Based on the foundations of thermodynamics and the equilibrium conditions for the coexistence of two phases in a magnetic Ising-like system, we show, first, that there is a critical point where the isothermal susceptibility diverges and the specific heat may remain finite, and second, that near the critical point the entropy of the system, and therefore all free energies, do obey scaling. Although we limit ourselves to such a system, we elaborate about the possibilities of finding universality, as well as the precise values of the critical exponents using thermodynamics only.

In this article, it is demonstrated that if the zeta function does not have a sequence of zeros whose real part converges to 1, then it cannot have any zeros in the critical strip, showing that the Riemann Hypothesis is false.

Background: Nearly half of congenital heart defects (CHDs) related mortality occur during infancy although advancement in treatments have increased the survival rates. This study comprehensively examines overall and surgical mortality of CHD infants with the highest mortality in an effort to improve our understanding of CHD epidemiology. Methods: Participants were drawn from a dataset of 1,964,691 infants born between 2014 and 2018 in Korea. Target patients defined as those with crucial CHDs including classical critical CHDs and diverse categorical defects but excluding simple shunt defects. Overall mortality (procedural and natural mortality) and procedural mortality (interventional and surgical mortality) for infants were analyzed. Results: Performance rate of multiple procedures in infants with crucial CHDs was 16%. Overall and surgical mortalities of crucial CHDs were 8% and 7%. Mortalities of palliative procedures were relatively high. Procedural mortalities for infants were significantly decreased in tetralogy of Fallot (TOF), atrioventricular septal defects, and total anomalous pulmonary venous return (TAPVR) compared with overall mortalities for infants. Surgical mortalities for infants involving TOF and TAPVR were significantly lower, but those for infants involving hypoplastic left heart syndrome (HLHS) was higher than the those for all ages. Conclusions: Palliative procedural technique in infants must be improved to obtain better outcome particularly in palliative surgery of HLHS. The infantile procedural outcomes for TOF and TAPVR are excellent and important to overcome disastrous circumstances during infancy. This comprehensive study of overall and procedural mortalities of CHDs may lay a cornerstone for CHD epidemiology in Korean infants.

The critical period (CP) phenomenon in language development ranks among the 125 conundrums facing scientists in the 21st century, according to Science. While the phenomenon itself has been noncontroversial in first language acquisition, it still warrants an adequate explanation. Predicated on language acquisition as a complex process, questions among the first to be raised include: How do children accomplish this remarkable feat in such a short amount of time? And how do nature and nurture come together to influence language learning? In second language acquisition, however, both the notion of CP, albeit popular, and its empirical evidence have remained contested to this date - among the questions, whether the observed evidence counts as CP-specific and/or whether or not it warrants an isomorphic attribution to maturational constraints. Entwined in this debate are two well-established facets of inter-learner differential attainment. The first is that there exists a stark difference in ultimate attainment between younger and older learners. A second facet is the vast differences in ultimate attainment among older learners. In this article, adopting a social physics approach, we mathematically establish both the relationship between nature and nurture contributions and the presence of a critical period, and, at once, tender a parsimonious and probable theory for the twin phenomena of inter-learner differential attainment.

Neonatal rats that receive sucrose during a critical postnatal period (CP, days 12 to 28) develop hypertension by the time they reach adulthood. Changes during this period could contribute to inflammation and be associated with variations in the vascular smooth muscle (VSMC) phenotype. We studied changes in inflammatory pathways that could underlie the expressions of the secretory phenotype in the VSMC in the thoracic aorta of rats that received sucrose during CP. We analyzed histological changes in the aorta and expressions of the COX-2, TLR4, iNOS, eNOS, MMP-2, -9, β-, α-actin, and TNF-α, IL-6 and IL-1β expressions, and fatty acids by gas chromatography. The aortic wall presented disorganization, decellularization, wavy elastic fibers and increase in the lumen area. The COX-2, TLR4 expressions, TNF-α and IL-6 were increased, but iNOS, MMP-2 and -9 tended to increase and eNOS and arachidonic acid tended to decrease, con increase in oleic acid in CP in comparison with control group. There is a transient hypertension at the end of the CP that is accompanied by an inflammation and a change in the phenotype of VSMC to the secretory phenotype. The inflammatory changes could act as epigenetic signals to determine the hypertension development during adulthood.

We review extrapolation methods for calculation of critical points and indices from the perturbative expansions by means of Pad\'{e}-based techniques and their various post-Pad\'{e} extensions by means of root and factor approximants. Factor approximants are applied to finding critical points. Roots are employed within the context of finding critical index. Additive self-similar approximants are discussed and $DLog$ additive recursive approximants are introduced as their generalization. They are applied to the problem of interpolation.

This review of current research into at-risk programs serves to categorise and characterise existing programs and to evaluate the contribution of these programs to assisting students at-risk from marginalised backgrounds. This characterisation questions the (sometimes) implicit assumptions and the consequences of those assumptions inherent in and behind these various accounts. This involves a synthesis and reformulation, based on epistemological standpoints, both explicit and implied, of the various researchers. Using as a lens the (various and varied) understandings of social justice and the goals of education (Gale & Densmore, 2000; 2003) I identify three sometimes overlapping and sometimes contesting standpoints in relation to at-risk students, characterised as instrumentalist or rational technical, social constructivist or individualist and critical transformative or empowering. I argue that programs ‘which simply seek to achieve change in the individual young people are doomed to failure’ (Stewart, 1998, 4) and that a critical transformative understanding of at-risk may deliver improved outcomes for young people by challenging ‘the school context in which the young people are located’ (Stewart, 1998, 4).

The performance of Yttrium-Barium Copper Oxide (YBCO) high-temperature superconductors in high-frequency applications is significantly affected by the microwave surface resistance (Rs). The paper delves into the basics, measuring methods and factors affecting the resistance (Rs) in YBCO, highlighting its high critical temperature (Tc) and low resistance, positioning it as a promising material. YBCO's compatibility with epitaxial growth and microstructure engineering offers opportunities to reduce grain boundary effects and improve Rs, making it advantageous for high-frequency electronics, communication systems, and MRI coils. This is due to its high critical current density (Jc) and exceptional Rs at practical temperatures. Challenges remain in comprehending and managing Rs in YBCO, despite its favorable characteristics. Utilizing advanced fabrication methods and incorporating nanotechnology allow for customization of YBCO-based devices. Multi-scale modeling and simulation are essential for guiding experimental work and understanding YBCO's performance in high-frequency settings. This study highlights the promise of YBCO for future high-frequency technologies and stresses the importance of more research to overcome hurdles and fully exploit its capabilities, potentially transforming superconducting devices for practical use.

To clarify the relationships among critical temperature, critical magnetic field, and critical current density, this paper describes many-body interactions of quantum magnetic fluxes (i.e., vortices) and calculates pinning-related critical current density. All calculations are analytically derived, without numerical or fitting methods. Afteralculating a magnetic flux quantum mass, we theoretically obtain the critical temperature in a many-body interaction scenario (which can be handled by our established method). We also derive the critical magnetic field and inherent critical current density at each critical temperature. Finally, we determine the pinning-related critical current density with self-fields. The relationships between the critical magnetic field and critical temperature, inherent critical current density and critical temperature, and pinning critical current density and temperature were consistent with experimental observations. From the critical current density and critical magnetic field, we clarified the magnetic field transition. It appears that a magnetic flux quantum collapses when the lattice of magnetic flux quanta melts. Our results, combined with our previously published papers, provide a comprehensive understanding of the transition points in high-T_c cuprates.

The intensive care units in North West London are part of one of the oldest critical carenetworks in the UK, forming a mature and established strategic alliance to shareresources, experience and knowledge for the benefit of its patients. North WestLondon saw an early surge in COVID-19 admissions, which urgently threatened thecapacity of some of its intensive care units even before the UK government announcedlockdown. The pre-existing relationships and culture within the network allowed itsmembers to unite and work rapidly to develop agile and innovative solutions, protectingany individual unit from becoming overwhelmed, and ultimately protecting its patients.Within a short 50-day period 223 patients were transferred within the network todistribute pressures. This unprecedented number of critical care transfers, combinedwith the creation of extra capacity and new pathways, allowed the region to continue tooffer timely and unrationed access to critical care for all patients who would benefitfrom admission. This extraordinary response is a testament to the power and benefitsof a regionally networked approach to critical care, and the lessons learned maybenefit other healthcare providers, managers and policy makers, especially in regionscurrently facing new outbreaks of COVID-19.

Cobalt, like other critical elements, is gaining in importance today. The great technological advances and the deep knowledge of the physical and chemical properties of this element have allowed to enhance its applications in various fields, such as: catalysts, paints, alloys for the mechanical and aerospace industries, as well as the medical sector and in recent times, its use within the rechargeable battery industry. The main exploitable deposits are in the Democratic Republic of the Congo, which have economic potential due to a strong influence on their mineralization processes. However, the growing demand for cobalt and the search for less dependence on African deposits leads to targeting other regions, so it is necessary to carry out exhaustive exploration to find out the potential of its reserves for a subsequent benefit of the mineral. Generally, cobalt comes as a by-product of the extraction of other metallic minerals, mainly from Cu-Co, Ni-Co, Ni-Cu-Co deposits. From the above, a first review is carried out on the differences that exist in the geochemical, mineralogical and forecast properties that exist within the different deposits that harbor cobalt. As a second review topic, it delves into efficient processing for cobalt recovery, which is generally carried out by flotation, acid leaching, in addition to its recovery from secondary sources, such as batteries and metallurgical waste. However, generally speaking there is still a vast lack of fundamental knowledge about the processability of cobalt. Said processing has been affected from the point of view of mineralogy, that is, understanding and knowing the cobalt-bearing minerals, as well as gangue mineralogy, these aspects exercise significant control during their processing and selection of the most appropriate route. suitable for cobalt extraction (leaching and/or flotation). In this context, the document concludes with a vision of the challenges that the mining industry must implement to enter circular economy models, mainly in the creation of sustainable processes from secondary sources.

This article is about school evaluation. The objective was to explain critically the mediating relationships between educational evaluation and the production of school knowledge from the perspective of the Dialectical Historical Materialism. With this interest, a documentary analysis was made, obtaining as result four explanatory categories: production, subsumption, distribution and exchange of knowledge, which form a concrete totality with distinctions and antagonistic relationships between them, limited by their opposite. It is concluded that the evaluation as a mediating form lacks antagonistic pair and consequently of control by opposition, emerging from the school daily as autonomous and sovereign entity, oppressive of school subjects.

Across the global construction industry, fatalities continue to occur from high-risk activities where the risk controls have been defined, however were unreliable. In the mining industry, Critical Control Risk Management has provided positive results in reducing major accidents, which raises the question, could the Critical Control approach reduce the fatality rate in the construction industry? This study analysed 10 years of serious and fatal incident investigation reports from four international construction companies to i) assess the reliability of their Critical Controls (CCs) and ii) assess the factors which affect the reliability of CCs. The results show the reliability of CCs, measured by implementation and effectiveness, averaged just 42%. Human performance factors including risk identification, decision-making and competency together with supervision, job planning, communication organisational factors were identified as affecting the reliability of CCs. The study used bow-tie diagrams with real event data to find the actual CC effectiveness. This gave actionable findings directly related to individual CCs enabling the participating organization to focus resources on improving specific verification processes. The results confirm the applicability of CCs for the Major Accident Event hazards analyzed and highlights further review is required of the factors which need to be considered when implementing a CC program. This paper details our methodology and results, to assist others apply CCs as a risk management tool.

Objectives: The purpose of this systematic review was to ascertain critical care nurses’ understanding and experiences of patient advocacy in adult critical care settings. The specific objectives were to identify how critical care nurses define patient advocacy, to explore the understanding and experiences of critical care nurses regarding patient advocacy, to explore critical care nurses’ role in patient advocacy, and to ascertain the barriers to encouraging advocacy in the critical care setting. Research design: Systematic literature search of CINAHL and Medline databases, Google Scholar, and Cochrane Database of Systematic Reviews, as well as grey literature search, was conducted. Search dates were restricted from January 2005 to 2015 in both CINAHL and Medline. Findings: 62 studies were identified, of which 6 qualitative research papers were included. Nurses gave varied definitions of patient advocacy, which were categorized into three themes: communication, protection, and doing. Nurses perceive advocacy as truly listening to patients and their families. Conclusion: For critical care nurses to be effective advocates, there must be support, collaboration, and improved working relationship between professional groups. Moreover, nurses must be empowered to be able to give power to patients and family.

