The present study is to address performance of the dairy supply chain and emphasizes the significance of reliability of the chain as a fundamental and critical attribute for fulfilling the safety requirements. In order to evaluate the performance of the dairy supply chain, the present study utilizes the reliability attribute, which is an essential and informative system performance indicator. The study considers not only the inputs and outputs but also internal activities and relationships between customers, manufacturers, and suppliers. To minimize calculations and resolve uncertainties and vagueness that may be experienced in the performance evaluation process, this study proposes the use of the Fuzzy Inference System (FIS) approach and evaluates the reliability at each level of the supply chain: supply, manufacturing, and distribution. Combining the reliability of different levels, the study finally calculates the reliability of the entire supply chain. The proposed methodology offers a practical approach for evaluating the reliability performance of a dairy supply chain and can be easily extended to other industries as well. To verify the proposed methodology, a real case in the Iranian dairy industry is chosen to be studied. Results indicate that the proposed methodology can effectively identify bottlenecks or weaknesses in the dairy supply chain and help develop effective strategies to address them. Analyzing factors influencing supply chain reliability can optimize operations, reduce costs, and improve the overall quality of dairy product quality delivered to consumers.

In contrast to its traditional form, in which large, powerful companies were solely and exclusively responsible for supplies, manufacturing, and distribution, the supply chain has undergone substantial change over the past half-century. Today, nearly all supply chain processes are outsourced, thanks to the efforts of innovative, modern companies. The degree of risk associated with contemporary supply chains is greater than the majority of supply chain managers acknowledge, according to an accumulation of studies, analysts, and news outlets. Vulnerabilities within the supply chain remain a significant challenge for numerous organizations. Inadequate management of these risks—which include, but are not limited to, natural disasters, acts of terrorism, cyber assaults, the credit crisis, pandemic scenarios, and war—could lead to significant declines in profitability, productivity, revenue, competitive advantage, and other metrics. Concerns regarding the risk assessment of the supply chain remain unresolved. The objective of this article is to present a risk evaluation framework that can be effectively implemented in the assessment of supply chain risks. This study makes a fundamental contribution to the body of knowledge by providing supply chain managers with a practical instrument for assessing their processes, irrespective of the mathematical underpinnings or the diverse variables employed in risk assessment. A case study from an automotive EMS production is used to compare the outcomes of multiple aggregation methods; the conclusions are then validated by risk and FMEA specialists from the same factory.

The performance evaluation of the Internet of Things (IoT) based supply chain is challenging due to the involvement of multiple decision makers, the multi-dimensional nature of the evaluation process, and the existence of uncertainty and imprecision in the decision making process. To ensure effective decisions are made, this paper presents a fuzzy multicriteria analysis model for evaluating the performance of IoT based supply chain. The inherent uncertainty and imprecision of the performance evaluation process is adequately handled by using intuitionistic fuzzy numbers. A new algorithm is developed for determining the overall performance index for each alternative across all criteria. The development of the fuzzy multicriteria group decision making model provides organizations with the ability to effectively evaluate the performance of their IoT based supply chains for improving their competitiveness. An example is presented for demonstrating the applicability of the model for dealing with real world IoT-based performance evaluation problems.

In the current complex and uncertain macroeconomic situation, improving the inherent resilience of the new energy vehicle industry chain is the key to effectively addressing various risks and challenges, and achieving dynamic balance between high-quality industrial development and industrial chain security. Based on the basic concept of resilience and the actual situation of new energy vehicle industry chain development, this study constructs a comprehensive evaluation index system for the resilience of the new energy vehicle industry chain, which includes four dimensional first-level indicators of coping resistance, adaptive resilience, autonomous control and leading competitiveness. In addition, it is measured by combining the data related to the new energy vehicle industry chain in Changzhou City. Our study shows that the situation on the new energy vehicle industry chain is complicated, and the comprehensive evaluation index system is more favorable for evaluating its resilience level.

The Australian Bureau of Meteorology offers a national operational 7-day ensemble streamflow forecast service covering regions of high environmental, economic and social significance. This semi-automated service generates streamflow forecasts every morning and is seamlessly integrated into the Bureau's Hydrologic Forecasting System (HyFS). Ensemble rainfall forecasts, European Centre for Medium-Range Weather Forecasts (ECMWF) and Poor Man's Ensemble (PME), available in the Numerical Weather Prediction (NWP) suite, are used to generate these streamflow forecasts. The NWP rainfall undergoes pre-processing using the Catchment Hydrologic Pre-Processer (CHyPP) before being fed into the GR4H rainfall-runoff model, which is embedded in the Short-term Water Information Forecasting Tools (SWIFT) hydrological modelling package. The simulated streamflow is then post-processed using the Error Representation and Reduction In Stages (ERRIS). We evaluated the performance of the operational rainfall and streamflow forecasts for 96 catchments using four years of operational data between January 2020 and December 2023. Performance evaluation metrics included CRPS, relative CRPS, CRPSS, and PIT-Alpha for ensemble forecasts and NSE, PCC, MAE, KGE, PBias and RMSE and three categorical metrics CSI, FAR and POD for deterministic forecasts. The skill scores CRPS, relative CRPS, CRPSS and PIT-Alpha, gradually decreased for both rainfall and streamflow as the forecast horizon increased from Day 1 to Day 7. A similar pattern emerged for NSE, KGE, PCC, MAE and RMSE as well as the categorical metrics. Forecast performance also progressively decreased with the higher streamflow regime. Most catchments showed positive performance skills, meaning the ensemble forecast outperformed climatology. Both streamflow and rainfall forecast skills varied spatially across the country – and were generally better in the high runoff generating catchments, and poorer in the drier catchments situated in the western part of the Great Dividing Range, South Australia and mid-west of Western Australia. We did not find any association between model forecast skill and the catchment area. Our findings demonstrate that the 7-day ensemble streamflow forecasting service is robust and draws great confidence from agencies that use these forecasts to support decisions around water resources management.

In the past twenty years, the IT industry has moved away from using physical servers for workload management to workloads consolidated via virtualization and, in the next iteration, further consolidated into containers. In the next step, container workloads based on Docker and Podman as underlying container technologies were orchestrated/automated via Kubernetes or OpenShift. On the other hand, high-performance computing (HPC) environments have been lagging in that process, as there’s still much work to figure out how to apply containerization platforms for HPC in real-life scenarios. Kubernetes and OpenShift have many advantages – generally speaking, container technologies use quite a bit less overhead from the computing perspective while providing many benefits in flexibility, modularity, and maintenance. Therefore, they are ideal for tasks requiring a lot of computing power. There are also some tradeoffs regarding the complexity of these two platforms - they’re just not that user-friendly when used by people without years of experience managing them. In this paper, we propose a different architecture based on seamless hardware integration and user-friendly, dynamic workload placement based on real-time performance analysis and prediction coupled with Machine Learning-based scheduling.

Root crops grow in the soil deeply and bond with soil closely, which results in that the process of the separation between soil and root becomes the most difficult during the harvesting processes. In order to harvest root crops efficiently, the mechanical harvesting has become the main developing trend. However, high power and high damage rate are still occurred when mechanical harvester gets in touch with the roots. In this paper, we review the research of the development and evaluation of the mechanical harvesting of root crops and its performance optimization on the past years. The process of soil separation mainly consists in the initial separation between root and the ground and further separation between root and adhered soil. In general, the soil-cutting operation in the initial separation and the sieving mechanism in the further separation require high draught and power. And the dramatic friction, impact, pressure and so on, which happen in the components and soil-roots, are the key reasons to lead to root damage. The optimization of harvesting methods and parameters, including the digging shovel shape, working conditions, vibration, and screening way, is more significant in improving the harvesting performance. But there are still some limitations in the research and application of the mechanical harvester for root crops. Future research is suggested to focus on the development of the soil break-up when the digging shovel cutting soil, the insight into the interaction between soil and roots by different external compression loads, and the long-term studies to verify the high-efficiency and low-damage performances of mechanical harvester in practical application.

The sudden onset of natural hazards such as a flash flood events can be devastating to a country or region, often affecting numerous communities, and humanitarian supply chains play a major role in enabling the timely recovery of economic and social activities. However, the uncertainty and suddenness of natural disasters such as flash floods, as well as the potential for aftershocks, require humanitarian supply chains to be resilient during the relief process. This research first adopts the Delphi and literature review methods to identify the key indicators in the humanitarian supply chain to form an evaluation index system. Then, taking the 2021 mega-flash flood event which affected four cities in the mountainous region under the jurisdiction of the Zhengzhou municipal government, the ANP method is used to calculate the weights of each indicator and combines the weighted results with the Multi-styling and stereotyping method under Pythagorean fuzzy (PFs-VIKOR) to make an evaluation of the resilience of the humanitarian supply chain in the relief process. The findings suggest that policy makers and decision makers should pay close attention to the coordination of the parties involved in the humanitarian supply chain and improve the level of resilience of the entire supply chain by enhancing the resource scheduling capacity and responsiveness. At the same time, the VIKOR evaluation of the 4 cities highlighted the humanitarian supply chain in Dengfeng City to be most effective in this event due to the close cooperation and positive response of all parties involved in the humanitarian supply chain. The findings of this research provide some useful suggestions and guidance to the various practitioners involved in the humanitarian supply chain. Furthermore, the evaluation of the performance of the four cities in this mega-flash flood event provides some helpful indication of the importance of the various emergency measures which can help to inform policy recommendations for the Zhengzhou municipal government.

Using a sample of 103 surviving and non-surviving global bond funds over a long sample period of 1998 to 2022, we perform a comprehensive analysis of the funds under our modified Sharpe’s (1992) style analysis model. We find that dynamic style analysis is useful in explaining time-series and cross-sectional and in predicting future returns of global bond funds. The dynamic style analysis also allows us to examine asset allocation over time. The results show that, during 2001 to 2014, funds shift their allocations from intermediate-term bonds to world corporate bonds and from world corporate bonds to emerging market bonds in search of higher returns at the price of credit quality.

European cities are motivated to act towards the achievement of climate-neutral mobility solutions. Often, though, they are facing many challenges when bringing (innovative) sustainable mobility solutions forward. Capacity building that fills skills gap and/or enables acquisition of new ones related to the planning and implementation of such solutions can empower local/ regional authorities to identify them, adopt them and eventually deliver them properly. The aim of this paper is to present the Key Performance Indicator (KPI) framework that has been used for the assessment of the effectiveness of the Learning and Exchange Programme applied in an EU-funded project. It presents the methodological steps for the adoption of the KPIs, as well as the tools used for the selection of the KPI data and the KPI monitoring at project level. It also presents the results from the application of the framework for assessing the knowledge performance towards the deployment of sustainable mobility solutions. It finally reflects on recommendations for applying the KPI framework to other cases and thematic contents.

The estimation of ecological service system value of water resources in Tarim river basin is of great significance for resource allocation management and ecological protection. However, there is still no unified and complete evaluation method for ecological service system value of inland river in China. Based on the perspective of the whole value chain, the study classifies its ecological service functions, and divides 11 sub-categories into 4 categories (supply, regulation, culture and support) as evaluation indicators to carry out quantitative evaluation. The results showed that the total value of ecological service system in Tarim river basin in 2018 was 4156.5247×108 Yuan, and the value of regulating function, cultural function, supporting function and supply function were successively from high to low, which were as follows: 2565.6825×108 Yuan, 1009.5471×108 Yuan, 884.0770×108 Yuan, 20.3350×108 Yuan, among which the value of regulation function is dominant.

Abstract: Seismic performance and loss assessments can have widely varying degrees of uncertainty. An essential issue is whether a particular assessed seismic loss or performance result has sufficient reliability to serve as the basis for risk management decisions and actions, including whether or not a code prescribed performance level is met, or if an assessed loss level is acceptable. A method is developed measuring the reliability of performance and loss assessments for individual buildings and for portfolios. Consideration is given to how well the building investigation and corresponding evaluation process have been performed, the qualifications of the person(s) doing the assessment, the thoroughness of the evaluation, and the technical validity of the assessment procedure or model. The approach characterizes the uncertainty of each component of the assessment procedure for each building in qualitative terms. The resulting reliability measure is likely to be most useful for the cases where an entity is determining whether/or not a building has acceptable life safety performance, or if a portfolio has an acceptably low risk of seismic damage loss over a given period of time. In both cases, the reliability must either be sufficient to warrant action, or serve to indicate need for improved assessment.

