In 2021, an operational research study in two tertiary hospitals, Freetown, showed poor hand hygiene compliance. Recommended actions were taken to improve the situation. Between February-April 2023, a cross-sectional study was conducted in the same two hospitals using the WHO Hand Hygiene tool to assess hand hygiene practices and compare hand hygiene compliance with that observed between June-August 2021. In Connaught hospital, overall hand hygiene compliance improved from 51% to 60% (P<0.001), and this applied to both handwash actions with soap and water and alcohol-based-hand-rub: significant improvements were found in all hospital departments and amongst all healthcare worker cadres. In 34 Military Hospital (34MH), overall hand hygiene compliance decreased from 40% to 32% (P<0.001), with significant decreases observed in all departments and amongst nurses and nursing students. The improvements in Connaught Hospital were attributed to more hand hygiene reminders, better handwash infrastructure and more frequent supervision assessments compared with 34MH where interventions were less well applied, possibly due to extensive hospital reconstruction at the time. In conclusion, improved distribution of hand hygiene reminders, better handwash infrastructure and frequent supervision assessments are effective, and need to be strengthened, scaled-up and combined with other innovative ways to promote good hand hygiene practices.

The simplified, combined protocol admits children with a mid-upper-arm circumference (MUAC) of <125 mm or edema to malnutrition treatment with ready-to-use therapeutic food (RUTF) prescribing 2 daily RUTF sachets to children with MUAC <115 mm or edema and 1 daily sachet to those with MUAC ≥115 mm but <125 mm. This treatment has previously been shown to result in non-inferior programmatic outcomes compared to standard treatment. We aimed at observing its effectiveness in a routine setting at scale, including via delivery by community health workers (CHW). A total of 27 601 children were admitted to the simplified, combined treatment. Treatment resulted in 96% overall recovery with a mean LOS of 40 days and a mean RUTF consumption of 63 sachets per child treated. Among children admitted with MUAC <115 mm or edema 94% recovered with a mean LOS of 55 days and consuming an average of 97 RUTF sachets. Recovery in all sub-groups studied exceeded 90%.Treatment by CHWs resulted in similar (96%) recovery as treatment by formal health care workers (96%). The simplified, combined protocol results in high recovery and low RUTF consumption per child treated, and can safely be adopted by CHWs to provide treatment in the community-level.

This article addresses the question why initiatives in the field of green business and sustainable development often fail. Therefore, it dismantles some typical patterns of failure and shows – as a case study – how these patterns can be challenged through an innovative educational concept: the green business and sustainable development school. The applied methodology is a real-life project that is designed through blended, interdisciplinary elements from business model canvas, Theory U, participation and design thinking. The results of the school initiative are discussed and evaluated by four distinctive stakeholder groups and outline the school’s supporting potential to overcome typical patterns of failure by the younger generation in the future. This article concludes with ideas to enhance the school concept reaching out to even more stakeholder-groups to increase its reliability and viability.

Safety limits application has always been a traditional approach to ensure the safe operation of electro-mechanical systems within many industries including automated vehicles, robotics, aerospace, traditional automotive, railways, manufacturing, etc. In all of these applications, control and safety limits are usually hard-coded into the production firmware and are fixed throughout the entire product life cycle. Currently, due to the evolving needs of automated systems like automated vehicles and robots, this traditional approach does not address all the use cases and scenarios to ensure safe operation. Especially for data-driven machine learning applications that constantly evolve and learn over time, it is important to be able to adjust the safety limits application strategy to be more flexible and adaptable based on different Operational Design Domains (ODDs) and scenarios. Our ITSC conference paper ~\cite{4} introduced the concept of a new safety limits application strategy called the Dynamic Control Limits Application (DCLA) strategy that supports the flexible application of diverse limits profiles based on the parameters involved within the dynamic scenario at different layers of the Autonomy software stack.This paper extends the DCLA strategy to derive the complete methodology for safety limits application based on ODD elements, scenario identification and scenario classification using Decision Making Engines. It leverages the layered architecture introduced in the ITSC conference paper to implement the Decision Making (DM) algorithms. Another important extension is the use of cloud infrastructure that is based on the Vehicle-to-Infrastructure (V2I) technology to store the scenarios and the limits mapping to serve as a ground truth and/or a backup mechanism in case of errors or failures associated with the main Decision Making (DM) Engine. There is also a focus on providing a more comprehensive list of scenarios and a custom built experimental dataset to cover the maximum ODD elements, and multiple tables of safety limits to be chosen from, which eventually helps in creating different safety limits application profiles. These distinct safety limits application profiles are based on the scenario parameters that are perceived by the system upon which the Decision Making algorithms are applied or trained. This systematic approach can be used within the industry for any of the future automated vehicles and systems until Level 5 Autonomy.