Here we present calculation of the critical current of DC SQUID based on the Josephson junction on multi-band superconductor with frustration effect. It is shown that the changing of the critical current of DC SQUID with small geometrical inductance is determined by the ratio of supercurrent amplitude in different channels and the external magnetic field. In the a case of DC SQUID with high inductance frustration effects can be ignored.

The dependence of the critical temperature $T_c$ of high-temperature superconductors of various families on their composition and structure is proposed. A clear dependence of the critical temperature of high-temperature superconductors (hydrides, Hg- and Y-based cuprates) on the serial number of the constituent elements, their valence and crystal lattice structure has been revealed. For cuprates, it is shown that it is possible to obtain even higher temperatures of superconducting transitions at normal pressure by implanting mercury atoms into the crystal lattice of cuprate.

Sepsis, a syndrome characterized by systemic inflammation during infection, continues to be one of the most common causes of patient mortality in hospitals across the United States. While standardized treatment protocols have been implemented, wide variability in clinical outcomes persist across racial groups. Specifically, Black and Hispanic populations are frequently associated with higher rates of morbidity and mortality in sepsis compared to the Caucasian population. While this is often attributed to systemic bias against minority groups, a growing body of literature has found patient, community, and hospital-based factors to be driving racial differences. In this article, we provide a focused review on some of the factors driving racial disparities in sepsis. We also suggest potential interventions aimed at reducing health disparities in the prevention, early identification, and clinical management of sepsis.

This study aimed to investigate the prevalence, location, and characteristics of new-onset chronic pain by using a new definition in long-term survivors after discharge from a tertiary emergency center. We conducted a single-center ambidirectional cohort study from January to May 2022. A survey of patients was conducted by postal mail 2-2.5 years since their discharge from a tertiary emergency center. We used the Brief Pain Inventory to investigate chronic pain parameters, and the painDETECT questionnaire to investigate neuropathic pain. Patient information during hospitalization was collected retrospectively from medical records. The survey was sent to 78 patients, 63 (81%) of whom responded and were included in the analysis. Nine of the 63 patients (14%) had new-onset chronic pain. Of these, six (67%) had chronic pain of moderate or severe intensity which interfered with daily life. The most frequent location of chronic pain was the ankle/foot (n=4, 44%). Neuropathic pain was present in four (44%) patients with new-onset chronic pain. New-onset chronic pain may occur for up to 2-2.5 years after discharge from a tertiary emergency center, and this may interfere with daily life. Therefore, a follow-up system for chronic pain is warranted.

The accurate identification of bacterial infections is critical for effective treatment in intensive care units (ICUs), yet current diagnostic methods face limitations in sensitivity and specificity, along-side cost and accessibility issues. Consequently, there's a pressing need for a marker that is economically feasible, rapid, and reliable. Presepsin (PSP), also known as soluble CD14 subtype (sCD14-ST), has emerged as a promising biomarker for early sepsis diagnosis. PSP, derived from soluble CD14, reflects the activation of monocytes/macrophages in response to bacterial infec-tions. It has shown potential as a marker of cellular immune response activation against patho-gens, with plasma concentrations increasing during bacterial infections and decreasing post-antibiotic treatment. Unlike traditional markers such as procalcitonin (PCT) and C-reactive protein (CRP), PSP specifically indicates monocyte/macrophage activation in bacterial infections. While limited studies in critical illness have explored PSP's role in sepsis, its diagnostic accuracy varies with threshold values, impacting sensitivity and specificity. Recent meta-analyses suggest PSP's diagnostic potential for sepsis, yet its standalone effectiveness in ICU infection management remains uncertain. This review provides a comprehensive overview of PSP's utility in ICU set-tings, including its diagnostic accuracy, prognostic value, therapeutic implications, challenges, and future directions.

Throughout its history Western science has tended to treat complexity as a problem to be avoided or solved. A philosophy of simplification achieved significant improvements in human life and prevails as a model for achieving societal good. However, misplaced efforts to control complexity worsen our sustainability challenges. Effective responses to modern day dilemmas such as floods and climate change require ways of thinking that are more congruent with the complexity of the world. Further, governmental programs to reduce flood risk depend on the support of an informed and engaged public. It has proven difficult to communicate risk in ways that align scientific and technical expertise based on an objective worldview, with communal and individual under-standings of risk based on subjective experiences and perspectives. I introduce Paul Cilliers’ philosophy of critical complexity as the basis of a new conceptual framework that values and balances complexity and simplicity. This paper shows how objective strategies that rely on analytic and probabilistic thinking can be integrated with subjective approaches that draw on the experiential and possibilistic. An example depicts how the problematic framing of the “100-year flood” can be replaced by a model of the data that covers a range of possibilities within an experiential time frame. Cilliers’ work opens an ethical dimension in which we make more intentional choices and acknowledge our limitations. Complexability – understanding how to live with complexity rather than aiming to simplify it – is a vital component of sustainability communication and education.

During the last decade, the demand for lithium has been growing exponentially with its widespread uses in manufacturing, especially with the worldwide deployment of electric vehicles. Thus, lithium is considered integral to the U.S. economy, technological advancement, and the pursuit of sustainable and clean energy solutions. The produced water is known to be rich in several minerals and valuable elements, such as potassium and magnesium, and a trace amount of precious elements including lithium. However, the existence of metals in the produced water is one of the challenges to extract lithium, especially magnesium which is located in diagonal positions within the periodic table that exhibit similarities. The produced water was first purified, resulting in the complete removal of magnesium, and then lithium was precipitated by phosphate. The effects of operating conditions on the Li₃PO₄ precipitation behaviors were evaluated. The effect of different precipitating reagents was evaluated on the percentage of lithium extracted, Na₃PO4 (TSP) was found to be a promising Li precipitating reagent. The highest percentage of lithium extracted was reached when the Li concentration of produced water was enriched and increased up to 350 mg/l, then Li removal was 53% at 7 grams of TSP and 200 rpm for 2 hours. The results indicated that temperature is a more important factor than stirring speed. The novelty of the current work is not only by the results obtained that may create additional financial benefits to oil-producing areas but on that the sustainable disposal of produced water may encourage the recycling and reuse practice, ultimately reducing the use of freshwater for hydraulic fracturing.

In an increasingly changing world, critical thinking is one of the key skills that ensure organisations' competitive advantage. Thus, in higher education institutions there is an accelerating emphasis on developing critical thinking (CT) among students. This paper presents the results of three experimental courses (Pedagogy and didactics of financial accounting, Virtual Learning Environments in Economics, Business Communication), using a blended learning method, aimed at improving students' CT skills. The three courses were delivered by both higher education teachers and trainers from the labour market. After analysing the data from the three experimental courses, it will be possible to assess whether the intervention of labour market trainers contributed to the improvement of students' critical thinking skills, and, in particularly at the level of which components improvements have been identified.

Mitochondrial alternative oxidase 1a (AOX1a) plays an extremely important role in critical node of seed viability. However, the regulatory mechanism is still poorly understood. The study aims to identify regulatory mechanisms by comparing between OsAOX1a-RNAi and wild type (WT) rice seed during artificial aging treatment. Gain weight and P50 significantly decreased in OsAOX1a-RNAi rice seed, indicating that there might be impaired in seed development and storability. Compared to WT seeds in the 100%, 90%, 80%, and 70% germination, respectively, NADH and succinate-dependent O2 consumption, the activity mitochondrial malate dehydro-genase and ATP contents were decreased in OsAOX1a-RNAi seeds in the 100%, 90%, 80%, and 70% germination, respectively, indicating that mitochondrial status in the OsAOX1a-RNAi seeds after imbibition was weaken than the WT. In addition to, the reduced abundance of complex I N and P module subunits might showed that the capacity of mitochondrial electron transfer chain was significantly inhibited in the OsAOX1a-RNAi seed at critical node of seed viability. Above results might indicated that the ATP production was impaired in OsAOX1a-RNAi seeds during ageing. Therefore, we conclude that the activities of mitochondrial metabolism and alternative pathways were severely inhibited in OsAOX1a-RNAi seeds at critical node of viability, which was leading to accelerate the collapse of seed viability. The precise regulatory mechanism of the alternative pathway at the critical node of viability still needs to be further analyzed.

The sense of uncertainty and fragility due to the effects and magnitude of global challenges we are facing (from pandemic circumstances to climate change impacts) requires – much more than in the past – the capacity to generate a visionary and forefront design approach in the young gen-erations aiming at stimulating their reaction attitude rather than providing consolidated tools from past conditions that no longer exist or will rapidly evolve. Within this general framework, we have investigated the effectiveness and impacts of experienced-based methods of learning and innovative educational tools in architecture aimed at shaping expertise in which the environ-mental dimension and the climate-change challenge dialogues with the context's complexity in terms of socio-cultural dynamics, real potentialities and constrains, addressing their transdisci-plinary trajectories. The paper analyses 5 international pioneering teaching experiences that provide the opportunity to understand the outcomes of collaborative and experiential learning processes in which the educational activities leverage a dialogue between diverse communities (academia-citizens-policymakers-practitioners). The study outcomes show that shifting the pedagogical paradigm towards in-field-experience-based models can improve the awareness of future practitioners for climate implications of architectural design, implement their analysis and project skills while triggering processes of knowledge transfer and co-production at community level, and allow them to better address the societal and cultural issues involved within decision making.

The morphological transformation of an arched ribbon driven by torsion is a scientific problem that is connected with daily life and requires thorough analysis. An arched ribbon can achieve an instantaneous high speed through energy transformation and then return to the original shape of the structure. In this paper, based on the characteristics of the ribbon structure, the dynamic mathematical model of the arched ribbon driven by torsion is established from the Kirchhoff rod equation. The variations of the Euler angle of each point on the center line of the ribbon with the arc coordinate s and the rotation angle of the supports $\phi$ was examined. The relationship between the internal force distribution of each point in the direction of $\hat{d}_{a}$ and the material, cross-sectional properties, and rotation angle of the supports was obtained. We used ABAQUS, a nonlinear finite element analysis tool, to simulate the morphological transformations of the ribbons, verified our theory with simulation results, and reproduced the experimental results of Sano. Furthermore, we redefined the concept of the ``critical flipping point'' of Sano. In this paper, the dimensional analysis method was used to fit the simulation data. The following relationship between the critical width $ w ^{*} $, thickness h, and the radius R of the ribbon with different cross sections was obtained: $w^{*}=A\cdot R\left(h/R\right)^{0.6}$, where A is 3.19 for rectangular cross sections and 3.06 for elliptical cross sections. By analyzing the simulation data, we determined the variation behavior of the out-of-plane deflection of the center point of the ribbon with the radius R, width w, and thickness h. Our research has guiding significance for understanding and designing arched ribbons driven by torsion, and the results can be applied to problems of different scales.

Most traditional theories of intelligence have little to do with the question of whether people with high intelligence can successfully address real world problems. A high IQ is correlated with many important outcomes (e.g., academic prominence, reduced crime), but it does not protect against cognitive biases, partisan thinking, reactance, confirmation bias, and even falling for discredited beliefs such as alchemy, cold fusion, and astrology. There are several newer theories that directly address the question about solving real-world problems. Prominent among them is Sternberg’s adaptive intelligence with “adaptation to the environment” as the central premise, a construct that does not exist on standardized IQ tests (e.g., Sternberg, 2019). Similarly, Stanovich and West (2014) argue that standardized tests of intelligence are not measures of rational thought—the sort of skill/ability that would be needed to address complex real-world problems. Halpern and Butler (2020) advocate for critical thinking as a better model of intelligence for addressing real-world problems than those that are based on psychometric properties of general intelligence. Yes, intelligence (i.e., critical thinking) can be enhanced and used for solving a real-world problem like Covid-19, which we use as an example of contemporary problems that need a new approach. Critical thinking may be an antidote for the chaos of the modern world.

