market, which will require an increase in the electrical grid capacity to meet the demand of charging. If, on the one hand, the introduction of energy generation from renewable sources can be used to meet that requirement, the intermittent nature of some of these sources poses challenges to the required real time equilibrium between generation and consumption. The impossibility of controlling generation from some of these sources leads to the attempt of controlling and manage the consumption of electricity, according with the levels of generation. In this context, the emergence of smart grids has introduced mechanisms that guarantee a balance between consumption and generation of electricity. One of these mechanisms is the smart charging of electric vehicles. Effective smart charging relies on communication between the supply equipment and the electric vehicle, en-abling the adjustment of the energy transfer according with the generation levels. Thus, there is a necessity for a standardised system that guarantees this communication. In this context, the ISO 15118 standard, allows high level communication mechanisms, much beyond the basic control solutions offered by the IEC 61851-1 specification. In this context, this paper presents the development of a charge emulation system, based on the ISO 15118 communication protocol and discusses its application for demand response purposes.

As urban populations continue to grow, efficient traffic management becomes paramount in reducing congestion, enhancing air quality, and improving overall quality of life. This study addresses the critical issue of intersection efficiency through the implementation of smart green time allocation strategies at a signalized intersection equipped with two LiDAR sensors. This research aims to investigate optimal green time allocations provided by two LiDAR sensors and analyze the LiDAR results by microsimulation in AIMSUN. The research first introduces the concept of LiDAR-equipped signalized intersections and their potential to enhance traffic control precision. Two LiDAR sensors are strategically placed at the intersection of Marlboro Pike and Brooks Dr. in Coral Hills, MD, USA to capture real-time data on vehicle and pedestrian movements. The data are then processed to generate accurate and dynamic traffic profiles, ensuring the responsiveness of the green time allocation system to varying traffic conditions.The heart of this study lies in the integration of AIMSUN microsimulation with LiDAR data. Through meticulous modeling and simulation, the research explores the optimal green allocation at morning, mid-day, and afternoon peak hours’ scenarios to comprehensively assess the impact of LiDAR-enabled dynamic signal control. The findings demonstrate that smart green time allocation, informed by real-time LiDAR data and implemented through AIMSUN microsimulation, significantly enhances intersection efficiency. By adapting signal timings to real-time traffic demands, congestion, travel times, and emissions are reduced. Furthermore, this research highlighted that the optimal green time allocation in morning, mid-day, and afternoon peak hour intervals can improve the delay time by 55.3%, 59.7%, and 55.6%, respectively.In conclusion, this paper sheds light on the potential of LiDAR technology to transform intersection management. Through a case study involving two LiDAR sensors and AIMSUN microsimulation, it reveals the tangible benefits of dynamic signal control in enhancing intersection efficiency and creating more sustainable urban environments. These findings are pivotal in advancing the discourse on modern urban traffic management and promoting data-driven solutions for the challenges of today's cities.

Computer and Smart Device-assisted Learning (CSDL) has gained increasing attention from educational researchers and practitioners in recent years. However, it remains controversial whether student can benefit from CSDL and what moderator could affect the impact of CSDL. Within the specific context of Korea, where the interest in digital education is steadily increasing, the number of empirical studies exploring the causal effect of CSDL remains relatively scarce. The primary objective of this empirical study was to investigate the impact of CSDL on students' academic achievement in Korea. To achieve this objective, a two-way fixed effect model was employed, utilizing a panel dataset spanning three years derived from the 'Korean Education Longitudinal Study 2013'. The findings revealed a significant positive impact of CSDL on students’ Mathematics achievement. Notably, higher income levels, increased availability of computer resources provided by schools, and the implementation of more individualized education were identified as factors that moderate the effect of CSDL on students' achievement levels in Korean and English subjects. These findings underscore the need for an approach that optimizes the educational benefits of CSDL by considering subject-specific characteristics. Furthermore, this study highlights the importance of allocating educational resources, such as computers and smart devices, and integrating individualized educational activities within the classroom environment.

Alginate films (2% w·v-1) were prepared with varying concentrations (5-20% w/w) of citric acid and aqueous grape seed extract (GSE) filtrate (11.66 ± 1.32 g GAE/L) by the solvent-evaporation method. Crosslinking alginate via ester bonds (FTIR analysis) with citric acid up to 10% (w/w) led to a 33% increase in tensile strength, a 34% reduction in water vapor transmission rate (WVTR), and had no impact on elongation at break. Crosslinking alginate with citric acid in presence of GSE increased the tensile strength by 17%, decreased WVTR by 21%, and significantly improved DPPH scavenging activity. Moreover, after incubation for 24 h at 37°C, the film-forming solutions exhibited increased antimicrobial activity, resulting in 0.5 and 2.5-log reductions for Escherichia coli and Staphylococcus aureus, respectively, compared to the values obtained without the addition of GSE. The stronger inhibitory effect observed against Gram-positive bacteria can be attributed to the unique composition and structure of their cell walls, which create a barrier that restricts the penetration of polyphenols into the cells. pH adjustment of the GSE film-forming solution from 2.0 to 10.0 shifted the UV/VIS absorption spectra, resulting in a colour change from yellow to red. The findings of this study have showcased the potential of combining GSE and citric acid to enhance the functionality and bioactivity of alginate films for applications in smart food packaging.

Abstract: Climate change is one of the main barriers for agricultural production and productivity globally. Hence, understanding farmers’ adoption level of CSA practices and determinants is of highly important for policy decisions. Consequently, the study's purpose was to assess adoption level of multiple CSA practices and determinants of climate-smart agriculture practices in the study area. The study was conducted in Welmera Woreda, Oromia Region, Ethiopia. From the Woreda, three kebeles were identified, and 306 respondent farmers were selected. A cross-sectional household survey, focus group discussion, and key informant interviews were used. Multivariate probit model was used to examine adoption determinants of multiple climate-smart agriculture practices. According to the result, Conservation agriculture, integrated soil fertility management, and crop diversification are the most commonly practiced CSA techniques in the study area. Demographic factors result indicated that being male as compared with female farmers, has positive and significant effect on crop diversification and improved livestock feed and feeding practices. Age of farmers significantly and negatively affecting the probability of adoption of improved soil fertility management practices and crop diversification. However, it affects the adoption of agroforestry practices positively and significantly. Based on the result of economic factors, having relatively large farm land size significantly increases the adoption of conservation agriculture, improved soil fertility management, crop diversification, improved livestock feed and feeding practices, and postharvest technology practice. Better farm income increases the likelihood of uptake of improved livestock feed and feeding. Having a large number of livestock positively influences adoption of conservation agriculture and having access to credit services positively influences the implementation of agroforestry, crop diversification, and postharvest technology. In addition, institutional factors such as access to agricultural extension service and training found that significantly and positively influences the adoption of crop diversification; access to participation on farmers’ field day similarly significantly and positively influence the adoption of both conservation agriculture and improved soil fertility management practice. Awareness creation for farmers and experts about climate change and including location specific CSA practices in to agricultural program is crucial.

Predicting trip purpose from comprehensive and continuous smart card data is beneficial for transport and city planners in investigating travel behaviours and urban mobility. Here we propose a framework, ActivityNET, using machine learning (ML) algorithms to predict passengers’ trip purpose from smart card data and Points-of-Interest (POIs) data. The feasibility of the framework is demonstrated in two phases. Phase I focuses on extracting activities from individuals’ daily travel patterns from smart card data and combining them with POIs using the proposed ‘activity-POIs consolidation algorithm’. Phase II feeds the extracted features into an artificial neural network (ANN) with multiple scenarios and predicts trip purpose under primary activities (home and work) and secondary activities (entertainment, eating, shopping, child drop-offs/pick-ups and part-time work) with high accuracy. As a case study, the proposed ActivityNET framework is applied in Greater London and illustrates a robust competence to predict trip purpose. The promising outcomes demonstrate that the cost-effective framework offers high predictive accuracy and valuable insights into transport planning.

Crop plants should be resilient to climatic factors in order to feed ever-increasing populations. Plants have developed stress-responsive mechanisms by changing their metabolic pathways and switching the stress-responsive genes. The discovery of plant transcriptional factors (TFs) as key regulators of different biotic and abiotic stresses have opened up new horizons for plant scientists. TFs perceive the signal and switch certain stress-responsive genes on and off by binding to different cis-regulatory elements. The above 50 species of plant TFs have been reported in nature. DREB, bZIP, MYB, NAC, Zinc-finger, HSF, Dof, WRKY, and NF-Y are important with respect to biotic and abiotic stresses whereas the role of many TFs is yet to explore. In this review, we summarize the role of different stress-responsive TFs with respect to biotic and abiotic stresses. Further, challenges and future opportunities linked with TFs for developing climate-resilient crops are also elaborated.

Prediction models in mobility and transportation maintenance systems have been dramatically improved through using machine learning methods. This paper proposes novel machine learning models for an intelligent road inspection. The traditional road inspection systems based on the pavement condition index (PCI) are often associated with the critical safety, energy and cost issues. Alternatively, the proposed models utilize surface deflection data from falling weight deflectometer (FWD) tests to predict the PCI. Machine learning methods are the single multi-layer perceptron (MLP) and radial basis function (RBF) neural networks as well their hybrids, i.e., Levenberg-Marquardt (MLP-LM), scaled conjugate gradient (MLP-SCG), imperialist competitive (RBF-ICA), and genetic algorithms (RBF-GA). Furthermore, the committee machine intelligent systems (CMIS) method was adopted to combine the results and improve the accuracy of the modeling. The results of the analysis have been verified through using four criteria of average percent relative error (APRE), average absolute percent relative error (AAPRE), root mean square error (RMSE), and standard error (SD). The CMIS model outperforms other models with the promising results of APRE=2.3303, AAPRE=11.6768, RMSE=12.0056, and SD=0.0210.