Aldehydes are natural volatile aroma compounds generated by the Maillard reaction of sugars and amino acids in food and affect the flavor of food. They have been reported to exert taste-modifying effects, such as increases in taste intensity at concentrations below the odor detection threshold. The present study examined the taste-enhancing effects of short-chain aliphatic aldehydes, such as isovaleraldehyde (IVAH) and 2-methylbutyraldehyde, attempted to identify the taste receptors involved. The results obtained revealed that IVAH enhanced the taste intensity of taste solutions even under the condition of olfactory deprivation by a noseclip. Furthermore, IVAH activated the calcium-sensing receptor CaSR in vitro. Receptor assays on aldehyde analogues showed that C3-C6 aliphatic aldehydes and methional, a C4 sulfur aldehyde, activated CaSR. These aldehydes functioned as a positive allosteric modulator for CaSR. The relationship between the activation of CaSR and taste-modifying effects was investigated by a sensory evaluation. Taste-modifying effects were found to be dependent on the activation state of CaSR. Collectively, these results suggest that short-chain aliphatic aldehydes function as taste modulators that modify sensations by activating orally expressed CaSR. We propose that volatile aroma aldehydes may also partially contribute to the taste-modifying effect via the same molecular mechanism as kokumi substances.

The Inefficient water use, varying and low productivity in Kenya public irrigation schemes is a major concern. It is therefore necessary to periodically monitor and evaluate the performance of public irrigation schemes. The performance of public irrigation in western Kenya was assessed by combining benchmarking methodology and principal component analysis. The aim was to quantify and rank the performance of pumped public irrigation schemes in Kenya. Eleven benchmarking indicators were computed for the period from 2012 to 2016 and compared to global benchmark values. The indicators used fall under agricultural productivity, water supply and financial performance categories. The computed agricultural productivity was 36%–51% in Ahero, 23%–42% in West Kano and 26%–50% Bunyala irrigation scheme. Water supply performance in Ahero, West Kano and Bunyala irrigation schemes varied from 24% to 58%, 3% to 49% and 19% to 43% respectively. Financial performance varied from 46% to 54% in Ahero, 25% to 32% in West Kano and 54%–56% in Bunyala irrigation scheme. An average overall performance efficiency of 46%, 39% and 31% was obtained in Ahero, Bunyala and West Kano irrigation schemes respectively. The performance of the irrigation schemes is very poor and measures on improving performance are needed.

Risk management strategies protect the company as a whole as well as employees from unforeseen financial impacts. As in the case of personal finance, preparing for certain scenarios helps to face any difficulties that the company may encounter and allows it to get out of this impasse.For any project to be successful, the way the project executing agency will deal with potential risks must be determined so that it can identify, mitigate or avoid problems when it needs to do so. Successful project managers realize that risk management is important, because the achievement of project objectives depends on planning, preparation, results and evaluation that contribute to the achievement of strategic goals, especially the sustainable development of societies.Risk management strategies work to protect the company as a whole as well as employees from unexpected financial effects, and as is the case in personal finance, preparing for certain scenarios helps to face any difficulties that the company may face and allows it to get out of this impasse.To ensure the success of your project, determine how you will handle potential risks so that you can identify, mitigate or avoid problems when you need to do so. Successful project managers understand that risk management is important, because the achievement of project objectives depends on planning, preparation, results, and evaluation that contribute to the achievement of strategic objectives.

This study investigates the implementation and performance benefits of using a MongoDB replica set compared to a single node setup. The primary objective was to evaluate the efficiency and reliability improvements provided by replication in a NoSQL database cluster. The research involved configuring a single node and a three-node replica set, followed by conducting performance tests using CRUD operations on both setups. The results indicated that while the single node exhibited faster write operations, the replica set significantly improved read performance and provided high availability and fault tolerance. The findings highlight the advantages of using a replica set for applications requiring robust data access and consistent performance under varying workloads.

Background: The purpose of this study was to evaluate and compare the performance of health, safety and environmental management of civil, traffic and urban services contractors in the 18th district of Tehran municipality in 2015-2016. Methods: This is an applied, longitudinal, descriptive-comparative study. The statistical population of this study was construction contractors, urban services and traffic in the municipality of district 18 of Tehran in the years 2015-2016. from 52 contractors, 18 construction contractors, 21 utilities contractors and 13 traffic contractors, respectively, were selected using census method. the research instrument consisted of periodic direct observation and completion of the HSE standard checklist by researchers. Data were analyzed using Kruskal-Wallis nonparametric test by SPSS software.Results: The HSE performance of all contractors (civil, utilities and traffic) was acceptable and the results of Kruskal-Wallis test showed that the HSE performance of contractors at the second visit of 2015 and the first visit of 2016 was significantly different in favor of civil contractors )p <0.01), but there was no significant difference between the first and third visits of 2015 and the second and third visits of 2016 (p> 0.05). visits in six periods indicate HSE Civil Contractors status increased from 100% unfavorable to 88.88% acceptable level and 11.11% good level, and in the case of civil service contractors who initially had 95.23% in an unfavorable situation and 4.76% in a favorable situation achieved 100% acceptable performance, and finally, the traffic contractors, who were 100% unfavorable, were upgraded to 100% acceptable. Conclusion: According to the findings of the study, it seems that the supervision of municipality inspectors on HSE performance of contractors can be effective in improving and strengthening the commitment to HSE requirements, therefore, it is suggested that periodical visits be made to the municipal contractors.

The most commonly used real-time augmentation services in China are International GNSS Service (IGS) real-time service, PPP-B2b service, and BeiDou Satellite-Based Augmentation System (BDSBAS) dual-frequency augmentation service. However, the research on the performance evaluation, comparison and application scope of these three products is still unknown and unrevealed. This article introduces methods for obtaining real-time augmentation information and real-time orbit and clock offset recovery. Based on real-time orbit and clock offset accuracy, positioning accuracy, and positioning availability, it systematically evaluates the performance of CNES, PPP-B2b, and BDSBAS augmentation information. The results indicate that the radial accuracy of CNES and PPP-B2b real-time orbit products is consistent, and the Root Mean Square (RMS) is better than 5 cm. CNES can achieve centimeter-level accuracy in both along-track and cross-track components, surpassing the decimeter-level accuracy of PPP-B2b. Both services demonstrate consistent accuracy in real-time clock offset, with PPP-B2b showing similar standard deviations (STD) of 0.16 ns for different satellites. However, for CNES, the STD of real-time clock offset varies for GPS, BDS-3 MEO, and BDS-3 IGSO satellites, with values of 0.10 ns, 0.19 ns, and 0.60 ns, respectively. The accuracy and availability of the two PPP services exhibit the same levels, with centimeter-level accuracy achieved after convergence and positioning availability exceeding 99%. Therefore, the difference between the two services in application areas depends on the acquisition of augmentation information. However, BDSBAS, which concentrates on code observations, demonstrates lower accuracy in real-time orbit and clock offset, positioning accuracy, and positioning availability compared to the other two services. Its primary application is in the aviation and maritime domains, where there is a greater need for service integrity, continuity, and reliability.

Given the many approaches to and definitions of gender responsive monitoring and evaluation (M&E) for health programs and interventions there is a lack of clarity on how to operationalize it including what to measure and how to measure it. We conducted a scoping review to understand what makes M&E gender responsive. We included 31 studies and conducted two rounds of extraction to delineate ways in which gender was integrated into M&E. Twelve articles described the use of theory to guide M&E though most were not related to gender. Twelve articles employed a gender score in data collection, most of which measured Likert scale responses related to gender equity. Even though most studies did not use a specific gender framework, most incorporated gender domains in their analysis. Seven studies used participatory methods in the design and implementation of M&E. Most studies conducted M&E on programs or interventions that were designed to be gender intentional and related to gender issues. Gender responsive M&E intentionally integrates gender into the M&E process, regardless of how gender-intentional the program or intervention is. Gender dimensions can be identified through gender theories, models, scores, and frameworks to inform tool development, data collection, analysis, and stakeholder engagement processes.

The Kabul River basin (KRB) of Afghanistan, a lifeline of around 10 million people, has multiplicity of governance, management and development related challenges leading to inequity, inadequacy and unreliability of irrigation water distribution. Prior to any uplifting intervention, there is a need to evaluate the performance of irrigation system on long term basis to identify the existing bottlenecks. Although there are several indicators used for the performance evaluation of the irrigation schemes, but we used the coefficient of variation (CV) of actual evapotranspiration (ETa) in space (basin, sub-basin, and provincial level), relative evapotranspiration (RET) and temporal CV of RET to assess the equity, adequacy and reliability of water distribution respectively, from 2003 to 2013. The ETa was estimated through surface energy balance system (SEBS) algorithm and the ETa estimates were validated using advection aridity (AA) method with R2 value of 0.81 and 0.77 at Nawabad and Sultanpur stations respectively. The global land data assimilation system (GLDAS) and moderate-resolution imaging spectroradiometer (MODIS) products were used as main inputs to the SEBS. Results show that mean seasonal sub-based RET values during summer (May – September) (0.37 ± 0.06) and winter (October – April) (0.40 ± 0.08) are below the target values (RET ≥0.75) during 2003-2013. The CV of mean ETa within sub-basins and provinces for the entire study period has equitable distribution of water from October-January (0.09±0.04) whereas the highest inequity (0.24±0.08) in water distribution is during early summer. The range of the CV of mean ETa (0.04-0.06) on monthly and seasonal basis shows the unreliability of water supplies in several provinces or sub-basins. The analysis of temporal CV of mean RET highlights unreliable water supplies across the entire basin. The maximum ETa during the study period was estimated for Shamal sub-basin (552±43mm) while among provinces Kunar experienced the highest ETa (544±39mm). This study highlights the dire need for interventions to improve the irrigation performance in time and space. The proposed methodology can be used as a framework for monitoring and implementing the water distribution plans in future.

Part 1 of this 2-paper series identified a wide and deep network of context, generative mechanisms and outcomes responsible for psychosocial development in a performance basketball club. In this – part 2 – study, the stakeholder’s programme theories were tested during a full-season ethnography of the same club. The findings confirm the highly individualised nature of each young person’s journey. Methodologically, immersion in the day-to-day environment generated a fine-grain analysis of the processes involved, including: i) sustained attentional focus; ii) structured and unstructured skill building activities; iii) deliberate and incidental support; and iv) feelings indicating personal growth. Personal development in and through sport is thus shown to be conditional, multi-faceted, time-sensitive and idiosyncratic. The findings of this two-part study are considered to propose a model of psychosocial development in and through sport. This heuristic tool is presented to support sport psychologists, coaches, club administrators and parents to deliberately create and optimise developmental environments.

Embryonic and larval Danio rerio is increasingly used as a toxicological model to conduct rapid in vivo tests and developmental toxicity assays; the zebrafish features as high genetic homology to mammals; robust phenotypes; and its value in high-throughput genetic and chemical screening have made it a powerful tool to evaluate in vivo toxicity. New methodologies of genome editing as CRISPR/Cas9; ZFN or Talen make it a suitable model to perform studies to pair human genetic diseases as well. This review surveys recent studies; employing zebrafish as experimental model; comparing it with other in vivo and in vitro models; presenting zebrafish as a potent vertebrate tool to evaluate drug toxicity to facilitate more extensive; easy and comprehensive knowledge of new generation drugs.

This study aims to assess the operational capabilities of disaster and emergency management re-sources (DEMRs), which are pivotal in mitigating risks and minimizing losses amid the increas-ing frequency of disasters. The research constructs an effective operational capability evaluation system for DEMRs, encompassing four key aspects: resource planning, organizational manage-ment capability, resource support capability, and information processing capability. It focuses on identifying the factors that influence the effective operational capability of DEMRs in China and Korea, comparing and analyzing the relative importance and priority of each evaluation domain and indicator within these countries to enhance DEMRs' operational effectiveness. The method-ology involves calculating and ranking the weight of the four domains, with findings indicating that organizational management capability is most significant in China, whereas resource sup-port capability is prioritized in Korea. A comparative analysis of the local weight of indicators within each domain revealed the largest discrepancy between China and Korea in the infor-mation processing capability domain. The study concludes by calculating global weights, identi-fying fast response capability and resource allocation capability as the most impactful factors on DEMRs' operational capability, highlighting their critical role in disaster and emergency man-agement.

