This paper presents an optimized energy management strategy for Li-ion power batteries used on electric vehicles (EVs) at low temperatures. Under low-temperature environments, EVs suffer a sharp driving range loss resulted from the energy and power capability reduction of the battery. Simultaneously, because of Li plating, battery degradation becomes an increasing concern as temperature drops. All these factors could greatly increase the total vehicle operation cost. Prior to battery charging and vehicle operating, preheating battery to a battery-friendly temperature is an approach to promote energy utilization and reduce total cost. Based on the proposed LiFePO4 battery model, the total vehicle operation cost under certain driving cycles is quantified in the present paper. Then given a certain ambient temperature, a target temperature of preheating is optimized under the principle of minimizing total cost. As for the preheating method, a liquid heating system is also implemented on an electric bus. Simulation results show that the preheating process becomes increasingly necessary with a decreasing ambient temperature; however, the preheating demand declines as driving range grows. Vehicle tests verify that the preheating management strategy proposed in this paper is able to save total vehicle operation cost.

Rheumatoid arthritis (RA) is a chronic inflammatory disease. Despite new methods of diagnostics and treatment as well as extensive biological and immunosuppressive treatment, the etiology of RA is not fully understood. Moreover, the problem of diagnosis and treatment of RA patients is still current and affects a large group of patients. It is suggested that these ER-related features may impair adaptation to chronic stress, inferring the risk of rheumatoid arthritis. The main goal in this study was evaluation of changes in mRNA translation to determine chronic ER stress conditions in rheumatoid arthritis patients. The study group consist of 86 individuals including total 56 rheumatoid arthritis patients and 30 healthy controls. The expression level of mRNA form blood samples of RA patients as well as controls of the PERK-UPR associated genes: p-eIF2, BCL-2, PERK, ATF4, BAX were investigated by Real-Time qPCR. GAPDH expression was used as a standard control. Considering the median, the expression of PERK, BCL-2, p-eIF2, ATF4, BAX was found to be significantly increased in the blood of RA patients compared with the control group. The p-value for the PERK gene was 0.0000000036, the p-value for the BCL-2 gene was 0.000000014, the p-value for the p-eIF2 gene was 0.006948, the p-value for the ATF4 gene was 0.0000056 and the p-value for the BAX gene was 0.00019, respectively. Thus, it can be concluded that targeting of the components of the PERK-dependent UPR signaling pathway via small-molecule PERK inhibitors, may contribute to the development of novel, innovative treatment strategies against rheumatoid arthritis.

Global warming may increase the potential evapotranspiration (Etp), thereby affecting the amount of clean water resources available in a region. In this study, the systematic biases in temperature outputs of 24 global climate models (GCMs) under 3 emission scenarios are corrected by using 8 bias correction methods. The trend of Etp in Yangzi River Delta in the 21st century is projected by using 4 Etp calculation formulas. The uncertainty of the projections is estimated and decomposed by using multi-way analysis of variance. The influence of uncertainty on the projected change signal is quantified by using the signal-to-noise ratio. The results show that, relative to the reference period (1971~2000), the annual mean daily Etp in Yangzi River Delta will increase by 0.14~0.17mm/d during the period 2021~2050 and by 0.21~0.41mm/d during the period 2061~2090, respectively. During 2021~2050, the uncertainty of Etp increase projections is dominantly contributed by the main effects of GCM (63%) and Etp calculation formula (24%). During 2061~2090, it is mainly contributed by the main effect of GCM (36%), followed by the main effects of emission scenario (34%) and Etp calculation formula (18%). The increase projections of Etp are generally reliable and robust during the two projection periods.

Monitoring the integrity of aeronautical structures is fundamental for safety. Structural Health Monitoring Systems (SHMS) perform real-time monitoring functions, but their performances must be carefully assessed. In this work the damage detection performances of a strain-based SHMS, were evaluated on a composite helicopter rotor blade root. The SHMS monitored the bonding between the central core and the surrounding antitorsional layer. A damage detection algorithm was trained through Finite Element analyses performed on the component. The effects of the loads variability and of damages were decoupled by including a load recognition step in the algorithm. Load recognition was accomplished in different ways: version#1 adopted an Artificial Neural Network (ANN) trained on blades in pristine condition; version#2 was trained also on damaged blades; version#3 adopted a calibration matrix method. Anomaly detection, damage assessment, and localization were performed by using an ANN. Results showed a higher load identification and anomaly detection accuracy for version#1 and version#2 compared to version#3. Gaussian noise reduced anomaly detection and damage assessment performances, and reduced damage localization accuracy for bigger damages. The damage detection performance were obtained for a fibre optic based-SHMS, including the trade-off between probability of detection and false alarm rate for different damage sizes.

The research aimed at the ecological assessment of the environment around uranium mining enterprises in the Turkestan region. The authors examined the state of the soil and vegetation for 2021-2023, their chemical composition and the effects of radiation. Excesses of background radiation were detected by alpha and beta studies. To study the structural organization of plant communities, we conducted floristic studies in the areas immediately adjacent to NAC “Kazatomprom” enterprises. The general habitus, size, number and shape of vegetative parts of plants were taken into account as comparison parameters. The flora growing in the study areas of the Suzak district of the region, which is distinguished by its uniqueness and narrow relevance to the ecological conditions of the area, was taken as biological objects of study. To determine the ecological state of the adjacent territories of NAC “Kazatomprom” and for physical, chemical and taxonomic analyses, 78 soil samples and 37 plant samples were obtained. The studied samples were taken near settlements N, B and S, which are closest to the territories of NAC “Kazatomprom”.

Climate change is affecting the planet, compromising survival and altering forest ecosystems. Investigating climatic variations in all regions is important. The aim of this research was to assess such variations in the W and Pendjari Biosphere Reserves in Benin from 1985 to 2015 and predict climate up to 2045. Drought frequency was assessed by using the Standardized Precipitation and Evapotranspiration Index (SPEI) and correlation was performed between climatic variables. Then a predictive analysis was computed. From 1985 to 2015, there was change in the climate with few severe dry and wet years while no extreme climatic condition was noticed. Most of the years showed nearly normal climatic conditions. The predicted climate indicates an absence of extreme conditions up to 2045 but an increase in the annual humidity is expected. A low decrease in annual mean temperature with high confidence is expected. Decision-makers can better organize adaptation programs and sensitize people in the reserves on their role in environmental conservation and mitigation of climate change using these outputs.

Manufacturing enterprises are increasingly compelled to pursue innovative solutions to environmental issues. Addressing such issues requires mindful leadership to support employees and organizations in maintaining awareness during complex situations, thereby promoting environmental sustainability. Drawing on social information processing theory, this study theorizes and tests the relationships mindfulness leadership, employee moral reflectiveness, environmental passion, and employee green creativity. To test the model, we utilize a two-wave multi-source dataset comprising 215 workers from manufacturing firms in China. The findings demonstrate that mindful leadership is positively related to employee green creativity. Additionally, our research reveals that both moral reflectiveness and environmental passion serve as mediators in linking mindful leadership to employee green creativity. Crucially, our empirical analysis suggests a serial mediation model, examining the sequential role of moral reflectiveness and environmental passion in the relationship between mindful leadership and employee green creativity. The findings provide a new viewpoint on employees' eco-friendly behaviors and have practical implications for improving environmental sustainability within organizations.

Patients with Multiple Myeloma have an increased susceptibility to severe infections due to several various factors, especially the high tumor burden. The use of the anti-CD38 monoclonal antibodies-based therapies has changed the frequency and epidemiology of infections. We report herein the safety profile of the pivotal clinical trials conducted with anti-CD38 mAbs (daratumumab and isatuximab) and anti-SLAMF7 mAbs (elotuzumab) that led to the approval of regimens employed today in NDMM and RRMM patients.

Households and businesses are generating unprecedented levels of electrical and electronic wastes (e-waste), fueled by modernisation and rapid obsolescence. While the challenges imposed by e-waste are similar everywhere in the world, disparities in progress to deal with it exists; with developing nations such as South Africa lagging. The increase in e-waste generation increases the need to formulate strategies to manage it. This paper presents an overview of e-waste management on a global and South African scenarios with a specific case for Cathode Ray Tube (CRT) waste management practices in South Africa. CRTs present the biggest problem for recyclers and policy makers because they contain hazardous elements such as lead and antimony. Common disposal practices have been either landfilling or incineration. The research into the South African practices with regards to CRT waste management showed that there is still more to be done to effectively manage this waste stream. This is despite clear waste regulatory frameworks in the country. However, recent developments have placed e-waste as a priority waste stream, which should lead to intensified efforts in dealing with it. Overall, these efforts should aim to maximise diversion from landfilling and to create value-addition opportunities, leading to social and environmental benefits.

There are many uncertainties and risks in residential electricity consumption during the economic development. Knowledge of the relationship between residential electricity consumption and its key determinant—income—are important to the sustainable development of electric power industry. Using panel data from 30 provinces for the 1995-2012 period, this study investigates how residential electricity consumption changes as incomes increase in China. Previous studies typically used linear or quadratic double-logarithmic models imposing ex ante restrictions on the indistinct relationship between residential electricity consumption and income. Contrary to those models, we employed a reduced piecewise linear model that is self-adaptive and highly flexible and circumvents the problem of “prior restrictions.” Robust tests of different segment specifications and regression methods are performed to ensure the conservatism of the research. The results provide strong evidence that the income elasticity was approximately one, and it remained stable throughout the estimation period. The income threshold at which residential electricity consumption automatically remains stable or slows has not been reached. To ensure the sustainable development of the electric power industry, introducing higher energy efficiency standards for electrical appliances and improving income levels are vital. And government should emphasize electricity conservation in industrial sector rather than in residential sector.

Accurate measurement of systemic financial risk is critical to maintaining the stability of financial markets. Taking China as the subject of investigation, the Chinese Financial Stress Index (CFSI) indicator system was con-structed by integrating six dimensions and employing Gray Relation Analysis (GRA) for dimensionality reduction of the indicators. The CFSI was derived using the Attribute Hierarchy Model (AHM) method with the Criteria Importance Through the Intercriteria Correlation (CRITIC) method, and an Improved Gravitational Search Algorithm (IGSA) optimized Radial Basis Function Neural Network (RBFNN) was proposed for out-of-sample prediction of CFSI trends from 2024 to 2026. By analyzing the trend of financial pressure indicators, the relationship between financial pressure and economic activity can be effectively identified. The research findings indicate that: (1) The CFSI is capable of accurately reflecting the current financial stress situation in China; (2) The IGSA-RBFNN demonstrates good robustness and generalization capabilities, predicting that the CFSI index will reach a peak value of 0.543 by the end of 2024, and there exists a regular pattern of stress rebound towards the end of each year. The novel methodology benefits policymakers and regulatory authorities to formulate preventive measures and risk management by identifying potential risks and vulnerabilities in advance.

Although promoting healthy eating is a policy objective, the controllability of dietary habits remains uncertain. The personal dietary patterns reflect many factors, of which some are relatively controllable for individual, and others are not. In this article, assuming that some sort of information about controllability of dietary habits is contained in the observed pattern of food consumptions, we focused on dietary pattern on its own. We introduced a statistical descriptive model for data on food frequency questionnaire, estimated strength of pairwise linkage between foodstuffs, and grouped foodstuffs by applying community detection to the networks of the estimated inter-food linkages. Those linkages represent co-movement of pairs of foods consumption. Furthermore, we demonstrated an analysis on the relationship between health of mind and dietary habits considering the aspect of controllability of dietary habits. Using an observational study in Japan, we obtained the following results: 115 foodstuffs were divided into 3 groups for both of genders, but the compositions were different by gender; in the analysis of mental health, some stress response items were associated with the dependence on some of those food groupings. As the grouping of foodstuffs based on our estimation depicted the internal structure of dietary habit that a healthy eating policy should regard as constraint, it follows that we should design the policy along the line with that grouping.

Capital structure decision plays an imperative role in firm’s performance. Recognizing the importance, there has been many studies inspected the rapport of capital structure with performance of firms and findings of those studies are inconclusive. In addition, there is relative deficiency of empirical studies examining the link of capital structure with performance of banks in Bangladesh. This paper attempted to fill this gap. Using panel data of 22 banks for the period of 2005-2014, this study empirically examined the impacts of capital structure on the performance of Bangladeshi banks assessed by return on equity, return on assets and earnings per share. Results from pooled ordinary least square analysis show that there are inverse impacts of capital structure on bank’s performance. Empirical findings of this study is of greater significance for the developing countries like Bangladesh because it will call upon concentration of the bank management and policy makers to pursue such policies to reduce reliance on debt and to accomplish optimal level capital structure. This research also contributes to empirical literatures by reconfirming (or otherwise) findings of previous studies.