Information and communication technologies play an increasingly important role in the process of acquiring knowledge from a territory and managing it at different scales. ICTs allow a rapid diffusion of data not only through institutional channels but also through social networks where the smart community share experiences and perceptions. In this sense, ICTs become strategic to support the promotion of sustainable tourism development of territories. An important tool to implement it, can be a circular smart dashboard, a decision support system in which the digital data are organized and processed to produce an information output, to be used, after the evaluation by the decision makers, as a new input for the system. The present paper deals with a wider research the authors are involved in, related to the reconversion and valorization of a former mining area towards slow tourism, as the Santa Barbara Walk (SBW), an ancient mining route in the Sulcis Iglesiente area (Sardinia, Italy) . In particular, we here focus on the design proposal of a dashboard, capable of organizing information concerning the main features of the walk, in order to facilitate a shared governance for an effective tourism promotion. The paper is based on a thorough recognition of the main characteristics of the Walk, both the material ones and the digital, immaterial ones. The SBW represents in fact a network connecting the main points of interest along the Walk. On the contrary, its digital network – consisting of intangible infrastructure and flows - is however fragmented in terms of policies and contents Also a state of disorganization in slow tourism promotion activities can be observed. The goal of this paper is to present and analysis of the area, and to propose an evaluation and planning tool as the design of a circular dashboard of the SBW.

The Smart Park (well-known as Taman Pintar) as a major educational tourism destination in Jogjakarta offers a variety of tourism attractions that are very interesting for tourists. The main purpose of tourists visiting Smart Park is to get an educational tourism experience. A subjective experience raises a specific challenge for Smart Park toward the status of competitive destination. The purpose of this study is to analyze the aspects of educational tourism experience that are affected by tourism demand and supply. Data were collected by survey technique to 150 respondents and analyzed using path analysis. The results of analysis show that tourism demand and supply contributed to the variation of tourism activities by 45.1%, while the remaining was explained by other variables, such as National Budget, Local Budget, ticket sale, and cooperation with some stakeholders. Tourism supply had a higher effect than tourism demand. Tourism demand did not partially affect tourism experience. However, the results of the path analysis indicate that tourism supply had direct and indirect effects on tourism experience through the variation of tourism activities with indirect effect being dominant. In the management of Smart Park, there is still a gap between tourism demand and supply, so that the environment of tourism experience has not been created maximally.

The binomial nomenclature system, introduced by Carl Linnaeus in the 18th century, has been fundamental for scientific communication and data management. Despite its utility, some scientific names reflect historical biases and ethical issues, including colonial legacies, racism, sexism, and derogatory terms. Recent debates highlight the need to address these injustices, with arguments both for and against revising such names. Critics argue that extensive revisions could disrupt scientific stability, while proponents emphasize the moral imperative to correct these issues. In this opinion paper, we advocate for the establishment of a dedicated committee within international nomenclature bodies to revise taxonomic names with clear ethical concerns and recommend the use of persistent identifiers to effectively manage and track name changes, mitigating potential disruptions to taxonomy and the science that depends on it. By adopting transparent revision processes and making use of digital technology, we can address ethical issues without remarkable upheaval. Science should not perpetuate historical injustices, and it is vital for the scientific community to proactively address social injustices in nomenclature to mitigate ongoing debates and resistance.

The study is aimed at developing a resilient benchmarking system for small hotels in Ukraine, designed to ensure their survival and growth amid global disruptions and local crises. Given the severe challenges associated with the COVID-19 pandemic and military actions, the resilience of the regional tourism business becomes particularly relevant. The methods used in the study, including factor and cluster analysis, the method of taxonomy, and dendrograms, have enabled the development of development programs for two clusters of hotels: those located in areas with increased military risk and those in relatively safe territories. The taxonomic analysis revealed significant differences in managerial practices and operational efficiency, largely determined by the geographic location of the hotels. Hotels in active combat zones experience a 40% reduction in tourist flow and financial instability, while hotels in safe areas demonstrate a 30% higher level of customer satisfaction. The application of advanced security systems and modern marketing techniques has led to a 40% reduction in incidents.

Citizen science substantially contributes to large-scale biodiversity monitoring and the enhancement of public literacy. While both of the contributions largely depend on the public’s self- regulated learning. In this study, we employed a mix- method approach, incorporating both a questionnaire survey of 133 participants and interviews with 12 volunteers, aiming to explore the feature of self- regulated learning in citizen science, as well as identify the main factors impacting it. The volunteers are all different ages, from different jobs, with varying educational backgrounds. The findings revealed that the educational background of volunteers did not significantly impact their self-regulated learning. However, an increased frequency of participation was linked to higher levels of self-regulated learning. Furthermore, achievement goal orientation mediates the prediction of self-regulation by scientific epistemology. These insights underscore the importance of enhancing citizen science's impact on scientific literacy by fostering self-regulated learning among participants. This can be achieved through explicit instruction in scientific epistemology and by fostering a sense of achievement to boost achievement goal orientations. Additionally, our study advocates for the promotion of social interaction between students and out- of- school citizen scientists in school-based citizen science projects. The main innovation of this study is to consider volunteers as learners, not merely as contributors of data.

A bacterium known as Akkermansia muciniphila (AkkermansiaA. muciniphila) was detected in human feces in 2004. It is defined as a gram-negative, anaerobic, and mucin-degrading microbe belonging to the Verrucomicrobia species. Although the majority of A. muciniphila is found in the human intestinal tract playing a role in the gut microbiome, there are also smaller levels detected in breast milk and oral cavities as well as in the pancreas and appendix.Evidence suggests that having A. muciniphila present in the gut microbiome has positive effects on human health. As a result, A. muciniphila has been shown to have health benefits when taken as a dietary supplementation where it is considered a promising next-generation probiotic. However, the large-scale production of A. muciniphila remains a challenge due to its need for a stable environment. While culturing A. muciniphila in a mucin-based medium is one option, other strategies that use plate-based mediums have also been explored. Currently, both live and pasteurized forms of A. muciniphila are available on the market and shown to have promising outcomes in animal models. Additionally, researchers are investigating various prebiotics to increase the abundance of A. muciniphila in the human gut. This article presents a detailed summary of the phenotypic characteristics of A. muciniphila and its associations with various human health condition illnesses. Finally, the paper explores A. muciniphila's potential as an effective next-generation probiotic.

Corporate Sustainability has garnered increasing attention within the business community, as corporates communicate to influence its stakeholders for building sustainable relationships. There has been a surge in research exploring its connection to firm performance but, existing studies lack a cohesive and concentrated approach. This study employs scientometric and bibliometric methods to analyse scientific production which signals a scarcity of research from developing countries, indicating a need for greater investigation. Focussing on specific subfields of Corporate Sustainability and Firm Performance, we analyze and narrow down the scope of our study to a focussed sample. Employing use of structured methods and PRISMA Protocol, this scientifically rigorous study, points towards identification of research themes linking sustainability practices to firm performance for achieving business excellence. It goes beyond mapping of literature, thereby establishing linkages to Sustainable Development Goals (SDGs). Our analysis reveals clusters centered on Environmental Performance, Firm Performance, Corporate Sustainability Reporting, Corporate Social Performance and Green Supply Chain Management with significant citations related to various SDGs. We make use of time series analysis to determine the future trends of research in the field. This scientometric and bibliometric analysis study contributes to a more focused understanding of the linkages between corporate sustainability and firm performance, emphasizing the need for cohesive research approaches to address the complexities of sustainable business practices and their implications for financial performance and the economy.

This article examines the integration of artificial intelligence (AI) and robotic process automation (RPA) in financial accounting and management, underscoring their role in driving the digital transformation of corporate finance. It discusses the shortcomings of traditional financial processes and highlights the potential of AI and RPA technologies to enhance efficiency, accuracy, and cost-effectiveness. The paper also explores the limitations of RPA, such as its challenges in processing unstructured data and handling complex decision-making scenarios. Looking forward, it considers the future trends in AI and RPA, emphasizing the benefits of cloud technology in scaling automated systems and addressing associated challenges.

Viruses are the most common congenital infections and an important cause of fetal malformations, morbidity, and mortality. The effects of these infections, which are transmitted in-utero (transplacentally), during childbirth or in the puerperium depend on the timing of the infections. These vary from miscarriages (usually with infections in very early pregnancy), congenital malformations (where the infections occur during organogenesis) and morbidity (with infections occurring late in pregnancy, during childbirth or after delivery). The most common of these viruses are cytomegalovirus, hepatitis, parvovirus B-19, rubella, varicella and zika. There are currently very few efficacious antiviral agents licensed for use in pregnancy and therefore for most of these infections, prevention by means of immunisation (where there is a vaccine), administration of immunoglobulins to those exposed to the virus to offer passive immunity or appropriate measures to avoid being infected would be options to minimise the infections and their consequences. In this review, we discuss the current understanding of some of the congenital infections and their consequences on both the mother and fetus and their management focusing mainly on prevention.

This paper explores the application of fisheries management theories to broader environmental issues, including climate change and biodiversity conservation. It underscores the inherent trade-off in fisheries between yield and resource conservation, identifying harvesting as a significant environmental burden. Early recognition of the sustainability concept aimed to address challenges like economic discounts and the tragedy of the commons, contributing to the issue of overfishing. These insights extend beyond fisries to other environmental concerns, particularly climate change. The development of adaptive management, initially tailored to address uncertainties and non-stationarity in fisheries, has found application in diverse environmental issues. Recognizing humans as integral parts of ecosystems highlights the impossibility of achieving zero environmental impact when utilizing natural resources. The paper advocates for passive restoration to prevent overfishing, leveraging nature's resilience. While goals like complete biodiversity restoration are inherent in fisheries, their relevance may not be immediately apparent to other environmentalists. Despite ongoing discussions on the sustainability of ecosystem services, legislation often tends to favor the long-term maximization of fisheries yield. The paper calls for mutual understanding of theories and experiences across various environmental fields, including fisheries, to enhance collaborative efforts in each field.