In this paper, we derive the distribution of eigenvalues for a 2×2 random confusion matrix stemming from a machine learning (ML) evaluation problem. Additionally, we present the distributions of both the matrix’s trace and the difference between the two traces of random confusion matrices. We also illustrate the application of these derived distributions in calculating the superiority probability of four baseline ML models.

This study aims to develop a performance evaluation system that can facilitate performance evaluation at region, hospital, and department levels to enable better cost management for sustainable development. A multi-level system of performance evaluation informs a hierarchical assessment of cost management from regions to hospitals to departments using diagnosis-related group (DRGs). Various metrics are developed employing the variances between targets and actuals where targets are determined from two perspectives: benchmarking using external regional prices and change management using internal data. Targets for the latter are statistically based and specifically incorporate variability. The model is applied to two hospitals, twenty departments, nine DRGs and 1071 inpatients. The analyses indicate that the approach can provide a practical evaluation tool that allows for particular characteristics at multiple levels. The system provides macro-micro and external-internal perspectives in performance, enabling high-level variances to be decomposed thereby identifying sources of performance variability and financial impact.

Introduction Urolithiasis, a prevalent urological condition (8-13% globally) exhibits regional variations, influenced by water quality, climate, health factors and diet. Sri Lanka with its tropical climate and dietary patterns is part of the "Stone Belt" of Asia. This study in Northern Sri Lanka examines urinary stone compositions and assesses the prevalence of metabolic disorders among urolithiasis patients. Methods This prospective cross-sectional study, conducted at tertiary urology centre from July 2022 to June 2023, focused on surgically treated urolithiasis patients. Institutional ethical clearance was obtained. Patient details and investigational findings were collected through questionnaires and data extraction forms. Stone analysis utilized Fourier transform infrared spectroscopy and detailed metabolic evaluation of 24 hour urine collection sample is carried out. Results This study followed 153 surgically treated urolithiasis patients, primarily male (64.3%), mean age 48.64. Ureteric colic (48.4%) was common, with kidney stones (45.8%) prevalent; 57.52% had recurrent stones. Diabetes mellitus (DM=23.5%) was the top comorbidity. Calcium oxalate monohydrate (COM) stones (78.4%) were most frequent, followed by uric acid (12.4%). COM predominated in 40-59 age group. No significant gender-stone type association. 86.9% had metabolic abnormalities, notably hypocitraturia (60.1%). 23% had both hypocitraturia and hypomagnesuria. Some metabolic disorders showed gender differences, with a marginal age-metabolic disorders association (p < 0.061). Urine oxalate levels were normal with higher variability in males. Conclusion Middle-aged males with urolithiasis commonly presented with ureteric colic and predominantly had calcium oxalate monohydrate stones. Recurrent stones were common, often accompanied by metabolic abnormalities such as hypocitraturia and hypomagnesuria, with diabetes mellitus as the primary comorbidity.

Background: Differentiating essential tremor (ET) and functional tremor (FT) remains challenging due to their overlapping clinical presentations. Objective: In this study, we aimed to elucidate the demographic and psychometric differences between the aforementioned tremor types to enhance the diagnostic accuracy and therapeutic strategies. Methods: In this prospective study, we included 96 patients diagnosed with ET or FT and analysed their related demographic data, clinical symptoms, and psychometric evaluation scores. Our statistical analysis involved Pearson’s chi-square tests, Fisher’s exact tests, and logistic regression to assess how the different variables impact tremor diagnosis. Results: Our study demonstrated a higher ET prevalence in males (p = 0.015). Furthermore, we demonstrated that patients with ET displayed a significantly lower body mass index and a lower age of onset compared to those with FT (p = 0.050 and p = 0.023, respectively). Our psychometric assessments revealed higher cognitive and body image scores in patients with ET, whereas those with FT scored higher on depression and anxiety scales. The misdiagnosis rate was 14.5%, emphasising the need for improved diagnostic criteria. Conclusions: We established specific demographic and psychometric distinctions between ET and FT, which could potentially benefit clinicians in making accurate diagnoses and tailoring treatment approaches. These findings support the inclusion of comprehensive psychometric evaluations into standard diagnostic procedures to better differentiate tremor types.

Emotion detection from the text is an important and challenging problem in text analytics. The opinion-mining experts are focusing on the development of emotion detection applications as they have received considerable attention of online community including users and business organization for collecting and interpreting public emotions. However, most of the existing works on emotion detection used less efficient machine learning classifiers with limited datasets, resulting in performance degradation. To overcome this issue, this work aims at the evaluation of the performance of different machine learning classifiers on a benchmark emotion dataset. The experimental results show the performance of different machine learning classifiers in terms of different evaluation metrics like precision, recall ad f-measure. Finally, a classifier with the best performance is recommended for the emotion classification.

Construction using earth materials demonstrates ecological sustainability using locally sourced natural materials and environmentally friendly demolition methods. In this study, the environmental impact of adding cement to soil materials for rammed-earth farmhouse construction in rural China was investigated and comparatively simulated using the One Click LCA database, focusing on the conflict between sustainability objectives and the practical aspects of cement addition. By analyzing how the addition of cement aligns with local construction practices and by addressing the debate surrounding the inclusion of cement in rammed earth construction, our objective is to provide insights into achieving a balance between the environmental impact and the pragmatic considerations of using cement in earthen building practices. Three local structure scenarios are evaluated via simulations: a cement-stabilized rammed earth wall, a fired brick wall, and a localized reinforced concrete frame structure. The quantitative environmental impacts are assessed, and the qualitative differences in adaptation, economic sustainability, and other factors are examined in the context of present-day development in rural China. The results show that the use of cement-stabilized rammed earth wall-supported structures is associated with higher embodied carbon emissions compared to structures supported by reinforced concrete frames and enclosed by brick walls; however, these emissions are lower than those for brick wall-supported structures, while effectively meeting the structural requirements. In addition, the use of cement-stabilized earth for perimeter walls simplifies material management and disposal throughout the building's life cycle, and the cost-effectiveness of cement has been found to be substantially greater than that of reinforced concrete frames and brick structures, improving economic viability and social acceptability, especially among low-income communities in rural areas.

Background: Patients undergoing brain tumor resection experience changes to their neurocognitive abilities, many of which can be difficult to predict. We hypothesized that changes in brain connectivity could predict changes in neurocognitive functioning, demonstrating the potential for brain connectivity aware surgical planning to provide enhanced outcomes for patients. Methods: Patients underwent functional and diffusion MR scanning and neuropsychological testing before tumor resection and two weeks post-resection. Using this functional and diffusion imaging, we measured changes in the topology of the functional and structural graph networks, respectively. From the neuropsychological testing scores, we derived a composite score that describes a patient’s overall level of neurocognitive functioning. We then used a multiple linear regression model to test if structural and functional connectivity measures could predict changes in composite scores. Results: Twenty-one subjects completed imaging and neuropsychological evaluation both before and after surgery. The multiple linear regression model showed that changes in functional local efficiency were inversely correlated with changes in composite score (p

With the development of organizational biology and forced from the EU Cosmetic Regulation (EU/1223/2009) with the complete ban of animal testing for cosmetic purposes, 3D skin models have been widely developed due to their similar physiological structure and metabolic function to native human tissue. 3D skin models for in vitro cosmetic evaluation are still promising alternative methods for evaluating phototoxicity, corrosivity and irritation. These models have been used for early screening and later validation of toxicity and efficacy evaluation by many well-known cosmetic companies. 3D skin models have become an important tool in cosmetic evaluation research. This article reviews the development of 3D skin models and their application in cosmetic evaluation. An outlook on the current application and future technological development directions in the cosmetic field is also presented.

Introduction: The World Health Organization (WHO) recommends visual inspection with acetic acid (VIA) for cervical cancer screening (CCS) in lower-resource settings; however, quality varies widely, and it is difficult to maintain a well-trained cadre of providers. The Smartphone-Enhanced Visual Inspection with Acetic acid (SEVIA) program was designed to offer secure sharing of cervical images and real-time supportive supervision to health care workers providing screening in semirural Tanzania, in order to improve quality and accuracy of visual assessment of the cervix for treatment. The purpose of this evaluation was to document early learnings from patients, providers, and higher-level program stakeholders, on barriers and enablers to program implementation. Methods: From September 9th to December 8th, 2016, observational activities and open-ended interviews were conducted with image reviewers (n= 5), providers (n=17), community mobilizers (n=14), patients (n=21), supervisors (n=4) and implementation partners (n=5) involved with SEVIA. Sixty-six interviews were conducted at 14 facilities, in all 5 of the program regions. Results SEVIA was found to be a highly regarded tool for the enhancement of CCS services in Northern Tanzania. Acceptability, adoption, appropriateness, feasibility, and coverage of the intervention were highly recognized. It appeared to be an effective means of improving good clinical practice among providers and fit seamlessly into existing roles and processes. Barriers to implementation included network connectivity issues, and community misconceptions and adoption of CCS more generally. Conclusion: SEVIA is a practical and feasible mobile health intervention and tool that easily integrated into the National CCS program to enhance quality of care. With the introduction of HPV DNA testing as a primary screening strategy for cervical cancer prevention in settings such as Tanzania, the role of a mobile health platform for program surveillance, tracking follow-up care, and quality assurance of visual assessment of the cervix for treatment (in women who test positive for high-risk HPV) further supports the importance of programs, such as SEVIA, in low resource contexts. Further expansion of the program, especially to rural areas where screening providers can benefit from virtual support for screening services through the use of the mobile App, could strengthen the delivery of services within the national cervical cancer prevention program.

This publication aims to create 4K UHD video sequences with a specific focus on smart cities and transport. The created database will be accessible to all experts in the field and can be further used for research purposes. All reference video sequences will be transcoded into different quality settings. The resolution, compression standard, and bitrate will be changed. The work will aim to find out the best combination of video parameters from the measured values. Thanks to the overall evaluation, we will ensure for each single video sequence the quality with the best experience for the providers that will offer the service. The database will also be available with its objective and subjective ratings, with dynamicity information characterized by spatial and temporal information. After, It will be possible to compare the results of the subjective evaluation of a selected sample of our respondents with the work of other researchers who can evaluate with a different sample of evaluators.

Machine Learning is increasingly and ubiquitously being used in the medical domain. Evaluation metrics like accuracy, precision, and recall may indicate the performance of the models but not necessarily the reliability of their outcomes. This paper assesses the effectiveness of a number of machine learning algorithms applied to an important dataset in the medical domain, specifically, mental health, by employing explainability methodologies. Using multiple machine learning algorithms and model explainability techniques, the project provides insights into the model workings to help determine the reliability of the machine learning algorithm predictions. The results are not intuitive. It was found that the models were focusing significantly on less relevant features and at times, unsound ranking of the features to make the predictions. The paper therefore argues that it is important for research in applied machine learning to provide insights into explainability of the models in addition to other performance metrics like accuracy. This is particularly important for applications in critical domains such as healthcare. A future direction is to investigate methods to quantify the effectiveness of the machine learning models in terms of the insights from their explainability.

South Africa (SA) is grappling with a severe food insecurity crisis exacerbated by socioeconomic challenges. This resulted in the Department of Basic Education (DBE) advocating for the establishment of vegetable gardens at schools. However, information on the suitability of the soils in SA for sustainably growing Beetroot is unavailable. This study aimed to assess the suitability of soils for sustainable Beetroot production at various schools in the Kgakotlou circuit. Four Secondary Schools were selected: Mothimako, Madipoane, Klaas Mothapo and Phomolong. A detailed soil survey was carried out to study soils in vegetable gardens. Soil samples were collected for laboratory analysis of physicochemical properties. The soil suitability was evaluated using the physicochemical properties of the soils and optimal soil requirements for Beetroot production. We found various soils in the schools, including Cambisols (Hutton and Nkonkoni), Leptosol (Glenrosa), Plinthosol (Westleigh), and Acrisols (Tshiombo and Tubatse). Portions of the gardens on Hutton and Westleigh soil were moderately suitable (S2), limited by electrical conductivity (EC). Meanwhile, portions of Tshiombo, Tubatse, and Nkonkoni were marginally suitable (S3), limited by pH and EC. Portions on Glenrosa soil at Klaas Mothapo and Phomolong were not suitable (NS) and were limited by shallow depth, soil pH and EC. The results reveal the importance of considering soil suitability before establishing vegetable gardens in school settings. Indexing soil suitability using the physicochemical properties of soil resources for sustainable beetroot production is proposed for schools in the Kgakatlou circuit and other parts of SA.