Background: Falls risk assessment tools are used in hospital inpatient settings to identify pa-tients at increased risk of falls (which may be related to muscle loss/sarcopenia) to guide and target interventions for falls prevention. In 2022, Western Health, Melbourne, Australia, intro-duced a new falls risk assessment tool, the Western Health St. Thomas’ Risk Assessment Tool (WH-STRATIFY), a modified version of The Northern Hospital’s risk tool (TNH-STRATIFY), which replaced the Peninsula Health Risk Screening Tool (PH-FRAT). Aims: To determine the predictive accuracy of three falls risk assessment tools (PH-FRAT, TNH-STRATIFY and WH-STRATIFY) on admission to Geriatric Evaluation Management (GEM) units. Method: A retrospective observational study was conducted on four GEM units. Data was col-lected on 54 consecutive patients who fell during admission and 62 randomly sampled patients who did not fall between December 2020 and June 2021. Participants were scored against three falls risk assessment tools. The event rate Youden (Youden IndexER) indices were calculated and compared using default and optimal cut points to determine which tool was most accurate for predicting falls. Results: Using default cut points to compare falls assessment tools, TNH-STRATIFY had the highest predictive accuracy (Youden IndexER = 0.20, 95% confidence interval CI = 0.07, 0.34). The PH-FRAT (Youden IndexER = 0.01 and 95% CI = -0.04, 0.05) and WH-STRATIFY (Youden IndexER = 0.00 and 95% CI = -0.04, 0.03) were statistically equivalent and not predictive of falls compared to TNH-STRATIFY. When calculated optimal cut points were applied, predictive accuracy im-proved for PH-FRAT (Cut point 17, Youden IndexER = 0.14 and 95% CI = 0.01, 0.29) and WH-STRATIFY (Cut point 7, Youden IndexER = 0.18 and 95% CI = 0.00, 0.35). Overall, all tools had low predictive accuracy for falls. Conclusion: TNH-STRATIFY had the highest predictive accuracy for falls. The predictive accu-racy of WH-STRATIFY improved and was significant when the calculated optimal cut point was applied. The optimal cut points of falls risk assessment tools should be determined and validated in different clinical settings to optimise local predictive accuracy, enabling targeted falls risk mitigation strategies and resource allocation.

Polycystic ovary syndrome (PCOS) is a common condition in reproductive-age women. Women with PCOS are at higher risk of pregnancy complications including gestational diabetes (GDM). The prevalence of PCOS and GDM varies according to the diagnostic criteria used. The mechanism for the occurrence of GDM in women with PCOS is still unclear. Materials & Methods- A systematic search of the electronic database was done using keywords like PCOS, and GDM to include studies between April 2008 and March 2023 where uniform diagnostic criteria were used. Studies were excluded with high-risk of bias after the assessment of bias, and meta-analysis was done with relative risks and confidence intervals. Results & Discussion-Out of 1896 search results, 95 were selected for full-text. The quality of the studies was scrutinized and a total of 28 studies were included as they fulfilled the inclusion criteria. The incidence of GDM in women with PCOS was found to be 10.55 % (2.9- 54.9%) from pooled data involving 1,280,245. The prevalence of PCOS in women diagnosed with GDM was found from pooled data of 36,351 women in retrospective studies to be 2.47% (1.5- 50.1%). Selection predominantly included cohort studies, most commonly from China. The meta-analysis reported the risk of GDM is higher in women with PCOS than in those without PCOS (HR: 1.59, 95% CI: 1.27–1.91, p < 0.001). Family history of diabetes, ethnicity, pre-pregnancy BMI, insulin resistance, gestational weight gain, use of assisted reproductive techniques, and multifetal gestation were the risk factors for GDM in women with PCOS. Conclusion- The prevalence of GDM in patients with PCOS is high, but the causality is complex. The newer predictive models are promising in clarifying the causative relationships, yet use various parameters at different cut-offs. There is a need for the development of universally acceptable parameters for the early prediction of GDM in women with PCOS.

Iron plays a critical role in lung infections due to its function in the inflammatory immune response but also as an important factor for bacterial growth. Iron chelation represents a potential therapeutic approach to inhibit bacterial growth and pathologically increased pro-inflammatory mediator production. The present study was designed to investigate the impact of the iron chelator, DIBI, in murine lung infection induced by intratracheal Pseudomonas aeruginosa (strain PA14) administration. DIBI (80mg/kg) was given by intraperitoneal injection either as a single dose immediately after PA14 administration or a double dose (second dose 4 h after PA14 administration). The results showed that lung NF-κBp65 levels, as well as levels of various inflammatory cytokines (TNFα, IL-1β, IL-6) both in lung tissue and bronchoalveolar lavage fluid (BALF), were significantly increased 24h after PA14 administration. Single-dose DIBI did not affect the bacterial load or inflammatory response in the lungs or BALF. However, two doses of DIBI significantly decreased bacterial load, attenuated NF-κBp65 upregulation, reduced inflammatory cytokines production, and relieved lung tissue damage. Our findings support the conclusion that the iron chelator, DIBI, can reduce lung injury induced by P. aeruginosa, via its anti-bacterial and anti-inflammatory effects.

Nowadays, considering the growing tendency of companies towards e-commerce as well as green production, and dual-channel green supply chain management has become particularly important. This paper investigates pricing decisions within a dual-channel green supply chain framework while considering the capital constraints faced by risk-averse manufacturer. Simultaneously, the impact of the degree of risk aversion, consumer green preferences, and channel preferences on the optimal decision-making process of green supply chain members is analyzed. We address the issue of financial constraints faced by manufacturer through bank loans and trade credit financing and compare the two cases. Our findings illustrate that trade credit financing outperforms bank loan financing in the dual-channel green supply chain. Moreover, pricing decisions under different models are influenced by consumer preferences and risk aversion. Specifically, the greenness of the product, wholesale price, and sale price exhibit negative correlations with manufacturers' risk aversion but positive correlations with consumer preferences.

Introduction: Despite its high prevalence and impact on health, metabolic dysfunction-associated steatotic liver disease (MASLD) is inadequately addressed in European primary care (PC), with a large proportion of cases going undiagnosed or diagnosed too late. A multi-country European re-search consortium led a project to design and evaluate a patient-centered, integrated model for MASLD screening, diagnosis and linkage to specialty care for European PC settings. Aim: Based on the lessons from this project, the latest research evidence and existing guidelines for the management of MASLD, we sought to develop a set of practice recommendations for screening, referral and management of MASLD in PC. Methods: The Rand/UCLA modified Delphi panel method, with two rounds, was used to reach consensus on practice recommendations. The international panel consisted of experts from six countries, representing family medicine, gastroenterology, hepatology, cardiology and public health. Initially, fifteen statements were drafted based on a synthesis of evidence from the literature and earlier findings from our consortium. Prior to the consensus meeting, the statements were rated by the experts in a first round. Then, in a hybrid meeting, the experts discussed findings of round one, adjusted the statements and reassessed the updated recommendations in a second round. Results: In round one, there was already a high level of consensus on 10 out of 15 statements. After round 2, there were fourteen statements with a high agreement (>90%). One statement was not endorsed. The approved recommendations addressed the following practice areas: risk screening and diagnosis, management of MASLD – Lifestyle interventions, pharmacological treatment of MASLD/MASH, pharmacological treatment for co-morbidity, integrated care, surgical management and other referrals to specialists. Conclusion: The final set of 14 recommendations focuses on increasing comprehensive care for MASLD in PC. The recommendations provide practical evidence-based guidance tailored to PC practitioners. We expect that these recommendations will contribute to the ongoing discussion on systematic approaches to tackle MASLD and support European PC providers by integrating the latest evidence into practice.

Forests have multifunctional roles. They not only increase forest carbon sinks through afforestation and management, but also indirectly realize multiple benefits of "economy + ecology + society". Therefore, we construct a multiple output-benefit system of forest carbon sinks based on the development of forest carbon sinks in provinces of China. This system is also able to distinguish the importance of forest carbon sinks from other outputs. For the efficiency evaluation of multi-level output systems, this paper constructs a cross-evaluation model based on evidential reasoning method, the original efficiency information by conducting efficiency evaluation before information fusion. Further, the spillover effects and influencing factors of forest carbon sink efficiency are analyzed through a spatial regression model to explore the spatial characteristics of forest carbon sink efficiency in China. The results show that: (1) there is a large gap between the cross-efficiency levels of forest carbon sinks in various regions of China, with significant spatial correlation. For the perspective of direct output benefits, the cross-efficiency of the eastern region is higher, while the cross-efficiency of the northwestern region is lower; for the perspective of indirect output benefits, the cross-efficiency of the southeastern region is higher. (2) China's forest carbon sink has a significant positive spillover effect, and the indirect output cross-efficiency has a significant negative impact on the forest carbon sink in its own region. Further analyzing the impact of indirect output cross-efficiency, it is found that the cross-efficiency of the ecological dimension and the cross-efficiency of the social dimension have a significant negative impact on the forest carbon sink in its own region, and the economic dimension has a significant positive impact on the forest carbon sink in its own region. In conclusion, corresponding policy recommendations are proposed for the development of forest carbon sinks to promote the realization of the dual-carbon goal.

This research explores the behaviors of Generation Z consumers in China, particularly focusing on their interaction with companies through social media for the joint creation of value. Adopting a qualitative methodology, the research initially constructs a scale for assessing co-creation of value on social media platforms. Subsequently, it delves into the motivational aspects of users' engagement in these co-creative activities. The study unveils a range of utilitarian and hedonic motivations that drive Generation Z's value co-creation actions on social media. Insights derived from the findings offer both theoretical and practical implications for the field.

Viral infections cause metabolic dysregulation in the infected organism. The present study used metabolomics techniques and machine learning algorithms to retrospectively analyze the alter-ations of a broad panel of metabolites in the serum and urine of a cohort of 126 patients hospi-talized with COVID-19. Results were compared with those of 50 healthy subjects and 45 COVID-19 negative patients but with bacterial infectious diseases. Metabolites were analyzed by gas chro-matography coupled to quadrupole time-of-flight mass spectrometry. The main metabolites al-tered in the sera of COVID-19 patients were those of pentose glucuronate interconversion, ascorbate and fructose metabolism, nucleotide sugars, and nucleotide and amino acid metabolism. Alterations in serum maltose, mannonic acid, xylitol, or glyceric acid metabolites segregated positive patients from the control group with high diagnostic accuracy, while succinic acid seg-regated positive patients from those with other disparate infectious diseases. Increased lauric acid concentrations were associated with severity of infection and death. Urine analyses could not discriminate between groups. Targeted metabolomics and machine learning algorithms facilitated the exploration of the metabolic alterations underlying COVID-19 infection, and to identify po-tential biomarkers for the diagnosis and prognosis of the disease.

The COVID-19 pandemic struck unexpectedly, emergency services and chronic care institutions, including dialysis centers, were overloaded. An important problem was the care of positive COVID patients, but also the care of chronically dialyzed patients who presented emergencies. In our Hospital, which has become a COVID support for dialysis patients with severe forms of the disease, we had to care for PD patients with dialysis-related emergencies. We presented 2 cases of patients managed on an outpatient basis or 1 day hospitalization, treated successfully and without compromising the quality of the care provided. We used remote monitoring, we worked in a multidiscipli-nary team, we shortened the hospitalization of patients (and implicitly the risk of contact). In pandemic conditions, the advantage of PD was represented by the possibility of patient isolation, so that in the first 6 months of the pandemic, we recorded no deaths in this category of patients. In case of hemodialysis patients, in-fection and mortality rates were high. Although we expected an increase in the number of peritoneal dialysis patients in the post-pandemic period, this did not happen. We continue to plead for the popularization of the PD method among patients and doctors, which has proven its advantages under the conditions of the pandemic.

In an age of market liberalization, globalization, and expanding agribusiness, there is a danger that small-scale farmers will find difficulty in fully participating in the market economy. One of the solutions to solve the above situation is to strengthen linkages between farmers and firms through contract farming. The purpose of this study is to assess the factors affecting the level of linkages between businesses and farmers in crop development in Thai Binh province, Vietnam. The two main research methods used were exploratory factor analysis (EFA) and regression analysis with survey data which was conducted from 300 farmers, 10 firms, and 15 factors related to contract-farming. The results indicated that there are 5 factors that significantly affect the level of participation of farmers in the linking process, the order of impacts from strong to weak is as follows: (1) Commitment and sharing of benefits and risks between farmers and firms in the linking process, (2) Issues related to management skills and enterprises capacity of link firms, (3) Price issues that farmers are interested in in the process of implementing links with firms, (4) Policy environment - Institutions related to farmer contracts between firms and farmers, (5) Household awareness about the benefits brought about by farmer contracts with firms. Based on results, a number of specific solutions have been proposed to enhance the efficiency of farming contracts between firms and farmers in cultivation production.

This article presents a low-cost insurance system developed for small-hold farms in disaster-prone regions, primarily using free Earth Observation (EO) data and Free Open Source Software (FOSS) – collectively termed sustainable geoinformatics - with a proprietary mobile phone app that enables verification. The study examined 30 farms in Risaralda department, Colombia. A Digital Elevation Model (12.5m pixels) from the ALOS PALSAR satellite sensor was used with a Geographical Information System (GIS) to map the terrain, drainage and geohazards of each farming district. Google Earth Engine (GEE) was used to carry out Time Series Analysis of 15 EO and weather datasets for 1998 to 2020. This analysis enabled the levels of risk from hydrometeorological hazards to be determined for each farm of the study, providing key data for the setting of insurance premiums. A parametric insurance product was piloted using GPS-tagged, time-stamped mobile phone photos to verify crop health. Key features of this insurance system are its low operational cost and rapid damage verification, relative to conventional approaches to farm insurance. It is an affordable form of insurance for small-scale farmers, with the rapid verification and payment of claims. This relatively fast, low-cost and affordable approach to insurance for small-scale farming enhances sustainable development by enabling policy-holder farmers to recover more quickly from disasters.

