A new requirement for the manufacturing companies in Industry 4.0 is to be flexible with respect to changes in demands, requiring them to react rapidly and efficiently on the production capacities. Together with the trend to use Service-Oriented Architectures (SOA), this requirement induces a need for agile collaboration among supply chain partners, but also between different divisions or branches of the same company. In order to address this collaboration challenge, we~propose a novel pragmatic approach for the process analysis, implementation and execution. This~is achieved through sets of semantic annotations of business process models encoded into BPMN 2.0 extensions. Building blocks for such manufacturing processes are the individual available services, which are also semantically annotated according to the Everything-as-a-Service (XaaS) principles and stored into a common marketplace. The optimization of such manufacturing processes combines pattern-based semantic composition of services with their non-functional aspects. This is achieved by means of Quality-of-Service (QoS)-based Constraint Optimization Problem (COP) solving, resulting in an automatic implementation of service-based manufacturing processes. The produced solution is mapped back to the BPMN 2.0 standard formalism by means of the introduced extension elements, fully detailing the enactable optimal process service plan produced. This approach allows enacting a process instance, using just-in-time service leasing, allocation of resources and dynamic replanning in the case of failures. This proposition provides the best compromise between external visibility, control and flexibility. In this way, it provides an optimal approach for business process models' implementation, with a full service-oriented taste, by implementing user-defined QoS metrics, just-in-time execution and basic dynamic repairing capabilities. This paper presents the described approach and the technical architecture and depicts one initial industrial application in the manufacturing domain of aluminum forging for bicycle hull body forming, where the advantages stemming from the main capabilities of this approach are sketched.

Image fusion is a useful tool for producing a high-resolution multispectral image to be used for land use and land cover mapping. In this study, we use nine pansharpening algorithms namely Color Normalized (CN), Gram-Schmidt (GS), Hyperspherical Color Space (HCS), High Pass Filter (HPF), Nearest-Neighbor Diffusion (NND), Principal Component Analysis (PCA), Resolution Merge (RM), Stationary Wavelet Transform (SWT), and Wavelet Resolution Merge (WRM) to fusion Worldview-3 multispectral Bands and panchromatic band. In spectral and spatial fidelity, several image quality metrics are used to evaluate the performance of pansharpening algorithms. The SWT and PCA algorithms showed better results compared to other pansharpening algorithms while GS and CN algorithms showed the worst results for the original image fusion. The effect of fusion on each band was separately investigated and according to the calculations, we found that the CoastalBlue band and the Blue band showed the best result and the NIR-1 band and NIR-2 band show the worst result for the original image fusion. In the end, we conclude that the choice of fusion method depends on the requirement of remote sensing application.

The key goal of the current study was to determine suitable areas of water pumping for drinking and agricultural harvest in Tabriz aquifer, located in East Azerbaijan province, northwest Iran. In the study area, groundwater is the key foundation of water for drinking and farming requirements. Groundwater compatibility study was conducted by analyzing Electrical conductivity (EC), Total dissolved solids (TDS), Chloride (Cl), Calcium (Ca), Magnesium (Mg), Sodium (Na), Potassium (K), Sulfate (SO4), Total hardness (TH), Bicarbonate (HCO3), pH, carbonate (CO3) and Sodium Adsorption Ratio (SAR) obtained from 39 wells in the period of 2003 to 2014. For this purpose, the Water Quality Index (WQI) and irrigation water quality (IWQ) index were utilized. The WQI index zoning exposed that the groundwater of the study area for drinking purposes is categorized as excellent, good and poor water. Most drinking water harvested for urban and rural areas are in the class of 'excellent water'. The results revealed that about 37 percent (296 km2) of groundwater has high compatibility, and 63 percent of the study area (495 km2) has average compatibility for agricultural purposes. The trend of IWQ and WQI indexes demonstrates that the groundwater is getting worse over the time.