Pro-regenerative lipid mediator 1 (PreM1) is a specialized pro-resolving lipid mediator capable of promoting wound healing and regenerative functions of mesenchymal stem cells (MSCs), en-dothelial cells, and macrophages. The third-degree (3o) burn healing and regenerative functions of MSCs are also enhanced by ACgel1, an arginine and chitosan-based protein-mimic hybrid hy-drogel. Adipose-tissue derived microvascular fragments (MVFs) are native vascularization units and a rich source of MSCs, endothelial cells, and perivascular cells for tissue regeneration. Here we describe an innovative PreM1-MVFs-ACgel1 construct that incorporates PreM1 and MVFs into ACgel1 via optimal design and fabrication is capable of delivering PreM1 to 3o burn wounds at least up to 7 days post-burn (dpb), and of scaffolding and delivering MVFs, which promoted 3o burn the healing in mice, including vascularization and collagen formation. The re-epithelization and closure of 3o burn wounds were promoted by ACgel1, MVFs, PreM1, MVFs-ACgel1, PreM1-ACgel1, or PreM1-MVFs-ACgel1 at certain time-point(s) while PreM1-MVFs-ACgel1 was most effective. The PreM1-ACgel1 and MVFs-ACgel1 also promoted blood vessel regeneration of the 3o burns. These PreM1- and/or MVFs- functionalized ACgel1 have nonexistent or minimal graft-donor requirements and are promising adjuvant therapies for overcoming the drawbacks of current skin grafting or substituting for treating severe deep burns.

Mereotopology is a concept rooted in analytical philosophy. The phase-field concept is based on mathematical physics and finds applications in materials engineering. The two concepts seem to be disjoint at a first glance. While mereotopology qualitatively describes static relations between things like x isConnected y (topology) or x isPartOf y (mereology) by first order logic and Boolean algebra, the phase-field concept describes the geometric shape of things and its dynamic evolution by drawing on a scalar field. The geometric shape of any thing is defined by its boundaries to one or more neighboring things. The notion and description of boundaries thus provides a bridge between mereotopology and the phase-field concept. The present article aims to relate phase-field expressions describing boundaries and especially triple junctions to their Boolean counterparts in mereotopology and contact algebra. An introductory overview on mereotopology is followed by an introduction to the phase-field concept already indicating first relations to mereo- topology. Mereotopological axioms and definitions are then discussed in detail from a phase-field perspective. A dedicated section introduces and discusses further notions of the isConnected relation emerging from the phase-field perspective like isSpatiallyConnected, isTemporallyConnected, isPhysicallyConnected, isPathConnected and wasConnected. Such relations introduce dynamics and thus physics into mereotopology as transitions from isDisconnected to isPartOf can be described.