This paper presents the development of a prescriptive digital twin model designed to optimize building environments by leveraging advanced smart technologies such as machine learning, artificial intelligence, cloud computing, and the Internet of Things. The study identifies critical factors affecting user activities, including lighting, HVAC, indoor air quality, and acoustics, and incorporates these into the model to enhance user productivity and comfort in workspaces. Our findings demonstrate that the integration of smart technologies can significantly improve workspace efficiency and user satisfaction, providing actionable insights for future implementations. This study not only highlights the potential benefits of prescriptive digital twins in smart buildings but also emphasizes the importance of comprehensive data gathering and analysis from various sources to support further research. Ultimately, our work offers valuable contributions to the field of building management and underscores the need for continued exploration of digital twin technologies.

The diagnosis and management of cow's milk allergy (CMA) is a topic of debate and controversy. We aimed to compare the opinions of expert groups from the Middle East (n=14) and the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) (n=13). These Expert groups voted on statements developed by the ESPGHAN group and published in a recent position paper. The voting outcome was compared. Overall, there was consensus amongst both groups of experts. Most experts agreed that symptoms of crying, irritability and colic, as single manifestations, do not suggest CMA. They agreed that amino-acid-based formula (AAF) should be reserved for severe cases (e.g. malnutrition and anaphylaxis) and that there is insufficient evidence to recommend a step-down approach. There was no consensus on the statement that a cow’s milk-based extensively hydrolysed formula (eHF) should be the first choice as a diagnostic elimination diet in mild/moderate cases. Although the statements regarding the role of hydrolysed rice formula as a diagnostic and therapeutic elimination diet were accepted, 3/27 disagreed. The votes regarding soy formula highlight the differences in opinion in the role of soy protein in CMA dietary treatment. Generally, soy-based formula is seldom available in the Middle East region. All ESPGHAN experts agreed that there was no added value of probiotics, prebiotics, and synbiotics to the efficacy of elimination diets, whereas 3/14 of the Middle East group thought there was sufficient evidence. Therefore, there is not a consensus on the optimal diagnostic and therapeutic elimination diet for CMA, but the first-choice elimination diet and the stepwise management approach reveal some differences.

Contract between grower and integrator has been used extensively in broiler industry all over the world. One important advantages of contract is risk management, in which contract shifts a portion of grower risk to integrator. Thus, this paper attempted to measure the amount of risk shifted from grower to integrator and the consequences of this benefit to grower. Using a panel data of actual production records of 46 Indonesian broiler growers for the period of January 2014 through December 2017, we systematically measure the amount of risk shifted to integrator and its consequences to grower. The results showed that 78.43% grower risk is shifted to integrator. However, to acquire this benefit grower receive 15% less income. Furthermore, grower face the possibility of losing their asset and stopping their production as the consequences of entering contract.

Plastics, once regarded as a revolutionary material shaping modern society, now poses an unprecedented threat to our environment. Household solid waste sorting stations produce several fractions, one of which contains a high concentration of Low-Density Polyethylene (LDPE) film waste (packaging, sunscreen film, etc.). This fraction is difficult to recycle because it contains quite a lot of impurities. Usually, it is sent to the cement factories that burn it together with other fuels. However, with some processing techniques such catalytic pyrolysis this fraction could be valorized. In this paper the experiments which were carried out at a laboratory scale installation, in batches with a processing capacity of 1-3 kg of waste. The pyrolysis reactor is connected to a distillation column giving the possibility to separate the fractions. The gaseous and liquid fractions were characterized by GC-FID-TCD (gases) and GC-MS (liquids) analysis. Natural catalysts such as bentonite or clinoptilolite were studied and used in the melting of plastic mass to simplify the process as much as possible. To test the activity of the catalysts, the pyrolysis of LDPE granules was initially studied. It was found that natural zeolites are much more active than bentonite and that a minimum concentration of 5-10% is needed to have a positive effect on the composition of the fractions (increasing the weight of the light fractions C1-C6, C6-C10 and C11-C13) in relation to the heavy fractions C13-C20 and C20+. Catalytic pyrolysis gives a completely different distribution of light hydrocarbons. The best catalyst selected from LDPE lab experiments, was then tested upon the pyrolysis of plastic film waste obtained by a waste treatment plant. The research objective reported in this paper was to obtain a fraction of combustible gases in the largest possible proportion, which can be much easier exploited by burning in an engine that drives an electric generator.

This paper presents a novel approach to power management techniques in energy storage system (ESS) interoperability with the energy power system (EPS) by inserting a SCADA controlled directional protection relay for improving the mode switching sequence. According with latest European standards, all necessary measures for re-synchronization and reconnection for health work of the system must be taken. The proposed approach intends to improve the “interface” between storage systems and electric power grid by using a directional relay which provides interoperability improvement by automatic recognizing and differentiating the switching sequence of the mode of operation from the fault mode. Simulated results from a small scale electrical generating system are provided. The results demonstrate that the proposed power management solution is technically ideal to achieve high quality energy while retaining the stability of the power grid network. The interoperability of PHS systems integrated with the electric power grid usually leads to perturbations in terms of frequency of the generated voltage, and for improving it we designed an automatic treating and re-connecting software module. This work regards the importance of producing electricity from green and renewable energy sources, while retaining the stability and reliability of the power grid. ESS systems are widely used to help balancing of intermittent forms of load demand on the electrical power grid at specific key moments. In this article, the pumped hydro storage (PHS) technologies are proposed as an economical way to utilize smoothly the off-peak energy or surplus energy, by pumping water to a reservoir at a higher level. During peak load periods, the stored water is discharged through the reversible pump-turbine to generate electricity to meet the peak demand controlled by designed SCADA application.

Cardiac autonomic neuropathy (CAN) is a severe complication of diabetes mellitus (DM) strongly linked to a nearly five-fold higher risk of cardiovascular mortality. Patients with Type 2 Diabetes Mellitus (T2DM) are a significant cohort in which these assessments have particular relevance to the increased cardiovascular risk inherent in the condition. This study aimed to explore the subtle correlation between the Ewing test, Sudoscan-cardiovascular autonomic neuropathy score, and cardiovascular risk calculated using SCORE 2 Diabetes in individuals with T2DM. The cohort consisted of 211 patients diagnosed with T2DM with overweight or obesity without established ASCVD, aged between 40 to 69 years. The prevalence of CAN in our group was 67.2%. In the study group, according SCORE2-Diabetes, four patients (1.9%) were classified with moderate cardiovascular risk, thirty-five (16.6%) with high risk, and one hundred seventy-two (81.5%) with very high cardiovascular risk. On multiple linear regression, the SCORE2-Diabetes algorithm remained significantly associated with Sudoscan CAN-score and Sudoscan Nephro-score and Ewing test score. Testing for the diagnosis of CAN in very high-risk patients should be performed because approximately 70% of them associate CAN. Increased cardiovascular risk is associated with sudomotor damage and that Sudoscan is an effective and non-invasive measure of identifying such risk.

The abundant use of lithium-ion batteries (LIBs) in a wide variety of electric devices and vehicles will generate a large number of depleted batteries, which contain several valuable metals such as Li, Co, Mn, and Ni present in the structure of the cathode material (LiMO2). The present work investigates chemical, technological, and environmental aspects in the treatment of such wastes, development of a methodology for the extraction of lithium, cobalt, nickel, manganese, and graphite by a carbochlorination pyrometallurgical process. Mixtures of cathode and anode materials (called black mass, mixed oxides of Li, Co, Ni, Mn, and graphite) from different LIBs, carbon black (as reducing agent), and CaCl2 (as chlorinating agent) were used. Non-isothermal thermogravimetric tests up to 850°C and isothermal tests at 700°C of the mixtures in an inert atmosphere were carried out. It was experimentally observed that the LiMO2-C-CaCl2 reaction takes place at 700°C. LiCl, Ni, and Co were obtained as final products, and to a lesser extent, CoO, NiO, and MnO2. CaCO3 was also obtained as a by-product. The obtained results show that carbochlorination is an efficient and effective alternative route for the extraction and recovery of metals from different LIBs, focused on the sustainability and circular economy

Enteroaggregative Escherichia coli (EAEC) are highly heterogeneous in virulence; we wanted to understand the pathogenic potential of EAEC isolated various clinical and non-clinical sources in an animal model. We infected male BALB/c mice in six mice/group with 50 EAEC isolates, isolated from clinical and non-clinical sources. We studied colonization, weight loss, stool shedding, inflammatory markers and its relationship with 21 virulence genes and phylogroups, EAEC organ burden and histopathological changes. We detected significantly more inflammatory changes and fecal lactoferrin and calprotectin levels in mice infected with EAEC isolated from symptomatic cases. In clinical EAEC isolates, the presence of chromosomal genes {(aap (46%), aaiC (23.3%), and SPATEs (pet (13.3%), sat (20%), sigA and pic (6.6%)}, adhesive variants {(agg4A (53.3%), aggA (53.3%), aafA (36.6%), agg3A (40%)} of EAEC, and master regulator gene aggR (66.6%) were associated with higher levels of lactoferrin and calprotectin. Also, 70% (9/13) of EAEC isolated from acute diarrheal cases bearing chuA (70%) in our study were assigned to group B2 (4 isolates) and D (5 isolates). Real-time PCR analysis revealed that colonization by EAEC strains from different clinical and non-clinical sources occurs up to 10-15 days of life. Even from non-diarrhoeal stools and non-clinical sources, had the potential to cause prolonged colonization, weight loss, and inflammation in the intestine though the degree varied. Moreover, better understanding of EAEC pathogenic pathways is desperately needed in different clinical scenarios.

Academics in healthcare grapple with the challenge of efficiently managing time while addressing diverse roles and responsibilities, leading to heightened levels of anxiety and stress within the academic community. The primary objective of this study is to offer a sustainable and systemic solution to the prevalent time-management challenges in healthcare academia, through the development of a predictive model. Employing systemic analysis software and adopting a systemic management approach, we crafted a model to address academic time-management concerns. The dynamics of time allocation for academicians are governed by three fundamental pillars: teaching, research, and administrative tasks. Significantly prioritizing administrative tasks depletes valuable academic time, making time management within academia excessively costly. This occurs as highly skilled individuals find themselves diverted towards administrative duties at the expense of their academic roles diminishing resilience levels. The proposed Timebooster Academic Systemic Model (TASM) advocates for the cultivation of soft skills in academia, en-compassing prioritization, seeking assistance, and addressing tendencies of perfectionism and procrastination. Additionally, TASM recommends the implementation of full automation, delegation of administrative responsibilities, and the mitigation of both overt and covert time-consuming elements. Furthermore, TASM reports on the pivotal role of the academic resilient manager-leaders, who actively contribute to their own satisfaction and academic growth by enhancing collaboration and teamwork. Time-management challenges emerge as a critical determinant of academic well-being and resilience. Systemic models, exemplified by TASM, offer a valuable framework for investigating prioritization concerns, identifying administrative impediments in academic processes, and managing low-value time-consuming elements. The TASM model, along with the systemic philosophy underpinning its design, presents an avenue for advancing the exploration of time-management phenomena within the context of healthcare academia.

This article explores the pressing need for a paradigm shift in economics, challenging the dominance of classical economic theories and models that have long held sway. We delve into the limitations of traditional economic paradigms, which often rely on unrealistic assumptions and fail to capture the complexities of human behavior and the modern global economy. Drawing from insights in behavioral economics, environmental economics, and complexity theory, we argue for a more nuanced and multidisciplinary approach to economic analysis. Our discussion addresses the challenges of breaking away from deeply entrenched academic norms and the resistance to change within the economics profession. We highlight strategies for individuals and groups to advocate for the incorporation of modern economic theories in education and research. By fostering interdisciplinary collaboration, encouraging critical thinking, and engaging with policymakers and the public, we aim to catalyze a shift toward economics that is better equipped to address the intricate challenges of the 21st century. This article serves as a call to action for economists and educators alike to embrace a more dynamic and responsive approach to understanding human behavior and decision-making in the modern world.

histology, the processing and staining of cells, tissues and organs to highlight contrast, visualize and analyze their microstructure under microscopy, encompasses a vast array of techniques used to confirm, refine, or refute the macroscopic findings in forensic investigations, for example in the case of autopsies. This review presents several applications of histological protocols, staining methods and techniques to case studies, with the aim of illustrating the established, current and potential applications of histological investigations to forensic sciences. The list of disciplines include anthropology, cytology, dendrochronology, diatomology, entomology, fiber analysis, palynology,human and veterinary pathology, taphonomy and thanatology.

Breast cancer represents the most common neoplasm worldwide. Viral infections are involved with carcinogenesis, especially those caused by oncogenic Human Papillomavirus (HPV) genotypes. The relationship between HPV and various types of cancer, such as breast and lung, still requires further studies. After infection with HPV, there is a remodeling of the tumor microenvironment, providing a post-infection alteration with immunosuppressive characteristics. This study evaluated the role of HPV in breast adenocarcinoma cell lineage (MDA-MB-231), transfected with the HPV16 E5, E6, and E7 oncogenes and co-cultured with PBMCs. Immunophenotyping was performed. There was an increase in CD4+ T cells number when compared with non-transfected and transfected MDA-MB-231, especially the Treg profile. Moreover, proinflammatory intracellular cytokines, such as IFN-γ, TNF-α, and IL-17 were impaired by transfected cells and a decrease in the cytolytic ac-tivity of the CD8+ and CD56+ lymphocytes was also observed in the presence of HPV oncogenes, mainly with E6 and E7 in NK and TCD8+ cells. In conclusion, MDA-MB-231 breast cell lineage transfected with HPV oncogenes can downregulate the number and function of lymphocytes and monocytes.