Introduction SARS-CoV-2 infection normally damages respiratory system but may likewise impair endocrine organs’ function. Thyroid dysfunction and hyperglycemia are common endocrine complications of SARS-CoV-2 infection. Onset of T1D and associated complications including DKA, hospitalization and death, are thought to be increased during the COVID-19 pandemic. The aim of this study is to review the available data about the incidence rate of T1D and accompanying complications since the beginning of the COVID-19 pandemic. Methods: A systematic review was conducted using electronic databases PubMed and Google Scholar. The keywords “T1D, T1DM, Type 1 DM or Type 1 Diabetes”, “Coronavirus, SARS-CoV-2 or COVID-19” were used to search these databases. Titles and abstracts were screened for selection, and then relevant studies were reviewed in full text. Result: we selected 21 manuscripts out of 296 identified studies. Data about the incidence rate of T1D, hospitalization and death are not consistent across countries, but DKA incidence and severity seem to be higher during the COVID-19 pandemic. Conclusion: Our data collection demonstrated that COVID-19 may or may not increase the incidence of type 1 diabetes. Nevertheless, it is associated with higher incidence and severity of DKA in T1D patients. Antivirals are not fully protective against endocrine complications of SARS-CoV-2 infection. Combining medications that reduce SARS-CoV-2 entry into the cells and modulate the immune response to infection is an alternative practical approach to treating COVID-19.

Gender Identity Dysphoria (GID) is a condition characterized by a strong and persistent identification with the opposite sex. These people consider themselves victims of a sort of biological accident: "a soul in a wrong body". There are numerous theories on the origin of transsexualism: genetic, hormonal and psychological causes have been hypothesized, but those currently most accredited are the neuroanatomical ones. The cornerstones of hormone conversion therapy (Gender Affirming Hormone Therapy, GAHT) are feminizing hormones for transgender women (MtFs) and virilizing for transgender males (FtMs). GID can be present among adolescents and older people. For adolescents is now accepted reversible treatment of puberty withdrawal with hormones that stops the progression of pubertal development in the biological direction not accepted; for elderly people is suggested GAHT in reduced doses. Physicians should consider and discuss with people with GID about fertility preservation, general and cancer risks. We present also data of 127 transsexual patients enrolled at the Garibaldi-Nesima Andrology Clinic in Catania (Italy) from 2003 to 2020. To optimize the conversion treatment with sex hormones, transsexuals require long-term follow-up. GAHT must be performed by a doctor who is familiar with these problems. Therefore, the “do-it-yourself” trend and the lack of medical and laboratory checks over time should be absolutely discouraged. Before proceeding with the surgical sex reassignment, it is recommended to refer to an endocrinologist and psychologist or psychiatrist for a period of 2-3 years. The transition surgical conclusion process must be practiced by a quality surgical team.

Temporomandibular disorders (TMD) is a group of orofacial pain conditions which is the most common non-dental pain complaint in the maxillofacial region. Due to the complexity of the etiology and often cyclical nature of the disease, the diagnosis and management of TMD remain a challenge where consensus is still lacking in many aspects. While clinical examination is considered the most important process in the diagnosis of TMD, imaging may serve as a valuable adjunct in selected cases. Depending on the type of TMD, many treatment modalities have been proposed, ranging from conservative options to open surgical procedures. In this review, the authors discuss the present thinking in the etiology and classification of TMD, followed by the diagnostic approach and the current trend and controversies in management.

Hyaluronic acid, in the form of a gel or viscoelastic colloidal solution, is currently used for viscosupplementation of joints affected by osteoarthritis, but its effectiveness is under debate in relation to newer alternatives. Based on meta-analytical arguments, the present article reinforces the opinion that there are still no decisive arguments for its complete replacement, but for its use adapted to the peculiarities of the disease manifestation and of the patients. A “broad” comparison is first made with almost all alternatives studied in the last decade, and then a meta-regression study is performed to compare and predict the effect size induced by viscosupplementation and platelet-rich plasma therapies. If they are computerized, the developed models can represent tools for clinicians in determining the appropriateness of the option or not for viscosupplementation, in a manner adapted to the pain felt by the patients, to their age, or to other clinical circumstances. The models were generated using the latest algorithms for meta-analysis and meta-regression implemented in the R language and assembled in different R packages. All primary data and necessary R scripts are provided in accordance with the philosophy of reproducible research. Finally, HA-based products, currently under circumspection, are still clinically useful.

Corrugated boards are used for packaging because of their high strength-to-weight ratio, recyclability, and biodegradability. They have an orthotropic sandwich structure with unique characteristics for each direction owing to their flute shape. In this study, the bending behavior was qualitatively analyzed for various variables through an FE-based simulation, and the possibility of an alternative test method for the four-point bending test on a corrugated board was examined through a similarity analysis with the experimental results. The cross-machine direction (CD) bending stiffness through finite element analysis (FEA) simulation was closely related to the thickness of the corrugated board. In AB-flute-double-wall (AB/F-DW), the difference in CD bending stiffness based on the bending direction was approximately 17.2% in the FEA simulation and approximately 10.5% in the experiment. However, the differences in the bending behavior (bending force vs. deflection plot) and bending stiffness based on the phase shift between the two flutes constituting BB-flute-double-wall (BB/F-DW) were insignificant. Overall, the CD bending behavior of the corrugated board was simulated relatively well through FEA simulation. However, it was impossible to simulate the machine-direction (MD) bending behavior through FE-based simulation because of a decrease in convergence and a large error caused by the variability of the contact condition of the modeled test specimen with a non-uniform MD cross-section.

(1) Background: Considering highly selected patients with ductal carcinoma in situ (DCIS), active surveillance is a valid alternative to surgery. Our study is aimed at showing the reliability of post-biopsy complete lesion removal, documented by mammogram, as additional criterion to select these patients. (2) Methods: 2173 Vacuum Assisted Breast Biopsies (VABB) documented as DCIS have been reviewed. Surgery has been performed in all cases. We retrospectively collected the reports of post-VABB complete lesion removal and the histological results of the biopsy and surgery. We calculated the rate of upgrade of DCIS identified on VABB upon excision for patients with post-biopsy complete lesion removal and for those showing residual lesion. (3) Results: We observed 2173 cases of DCIS: 408 classified as low grade; 1262 as intermediate grade; 503 as high grade. The overall upgrading rate to invasive carcinoma was 15.2% (330/2173). The upgrade rate was significantly lower (8.2%) when considering patients showing mammographically documented complete removal of the lesion. (4) Conclusion: The absence of mammographically documented residual lesion following VABB is associated to a lower upgrading rate of DCIS to invasive carcinoma on surgical excision and should be considered when deciding the proper management DCIS diagnosis.

Integrating sustainable processes and innovative waste utilization not only addresses environ-mental challenges but also aligns with evaluating energy sustainability and creating the circular waste management. This study presents a comparative analysis of liquid fuel production from waste tires and water hyacinth using two thermochemical methods: co-pyrolysis (direct method) and co-gasification integrated with the Fischer-Tropsch (FT) process (indirect method). The As-pen Plus simulation software version 9 is employed to develop models, determining optimal operating conditions for maximum liquid fuel, and assessing economic viability. Co-pyrolysis simulations reveal an increase in oil products and a decrease in gas products with higher blending weight ratios of waste tires/water hyacinth (W/B) and lower pyrolyser temperatures. Operating at 400°C with a blending weight ratio of 75:25 provided the maximum liquid fuel rate of 6649.22 gal/day. For co-gasification, optimal conditions (W/B = 50:50, T = 800°C, steam to feed ratio (S/F) = 1) result in the highest syngas yield of 115.92 kmol/h. Fischer-Tropsch simulations demonstrate an increase in gasoline and a decrease in diesel with rising reactor temperatures. At 230°C, the maximum liquid fuel rate reaches 8817.15 gal/day. The economic and production yield analysis indicates that the indirect method better than the direct method, providing higher liquid fuel yields and investment worthiness.

The construction of reinforced concrete (RC) structures inevitably consumes an excessive number of rebars, leading to significant cutting waste and carbon emissions. Extensive research has been conducted to minimize this issue and its consequences; however, these methods consistently consume a substantial number of rebars. This includes a previous study that utilizes the lap splice position optimization and special-length rebar concept without considering the lapping zone regulation. Moreover, conventional lap splices pose inherent drawbacks that could jeopardize the structural integrity of RC members. In contrast, mechanical couplers eliminate the need for rebar lapping, effectively reducing rebar consumption. This research aims to evaluate the impact of an integrated mechanical coupler and special-length-priority minimization algorithm on the reduction in rebar consumption and cutting waste in RC columns, achieving near-zero cutting waste. To validate the effectiveness of the proposed algorithm, it was applied to the column rebars of an RC building. The results revealed a significant reduction in ordered rebar consumption by 18.25%, accompanied by substantial reductions in cutting waste (8.93%), carbon emissions (12.99%), and total costs (10.81%) compared with a previous study. The outcomes provide the industry with insights into further reducing rebar consumption and its related consequences. Applying the proposed algorithm to various construction projects will further amplify the corresponding benefits.

Liability to prevent consequences of an unhealthy situation due to accumulating toxic and hazardous emissions caused by open dumping of municipal solid waste with increasing urbanization has necessitated a renewed thinking on waste disposal. Grate fired incineration systems were adopted by urban managements in past and present but with criticisms due to formation of air borne emissions. Improved combustion methods like fluidized bed are now propagated because of current requirements like efficient energy recovery potential, stricter emission norms, adaptability with urban growth, adaptability to co-firing with other waste like biomass, edible oil wastes or industrial effluent and integration with conventional energy generation. Such a comprehensive and futuristic approach is more sustainable for the community. Multi-criteria decision-making tool is used to identify the best technology option among grate combustion and fluidized bed combustion for disposing and energy recovery from waste. Ten different collection and disposal options involving two combustion methods, namely, grate combustion and fluidized bed method are considered. Utilization of the energy is done for three end uses, namely, power generation, water distillation and district cooling. Two different regions in Saudi Arabia are considered for this study under two types of scenario, namely with recycling and without recycling. The different options are prioritized based on their overall ranking using five major performance factors.

The article examines the relationship between household food waste and GDP in various European regions, aiming to determine how economic prosperity influences household food waste levels. Using comparative analysis of secondary and tertiary data, we developed a synthetic indicator (IpFW), to assess the interaction between GDP per capita and household food waste per capita. Despite expectations, higher GDP did not consistently correlate with lower food waste, challenging assumptions about economic prosperity and environmental stewardship. The research underscores the complex interplay between economic factors and food waste management, revealing no significant correlation even at regional levels. It also highlights the potential of e-commerce in enhancing food waste reduction strategies. E-commerce platforms can optimize food supply chains and consumer behavior, contributing to more sustainable consumption patterns. The conclusions call for a reevaluation of policies and suggest that integrating e-commerce could bolster efforts to manage food waste more effectively, aligning with the Sustainable Development Goals.