With an increased interest in applications that require a clean background image, such as video surveillance, object tracking, street view imaging and location-based services on web-based maps, multiple algorithms have been developed to reconstruct a background image from cluttered scenes. Traditionally, statistical measures and existing image quality techniques have been applied for evaluating the quality of the reconstructed background images. Though these quality assessment methods have been widely used in the past, their performance in evaluating the perceived quality of the reconstructed background image has not been verified. In this work, we discuss the shortcomings in existing metrics and propose a full reference Reconstructed Background image Quality Index (RBQI) that combines color and structural information at multiple scales using a probability summation model to predict the perceived quality in the reconstructed background image given a reference image. To compare the performance of the proposed quality index with existing image quality assessment measures, we construct two different datasets consisting of reconstructed background images and corresponding subjective scores. The quality assessment measures are evaluated by correlating their objective scores with human subjective ratings. The correlation results show that the proposed RBQI outperforms all the existing approaches. Additionally, the constructed datasets and the corresponding subjective scores provide a benchmark to evaluate the performance of future metrics that are developed to evaluate the perceived quality of reconstructed background images.

During the construction of buildings, dangerous chemicals such as benzene, formaldehyde and others are used, which accumulate during the operation of the building. High concentrations of these substances can harm human health. In this article, we have analyzed the possible impact of modular green wall systems on improving of the air. During the research, four different modular green wall systems and various plant species were considered. The result showed that a modular green wall system can improve the air quality by removing harmful pollutants from the air in the buildings. Urban design used to be turned greener and more sustainable using the modern technologies of modular green wall systems. This study focuses on the air-cleaning benefits provided by modular green wall systems and their assessment. This research contributes to fill existing literature gaps on the green wall systems on the buildings and biophilic architecture.

Background: Only few studies have studied the link between risk perception and sleep in the context of the COVID-19 pandemic. This study investigates the effect of two distinct risk appraisals—risk perception and perception of collective coordinated defense (PCCD) on Chinese adults’ sleep quality during the COVID-19 pandemic, and tested COVID-19-related fear and rumination as potential mediators of the relationships. Methods: Data were collected using a self-report online questionnaire from a sample of 224 Chinese adults during the fourth wave of the COVID-19 pandemic in Hong Kong. Results: COVID-19 risk perception and PCCD were related to poor sleep quality. Mediation analysis showed that both fear and rumination mediated the relationship between risk perception and sleep quality, whereas only fear mediated the relationship between PCCD and sleep quality. The model showed an excellent fit to the data and accounted for 44% of the variance in sleep quality in Chinese adults. Conclusions: This study demonstrates the distinct perceptual processes—risk appraisals in particular—contributed to poor sleep quality in Chinese adults during the COVID-19 public emergencies. These findings would be helpful for policy makers to address the sleep problems induced by psychological consequences of the pandemic.

We present a general theory of estimation of analysis error covariances based on cross-validation as well as a geometric interpretation of the method. In particular we use the variance of passive observation–minus-analysis residuals and show that the true analysis error variance can be estimated, without relying on the optimality assumption. This approach is used to obtain near optimal analyses that are then used to evaluate the air quality analysis error using several different methods at active and passive observation sites. We compare the estimates according to the method of Hollingsworth-Lönnberg, Desroziers et al., a new diagnostic we developed, and the perceived analysis error computed from the analysis scheme, to conclude that, as long as the analysis is near optimal, all estimates agree within a certain error margin.

Significant changes to the new National College Entrance Examination (NCEE) and the implementation of the “Double First-Class” (DFC) initiative in China are coincidentally in the national spotlight and fall within the same policy window. However, few studies have investigated the effects of the new NCEE on the quality of students in DFC universities. By leveraging the 2018-2022 college admission data from Shandong Province, these effects are examined via the interrupted time-series technique. Weighted rankings for liberal arts and science disciplines and the admission ranking coefficient are adopted to ensure comparability before and after the reform. The findings reveal that after the reform, the quality of students in both world-class universities and first-class discipline universities improved, with greater improvements seen in world-class universities. Focusing on urban differences, the quality of students in DFC universities located in second-tier cities is found to have experienced a higher increase as compared with students in the first-tier and new first-tier cities. In addition, the reform has had different impacts on the quality of students in different majors. Furthermore, when selecting postsecondary institutions, high-scoring students prioritize the quality of universities and majors over urban factors. Finally, the implications of the new NCEE in relation to a sustainable development of DFC universities for research, policy, and practice are further discussed.