Meningitis is a severe disease associated with death in children under five with highest rates of infections under age of one. Vaccines for Neisseria meningitides and Haemophilus influenza are used to prevent the main causative agents of meningitis. Administration of H. influenzae type b (Hib) vaccine is recommended at 2, 4 and 6 months with a booster dose at 18 months. N. meningitidis has two commercially available vaccines, the pure polysaccharide is recommended at 24 months meanwhile the protein-conjugated vaccines at 12 months. We sought in this study to examine if coadministering the vaccines for the two main meningitis causing bacteria might be synergistic as a preliminary step towards the possibility of shuffling immunization schedule. So, we coadministered Hib vaccine with commercially available vaccines either quadrate (ACWY) polysaccharide meningococcal (Men) or conjugated meningococcal (Nim) vaccines in Balb/C mice (n = 6/group) and compared to each vaccine administered separately and controls. Thirty-five days post immunization, we measured specific antibodies titers. Hib vaccine increased Men antibody titers significantly for serotypes Y and W. When Hib vaccine was coadministrated with Nim, antibody titer for Y, W and A significantly increased. For serotype C, there was no significant difference in antibody titers among immunized groups. As for effect of meningococcal vaccines on Hib, Men significantly increased Hib antibody titers while Nim had no effect. Collectively, our data suggested that coadministration of Hib and Men or Nim vaccines was safe and had synergistic effect on immune responses elicited to both vaccines. Further studies are needed before immunization schedule modifications. Such immunization schedule recommendation should provide better protection against this life-threatening disease in young children.

Cell-culture meat is a novel concept to replace traditional meat produced from animals, and to satisfy rising food demands due to the world population growth. It is still a young field and requires to solve technical issues including cell sources and types, efficient culture for large scale production, taste and texture for customer satisfaction. The current review summarized traditional beef meat production and evaluation methods for customer satisfaction. In particular, serum biomarkers for beef meat evaluation are discussed, which can be applicated for cell-culture meat production.

To improve efficacy and safety of sunscreen emulsions, UV‐filter skin permeation could be kept as low as possible by reducing UV‐filter content or changing emulsion composition. In this work, different lipid phase ratio (12, 14 and 16% w/w) were assessed for their ability to affect the technological and sensory properties of O/W emulsions in which bemotrizinol (BMTZ), a broad spectrum sunscreen agent, was incorporated free or loaded into nanostructured lipid nanocarriers (NLC) to reduce its release from the vehicle and, hence, its skin permeation. The following technological properties were evaluated in vitro by suitable methodologies: spreadability, viscosity, pH, occlusion factor, BMTZ release, sun protection factor (SPF). Sensory attributes were assessed by trained panelists in three different phases: before/during pick‐up, rub‐in, after application. Raising the lipid phase ratio led to an increase of viscosity and to a corresponding drop of spreadability while the incorporation of BMTZ‐loaded NLC determined a decrease of occlusion factor and an increase of SPF. No BMTZ release was observed from all emulsions. Sensory attributes were mainly affected by lipid phase ratio. These results suggest that lipid phase ratio and BMTZ incorporation into NLC could contribute to determine technological and sensory properties of O/W emulsions.

Developing and utilising of underground space is an vital direction for urban growth. Underground commercial streets, as a significant component of underground space accommodating extensive human social activities, and consequently necessitate the creation of human-scale spaces. In the evolution of urban design development towards greater refinement, applying architectural theories and excessively subjective designs has resulted in a deficiency of human-centered design and a disordered spatial environment. This study merges environmental psychology and architectural theory to determine the appropriate length of spatial scale. Two experiments focusing on spatial perception evaluation were conducted using a virtual experimental platform that featured varying dimensions of spatial scale combinations. These quantified combinations were correlated with perception evaluation, and regression analysis was employed to identify appropriate scale ranges, which were superimposed on the range of length selection. Finally, the optimal length and scale combination for underground commercial street spaces were established, providing a reference for the human-centered design of these environments.

Background: Upper respiratory tract infections (URTIs) are a major public health concern due to their high incidence and potential for complications. Pharmacists often serve as the first point of contact for patients with URTIs. This study aims to develop and evaluate the RESP-8 tool to assist pharmacists in determining the need for medical evaluation. Methods: This prospective interventional cohort study was conducted over six months (October 2023 to March 2024) in community pharmacies. Participants included adults aged 18 years and older presenting with URTI symptoms. Pharmacists used the RESP-8 tool, which comprises eight criteria to assess the need for medical referral. Data on medical history, symptom duration, and progression were recorded. The primary outcome was the feasibility of implementing the RESP-8 tool. Secondary outcomes included the accuracy of the tool, the percentage of patients recommended for medical evaluation, and compliance with these recommendations. Results: A total of 64 participants were included, with an average age of 55.7 years. Pharmacists recommended medical evaluation for 75% (48/64) of patients using the RESP-8 tool. Among these, 70.83% (34/48) complied with the recommendation. The tool demonstrated high accuracy in identifying patients needing further medical evaluation, with only two noted errors. All compliant patients received appropriate treatment without complications. The tool was easy to implement, taking less than 5 minutes per patient. Discussion: The RESP-8 tool effectively guided pharmacists in recommending medical evaluations for URTI patients. The high compliance rate indicates patient trust in pharmacists' guidance. While the study's small sample size limits generalizability, the results are promising. Future studies with larger populations are necessary to validate these findings and further refine the tool. Conclusion: The RESP-8 tool shows potential in enhancing pharmacists' ability to make informed decisions about medical referrals for URTIs, ultimately improving patient outcomes and optimizing healthcare resource management.

This paper formulates the performance evaluation of cloud services as a multicriteria group decision making problem, and presents a fuzzy multicriteria group decision making method for evaluating the performance of cloud services. Interval-valued intuitionistic fuzzy numbers are used to model the inherent subjectiveness and imprecision of the performance evaluation process. An effective algorithm is developed based on the technique for order preference by similarity to ideal solution method and the Choquet integral operator for adequately solving the performance evaluation problem. An example is presented to demonstrate the applicability of the proposed fuzzy multicriteria group decision making method for solving the multicriteria group decision making problem in real world situations.

This paper undertakes a comprehensive review to underscore the central role of sustainability in the evaluation and innovation of jet grouting technologies. It meticulously traces the evolution of evaluation methodologies, emphasizing the imperative of sustainable practices throughout history. Traditional evaluation paradigms are examined alongside contemporary trends, with a particular focus on sustainability metrics and visualization techniques. Through an examination of innovative jet grouting technologies, this paper illustrates how sustainability principles have driven advancements aimed at improving the efficiency and environmental impact of jet grouting methods. Central to this review is an assessment of sustainability across multiple dimensions, including method applicability, installation and operational compatibility, and the performance of the resulting jet grouted piles. By emphasizing sustainability considerations, the paper highlights the intrinsic link between environmental integrity and technological innovation in the field of jet grouting. In addition, it discusses analytical evaluation methods designed to proactively address sustainability concerns prior to construction, thereby promoting a more environmentally responsible approach. Finally, this paper presents a pioneering evaluation framework that integrates real-time monitoring and visualization tools, allowing stakeholders to track sustainability milestones throughout the construction process. By emphasizing sustainability as a guiding principle, this review advocates for a paradigm shift toward more ecologically sound and resilient jet grouting practices.

A novel investigation into the structure-function relationship was undertaken to enhance understanding of the mechanism of action of the vasoactive peptide angiotensin II (AngII) using unconventional substitutions such as AIB (α-aminobutyric acid), CHA (cyclohexylalanine acid), IAP (isonipecotic acid), TOAC (2,2,6,6-tetramethylpiperidine-1-oxyl-4-amine-4-carboxylic acid) at position 3, and DMT (2,6-dimethyl-Tyrosine) at position 4. Biological potency assays were conducted on guinea pig ileum, and structural features were analyzed using circular dichroism (CD) and molecular dynamics (MD). CHA3-AngII and AIB3-AngII analogs retained some agonistic activity, whereas IAP3-AngII and TOAC3-AngII derivatives were inactive. CD results indicated low conformational flexibility for AIB3-AngII and CHA3-AngII, and greater conformational restrictions for IAP3-AngII and TOAC3-AngII, consistent with computational modeling analyses. DMT4-AngII exhibited significant agonistic activity compared to the inactive Phe4AngII. Molecular modeling suggested a potential interaction between the hydroxyl group of Tyr4 and the amide bond between positions 7 and 8. AngII showed greater conformational restriction compared to DMT4-AngII and Phe4-AngII, underscoring the importance of tyrosine at position 4.

Selecting road networks in cartographic generalization has consistently posed formidable challenges, driving research towards the application of intelligent models. Despite previous efforts, the accuracy and connectivity preservation in these studies, particularly when dealing with road types of similar sample sizes, still warrant improvement. To address these shortcomings, we introduce a Heterogeneous Graph Attention Network (HAN) for road selection, where feature masking method is initially utilized to assess the significance of road features. Concentrating on the most relevant features, two meta-paths are introduced within the HAN framework: one for aggregating features of the same road type within the first-order neighborhood, emphasizing local connectivity, and another extending this aggregation to the second-order neighborhood, capturing a broader spatial context. For a comprehensive evaluation, we introduce a set of metrics considering both quantitative and qualitative aspects of the road network. Compared to traditional neural networks, our HAN model demonstrates superior accuracy and F1-score, particularly for road types with comparable samples. Additionally, it enhances the overall connectivity of the selected network. In summary, our HAN-based method provides an advanced solution for road network selection, surpassing previous approaches in terms of accuracy and connectivity preservation.

This study identified, analysed, and prioritised significant factors for standardising the Korean smart city project evaluation system. We analysed the efficiency and productivity of companies currently providing smart city services to consider both policy and practical aspects. The prioritisation of smart city planning reflects the latest trends in South Korea, where urban planning is moving towards smart city planning. Furthermore, the capacity building of public-private/private-private partnerships indicate the importance of business scalability. This indicates that smart city services are only stabilised when the private sector is involved and leads the project, rather than focusing on public development. The feasibility of building intelligent facilities indicates that smart city projects should be implemented after securing cost-benefit feasibility. The results were used as the basis for building an evaluation system, showing that in smart city convergence alliances, small- and medium-sized enterprises achieved the highest efficiency by reducing inputs to 81% and 86%, under the assumptions of constant and variable returns to scales, respectively. As the operational aspect is more problematic than the technical aspect, policy alternatives are necessary for smooth business progress, including increased flexibility of laws and institutions and the activation of policies that temporarily relieve regulations to demonstrate smart city projects.

With the development of higher voltage power grid, the high and low voltage parallel loops are emerging, which lead to energy losses, even threaten the security and stability of power system. The multi-infeed HVDC configurations widely appearing in AC/DC interconnected power system make this situation even worse. Aimed at energy saving and system security, a decision optimization method for power grid operating condition with high and low voltage parallel loops is proposed in this paper. Firstly, considering hub substation distribution and power grid structure, parallel loop opening schemes are generated with GN algorithm. Then, candidate opening schemes are preliminarily selected from all these generated schemes based on a filtering index. Finally, with the influence on power system security, stability and operation economy in consideration, an evaluation model for candidate opening schemes is founded based on analytic hierarchy process (AHP). And a fuzzy evaluation algorithm is used to find the optimal scheme. Simulation results of New England 39-bus system and an actual power system validate the effectiveness and superiority of this proposed method.

Background: Dental education blends theoretical and practical training to prepare students for independent patient care. This study examines the confidence levels of dental students in Umeå regarding independent performance of general dentistry tasks, and whether this confidence changes after clinical training. Methods: Surveys were conducted before and after a summer clinical internship, with s tudents rating their comfort levels on a scale from 0 to 10 for various procedures. Results: Results from 64 initial surveys and 54 follow-up surveys showed no significant difference in confidence before and after the internship. However, confidence levels varied based on whether students had practiced specific tasks during the internship. Students felt least confident in managing acute dental trauma and treating cavities in young children, while they were most confident in tasks like obtaining radiographic surveys and debriding periodontally compromised dentition. Tooth extraction and dental fillings were the most practiced procedures during the internship. Conclusions: The study concludes that the internship between the ninth and tenth semesters does not notably boost students' confidence in specific dental procedures, possibly due to the short duration of the training. Further exploration, including input from clinical supervisors, is suggested to optimize clinical training in dental education.