An investigation studied the impact of various solid waste types on Helianthus plant growth, encompassing both Helianthus annuus and Helianthus giant. Common sunflowers (Helianthus) were cultivated to assess the influence of soil substrates with differing compositions and solid waste concentrations on plant growth and morphology. Materials included fireplace ash, oil burner dust, forge dust, land of Milos (pozzolan), and land of Milos mixed with olive core. The aim was to determine if Helianthus could remediate soil contaminated by these wastes. Results re-vealed plant growth relied on substrate quality and quantity. High concentrations of fireplace ash and oil burner dust were detrimental, while forge dust, land of Milos, and olive core combinations supported satisfactory growth and improved resistance. Generally, Helianthus annuus outper-formed Helianthus giant. These findings highlight Helianthus' potential for soil restoration and decontamination under specific substrate conditions concerning solid waste type and concentration.

"Hydrogen is an extremely promising energy carrier, poised to become a commercially viable product in the coming years. However, there are significant hurdles that need to be addressed. One such challenge is the high energy consumption during the electrolysis process, which is used to produce hydrogen. Furthermore, the co-production of CO and CO2 during steam hydrocarbon reforming adds to the complexity. Finding innovative solutions to these issues is crucial for the widespread adoption of hydrogen as a clean and efficient energy source." Simultaneously, various industries have the capability to generate hydrogen as a by-product, each with differing levels of purity. For instance, sodium and chlorine production plants have the potential to produce high-purity hydrogen. On the other hand, digester and sewage gas can yield low-purity hydrogen. In both instances, there is an economic incentive to utilize this hydrogen for energy production or to inject it into existing natural gas pipelines A brief estimation of the technical potential of utilizing hydrogen from various sources in Nigeria, specifically for fuel cell usage, has been conducted. Moreover, resource potential visualization maps have been generated to help visualize the availability and distribution of these hydrogen sources throughout the country.

To ensure sustainable production and consumption in the agricultural sector, it is necessary to assess the contribution of each element of the nexus in the agricultural production chain. The aim of this study is to make a quantitative and qualitative analysis of the contributions of each element of the energy, water, waste and land nexus to agricultural products. A composite method approach combining aspects based on input-output model, Location Quotient (LQ) as well as competitive position is adopted. A database of nexus elements over a period from 2009 to 2018 is used for Cameroon, with ten regions considered. The results show proportions of around 0.42% energy, 67.88% water withdrawal, 11.91% harvested area, 97.81% waste for agricultural products. The geolocation of harvested areas shows that the largest portion is in the far north (1,373,829 ha) and the smallest in Adamawa (224,038 ha). Maximum production is in the central region (4,334,095 tons) and minimum in the Adamawa region (915,841 tons). The central, littoral and west regions are more representative of agricultural products. The analysis of the competitive position of agricultural products contributes to a better orientation of national strategies for agricultural sustainability according to existing potentials.

Acerola (Malpighia spp.) is a tropical plant genus of shrubs and trees whose fruit is rich in nutrients and bioactive compounds. However, its production generates significant waste that could pose an environmental issue. This review aims to summarize recent research on the potential uses of acerola wastes, including the extraction of bioactive compounds such as polyphenols, carotenoids, and pectins, as well as the development of materials such as nanomaterials, chitosan, and biofuels. Additionally, the paper discusses the potential medical applications of acerola wastes, such as wound healing, antioxidant, and anticancer effects. Finally, the paper explores the challenges and opportunities of using acerola waste as a sustainable source of raw materials and energy. The findings suggest that acerola waste could be a valuable resource for developing high-value products and promoting sustainable production practices in the fruit industry.

Since a large amount of sewage sludge (WSS) has been generated daily, it is necessary to explore effective methods for utilizing WSS. Although a photo-fermentation system sometimes alters the characteristics of microbial functions, there are no attempts to perform the photo-fermentation using WSS which is regularly treated under a dark-fermentation style. In this study, the effect of photo-fermentation (photo-irradiation) on anaerobic digestion using WSS was revealed. Photo-irradiation during the anaerobic digestion of WSS significantly reduced the amount of organic acids and hydrogen sulfide and methane production was also suppressed. However, it was shown that the activity of sulfate-reducing bacteria in WSS under the light treatment increased. Photo-irradiation also stimulated the growth of green-sulfur bacteria and induced anoxygenic photosynthesis, by which the fermented samples turned green linking with the consumption of hydrogen sulfide. Finally, a dark/light switching fermentation was able to reduce only hydrogen sulfide while methane production remained the same.

Investigating the potential impact of composting and recycling waste on income distribution are crucial to promote a fairer and more sustainable fresh tomato supply chain (FTSC). Therefore, this study aims to explore the potential of gaining extra income from recycling tomatoes waste generated along the FTSC and to calculate the contribution of extra income from recycling tomato waste to reduce income inequality along the FTSC. Data were collected from 136 greenhouse tomato producers, 60 wholesalers, 18 exporters, 120 domestic retailers, 22 overseas retailers, and 3 recycling facilities in Türkiye. Marketing cost, absolute marketing margin, relative marketing margin and net profit margin were used when economically analyzing the FTSCs. Research results showed that the net profit share of the producer decreased associated with the increasing number of intermediaries. Research results also showed that revenue gained from composting and recycling of product loss and waste increased the welfare of greenhouse producer more than other supply chain actors. When taking into account the revenue from composting and recycling of wastes, producers increased their net profit by 9.85% at first FTSC, while that of second and third FTSCs were 8.29% and 9.21%, respectively comparing to the prevailing conditions. The contribution of extra revenue from composting and recycling of wastes to retailers was more comparing wholesaler and exporter. Retailers and wholesalers gaining from recycling in domestic FTSCs was more comparing to overseas one. Close cooperation between producers, wholesalers, exporters, retailers, and recycling facilities is essential for the effective implementation of waste recycling initiatives. Organizing the training and education programs focused on waste management can increase the extra income of producers and active intermediaries in FTSC from composting and recycling tomato wastes. Offering financial incentives, grants, or subsidies can encourage producers and other actors within the supply chain to adopt waste recycling practices. Continuous research and innovation are crucial in identifying and developing new technologies, processes, and strategies to minimize food loss and waste. Dominating fair-trade practices to ensure that all FTSC actors may balance the income distribution among FTSC actors.

The edible portion of Cannabis sativa L. are the seeds. The seeds are generally used for the production of hemp oil, appreciated for the high percentage of α-linolenic acid. The waste obtained after seeds oil extraction, reduced in fine powder, is the subject of this study. Since hemp seeds are considered to be a source of many valuable bioactive compounds, the addition of hemp seed flour to durum wheat for making fortified bread could have an effect on the health of consumers. The aim of this study was to use variable percentages of hemp seed flour for the production of bread, and to determine the fortification impact on chemicals, texture, organoleptic characteristics, crumb color, changes in crumb texture, total polyphenols, free radical scavenging activity and amino acids contents. The rheological and chemical qualities of bread samples, obtained by using a durum wheat cultivar Ciclope fortified with defatted hemp seeds flours, were evaluated. The solid residue left after the extraction of the oil from seeds (generally thrown away as waste or added to feed) was shredded and sieved at 0.530 mm (Hemp 1) or 0.236 mm (Hemp 2). Samples of fortified breads were obtained by substitution of variable percentages of durum wheat flour with the two hemp flours (5%, 7.5%, and 10%). Fortified bread’s total phenolic content was in a range of 0.73±0.017 and 1.73±0.029 mg GAE/g and an-ti-radical scavenging activity was included in the range from 1.17±0.099 and 3.18±0.071mmol TEAC/100g, according to the increasing fortification. Comparison between bread made with Ciclope semolina and hemp flour fortified breads, showed a large increase in amino acid content in fortified samples ones. In particular, bread fortified with 10% Hemp 2 flour highlights a greater content of glutamic acid, tyrosine, proline and essential amino acids such as leucine and isoleucine, compared to the other samples with same percentage of substitution. The amount of hemp seed flour influenced the color of the crumb by increasing the yellow index from 18.24 (100% Ciclope) to 21.33 (bread with Hemp 2 flour at 5%).

In order to reduce the environmental damage caused by coal waste landfills, it is necessary to look for rational ways of their management. One of the methods of their development may be the creation of soil-like substrates. The aim of the study was to assess the properties of soil-like substrates from coal mining waste with a varied share of sewage sludge and waste mineral wool. The evaluation of the properties of the substrates was carried out in a pot experiment. The properties of the substrates and their yield potential were determined. Coal mining waste as a substrate, compared to anthropogenic soil, was characterized by: significantly higher sorption capacity, content of alkaline cations and pH, significantly higher content of organic carbon, nitrogen and assimilable forms of K and Mg, and lower content of assimilable P. The substrates enriched with sewage sludge showed: significant increase in the content of organic carbon, nitrogen and assimilable forms of P and Mg, optimization of sorption properties. Extending the composition of substrates with mineral wool resulted in further improvement of their properties. Yields of plants grown on coal mining waste were significantly lower than on anthropogenic soil. Substrates with sewage sludge and mineral wool had a significantly higher yield potential.

Modified aluminum slag (MAS) was applied as an adsorbent for Congo red (CR) prepared by the hydrothermal treatment of Ca (OH) 2. At 25 ℃, with a MAS dosage of 0.3g, initial CR concentration of 100 mg/L and initial pH=5, and the adsorption time was 40 min, the CR removal efficiency was 98.41%. The adsorption trend of CR conformed to the second-order kinetics, and the adsorption isotherm follows the Freundlich isotherm model. Compared with RAS, MAS has a larger pore volume and specific surface area. The mechanism of action of MAS on CR was the interaction between membrane diffusion and internal diffusion, and the adsorption rate during the membrane diffusion was the fastest.