This research aims to examine the level of readiness of the community to carry out sustainable tourism development, especially community-based tourism on small islands, such as Lombok Island, Indonesia. More specifically, the objectives of this study are as follows: (1) Knowing the level of community readiness in carrying out sustainable tourism development. (2) Knowing the various dimensions that influence sustainable tourism development. (3) Knowing the role of stakeholders in sustainable tourism development. The method applied in this research is mixed methods, a combination of quantitative and qualitative approaches. Quantitative methods are used to determine community readiness for sustainable tourism development. A qualitative approach is used to determine the various factors that influence the development of community-based tourism and to determine the role of stakeholders in the development of community-based tourism. The level of community readiness for sustainable tourism development is high in terms of economic, social, cultural, environmental, and symbolic capital aspects. Aspects that influence the development of sustainable tourism are economic, social, and cultural. Stakeholders who play a role in developing sustainable tourism in the research area are the government, the private sector, universities, non-governmental organizations, and the media.

Background: Hypertension is a condition of a person's blood pressure being at a level above normal, hypertension treatment can be done herbally using avocado leaves. Avocado leaves can lower blood pressure because they contain active substances, namely flavonoids and quercetin. This research was conducted in the working area of the Tilango Health Center. Objective: This study aims to determine the effect of giving boiled water of avocado leaves on reducing blood pressure in the elderly with hypertension. Methods: Design This study used a two-group quasi-experimental pre-test - post-test design. The sample is the elderly who have hypertension, amounting to 125 people with purposive sampling technique. The research instrument used a questionnaire. Results: Statistical test using T-Test on blood pressure before and after the intervention was given a significance value of 0.000 (p-value < 0.05 ). Conclusion : This study concludes that there is a significant effect between giving avocado leaf boiled water on reducing blood pressure in the elderly with hypertension in the working area of the Tilango Health Center.

Many pilot-based initiatives have been developed to promote awareness and use of climate information services among vulnerable smallholder farmers in Africa through million-dollar investments. However, despite their experimental nature, these pilot projects have been successful in raising participating farmers’ awareness and use of climate information services and they can inform transferrable good practices. Through a systematic literature review approach, this review sought to understand ways in which these past pilot projects have contributed to climate risk management in the context of smallholder farming and the factors that led to their success. Results showed that climate information services main contribution to climate risk management has been through facilitating farm level decision making. Factors that led to success of the pilots include: use of downscaled information; building institutional partnerships to add value to climate information; involving farmers through the co-designing and co-developing process; face-to-face way of communication; embedding pre-seasonal workshops in the activities of local institutions for sustainability; using diversity of communication channels to enhance reach among others. These factors can be borrowed as good practices to inform future efforts focused on increasing adoption of climate information services among a wider population beyond pilot project reach.

Gestational diabetes mellitus (GDM) pathophysiology comprises clinical and genetic factors. In fact, GDM has been associated with several single nucleotide polymorphisms (SNPs). This study aimed to build a prediction model of GDM combining clinical and genetic risk factors. A total of 1588 pregnant women from the San Carlos Cohort participated in the present study, 1069 (67.3%) Caucasian (CAU) and 519 (32.7%) Latin American (LAT), 255 (16.1%) with GDM. The incidence of GDM was similar in both groups (16.1% CAU and 16.0% LAT). Genotyping was performed by IPLEX Mass ARRAY PCR selecting 110 SNPs based on literature references. The SNPs showing the strongest likelihood of GDM development were the rs10830963, rs7651090 and rs1371614 in CAU and rs1387153 and the rs9368222 in LAT. Clinical variables including age, pre-pregnancy body mass index and fasting plasma glucose (FPG) at 12 gestational weeks predicted the risk of GDM (AUC 0.648, 95%CI 0.601-0.695 in CAU; AUC 0.688, 95%CI 0.628-9.748 in LAT) and adding the SNPs modestly improved prediction (AUC 0.722, 95%CI 0.680-0.764 in CAU; AUC 0.769, 95%CI 0.711-0.826 in LAT). In conclusion, adding genetic variants enhanced the prediction model of GDM risk in CAU and LAT pregnant women. An RCT is underway to demonstrate its usefulness

The Saudi Vision 2030 is critical to boosting national development, notably in the construction industry. The construction industry is getting a lot of attention in a variety of ways, the most visible of which is the promotion of best practices, including project management office (PMO) applications. Hail province, like others, is experiencing project delivery issues. Thus, the purpose of this research is to explore the suitable PMO model for Hail public construction projects. A literature review included the drive factors for establishing PMO in construction firms, as well as PMO models and typologies that describe functions. Therefore, those drive factors and PMO models were subjected to a focus group to explore their suitability in the context of Hail. The research findings reveal that the Enterprise PMO is the main for Hail public construction pro-jects, followed respectively by the Program Management Office model and the Project Management Center of Excellence (PMCOE). This method of selection a PMO model is driving construction companies and related businesses to change in order to improve the sector while also ad-dressing construction project delivery challenges in Hail province.

The present study aims at investigating the relationship between Initial Public Offerings (IPOs) variables mainly underpricing on one hand, and the brand value measures on the other. Our final data set is 104 international brand companies. We implement empirical approach using hierarchical OLS regression and descriptive statistics. We show that underpricing is positively related to brand value which emphasizes the marketing role of going public and underpricing in enhancing brand equity through the product market, which additionally confirms some information asymmetry models. We also find that on average brand companies had not been recognized as brands at the IPO time. Moreover, we show the positive role of private equity in enhancing brand value, additionally, the non-linear association between underpricing and brand value is not evident. Finally, we draw some policy implication and suggestions for future research.

Background: Annual influenza epidemics are a serious public health problem, causing particularly severe morbidity and mortality in high-risk groups. The study aimed to understand Poles' attitudes and beliefs towards influenza vaccinations in the flu season of 2022–2023, analyze preferences and unmet needs regarding influenza vaccinations, and examine the perception and acceptance of the influenza vaccine among individuals at risk of flu complications. Methods: A cross-sectional survey-based study was carried out on a sample of 1446 respondents. The Google Forms questionnaire was created and disseminated electronically using social media and e-mail. The pre-test was performed at the beginning of the project. Results: The majority of respondents (71%) could identify "high-risk groups" recommended for influenza vaccination. Furthermore, it was observed that individuals aged 21 to 59 demonstrated a higher level of knowledge in this regard compared to those below 20 and above 65 years old, and individuals with higher and medium education levels were much better at identifying risk groups for influenza virus infection. The majority of respondents (52.01%) reported receiving influenza vaccination at some point in the past, with 32.12% receiving it in the 2022–2023 flu season and 41.09% in the 2021–2022 season. The majority of respondents declaring acceptance of the vaccine for the 2022-2023 season were in the high-risk group. Only 17.28% of respondents declared receiving both influenza and SARS-CoV-2 vaccines in the 2022-2023 season, with the vast majority being respondents from the "high-risk group" (p

This study examines the dynamic relationship between Green Human Resource Management (Green HRM), Environmental Performance (EP), Green Employee Behavior (GEB), and Environmental Knowledge and Awareness (EKAW) within the Egyptian hospitality sector context. Using Pearson correlation coefficients and regression analyses on a sample of 400 staff members from hotels and tourist villages in Egypt, the study examines Green HRM practices’ influence on EP, mediated by GEB and moderated by EKAW. The findings reveal significant positive correlations between Green HRM practices and these mediators, indicating that comprehensive environmental strategies and incentive management are pivotal in promoting eco-friendly practices among employees. The study further confirms GEB and EKAW’s substantial mediating role in enhancing EP. The results also suggest that while EKAW and GEB independently contribute to EP, their interaction and the role of environmental awareness as a potential moderator warrant further examination. This research contributes to the literature on sustainable business practices by underscoring human resource strategies’ integral role in achieving environmental sustainability goals, highlighting the importance of incentivizing green practices, and cultivating an organizational culture that prioritizes EKAW. These insights are particularly valuable for organizations seeking to enhance their ecological footprint through effective Green HRM practices.

This research analyzes the phenomenon of the reduction of urban green spaces in the post-socialist city. Belgrade was selected as a post-socialist city of the former Yugoslavia. The article analyses the views of urban planners on the reasons for the reduction of urban green areas in the post-socialist city based on semi-structured interviews with representative samples for urban areas. This result research confirms the hypothesis that post-socialist city planning reduces urban green areas due to the lack of new mechanisms in documents for the planning of urban green space. The concept of sustainability should connect and balance the skills of urban planners and focus on how urban planners develop and apply standards and protect them in market-democratic systems. In other words, a new mechanism of post-socialist city planning implies a balance between the private and public sectors. In the planning document, urban planners should find a common denominator between the public interest, citizens, investors, and spheres determined by the sustainable principles of the development. City institutions should provide opportunities for the application of those standards. With the new approach, planning would imply work in the service of citizens in the concepts of a sustainable and green city.

This paper present a platform for airborne sensor applications using low-cost, open-source components carried by an easy-to-fly unmanned aircraft vehicle (UAV). The system, available in open-source [1], is designed for researchers, students and makers for a broad range of their exploration and data-collection needs. The main contribution is the extensible architecture for modularized airborne sensor deployment and real-time data visualisation. Our open-source Android application provides data collection, flight path definition and map tools. Total cost of the system is below 800 dollars. The flexibility of the system are illustrated by mapping the location of Bluetooth beacons (iBeacons) on a ground field and by measuring water temperatures in a lake.

Digitalization have force emerging markets (EMs) firms operating in resource-constrained environment to adopt market-driven strategies, particularly frugal innovation, to provide affordable, optimize processes and high-value solutions. However, understanding the mechanisms behind developing frugal innovation capability (FIC) at the firm level in diverse EMs remains limited. From the perspective of the Resource-based View, this study added to the existing body of knowledge by exploring how strategic orientation (entrepreneurial orientation (EO) and market orientation (MO)) and organizational ambidexterity (OA) impact the development of FIC in EMs. The study utilized a cross-sectional survey in data collection with 386 valid respondents from Tanzanian manufacturing firms to empirically validate our theoretical predictions. The results show that both EO and MO have strong and positive association with OA and the development of FIC in EMs. In addition, OA partially mediate the relationship of both EO and MO with the development of FIC. Furthermore, our results indicate that MO exerts a more significant impact on the development of FIC than EO in EMs. Managers of manufacturing firms in EMs can use these findings to review their strategic decisions and their exploitative and exploratory approaches to enhance supply chains, develop cost-effective technologies, and produce affordable offerings that cater to the preferences of price-conscious consumers in the digitalization age.

Background: The two-stage technique combining the Endoscopic Retrograde CholangioPancreatography (ERCP) with common bile duct (CBD) clearance carried out before the laparoscopic cholecystectomy represents the most common approach for CBD stones. Over time, different techniques have been proposed to manage cholecysto- choledocholithiasis (CCL) advantageously in one stage. Among these, the laparoendoscopic rendez-vous (LERV) addresses the CCL issue with a laparoscopic cholecystectomy with insertion of a guide wire performed at initial stage of the procedure, followed by the clearance of the bile duct carried out by the endoscopists. The goal of this study was to evaluate the efficacy and safeness of LERV procedure recording results and complications, also making a comparison between our results and current literature. Methods: We reviewed our experience of all consecutive patients with cholecysto-choledocholithiasis managed with LERV between January 2018 and December 2023. LERV success rate, operative time, length of hospital stay, stone recurrence, incidence of endoscopic and surgical complications were analysed. Results: A total of 120 patients underwent LERV in our facilities. We reported a 97% LERV success rate, 1.6% conversion-to-open rate, a median intraoperative time of 122 (range 95-220) min. The median hospital stay was 4 (range 2-38) days. An overall morbidity of 15% was reported (18/120): 15 Clavien-Dindo type 1/2, 2 type 3a and one type 3b. In two cases a re-operation during the hospital stay was necessary. At a median follow-up of 14 months (3-59) five patients experienced stone recurrence requiring redo-ERCP in two cases. Conclusion: LERV offers the significant advantage of a single stage procedure and hospitalisation along with a lower risk of post-ERCP pancreatitis, failed CBD cannulation and complications. Our experience confirms safety and effectiveness of the technique for CCL management.

In this paper, a continuous power management for a decentralized DC microgrid (DCMG) is proposed to achieve voltage regulation and power balance even under system uncertainty and voltage sensor failure. The DCMG system achieves a continuous power management through only the primary controller to reduce the computational burden of each power agent. To enhance the reliability and resilience of the DCMG system under voltage sensor failure, a DC bus voltage (DCV) sensor fault detection algorithm is proposed. In this algorithm, the DCV sensor failure is detected by comparing the measured DCV with the estimated DCV. When the power agent identifies the DCV sensor failure, it changes the operation properly according to the proposed control mode decision algorithm to maintain the stability of the DCMG system. When uncertain conditions such as the power variation of the distributed generations, sudden grid disconnection, DCV sensor failure, electricity price change, and critical battery status occur, the DCMG system is changed to transitional operation modes. These transitional operation modes are employed to transmit the power agent information to other agents without digital communication links (DCLs) and to accomplish power sharing even under such uncertain conditions. In the transitional operation modes of the DCMG system, the DCV levels are temporarily shifted to an appropriate level, enabling each power agent to detect the uncertainty conditions, and subsequently to determine its operation modes based on the DCV levels. Simulation and experimental results under different test conditions confirm the reliability and effectiveness of the proposed control scheme.