This paper presents a study conducted to identify, assess, rank, and compare the most influencing factors causing schedule delay during construction phase of petrochemical projects in Saudi Arabia. The methodology followed in this research to achieve the main aims is a combination of comprehensive review of the literature and interviewing number of local experts, which have resulted in identifying of 23 factors. Through a web-based questionnaire survey, the identified factors were ranked. Total of 90 completed responses were gathered from 106 received responses. The completed responses gathered from 38 contractors and 52 owners. Of 90 participants, there are 32 project managers, 22 project engineers, 7 construction supervisors and the other 31 having different positions in projects departments The study has found that the most influencing factors causing schedule delay during construction in petrochemical projects in Saudi Arabia are “Poor site management and supervision by contractors”; “Conflict between main contractor and subcontractor”; “poor planning and scheduling of projects by contractor”; “Delay of material or equipment delivery”; and followed by “Delay in Handing Over Construction Site to Contractor”. This paper is original in the sense that the areas of knowledge and practice covered in the identified factors were distributed and not available in one source. The factors are derived from personal interviews with selected project managers, project engineers, construction supervisors and the others from different positions in project department and from the relevant literature.

A unified critical state model has been developed for both clean sand and silty sand using the modified Cam-clay model (MCC). The main feature of the proposed model is a new critical state line equation in the e-ln(p) plane that is capable of handling both straight and curved test results. With this feature, the error in calculating plastic volumetric strain is eliminated in theory. Another crucial feature of the model is the transformed stress tensor based on the SMP (spatially mobilized plane) criterion, which takes into account the proper shear yield and failure of soil under three-dimensional stresses. Additionally, the proposed model applies the intergranular void ratio with the fines influence factor for silty sand. Only eight soil parameters are required for clean sand, and a total number of twelve soil parameters are needed for silty sand.

Euler’s product formula over the primes and Euler’s zeta function equate to enshrine the Fundamental Theorem of Arithmetic that every integer > 1 is the product of a unique set of primes. The product formula has no zero, and with a domain ≤1 Euler’s zeta diverges. Dirichlet’s eta function η(s), negates alternate terms of zeta, permitting convergence when s∈C and Re(s) < 1, and its non-trivial zeros {ρ}, have a deep relationship with the distribution of the primes. The Riemann Hypothesis is that all the non-trivial zeros have Re(ρ) = 1/2. This work examines the symmetries in a partial Euler’s zeta series with a complex domain equating it to the difference between two finite vector series whose matched terms have mirror-image arguments, but whose magnitudes differ when Re(s) ≠ 1/2. Analytical continuation generates a modified eta series η_l(s), in which every l^th term is multiplied by (1-l). If the integer l is appropriately determined by the Im(s), similar paired finite vector series have a difference that closely follows η_l (s) and their terminal vectors intersect in a unique way permitting zeros only when Re(s) = 1/2. Furthermore, those vectors tracking the derivatives of the series, have a special relationship permitting zeros of the differential only when Re(s) > 1/2.

Handmade papers, as carriers of paper-based cultural relics, have played a crucial role in the development of human culture, knowledge, and civilization. Understanding the intricate relationship between the structural properties and degradation mechanisms of handmade papers is essential for the conservation of historical documents. In this work, an artificial dry-heat accelerated ageing method was used to investigate the interplay between the mechanical properties of paper, the degree of polymerization (DP) of cellulose, chemical composition, hydrogen bond strength, crystallinity, and degree of hornification. The results show that the mechanical properties of handmade bamboo paper exhibited a first plateau region, a rapid decline region, and sometimes a second plateau region. A critical point in the mechanical properties of the paper occurs when the cellulose DP decreases to a range of 400-600, signifying a shift from the initial plateau to a sharp decline phase. The strengthening of intermolecular hydrogen bonds and the hornification process help counteract the embrittlement of fibers caused by cellulose chain scission due to DP reduction. A secondary plateau emerges when the DP is smaller than 400, cellulose degradation is slow, and the component content, hydrogen bond strength, crystallinity, and degree of hornification reach a secondary plateau.

Iron is an essential nutrient for humans and microbes, such as bacteria. Iron deficiency occurs commonly in critically ill patients, but iron replacement therapy is not considered during the acute phase of critical illness, since it increases iron availability for invading microbes and oxidative stress. However, persistent iron deficiency in the recovery phase is harmful with potential adverse outcomes such as cognitive dysfunction, fatigue and cardiopulmonary dysfunction. Therefore, it is important to treat iron deficiency timely and efficiently. This article reviews current knowledge about iron-related biomarkers in critically ill patients and provides possible criteria to guide decision-making for iron supplementation in the recovery phase of critical illness.

Given the long-standing debate about the nature of the concept of disease, the objective of this study was to understand how doctors categorize a condition as a disease or not and what kind of information they use. A survey with a set of clinical vignettes was designed, and a group of physicians were asked to interpret those situations as a disease or not and to motivate their choice with a short written text. Thematic analysis of the answers resulted in four themes: the temporal dimension of a disease, reification of disease, disease as an existential condition, and disease as a motivation to action. The respondents’ interpretations were very heterogeneous, supporting the idea that physicians do not share a common prototypical concept of disease. An interpretation of these results according to a critical realist and systemic approach suggested that the doctor-patient relationship is the context able to influence the interpretation of a condition as a disease or not as the final outcome of a process in which both objective, subjective, and socially mediated elements are taken into consideration.

Lophomonas are flagellated protozoa which have been increasingly associated with upper and lower airway infection in humans. The prevalence and characterization of this disease in the critically ill remains poorly understood. We present a series of eleven ICU patients with confirmed Lophomonas spp. identification in respiratory samples.

This essay discusses the complicated relationship between ideology and faith, focusing on the importance of faith. It endeavors to enrich the critical examination of religion by providing a platform to analyze the multifaceted nature of ideologies and their profound influence on human geography. This study is particularly distinctive for its focus on the complex interplay of Marxism, religion, and modernity, deepening our understanding of how these dynamics shape contemporary societies.

Transformation studies have been leaning towards the more practical aspects of change processes and have not yet dealt sufficiently with their personal and political dimensions. They are arguably constrained in doing so if they are either overly focussed on systems and how to control them or on individualistic values and behaviours. In this study we show how the actually-occurring societal transformations that people face can be usefully approached through the lenses of dialogical sense-making and critical phenomenology. While distinct, these approaches share a concern with aspects missed when transformation is abstracted and alienated from people’s lives; namely people’s lived experiences during times of change, and the conditions of possibility for these experiences. Dialogical sense-making explores how people create meaning around transformations, through interactions with other people, with different lines of arguments, and as part of broader public discourse. Critical phenomenology engages with subjectivity and lived experience, and with the role of foundational as well as socio-culturally dominant yet contingent structures in shaping our ways of perceiving, experiencing and knowing the world. Through a discussion of insights from these approaches, we show how they offer tools that enable new questions about transformative change as it is experienced and made sense of. Situating analyses of tranformation from within a focus on experience brings us closer to understanding the significance of change processes in people’s lives, and allows for an inquiry into the conditions of experience, including transformative experiences.

Aims and Objectives: Our primary aim was to study association between nonsurgical techniques related complications and mortality and our secondary aim was to determine factors responsible for non surgical technique related complications. Material and Methods: All gastrointestinal and hepatobiliary procedures performed in last 3 years have been evaluated retrospectively. Nonsurgical procedure related postoperative complications were defined as perioperative complications nonrelated to surgical procedures or techniques and related to patients’ physiological health or comorbidities. To avoid selection bias in attempt to evaluate effect of non-surgical procedural related complication on mortality, we did 1:1 propensity score matching analysis with nonsurgical technique related complications as dependent factor. Propensity scores were calculated using logistic regression. Pre operative confounding factors like age, sex, American society of Anesthesia score (ASA), emergency surgery, type of surgeries like HPB surgeries, Upper gastrointestinal surgeries, small bowel surgeries, colorectal surgeries, hernia surgeries, open or laparoscopic surgeries were entered in model as covariates. We used nearest neighbor matching protocol with a calipher of 0.2. Cases were not reusable after matching. Statistical analysis was done using SPSS version 23. Results: Total 348 patients underwent various abdominal surgeries (gastrointestinal and hepatobiliary) in our department from April 2017 to March 2020. Total 24 patients developed nonsurgical technique related complications. Before Propensity score matching nonsurgical technique related complications were significantly higher in Upper Gastrointestinal surgeries (gastric and esophageal), emergency surgeries, Open surgeries, in patients who developed intraoperative hypotension, patients operated for malignancies, patients with higher ASA grades, patients in whom more blood products were used and patient who had more operative time. ASA scores independently predicted nonsurgical technique related complications. [P=0.001. Odds Ratio 3.955 (95% C.I.) 1.774-8.813)]. After Matching 24 patients patients were included in nonsurgical complication related complication group and they were compared with 23 matched controls. After matching also nonsurgical procedural related complications were significantly associated with mortality. (p< 0.0001). No intraoperative factors like intraoperative hypotension, blood product requirement, operative time predicted non-surgical technique related complication. Surgery related complications were not associated with mortality after matching. Conclusion: Nonsurgical technique related complications are associated with significant increase risk of mortality.

The interaction of solution of poly (diallyldimethylammonium) chloride, PDADMAc and sodium dodecylsulfate, SDS has been studied using conductometric, densimeter and zeta potential methods. the critical micellization concentration (cmc) was determinated with conductance results and increased with the addition of PDADMAc comparing with solutions containing pure SDS. Further the degree of dissociation,  and thermodynamic parameters viz. free energy of micellization, and entropy of micellization, has been evaluated. there results demonstrated that surfactant/polymer complex is governed by both electrostatic and hydrophobic interactions. The apparent molar volume, Vϕ and adiabatic compressibility, Kϕ;s have been determined for the SDS solution from density and speed sound data. the negative charge of the SDS solutions with polymer shows that these complexes probably do not contain surfactant in the form of micelles.

The new IoT/IoE (internet of things/everythings) paradigm and architecture permits to rethink about the way the Smart City infrastructures are designed and managed, on the other hand a number of problems have to be solved. In terms of mobility the cities that embrace the sensoring era can take advantage of this disruptive technology to improve the quality of life of their citizen, also thanks the rationalization in the use of their resources. In Sii-Mobility, a national smart city project on mobility and transportation, a flexible platform has been designed and here, in this paper, is presented. It permits to setup heterogeneous and complex scenarios that integrate sensors/actuators as IoT/IoE in an overall scenario of Big Data, Machine Learning and Data Analytics. A detailed and complex case-study has been presented to validate the solution in the context of a system that dynamically reverse the traveling direction of a road segment, with all the safety conditions in place. This case study composes several building blocks of the IoT platform, which demonstrate that a flexible and dynamic set-up is possible, supporting off-grid, security, safety, cloud and mixed solutions.

This work focuses on the theoretical study of the effect of entanglement in the Yttrium Barium Copper Oxide (YBCO) superconductor on the critical current density, critical magnetic field, and penetration depth. Using the Ginzburg Landau (GL) theory, the expression for the GL coherence length, the critical current density, the lower critical magnetic field (Hc1), and the upper critical magnetic field (Hc2) for the entangled superconducting YBCO was obtained. At zero external magnetic fields, YBCO was found to undergo a transition from the normal state to the superconducting state at 93K and returned to normal. We found a direct relationship between the GL coherence length penetration depth and the temperature of the entangled superconducting YBCO. The graphs of the lower critical magnetic field (Hc1) and critical current density against temperature show a non-linear dependence.In contrast, the graph of the upper critical magnetic field (Hc2) against temperature (T) shows the linear dependence, which is in agreement with existing theoretical observations. On the other hand, the graph of critical current density against the distance of separation between the entangled electrons that form a cooper pair showed that the critical current density increases between 1.8 and 6 nanometers attaining a constant value after reaching 7 nanometers for infinite distances. Finally, for lower critical fields, the magnetic field decreases between 1.5 to 6 nanometers attaining a constant value of the magnetic field, for infinite values of distance of separation between the entangled pair of electrons.

In this study, Fe-based superconductors (SCs) are described with a model showing a novel attractive force. First, we describe this novel force using an analog from electromagnetism. From electromagnetism, it was found that this force is a Lorentz force in which two electrons orbit around a Fe-ion with the same velocity. Then, we consider a wave function of an electron. Consequently, due to the property of the proposed attractive force and the quantum-field Hamiltonian, we clarified that the Bardeen–Cooper–Schrieffer (BCS) ground state can be reused. Afterward, attractive force energy was calculated according to the presented model. In Fe-based SCs, a structure transition is essential. Considering that the derived attractive force energy is relatively large, we employ the expanded T_c-equation from the BCS theory that includes the structure transition effect and the derived attractive force energy. In addition, we succeed in analytically reproducing T_c-dome diagrams in various types of Fe-based SCs. Moreover, we discuss the universal property a general SC should have as well as the quantum critical point.