Less than half of e-waste plastics is sorted worldwide and this rate is likely to decline as major processing countries have banned importation of e-waste plastics. This forces the development of decentralized processing facilities, also known as microfactories. The present work investigates the recyclability of different grades of acrylonitrile-butadiene-styrene (ABS) copolymer, polycarbonate, and polypropylene, which were found to be very abundant in a recycling site in the UK. The determination of the matrix relied on the resin identification code imprinted in the e-waste plastic and subsequent FTIR analysis. The melt-blend extrusion technology enabled the valorization of the wasted thermoplastics as 3D filament without significant degradation of the polymers. The recycled materials maintained the tensile strength around 2.5 MPa in agreement with the specifications offered by virgin polymers. Further characterization was done by means of laser microscope, thermogravimetric analysis, and XRF to determine the commercial viability of the recycled filament. A modified solvent-based method was developed with acetone to remove the brominated flame retardants: 25g/100mL, 30 minutes of contact time, and 4 extraction steps. The FTIR results show that the degradation of the rubbery dispersed phase corresponding to the butadiene can be accumulated in the less soluble fraction of the waste ABS.

Recently, the amount of waste generated has been rapidly increasing, there have been difficulties disposing of waste in Korea. As a solution to this, treating waste using a cement kiln has suggested, but the environmental and economic effects have not been specifically studied. In this study, the effects of alternative resources, and reducing the social costs(Installation and Operation) associated with waste treatment facilities were analyzed. Through a co-processing method, a reduction of approximately 53kg of CO2 can be realized during the production of one ton of cement, and cost savings of about 3,815 milion USD. Another effect is an extension of the expiration date for landfills by 7.55 years.

Abstract: The promotion of sustainable packaging is part of the European Green Deal and plays a key role in the EU’s social and political strategy. One option is the use of renewable resources and biomass waste as raw materials for polymer production. Lignocellulose biomass from annual and perennial industrial crops and agricultural residues are a major source of polysaccharides, proteins, and lignin, and can also be used to obtain plant-based extracts and essential oils. Therefore, these biomasses are considered as potential substitute for fossil-based resources. Here, the status quo of bio-based polymers is discussed and evaluated in terms of properties related to packaging applications such as gas and water vapor permeability as well as mechanical properties. So far, their practical use is still restricted due to lower performance in fundamental packaging functions that directly influence food quality and safety, the length of shelf life and thus the amount of food waste. Besides bio-based polymers, this review focuses on plant extracts as active packaging agents. Incorporating extracts of herbs, flowers, trees, and their fruits is inevitable to achieve desired material properties that are capable to prolong the food shelf life. Finally, the adoption potential of packaging based on polymers from renewable resources is discussed from a bioeconomy perspective.

Slope failures pose a substantial threat to mining activity due to their destructive potential and high probability of occurrence on steep slopes close to limit equilibrium conditions, often found both in open pits and in waste and tailing disposal facilities. The development of slope monitoring and modeling programs usually entails the exploitation of in situ and remote sensing data together with the application of numerical modeling, and it plays an important role in the definition of prevention and mitigation measures aimed at minimizing the impact of slope failures in mining areas. Here we present a new methodology combining satellite radar interferometry and 2D finite element modeling for slope stability analysis at a regional scale, applied within slope unit polygons. We studied a former mining area in southeast Spain, and the method proved useful in detecting and characterizing a considerably large number of unstable slopes. Out of 1,959 slope units used for the spatial analysis of the radar interferometry data, 43 were unstable, with varying values of safety factor and landslide size. Out of the 43 active slope units, 21 exhibited line of sight velocities greater than the maximum error obtained through the validation analysis (2.5 cm/year). Eventually, this work discusses the possibility of using the results of the proposed approach to devise a proxy for landslide hazard. The proposed methodology can help to provide non-expert final users with intelligible, clear and easily comparable information to analyze slope instabilities in different settings, not limited to mining areas.

Given the importance of the development of urban infrastructure and environmental impacts produced by the civil construction waste (CCW), it is important to correct the handling of CCW with objective solutions that are more environmentally friendly. In that sense the present study aimed to determine indicators that make it possible to estimate the amount of CCW generated from construction sites in the city of Londrina, Parana State, Brazil. The generation of CCW was estimated in a general way, regarding the composition of its mixture, correlated to the gross areas of the buildings studied and their generated volumes of RCC. This generating rate was evaluated in a general way and specifies two types of sites: the new residential and new non-residential constructions. The data required for the development of these indicators was obtained through extensive survey and interviews carried out at the environment secretariat of the City Hall. The generating rate of CCW obtained for non-residential buildings was 0.2052m3/m2 or 170.44kg/m2, for new residential sites was 0.2054m3/m2 or 170.60kg/m2 and for new commercial or non-residential construction sites, it was 0.20453 m3/m2 or 169.85kg/m2. It was also possible to estimate the amount generated annually per inhabitant in the municipality, which is 0.60m3/inhabit.year or 498.55kg/inhabit.year.

To develop aryloxyphenoxypropionate herbicides with novel structure and improved activity, a total of twenty-eight novel quinazolinone–phenoxypropionate derivatives containing a diester moiety were synthesized and tested for herbicidal activity. The bioassay results in the greenhouse showed that QPEP-I-4 exhibited excellent herbicidal activity against E. crusgalli, D. sanguinalis, S. alterniflora, E. indica, and P. alopecuroides with inhibition rates &gt;80% at a dosage of 150 g ha-1, and displayed higher crop safety to G. hirsutum, G. max, and A. hypogaea than the commercial herbicide quizalofop-p-ethyl. Studying of the molecular mode of action by phenotypic observation, membrane permeability evaluation, and transcriptomic analysis revealed that a growth inhibition of plant by QPPE-I-4 was the result from damage of plants biomembrane. The evaluation of ACCase activity in vivo indicated that QPPE-I-4 could inhibit ACCase and may be a new type of ACCase inhibitor. The present work demonstrated that QPPE-I-4 could serve as a lead compound for further developing novel AOPP herbicides.

The growing emphasis on sustainability and environmental stewardship in the pharmaceutical industry necessitates innovative solutions to manage pharmaceutical waste, particularly medication bottles. This research paper explores the potential of integrating Radio Frequency Identification (RFID) and blockchain technology to enhance the traceability, accountability, and efficiency of recycling empty medication bottles. By utilizing RFID for real-time tracking and blockchain for secure, immutable data storage, this proposed system improves transparency across the supply chain and incentivizes consumer participation in recycling programs. The solution provides benefits to pharmaceutical manufacturers, regulators, and consumers, contributing to sustainability, regulatory compliance, and environmental protection.

Behavior analysis is a widely used non-invasive tool in the practical production routine, as the animal acts as a biosensor capable of reflecting its degree of adaptation and discomfort to some environmental challenge. Predominantly, conventional statistics use occurrence data for behavioral evaluation and well-being estimation, disregarding the temporal sequence of events. The Generalized Sequential Pattern (GSP) algorithm is a data mining method that identifies recurrent sequences that exceed a user-specified support threshold, whose potential has not yet been investigated for broiler chickens in enriched environments. Enrichment aims to increase environmental complexity with promising effects on animal welfare, stimulating priority behaviors and potentially reducing the deleterious effects of heat stress. The objective was to validate the application of the GSP algorithm to identify temporal correlations between heat stress and the behavior of broiler chickens in enriched environments through proof of concept. Video image collection was carried out automatically for 48 continuous hours, analyzing a continuous period of seven hours, from 12:00 PM to 6:00 PM, during two consecutive days of tests for chickens housed in enriched and non-enriched environments under comfort and stress temperatures. Chickens at comfort temperature showed high motivation to perform the behaviors of Preening (P), Foraging (F), Lying down (Ld), Eating (E), and Walking (W) whose sequences &lt;{Ld,P}&gt;; &lt;{Ld,F}&gt;; &lt;{P,F,P}&gt;; &lt;{Ld,P,F}&gt; and &lt;{E,W,F}&gt; were the only ones observed in both treatments. All other sequential patterns (comfort and stress) were distinct, suggesting that environmental enrichment alters the behavioral pattern of broiler chickens. Heat stress drastically reduced the sequential patterns found at the 20% threshold level in the tested environments. The behavior of lying laterally "Ll" is a strong indicator of heat stress in broilers and was only frequent in the non-enriched environment, which may suggest that environmental enrichment provides the animal with better opportunities to adapt to stress-inducing challenges, such as heat.

Aim: The aim of the study is to analyze quantitatively the scientific literature covering nursing studies on patient safety. Method: The Web of Science database is queried in this retrospective bibliometric analysis to identify relevant publications. The study themes, contributing journals, countries, institutions, and authors were evaluated quantitatively. Thus, a total of 5470 publications concerning patient safety in nursing were included and analyzed. Findings: The number of studies conducted increased every year from 1992 to 2023. While the country whose articles receive the most citations (31072) is the United States of America (USA), Turkey is ranked as last with the lowest number of citations (581). Journal of Clinical Nursing, with 338 articles, appeared to have the highest number of publications, Chaboyer W. appeared to have the highest number of citations with a total of 1426 and 45 publications. The countries that have the strongest international cooperation for research in this field are the USA, England, Australia and China. Results: After examining the literature in the field of patient safety in nursing through bibliometric analysis, it is seen that themes such as patient safety, medication errors, nursing care, nursing, education, systematic review, quality care and leadership were emphasized as important considerations.

Traceability has been applied in the fisheries, for example in tuna, as a means of verification and validation of the quality of fish meat and its origin. Traceability as a platform in the fisheries remains elusive in many parts of the country due to slow adoption. This study reviewed the existing literature in relation to, “agri-fishery traceability system,” “fishery traceability,” and “food safety” from year 2000-2023. It aimed to elucidate the common drivers and barriers to the adoption of fisheries traceability system. The authors used PRISMA to analyse articles obtained from SCOPUS and WOS (Web of Science), DOAJ (Directory of Open Access Journal), Academia, and PubMed central databases. The results showed that 125 articles were included after the inclusion and exclusion process. There were nine articles included in the year 2000 to 2005, followed by 19 in 2006 to 2010, and 26 from the year 2011 to 2015. A total of 40 articles were recorded from the year 2016 to 2020 and 31 from the year 2021 to 2023. In terms of text data from the authors, “fish”, “supply chain”, “traceability system”, and “food safety” have the highest total link strength. Moreover, food safety, market compliance, consumer protection, product origin, quality, and seafood fraud are driving factors in the implementation of traceability system. Costs, inadequate practices, lack of support from the government, infrastructure, information, and laws and regulations are foreseen barriers to the adoption of a traceability system. Leading countries in fisheries traceability studies include, China, USA, Italy, Indonesia, UK, and Taiwan where the first and corresponding authors originated. While this review endeavored to find fish traceability studies in the Philippines, the lack of comprehensive and relevant literature published in this topic shifted our focus to finding barriers and drivers to adopting a traceability system. We recommend that government agencies that oversee various commodities, should link up with academics and non-government organizations in the implementation and monitoring of their traceability systems.