Sport has the potential to support psychosocial development in young people. However, extant studies have tended to evaluate purpose-built interventions, leaving regular organised sport relatively overlooked. Moreover, previous work has tended to concentrated on a narrow range of outcomes. To address these gaps, we conducted a season-long ethnography of a youth performance sport club based on a novel Realist Evaluation approach [1]. We construed the club as a social intervention within a complex system of agents and structures. In this - Part 1 - account we detail the perceptions of former and current club parents, players and coaches, using them to build a set of programme theories. The resulting network of outcomes (i.e. self, emotional, social, moral and cognitive) and generative mechanisms (i.e., the attention factory, the greenhouse for growth, the personal boost, and the real-life simulator) spanning across multiple contextual layers provides a nuanced understanding of stakeholders’ views and experiences. This textured perspective of the multi-faceted process of development provides new insights for administrators, coaches and parents to maximise the developmental properties of youth sport, and signposts new avenues for research in this area.

Currently, most middleware application developers have two choices when designing or implementing API services: They can either stick with REST or explore the emerging GraphQL technology. Although REST is widely considered the standard method for API development, GraphQL is believed to overcome the main drawbacks of REST, especially data fetching issues. Yet, doubts remain as there are no experimental studies with convincing results to evaluate the performance of the two services. In this paper, we propose a research methodology to evaluate the performance of REST and GraphQL API services, which includes two main contributions. The first contribution is that the performance evaluation of the two services is conducted in the real operation of a massive and intensively accessible management information system. The second contribution is the fair and independent performance evaluation results obtained for both API services. The performance evaluation was studied using basic measures of QoS, including response time, throughput, CPU load, and memory usage. The results show that REST is still faster in response time and throughput, while GraphQL is very efficient in resource utilization, i.e., CPU load and memory utilization. Therefore, GraphQL is the right choice when data requirements change frequently and resource utilization is the most important consideration. REST is used when some data is frequently accessed called by multiple requests.

This research focuses on developing a Student Performance Evaluation System to enhance effectiveness and oversight in higher education. The system aims to address challenges faced by instructors in evaluating student performance using a distributed system approach. Agile methodology is employed in development, and database replication techniques are applied for data synchronization. System features include registration, assessment form creation, assessment submission, statistical visualization, and access to assessment history. The system is designed to improve efficiency and transparency in the assessment process. Key features of the system include registration process, assessment form creation, assessment submission, statistical visualization, and access to assessment history. Its goal is to enhance efficiency and transparency throughout the assessment process. The article details the system workflow and the roles played by Admins, Instructors, and students in system usage. Additionally, it discusses the back-end development model and pathways, as well as the performance testing results. Performance testing indicates that the system achieves high throughput of up to 21.55 requests per second, with an average response time of only 34 milliseconds and an error rate of zero percent. These results affirm that the system efficiently handles user loads and nearly instantaneously responds to requests, providing an optimal user experience in the context of student performance evaluation in higher education.

Carotid atherosclerotic lesions are a major cause of cerebrovascular disease (CVD). Identification and quantification of carotid plaques are important for categorizing the vulnerability of plaques for rupture and assessing the impact of treatments. The irregularity of plaque surface is associated with previous plaque rupture and plays an important role in the risk of stroke. Thus, the aim of this study is to develop and validate novel vulnerability biomarkers from three-dimensional ultrasound (3DUS) images by analyzing the surface morphological characterization of carotid plaque using fractal geometry features. 3D box-counting and 3D blanket are the two types of 3D fractal dimension that were employed to describe the smoothness of plaques. This fractal dimension analysis tool was used to evaluate the effect of atorvastatin using 3DUS carotid images, which were acquired from 6 patients treated with atorvastatin with 80 mg daily and 5 patients with placebo. The Student's T Test results showed that those two fractal features were effective for detecting the statin-related changes in carotid atherosclerosis with p<0.0068 and p<0.015 respectively, suggesting that 3D fractal dimension measurements can be used effectively to analyze the surface characteristics of carotid plaques, especially for evaluating the impact of the treatment.

The Internet of Healthcare Things (IoHT) is an essential IoT domain that encompasses the necessary capabilities to transform the current healthcare system. IoHT generates, transfers, manages, stores, and processes highly confidential medical data and sensitive personal information. Thus, IoHT is a critical application from a security perspective and is most favorably targeted by attackers. Several security-breaching attempts can be carried out due to the vulnerabilities of the IoHT that put classified data at constant risk. Henceforth, this work aims to inspect the performance of 6LoWPAN-RPL-based `Patient-Centric IoHT’ in the presence of malicious intruders conducting blackhole, rank, and DoDAG attacks in both normal and emergency operational modes of the mentioned resource-constraint network. PC-IoHT is simulated on the Cooja simulator and Contiki-OS for each attack with two and four intruders (out of 10 motes) for both operation modes. Several performance evaluation parameters are used to assess the overall performance of the considered PC-IoHT. The attacks’ impact on PC-IoHT is analyzed by comparing blackhole, rank, and DoDAG attacks with the no-attack scenario.

Comparing sonification with visualization is like comparing apples and oranges. While visualizations are ubiquitous to the public and have established names, principles, application areas, and sophisticated designs, sonifications tend to be unique, self-made and completely new to users. In this study we developed a rudimentary visualization that is related closely to the principle of the sonification designs that we want to evaluate. In addition, we implemented a prototypical sonification that uses the most common mapping principles. Experiment results show that participants perform similarly well using the rudimentary visualization and the prototypical sonification, which is much better than chance but significantly worse than using our new sonification results. We therefore argue that both rudimentary visualization and prototypical sonifications can serve as a suitable benchmark to evaluate new sonifications designs against.

SacreBLEU, by incorporating a text normalizing step in the pipeline, has been well-received as an automatic evaluation metric in recent years. With agglutinative languages such as Korean, however, the metric cannot provide a conceivable result without the help of customized pre-tokenization. In this regard, this paper endeavors to examine the influence of diversified pre-tokenization schemes –word, morpheme, character, and subword– on the aforementioned metric by performing a meta-evaluation with manually-constructed into-Korean human evaluation data. Our empirical study demonstrates that the correlation of SacreBLEU (to human judgment) fluctuates consistently by the token type. The reliability of the metric even deteriorates due to some tokenization, and MeCab is not an exception. Guiding through the proper usage of tokenizer for each metric, we stress the significance of a character level and the insignificance of a Jamo level in MT evaluation.

Our work is regarding the analysis of land use changes, in the light of “saving soil” against the expansion due to unearned plus value of land: The loss of natural and agricultural surface in front of the expanding urban environment is a critical aspect of unsustainability of urban development, especially in the way it was carried out in the past decades. The measure of the physical transition of land use and characters from a more natural condition of land surface to a new artificial one, joint with a parallel analysis of the increase of land value due to such change is nowadays a major land-policy tool. The interplay of urban economics regulation with planning, reveals new key issues in urban governance and environmental preservation. In this paper it will be shown some experiment about the impact assessment of soil take, related with the seek of valorization of property inside the planning process. Our paper reports as well about the experimental activity carried out inside the MITO Lab of the Polytechnic of Bari, where reports about property values and environmental values have been produced, specially looking at the reality of the Apulia, a southern Italian Region, that is rich of farmlands and coastlines, often invaded by constructions with a severe loss of nature, landscape and ecosystems services.

This study explores the public library service evaluation domain through user-generated content on Google Maps, highlighting digital feedback's significant yet underexplored potential in understanding public library patronage across Taiwan's six major cities. Utilizing a mixed-methods research design, this study integrates Google Maps review content analysis with Social Network Analysis to delineate public perceptions and identify areas for service enhancement in public libraries. It innovatively leverages personal experiences extracted from over 60,000 Google Maps reviews to evaluate public library services in cities such as Taipei, New Taipei, Taoyuan, Taichung, Tainan, and Kaohsiung. The research taps into the National Library of Taiwan's National Library Statistics System to provide a robust analysis of library performance and user satisfaction, offering a novel perspective by emphasizing user-centric feedback from Google Maps as a primary data source. This approach provides quantitative data on library usage and geographic distribution and enriches our understanding of the qualitative experiences of library users. In analyzing the keywords from Google Maps reviews of public libraries, we categorize and interpret these under the three core LibQUAL+ dimensions—Affect of Service, Information Control, and Library as Place. The findings expose variances in perceived service quality among the cities, with Kaohsiung and Taichung receiving the highest accolades for service satisfaction. Simultaneously, the study identifies potential areas for improvement, particularly in cities with lower satisfaction ratings like Taipei. This personalized feedback illustrates the intimate relationship between public libraries and their communities, offering invaluable insights for policymakers and library management to enhance service delivery and user experience.

The airline sector is critical in today's globalized society, supporting the efficient movement of people and products worldwide. Airlines are continuously looking for methods to enhance their operational performance to remain competitive in the face of increased competition. This study focuses on the application of Multi-Criteria Decision Making (MCDM) techniques to improve low-cost carrier (LCC) also known or low-cost (budget) airlines' ground operational performance. MCDM techniques have gained considerable attention in recent years to address complex decision problems with multiple conflicting goals. This research aims to bridge this gap by proposing a comprehensive framework that combines MCDM techniques to enhance airline operational strategies to increase performance. The study utilizes qualitative and quantitative data, drawing on previously published materials on MCDM techniques in the aviation sector. It utilizes fuzzy Analytic Hierarchy Process (AHP) and fuzzy Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) methodologies. A case study is conducted to evaluate the ground operational performance of three airline companies based in Türkiye, considering five main criteria and 18 sub-criteria. The findings of this research will contribute to a comprehensive understanding of operational performance in the airline sector. It also highlights the implications and limitations of the research and suggests future research directions.

Intense climate change and rapid urbanization have increased the risk of urban flooding, seriously affecting urban economic and social stability. Enhancing the urban flood resilience (UFR) has required a new solution to cope with urban flood disasters. In this study, taking Yingtan city as an example, a system of indicators for evaluating UFR was constructed, with 17 representative indicators, comprising three subsystems: socio-economic, ecological and infrastructural. A hybrid (FAHP-EWM)-TOPSIS model was applied, to develop an index-based measurement to compare and evaluate UFR, and Gray Relational Analysis (GRA) was used to discover the main factors affecting UFR. In addition, the natural discontinuous method was innovatively used to divide the UFR grade interval into levels, and the grade change was evaluated based on the TOPSIS method. The results showed that (1) from 2010 to 2022, the UFR in Yingtan City increased by 80.69%, and the factors affecting UFR are highly correlated with urban infrastructure development. However, the ecological resilience in the subsystem showed a fluctuating downward trend, because of the influence of the surface area of lakes and rivers. (2) The grades of UFR for Yingtan City increased from Level III (2010 and 2016) to Level IV (2022), with local financial expenditures and the age structure of the population being the main factors currently limiting the development of UFR. The study provides a theoretical basis for the construction of an indicator system for assessing the UFR of Yingtan and proposes practical improvement directions for UFR.

The focus of this article is the evaluation of the quality and the degree of community engagement in an expert-based, public-health communicative intervention for Alcohol Use Disorder (AUD). In 2023 the Canadian Alcohol Use Disorder Society collaborated with a grass-roots community health group, a regional health authority, and an academic participatory researcher to organize a working group to mount a social-marketing campaign to increase community support for AUD medical treatment in family-practice settings in a rural community in British Columbia. The partnership working group conducted a series of activities in the school system, the town council, and the community. This article covers the formative evaluation and the summative evaluation of the working group's effectiveness. The formative evaluation ("lessons learned" and "recommendations") consists of consensus evaluations of the quality of each activity using a variety of data sources. The formative evaluation followed improvement science methods and used consensus meetings to provide and reflect on formal and informal feedback. Formative results reflect the consensus of the participants in the working group and they record the reactions in the community. The summative evaluation measures evidence of community engagement found in transcribed text from meeting minutes. The summative evaluation used theory-based frameworks and text data visualization to assess the engagement dynamics of the working group. The summative evaluation helps to put the formative evaluation into perspective as communicative action. The summative evaluation validates the formative evaluation by revealing the communicative dynamics of engagement which resulted in the community’s increased capacity to understand and support Alcohol Use Disorder Treatment options. The working group and the entire intervention was seen by the participants and the public as a success and capable of replication. In a small community, it instilled new understandings and attitudes, bringing an emerging awareness of medication as an optional health mitigation strategy for Alcohol Use Disorder. Our study furthers this overall assessment by using theoretical constructs and analysis of communicative records to trace engagement characteristics of interest to researchers, societies, and community groups contemplating similar interventions in the future. The study also validates the effectiveness of communicative analysis as a measure of social-marketing for expert-based public health interventions.