Critical thinking skills are important assets for scientific development. Therefore, there are many ways to enhance the critical thinking skills of students, researchers, etc., both in the field of education and scientific enterprise. In this article, we propose the practice of solving probability paradoxes and puzzles for the purpose since these problems are often complex, subtle and tricky; therefore, their solutions require many aspects of critical thinking. In the following, the Introduction outlines some of the current research on the topic without going into more details. We provide background descriptions of the paradoxes and probability paradoxes in Section 2. Section 3 provides a short description of critical thinking. We present several definitions since there is no clear consensus on one single definition, both in the literature and in the general literature. And in Section 4 current research on using puzzles for enhancing critical thinking is given. We then discuss several probability paradoxes, namely, the Monte Hall paradox, the two-envelope (exchange) paradox and the St. Petersberg paradox, in Sections 5, 6 and 7, respectively. In Section 8, a brief discussion of the statistical hypothesis testing is given emphasizing its controversial nature. We analyse these problems and concepts in such a way that critical thinking is evoked while keeping the technical details to a minimum.

Inspired by the phenomenology of high-critical-temperature superconducting cuprates, we investigate the effect of an anisotropic scattering rate on the magnetoresistance of a metal, relying on Chambers’ solution to the Boltzmann equation. We find that if the scattering rate is enhanced near points of the Fermi surface with a locally higher density of states, an extended regime is found magnetoresistance that varies linearly with the magnetic field. We then apply our results to fit the experimental magnetoresistence of La1.6-xNd0.4SrxCuO4 and speculate about the possible source of anisotropic scattering.

This research aims to explore and analyze the critical success factors (CSFs) that increase the likelihood of successful implementation of tourism PPP projects in China. As an important step toward developing such a protocol, this study identifies and examines 22 critical success factors for tourism PPPs based on a systematic research approach, which includes a rigorous literature review, and semi-structured interviews. A questionnaire survey was conducted to evaluate the relative importance of these 22 CSF. The results show that the top three critical success factors for China’s tourism PPPs are: adequate project evaluation and demonstration; political support and stability; clear and stable policy documents on PPP. Factor analysis indicated that the 22 CSFs could be grouped into five principal success factor groups. These insights are expected to profoundly influence the development of policies related to tourism PPPs, providing a structured framework to enhance the efficiency and success of these ventures.

The ability of thermoresponsive polymers to respond to temperature with a reversible conformational change makes them promising ‘smart’ materials for solutions in medical and biotechnological applications. In this work, two such polymers and structural isomers were studied: poly(N-isopropyl acrylamide) (PNiPAm) and poly(2-isopropyl-2-oxazoline) (PiPOx). We compare the critical solution temperatures (CST) of these polymers in D2O and H2O in the presence of Hofmeister series salts, as results obtained under these different solvent conditions are often compared. D2O has a higher dipole moment and electronegativity than H2O, which could significantly alter the CST transition. We used two complementary methods to measure the CST, dynamic light scattering (DLS) and differential scanning calorimetry (DSC), and found that the CST decreased significantly in D2O compared to H2O. In the presence of highly concentrated kosmotropes, the CST of both polymers decreased in both solvents. The influence of the kosmotropic anions was smaller than the water isotope effect at low ionic strengths but considerably higher at physiological ionic strengths. However, the Hofmeister anion effect was quantitatively different in H2O than in D2O, with the largest relative differences observed for Cl-, where the CSTs in D2O decreased more than in H2O measured by DLS but less by DSC. PiPOx was more sensitive than PNiPAm to the presence of chaotropes. It exhibited much higher transition enthalpies and multistep transitions, especially in aqueous solutions. Our results highlight that measurements of thermoresponsive polymer properties in D2O cannot be compared directly or quantitatively to application conditions or even measurements performed in H2O.

Converting chemical energy from green hydrogen to electricity using Membrane Exchange Protons Fuel cell (PEMFC) is a promising solution in various applications such e-mobility and building facilities. The electrical efficiency of PEMFCs can reach 60%. However, they are immensely sensitive to the working temperature, requiring good thermal management. Active thermal management systems are expensive and energy-consuming. Passive thermal management systems enable PEMFC thermal management without additional energy consumption. Here various passive thermal management technologies are reviewed. Different techniques are thorougly described and critically compared in terms of complexity, efficiency, cooling rate, scope of applicability, and the sizes of PEMFCs to which they apply. The conclusions provide a solid background for further investigations, and recommendations for future work are suggested.

Sepsis is associated with dysregulated cortisol secretion, leading to abnormal levels of cortisol in the blood. In the early stages of sepsis, cortisol levels are typically elevated due to increased secretion from the adrenal glands. However, as the disease progresses, cortisol levels may decline due to impaired adrenal function, leading to relative adrenal insufficiency. The latter is thought to be caused by a combination of factors, including impaired adrenal function, decreased production of corticotropin-releasing hormone (CRH) and adrenocorticotropic hormone (ACTH) by the hypothalamus and pituitary gland, and increased breakdown of cortisol by enzymes such as 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2). The dysregulation of cortisol secretion in sepsis is thought to contribute to the pathophysiology of the disease by impairing the body's ability to mount an appropriate inflammatory response. The actions of cortisol are mediated through two types of corticosteroid receptors: the mineralocorticoid receptor (MR) and the glucocorticoid receptor (GCR). In sepsis, the expression and activity of GCR is altered, contributing to the pathophysiology of the disease. GCR expression and activity are typically downregulated in sepsis, impairing the body's ability to mount an appropriate inflammatory response. Given the dysregulation of cortisol secretion and corticosteroid receptors in sepsis, there has been considerable interest in the use of steroids as a treatment for sepsis. The rationale for steroid-based treatment is to supplement the body's endogenous cortisol production, restore normal cortisol levels, and improve the body's ability to mount an appropriate inflammatory response. However, the use of steroids in sepsis remains controversial, and clinical trials have yielded mixed results. Some studies have shown that steroid-based treatment can improve shock reversal, reduce the need for vasopressors, and improve overall survival in patients with septic shock, whereas other studies have found no benefit or even harm from steroid-based treatment in sepsis.

On 11 March 2020, the COVID-19 emergency was declared and a large number of patients were admitted to the ICUs. Consequently, ICUs had to recruit nurses from other units as well as Nursing students without working experience in critical patients care. Since Critical nursing competence is crucial to avoid medical errors, the aim of this study was, to describe the level of safety and nursing competence in critical patient care of recruited nurses and students, during the COVID-19 pandemic in ICUs. A cross-sectional descriptive study of 66 participants using the validated competency assessment questionnaire for nurses in hospital care (COM-VA©) was performed. Our results showed that the level of safety perceived in critical patients care by the students on placement in ICUs and mentors scored higher than the rest of the participants. Interestingly, whereas the participant’s COM-VA© score indicated a level of competence good enough to work autonomously, the supervisor/mentor’s COM-VA© evaluation showed that only the group of students on placement obtained this level of competency. Altogether, we found that students on placement in ICU possesses a higher level of safety and COM-VA© scores than the rest of participants probably due to the close support of the mentor.

Parasitic capacitance represents the main error source in measurement systems based on electrical impedance spectroscopy. The capacitive nature of electrodes’ impedance in tetrapolar configuration can give origin to phase errors when electrodes are coupled to parasitic capacitances. Nevertheless, reactive charges in tissue excitation systems are susceptible to instability. Based on such a scenario, mitigating capacitive effects associated with the electrode is a requirement in order to reduce errors in the measurement system. A literature review about the main compensation techniques for parasitic capacitance was carried out. The selected studies were categorized into three groups: (i) compensation in electronic instrumentation; (ii) compensation in measurement processing, and (iii) compensation by negative impedance converters. The three analyzed methods emerged as effective against fixed capacitance. No method seemed capable of mitigating the effects of electrodes’ capacitance, that changes in the frequency spectrum. The analysis has revealed the need for a method to compensate varying capacitances, since electrodes’ impedance is unknown.

It has been suggested that the measured magnetic properties of hydrides under pressure claimed to be high temperature superconductors indicate that the materials are granular superconductors. Such materials will show reduced or no magnetic field expulsion under field cooling, and will trap magnetic fields when the external magnetic field is removed. They will also exhibit hysteretic behavior in magnetoresistance and other transport properties. Here we point out that hysteresis in transport properties has never been reported for hydrides under pressure. Its presence, with the expected features, would indicate that the materials trap magnetic flux, hence that they can sustain persistent currents without dissipation, something that all superconductors can do. Conversely, its absence would indicate that these materials are not superconductors.

Critical illness has been recognized to acutely influence bone metabolism and, consequently, bone mineral density. The main purpose of this study was to describe bone metabolism changes in adult survivors of critical illness in the attempt to correlate changes with severity scores. It is an open, prospective, observational, monocentric study on patients admitted to the ICU was conducted, evaluating bone metabolism at baseline (within 72 hours of ICU admission), 6 months, and 12 months. Fifty-nine patients admitted to the ICU (63% males), mean age 58 ± 16 years, were enrolled. Of these, 20 patients (34%) completed the one-year follow up. At baseline, bone resorption showed an increase, which was maintained at 6 months, with normalization at 12 months. Patients showed, in a majority of cases, hypovitaminosis D with hyperparathyroidism at baseline with subsequent normalization. A trend towards a correlation was described between severity scores and serum 25(OH) vitamin D and bone turnover marker levels. These results contribute to the confirmation of a positive association between critical illness requiring ICU and bone metabolism changes. This study poses the bases for further studies to evaluate bone health in ICU patients.

Objective: This study aims to identify the impact of nutritional factors on mechanical ventilation duration for critical patients. Patients and Methods: The current study was a single-center, prospective observational design which enrolled one-hundred critically ill patients who were admitted to an intensive care unit (ICU). It demonstrates purposive sampling and also performs the descriptive nutritional factors influencing the mechanical ventilation duration. Daily calories target requirement scale (DCRS), subjective global assessment form (SGA), dyspnea assessment form, and APACHE II have been used as methods in the study along with time to initial enteral nutrition (EN) after 24-hour admission and daily calories target requirement over 7 days to assess patients. Data is analyzed using the multiple regressions. Results: As a result, nutritional status monitoring, time to initial EN, calories and target requirements are statistically positive significance associated with the mechanical ventilation duration respectively (R = 0.54, R = 0.30, R= 0.40, p < 0.05). However, age, illness severity, and dyspnea scales are not associated with the mechanical ventilation duration (p> 0.05). Therefore, the nutritional status, malnutrition scores and calorie target requirements can be used to significantly predict the mechanical ventilation duration. The predictive power is 58 and 28.0% of variance. The most proper influencer to predict the mechanical ventilation duration is nutritional status or malnutrition scores. Conclusion: The research findings show that the nutritional status, time to initial EN, and calorie target requirement within 7 days of admission are associated with the mechanical ventilation duration in the critical patients. Therefore, it can be used to develop guidelines reducing the mechanical ventilation duration and to promote the ventilator halting for critical patients.

History learning is often regarded as something that is considered unimportant and boring to be taught in the modern era like now. The existence of history learning itself is still important enough to be studied in the 21st century with all its benefits and uses. One of the uses of history is as a reasoning education. The research questions are how do we take advantage of history learning as reasoning and critical thinking education in the 21st century and how the usage of new media can make historical learning looks more interesting. The method used in this article is literature review with data obtained and analyzed from several journals and research results related to history learning and reasoning education, especially forms of critical thinking in the 21st century. From the results of the research, it was found that there was a link between learning history and its relation as a form of critical thinking in the 21st century, in several ways, such as teaching history based on historical thinking, and the usage of new media in history learning.

The complex systems that require safety are the Safety Critical Systems. Maintaining these systems is a big challenge. Now a days, safety is a very critical requirement for the latest systems. Safety critical systems must be safe. Different approaches to ensure quality and safety in safety critical systems has been discussed in this paper. A comparison is also conducted between these various approaches. Safety critical systems must remain more influential in future.