This study aims to quantify greenhouse gas (GHG) emissions from China's sludge treatment industry and explore the potential of novel technologies to mitigate these emissions, promoting sustainable sludge management practices. Using a life cycle assessment approach, the total GHG emissions from sludge treatment in 2017 were estimated at 18.54 Mt CO2-eq, with significant regional variations. Incineration contributed the highest emissions (1,011.53 kg CO2-eq/t dry sludge), followed by landfill (717.51 kg CO2-eq/t) and land application (276.41 kg CO2-eq/t). The uneven distribution of emissions across cities highlights the need for targeted mitigation strategies that consider local sustainability challenges. Principal component analysis revealed that economic factors and treatment scale significantly influence emissions, emphasizing the importance of integrating sustainability goals with economic development. To reduce the carbon footprint of sludge treatment and enhance sustainability, the mitigation potential and costs of various technologies were evaluated, including thermal conversion, anaerobic digestion, hydrothermal processes, and wet oxidation. These technologies offer GHG emission reductions ranging from 0.09 to 0.46 t CO2-eq/t dry solids compared to conventional methods, while also promoting resource recovery and circular economy principles. However, further optimization is necessary to enhance their environmental and economic performance, ensuring long-term sustainability. By implementing these technologies and adopting optimization strategies, China's sludge treatment industry can significantly contribute to achieving the country's carbon neutrality goal and fostering sustainable development.

Hydrodynamic modeling and hazard mapping are essential tools for urban flood mitigation and spatial planning. Leveraging software like HEC-RAS (Hydrologic Engineering Center - River Analysis System) and ArcGIS, this study aimed to map flood-prone areas along the Jijia River in the Ungheni administrative unit of Iasi County. Human-induced environmental changes and global climate shifts have heightened flood risks worldwide, particularly in urbanized areas. Hydrological and hydraulic modeling anticipate and assess flood events, while hydrodynamic modeling accurately simulates flow propagation, in-forming flood extent, timing, and volume. Flood hazard maps offer essential insights into flooded areas, water depths, and velocities, assisting in risk assessment and mitigation strategies. Through the use of different scenarios, river modeling aims to accurately replicate real-world conditions. This study focuses on Ungheni commune in Iasi County, Romania, situated along the Prut River's eastern bank. Utilizing a combination of fixed-grid and irregular mesh elements in modeling al-lows for fine-tuning of flow details and optimization of simulation times. Model accuracy, particularly regarding peak river levels, hinges on hydrograph duration. While a 30-minute error is typically accepted, greater tolerances may apply to river basins with longer response times. The extraction and processing of model results, including maximum water depths, flood extents, and velocity maps, are facilitated by ArcGIS, providing valuable data for effective flood management strategies.

A review of quantitative risk assessment (QRA) models of L. monocytogenes in produce was carried out, with the objective of appraising and contrasting the effectiveness of the control strategies placed along the food chains. Despite nine of the thirteen QRA models recovered focused on fresh or RTE leafy greens, none of them represented important factors or sources of contamination in the primary production, such as type of cultivation, water, fertilisers or irrigation method/practices. Cross-contamination at processing and during consumer’s handling was modelled using transfer rates, which were shown to moderately drive the final risk of listeriosis; highlighting therefore the importance of accurately representing the transfer coefficient parameters. Many QRA models coincided in the fact that temperature fluctuations at retail or temperature abuse at home were key factors contributing to increasing the risk of listeriosis. In addition to a primary module that could help assess current on-farm practices and potential control measures, future QRA models for minimally-processed produce should also contain a refined sanitisation module able to estimate the effectiveness of various sanitisers as a function of type, concentration and exposure time. Finally, L. monocytogenes growth in the products down the supply chain should be estimated by using realistic time-temperature trajectories, and validated microbial kinetic parameters, both of them currently available in the literature.

Introduction: A plethora of biological molecules regulate chondrogenesis in the epiphyseal growth plate. Disruptions of quantity and function of these molecules can manifest clinically as stature abnormalities of various etiologies. Traditionally, the growth hormone/insulin-like growth factor 1 (IGF1) axis represents the etiological center of final stature attainment. Of note, little is known about the molecular events that dominate the growth of the craniofacial complex and its correlation with somatic stature. Aim: Given the paucity of the relevant data, this review discusses available information regarding potential applications of lateral cephalometric radiography as a potential clinical indicator of genetic short stature in children. Materials and Methods: A literature search was conducted in the PubMed electronic database using the key words: cephalometric analysis and short stature; cephalometric analysis and achondroplasia; cephalometric analysis and hypochondroplasia; cephalometric analysis and skeletal abnormalities; cephalometr* and SHOX; cephalometr* and CNP; cephalometr* and ACAN; cephalometr* and CNVs; cephalometr* and IHH; cephalometr* and FGFR3; cephalometr* and Noonan syndrome; cephalometr* and “Turner syndrome”; cephalometr* and achondroplasia. Results: In individuals with genetic syndromes causing short stature, linear growth of the craniofacial complex is confined, following the pattern of somatic short stature regardless of its etiology. The angular cephalometric measurements differ from the average height normal individuals and are suggestive of a posterior placement of the jaws and a vertical growth pattern of the face. Conclusion: The greater part of the existing literature regarding cephalometric measurements in short statured children with genetic syndromes provides qualitative data. Furthermore, cephalometric data for individuals affected with specific rare genetic conditions causing short stature, should be the focus of future studies. These quantitative data are required to potentially establish cut-off values to refer for genetic testing based on craniofacial phenotypes.

This project aims to simulate and analyze population dynamics in evolutionary systems, using stochastic differential equations and probabilistic rules for crossbreeding and benefits. The study employs advanced computational techniques to model the evolution of populations over an extended period. Specifically, we explore a scenario with ten distinct groups, each starting with an equal population and evolving under defined genetic and cooperative behaviors. The simulation spans 1000 years, incorporating individual lifespans, stochastic updates, and probabilistic interactions. To ensure robustness and reliability, the study includes detailed statistical analysis, encompassing descriptive statistics, confidence intervals, and ANOVA tests. We further visualize the temporal behavior of populations and subpopulations, providing insights into the evolutionary dynamics and stability of the system. The results demonstrate the effectiveness of balanced cooperation and genetic diversity in maintaining stable population distributions. The project showcases the integration of mathematical modeling, statistical analysis, and computational simulations, contributing valuable insights into evolutionary biology and complex systems. It highlights the importance of interdisciplinary approaches in understanding and predicting population behaviors, with implications for both theoretical research and practical applications in fields such as ecology, genetics, probability and social sciences.

This study explores the transformative potential of integrating Building Information Modeling (BIM) and Generative Design methodologies in heritage conservation and building management. By utilizing BIM, detailed architectural, structural, and MEP models were created, facilitating precise design and effective stakeholder collaboration. Generative Design enabled the exploration of multiple design solutions, optimizing spatial layouts and structural integrity. The project also integrated automated management systems and IoT sensors to enhance real-time monitoring, energy efficiency, and user comfort through the development of a digital twin. Despite encountering challenges such as technical complexities and budget constraints, the project successfully preserved the cinema's historical essence while incorporating modern functionalities. The findings highlight the contributions of BIM and Generative Design to the AEC industry, emphasizing their role in improving design accuracy, operational efficiency, and sustainability. This research provides valuable insights for future projects in heritage conservation, offering a blueprint for balancing historical preservation with contemporary needs. The revitalization of the "Ex Cinema Santa Barbara" in Paternò exemplifies these advancements, demonstrating how these technologies can restore and modernize culturally significant historical buildings effectively.

This paper presents a co-designed solution aimed at improving community healthcare assistance management. To enhance patients’ self-awareness of their health status, encouraging active participation in care process, and to support nurses in delivering patient-centered care, we have developed an innovative platform with a highly customized app. This platform was designed using a multi-disciplinary bottom-up approach. Patient data collection and processing facilitate the automation of care timeline planning, based on real time patients’ needs and the available resources. To achieve this goal different components have been considered: real-time health data collection and processing, patient care planning, decision support for nurses, secure communication for data transmission, and user-friendly interfaces to ensure easy access to platform functionalities.

The experiences gathered during the past 30 years support the operational use of irrigation scheduling based on frequent multi-spectral image data. Currently, the operational use of dense time series of multispectral imagery at high spatial resolution makes monitoring of crop biophysical parameters feasible, capturing crop water use across the growing season, with suitable temporal and spatial resolutions. These achievements, and the availability of accurate forecasting of meteorological data, allow for precise predictions of crop water requirements with unprecedented spatial resolution. This information is greatly appreciated by the end users, i.e. professional farmers or decision-makers, and can be provided in an easy-to-use manner and in near-real-time by using the improvements achieved in web-GIS methodologies. This paper reviews the most operational and explored methods based on optical remote sensing for the assessment of crop water requirements, identifying strengths and weaknesses and proposing alternatives to advance towards full operational application of this methodology. In addition, we provide a general overview of the tools which facilitates co-creation and collaboration with stakeholders, paying special attention to these approaches based on web-GIS tools.

As the digital transformation accelerates in our society, open data is being increasingly recognized as a key resource for digital innovation in the public sector. This study explores the following two research questions: 1) Can a machine learning approach be appropriately used for measuring and evaluating open data utilization? 2) Should different machine learning models be applied for measuring open data utilization depending on open data attributes (field and usage type)? This study used single-model (Random Forest, XGBoost, LightGBM, CatBoost) and multi-model (Stacking Ensemble) machine learning methods. A key finding is that the best-performing models differed depending on open data attributes (field and type of use). The applicability of the machine learning approach for measuring and evaluating open data utilization in advance was also confirmed. This study contributes to open data utilization and to the application of its intrinsic value to society.

Reducing carbon emissions is a major ways to achieving green development and sustainability for China’s future. This paper elaborates the detailed feature of China's carbon flow for 2013 with the carbon flow chart and gives changing characteristics of China's CO₂ flow from the viewpoint of sector and energy during 2000 and 2013. The results show that (1) during 2000 to 2013, China's CO₂ emissions with the approximately growth portion of 9% annually, while the CO₂ intensity of China diminishes at different rates. (2) The CO₂ emissions from secondary industry are prominent from the perspective of four main sectors accounting for 83.5%. The manufacturing play an important part in the secondary industry with 45%. In which the "smelting and pressing of metal" takes up a large percentage as about 50% in manufacturing. (3) The CO₂ emissions produced by coal consumption is keep dominant in energy-related emissions with a contribution of 65%, while it will decrease in the future. (4) From the aspect of sector, the CO₂ emissions mainly come from the "electricity and heating" sector and the "smelting and pressing of metals" sub-sector. While it is essential and urgent to propose concrete recommendations for CO₂ emissions mitigation. Firstly, the progression of creative technology is inevitable and undeniable. Secondly, the government should make different CO₂ emissions reduction policies among different sectors. For example, the process emission plays an important role in "non-metallic mineral" while in "smelting and manufacturing of metals" it is energy. Thirdly, the country can change the energy structure and promote renewable energy for powering by wind or other low-carbon energy. Besides it, the coke oven gas can be a feasible substitution. Finally, policy maker should be aware of the emissions from residents have been growing in a fast rate. It is effective to involve the public in the activity of energy conservation and carbon emissions reduction such as reducing the times of personal transportation.

A key step in providing management/treatment options to men with suspected prostate cancer (PCa) is categorizing the risk for the presence of benign, low risk, intermediate risk, or high-risk disease. Our novel modality brings new evidence, based on the long-known hallmark characteristic of PCa – decreased Zinc (Zn), which is the most direct metabolic sign of malignancy and its aggressiveness. To date, this approach has not been adopted for clinical use for a number of reasons that are described in this article and which have been addressed by our approach: Zn has to be measured on fresh samples, prior to fixating in formalin, therefore samples have to be scanned during the biopsy session; as Zn depletion occurs in the glands, where the tumors develop, estimation of the glands’ levels in the scanned tissue along with their compactness, are essential for accurate diagnosis. Combined with the Zn depletion, this facilitates a reliable assessment of the disease aggressiveness. Data gathered in the clinical study described here indicate that in addition to improving the biopsy quality by real-time interactive guidance, a malignancy score can now be established for the entire prostate, allowing higher granularity personalized risk stratification and more decisive treatment decisions for all PCa patients.

Although global life expectancy has increased over the past 20 years due to improvements in managing infectious diseases, one in five people still succumbs to infections. Humanity is tirelessly working towards developing vaccines and antimicrobial agents in response to this ongoing threat. However, pathogens continue to acquire numerous resistance mechanisms and proliferate. Meanwhile, the COVID-19 pandemic has prompted us to recognize that focusing solely on the killing strategies of immunology and microbiology in complex and multisystemic infectious diseases is insufficient for understanding survival. In essence, there is a need for a treatment approach centered on disease tolerance, capable of alleviating pathology and/or promoting physiological functions in conjunction with the existing strategies of host immune response and pathogen destruction. Against this backdrop, this narrative review comprehends and introduces microbiome therapeutics, which recently garnered attention as next-generation treatments regarding two defense strategies against infectious diseases. First, we delineate the application of existing probiotics and then the microbiome in infectious diseases. Subsequently, we expand this concept to encompass host microbiome crosstalk and present related microbiome therapeutics' current status and direction. Ultimately, the review presents a fresh perspective on understanding microbiome therapeutics in infectious diseases based on a cooperative defense system.