This research focuses on developing a Student Performance Evaluation System to enhance effectiveness and oversight in higher education. The system aims to address challenges faced by instructors in evaluating student performance using a distributed system approach. Agile methodology is employed in development, and database replication techniques are applied for data synchronization. System features include registration, assessment form creation, assessment submission, statistical visualization, and access to assessment history. The system is designed to improve efficiency and transparency in the assessment process. Key features of the system include registration process, assessment form creation, assessment submission, statistical visualization, and access to assessment history. Its goal is to enhance efficiency and transparency throughout the assessment process. The article details the system workflow and the roles played by Admins, Instructors, and students in system usage. Additionally, it discusses the back-end development model and pathways, as well as the performance testing results. Performance testing indicates that the system achieves high throughput of up to 21.55 requests per second, with an average response time of only 34 milliseconds and an error rate of zero percent. These results affirm that the system efficiently handles user loads and nearly instantaneously responds to requests, providing an optimal user experience in the context of student performance evaluation in higher education.

Teaching, learning, research, and development are all supported in a favorable atmosphere at the University of Lagos (UNILAG). The wetland systems made up of freshwater that are extremely biodiverse makeup about 10% of the total land area. Flooding, deforestation, excessive sedimentation, blockages to streams, abuse, overuse, and invasion of wetlands are some of the recent environmental challenges that the university faced. Urban heat island impacts, contaminants in the air, wetland degradation, social issues including stress, and a detachment from nature are all major concerns. With the green corridor behind the faculties of law and management science serving as a model supported by sustainability as a true foundation for UNILAG's campus landscapes, this article investigates the sustainable restoration of wetlands within the boundaries of the university. The use of qualitative techniques was employed, utilizing the Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis. Additionally, a geospatial mapping of the wetlands and tributaries that connect the Lagos Lagoon was conducted to evaluate the intrinsic ecological goods and services through a series of analytical steps, beginning with an analysis of the land area, current biodiversity, hydrology, and its potential through landscape mapping and analysis. The biophysical setup, landscape features, climatic data analysis, the ecological goods and services derived from the wetlands, and the records of flooding and rainfall are all included in the geospatial evaluation and analysis. The educational institution's site planning for the remediation of its wetlands takes into account the actual evolution of the area's drainage network. Throughout the wetlands, low carbon emissions are generated by off-road bike lanes, trails for walking, and raised hardwood platforms. Combining native plant species and park furniture, the academic landscape atmosphere will be improved in each of the wetlands and aesthetic values. the country's "University of First Choice" and its biophysically restored wetlands will help illuminate the landscape while the green corridors have an innate ability to attract human affinity within the academic community. All of these elements are implemented following an environmentally friendly landscape planning, management, design model, and enforcement process.

As an important support for power system with high penetration of renewable energy, energy storage system (ESS) has changed the traditional model of simultaneous implementation of electricity production and consumption, and its installed capacity under the source-grid-load scenario is rising year by year, but it faces the problems of insufficient utilization and benefits. This study analyzes the functional combination of ESS under the source-grid-load scenarios, and proposes a comprehensive benefit evaluation method of energy storage projects based on fuzzy decision-making trial and evaluation laboratory (DEMATEL) and super efficiency data envelopment analysis (DEA) model, which considers the perspective of economic and social environment. Firstly, the functional requirements of energy storage on the source-grid-load scenarios are explored respectively, and the characteristics of various functions are analyzed to form functional combination schemes. Secondly, index modeling is carried out from three aspects: the whole life cycle cost, functional combination benefit and social environmental benefit, and the comprehensive benefit evaluation index system of energy storage project is proposed, which includes both economic and social environment. Then, the intuitionistic trapezoidal fuzzy number is combined with DEMATEL to form an effective analysis method for the input-output relationship of the indexes, and the comprehensive evaluation is realized based on the super efficiency DEA model. Finally, the effectiveness of the proposed evaluation method and the rationality of the functional combination are verified under source-grid-load scenarios respectively.

The objective of this study is to investigate the correlation between the advancement of flood research and the utilization of Geographic Information Systems (GIS) and multi-criteria evaluation techniques, both from a theoretical and practical standpoint. Additionally, this research seeks to identify potential ways to address the aforementioned relationship. The present study employs a thorough literature review methodology. In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology, a total of 28 papers were identified and included in the analysis, as they fulfilled the predetermined criteria. The findings of the study indicate that current research pertaining to the utilization of Geographic Information Systems (GIS) and multicriteria evaluation in flood control mostly centers around five key areas, namely natural factors, technical considerations, institutional factors, socio-economic factors, and financial factors. However, the aforementioned studies have identified specific areas of focus, including natural factors pertaining to climate, technical factors related to infrastructure, institutional factors concerning flood management strategies, socio-economic factors associated with demographics, and financial factors pertaining to financial obligations. However, there is a limited amount of existing research that specifically addresses flood management in developing nations. Therefore, it is anticipated that this study can serve as a valuable resource for future research endeavors, particularly in informing decision-making processes pertaining to the establishment of priorities in flood control plans. The primary subject of this study pertains to flood management occurrences within developing nations.

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.

The construction time of concrete structures in hydraulic tunnels is long, the construction environment is complex, and there are many influencing factors. The requirements for construction quality are high, not only to meet the strength requirements, but also to meet the design requirements of erosion resistance, crack resistance, and seepage resistance according to its specific operating environment. Therefore, evaluating the construction quality of concrete structures in hydraulic tunnels is of great significance. Considering the randomness and fuzziness of factors affecting the construction quality of concrete structures in hydraulic tunnels, this paper proposes a comprehensive evaluation model based on Combined Weighting (CWM) and Uncertainty Measurement Theory (UM). The IAHP method and CRITIC method are used to determine the subjective and objective weights of evaluation indicators, combined weighting is based on the principle of minimum entropy, and the UM method is used to evaluate the construction quality level. Finally, taking a hydraulic tunnel as an example, its construction quality grade is calculated to be III according to the evaluation model proposed in this paper, which matches with the engineering reality, and a comparative study is made with the mixture element topology theory at the same time. It is verified that the evaluation model can scientifically and reasonably evaluate the construction quality level of concrete structures in hydraulic tunnels.

Accurate and reliable mid-long runoff prediction (MLTRP) is of great importance in water re-sources management. However the MLTRP is not suitable in each basin and how to evaluate the applicability of MLTRP is still a question. Therefore, the total mutual information (TMI) index is developed in this study based on the predictor selection method using mutual information (MI) and partial MI (PMI). The relationship between the TMI and the predictive performance of five models is analyzed by applying five models in 222 forecasting scenarios in Australia. The results over 222 forecasting scenarios demonstrate that, compared with the MI, the developed TMI index can better represent the available information in the predictors, and has more significant negative correlation with the RRMSE with the correlation coefficient between -0.62 and -0.85. This means the model's predictive performance will become better along with the increase of TMI, and there-fore the developed TMI index can be used to evaluate the applicability of MLTRP. When TMI is more than 0.1, the available information in the predictors can support the construction of MLTRP models. In addition, the TMI is used to partly explain the difference of predictive performance among five models. In general, the complex models, which can better utilize the contained infor-mation, are more sensitive to the TMI, and have more significant improvement in terms of predic-tive performance along with the increase of TMI. This research can provide support for the study of MLTRP.

This study aims to develop an auditory experience evaluation questionnaire to improve the presence of metaverse environments, and to derive evaluation components considering auditory presence and auditory user experience (AUX) through a survey. After conducting a survey with a total of 232 participants, five evaluation components were extracted from auditory presence and AUX evaluation factors through principal component analysis (PCA) and reliability analysis (RA): 'realistic auditory background', 'acoustic aesthetics', 'consideration of acoustic control and accessibility', 'auditory utility and minimalist design', and 'auditory consistency'. In particular, although AUX evaluation factors such as 'ease of access to sound control' have limitations in improving the sense of presence, negative factors of presence such as 'distraction due to sound' can be improved by utilizing AUX evaluation factors, so it is judged that the sense of presence in the metaverse environments can be improved by enhancing the auditory sense of presence and AUX evaluation factors according to the composition of the five evaluation components derived in this study. This study can be used as a basis for developing an auditory experience evaluation questionnaire for the metaverse platform, creating sound design guidelines, and identifying sound development priorities.

Introduction: Pre-Exposure Prophylaxis (PrEP) for HIV prevention has been implemented in several countries. Previous literature has shown that its cost-effectiveness (and, under some specifications, cost-saving character) is dependent on the reduction in price due to generics, the time-horizon and its effectiveness. The intervention has never been studied in Catalonia, a territory with extensive implementation. Methods: Economic evaluation of the implementation of HIV pre-exposition prophylaxis using administrative data from Men who have Sex with Men (MSM) who receive the treatment (at the generic price). A deterministic compartmental model and a social perspective with a micro-costing approach over the time horizon 2022-2062 are used. A baseline 86% effectiveness of PrEP is assumed. Results: Daily oral PrEP is found to be cost-saving: discounted savings in costs are attained after 16 years, and after 40 years they reach 81 million euros. In terms of health indicators, 10,322 additional discounted QALYs are generated by the intervention. Results are sensitive to sexual behavioral patterns among MSM, the price of PrEP (reduced if offered on-demand), its effectiveness and the discount rate. Conclusions: The use and promotion of PrEP in Catalonia is predicted to result in substantial health and monetary benefits because of reductions in HIV infections. Short-term investments in the promotion of PrEP will result in important cost-savings in the long term.

Improper sitting positions are known as the primary reason for back pain and the emergence of musculoskeletal disorders (MSD) among individuals who spend prolonged time working with computer screens, keyboards, and mice. At the same time, it is well understood that automated technological tools can play an important role in the process of unhealthy habit alteration, so plenty of research efforts are focused on research and technology development (RTD) activities that aim to provide support to the prevention of back pain or the development of MSD. Here, we report on creating a new resource in support of RTD activities aiming at the automated detection of improper sitting positions. It consists of multimodal multisensory recordings of 100 persons made with a video recorder, camera, and wrist-attached sensors that capture physiological signals (PPG, EDA, Skin temperature), as well as motion sensors (three-axis accelerometer). Our multimodal multisensory dataset (MMD-MSD) opens new opportunities for modeling the body stance (sitting posture and movements), physiological state (stress level, attention, emotional arousal, valence), and performance (success rate on the Stroop test) of people working with a computer. Finally, we demonstrate two use cases: improper neck posture detection from pictures and cognitive load detection from physiological signals.

This study delves into the realm of heuristic evaluation within usability testing, focusing on refining and applying a tailored algorithm that simplifies the implementation of the Analytic Hierarchy Process for heuristic prioritization. Addressing the prevalent challenge of disparate evaluation methodologies and the absence of a standardized process in usability testing, our research introduces a novel method that leverages the Analytic Hierarchy Process alongside a bespoke algorithm. This algorithm utilizes transitive properties for pairwise comparisons, significantly reducing the evaluative workload. This innovative approach facilitates the estimation of heuristic relevance irrespective of the number of items per heuristic or the item scale and streamlines the overall evaluation process. In addition to rigorous simulation testing of the tailored algorithm, we applied our method in a practical scenario, engaging seven usability experts in evaluating a web interface. This empirical application underscored our method’s capacity to diminish the requisite comparison count and spotlight areas of improvement for critically weighted yet underperforming heuristics. The outcomes of this study underscore the efficacy of our approach in enhancing the efficiency and organization of heuristic evaluations, paving the way for more structured and effective usability testing methodologies in future research endeavors.

Ethics is a research field that is obtaining more and more attention in Computer Science due to the proliferation of artificial intelligence software, machine learning algorithms, robot agents (like chatbot), and so on. Indeed, ethics research has produced till now a set of guidelines, such as ethical codes, to be followed by people involved in Computer Science. However, a little effort has been spent for producing formal requirements to be included in the design process of software able to act ethically with users. In the paper, we investigate those issues that make a software product ethical and propose a set of metrics devoted to quantitatively evaluate if a software product can be considered ethical or not.