Background: The financial austerity policy imposed to Portugal by Troika - the European Commission, European Central Bank and International Monetary Fund in 2011, led to a tremendously social crisis. Under these dominant trends in Europe, which were felt especially in certain countries, such as Portugal, we feel ourselves forced into an analysis and reflection on the impact of this conjuncture in social workers, especially analyzing the role played by social workers and its critical consciousness relative to this neoliberal model and imposed austerity policies. Methods: This article results from an analysis of empirical data collected after the entry of Troika in Portugal, during 2013. Were conducted 26 in-depth interviews to front line social workers, with the purpose of obtaining a narrative of their daily work practice and with the concern of encouraging reflection on them. Results: Analysis shows the predominance of a maintenance role at the expense of more emancipatory approaches and thus, this results point to the relationship of this maintenance role with the sociological paradigm of social regulation and shows also, how social work is still attached to a conservative agenda. Secondly, one finds a weak critical reflection among social workers, being very afraid to speak out against the system, taking on a submissive attitude and subservient to the policies of social cuts imposed. The analysis then raises the challenge for social workers to develop a critical reflexivity Conclusion: The results highlight several important observations in terms of social woker role and that a critical activity is urgently required to social workers.

Background: To investigate the association between enteral feeding and the risk of pneumonia in critical care adult patients. Methods: An updated literature review of studies discussing between 2016 and 2023. CINAHL, Cochrane, Embase, PubMed, Scopus, and Web of science databases were used to explore studies regarding our subject, the association between enteral feeding and the risk of pneumonia in critical care adults. Results: Enteral nutrition (EN) has been linked to a significant reduction in pneumonia, as well as shorter ICU or hospital stays, and decreased mechanical-ventilation duration in numerous studies. Conversely, pneumonia risk and other infections, as well as the fatality rate, has been found to increase with EN. Early initiation of EN within 48 hours, along with a low-calorie diet containing (< 600 Kcal/day) demonstrated a notable decrease in the occurrence of Ventilator-Associated Pneumonia (VAP) when contrasted with delayed EN and a high-calorie diet. EN was associated with a marked decrease in adverse events including aspiration pneumonia, emesis, and the escalation of respiratory support. Conclusion: EN is safe and effective in critically ill patients. It is advisable for future research to investigate the monitoring of larger sample sizes to ascertain the most effective feeding methods in the intensive care unit.

Background: Electrical Impedance Tomography (EIT), combined with variable ventilation strate-gies and Artificial Intelligence (AI), is poised to revolutionize critical care by transitioning from reactive to predictive approaches. This integration aims to enhance patient outcomes through personalized interventions and real-time monitoring. Methods: This narrative review explores the principles and applications of EIT, variable ventilation, and AI in critical care. EIT’s impedance sensing creates dynamic images of internal physiology, aiding in the management of conditions like Acute Respiratory Distress Syndrome (ARDS). Variable ventilation mimics natural breathing variability to improve lung function and minimize ventilator-induced lung injury. AI enhances EIT through advanced image reconstruction techniques, neural networks, and digital twin technology, offering more accurate diagnostics and tailored therapeutic interventions. Conclu-sions: The confluence of EIT, variable ventilation, and AI represents a significant advancement in critical care, enabling a predictive, personalized approach. EIT provides real-time insights into lung function, guiding precise ventilation adjustments and therapeutic interventions. AI inte-gration enhances EIT's diagnostic capabilities, facilitating the development of personalized treatment plans. This synergy fosters interdisciplinary collaborations and sets the stage for in-novative research, ultimately improving patient outcomes and advancing the future of critical care.

Adaptation to the impacts of human induced global heating is inevitable. For a socially just and ecological sustainable adjustment to these new circumstances, we need to draw from diverse knowledge systems while, simultaneously, foster a social-ecological transformation. We approach these concerns through the concept of community-based adaptation (CBA) and discuss remedies. Synergies with feminist knowledge systems and indigenous ways of living show the transdisciplinary essence of CBA. By abstracting from its origin and overlapping disciplines, revealing the social metabolism as a common problem, CBA is prone to achieve more equitable and sustainable adjustments. Transdisciplinarity itself and the current related CBA literature point beyond mere adjustments and call for a redesign of the social metabolism, thereby shifting from adaptation to global heating towards adaptation with nature by focusing on social provisioning. An engagement with transformative adaptation and heterodox economics further shows the potential of CBA to serve as an instrument in support of a social-ecological transformation by addressing root causes of vulnerability and by fostering epistemic justice. Reflecting these points back on the epistemological and ontological assumptions of CBA, the viewpoint proposes critical realism as a guiding philosophy of science to move forward.

Purpose: To identify factors linked with nutritional risk via the Malnutrition Universal Screening Tool scale assessment among critically ill patients from a hospital in Cali (Colombia). Materials and methods: A retrospective, analytical observational study was conducted with patients admitted to an intensive care unit (ICU). Sociodemographic, clinical, hematological, and biochemical parameters were analyzed, as well as their association with nutritional risk and patient mortality. Binary logistic regression was applied to outline nutritional risk. Results: Overall, 28.4% prevalence of elevated nutritional risk was observed. An association was found between nutritional risk and hemoglobin and hematocrit values, primary diseases accounting for ICU admission, gastrointestinal symptoms, and nutritional support route (p < 0.05). Mortality was 11.6% and it was correlated with nutritional risk, hemoglobin, and blood urea nitrogen. Conclusions: Gastrointestinal symptoms and the type of nutritional support received during hospitalization may increase nutritional risk, whereas polycythemia was a protective factor. We found an associative model to determine nutritional risk with high specificity and an adequate diagnostic validity index.

With the rise of serious problems of urbanization and climate change, the call for intelligent and sustainable urban development is increasing nowadays. Therefore, smart cities have become a hot topic in academia, industry, and politics, resulting in the emergency of numerous smart city programs and projects. This study selected 26 evaluation frameworks proposed in recent years or large-scale research projects that have lasted for many years and analyzed and compared them from the 7 aspects of generalizability, comprehensiveness, availability, flexibility, scientific, transparency, and interpretability. The result indicates that the current smart city evaluation framework still needs to be upgraded and updated. These standards can not only guide the development direction and hotspot of the future smart city evaluation model but also serve as a guide for model demanders to test results and an effective tool to verify the framework designed by themselves.

We evaluated the impact of COVID-19 restriction on the angioplasty service and outcome of critical limb ischaemia (CLI) patients undergoing lower limb angioplasty in a UK secondary care setting. Consecutive patients were analysed retrospectively. Pre-COVID-19 (08/2018-02/2020), 106 CLI-patients (91% Fontaine 4; 60% diabetes mellitus) and during COVID-19 (03/2020-07/2021) 94 patients were treated (86% Fontaine 4; 66% diabetes mellitus). While the average monthly number of patients treated did not change, the proportion of day cases significantly increased (53% to 80%) and hospitalised patients decreased. Patients treated in <=14/5 days after referral significantly increased to 64/63%. Kaplan-Meier survival analysis (30-day/1-year) showed that neither wound healing nor mortality were significantly changed during COVID-19. In day cases, 1-year but not 30-day major amputations significantly increased, and clinically driven target lesion revascularisation decreased during COVID-19. 1-year mortality was significantly worse in hospitalised as compared to day cases (14% vs 43%) at similar wound healing rates (83% vs 84%). The most frequent known-causes-of-death were infectious disease (64%) and cardiovascular (21%) was less frequent. Despite COVID-19 restriction a safe and effective angioplasty service was maintained while shortening waiting times. Very high mortality rates in hospitalised patients may indicate that CLI should be treated more aggressively and earlier.

The global shipping industry faces many uncertainties which impact on how organisations within this sector will perform in the future. Research in the critical success factors which impact global shipping industry in the digital era is lacking. This study plugs the gap in the literature by identifying four key critical success factors which are innovation capability, risk governance capability, leadership and strategic capability and technological capability. In addition, this study also found three organisational performance measures that are useful for senior management teams within the industry, namely, financial performance, operational performance and marketing performance. The findings establish a set of critical success factors and the corresponding relationships between the identified critical success factors and the identified organisational performance measures. The paper also provides managerial insights for industry practitioners for defining, prioritising and allocating resources in order to improve organisational performance.

(1) Background: Ventilator-associated pneumonia (VAP) causes high mortality among patients with respiratory disease and imposes major burdens on healthcare infrastructure. Models that use electronic health record data to predict the onset of VAP may spur earlier treatment and improve patient outcomes. We developed and studied the performance of interpretable machine learning (ML) models that predict the onset of VAP from electronic health records (EHRs); (2) Methods: We trained Logistic Regression (LR), full feature Explainable Boosting Machine (fEBM), and eXtreme Gradient Boosting (XGBoost) ML models on data from the MIMIC- III (v1.3) database. Model performance was measured by area under the receiver operating characteristic curves (AUCs). We trained a minimal-feature EBM model (mEBM) with features derived from white blood cell (WBC) counts, duration of ventilation, and Glasgow Coma Scale (GCS). Finally, model robustness was evaluated on randomly sparsified EHR datasets; (3) Results: The fEBM model outperformed the XGBoost and LR models at 24 hours post-intubation. The mEBM model maintained an AUC of 0.893. The fEBM model performance remained robust on sparsified datasets; (4) Conclusions: Our novel interpretable ML algorithm reliably predicts the onset of VAP in intubated patients. Integration of this EBM-based model into clinical practice may enable clinicians to better anticipate and prevent VAP.

Background: The Sequential Organ Failure Assessment (SOFA) is a scoring system used for the evaluation of disease severity and prognosis of critically ill patients. The impedance ratio (Imp-R) is a novel mortality predictor. Aims: This study aimed to evaluate the combination of SOFA + Imp-R in the prediction of mortality in critically ill patients admitted to the emergency department (ED). Methods: A retrospective cohort study was performed in adult patients with acute illness admitted to the ED of a tertiary-care referral center. Baseline SOFA score and bioelectrical impedance analysis to obtain the Imp-R were performed within the first 24 hours after admission to the ED. A Cox regression analysis was performed to evaluate mortality risk of initial SOFA score plus Imp-R. Harrell's C-statistic and decision curve analyses (DCA) were performed. Results: Out of 325 patients, 240 were included for analysis. Overall mortality was 31.3%. Only 21.3% of non-surviving patients died after hospital discharge, and 78.4% died during hospital stay. Of the latter, 40.6% died in the ED. SOFA and Imp-R values were higher in non-survivors and were significantly associated with mortality in all models. The combination of SOFA + Imp-R significantly predicted 30-day mortality, in-hospital mortality, and ED mortality with area under the curve (AUC) of 0.80 (95% CI: 74-0.86), 0.79 (95% CI: 0.74-0.86) and 0.75 (95% CI: 0.66-0.84) respectively. The DCA showed that combining SOFA + Imp-R improved the prediction of mortality through the lower risk thresholds. Conclusion: The addition of Imp-R to baseline SOFA score at admission to the ED improves mortality prediction in severely acutely ill patients admitted to the ED.

The aim was to evaluate levels of compassion fatigue in nursing professionals working in complex care units of a Brazilian university hospital. A cross-sectional, descriptive, and correlational study was carried out with nursing workers from complex care units of a University Hospital. Data were collected in the second half of 2019, in the pre-pandemic period of COVID-19, using the Brazilian version of the Professional Quality of Life Scale (ProQoL-BR). A total of 146 individuals partici-pated, including 41 (28.1%) nurses, 92 (63.0%) nursing technicians and 13 (8.9%) nursing assis-tants. It was observed that 26.1% presented high level of compassion satisfaction. For 17.5% there was level of burnout and 49.7%, medium level of burnout; and 22.0% with high and 46.1% with medium level of secondary traumatic stress. Twenty-eight (19.2%) professionals had compassion fatigue, of which 16 (57.1%) were nursing technicians. There is a high percentage of professionals with medium and high rates of burnout and secondary traumatic stress, a fact that is reinforced by the presence of compassion fatigue in almost one fifth of the studied individuals. These results highlights how much the health of these workers can be affected by living with traumatic patient experiences.