Intelligent algorithms are recently used in the optimization process in chemical engineering and application of multiphase flows such as bubbling flow. This overview of modeling can be a great replacement with complex numerical methods or very time-consuming and disruptive measurement experimental process. In this study, we develop the adaptive network-based fuzzy inference system (ANFIS) method for mapping inputs and outputs together and understand the behavior of the fluid flow from other output parameters of the bubble column reactor. Neural cells can fully learn the process in their memory and after the training stage, the fuzzy structure predicts the multiphase flow data. Four inputs such as x coordinate, y coordinate, z coordinate, and air superficial velocity and one output such as pressure gradient are considered in the learning process of the ANFIS method. During the learning process, the different number of the membership function, type of membership functions and the number of inputs are examined to achieve the intelligent algorithm with high accuracy. The results show that as the number of inputs increases the accuracy of the ANFIS method rises up to almost for all cases, while the increment in the number of rules has a effect on the intelligence of artificial algorithm. This finding shows that the density of neural objects or higher input parameters enables the moded for better understanding. We also proposed a new evaluation of data in the bubble column reactor by mapping inputs and outputs and shuffle all parameters together to understand the behaviour of the multiphase flow as a function of either inputs or outputs. This new process of mapping inputs and outputs data provides a framework to fully understand the flow in the fluid domain in a short time of fuzzy structure calculation.

Breast Cancer Associated Susceptibility Proteins Type 1/2 (BRCA1/2) promote cellular functioning by modulating NRF2-mediated antioxidant signaling. Redox failure in women with BRCA1/2 insufficiency increases the risk for breast/ovarian/uterine cancers. Risk‐reducing salpingo‐oophorectomy (RRSO) is a prophylactic surgery of the reproductive organs, which is frequently conducted by the age of 40 to lower the occurrence of cancer in women with BRCA1/2 mutations. However, abrupt estrogen decline following RRSO causes ovarian failure, which implicates various cellular physiological processes, resulting in increased release of free radicals and subsequent severe onset of menopausal symptoms. Comfort measures (e.g., hormonal replacement therapy (HRT) and mindfulness-based stress reduction (MBSR)) may improve chronological menopause-related quality of life, but their specific effects are not clear in women with gene mutations. Aiming to fill the gap, this study used path analysis to examine the effects of HRT and MBSR on menopausal symptoms among RRSO patients (N = 199, mean age = 50.5 ± 6.7 years). HRT alleviated menopausal symptoms in BRCA2 carriers and women who were physically active, premenopausal at the time of RRSO, had a high BMI, and had no history of breast cancer. It increased the severity of urogenital symptoms in those with a history of cancer. MBSR, on the other hand, was associated with increased intensity of most menopausal symptoms. The results suggest that young women undergoing recent RRSO may benefit from HRT at an individual level while their need for extensive measures to optimize their psychological wellbeing is ongoing. Adverse effects of MBSR, which are captured in the present study imply that MBSR may interfere with redox sensitivity associated with estradiol fluctuations in BRCA1/2 carriers. Investigations are needed to test this hypothesis and elaborate on the underlying mechanisms in those women.

As the telecommunications landscape braces for the post-5G era, this paper embarks on delineating the foundational pillars and pioneering visions that define the trajectory towards 6G wireless communication systems. Recognizing the insatiable demand for higher data rates, enhanced connectivity, and broader network coverage, we unravel the evolution from the existing 5G infrastructure to the nascent 6G framework, setting the stage for transformative advancements anticipated in the 2030s. Our discourse navigates through the intricate architecture of 6G, highlighting the paradigm shifts towards super convergence, non-IP-based networking protocols, and information-centric net-works, all underpinned by a robust 360-degree cybersecurity and privacy-by-engineering design. Delving into the core of 6G, we articulate a systematic exploration of the key technologies earmarked to revolutionize wireless communication including terahertz (THz) waves, optical wireless technology, and dynamic spectrum management,while elucidating the intricate tradeoffs necessitated by the integration of such innovations. This paper not only lays out a comprehensive 6G vision accentuated by high security, affordability, and intelligence but also charts the course for addressing the pivotal challenges of spectrum efficiency, energy consumption, and the seamless integration of emerging technologies. In this study, our goal is to enrich the existing discussions and research efforts by providing comprehen-sive insights into the development of 6G technology, ultimately supporting the creation of a thoroughly connected future world that meets evolving demands.