Using recent developments in econometrics and computational statistics we consider the estimation of the instantaneous rate of asset return process when the underlying Data Generating Mechanism (DGM) is an Ornstein-Uhlenbeck process, driven by fractional noise, and sampled at fixed intervals of length h. To address the problem we adopt throughout the paper an exact discretization approach. This enable us to exploit the fact that a flow sampling scheme arises naturally when observing the DGM. For, while the instantaneous rate of return process is unobservable at points in time, its time integral over successive observations is observable since it equals the increment of log-prices. Exact discretization delivers an ARIMA(1,1,1) model for log-prices with a fractional driving noise. Building on the resulting exact discretization formulae and covariance function, a new Markov Chain Monte Carlo (MCMC) scheme is proposed and we examine the properties of both the time and frequency domain likelihoods / posteriors through Monte Carlo. For the exact discrete model we adopt a general sampling interval of length h. This allow us to determine the optimal choice of h independent of the sample size. An empirical application using high frequency stock price data is presented showing the relevance of aggregation over time issues in modelling asset prices.

Background: With the rapid improvement of the healthcare technologies, security and privacy of the most sensitive data, health data is at risk. Protecting patient privacy has many components, even though the data are in electronic format. Although patient privacy is thoroughly discussed in the literature, there is no study presenting all components of patient privacy protection. Methods: In this study, a complete evaluation framework is presented, as an evaluation tool, an inventory is developed, reliability and validity of the inventory is examined. Study is conducted in three phases: Conceptual framework development, inventory development and an evaluation case study. In the evaluation, fuzzy conjoint analysis is employed to handle the subjectivity and am-biguity. As the result of the evaluation, the institution is given a patient privacy protection ma-turity grade, between 1 and 5, where 1 is the worst and 5 is the best grade. Results: In the case study, XXX’s biggest hospital, employing 800 nurses, is evaluated. Half of the nurses, 400, have partici-pated in the study. Literature tells healthcare institutions do not invest enough to protect patient privacy, and the study results support this finding. Institution’s maturity grade resulted as level 2, which is bad. Conclusion: The study measures he privacy maturity with many evaluation com-ponents. Result of the evaluation explains to the patients and the public if their data is safe or not. With this maturity grade, patients have an idea about which institution to choose, public can conclude the institutions’ reliability in terms of patient privacy.

Purpose: To report a novel application of excimer ablation for normalization of central corneal refractive irregularity, combined with higher fluence CXL in the effective management and visual rehabilitation of progressive keratoconus. Methods: 17 cases with progressive keratoconus were treated with a corneal surface excimer laser ablation normalization using the topographyguided (Contura) myopic ablation for customized corneal re-shaping using a 6mm optical zone. The epithelial removal was accounted for by adding a -2.75 diopters correction in the topographyguided normalizing surface ablation followed by, a second, wavefront-optimized hyperopic excimer treatment of + 2.75 diopters at 6mm optical zone. The 2 sequential excimer ablations were followed by the corneal crosslinking (CXL). Visual acuity, refraction, and keratoconus documentation via keratometry, topography, and pachymetry, as well as endothelial cell density were evaluated over 36 months. Results: Keratoconus stabilized in all cases. The severity of keratoconus stage by Amsler-Krumeich criteria improved for the OD from an average 2.2 to 1. Mean UDVA showed marked improvement at one-year follow-up all values in decimal: from 0.21±0.18 pre-operative to 0.51±0.25 at 12 months, with small additional improvement through the 3 years to 0.51±0.16. CDVA respectively increased from 0.55±0.11 to 0.77±0.14 at 1 year, and to 0.79±0.16 at 3 years. Mean minimal corneal thickness decreased significantly from 466.74±34.25 µm to 396.17±45.17 µm (P<.01) as recorded the first year postoperatively and then slightly increased to 405.17±32.21 µm at the 3-year follow-up. Conclusions: We introduce herein initial clinical data with the use of novel, off-label therapeutic excimer laser surface ablation application: Designed to perform both epithelial removal and anterior corneal stroma reshaping, to be combined with CXL, in order to apply the Athens Protocol CXL with US excimer laser approved specifications.

(1) Introduction: The COVID-19 pandemic presented unique challenges for patients and healthcare providers, especially for those working with obesity and related health problems. E-health has emerged as a crucial tool for the follow-up of users undergoing bariatric surgery during this period, allowing remote monitoring of users' health status and providing access to virtual consultation with health professionals. This study aims to analyze the impact of the use of telemedicine during the COVID-19 pandemic on the results of bariatric surgery and user satisfac-tion with this follow-up. (2) Method: Observational study with retrospective data collection. The variables were divided into several groups: health data, associated comorbidities, quality of life, quality of sleep and satisfaction with telemedicine monitoring. (3) Results: Surgery significantly affected weight loss, in general more than 75% loss of excess weight. Comorbidities, like the qual-ity of life, were reversed over time, with 50% of subjects maintaining excellent levels. Although most users were satisfied with the monitoring, the variables had no relationship. (4) Conclusions: The follow-up assured by telemedicine did not alter the results of bariatric surgery, which may allow us to infer that it may be an option to consider for regular monitoring of the post-bariatric surgery process.

This narrative review aims to summarize evidence regarding the current utilization and future applications of neuromodulation in patients with headaches, with special attention paid to migraine and chronic cluster headache. We performed a narrative review of the literature to identify studies that detail the effectiveness of neuromodulation therapies in the treatment of headache syndromes. The literature was refined to predominantly focus on systematic reviews published in the last year that have the most robust reporting of research done on this topic. Patients with headache face several challenges, including medication overuse, cost burden, non-compliance to medications due to inability to tolerate side effects, or treatments that are ineffective. Neuromodulation is an emerging field that encompasses implantable and non-implantable technologies that intervene on the signaling and perception of pain. In recent years, this technology has been used as an analgesic, and has been shown to be effective for treatment-resistant headache, particularly when used in patients with migraine and chronic cluster headache.

Gastric perforations and leaks are significant complications that can arise from various gastrointestinal disorders and surgical interventions. Over the past decade, endoscopic techniques have emerged as effective method for managing these conditions. Furthermore, as endoscopic resection techniques have grown in popularity, the risk of acute and delayed perforations has also grown. This review aims to provide an in-depth analysis of the endoscopic management strategies employed in the management of gastric perforations and leaks. We will discuss the etiology, diagnostic modalities, and various endoscopic techniques utilized, and emerging trends in endoscopic management. Our attempt in writing this review paper is to educate and guide clinicians in making informed decisions when faced with gastric perforations and leaks.

Disabled children on the one hand have a wide range of impairments that translate into functional limitations but at the same time they possess various talents and capacities. These are manifested into the dynamics of society and the environment that they interact with. This article discusses disaster management with disabled children as a focus group. Disaster, disability and its management is discussed in the context of international practices in general and suited to India in particular. The research follows a review of the recommendations of the United States National Commission on Children and Disaster. In addition to this Disaster Medicine as one approach to Disaster Management concerning disabled children has been explored. The research concludes that the understanding of particular issues of Children with disabilities as one stakeholder, their capacity to engage and a shift in mindset and power relations in which they can contribute to disability inclusive disaster management are fundamental to disability-inclusive DRR.

Clearly policy makers should consider the impacts of any decisions they might make before making them. Science can provide estimates of various economic, ecologic, environmental, and even social impacts of alternative policies, impacts that determine how effective any particular policy will be. These impact estimates can be used to compare and evaluate alternative policies in the search for identifying the best one to implement. Among all scientists providing inputs to policy making processes are analysts who develop and apply models that provide these estimated impacts and, possibly, their probabilities of occurrence. But just producing them is not a guarantee that they will be considered by policy makers. This paper discusses ways scientists, including systems analysts, can effectively contribute to and inform those involved in making water management decisions. Brief descriptions of a variety of past and on-going water management policy making processes illustrate both some successes and failures of science informing policy.

Based on a large sample of publicly listed and non-listed US commercial banks from 1996 to 2011, we find robust evidence consistent with banks using realized available for sale (AFS) securities gains and losses to smooth earnings and increase low regulatory capital. We also find that (i) banks with positive earnings smooth earnings, and banks with negative earnings generally take big baths; (ii) regulatory capital constrains big baths; (iii) banks with more negative earnings and more unrealized beginning-of-quarter losses (gains) take big baths (smooth earnings); and (iv) banks with low regulatory capital and more unrealized gains realize more gains. Also, banks with negative earnings tak big baths (avoid or reduce the earnings loss) if their unrealized gains are insufficient (sufficient) to offset the negative earnings. Our inferences apply to listed and non-listed banks, which indicates that the earnings management incentives do not derive solely from public capital markets. Our findings reveal that the accounting for AFS securities gains and losses enables banks to manage regulatory capital and earnings in a variety of ways.

This paper formulates a new strategy for participatory forest management consisting of encouraging public participation as long as it increases empathy among participants. The strategy requires the homogeneous representation of the opinion of a participant (i.e. to determine how they assess a forest plan and identify the best one). Utility assessments are prepared for participants through pair-comparisons between meaningful points in the territory and from value functions based on forest indicators. The best plan is designed by applying combinatorial optimization algorithms to the utility of a participant. The calculating of empathy -of one participant relative to another - is based on the equivalence of their respective utilities when the current forest plan is modified. This involves calculating the opinions that are due to systematic changes in the collective plan for those participants that each participant supposes will affect the utility of the other participants. Calculating empathy also requires knowing the interactions among participants, which have been incorporated through agent-based simulation models. Application of the above methodology has confirmed the association between increases in empathy and convergence of opinions in different scenarios: well and medium-informed participants and with and without interaction among them, which verifies the proposed strategy. In addition, this strategy is easily integrated into available information systems and its outcomes show advantages over current participatory applications.