In most world’s countries, scholarship evaluation for tenure and promotion continues to rely on conventional criteria of publications in journals of high impact factor and grant funding. Continuing to hire and promote scholars for their achievements in research and in securing research funds exposes universities at risk because students, directly and indirectly through government funds, are the main source of revenues for academic institutions, whereas talented young researchers are those who actually carry out most of the published research. Purposeful scholarship evaluation needs to include all three areas of scholarly activity: research, teaching and mentoring, and service to society. Young scholars seeking tenure and promotion benefit from the practice of open science because it provides better and more impactful results with respect to each of the three areas of scholarship.

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

Residential burns camp programmes provide help and support to children with burn injuries by providing activities designed to build their confidence and self-esteem. Our regional burns service has been running camps for over 20 years and evaluation is an important part of assessing their effectiveness. In this study we report both qualitative and quantitative data from 10 consecutive years of burns camps. Qualitative feedback was gathered using Likert scales and free response questionnaires at the end of camp and six weeks post-camp. Three quantitative outcome measures, the Paediatric Quality of Life Inventory v4, the Children’s Revised Impact of Event Scale (CRIES8) and the Satisfaction with Appearance Scale (SWAP) were completed before and six weeks after camp. Children and their parents/carers both reported attending burns camp was helpful for them/their child; the themes of meeting other children with burn injuries and developing confidence and self-esteem were cited as reasons. Parents/carers also reported significant improvements in their child’s physical and psychological functioning post-camp in some years. These findings confirm the importance of providing burns camp programmes for children with burn injuries as part of their post burn rehabilitation.

Urban rail transit hub platform is the most important area for passenger flow distribution. In order to calculate passenger flow volume in platform and evaluate platform service level during rush hours, this paper presents a method for modeling and simulation of passenger flow distribution in platform. Passenger flow distribution model (PFDM) is proposed based on the basic analysis and the superposition principle of passenger flow. Simulation design for PFDM is proposed by Anylogic, which contains simulation process and simulation model. Experiment results show that PFDM and simulation design are effective and accordant with the reality scenario, and the simulation precision is comparatively ideal. This research could provide a beneficial reference for train scheduling and operation management under the viewpoint of traffic safety and service level.

Distributional word vector representation orword embedding has become an essential ingredient in many natural language processing (NLP) tasks such as machine translation, document classification, information retrieval andquestion answering. Investigation of embedding model helps to reduce the feature space and improves textual semantic as well as syntactic relations.This paper presents three embedding techniques (such as Word2Vec, GloVe, and FastText) with different hyperparameters implemented on a Bengali corpusconsists of180 million words. The performance of the embedding techniques is evaluated with extrinsic and intrinsic ways. Extrinsic performance evaluated by text classification, which achieved a maximum of 96.48% accuracy. Intrinsic performance evaluatedby word similarity (e.g., semantic, syntactic and relatedness) and analogy tasks. The maximum Pearson (ˆr) correlation accuracy of 60.66% (Ssˆr) achieved for semantic similarities and 71.64% (Syˆr) for syntactic similarities whereas the relatedness obtained 79.80% (Rsˆr). The semantic word analogy tasks achieved 44.00% of accuracy while syntactic word analogy tasks obtained 36.00%

The high genetic diversity of the tomato and its high micronutrient content make this fruit very interesting from an economic and nutritional point of view. The genetic erosion suffered by this crop, due to breeding objectives based on yield and marketing, makes it necessary to return to the origins in search of the nutritional and organoleptic quality lost in traditional varieties. In this study, the agronomic, physical, organoleptic and nutritional characteristics of eighteen F1 hybrids obtained by crossing fourteen traditional varieties, previously selected for their quality, were studied to select genotypes of superior quality that could be candidates for new. All parameters studied were strongly influenced by genotype, showing a wide range between cultivars. Principal Component Analysis revealed the characteristics of each hybrid that made it stand out from the others. Some hybrids (H3, H4, and H6) stand out because of their high concentration of active compounds, others (H16, H15, H10, H17, H9, and H11) because of agronomic performance and high content of β-carotene, and H5 was the only one to contain chlorophyll in their ripe fruits. Finally, the evaluation index allowed the selection of five hybrids with interesting characteristics, combining good yield performance and high quality

The Coronavirus outbreak that began in December, 2019 became a worldwide pandemic by March, 2020. The education industry had to adapt to this new change in a speedy and most feasible way by shifting to virtual classes over the internet and other available resources. WhatsApp has turned out to be a boon in academic’s section where in all the teachers have their own subject-wise groups on the said application. This not only helps them to share the necessary information resources but also to have discussion regarding the subject matter. On the other side, this application allows easy access for the students to all the resources shared by the teacher, and they can share their assignments without much difficulty with their subject teachers. Therefore, it has become a primary tool for conducting teaching, learning and evaluation online. The researchers have tried to analyze impact of online classes and the efforts required by the students to learn online with the help of survey conducted with the sample size of 514. The survey questionnaire was grouped into 4 categories namely; Opinion on Information and Communications Technology (ICT) based Teaching, Changes in communication behavior due to ICT using WhatsApp, the main hindrance for integration of ICT (Information Communication Technology) in the teaching-learning process and disadvantages of using ICT for teaching and learning.

Although numerous citrus varieties have recently been developed to enhance their quality, information on their quality characteristics is limited. We assessed the quality characteristics of Yellowball, a novel citrus variety, by evaluating its appearance, storability, sensory properties, functionality, and metabolite profiles and comparing these characteristics with those of its parent varieties: Haruka and Kiyomi. The metabolite profiles between the citrus varieties differed significantly, resulting in distinct physicochemical and functional qualities. The storability of Yellowball was significantly increased compared with that of its parent varieties owing to its strong antifungal activity and unique peel morphology, including the stoma and albedo layers. While we did not investigate the volatile compounds, overall functional activities, and detailed characteristics of each metabolite, our data provide valuable insights into the relationship between citrus metabolites, peel morphology, physicochemical properties, and storability and demonstrate the potential of Yellowball as a promising variety in the citrus industry.

In the rapidly evolving landscape of the AI era, the measurement of Computational Thinking ability among Computer Science (CS) University students is of paramount importance. This study introduces UniCTCheck, a novel method designed to assess the main components of Computational Thinking in CS students. Utilizing two key instruments, namely the web application CTScore and the psychometric scale CTProg, this research aims to precisely evaluate seven core components of Computational Thinking and six programming concepts skills essential for CS students. The study, conducted at Rey Juan Carlos University and Atlantic Technological University Galway, involved a diverse sample of students from different year levels and program specializations. Through a rigorous research design, including sampling strategies and data collection tools, this study seeks to address critical research questions related to measurement of variations in students' Computational Thinking and programming skills by gender, university level, and location. By shedding light on the significance of Computational Thinking and programming in the educational realm, this research contributes to the existing literature and underscores the essential role of computational skills in the modern era.

The application of smartphone-based color evaluation of passive sampling devices for gases has only been sparsely reported. The present review aims to compile available publications with respect to the configuration of the passive samplers, conditions of smartphone photographing, analytical procedure for color detection and quantification (including calibration processes), and their application to different target gases. The performance of the methods - whenever available - is presented regarding the analytical specifications selectivity, sensitivity, and limit of detection in comparison with other color evaluation methods of passive samplers. Practical aspects like requirements of instrumentation and ease of use will be outlined in view of the potential employment in education and citizen science projects. In one section of the review the inconsistent terminology of passive and diffusive sampling is discussed in order to clarify the distinction of information obtained from the uptake of the passive samplers between gas-phase concentration and the accumulated deposition flux of gaseous analytes. Colorimetric gas sensors are included in the review when applied in passive sampling configurations and evaluation is performed with smartphone-based color evaluation. Differences in the analytical procedures employed after the passive sampling step and prior to the detection of the colored compounds are also presented.

With the spread of compulsory education emerged school management problems continued, and the quality of school management in compulsory education has attracted a great deal of attention in China. However, the application of information technology in the field is not yet detailed and wide, resulting in problems of heavy workload and high difficulty in the whole evaluation process. Accordingly, we use big data technologies such as Apache Spark, Apache Hive, and SPSS to carry out data cleaning, correlation analysis, dynamic factor analysis, principal component analysis, and visual display on 1760 sample data from 40 primary and secondary schools in Q Province in China, and constructs a model school management of quality evaluation in the compulsory education stage, which reduces the 22 management tasks required for previous evaluation to 5, greatly reducing the workload and difficulty of evaluation. It has improved the efficiency and accuracy of evaluation, and further promoted the simultaneous development of education of five domains and education equity in the compulsory education stage.

This research centers on the Mulberry-Dyke and Fish-Pond System in Digang Village, Huzhou, exem-plifying the traditional cyclic agricultural models of China. The study's objective is to evaluate its integral value concerning agricultural production, ecological environment, and heritage conservation. Employing the Analytical Hierarchy Process (AHP) and Fuzzy Comprehensive Evaluation (FCE) methodologies, we developed a comprehensive evaluation framework comprising 8 dimensions and 29 factors, aimed at assessing the provisioning, regulating, and cultural services of this ecosystem. The findings indicate a robust performance of the ecosystem services in Digang Village's Mulberry-Dyke and Fish-Pond System, with cultural services significantly standing out. In contrast, the regulating services appeared relatively weaker, pinpointing shortcomings in mulberry land management, while the provisioning services demonstrated substantial strength. These insights are pivotal for comprehending the system's ecosystem service values, highlighting areas for managerial improvements, and guiding future assessment and management strategies. This study contributes theoretical insights and empirical experiences for future evaluations of the Mulberry-Dyke and Fish-Pond System's ecosystem services.

Background: Transposable elements (TEs) constitute the vast majority of all eukaryotic DNA, and display extreme diversity, with thousands of families. Given their abundance and diversity, TEs discovery and annotation becomes challengeable. At present, tools and databases have built libraries to mask TEs in genomes based on de novo- and homology-based identification strategies, but no consensus criteria about which tools should be used have been proposed. Results: In the de novo-based strategy, we compared performances of TE libraries developed by four commonly used tools, including RepeatModeler, LTR_FINDER, LTRharvest, and MITE_Hunter, by using a simulated genome as a standard control. The results showed that the performance of RepeatModeler decreased as it was combined with either LTR_FINDER or LTRharvest. Combination of RepeatModeler and MITE_Hunter showed better performance than RepeatModeler and MITE_Hunter alone. In the homology-based strategy, we evaluated different sources from a taxonomic point of view to build an accurate TE library. When we selected a library from databases to identify TEs for Arabidopsis thaliana genome, the library from a genus genetically closer to Arabidopsis achieved better performance than other genera with further genetic distance. Without the Arabidopsis, combination of top three genera closer to Arabidopsis showed better performance than combination of all genera. Conclusion: This study proposes a series of recommendations to perform an accurate TE annotation: 1) For de novo-based strategy, RepeatModeler and MITE_Hunter are suggested to build a TE library; 2) For homology-based strategy, it is recommended to use library of genus genetically close to the species rather than use combined library from all genera.

With the branding development of the international exhibition industry and the increase in the number of mergers and acquisitions of exhibitions, the assessment of the brand value of exhibitions has gradually come into the view of governments, investment and financing institutions and researchers. Compared with the brand value assessment of consumer goods and industrial sectors, the brand value assessment of exhibitions, especially B2B exhibitions, has special characteristics. A model for brand value assessment of B2B exhibitions is proposed, which can not only provide a reference for decision-making on M&A behaviour of exhibitions, but also provide a decision-making tool for government exhibition brand promotion. The aim of this paper is to explore the feasibility of constructing an AHP-based conceptual model for brand value assessment of exhibitions in Shanghai through a hybrid study. The applicability of the conceptual model for exhibition brand value assessment is empirically demonstrated by analysing six steps, including establishing pairwise comparison matrices, calculating the maximum eigenvalues and normalised eigenvectors of each comparison matrix, conducting consistency checks, group decision matrix synthesis and weight allocation of exhibition brand value assessment indicators. On this basis, the three values of the model in practice and theory are explored separately. The research results can provide better brand value assessment and development support for exhibition stakeholders and improve the sustainability of exhibition brands.