Background: This study examines the relationship between energy usage, health issues, and pro-environmental behavior (PEB) in Kyrgyzstan, amidst the country's commitment to transition from coal-based energy to renewable sources in line with the Paris Agreement. The purpose is to investigate citizens' attitudes towards PEB and their intentions to engage in environmentally friendly actions, focusing on gas, electricity, and coal. Methods: Drawing upon the Theory of Planned Behavior (TPB) framework, a survey was conducted among 1,455 respondents to explore attitudes towards PEB and energy sources' impact on health issues. Results: Decarbonization efforts in Kyrgyzstan and Central Asia are in their early stages, with coal remaining a primary energy source. The study emphasizes the importance of governmental policies and citizen action in achieving decarbonization goals. Rising electricity costs outweigh the increase in indirect energy costs for food, posing challenges for households in adapting to changing energy dynamics. Conclusions: Targeted interventions and communication strategies are crucial to promote pro-environmental behavior and facilitate the transition to sustainable energy sources. Understanding the relationships between health concerns, air pollution awareness, PEB, and energy source choices can inform policymakers and organizations in their efforts to ensure a sustainable and healthy future for Kyrgyzstan and other Central Asian countries.

The use of naturally available materials not conforming to traditional specifications or standards, in the base and sub-base layers of road pavement structures, stabilised with New-age (Nano) Modified Emulsions (NME), have been tested, implemented and successfully verified through Accelerated Pavement Testing (APT) in South Africa. This was made possible through the development and use of a design procedure addressing fundamental principles and based on scientific concepts, which are universally applicable. The understanding of and incorporation of the chemical interaction between the mineralogy of the materials and a NME stabilising agent (compatibility between the chemistry of the reactive agents and material mineralogy) into the design approach is key to achieving the required engineering properties. Stabilised materials evaluation is done using tests indicative of the basic engineering properties (physics) of compressive strengths, tensile strengths and durability. This article describes the basic materials design approach developed to ensure that organofunctional nano-silane modified emulsions can successfully be used for pavement layer construction utilising naturally available materials, at a low risk. The enablement of the use of naturally available materials in all pavement layers can have a considerable impact on the unit cost and life-cycle costs of road transportation infrastructure. TRANSLATE with x English ArabicHebrewPolish BulgarianHindiPortuguese CatalanHmong DawRomanian Chinese SimplifiedHungarianRussian Chinese TraditionalIndonesianSlovak CzechItalianSlovenian DanishJapaneseSpanish DutchKlingonSwedish EnglishKoreanThai EstonianLatvianTurkish FinnishLithuanianUkrainian FrenchMalayUrdu GermanMalteseVietnamese GreekNorwegianWelsh Haitian CreolePersian TRANSLATE with COPY THE URL BELOW Back EMBED THE SNIPPET BELOW IN YOUR SITE Enable collaborative features and customize widget: Bing Webmaster Portal Back

Breast cancer is the most common cancer in women globally, often necessitating mastectomy and subsequent breast reconstruction. Silicone mammary implants (SMIs) play a pivotal role in breast reconstruction, yet their interaction with the host immune system and microbiome remains poorly understood. This study investigates the impact of SMI surface topography on host antimicrobial responses, wound proteome dynamics, and microbial colonization. Biological samples were col-lected from ten human patients undergoing breast reconstruction with SMIs. Mass spectrometry profiles were analyzed for acute and chronic wound proteomes, revealing a nuanced interplay between topography and antimicrobial respondseproteins. 16S rRNA sequencing assessed mi-crobiome dynamics, unveiling topography-specific variations in microbial composition. Surface topography alterations influenced wound proteome composition. Microbiome analysis revealed heightened diversity around rougher SMIs, emphasizing topography-dependent microbial inva-sion. In vitro experiments confirmed staphylococcal adhesion, growth, and biofilm formation on SMI surfaces, with increased texture correlating positively with bacterial colonization. This comprehensive investigation highlights the intricate interplay between SMI topography, wound proteome dynamics, and microbial transmission. The findings contribute to understanding host-microbe interactions on SMI surfaces, essential for optimizing clinical applications and minimizing complications in breast reconstruction.