This study comprehensively explores Serbia's Disaster (Risk) Management System, aiming to critically evaluate its inherent strengths and weaknesses. Using descriptive-analytical methods and qualitative interpretation, SWOT analysis was applied to collect data from scientific papers, books, and institutional reports. This study delves deeply into the nuances of Serbia's Disaster Management Framework, revealing a nuanced landscape of strengths, weaknesses, and strategic improvement opportunities. Identified strengths underscore a robust foundation characterized by proficient professionals, state-of-the-art technology, and cohesive teamwork, all pivotal for effective emergency preparedness and response. Conversely, weaknesses underscore pressing imperatives for enhancements in regulatory enforcement, resource allocation, and infrastructure upgrades, presently hampering the framework's efficacy and response readiness. This research contributes to the ongoing discourse on disaster risk management and serves as a catalyst for further scholarly inquiry and policy formulation. By mapping out the structure of Serbia’s Disaster (Risk) Management Framework and integrating diverse data sources, the study enriches theoretical models and lays the groundwork for practical policy interventions. Its findings, including precise recommendations for policy reform and strategic improvements, provide valuable insights for policymakers, emergency management experts, and stakeholders seeking to enhance disaster preparedness and response capabilities on both national and global scales.

Lean practice is recognised for having a great potential in promoting safety risk management in offsite construction (OSC). This paper presents results of a study conducted to assess the impact of lean practice in safety risk management in OSC in a developing country. A quantitative approach using survey-based questionnaire was adopted. Lean management practices (LMPs) identified from literature review were empirically tested using a sample survey of 103 OSC contractors. The survey responses were subjected to descriptive and inferential statistics. The top ranked LMPs for safety risk management in OSC included two mistake proofing practices, i.e., use of personal protective equipment (PPE) and use of hazard warning equipment; two last planner system (LPS) practices, i.e., involvement of workers in safety planning and providing necessary working equipment and one first run studies (FRS) practice, i.e., critical analysis of work methods. These LMPs are useful in controlling high consequence safety risks in OSC. Based on evidence found in this study, the paper argues that lean practice can bring great value in the safety risk management in OSC in countries where OSC is transitioning.

This study provides an evaluation of a web-based platform for game management and sales, developed using PHP, MySQL, and SASS. The development process utilized the SCRUM methodology, concentrating on essential modules such as user management, game catalog, payment processing, and technical support. The platform's performance was assessed using Google's Lighthouse tool, which evaluates four critical areas: performance, accessibility, best practices, and SEO. The results demonstrated exceptional performance with a score of 99/100 and perfect adherence to best practices with a score of 100/100, reflecting high efficiency and compliance with web development standards. Accessibility received a score of 83/100, indicating potential areas for improvement, while SEO achieved a score of 91/100, suggesting effective search engine optimization. The findings reveal that the platform exhibits high levels of optimization and operational efficiency. However, there remains an opportunity to enhance accessibility features. This study highlights the significance of rigorous web development practices and optimization efforts in achieving superior performance and user experience in web-based systems.

Studies on social media (SM) and disaster management (DM) have mainly focused on the adap-tation, application and use of SM in each stage of DM. With the widespread availability and use of SM, the effective utilisation of SM in DM is impeded by various challenges, but not yet com-prehensively researched. Therefore, this paper aims to identify the challenges, as well as the strategies to overcome the challenges and categorises them into a classified model. The study adopts a systematic literature review to present and analyse the challenges and strategies for us-ing SM in DM. Utilising prominent databases, 72 publications were carefully selected and ana-lysed qualitatively using content analysis. The findings revealed four key challenges to its users: spread of misinformation; insufficient human resources to manage SM use; lack of trust in infor-mation and authorities; and, poor information quality and content of messages. The study identi-fied several strategies to overcome challenges, which can be classified into three sectors of the SM community: individuals, organisations, and SM companies. These findings contribute to enhanc-ing the effective utilisation of SM in DM by community practitioners. Furthermore, this study provides insight into the current status of knowledge and identifies the research gaps around SM in DM for future research.

SUDEP is a sudden death in a person with epilepsy, without evidence of a seizure before death. While its cause is still unclear, various factors have been linked to seizure onset and cardiopulmonary function. Studies have shown that although 91.3% of epilepsy patients want information on premature death, only 31% of them receive it. The numbers emphasize the need for open and sensitive communication by medical professionals. It is important to choose the appropriate moment for the conversation, avoiding periods of stress and ensuring emotional stability in the patient, as well as clear, appropriate and easy to comprehend information about SUDEP. To facilitate this, knowing the patient's level of knowledge is essential. Education on the warning signs of seizures and SUDEP can help take precautions and can decrease the incidence of the phenomenon itself. Effective epilepsy care requires a comprehensive plan, including medication adherence and lifestyle changes. Regular communication and collaboration between the patient, caregiver and health professionals are essential for the effective management of epilepsy, so just as epilepsy has a fluid, changeable course of disease and follow-up appointments are very important, the topic of SUDEP is not a one-time conversation either.

The automobile industry is undergoing technological advancement, which includes breakthroughs such as hybrid cars, electric vehicles (EVs), and self-driving capabilities. However, despite these advances, issues remain, notably in recall management efficiency, security and risk of fraud. To solve these difficulties, the idea of Industry 4.0 has been adopted, which uses technologies such as sensors, IOT’s, and machine learning. Even this technology still has loopholes in the area of security which has been exploited negatively over time. In other to mitigate these loopholes we introduce Blockchain technology as a viable alternative, providing a safe and transparent environment. This study investigates and proposed the use of blockchain to create an enhanced Vehicle Tracking System (VTS) intended at enhancing recall management and reducing fraud in the automobile sector. The proposed solution was discussed in detail and a mock smart contract was also written, which was deployed on the Ethereum Virtual Machine (EVM).

This research delves into the epidemiology, clinical manifestations, and management of hyperprolactinemia, particularly focusing on prolactin-secreting pituitary adenomas, or prolactinomas, in Dolj County, a region historically underrepresented in medical literature. Hyperprolactinemia, a prevalent endocrine disorder, arises from excessive prolactin secretion by the pituitary gland's lactotrope cells and presents a diverse clinical picture. The most significant etiological contributors identified are prolactinomas, accounting for approximately 39% of all secretory pituitary tumors. In light of hyperprolactinemia's substantial morbidity and prevalence, this study underscores the necessity of comprehensive understanding of its regional epidemiology and clinical presentations. Our methodology incorporated collecting retrospective data across various medical facilities in Dolj, ensuing a meticulous analysis of clinical features, paraclinical investigation outcomes, and therapeutic responses among patients with prolactinomas. Emphasis was placed on discerning risk factors, demographic characteristics, and associated comorbidities to encapsulate the full spectrum of these tumors' impact within the community. Preliminary results suggest a nuanced incidence rate of prolactinomas within Dolj, with specific demographic and clinical trends potentially distinct from those reported in wider literature. These findings stress the critical role of localized studies in enhancing screening, diagnostic, and therapeutic protocols. Ultimately, this investigation offers critical insights into the epidemiology and symptomatology of prolactinomas in Dolj, significantly augmenting existing literature and informing regional medical practices.

Gastroesophageal (GE) junction adenocarcinoma is an aggressive malignancy of growing incidence and is associated with public health issues such as obesity and GERD. Management has evolved over the last 2 decades to incorporate a multidisciplinary approach including endoscopic intervention, and neoadjuvant chemotherapy/ chemoradiation and minimally invasive or more limited surgical approaches. Surgical approaches include esophagectomy, total gastrectomy, and more recently proximal gastrectomy. This review analyzes the evidence for and applicability of these varied approaches in management as well areas of continued controversy and investigation.

Bronchiolitis is an acute viral infection of the lower respiratory tract that affects infants and young children. Respiratory syncytial virus (RSV) is the most common causative agent, however other viruses can be the reason of the disease. We retrospectively reviewed the clinical features of infants aged less than 12 months referred to our Pediatric Units of Chivasso, Cirié and Ivrea for acute bronchiolitis requiring hospitalization over two consecutive bronchiolitis seasons. Patient-, disease- and treatment related variables were analyzed in this retrospective study. We were able to show how with the high flow oxygen support (HFNC) only a very low number of children (8 out of 192) need to be trasferred to our HUB referral centers. The probability of success were 96% for all patients and 93% for RSV vs. 98% for non-RSV patients (P=NS). Factor associated to failure of treatment were age below 1 months and the failure of HFNC. The wide and increasing use of HFNC in pediatric inpatients improved management of bronchiolitis in Spoke hospitals, reducing transfer to a Hub hospital provided with Intensive Care Units.

Traumatic Brain Injury (TBI) remains a leading cause of morbidity and mortality among all ages; despite the advances, understanding pathophysiological responses after TBI is still complex, involving multiple mechanisms. Previous reviews have focused on potential targets; however, the research on potential targets has continuously grown in the last five years, bringing even more alternatives and elucidating previous mechanisms. Knowing the key and updated pathophysiology concepts is vital for adequate management and better outcomes. This article reviews the underlying molecular mechanisms, the latest updates, and future directions for pathophysiology-based TBI management.

Telemedicine has been increasingly considered an effective strategy to support patients with several diagnosis and therapies, avoiding the on-site visit and drastically reducing the risks to share infections. In the recent years, a number of different technologies have been developed and applied to clinical studies, with the aim to investigate new ways for increase the early diagnoses and monitor the clinical evolution of the most predictable diseases directly from the patients’ home. Telemedicine refers to all those technological interfaces used to remotely perform clinical procedures. Telemedicine applications could be useful in several medical fields, such as preventive medicine, home patient care, education for healthcare professionals and patients, research, public health, and health management. On the other hand, the synergy of these different technologies has a significant impact on the clinical risks analysis, particularly useful in frail patients. Although Telemedicine shows to have important advantages, undoubtedly important issues still remain. The present work aims to shed light on the main advantages and disadvantages related to of each application’s features, which may serve as a useful tool for researchers.