Weather has significant impact on growth and plants development. It is important to analyze the influence of changing climate conditions on expression of plants agronomical characters. Two flax varieties were grown from 1987 to 2018 in the North-West of Russia. Whether conditions and their influence on flax agronomic characters were analyzed using variance and correlations analyses. Significant influence of year conditions on the manifestation of all evaluated characters was revealed. Starting from June high temperatures accelerate the development of plants at all stages. Prolongation of germination - flowering period is the most important for fiber productivity improvement. Oppositely, for formation of high quality fiber fast ripening in hot weather after flowering is preferable. Such data give possibility to predict the amount and quality of yield. Usage of weather conditions data also permits to compare results obtained in different years. Suggested method of year’s meteorological conditions classification can be used in other genebanks for systematization and analyses of crops field evaluation results. Correlation analyses reviled 3 correlated pleiades: (1) pleiade of productivity, (2) pleiade of fiber quality and yield, (3) pleiade of the growing season phases duration, the sums of active temperatures and precipitation during each period. Great influence of growing conditions on economically valuable traits indicates the necessity of searching for genotypes with stable characters manifestation for breeding new varieties, which will give stable yield and fiber of good quality.

This narrative review delves into the evolving landscape of fertility preservation techniques with a particular focus on their use in patients undergoing oncology treatment that carries a risk of ovarian insufficiency. Advances in established methods such as cryopreservation of oocytes and embryos are highlighted and the increasing use of gonadotropin-releasing hormone (GnRH) agonists is discussed. The review also addresses the complexities and controversies associated with these approaches, such as the 'flare-up' effect associated with GnRH agonists and the potential of GnRH antagonists to reduce the risk of ovarian hyperstimulation syndrome. Despite advances in fertility preservation, the report highlights the challenges we face, including the need for personalized treatment protocols and management of associated risks. It calls for continued research and collaboration between healthcare professionals to refine these techniques and ultimately improve reproductive outcomes for patients facing the prospect of fertility-impairing treatment.

A paddle wheel aerator is developed in this research, which includes a wireless sensor network for measuring the water quality in the aquaculture of marine shrimp ponds. It can also move to the desired position to fill oxygen and measure water quality. A basic requirement is good standard water quality to prevent shrimp from epidemics and improve production. The water quality paddle wheel aerator applies a microcontroller and sensors to measure eight parameters of water quality. These water quality parameters are observed on the web application via an IoT module. The movement system of the water-quality paddle wheel aerator consists of a LiDAR, GPS, and remote RF signal. Each item of data is recorded immediately on the cloud server while the water-quality paddle wheel moves in the marine shrimp farm. The controlled paddle wheel aerator is harnessed automatically to enhance precisely the spatial monitoring resolution of the measurement system installed, which is needless for a multiple measurement system with high cost of investment. Also, farmers can access real data through the Line application. Hence, they are able to plan and control a good environment for aquaculture, preventing the occurrence of various epidemics and decomposing organic matter in the pond.

Applying the improved social network analysis method and the idea of rolling window regression, this paper explores the impact of HSR network on the quality of urbanization and its dynamics. Based on a sample of 273 cities in China over 2009–2019, we find that the high-speed railway network has an increasing positive effect on the quality of urbanization, which proves the existence of network effect. The empirical results further show that this effect is closely related to the cov-erage rate of high-speed rail network. In addition, heterogeneity analysis reveals that urban ag-glomeration cities are the main beneficiaries. Academically, our study provides a plausible expla-nation and evidence from network size differences for the two conflicting views of the HSR effect. Practically, we also propose some important policy implications for countries in different high-speed rail network construction stages.

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.