Structural health monitoring (SHM) is critical for ensuring the safety of infrastructures like bridges. This article presents a digital twin solution for SHM of railway bridges using low-cost wireless accelerometers and Machine Learning (ML). The system architecture combines edge on-premises computing and cloud analytics to enable efficient real-time monitoring and complete storage of relevant time-history datasets. After train crossings, accelerometers stream raw vibration data, which is processed in the frequency domain and analyzed via machine learning to detect anomalies indicating potential structural issues. The digital twin approach is demonstrated on an in-service railway bridge, where vibration data was collected over two years under normal operating conditions. By learning allowable ranges for vibration patterns, the digital twin model identifies abnormal spectral peaks, suggesting changes in structural integrity. The long-term pilot proves that this affordable SHM system can provide automated and real-time warning of bridge damage and also supports the use of in-house designed sensors of lower-cost and edge computing capabilities than those used in the demonstration. The successful on-premises-cloud hybrid implementation provides a cost effective and scalable model for expanding monitoring to thousands of railway bridges, democratizing SHM to improve safety by avoiding catastrophic failures.

This study advances the field of solar irradiance nowcasting by introducing a discrete-level classification approach, diverging from traditional continuous measurement methods. Grounded in a need for cost-effective and modular solutions, the research employs high-resolution computer vision coupled with a deep learning framework to predict Direct Normal Irradiance (DNI). By harnessing the capabilities of a Logitech C900 1080p HD camera and an NVIDIA Jetson module, the study achieves real-time data processing, pivotal for CSP systems' operational efficiency. The core of the methodology is the ResNet-50 convolutional neural network, refined via transfer learning on a bespoke dataset, culminating in a predictive accuracy of 85.78%. This discrete classification model contrasts with conventional, costly instruments like the MS-57, offering a novel and accessible alternative for DNI estimation. Such innovation not only demonstrates high predictive accuracy but also signifies a shift towards less resource-intensive and more adaptable solar energy forecasting tools, contributing a significant leap towards optimizing renewable energy systems.

A new generation of nano-technologies is expanding solid propulsion capabilities and increasing their relevance for versatile and manoeuvrable micro-satellites with safe high-performance propulsion. We propose the innovative concept, connected with application of new synergistic effect of the energetic materials performance enhancement and reaction zones programming for the next generation small satellite multimode solid propulsion system. The main idea of suggested concept is manipulating by the self-organized wave patterns excitation phenomenon, by the properties of the energetic materials reaction zones and by localization of the energy release areas. This synergistic effect can be provided through application of the functionalized carbon-based nanostructured metamaterials as a nano-additives along with simultaneous manipulating by their properties through the electrostatic field. Mentioned effect will be controlled through predictive programming both by the spatial structure and physics-chemical properties of the functionalized carbon-based nano-additives and through the electromagnetic control of the self-organized wave pattern excitation and micro- and nano- scale oscillatory networks in the energetic material reaction zones. Suggested new concept makes it possible to increase the energetic material regression rate and increase the thrust of the solid propulsion system with minimal additional energy consumption.

This paper explores the pivotal role of personalized product recommendations in enhancing the e-commerce experience. As online shopping becomes increasingly prevalent, the demand for tailored user experiences has surged, prompting the development of sophisticated recommendation systems. This study presents a comprehensive analysis of various methodologies employed to deliver personalized suggestions, including collaborative filtering, content-based filtering, and hybrid approaches. The implementation of a user-centric recommendation engine demonstrates significant improvements in user engagement, satisfaction, and conversion rates. Furthermore, the paper discusses the importance of real-time adaptation mechanisms and user feedback loops in optimizing recommendations. By providing insights into the challenges and solutions associated with recommendation systems, this research aims to equip e-commerce businesses with the tools necessary to leverage personalization effectively, ultimately leading to enhanced customer experiences and increased sales