The overarching purpose of this review was to highlight the utility of different aerobic field tests in terms of the parameters they provide, with a specific focus on shuttle running and all-out testing. Various field tests are discussed in detail and are categorised according to linear continuous running tests (e.g. 12-minute Cooper Test, University of Montreal Track Test [UMTT], 1200/1600 m time trials, 3-minute all-out test for running [3MT]), intermittent shuttle running tests (e.g. yo-yo inter-mittent recovery test level 1 [YYIR1], 30-15 intermittent fitness test [IFT], and the intermittent all-out shuttle test [IAOST]), and continuous shuttle running tests (e.g. 1.2 km shuttle run test [1.2SRT], maximal multi-stage 20-m shuttle test [MSR], 25-m, 30 m and 50-m 3-minute all-out shuttle test [AOST]). Readers will be guided through the theoretical and practical underpinnings of the 3MT methodology, where the all-out testing methodology is stationed within the testing paradigm, and how to practically implement and interpret the results thereof.

Aim: Aim of our study was to evaluate incidence and causative factors for acute kidney injury in hepatopancreaticobiliary (HPB) surgeries. Material and Methods: All the HPB surgeries performed between April 2018 to March 2020, in our institution have been analysed for acute kidney injury. Acute kidney injury defined according to acute kidney injury network classification. Categorical variables were evaluated by chi square test and fisher t test wherever approptiate and continuous variables by Mann Whitney U test. Statistical analysis was done using SPSS version 23. P< 0.05 was considered significant. Results: We performed 195 HPB surgeries between April 2018 to March 2020, Which included 114 biliary surgeries, 57 liver surgeries and 23 pancreas surgeries. 10 patients developed Acute Kidney Injuries. (AKI) On Univariate analysis AKI was associated with open surgeries, intra operative hypotension and liver surgeries, higher ASA grade, increase operative time, more blood products used, higher CDC grade of surgery and more hospital stay before diagnosis of AKI. However on multivariate analysis only higher ASA score independently predicted Acute Kidney Injury. (p=0.003, odds ratio 15.659, 95% confidence interval 2.54-93.36). AKI was also significantly associated with mortality. (p <0.0001). Conclusion: Pre operative higher ASA grade independently predicted post operative acute kidney injury. Post operative AKI is significantly associated with mortality.

A debris flows generation related to a poorly sorted mixture of soil, catchment topography and rainfall characteristic. Runoff of some depth on valley resulting from intensive rainfall can incur the sediments movement of beds or adjacent banks. The fluid flow in channel affected by rainfall parameters combinations, such as duration, intensity, cumulative rainfall, etc., is the key factor for debris movement. In this paper, the rainfall characteristics and occurrence conditions of debris flow in Xiongmao gully on July, 26th, 2016, have been explored, combined with field survey and indoor simulation experiment on the collected critical discharge parameters of debris movement. Further, debris distribution and the critical discharge characteristics have been analysed, by means of investigation on the catchment topography and occurrence cause of the debris flow, analysis of the critical discharge parameters on which the channel debris began to move, and K value clustering analysis method to characterize the rainfall pattern of the studied area, the discharge calculation of debris flow occurring in different rainfall patterns. The results have shown that, for the debris flow occurrence in Xiongmao gully, the debris initiation on the middle reaches of the gully provide the majority of solid particles for the disaster on July, 26th, 2016, and the upstream confluent provided catchment. Based on the relationship obtained from laboratory test, in which the calculated critical discharge was 43.8m3/s, less than the peak discharge (Qc =66.7m3/s), calculated by morphological method. In addition, it has been indicated that the dominated rainfall patterns of the studied area are first-quartile and second-quartile, that is, the rainfall is primarily at earlier or middle to preliminary stage of this time rainfall event. The critical discharge for the occurrence of debris flow on July, 26th was achieved 20a rainfall frequency, the larger runoff volume generated on shorten heavily rainfall. Based on individuality characteristics, such as distributed hydrological analysis, critical discharge and rainfall pattern of debris flow, the forewarning could be more efficient.

In an era characterized by a move towards a “knowledge society”, universities are central in fostering “knowledgeability”, that is the reflexive understanding of knowledge in knowledge societies. The objective of “knowledgeability” can be met through creating a stronger link between education and research. Furthermore, overall student performance, for example in critical thinking and problem solving, can be improved if research-related activities are incorporated into the curriculum. The aim of this paper is to use inter-national examples to discuss the research- education nexus from four different perspectives, namely context, policy, im- plementation and quality, with case studies from higher education institutions in Singapore and Sweden. We suggest that different integrative technologies can be used to enhance the links, but it will be essential to consider the inputs of training, service and support in using new technology. Interestingly, the act of evaluating the link between edu- cation and research will increase awareness of this linkage by stakeholders involved in both education and research. In turn the link can be strengthened, contributing to increased quality in both education and research.

Amine containing polymers are extensively studied as special carriers for short-chain RNA (13–25 nucleotides) which are applied as gene silencing agent in gene therapy of various diseases including cancer. Elaboration of the oligonucleotide carriers requires knowledge about peculiarities of oligonucleotide - polymeric amine interaction. Critical length of the interacting chains is the important parameter which allows to design sophisticated constructions containing oligonucleotide binding segments, solubilizing, protective and aiming parts. We studied interaction of (TCAG)n, n=1-6 DNA oligonucleotides with polyethylenimine and poly(N-(3-((3-(dimethyl­amino)propyl)(methyl)amino)propyl)-N-methylacrylamide). Critical length for oligonucleotides in interaction with polymeric amines is 8-12 units and complexation at these length can be accompanied by "all-or-nothing" effects. New dimethylacrylamide based polymers with grafted polyamine chains were obtained and studied in complexation with DNA and RNA oligonucleotides. The most effective interaction and transfection activity into A549 cancer cells was found for a sample with average number of nitrogens in polyamine chain equal to 27, i.e. for a sample in which all grafted chains are longer the critical length for polymeric amine - oligonucleotide complexation.

This article explores the intricate functioning of the human brain, highlighting how it operates near a critical state to optimize memory storage, adaptability, and the generation of thoughts. Through complex, fractal-like neural networks and brain waves, the brain largely governs our actions via subconscious processes, allowing for rapid, automated responses while reserving conscious thought for novel or complex tasks. Reasoning and planning emerge from the interplay of episodic memory and various neural networks such as Default Mode Network (DMN), Salience Network (SN), and Executive Network (EN), guiding decisions and actions. The "self" and “consciousness” are portrayed as functional illusions, which is being continuously constructed by dynamic neural activity, while free will is examined as a deterministic illusion shaped by prior neural states. We have argued that the brain's response to the physical world is a blend of subconscious automation and conscious sensory processing, thus, reality navigating through an evolving neural plasticity that promotes creativity and the illusion of a coherent, freely acting self. We discuss how does the mind select what to think about, how does it begin? Online and offline state of mind. We address what is an intelligence, understanding, creativity. We propose individual neuronal cells might store information beyond synaptic changes, the pathways through which neuronal thoughts propagate and Darwinian-like evolution of thoughts in minimizing surprises. We have drawn some parallels between the human brain and Large Language Model (LLM) like ChatGPT in terms of their functional roles.

In this paper, we consider the Cauchy problem of a time fractional nonlinear diffusion equation. According to the Kaplan’s first eigenvalue method, we first prove the blow-up of the solutions in finite time for some sufficient conditions. We next give sufficient conditions for the existence of global solutions by using the result of Zhang and Sun. In conclusions, we find the second critical exponent for the existence of global and non-global solutions via the decay rates of the initial data at spatial infinity.

Software systems are often maintained by a group of experienced software developers, in order to ensure that faults which may bring the system down are less likely. Large turnover in organizations such as CERN makes it important to think of ways of onboarding newcomers on a technical project rapidly. This paper focuses on optimizing the way that people get up-to-speed on the business logic and technologies used on the project, using a knowledge-imbued large language model that is enhanced using domain-specific knowledge from the group or team’s internal documentation.

Quantitative determination of the critical size of inclined coal pillar in old goaf water affected area is of great significance for water damage prevention and safe mining. The critical size of inclined waterproof coal pillar is derived by using theoretical analysis, numerical calculation and field engineering practice for the stability of the waterproof coal pillar in old goaf water affected area of 1303 working face of Dananhu I mine in Xinjiang region. Firstly, a force model of inclined waterproof coal pillar was established to reveal the law that the critical size of the coal pillar increases with the increase of coal seam inclination under the action of asymmetric load. Then, numerical simulation was applied to reveal the dynamic evolution process of plastic deformation-destabilization-destruction of section coal pillar under the influence of mining and single-side water pressure, and the critical size of waterproof coal pillar in study area was determined to be 19.09m. Finally, measures such as pumping and pressure relief and slurry reinforcement were adopted to reduce the deformation rate of the roadway on side of waterproof coal pillar, which ensured the stability of the coal pillar and roadway and the safe recovery of the working face.

This study assessed the impact of counter-mapping on university students' perception and knowledge of their cities, focusing on cultural diversity, urban dynamics, and social challenges. Using a quasi-experimental design with pretests and posttests in the province of Alicante, Spain, changes in the understanding of urban geography, everyday life, and cultural diversity were analyzed among 54 Geography Didactics students. Likert scale surveys and open-ended questions were employed, complemented by statistical and qualitative analyses, to measure knowledge and perceptions before and after the counter-mapping project. The results indicate that although quantitative correlations did not show statistically significant significance, qualitative analysis revealed significant and profound learning. Participants uncovered the hidden layers of their urban environments and gained a better understanding of the complexities and challenges of their cities. The project promoted the development of critical skills such as analytical thinking, active research, and effective communication, proving to be a valuable pedagogical tool that surpasses the limitations of traditional teaching methods and encourages active and committed citizenship. This inclusive and multidimensional approach enriches the diversity of experiences and knowledge, significantly contributing to the teaching of urban subjects, community engagement, and social responsibility, laying the groundwork for proper tourist, cultural, social, or urban planning of city spaces.

A significant percentage of children suffer from neurodevelopmental aberrations, which have long-term effects on both individuals and society. Since the developmental timelines of different brain regions vary, the type, severity and timing of harmful exposures are crucial for understanding the specific pathological processes and consequences involved. During development, the cerebellum is one of the first brain structures to begin to differentiate, but one of the last to achieve maturity. This relatively long period underscores its vulnerability to detrimental environmental exposures throughout gestation. Moreover, as the postnatal functionality of the cerebellum is multifaceted, enveloping sensorimotor, cognitive, and emotional domains, prenatal disruptions in cerebellar development can result in a variety of neurological and mental health disorders. Here, we review major intrauterine insults that affect cerebellar development in both humans and rodents, ranging from abuse of toxic chemical agents such as alcohol and nicotine, to stress and sleep, malnutrition as well as infections. Understanding these pathological mechanisms in the context of the different stages of cerebellar development in humans and rodents may help us to identify critical and vulnerable periods and thereby to prevent the risk of associated prenatal and early postnatal damage that can lead to lifelong neurological and cognitive disabilities.

Background: Nowadays, the prevalence of digital device usage has shifted the demands for multifocal intraocular lenses. To accurately capture outcomes, clinical practice must evaluate digital reading performance. We aimed to assess the digital reading performance using a digital device in patients with diffractive multifocal intraocular lenses. Methods: Patients with bilateral diffractive multifocal intraocular lens implantation were included in the study. Monocular and binocular uncorrected and corrected visual acuity was measured using the LogMAR chart and the MNREAD application. Binocular uncorrected defocus curves were obtained using the LogMAR chart at 4m. The reading acuity was measured using the MNREAD application with positive and negative display polarities. The mean digital critical print size (CPS) was recorded using the MNREAD application at 40cm. Results: Our study reported uncorrected distance, intermediate, and near visual acuity were -0.084 ± 0.079, -0.014 ± 0.078, and 0.040 ± 0.081, respectively. The mean reading acuity at three months postoperatively with positive display polarity at 60cm and 40cm was -0.115 ± 0.102 and -0.008 ± 0.083, respectively. The mean digital CPS at three months postoperatively was 0.238 ± 0.100 logMAR. Conclusions: Incorporating digital reading performance measurements provides additional advantages in assessing the effectiveness of bilateral diffractive multifocal intraocular lens implantation.