The Indian meal moth, Plodia interpunctella, poses a significant threat to global agricultural products. Although pheromone-based technologies show promise for P. interpunctella management, limitations like single-sex targeting necessitate exploring complementary strategies. Vegetable-based oils represent a potential alternative, but their efficacy, sex-specificity, and interaction with sex pheromones remain unclear. To answer these questions, we first examined attraction of P. interpunctella female and male adults to ten different vegetable oils, i.e., camellia, corn, olive, peanut, rapeseed, sesame, soybean, sunflower, walnut, and a blended oil (mixture of sunflower seed, rapeseed, soybean, peanut, and sesame oils), in the semi-field conditions. Sesame, olive, and blended oils demonstrated most attractive, capturing significantly more adults compared to other oils. We then evaluated effectiveness of these three attractive oils and their combinations with P. interpunctella sex pheromone in a grain warehouse. Traps baited with these oils captured significantly more females and males compared to control traps without attractants. However, sex pheromone addition did not improve male capture and significantly reduced female capture, suggesting an inhibitory effect. Our findings highlight the potential of blended, olive, or sesame oil trap alone as alternative monitoring and trapping tools for P. interpunctella, delivering novel insights into the development of efficient integrated pest management strategies for stored products.

A new type of artificial block is proposed by modifying the traditional block. Based on the physical model experiment, the wave reflection and run-up characteristics of the new ecological blocks under regular waves were examined, and the influence of the height of the "planting trough" border on the hydrodynamic properties was analyzed. The results indicate that the wave reflection and run-up would decrease with a decrease in the breakwater slope. As wave height increases, wave run-up increases, and the reflection coefficient falls. Wave reflection and run-up increase with an increasing wave period. The relative depth of the water has a smaller impact on the wave reflection than the wave run-up. The reflection coefficient of the new ecological blocks is consistently lower than that of the conventional and continues to decrease as the border of the "planting trough" is raised. The raised borders prevent water loss in the trough, resulting in no significant improvement in the wave run-up performance of the new blocks. The reflection coefficient and the relative run-up R/H gradually increase with the average wave breaking parameter ξ increase. The crude permeability coefficients for the new blocks, New Heights 1 and New Heights 2, are 0.53, 0.53, and 0.54, respectively.

With the increasing occurrence of rotator cuff injuries every year, there is a great need for a reliable treatment option. Wharton’s Jelly contains several components that can positively impact the replacement and repair of musculoskeletal defects. The overall objective of this study is to evaluate the improvement of patient-reported pain scales after applying Wharton’s Jelly (WJ) in rotator cuff defects. Eighty-seven patients with rotator cuff defects who failed at least eight weeks of conservative treatment were selected from the retrospective repository. 2cc of WJ flowable allograft was applied to the specific affected anatomy, the most common being supraspinatus tendon, biceps tendon insertion, labral tear, and subscapularis tear. No adverse reactions were reported. Statistically significant improvements were found from the initial to Day 90 in all scales. Patient satisfaction was calculated using minimal clinically important differences. No statistically significant differences were found in mean changes between gender, BMI, and age. Scanning Electron Microscopy images reveal the similarities between the collagen matrix in WJ and the rotator cuff. The significant improvement in patient outcomes coincides with current literature analyzing WJ applications with other structural defects around the body. WJ is a promising alternative for musculoskeletal defects when the standard of care fails.

Genetic engineering has become an essential element in developing climate-resilient crops and environmental sustainable solutions to respond to the increasing need for global food security. Genome editing using CRISPR/Cas [Clustered regulatory interspaced short palindromic repeat (CRISPR)-associated protein (Cas)] technology is being applied to a variety of organisms, including plants. This technique has become popular because of its high specificity, effectiveness, and low production cost. Therefore, this technology has the potential to revolutionize agriculture and contribute to global food security. Over the past few years, increasing efforts have been seen in its application in developing higher-yielding, nutrition rich, disease resistant, stress-tolerant “crops” fruits and vegetables. Cas proteins such as Cas9, Cas12, Cas13, and Cas14, among others, have distinct architectures and have been used to create new genetic tools that improve features that are important for agriculture. The versatility of Cas has accelerated genomic analysis and facilitated the use of CRISPR/Cas to manipulate and alter nucleic acid sequences in cells of different organisms. This review provides the evolution of CRISPR technology exploring its mechanisms and contrasting it with traditional breeding and transgenic approaches to improve different stress tolerance. We have also discussed the CRISPR/Cas system and explored three Cas proteins that are currently known to exist: Cas12, Cas13, and Cas14 and their potential to generate foreign DNA free or non-transgenic crops that could be easily regulated for commercialization in most countries.

We are experiencing an unprecedented urbanization process that alongside with physical, social and economic developments is having a significant impact on population’s health. Due to higher apprehensions of pollution, violence and poverty, our modern cities no longer ensure a good quality of life so they become unhealthy environments. This study aims to measure the socio-environmental and hematologic profile of residents of Santo André’s landfill – “Bairro Espírito Santo” by using the contextualization of the studied area. The research method is Observational type and from Retrospective cohort and by convenience sampling in Santo André in the Greater ABC region. The study determined a socio environmental profile and the hematologic diseases screening related to a close location to the landfill. The disease manifests itself within a broad spectrum of symptoms that causes changes in blood count parameters. The full blood counts analysis was performed, indicating that the blood counts of residents living near the landfill led to positive hematological changes and diseases like Leukopenia, Anemia, Neutropenia and lymphocytosis were the most common changes. However it is considered that the proof of the relation of cause- effect to environmental exposures that may trigger chronic manifestations in humans requires specific studies that are often complicated.

The sustainable management of Land - Water - Energy - Food (LWEF) nexus requires an envi-ronmental characterization that allows the comparison of complex interlinkages between nexus resources and livelihoods. This complexity makes this characterization difficult coupled with limited study in quantifying sustainability of LWEF nexus and its linkage with livelihood. Therefore, the present study aimed to investigate the link between sustainable LWEF nexus and livelihoods. We used analytical hierarchy process and pairwise comparison matrix in combina-tion with weighting model. The result of composite LWEF nexus index was 0.083 representing, low sustainability. This could be linked with nexus resources consumption, use, and manage-ment. From the analysis of the weight of land, water, energy and food nexus resources, the highest weight was observed for food. The focus of on food production only shows no clear synergy on provisioning, supporting or regulating nexus resources to address livelihoods. The result further showed that LWEF nexus resources have strong correlation with livelihoods. This was evidenced by social (r>0.8, P<0.01), natural (r>0.3, P<0.05) and physical (r>0.6, P<0.01) liveli-hood indicators showed strong positive correlation with LWEF nexus resources. From this re-sults, it was observed that managing nexus resources not only provide a significant contribution to achieve sustainable LWEF nexus, but also be effective for enhancing livelihood through food security. This could be attained by strong evidence based policy to ensure sustainable use of nexus resources. The results provided by this study would serve as the foundation for future study, policy formulation and implementation.

In the era of cloud computing, guaranteeing the safety and effectiveness of data management is of utmost importance. This investigation presents a novel approach that amalgamates sharding concept, encryption, zero-knowledge proofs (zkp), and blockchain technology for secure data retrieval and data access control to improve data security, efficiency in cloud storage and migration. Further we utilize user-specific digital wallets for secure encryption keys in order to encrypt the file before storing into the cloud. As Large files ( greater than 50 MB) or Big data file ( grater than 1 TB) computational complexity is more we leverage on sharding concept to enhance both space and time complexity in cloud storage, hence the large files are divided into shards and stored in different database servers. We also employed blockchain smart contract to enhance secure retrieval of the file and also a secure access method which ensures the privacy of the user. The zk-snark protocol is utilized to ensure the safe transfer of data between different cloud services. By utilizing this approach, data privacy is preserved, as only the proof of the data’s authenticity is shared with the verifier at the destination cloud, rather than the actual data itself. The suggested method tackles important concerns related to data protection, privacy, and efficient resource utilization in cloud computing settings by ensuring it meets all the cloud policies require to store data. As the environment maintains privacy of the user data and by not storing the raw data of the user anywhere, the entire environment is setup as a Zero trust model.

Civic participation is of great significance to urban management decision-making. In order to facilitate citizens to participate in city management decision-making, this paper proposes a large-scale group decision-making (LSGDM) method based on multi-granular probabilistic linguistic preference relations (MG-PLPRs). First, each decision maker selects a language terms set from the multi-granularity language terms set to represent individual preference relations and the MG-PLPRs are obtained by statistical calculation to represent sub-group’s preferences information. Then, an optimization model based on the expected consistency of PLPR and consensus measure of groups is established to achieving consensus reaching processes, which can ensure satisfactory individual consistency and group consensus. Finally, the validity and applicability of the proposed method is verified by a case of a city "shared garden" site selection with the participation of citizens.

The rise in population density, vehicle ownership, and urban development has significantly influenced travel demand and altered travel patterns, leading to traffic congestion in rapidly growing urban centers like Accra, Ghana. The traditional approach of expanding roadways to accommodate rising traffic is no longer environmentally sustainable. Instead, emphasis has shifted towards travel demand management (TDM) strategies as a more sustainable solution. This study aimed to investigate a range of TDM strategies that can be adopted in Accra to improve traffic flow through the lenses of everyday road users. The study employed a questionnaire survey and a stratified sampling technique to gather data from 615 respondents for relative importance index (RII) ranking, and Chi-square statistical analysis. The findings reveal that the topmost preferred strategies were mass transit improvements, walking and cycling improvements, and alternative work schedules. Notably, mass transit improvements emerged as the most preferred strategy. The study also unveiled a statistically significant correlation between variables such as age, education level, marital status, income level, and mode of transportation with all selected TDM preferences. However, no significant relationship was found between gender and car ownership with all selected TDM preferences. The study provides valuable insights regarding road users’ preferences for TDM strategies that can aid in planning future urban mobility systems to proactively manage travel demand, alleviate congestion, and promote sustainable transportation options for the city’s residents.

The most prevalent musculoskeletal disorder of childhood with unclear aetiology is Growing Pains (GPs). Anatomic deformities and factors that change bone turnover are implicated in GPs pathophysiology. Perinatal risk factors alter the bone metabolism affecting the bone mineral density and content. The aim of our study was to analyze the relationship between GPs, knock knees and perinatal factors. The examined population consisted of 276 children aged 3-7 years. Among them 10 pairs of dizygotic twins were evaluated. The data were collected by using a combination of semi-structured questionnaires, clinical examinations and medical charts of the children and the obstetric history of the mothers. 78 children presented GPs meeting Peterson’s criteria. Genu valgum severity was a significant factor for GPs manifestation and for their increased frequency and intensity. Subsequently, perinatal factors regarding gestational age, Apgar score, head circumference (lower than 33cm) and birth length or weight (smaller than 50 cm and 3000gr, respectively) made a remarkable contribution to the development of GPs. Conversely, antenatal corticosteroid treatment, increased maternal age and maternal smoking during pregnancy were not predictive for the disorder. Our data are potentially supportive for the “bone strength” theory and for the contribution of anatomical disturbances in GPs appearance.

Heart failure (HF) is a growing issue in developed countries and most patients present with a reduced ejection fraction. This condition significantly impairs quality of life and represents a threat not only for patients, but also for the entire healthcare system due to its high management cost. In the last decade, new medical treatments and devices have been developed to reduce HF hospitalizations and improve prognosis, while reducing the overall mortality rate. Medical therapy does not achieve the same results in all patients and, whenever it fails, technology comes in handy: novel devices for the management of HF have reduced symptoms. They have also improved the treatment of fluid retention and life threatening arrhythmias. The present review article gives to the readers a comprehensive overview of the most recent and important findings that need to be considered in HF with reduced ejection fraction patients. Both novel medical treatments and devices have been presented and discussed.

Gestational diabetes mellitus (GDM) is a common complication of pregnancy that adversely affects maternal and offspring health. A variety of risk factors, such as BMI and age, have been associated with increased risks of gestational diabetes. However, in many cases gestational diabetes occurs in healthy nulliparous women with no obvious risk factors. Emerging data suggest that the tendency to develop gestational diabetes has genetic and environmental components. Here we develop a polygenic risk score for gestational diabetes. We further investigate relationships between the genetic architecture of GDM and genetically constructed risk factors and biomarkers. Our results show that genetics can be used as an early screening tool that identifies at-risk at higher risk of GDM before its onset to propose comprehensive monitoring and preventative programs to mitigate the risks.

The aim of this paper is to study the main areas in which Artificial Intelligence (AI) will impact the field of project management that relates to cost, risk and scheduling. The research model was based on a previous study of the ten project management knowledge areas presented in the PMI’s PMBOK 6th edition where project schedule-, cost- and risk management knowledge areas were identified as being the ones most likely to be affected by the development of AI. A group of experts that participated in the study agreed that AI will affect the project management profession in the future. Different elements of the three knowledge areas were considered to be affected more by AI than others. The schedule baseline is the element believed to be affected the most out of the project schedule management elements. For project cost management, the estimation of resource cost is believed to be affected the most. In the case of project risk management, the application of AI will have the strongest impact on the probability and impact format.