This paper introduces an innovative theoretical framework for quantum-inspired data embeddings, grounded in foundational concepts of quantum mechanics such as superposition and entanglement. This approach aims to advance semi-supervised learning in contexts characterized by limited labeled data by enabling more intricate and expressive embeddings that capture the underlying structure of the data effectively. Grounded in foundational quantum mechanics concepts such as superposition and entanglement, this approach redefines data representation by enabling more intricate and expressive embeddings. Emulating quantum superposition encodes each data point as a probabilistic amalgamation of multiple feature states, facilitating a richer, multidimensional representation of underlying structures and patterns. Additionally, quantum-inspired entanglement mechanisms are harnessed to model intricate dependencies between labeled and unlabeled data, promoting enhanced knowledge transfer and structural inference within the learning paradigm. In contrast to conventional quantum machine learning methodologies that often rely on quantum hardware, this framework is fully realizable within classical computational architectures, thus bypassing the practical limitations of quantum hardware. The versatility of this model is illustrated through its application to critical domains such as medical diagnosis, resource-constrained natural language processing, and financial forecasting—areas where data scarcity impedes the efficacy of traditional models. Experimental evaluations reveal that quantum-inspired embeddings substantially outperform standard approaches, enhancing model resilience and generalization in high-dimensional, low-sample scenarios. This research marks a significant stride in integrating quantum theoretical principles with classical machine learning, broadening the scope of data representation and semi-supervised learning while circumventing the technological barriers of quantum computing infrastructure.

This qualitative research explores Supplier Relationship Management (SRM) within the context of subscription-based e-commerce models. Through in-depth interviews and thematic analysis, the study investigates key elements such as trust, collaboration, technology integration, sustainability, risk management, cultural alignment, innovation, cost management, globalization, supplier selection, and performance measurement. Findings reveal that trust is foundational in fostering reliable interactions and open communication between e-commerce businesses and suppliers. Collaboration emerges as crucial for innovation and operational efficiency, facilitating co-development and shared risk management. Technology integration, including AI and blockchain, enhances supply chain visibility and decision-making capabilities. Sustainability considerations drive businesses to engage with suppliers adhering to environmental standards, enhancing brand reputation and consumer loyalty. Effective risk management strategies mitigate disruptions and ensure supply chain resilience. Cultural alignment fosters harmonious partnerships and mutual understanding across diverse global markets. Innovation through supplier collaboration drives product development and market responsiveness. Cost management practices optimize operational efficiency and strategic supplier relationships. Globalization necessitates adaptive strategies to manage diverse cultural and regulatory landscapes. Strategic supplier selection and continuous performance measurement drive ongoing improvement and alignment with business objectives. This study contributes empirical insights and practical implications for enhancing SRM in subscription-based e-commerce, informing strategies to navigate challenges and leverage opportunities in a competitive marketplace.

There are many molecules used as drug carrier. TUD-1 is a newly synthesized mesoporous silica (SM) molecule possess two important features; consists of mesoporous so it is very suitable to be drug carrier in addition to that it has the ability to induce apoptosis in cancer cells. However, the effect of TUD-1 appears to act as cell death inducer, regardless of whether it is necrosis or apoptosis. Unfortunately, recent studies indicate that a proportion of cells undergo necrosis rather than apoptosis, which limits the use of TUD-1 as a secure treatment. On the other hand, lithium considered as necrosis inhibitor element. Hence, current study based on the idea of production a new Li/TUD-1 by incorporated mesoporous silica (TUD-1 type) with lithium in order to produce a new compound that has the ability to activate apoptosis by mesoporous silica (TUD-1 type) and at the same time can inhibit the activity of necrosis by lithium. Herein, lithium was incorporated in TUD-1 mesoporous silica by using sol-gel technique in one step synthesis procedure. Moreover, lithium was incorporated in TUD-1 with different loading in order to form different active sites such as isolated lithium ions, nanoparticles of Li2O, and bulky crystals of Li2O. The ability of the new compounds to induce apoptosis and prevent necrosis was evaluated on three different types of cancer cell lines which are; liver HepG-2, Breast MCF-7 and colon HCT116. The obtained results show that Li/TUD-1has the ability to control necrosis and thus reduce the side effects of treatments containing silica in the case of lithium has been added to them, especially in chronic cases. This has been demonstrated by the significant increase in the IC50 value and cell viability comparing to control groups. Consequently, the idea is new, so it definitely needs more develop and test with materials that have more apoptotic impact than silica in order to induce apoptosis without induction of necrosis.