Premature ventricular complexes (PVCs) are frequently encountered in clinical practice. The association of PVCs with adverse cardiovascular outcomes in the context of structural heart disease is well established, yet the association between PVCs and cardiovascular outcomes in the absence of structural heart disease is not fully elucidated. Cardiac magnetic resonance (CMR) seems to contribute prognostically in the latter subgroup. PVC- induced myocardial dysfunction refers to the impairment of ventricular function due to the PVCs and is mainly associated with a PVC burden greater than 10%. The surface 12- lead ECG is used to localize the anatomic site of origin and multiple algorithms have been developed to differentiate right ventricular and left ventricular outflow tract (RVOT and LVOT, respectively) origin. Novel algorithms include alternative ECG configurations and lately, sophisticated artificial intelligence methods have been utilized to distinguish the origins of outflow tract arrhythmias. The decision to therapeutically address PVCs should be taken upon the presence of symptoms or the development of PVC- induced myocardial dysfunction. The therapeutic modalities include pharmacological therapy, namely I-C antiarrhythmic drugs and beta blockers, as well as catheter ablation, which demonstrates superior efficacy and safety.

In the modern world, stress has become a pervasive concern that affects individuals' physical and mental well-being. To address this issue, many wearable devices have emerged as potential tools for stress detection and management, by measuring heart rate, heart rate variability (HRV), and various matrices related to it. This literature review aims to provide a comprehensive analysis of existing research on HRV tracking and Biofeedback using smartwatches and finger monitor/sensor pairing with reliable 3rd party mobile apps like Elite HRV, Welltory, and HRV4Training specifically designed for stress detection and management. we apply various algorithms and methodologies employed for HRV analysis and stress detection is discussed, including time-domain, frequency-domain, and non-linear analysis techniques. Prominent smartwatches, such as Apple Watch, Garmin, Fitbit, Polar, and Samsung Galaxy Watch, are evaluated based on their HRV measurement accuracy, data quality, sensor technology, and integration with stress management features. We describe the efficacy of smartwatches in providing real-time stress feedback, personalized stress management interventions, and promoting overall well-being. To assist researchers, doctors, and developers use smartwatch technology to address stress and promote holistic well-being, we discuss the data's advantages and limitations, future developments, and the significance of user-centered design and personalized interventions. Keywords: smartwatch; stress; wearable device; heart rate variability; comparative analysis

The article deals with human resource management and selected personnel indicators in 10 sustainable development. The main goal of this paper is to analyse and describe human resource 11 management focused on audit of workload, motivation of employees, the competence of staff, their 12 knowledge and experience. The article shows how the selected personnel indicators are examined 13 in selected establishments of multinational company in Slovakia, as an attractive employer inter-14 ested in growth of its employees, thus employer branding. For research methods, a case study meth-15 odology is used. Data collection was carried out through a questionnaire survey with employees in 16 the company as well as an interview with sale advisors and managers. The research aimed to point 17 out a case study of the investigation of selected personnel indicators in human resources manage-18 ment in a selected company and to examine the perception of the performance of employees in 19 connection with their financial evaluation and their satisfaction in the selected company with an 20 impact on employees´ performance. Furthermore, the research aimed to determine whether there 21 was a dependence between the subjectively perceived performance of the employees and selected 22 aspects. Further indicators were calculated, such as employment rate, proportion of wasted time 23 and labour productivity.

The article deals with human resource management and selected personnel indicators in sus-tainable development. The main goal of this paper is to analyse and describe human resource management focused on audit of workload, motivation of employees, the competence of staff, their knowledge and experience. The article shows how the selected personnel indicators are examined in selected establishments of multinational company in Slovakia, as an attractive em-ployer interested in growth of its employees, thus employer branding. For research methods, a case study methodology is used. Data collection was carried out through a questionnaire survey with employees in the company as well as an interview with sale advisors and managers. The research aimed to point out a case study of the investigation of selected personnel indicators in human resources management in a selected company and to examine the perception of the per-formance of employees in connection with their financial evaluation and their satisfaction in the selected company with an impact on employees´ performance. Furthermore, the research aimed to determine whether there was a dependence between the subjectively perceived performance of the employees and selected aspects. Further indicators were calculated, such as employment rate, proportion of wasted time and labour productivity.

According to the World Health Organization (WHO), dementia is the seventh leading reason of death among all illnesses and one of the leading causes of disability among the world’s elderly people. Day by day the number of Alzheimer’s patients is raising. Considering the increasing rate and the dangers, Alzheimer’s disease should be diagnosed carefully. Machine learning is a potential technique for Alzheimer’s diagnosis but general users do not trust machine learning models due to the black-box nature. Even, some of those models do not provide the best performance because of using only neuroimaging data. To solve these issues, this paper proposes a novel explainable Alzheimer’s disease prediction model using a multimodal dataset. This approach performs a data-level fusion using clinical data, Freesurfer MRI segmentation data, and psychological data. For Alzheimer’s disease vs cognitively normal prediction, the random forest classifier provides 100% accuracy. Furthermore, Alzheimer’s disease and non-Alzheimer’s dementia should be classified properly because their symptoms are similar. To the best of our knowledge, we are the first to present a three-class classification on Alzheimer’s disease vs cognitively normal vs non-Alzheimer’s dementia and achieved 99.86% accuracy using an ensemble model. Besides, a novel Alzheimer’s patient management architecture is also proposed in this work..

Gout is the most common form of inflammatory arthritis. Hyperuricaemia is the pre-requisite for gout and is influenced by variable modifiable and non-modifiable risk factors. Clinical features unique for gout are due to deposition of monosodium urate (MSU) crystal in articular and extra articular tissues. Among various treating agents, anti-inflammatory drugs and urate lowering therapies (ULT) are used widely and successfully, however, non-medicinal means are also effective in the disorder. In their updated guidelines, ACR (2012) and EULAR (2016) recommended both medicinal and non-medicinal approaches that could be used in treating gout, though some of the recommendations are based on lower level of evidence. Moreover, researchers’ continued effort in finding new gout managing agents appear promising, for example, role of Lesinurad in gout management (CLEAR1, CLEAR2). In this new synthesis the author is aimed to provide updated information on gout management based on a systematic review including published work within last ten years between 2008 and 2018 and for this purpose, using ‘clinical trials in gout management’ string, published worked searched in PubMed database from 1st September 2018 to 30 October 2018. Besides the recent ACR and EULAR evidence based management guidelines, the author reviewed another 91 (total 93) articles to make this new draft – 39 articles describe role of pharmacological agents and 54 describe different gout risks, pharmacokinetics/pharmacodynamics of ULT, association between raised sUA level and renal impairment, efficacy of non-pharmacological agents in reducing sUA. According to published work, anti-inflammatory agent is the most appropriate drug group in mitigating inflammatory symptoms of gout, though they often adversely affect over other vital 2 organs with impaired function. Besides ULT, uricase analogues are also found useful in non refractory gout. Since anti-inflammatory agents and ULT contraindicate in some clinical conditions, intra-articular steroid and or adrenocorticotropic hormone (ACTH) are appropriate alternatives instead. However, head-to-head comparison between different NSAIDs, NSAID and prednisolone, NSAID and colchicine are yet to perform. Use of combined anti-inflammatory preparations in gout is also based on lower level of evidence. Regarding effective maximum dose and long-standing impact of ULT on vital organs we are yet to reach a conclusion. Likewise, non-medicinal approaches are widely using in achieving target sUA level, though some of them are based on biased study outcomes and or study with inadequate power, requiring further analysis. Among non-pharmacological approaches, life-style modification, restriction of purine rich diets, avoidance of gout inciting agents are important, but inconclusive. Educating patients’ about diseases, risk factors, available treatment options and side effects from them are also important in terms of achieving sUA level, nevertheless too much counseling sometimes could be worthless.

The need to consider sustainability has substantially increased the complexity of implementing construction and infrastructure projects and new management practices have emerged during the past decade to tackle the global sustainability challenges, where the engagement and coordination of broader competences from stakeholders throughout the supply chain is required. This new project management paradigm has been accompanied by greater attention to the concept of collaborative business arrangements, often called partnering, that has emerged in construction and infrastructure projects to improve project deliveries. However, there are uncertainties about the optimal strategy to foster, integrate and maintain the required collaboration, particularly in sustainable management practices in infrastructure maintenance projects. This paper addresses these uncertainties, based on a single case study of an infrastructure maintenance contract involving an extensive collaborative business arrangement. The findings reveal that different collaborative practices affect diverse aspects of sustainable project management. Further, the extensive collaborative business arrangement has promoted sustainable deliveries based upon organizational learning and continuous improvements. Thus, this study offers an encouraging example of how extensive collaboration can be fostered and play a key role in sustainable project management practices.

Background: As noninvasive prenatal screening usage grows in the general obstetrics setting, proper patient education on the screen’s benefits and limitations is needed. Objective: Describe the use of a technology platform designed for large-scale dissemination of noninvasive prenatal screening information and results. Study Design: The technology platform functioned as follows: Patients were emailed a link to an noninvasive prenatal screening general-education video upon laboratory receipt of a test requisition. Providers were then notified upon availability of patients’ results. If noninvasive prenatal screening results were negative, the patient was sent an automated email with instructions to access results through a secure portal where she could watch tailored informational videos, request “on-demand” or scheduled genetic counseling, or decline any further services. If genetic counseling was elected, a summary of the session was sent to the ordering provider and patient upon completion. If noninvasive prenatal screening results were positive, either the ordering provider or a board-certified genetic counselor contacted the patient directly to communicate test results and provide counseling. The number and type of results issued through the platform, the number and type of genetic counseling consultations completed, and factors associated with requesting laboratory-delivered genetic counseling were tracked and analyzed for a 39-month period. Results: Over the study period, 67,122 noninvasive prenatal screening results were issued through the platform, and 4,673 patients elected genetic counseling consultations; 95.2% (n=4,450) of consultations were for patients receiving negative results. Over 70% (n= 3,370) of consultations were on-demand rather than scheduled. Median consultation time was 14 minutes for positive results and six minutes for negative results. A positive screen, advanced maternal age, family history, previous history of a pregnancy with a chromosomal abnormality, and other high-risk pregnancy were associated with the greatest odds of electing laboratory-delivered genetic counseling. Conclusions: By combining web education, automated notifications, and genetic counseling, we implemented a service that effectively facilitates results disclosure for ordering providers. These data demonstrate the capability to deliver noninvasive prenatal screening results, education, and counseling—congruent with management guidelines—to a large population, which is imperative to quality care as uptake increases.