The characteristics of exhaled aerosols outside the human respiratory airway are of significant importance in understanding virus transmission, yet they remain poorly understood. In order to effectively prevent and control the spread of respiratory infectious diseases, this study numerically investigates the exhaling characteristics of aerosols exhaled from the bronchus or larynx of a human upper airway model. This is achieved using the Euler-Lagrange method and considering various aerosol diameters (dp=0.1, 0.3, 0.5, and 1-20 μm) as well as five expiratory flow intensities (Q=15, 30, 60, 90, and 120 L/min). The important findings of this study are as follows: (1) Expiratory airflow exhibits complex flow phenomena, including jet-flow, flow separations, and vortex structures, with their characteristics being influenced by the expiratory flow intensities. (2) The exhaling characteristics of aerosols vary depending on the combined effects of expiratory flow intensities, virus aerosol diameters, and initial exhaled locations from either the bronchus or larynx. (3) A critical diameter (dc) is identified to represent the size at which aerosols can effectively exit the respiratory airway and potentially pose a transmission risk. This critical diameter is identical for aerosols exhaled from both the bronchus and larynx under the same expiratory flow intensity, but it decreases as the expiratory flow intensity increases. In conclusion, expiratory flow intensity is the most critical factor in determining whether aerosols can be expelled from the respiratory airway, as well as influencing the critical diameter (dc) for aerosols initially located in/after the larynx.

The circular economy is based on maintaining a circular flow of resources. Policymakers face difficulties in balancing national security and circular economy aspects in the field of mineral resources policy. With a uniquely expanded input-output table, this study estimates the final destination of several critical minerals (lithium, cobalt, yttrium, lanthanum, cerium, neodymium and dysprosium) and base metals (iron, copper and aluminum) in the Japanese economy for 2015. Our model shows quite a good similarity between the estimated composition and the actual data of products. The results reveal a detailed distribution of critical minerals and indicate prioritized implementation for creating and maintaining a circular flow of critical minerals. Developed decision flow guidance provides a comprehensive approach to national security and circular economy aspects for policymakers. For further actions, inclusive indicator development is required for policymakers to support the determination of implementation possibilities from social and technological aspects.

This study investigates the critical success factors (CSFs) of Lean Six Sigma (LSS) implementation and their impact on organizational growth in Nigerian enterprises. The objectives were to identify crucial CSFs for successful LSS deployment and assess their significance in achieving organizational growth. A mixed-method approach was used, including literature analysis, expert judgments, and a survey of 130 participants from various industries. The survey questionnaire employed a 5-point Likert scale to collect data on LSS CSFs and implementation success metrics. Structural equation modeling (SEM) with SmartPLS 4.0 analyzed the data, revealing that LSS CSFs significantly contribute (up to 39.2 percent) to the success of LSS implementations. The study identified 12 critical LSS CSFs, categorized into workers, business, and management, each influencing LSS implementation. Recommendations include creating a supportive environment, providing comprehensive training, and prioritizing continuous improvement efforts for successful LSS deployment. Future research possibilities include longitudinal studies, sector-specific analyses, and qualitative investigations to deepen understanding and enhance LSS implementation outcomes. In conclusion, successful LSS implementation empowers Nigerian organizations with improved productivity, waste reduction, and sustainable production systems, leading to overall growth and success.

Recently a measure termed F* was described, as an interpretable transformation of the F measure, also known as the Dice coefficient. Using elementary mathematical methods, it is shown that F* is in fact identical to a previously described measure, monotonically related to the F measure, and variously termed in previous publications, dating from the late 19^th to the late 20^th century, as the ratio of verification, the Jaccard similarity measure or index, the threat score, the Tanimoto index, and the critical success index. The origins of these different terms in different disciplines (weather forecasting, ecology, machine learning) may explain the repeated independent redescription of this measure.

High-flow Nasal Cannula (HFNC) oxygen therapy is gaining traction globally as a treatment for respiratory failure. There are several physiological benefits and there may be a growing patient preference for HFNC. In this narrative review, we aim to outline the basic mechanisms of HFNC, who can use it and review the literature regarding its utility both in the critical care setting, as well as in the home setting for chronic hypercapnic respiratory failure with an emphasis on Chronic Obstructive Pulmonary Disease (COPD). The role of non-pharmacological interventions like non-invasive ventilation (NIV) and HFNC in the prevention of hospital readmissions following acute exacerbations of COPD (AECOPD) is an area of increasing importance because randomised controlled trials and systematic reviews have found measures like nurse-led predischarge bundles to be clinically ineffective and to have a high cost per quality adjusted life year. This review therefore considers the evidence of NIV vs HFNC in the context of AECOPD and the application of HFNC at home in the prevention of AECOPD. We also look at applications of HFNC in specific settings, such as in the peri-operative period, emergency department, acute (mainly Critical Care) setting including in immunocompromised patients and palliative care.

In today's complex and rapidly changing world, integrating values, critical thinking, and moral reasoning in language and literature education is crucial for equipping students with the skills to navigate multifaceted ethical dilemmas and become responsible global citizens. This article highlights the connection between language, literature, critical thinking, moral reasoning, and values integration in education. Through language and literature, teachers can incorporate values education in their classroom, which can benefit not only individual students but also society as a whole. Theoretical frameworks such as character education, moral education, and values education provide the basis for this approach. The researcher recommends strategies for incorporating values integration in language and literature curricula, including the use of literary texts that promote critical thinking and moral reasoning skills. The limitations of this approach, including the challenges in assessing the effectiveness of values integration and potential resistance from some stakeholders, are also discussed. Ultimately, this article aims to call on educators to take a proactive role in promoting values integration in language and literature education, guided by the principles of Jesus Christ and the belief that education is not only about acquiring knowledge but developing character as well. Moreover, this concept has a significant and lasting impact on students' overall development that highlights the importance of values and moral reasoning needed to live a better life.

The results of experimental studies of ohmic conductivity degradation in the ensembles of nanostructured anatase bridges under long-term effect of direct current are presented. Stochastic sets of interelectrode partially conducting bridges consisting of close-packed anatase nanoparticles were formed by the seeding particles from drying aqueous suspensions on the surfaces of silica substrates with interdigital platinum electrodes. Multiple-run experiments at room temperature have shown that ohmic conductivity degradation in these systems is irreversible. It is presumably due to accumulated capture of conduction electrons by deep traps in anatase nanoparticles. The scaling analysis of voltage drops across the samples at the final stage of degradation gives a critical exponent for ohmic conductivity as 1.597. This value satisfactorily agrees with the reported model data for percolation systems. At an early stage of degradation, the spectral density of conduction current fluctuations wihin the frequency range of 0.01 Hz - 1 Hz decreases approximately as , while near the percolation threshold the decrease trend changes to . This transition is interpreted in terms of an increasing contribution of blockages and subsequent avalanche-like breakdowns of part of the local conduction channels in the bridges into electron transport near the percolation threshold.

This study introduces a new procedure for three-component spectral matching of seismic ground acceleration records. The procedure involves preserving the phase angle and varying the Fourier amplitudes to match the spectra of the recorded records with a provided target spectrum that represents the spectral values of ground motions in three orthogonal directions. Several three-component recorded records were matched against two target response spectra to test the method. An accurate convergence was achieved in the velocity and displacement records. In addition, the scales among the components’ magnitude were maintained, creating realistic three-component ground motions. Such ground motion inputs are important to qualify critical structures sensitive to three-component motions. Our proposed procedure is novel because the present practices are mostly created based on one-component ground motions.

The paper presents a review of currently available evaluations of the effects of continuously increasing anthropogenic loads on water resources. The increase in the fluxes of elements and compounds into the environment, such as the emission of greenhouse gases and dispersion of nutrients (nitrogen and phosphorus), acidifying gases, and toxic elements and compounds that adversely affect the water quality are considered. The significance of fresh waters as a life support factor of the human populations is demonstrated. Examples are presented to illustrate how key anthropogenic induced processes develop in land waters under the effect of anthropogenic loads, as exemplified by the Russian Kola regions. Climate warming and the increasing dispersion of elements are demonstrated to result in the eutrophication of surface waters even in areas remote from anthropogenic impacted regions. Although the emissions of acidifying gases diminish, the waters are still acidified in acid-vulnerable areas, and the chemical compositions of the waters have been significantly modified over the past decades, which indicates that the changes in the chemical composition of the waters are of irreversible. A new feature of the waters is distinguished: the toxicity of the habitats for aquatic organisms. Arguments are presented for establishing a theoretical approach for evaluating critical loads.

Demand for niobium and tantalum is increasing exponentially as these are essential ingredients for the manufacture of, among others, capacitors in technological devices and ferroniobium. Mine tailings rich in such elements could constitute an important source of Nb and Ta in the future and so alleviate potential supply risks. This paper evaluates the possibility of recovering niobium and tantalum from the slags generated during the tin beneficiation process of mine tailings from the old Penouta mine, located in Spain. To do so, a simulation of the processes that would be required to beneficiate and refine both elements is carried out. After tin carbothermic reduction, the slags are sent to a hydrometallurgical process where at the end niobium oxide and tantalum oxide are obtained. Reagents, water and energy consumption, in addition to emissions, effluents and product yields are assessed. Certain factors were identified as critical, and recirculation was encouraged in the model to maximize production and minimize reagents use and wastes. With this simulation, considering 3000 production hours per year, the metal output from the tailings of the old mine could cover around 1% and 7.4% of the world annual Nb and Ta demand, respectively.

Sustainability is very important in business. The residential high-rise building all firms wanted to successful and sustainability in business. There is need the construction to completed low time, low cost and high quality in construction work. Therefore, real estate developers must find various strategies to use in construction projects to achieve goals and success of the firm. The purpose of this study was to indicate the very importance of knowledge management can lead to sustainability in business. Analyze 14 critical success to sustainability in residential high-rise building projects, collected questions from literature review, and survey in deep interview senior managers of 15 projects real estate development firms listed on the stock market of Thailand. Budget building more than 1000 million baht per project. From conceptual frame work five foundations integrated to knowledge management of critical success (KMITL PROCESS) used made tool survey in deep interview the critical success to sustainability in residential high-rise building project from project managers. Used IBM SPSS evaluated the critical success to sustainability. Found was one very important of critical success to sustainability, which was quality of products x̄ = 4.83. All 14 critical success to sustainability was found can applied made the knowledge management of critical success to sustainability in residential high-rise building project in firm. Especially in the field of construction managements project can used improve of all construction projects.

Part of philosophy is to subject assertions to critical scrutiny, clarifying exactly what the assertion is saying, its implications, and thus its direct plausibility. The goal is to ensure clarity, logical consistency, and rational argumentation in order to arrive at reasoned conclusions. A common problem is that arguments have missing implied premises that, unless explicitly stated, are mistakenly assumed to be true. Here we subject conclusions made regarding the SARS-CoV-2 pandemic to critical scrutiny, revealing their implied premises so that these premises can be explicitly examined and refuted. Specifically, we refute the conclusions that “no one is protected until everyone is protected” and “population lockdowns are required to protect those at high risk of adverse outcomes.” In the end, we argue for the conclusion that “an Emergency Management principles based response to the pandemic, compared to population-wide lockdowns, offers a way to prevent more adverse outcomes from COVID-19, better prevent overwhelmed healthcare, and prevent most of the collateral damage to the wellbeing of the population that has resulted from the lockdowns.”

This review critically assesses the body of research about Measles-Mumps-and-Rubella (MMR) vaccine attitudes and uptake in the United Kingdom (UK) over the past 10 years. We searched PubMed and Scopus, with terms aimed at capturing relevant literature on attitudes, uptake, decision-making, and beliefs about the MMR vaccine. Two researchers screened for abstract eligibility and after de-duplication 934 studies were selected. After screening, 40 references were included for full-text review and thematic synthesis by three researchers. We were interested in the methodologies employed, and grouped findings by whether studies concerned: (1) Uptake and Demographics; (2) Beliefs and Attitudes; (3) Healthcare Worker Focus; (4) Experimental and Psychometric Intervention; (5) Mixed Methods. We identified group and individual level determinants for attitudes, operating directly and indirectly, that influence vaccine uptake. We found that access issues, often ignored within the public “anti-vax” debate, remain highly pertinent. Finally, a consistent theme was the effect of misinformation and lack of knowledge or trust in healthcare, often stemming from the Wakefield controversy. Future COVID-19 immunisation campaigns for children should consider both access and attitudinal aspects of vaccination, and incorporate a range of methodologies to assess progress, taking into account socio-economic variables and the needs of disadvantaged groups.