(1) Background: Sleep disordered breathing represent a growing public health concern, especially among children and adolescents. Full-night polysomnography is considered the gold standard for diagnosing obstructive sleep apnea. Our goals are to identify personal and environmental risk factors for the onset and persistence of sleep respiratory disorders. We also want to investigate the differences in neuropsychological profiles; (2) Methods: This is an observational, retrospective cohort study. We collected information on adenoidectomy or adenotonsillectomy. We reviewed the clinical history and preoperative visits and collected data through a telephone questionnaire. Pediatric Sleep Questionnaire (PSQ) and the Pediatric Quality of Life Inventory (PedsQL) are questionnaires used for screening sleep respiratory disorders in children. The data were statistically analyzed it using SPSS version 22.0 for Windows (SPSS Inc., Chicago, IL); (3) Results: The study involved 138 patients, but only 100 parents participated. A higher percentage of patients with sleep disordered breathing were observed to have mothers who smoked during pregnancy. A smaller proportion of patients with sleep disordered breathing had a habit of using a pacifier. A rise in physical results is associated with a reduction in the PSQ at follow-up (p=0.051). An increase of overall academic achievement is associated with an average decrease in the PSQ at follow-up (p&lt;0.0001). A more significant proportion of patients undergoing adenotonsillectomy were observed to have a history of prematurity and cesarean birth (4) Conclusions: These results provide essential information on the effectiveness and effects of adenotonsillectomy intervention compared to adenoidectomy intervention and the factors associated with SDB in children undergoing these interventions.

At present, countries around the world adopt digital strategy, so that enterprises apply digital technology, digital supply chain, blockchain, and a series of digital measures to enhance their competitiveness. By analyzing the relationship between digital transformation of manufacturing export enterprises, and their business performance and export performance, this paper focused on the current situation and existing problems of digital transformation of manufacturing export enterprises in China. Based on the Resource Based View theory and Trade theory, the impact of digital transformation of enterprises performance, proposing hypotheses, and building regression models were explored. With the samples of 1007 listed companies in Shanghai and Shenzhen Stock markets from 2012 to 2019, the regression analysis, intermediate effect test, robustness test, stage lag, and heterogeneity analysis were conducted. The results shew that: (1) Listed manufacturing export enterprises carried out digital transformation, which had a significantly positive effect on enterprise performance; (2) It was found that digital transformation could improve enterprise performance by reducing costs, improving R&amp;D intensity and improving human resources etc. (3) According to the fractal analysis, non-state-owned enterprises had more positive effects on enterprise performance, and digital transformation of manufacturing export enterprises in developed areas had a more significant impact on enterprise performance. Finally, according to the empirical results, relevant suggestions for digital transformation were provided.

The paper presents a new type of hydraulic clutch operating with magnetorheological (MR) fluids and the results achieved from both theoretical analysis and experimental measurement. The hy-draulic clutch system of its own design with MR working fluid and a rotating magnetic field lo-cated is designed. The principle of this clutch is to use a rotating magnetic field created by an al-ternating current electromagnet to set the MR fluid in motion. In the tests of the hydraulic clutch with a rotating magnetic field, MR fluid produced on their own, consisting of solid iron particles of various diameters mixed with a silicone oil, are used as working fluids. The rheological properties of MR fluids are assessed on the basis of tests carried out with a Brookfield DV2T rheometer equipped with a magnetic device for generating the magnetic field of its own design. The char-acteristics of the hydraulic clutch with MR working fluid and the rotating magnetic field are tested on a specially built test stand. As a result of the research, it has been found that the torque transmitted by the clutch is the greater, the higher the rotational speed of the magnetic field and the lower the rotational speed of the beaker in which the working fluid is placed, and that the greatest torque occurs for the working fluid with the highest iron content. Based on the analysis of the structure and characteristics of the clutch in which the magnetic field is used, it has been shown that the design of the developed clutch is similar to that of an induction clutch, and its characteristics correspond to the characteristics of the eddy current clutch. Therefore, the proposed new clutch working with MR fluid and the rotating magnetic field can be applied to stationary power transmission system similarly to an eddy current clutch.

The use of chemical pesticides in agriculture contributes to soil, water and air pollution, biodiversity loss and can harm non-target species. The European Commission has already established a Harmonized Risk Indicator to quantify the progress in reducing the risks linked to pesticides. Therefore, there is an increasing need to promote biopesticides or so-called low-risk pesticides (LRP). Extract from Melaleuca alternifolia – tea tree oil (TTO) is known for its antiseptic, antimicrobial, antiviral, antifungal, and anti-inflammatory properties. Tea tree oil has been extensively studied in pest management as well as in the pharmaceutical and cosmetic industry and there are already products based on its active substances on the market. This review focuses on the overall evaluation of tea tree oil in terms of effectiveness and safety as a biopesticide for the first time. The collected data can be an added value for further evaluation of tea tree oil in terms of the authorization extension as a fungicide in 2026.

Since the outbreak of COVID-19, mask-wearing has become a widespread phenomenon. Even after the pandemic, people continue to maintain the habit of wearing masks in their daily lives. While existing research has explored how mask-wearing can influence wearers’ behavior in everyday life, its effects in the workplace have received less attention. Drawing on self-perception theory, this study examined the positive effect of mask-wearing in the workplace on wearers’ voice behavior via psychological safety. An online experiment (N = 291) using a within-subject manipulation of wearing masks supported our hypotheses. This study uncovered the psychological and behavioral consequences of mask-wearing beyond its benefits in people’s health conditions and everyday life.

This study aimed to develop a state-of-the-art method for assessing chemical risks. The method combined desk research findings and the authors' practical knowledge to identify the major shortcomings in performing risk assessments at the workplace. Data were collected from nine SMEs across three sectors: agriculture, laboratory research, and conservation and restoration laboratories. The results of the discussions with the workers and on-site observations were used to develop the method to assess chemical risks. The method uses numerical factors to account for the level of conformity and the duration of exposure to support an estimation of the probability of an incident. The developed method was designed to enhance risk assessment practices and tackle common issues encountered by enterprises, including SMEs.

While digitization can make the health industry faster and more efficient, there are many financial, social and organizational obstacles and barriers to its implementation. This article offers a systematic review of the main troubles detected from the literature review. Also there is a proposal of new kind of restrictions to pay attention. Finally, its offer an heterodox reading about the problem analyzed.

Some of the recent large-scale national projects in South Korea are delayed or suspended due to belated responses to risk occurring on site. Currently, the Far East District (FED) project is being implemented to relocate the US Army bases from Yongsan to Pyeongtaek. Because of lack of experience and understanding about the characteristics of such a project, the deadline of taking over to the US Army Korea has been missed. This study identifies problems of each participant in the Yongsan Relocation Plan (YRP) of the US Army Korea with respect to construction project management and establishes a risk management strategy reflecting characteristics of FED project. To derive significant risk factors influencing YRP, various field data like weekly and monthly reports and other reports on construction condition are analyzed, and experts’ advices are collected and a survey is conducted. Mediators and latent variables are ultimately obtained. Furthermore, a structural equation model is used to both analyze and evaluate complex causal relations among many variables of YRP. The impact of risk factors on the schedule, quality and cost of the project is analyzed. In particular, the case of Site A is examined to see how the project is affected by those risk factors.

Background: The effect of velamentous cord insertion (VCI) on perinatal outcomes in twin pregnancies is unclear due to conflicting findings. This retrospective study aimed to examine VCI prevalence and related risk factors in twin pregnancies and its association with adverse perinatal outcomes. Methods: Women with twin pregnancies who delivered between January 2012 and December 2021 in a single tertiary hospital were included. The participants were divided into dichorionic (DC) and monochorionic diamniotic (MCDA) groups, and their maternal and fetal characteristics and VCI rates were compared. Logistic regression models were used to identify risk factors for VCI and VCI-related perinatal outcomes. Results: Among the 694 twin pregnancies included in this study, the VCI rate was significantly higher in MCDA than in DC twins. Body mass index and MCDA twins were significant risk factors for VCI, whereas assisted reproductive technology pregnancy was a significant protective factor against VCI. In DC twins, VCI did not affect perinatal outcomes. Conclusion: In MCDA twins, VCI was a significant risk factor for fetal growth restriction, twin-to-twin transfusion syndrome, and preterm birth at

This study investigates the evolving corporate governance mechanisms within the context of an emerging economy. Addressing a literature gap, we analyse the influence of corporate governance and earnings quality on idiosyncratic risk in an emerging economy. In particular, this research explores the impact of corporate governance practices and earnings quality on idiosyncratic risk. For this purpose, we utilise a sample of 75 non-financial firms listed on the Pakistani equity market over nine years from 2010 to 2018. Employing the generalised method of moments, the findings of our empirical analysis reveal that firms with robust governance mechanisms and higher earnings quality experience minimal idiosyncratic risk. These outcomes provide valuable insights for standard setters, regulatory authorities, policymakers, and other stakeholders, emphasising the importance of governance mechanisms and earnings management in mitigating idiosyncratic return volatility.

This retrospective study aimed to assess coronary artery calcium (CAC) progression in serial computed tomography measurements according to risk factor changes. In 448 asymptomatic adults who underwent CAC measurements with more than one-year intervals, CAC progression was assessed according to age, sex, variable traditional risk factors (diabetes mellitus, hypertension, hyperlipidemia, and smoking), and initial CAC score (0, 0.1–100, and &gt;100). Univariate and multivariate logistic regression analyses were assessed for independent predictors of rapid CAC progression (△CAC/year&gt;20). During the 3.5-year follow-up, coronary artery calcifications occurred in 43 (12.8%) of 336 individuals with an initial CAC score of zero. Of 112 individuals with initial CAC presence, 60 (53.6%) had △CAC/year&gt;20. Age, male sex, body mass index, and all risk factors were significantly associated with △CAC/year&gt;20, but recently diagnosed hypertension (odds ratio [OR], 11.3) and initial CAC score (OR, 1.05) were significant independent predictors in multivariate regression analyses. CAC progression was affected by demographic and traditional risk factors, but adjusting for these factors, recently diagnosed hypertension and initial CAC score were the most influential factors for rapid CAC progression. These findings suggest that patients with higher initial CAC scores may benefit from more frequent follow-up scans and checks regarding risk factor changes.

During the last decade, Bangladesh has been experienced a significant climatic anomalies which lead to an increase in magnitude and frequency of various climate relate extreme events. Climate scientists substantiate that global temperature and precipitation pattern is expected to change, which may result in consequential impact on agriculture, livelihood, and ecosystem. Bangladesh is therefore likely to face substantial challenges in the coming decades. In order to adequately understand this complex, dynamic phenomena, Analyzing historical Climate change scenarios as well as projecting its future trends is a great concern for researcher. This study aims to analyzes/ historical climatic data from (1901-2020), and predict future temperature and precipitation patterns in Bangladesh using CMIP6 data. Data used in this study (Observed data is from CRU TS 4.05 and future data is from CMIP6) have been acquired from WorldClim v2.1. Various methods including correlation, regression, standard deviation, correlation matrix, percentiles, cell statistics, and IDW interpolation were performed to analyze the trends, variability and spatial patterns of temperature and rainfall. This study revealed that Over the historical study period (1901-2020) Bangladesh has been experienced a significant warming trend with an average increase in temperature 2°C and with annual decline of the total precipitation 607.26 mm along with a shift towards drier conditions despite weak correlation with hotter years. Projected climate models represents that Bangladesh minimum temperature is expected to increase from 1°C to 4.4°C as well as maximum temperatures from 1°C to 4.1°C by 2100. Moreover, projected precipitation is expected to increase by 480.38 mm, with the biggest rises during monsoon months. Regional variations in temperature and precipitation are again expected, with the Southeast (SE) likely experiencing the most significant warming and the Northeast (NE) seeing the most substantial increase in precipitation.

Responding to changing value creation processes in the sheet metal working sec-tor, where the complexity and interchangeability of products challenge traditional dif-ferentiation strategies, this empirical analysis explores integrating service-oriented and data-driven business models as new paths to ensure competitiveness, especially for small and medium-sized enterprises (SMEs). This study aims to capture the current state and challenges associated with the implementation of these business models in this sector. The research was conducted through semi-structured interviews with SMEs in the industry. The findings indicate that service-oriented and data-driven business models are not yet widely adopted and that manufacturing companies re-quire support in their implementation. Fields of action were identified for the industry. These are "Creating awareness and understanding", "Recognizing added value", "In-creasing company maturity" and "Understanding the change process". Cooperation between science and industry is essential in tackling these fields of action to ensure the successful integration of such business models in manufacturing companies. This pa-per identifies challenges in the fields of action that companies must address through a structured approach promoting awareness, recognizing value, improving organiza-tional maturity, and understanding the change process to successfully implement ser-vice-oriented and data-driven business models.

A scientific carbon accounting system can help enterprises reduce carbon emissions. This study took the enterprise in the Yangtze River basin as a case study. The accounting classification of carbon emissions in the life cycle of lime production was assessed, and the composition of the sources of carbon emission was analyzed, covering mining explosives, fuel (diesel, coal), electricity and high temperature limestone decomposition. Using the IPCC emission factor method, a carbon life cycle emission accounting model for lime production was established. We determined that a total of 354,200 tons of carbon emissions were generated from producing 321,000 tons of lime in a year. The decomposition of limestone at a high temperature was the largest carbon emission source, accounting for 62.34% of the total carbon emission. Coal combustion was also an important source of carbon emissions, accounting for 32.66% of total carbon emissions. The carbon emission for one ton of activated lime was 1.46kg, 1.49kg, 1100kg and 1102.95kg respectively for the open-pit, mining stage, crushing stage, and the calcination stage. Based upon the main sources of carbon emission for lime production, carbon emission reduction should focus on CO2 capture technology, fuel optimization and energy control. Using our analysis of carbon emissions, the carbon emission factor of producing unit quicklime of the lime enterprise in the Yangtze River basin was determined. Furthermore, the research into carbon emission reduction for lime production can provide a point of reference for the promotion of carbon neutrality in the same industry.