The teaching of mathematics at the Faculty of Military Technology of the University of Defense in the first two years of the five-year Military master’s degree is divided into the teaching of students in four specializations: Military Technologies – Mechanical, Military Technologies – Electrical, Military Geography and Cartography, and Cybersecurity. The article discusses the previous five-year experience in teaching the subjects Mathematics I, Mathematics II, Mathematics III, and Graph theory for the specialization in Cybersecurity, that the author of the paper gained while teaching, as a guarantor of these four subjects. The article provides an overview of the topics that are covered, typical exam assignments, and an evaluation of the results of the semester exams in the five years since the accreditation of the Cybersecurity specialization was granted.

In recent years, there have been concerns raised about construction industrialization in China, which have initiated a wave of policy change in both governmental and industrial organizations in order to change the mode of conventional construction. However, the current development level of regional construction industrialization (RCI) in China has not been well-characterized. This study screened preliminary index systems in five dimensions: technical, economic, sustainable, enterprise development and development environment. Based on the data gathered from the questionnaire surveys and subsequently analyzed, twenty-two critical evaluation indicators were identified. Analytic Hierarchy Process (AHP) was then employed to determine the weighting of each indicator. The evaluation method of the development level was formulated on the basis of the evaluation criteria. Jiangsu Province was used as an example in this study, with the development level of this province being comprehensively examined using a combination of the index system and evaluation method. The results show that Jiangsu has a relatively high RCI development level. The data from analysis scores of five dimensions and twenty-two indicators show that the index system is feasible, with evaluation results being consistent with actual practice. These findings provide a good practical reference for making decisions about how best to guide the development of RCI.

In patients with heart failure, the evaluation of left ventricular (LV) diastolic function is vital, offering crucial insights into hemodynamic impact and prognostic accuracy. Echocardiography stands as the primary imaging modality for diastolic function assessment, and using it effectively requires a profound understanding of the underlying pathology. This review covers four main topics: first, the fundamental driving forces behind each phase of normal diastolic dynamics, along with the physiological basis of two widely used echocardiographic assessment parameters, E/e' and mitral annulus early diastolic velocity (e'); second, the intricate functional relationship between the left atrium and LV in patients with varying degrees of LV diastolic dysfunction (LVDD); third, the role of stress echocardiography in diagnosing LVDD and the significance of parameter changes in this context; and fourth, the clinical utility of evaluating diastolic function from echocardiography images across diverse cardiovascular care areas.

Artificial Intelligence (AI) systems involve diverse components, such as data, models, users and predicted outcomes. To elucidate these different aspects of AI systems, multifaceted explanations that combine diverse explainable AI (XAI) methods are beneficial. However, popularly adopted user-centric XAI evaluation methods do not measure these explanations across the different components of the system. In this position paper, we advocate for an approach tailored to evaluate XAI methods considering the diverse dimensions of explainability within AI systems using a normalised scale. We argue that the prevalent user-centric evaluation methods fall short of facilitating meaningful comparisons across different types of XAI methodologies. Moreover, we discuss the potential advantages of adopting a standardised approach, which would enable comprehensive evaluations of explainability across systems. By considering various dimensions of explainability, such as data, model, predictions, and target users, a standardised evaluation approach promises to facilitate both inter-system and intra-system comparisons for user-centric AI systems.

Establishing an effective evaluation model to analyze the actual environmental level of the multi-indicator systems is an urgent challenge. However, due to the complexity of the environmental system, the factors that determine the practical system are usually interrelated. To solve this problem, many methods have been proposed and verified. However, the disadvantage of unreasonable weight determination and only single-indicator assessment limits the practical application of these analysis methods. Here, we established an optimized entropy weight model and integrate it with the fuzzy comprehensive evaluation (FCE) method to quantify the complex environmental system. By introducing the linear programming method into the entropy weight solution, we can obtain high accuracy weight values and strong resistance to extreme data. Theoretical and simulation results demonstrate that our method can enhance the precision of weight calculation and evaluation results for multi-factor systems. Our work develops an effective method to quantify the complex environment system comprehensively and is significant to real applications of evaluation method.

Objectives: Few studies in literature evaluate the "mean measure" of root divergence. Most of them are linear measurements, they hardly describe the dental furcation conformation. It is left to the subjectivity of the operator deciding whether a furcation is convergent or divergent. The goal of this study is to create a visual evaluation method to overcome these problems giving a conformation of the entire interradicular space. Material and methods: A user-friendly software (Paint®, Windows10®) was used to measure endo-oral radiographs of upper and lower molars. Three kinds of measurements were taken. Three operators used the software to measure 20 radiographs, then the technique was repeated on 250 radiographic images to identify an average measurement. The ratio of these three measurements allowed to develop a new visual evaluation method of the interradicular space. Results: Intra and inter-operator reproducibility was statistically assessed on a sample of 20 anonymous endo-oral radiographs measured by 3 blind operators. Then, a sample of 250 anonymous endo-oral radiographs were measured by a blind operator and were statistically evaluated to identify an average value to define a main conformation of the interradicular space. Measurements made by the 3 operators on the 20 radiographic images showed that the technique is reproducible, and a mean value of the interradicular space was obtained. Conclusions: A new anatomical evaluation of the interradicular space in its entirety, which could help the clinicians in the therapy of furcated molars, can be obtained.

The paper addresses the problem of a statistically significant numerical evaluation of the biomechanics of respiration using the motion of the ribcage through the identification of the kinematics of the sixth rib. We report the results of an experimental campaign conducted using a RESPIRholter device prototype for efficient, comfortable, and numerical monitoring on two groups of volunteers, namely with healthy people and with chest operated patients. The results are reported in terms of statistical processing of the data extracted from the monitoring which are represented in plots of acquired motion characteristics with movement graphs in terms of angles and accelerations. This experimental campaign can be considered a first result for the construction of a database useful for a reference of diagnostics as reported by the discussed example case study.

The contribution deals with the joining of various types of materials by technology of thermal drilling. In various branches of industries, also in the automotive industry must be joining operations, service, repairing, substitution or protection workpieces, components with various types of materials. Equally, the important role as joint, is also used material, and a product preparation by assembly and disassembly operations. By utilization of new friction hybrid joining technologies we can shortage the production time, provide automation in operations, increase the quality of joints, spare of economical expenses and also we can protect the environment. In this paper authors have investigated the effect of friction drilling on the tested material, aluminium alloy AlMgSi, which was used for material testing. The created joints were evaluated visually and by microscopy methods. The errors of tested joining were documented and described, too. This contribution was made with cooperation of Technical University of Kosice and with U. S. Steel Kosice, s.r.o.

Injuries of repetitive efforts constitute one of the prime causes of absenteeism in the workplace, have bear a considerable cost for the public health system and can cast doubt on the sustainability of a company. The objective of this paper is to build, in the researchers, the needed knowledge to choose a set of relevant scientific articles about repetitive strain injuries in the poultry meat industry, aiming identify characteristics in those scientific publications that have the potential to contribute on the topic of this paper. The research is characterized as exploratory-descriptive, draws on primary and secondary data sources. The study involves the application of a method for selection and analysis of the selected articles. To this end, the method utilized was the Knowledge Development Process – Constructivist (Proknow-C) as theoretical intervention instrument. Within the process development, it was obtained a portfolio of 16 articles aligned to the research and scientifically recognized with the main periodicals, papers, authors and keywords. The ProKnow-C process allowed identify opportunities in the literature about injuries in the poultry meat industry and showed opportunities for research future. This paper, under the constructivist perspective, presents a structured process to build, in the researcher, the necessary knowledge to identification, selection and analysis of relevant scientific articles relating to research context and, for these articles, find prominences and opportunities for a research theme without similar publications.

The spread of fake news poses a serious threat to public trust and informed decision-making. The emergence of AI-generated fake news exacerbates this issue, as it can be produced more rapidly and convincingly than human-generated content. Addressing this issue, our paper introduces a robust approach to detect AI-generated fake news that is applicable across major disinformation domains: Politics and Elections, Health and Medicine, Science and Technology, and Entertainment and Celebrities. Our models differentiate between AI-generated and human-generated news articles while assessing their truthfulness. Utilizing large language models such as ChatGPT, we curated datasets spanning both AI and human generated fake and genuine news. Following extensive data preprocessing and the application of diverse feature extraction techniques, our models were trained using multiple machine learning algorithms. Our results show the feasibility of accurately identifying AI-generated fake news, thereby adding a significant layer of defense in combating misinformation across various sectors. In addition, we have explored the potential utility of transferable machine learning models trained on data from one domain (e.g., politics), when tested on another domain (e.g., health).

As a consequence of the global sanitary crisis in early 2020, universities had to tackle with a sudden shift in their teaching-learning strategies so that the preset competences could be fulfilled. This study presents the learning outcomes of the tasks implemented, student experiences and feedback, as well as some reflections from the instructors with a holistic perspective of the courses due to the measures and adaptations adopted. Six courses taught at Civil Engineering degrees of three universities, two from Spain and one from Peru, are analyzed. The teaching and evaluation strategies are described and some reflections are made by comparing the student’s performance with the previous course. Although the shift to online learning had to be made from day to day, with no time for preparation, the experience has proved that online learning can be beneficial in some aspects and have probably come to stay, although some others are difficult to replace with respect to face-to-face learning, especially students’ engagement and motivation.

The objective of this study is to analyze the assessment practices in primary education and how they relate to the valuation of the learning process. It seeks to understand the perceptions of teachers and students regarding assessment and to observe classroom activities, as well as to analyze the assessment instruments used. The method used is a mixed approach that combines qualitative interpretations of the participants’ realities with a phenomenological analysis to reflect on the evaluative practices. The results indicate a contradiction between what is said and what is done in terms of evaluation, with a tendency to use written tests and traditional exams instead of a combination of techniques that allow for a significant evaluation of student learning. In addition, significant differences are observed among teachers regarding the importance they give to evaluation within their practices and evaluative models.

Background: While the clinical factors of the post-COVID-19 condition (PCC) are becoming clearer, the economic implications remain uncertain, posing a challenge to healthcare professionals in terms of understanding and managing this emerging phenomenon. This article aims to investigate the demographic and clinical characteristics of PCC patients and quantify the economic impact of their healthcare resource utilisation. Methods: A retrospective and case-control observational study was conducted, comparing the case group of PCC population before and after diagnosis with a control group. Demographic and clinical variables were analysed with the objective of describing the population. Economic analysis was performed to evaluate the resource costs in procedures and primary, secondary (both outpatient and inpatient) and emergency care. Findings: PCC patients (N=341) exhibited older age and elevated cardiovascular risk factors compared to controls (N=49,078). There were differences in the socio-economic distribution between male and female patients in the PCC patients. Hypertension and diabetes mellitus type 2 were the most common chronic diseases observed among the case patients. Economic analysis revealed that PCC patients were approximately four times as costly as control patients, with increased utilisation of healthcare resources. However, post-diagnosis PCC patients showed a reduction in costs, primarily driven by decreased primary care visits and hospitalisations. Conclusion: Coordinated care management for PCC patients is associated with reduced costs and improved healthcare resource utilisation. Further research is warranted to investigate long-term health outcomes and establish causal relationships between COVID-19 sequelae and healthcare resource utilisation.

With the advent of Neural Machine Translation, the more the achievement of human-machine parity is claimed at WMT, the more we come to ask ourselves if their evaluation environment can be trusted. In this paper, we argue that the low quality of the source test set of the news track at WMT may lead to an overrated human parity claim. First of all, we report nine types of so-called technical contaminants in the data set, originated from an absence of meticulous inspection after web-crawling. Our empirical findings show that when they are corrected, about 5% of the segments that have previously achieved a human parity claim turn out to be statistically invalid. Such a tendency gets evident when the contaminated sentences are solely concerned. To the best of our knowledge, it is the first attempt to question the “source” side of the test set as a potential cause of the overclaim of human parity. We cast evidence for such phenomenon that according to sentence-level TER scores, those trivial errors change a good part of system translations. We conclude that to overlook it would be a mistake, especially when it comes to an NMT evaluation.

Obesity is associated with increased morbidity and mortality and impaired quality of life. Weight losse is associated with improvement or even cure of cardiovascular risk factors with cardiometabolic benefit. nonsurgical measures for weight loss is rarely successful in the long term. Bariatric surgery has achieved clear success in reversing the abnormal metabolic profile associated with obesity. Pre surgical evaluation is important to rule out any medical or psychological problems that increased the surgical mortality or adversely affect the outcome.