The era of globalization of the industrial revolution 4.0 was also marked by rapid economic, social, scientific, and technological developments. Currently, the company was demanded to maximize all its potential to compete with other companies. For this reason, it was hoped that companies could understand the importance of knowledge management-based intellectual capital through outreach, externalization, internalization, and combinations that had implications for improving employee performance and competency. This study was to identify and describe the enhancement of performance and competency-based on the optimization of the intellectual capital model in terms of critical thinking analysis. This study used a qualitative approach with critical thinking analysis through literature study methods. The findings results of this study were to improve performance and competency were the basic measurement models of intellectual capital, new intellectual capital measurement models in empirical studies, intellectual capital measurement models with bottlenecks, and environmental-based intellectual capital models. This study concluded that intellectual capital measurement should be determined as accumulation and interpretation in the proposed model for a company that was an applied subject with a qualitative intellectual capital index system, to provide a good tool for companies to managed intellectual capital.

We discuss methods for calculation of critical indices and amplitudes from the perturbative expansions. Several important examples of the Stokes flow through 2D and 3D channels are brought up. Power series for the permeability derived for small values of amplitude are employed to calculation of various critical exponents in the regime of large amplitudes. Special nonlinear approximations valid for arbitrary values of the wave amplitude are derived from the expansions. The technique developed for critical phenomena is applied then for relaxation phenomena. The concept of time-translation invariance is discussed, its spontaneous violation and restoration considered. Emerging probabilistic patterns correspond to a local breakdown of time-translation invariance. Their evolution leads to the timetranslation symmetry complete (or partial) restoration. We estimate typical time extent, amplitude and direction for such restorative process. The new technique is based on explicit introduction of origin in time. After some transformations we come to the exponential and generalized, exponential-type solution with explicit finite time scale, which was only implicit in initial parametrization with polynomial approximation. The concept of crash as a relaxation phenomenon, consisting of time-translation invariance breaking and restoration, is put forward. COVID-19 related mini-crash in the time series for Shanghai Composite is discussed as an illustration.

Therapeutic proteins are used to successfully treat hemophilia, Crohn’s Disease, diabetes, and cancer. Recent product recalls have occurred because of sub-visible particle formation resulting from the inherent instability of proteins. It has been suggested that particle formation is associated with late stage processing steps of filling, shipping, and delivery. Previous works demonstrated that cavitation might occur in therapeutic vials subjected to agitation or accidentally dropped, but that mitigation can be achieved with fluid property manipulation. The goal of this research was to (1) assess the risk of cavitation under common pharmaceutical manufacturing conditions (i.e., pipe contraction and pumps), (2) establish a simple threshold criterion for when particulate will form, and (3) suggest a series of mitigation techniques based on these thresholds. To accomplish these tasks, computational fluid dynamic simulations for a variety of pipe contraction and fluid properties were performed. The results of this research show that reducing the turbulence in a fluid system will reduce the likelihood of cavitation. Additionally, threshold bounds were created that establish a definitive transition at which cavitation will occur.

The paper aims in assessing risks of mandible fractures consequent to impacts or sport accidents. The role of the structural stiffness of mandible, related to disocclusion state, is evaluated through numerical simulations using the finite element method (FEM). It has been assumed that the quasi-static stress field, due to distributed forces developed during accidents, could explain the common types of mandibular fractures. Geometric model of adolescent mandible was built, upon the basis of medical imaging, in CAD software with distinction between cortical layer and inner spongy bone. The finite element model of disoccluded mandible was next created. Mandibular condyles were supposed jammed in the maxillary fossae. The total force of 700 N, simulating an impact on mandible, has been sequentially applied in three distinct areas: centrally, at canine zone and at the mandibular angle. Clinically most frequent fractures of mandible were recognized through the analysis of maximal principal stress and maximal principal strain fields. Mandibular fracture during accidents can be analyzed at satisfactory level using linear quasi-static FE models for designing protections in sport and transport. The proposed approach can be improved by introducing more realistic interactions between condylar processes and fossae.

There is limited evidence for the association between malnutrition and hospital mortality as well as Intensive Care Unit length-of-stay (ICU-LOS) in critically ill patients. We aimed to examine the aforementioned associations by conducting a prospective cohort study in an ICU of a Singapore tertiary hospital. Between August 2015 and October 2016, all adult patients with ≥24 h of ICU-LOS were included. The 7-point Subjective Global Assessment (7-point SGA) was used to determine patients’ nutritional status within 48 hours of ICU admission. Multivariate analyses were conducted in two ways: 1) presence versus absence of malnutrition, and 2) dose-dependent association for each 1-point decrease in the 7-point SGA. There were 439 patients of which 28.0% were malnourished, and 29.6% died before hospital discharge. Malnutrition was associated with an increased risk of hospital mortality [adjusted-RR 1.39 (95%CI: 1.10–1.76)], and this risk increased with a greater degree of malnutrition [adjusted-RR 1.09 (95%CI: 1.01–1.18) for each 1-point decrease in the 7-point SGA]. No significant association was found between malnutrition and ICU-LOS. Conclusion: There was a clear association between malnutrition and higher hospital mortality in critically ill patients. The association between malnutrition and ICU-LOS could not be replicated and hence requires further evaluation.

We describe a vision for a national-scale heavy mineral (HM) map generated through automated mineralogical identification and quantification of HMs contained in floodplain sediments from large catchments covering most of Australia. The composition of the sediments reflects the dominant rock types in each catchment, with the generally resistant HMs largely preserving the mineralogical fingerprint of their host protoliths through the weathering-transport-deposition cycle. Heavy mineral presence/absence, absolute and relative abundance, and co-occurrence are metrics useful to map, discover and interpret catchment lithotype(s), geodynamic setting, magmatism, metamorphic grade, alteration or mineralization. Underpinning this vision is a pilot project, focusing on a subset of the national sediment sample archive, which is used to demonstrate the feasibility of the larger, national-scale project. We preview a bespoke, cloud-based mineral network analysis (MNA) tool to visualize, explore and discover relationships between HMs as well as between them and geological setting or mineral deposits. We envisage that the Heavy Mineral Map of Australia and MNA tool will contribute significantly to mineral prospectivity analysis and modeling here, particularly for technology critical elements and their host minerals, which are central to the global economy transitioning to a more sustainable, decarbonized paradigm.

Background/Objectives: Multisystem Inflammatory Syndrome in children (MIS-C) is a rare but severe post-infectious complication of COVID-19, that often requires admission to the Pediatric Intensive Care Unit (PICU). The present study aimed to compare the demographic, clinical and laboratory characteristics between children diagnosed with MIS-C who were admitted to the PICU or did not require PICU admission. Methods: Children diagnosed with MIS-C from September 2020 to April 2023 were included in this case-control study. Patient’s demographic, clinical and laboratory data, were collected from medical records. Results: Fifty children with MIS-C were included in the study [median (IQR) age: 7.5 (4.3, 11.4) years, 28/50 (56%) males]. Twenty-two (22/50, 44%) children required admission to the PICU. In the multivariate regression analysis, hepatic (OR:12.89, 95%CI: 1.35-123.41, p-value=0.03) and cardiological involvement (OR:34.55, 95%CI: 2.2-541.91, p-value=0.01) were significantly associated with hospitalization at the PICU. Regarding the laboratory and imaging parameters during the first 48 hours from admission, D-dimer levels higher than 4μg/mL and decreased Left Ventricular Ejection Fraction were associated with an increased risk of PICU admission (OR:7.95, 95%CI:1.48-42.78, p-value=0.02 and OR=1.28, 95%CI:1.07-1.53, p-value=0.01). Children who were admitted to the PICU were more likely to develop complications during their hospitalization (10/22, 45.5% vs. 3/28, 10.7%, p-value=0.005) and were hospitalized for more days, than children in the pediatric wards (median length of stay (IQR): 20 (15,28) days vs. 8.5 (6, 14) days, p-value&lt;0.001). Conclusions: In the present study, cardiovascular, hepatic involvement and increased D-dimer levels in children with MIS-C were associated with admission to the PICU.

The Xihan River basin is located in the southern part of Gansu Province, where flood disasters occur frequently in summer and autumn, which easily pose significant risks to human life. In order to improve the accuracy of flood disaster predictions and early warnings, a flood model suitable for this region was constructed based on the HEC-HMS (Hydrologic Engineering Center's-hydrologic modeling system) model and used to determine the critical areal rainfall for flood disasters. Calibration of this model was performed using data of four flood events from May to October between 2020 and 2021, reserving data of two additional flood events for model validation. Using the calibrated HEC-HMS model, the critical areal rainfall was determined for the Pingluo and Tanjiaba hydrological stations in the basin through the model testing method. The results indicate that: (1) The stable infiltration rate of the XiHanShui River Basin was between 0.06 and 0.10 mm/h, with runoff concentration times primarily varying from 22.5 to 24.1 hours, a direct runoff storage coefficient was 0.2 hours, and a base flow index decay constant seted at 0.03 hours. (2) During the calibration and validation periods, the average peak flow relative error was 7.56%, the average runoff volume relative error was 14.76%, the average peak occurrence time difference was -0.5 hours, and the Nash efficiency coefficient was 0.769. (3) The warning areal rainfall for the Pingluo and Tanjiaba hydrological stations were 108.1mm and 128.5mm, and the guaranteed areal rainfall were 230.8mm and 184.6mm. The HEC-HMS model demonstrated high applicability and accuracy in simulating flood events in the XiHanShui River Basin, providing technical support for hydrological research and operational applications in the region.

The study of Internet of Vehicle (IoV) based on Fog Computing (FC) and Artificial Intelligent (AI) has attracted more and more attention. However, there are still many problems require to investigate such as time-critical, scalability, load-balancing, energy consumption, and so on. Focusing on these problems, we proposed an AI-based Vehicle-to-Everything (V2X) model for tasks and resource offloading model for IoVs network, which ensures reliable low-latency communication efficient tasks offloading in IoV network by using Software Defined Vehicular based FC (SDV-F) architecture. To fit to time-critical data transmission task distribution, the proposed model reduces unnecessary task allocation at the fog computing layer by proposing an AI-based task-allocation algorithm in IoV layer to implement task allocation of each vehicle. By applying AI technologies of Reinforcement Learning (RL), Markov decision process, and Deep Learning (DL), the proposed model intelligently makes decision on maximizing resource utilization at the fog layer, and minimizing the average end-to-end delay of time-critical IoV applications. The experiment demonstrates the proposed model can efficiently distribute the fog layer tasks while minimizing the delay.

Traumatic Brain Injury (TBI) is one of the leading causes of death and disability worldwide. Patient treatment and management pose a challenge for healthcare systems. The prognosis of these patients may be influenced by factors such as sex. This study aims to describe the clinical parameters of patients hospitalized in the Intensive Care Unit (ICU) of a Spanish hospital due to Trauma Brain Injury and to establish differences based on sex. Methodology: An observational, cross-sectional, and analytical study was conducted from March 2015 to December 2019. All patients admitted to the ICU during this period who presented isolated significant Traumatic Brain Injury, defined as an abbreviated injury scale (AIS) ≥ 3, were included. Data on baseline characteristics, mechanism of injury, substance use, and acute management in the prehospital and hospital stages (including the need for hospitalization) were recorded. A descriptive and in-ferential analysis was conducted using the chi-square test. Results: A total of 950 patients were ultimately included. The majority of the patients were men (723) with a mean age of 45.16 (± 17.55). There were statistically significant differences in terms of the mechanism of injury (p

The nozzle is the key element of the water jet generator for energy conversion. In order to explore the influence of the nozzle diameter on the pressure characteristics of the supercharged pulsed water jet plenum chamber, a supercharged pulsed water jet pressure acquisition system was established, and the Equations of motion and theoretical pressurization ratio equations of the supercharged pulsed water jet generator were established. The pressurization chamber pressure acquisition experiments under different nozzle diameters were carried out. The research results indicate that there is a critical nozzle diameter. When the nozzle diameter is less than the critical diameter, the pressure in the boost chamber is equal to the product of the driving pressure and boost ratio. As the nozzle changes, there is no significant change in the peak pressure and frequency of the boost chamber; When the nozzle diameter is greater than the critical diameter, there is a non-linear relationship between the boost chamber pressure and the driving pressure. As the nozzle diameter gradually increases, the actual boost ratio gradually decreases, and the peak pressure of the boost chamber further decreases. The nozzle diameter can no longer provide a load for the establishment of fluid pressure in the boost chamber. The research results provide a research basis for further controlling the pressure characteristics of the boost pulse water jet.