Background: Acute kidney disease (AKD) is a known risk factor for increased mortality and evolution towards chronic kidney disease (CKD) in adults. The data regarding children are scarce. The purpose of our study is to explore the risk factor for AKD and impact of AKD following an acute kidney injury (AKI) episode in children on mortality and new-onset CKD. Methods: We retrospectively evaluated 736 children with ages between 2 and 18 years old with AKI admitted in a tertiary care hospital from the west Romania over a 9 years period. Results: AKD incidence following AKI was 17%. Patients that developed AKD were older, with higher baseline serum creatinine values, urea, C reactive protein and lower proteins, haemoglobin and sodium. They were more often exposed to sepsis, critical illness and nephrotoxic medications and presented certain susceptibilities like CKD, neoplasia, anemia, heart failure, arterial hypertension, stem cell transplant and female gender. AKI causes that increased the risk of AKD were intrinsic ones. AKD increased the overall mortality by three times. The factors that independently increased the risk of evolution towards CKD were AKD, acute tubular necrosis and higher baseline serum creatinine values. Conclusions: AKD is an independent risk factor for mortality and new-onset CKD in children.

The chemistry and electrochemistry basic fields have been active since the last two decades of the past century studying how surface modification of electrodes by coating with conductive films enhances their activity and performance. In the light of the development of alternative sustainable ways of energy storage and carbon dioxide conversion by electrochemical processes, these research studies have jumped in the 21st century to more applied fields such as chemical engineering, energy and environmental science and engineering. The huge amount of literature on experimental works dealing with the development of CO2 electroreduction processes addresses electrocatalyst development. Membranes can help understanding and controlling the mass transport limitations of current electrodes and reactors designs. The present bibliometric review addresses the papers published in the 21st century regarding membrane coated electrodes and electrocatalysts to enhance electrochemical reactor performance and viability with a special focus on the urgent issue of carbon dioxide capture and utilization.

Artificial Intelligence (AI) and Machine Learning (ML) approaches that could learn from large data sources have been identified as useful tools to support clinicians in their decisional process; AI and ML implementations have had a rapid acceleration during the recent COVID-19 pandemic. However, many ML classifiers are “black box” to the final user, since their underlying reasoning process is often obscure. Additionally, the performance of such models suffer from poor generalization ability in presence of dataset shift. Here, we present a comparison between an explainable-by-design (“white box”) model (Bayesian Network (BN)) versus a black-box model (Random Forest), both studied with the aim to support clinicians of Policlinico San Matteo University Hospital in Pavia (Italy) during the triage of COVID-19 patients. Our aim is to evaluate whether the BN predictive performances are comparable with those of a widely used but less explainable ML model such as Random Forest and to test the generalization ability of the ML models across different waves of the pandemic.

As the world’s second largest economy, China ranks amount the world’s top nations when it comes to carbon emission, and therefore its attitude towards climate change is closely followed by all parties concerned. There have been few researches on the role of environmental governance in low-carbon city transformation process, especially the Chinese one. This paper analyses the role of government environmental regulation played in the low-carbon city transformation process by taking Shenzhen as the research object. One of the world's youngest super cities, it also happens to be the lowest carbon emission intensity city in China. Striving to explore green low-carbon development path for the whole country, Shenzhen provides practical experience for countries to cope with global climate change. However, its efforts to reduce the total carbon emissions failed, but it emphasized the carbon emission intensity, which is consistent with the international commitments made by the central government. China’s policy towards handling climate change relies on hierarchical governance arrangement. The strength of the NGOs in the country is weak and incomparable with the government’s, which has mastered most of the resources and is just a reality in China.

Abstract: Steamed ginseng water (SGW), the by-product generated from the heated processing of red ginseng, with high content of active substances, better skincare activities, and large amount output ineffective utilization, resulted in environmental pollution and resource waste. In current study, UHPLC-Q-Exactive-MS/MS liquid chromatography-mass spectrometry and multivariate statistical analysis were conducted to characterize the compositional features of the repeated thermal-treated SGW. The total sugar content, total sugar content, total reducing sugar content, total non-reducing sugar content, DPPH, ABTS+, Fe3+ reducing capacity, and the hydroxyl radical scavenging abilities were employed to evaluate the gross contents variation connect with anti-oxidant activities during heat processes. The result revealed the SGW content and antioxidant activity were highly correlated, the 7th SGW sample showed the highest content and the strongest ability on anti-aging capacities. 38 significant common differential markers were screened, by the four compared SGW groups (1- and 3-, 1- and 5-, 1- and 7-, and 1- and 9) through OPLS-DA analysis. The current study showed that the thermal proceeding times could be a vital index value during the recycling operation quality control of SGW, which has a huge potential in anti-aging cosmetic raw materials, In the meanwhile, our results provided a green, sustainable, low-cost thinking of rational application on ginseng resource.

: This study examines the prospects of residential water demand management policy regulations in Ethiopia and their implications for sustainable water resource management. This study aims to evaluate the existing policy regulations and analyze their effectiveness in promoting efficient water use and conservation practices in residential areas. By considering the potential challenges and opportunities associated with these regulations, the research provides insights into the future of residential water demand management in Ethiopia and suggests strategies for enhancing sustainable water resource management. Integrated literature and policy document review, alongside observation and interviews, was used to assess the viability of residential water demand management policies. The assessment of current policy regulations for residential water demand management in Ethiopian urban towns has revealed significant shortcomings in promoting water conservation activities. Hence, there is a need for significant improvements in the current water resource policy guidelines, which lack specificity, particularly in residential water demand management conservation strategies. The lack of awareness among residents regarding the importance of conserving their limited water resources is evident. To address these challenges and ensure the sustainability of the water supply, the government and policy developers must engage with various stakeholders, including the community, in the process of revising current policy documents. A more precise and tailored approach is necessary for its effective implementation.

Background/Objectives Bowel endometriosis (BE) is defined as the presence of endometrial-like tissue in the muscular layer of the bowel wall. When BE does not cause severe obstruction to fecal transit, not leading to (sub)occlusive symptoms, the decision to operate becomes challenging as intestinal surgery is associated with higher complication rates and long-term bowel dysfunction. The aim of this cross-sectional study is to evaluate the quality of life (QoL) in patients with BE undergoing medical therapy or expectant management, investigating the impact of characteristics of BE nodules on QoL and intestinal function. Methods A retrospective cross-sectional analysis was conducted on 580 patients with BE who did not undergo surgery but were treated conservatively by medical therapy or expectant management between January 2017 and August 2022. The diagnosis of BE was done by transvaginal ultrasound and confirmed at double contrast barium enema. After at least one year of follow-up, QoL and intestinal function of patients were evaluated by the Endometriosis Health Profile-5 (EHP-5) questionnaire and Bowel Endometriosis Symptom score (BENS), whereas pain symptoms were assessed by the Visual Analogic Scale (VAS 0-10). Statistical analysis was performed to investigate possible associations between QoL and characteristics of bowel nodules (dimension, location, and evidence of stenosis) as well as type and length of eventual medical therapy. Results Patients with BE had a satisfying overall QoL with a mean EHP-5 score of 105.42 ± 99.98 points and VAS lower than 3 for all pain domains; additionally, they did not show a significant impartment of bowel function with mean BENS score of 4.89 ± 5.28 points. Notably, patients under medical therapy had a better QoL than patients without therapy (p

Low carbon supply chain management (LCSCM) strategies are required in the Indian manufacturing industries due to rapidly growing energy usage for financial and environmental concerns. LCSCM technologies face a number of challenges that limit their adoption. Eleven hurdles were selected from the literature as well as the recommendations of business and academic experts. These barriers are defined by a number of factors, including a lack of information, financial worries, environmental concerns, and governmental limits, among others. In addition, efforts are being made to quantify the most optimal relevant barriers using Multi criteria decision making (MCDM) techniques such as interpretive structural modeling (ISM) and decision-making trail and evaluation laboratory (DEMATEL). MICMAC analysis is used to estimate the sensitivity and priority of barriers based on dependency power and driving power. One of these barriers is a needed factor; three are driving elements; four barriers are linked factors; and three are self-sufficient factors. The findings of this study can help academic specialists, industry representatives, and practitioners in their ongoing attempts to adopt 'LCSCM techniques' in Indian manufacturing industries. The model is appropriately explained and applies the link between the barriers.The objective of this paper is the Evaluation and selection of most influential of Barriers to Adopt Low Carbon Supply Chain Management (LCSCM) in the Indian Manufacturing Sector is interrelated.

Cocoa is a natural resource that plays a very important role globally, being one of the most produced and traded commodities. Being a labor-intensive product and considering that its cultivation involves about 50 million people globally, it seems significant to explore its social sustainability. In light of this, this research aimed to map social risks within the cocoa supply chain from a life cycle perspective. Therefore, according to a Reference Scale Approach, or Type I, the Social Life Cycle Assessment was used, considering the two most influential Countries in its production, i.e. Côte d'Ivoire and Ghana. The results showed that there could be a very high risk that more than half of the cocoa globally is produced through child labour and with wages too low to guarantee workers a decent living, returning incomes of $30-38/month. Forced labour is much less frequent than child labour, while cocoa from Ghana may induce a high risk of improper work, considering the 30.2 hours per week worked by farmers. This is mainly due to the low association power of 10-16%, which reveals a high risk that workers may not organize themselves into trade unions. Finally, at 23-25%, there is also a very high risk of discrimination due to the high presence of migrant labour. The S-LCA results, therefore, showed that the cocoa industry is still characterized by socially unsustainable sourcing.

Polycystic ovary syndrome (PCOS) is a multisystem disorder that presents with a variety of phenotypes involving metabolic, endocrine, reproductive, and psychological symptoms and signs. Women with PCOS are at increased risk of pregnancy complications including implantation failure, miscarriage, gestational diabetes, fetal growth restriction, preterm labour, and preeclampsia (PE). This may be attributed to the presence of specific susceptibility features associated with PCOS before and during pregnancy, such as chronic systemic inflammation, insulin resistance (IR), and hyperandrogenism, all of which have been associated with an increased risk of pregnancy complications. Many of the features of PCOS are reversible following lifestyle interventions such as diet and exercise, and pregnant women following a healthy lifestyle have been found to have a lower risk of complications, including PE. This review summarizes the evidence investigating the risk of PE and the role of nutritional factors in women with PCOS. The findings suggest that the beneficial aspects of lifestyle management of PCOS, as recommended in the evidenced-based international guidelines, extend to improved pregnancy outcomes. Identifying high-risk women with PCOS will allow targeted interventions, early pregnancy screening, and increased surveillance for PE. Women with PCOS should be included in risk assessment algorithms for PE.

This study examines the DCMA concerning the future risk of the water security status. We considered three risk factors: population growth, economic growth, and natural water supply demand differences. In the risk analysis part, we consulted with experts from several sectors including academia, Non-Governmental Organization (NGOs), and industry, to predict that the probability of future water stresses in high, medium, and low scenarios are 0.73, 0.24, and 0.03, respectively. In the decision analysis part, we adopted two Multiple Criteria Decision Analysis (MCDA) approaches that include Multiple Attribute Value Theory (MAVT) and Analytic Hierarchy Process (AHP) methods to evaluate the best alternative decision to alleviate future water stresses in the DCMA. The sensitivity analysis demonstrates the best option closely connects to the weighting scheme of the criteria considered in the framework. This study provides a valuable risk and decision analysis framework to analyze the water security status associated with the future water supply and demand gap decrease caused by three risk factors: population growth, climate change, and natural water supply.

Background: This systematic review aims to investigate whether percutaneous transhepatic gallbladder drainage (PTGDB), as definitive treatment, is superior to emergency cholecystectomy (EC) in high-risk patients with acute cholecystitis (AC). Material and methods: A systematic literature search was performed until December 2022 using Scopus, Medline/PubMed and Web of Science databases in order to compare PTGDB as definitive treatment vs EC in AC. Results: Seventeen studies (1 Randomized Control Trials and 16 observational studies) have been included with a total of 783,672 patients (32,634 treated with PTGDB vs 4,663 who underwent laparoscopic cholecystectomy, 343 who underwent open cholecystectomy and 746,032 who underwent cholecystectomy, but without laparoscopic or open approach being specified). The quality assessment (ROBINS-I) of the not randomized studies showed a serious risk, differently the evaluation of the randomized study (RoB 2) showed a low risk of bias. Analysis of the results shows that PTGDB, despite being minimally invasive, do not have different incidence of complications than EC (RR 0.77 95% CI [0.44 to 1.34]; I2 = 99%; P=0.36). A lower postoperative mortality was reported in patients who underwent EC (2.37%) than in PTGDB group (13.78 %) (RR 4.21; 95% CI [2.69 to 6.58]; P < 0.00001), furthermore the risk of hospital readmission for biliary complications (RR 2.19 95% CI [1.72 to 2.79]; I2 = 48 %; P<0.00001) and hospital stay (MD 4.29 95% CI [2.40 to 6.19]; P<0.00001) were lower in EC group. Conclusions: No advantage in using PTGDB as a definitive treatment over EC in the management of critically ill patients with AC has been demonstrated; the results of our systematic review and meta-analysis suggest using EC as the treatment of first choice, even for very high-surgical-risk patient in which PTGDB should be reserved. The major limitation of this systematic review and meta-analysis is associated to a low quality of evidence for the serious bias in the not randomized studies. For this reason, new high powered and well-designed clinical trials are needed to recommend PTGDB as definitive treatment in patients unfit for surgery or those who refuse to undergo surgery.