Background: Most prevalence surveys on nocturia have focused on older populations. This study aimed to measure the nocturia prevalence across the full spectrum of male adults living in Hong Kong, where severity and associated quality-of-life (QoL) were also explored. Methods: A cross-sectional population-based survey was conducted in men aged 18 or above using the ICIQ-NQoL Questionnaire. Results: With 1,239 respondents at age ranged 18-99, the overall nocturia prevalence were found to be 63.0% (ranged 41.6-84.6% at different age groups) and 31.2% (ranged 13.0-56.3% at different age groups), for ≥1 and ≥2 bedtime voiding episodes, respectively. The chance of nocturia was dramatically increased at age 60 or above while both prevalence and voiding frequency were increased with advancing age. About 83% of the nocturia men experienced 1-2 voiding episodes per night, but many of them had self-rated their QoL poor or very poor and indicated moderate-to-high bothersome. Younger men at age 18-39 were found to have high prevalence as 41.6% and almost 30% of them rated poor or very poor QoL. Conclusions: Nocturia was not only affecting the older populations but also caused significant bothersome and negative impacts on QoL in younger males.

The Covid-19 pandemic is a tragedy for those who have been hard hit worldwide. At the same time, it is also a test of concepts and practices of what good care is and requires, and how quality of care can be accounted for. In this paper, we present our Care-Ethical Model of Quality (CEMQ) and apply it to the case of residential care for older people in the Netherlands during the Covid-19 pandemic. Instead of thinking about care in healthcare and social welfare as a set of separate care acts, we think about care as a complex practice of relational caring, crossed by other practices. Instead of thinking about professional caregivers as functionaries obeying external rules, we think about them as practically wise professionals. Instead of thinking about developing external quality criteria and systems, we think about cultivating (self-)reflective quality awareness. Instead of abstracting from societal forces that make care possible but also limit it, we acknowledge them and find ways to deal with them. Based on these critical insights, the CEMQ model can be helpful to describe, interrogate, evaluate, and improve existing care practices. It has four entries: (i) the care receiver considered from their humanness, (ii) the caregiver considered from their solicitude, (iii) the care facility considered from its habitability and (iv) the societal, institutional and scholarly context considered from the perspective of the good life, justice and decency. The crux is enabling all these different entries with all their different aspects to be taken into account. In Corona times this turns out to be more crucial than ever.

The current article examined stoma self-care and health-related quality of life in patients with drainage enterostomy, describe clinical and sociodemographic variables and analyze the relations between all of them. Trained interviewers collected data using a standardized form that queried sociodemographic and clinical variables, collected from the electronic medical record, in addition to the Specific Self-Care for Ostomized Patients Questionnaire (CAESPO) and Stoma Quality of life (S-QoL) from January 2016 to January 2017. This was a multicenter, cross sectional study conducted in four hospitals of the province of Castellon (Spain) where 120 participants were studied. Significant differences were found in Self Care according to sex (p = .043); married participants show higher score (p < .01); also, significant differences according to work activity were observed (p < .01). Regarding the clinical variables, differences were observed according to the autonomy of care, the presence of complications in the stoma, the use of irrigation and the type of effluent (p < .01). We can highlight the importance of the skills related to self-care by ostomized patients has for a good level of quality of life related to health. In this learning process, the figure of the stoma therapist plays a very important role.

In this paper we analyze and propose new method and algorithm of selecting the optimal labor time as a function of skills following our main references Mirrlees (1971), Saez (2001) and Stancheva (2014). The optimal labor time is a situation when the utility function of individual reaches a maximum. One of the main differences with Saez (2001) is our algorithm for creation the skill distribution

Abstract This trial was realized in Yenisehir Vocational School between 2007 and 2008 on the purpose of study out the influence of lack of water in four growth periods of cabbage. In this trial, fourteen irrigation treatments was formed considering the growth periods (establishment, vegetative, yield formation and ripening) of cabbage (Brassicaceae Oleracea var. capitata L. Grandslam F1) and the results obtained from these treatments were evaluated. According to the content of the treatments, the water amount to the plants varied between 0 and 524 mm in the 2007 year, and between 0 and 536 mm in the 2008 year. Water consumption of cabbage in the 2007 year ranged between 200 and 795 mm and in the 2008 year ranged between 190 and 802 mm. Yield, head weight, diameter, height and dry matter ratio were determined statistically important. In 2007 and 2008 years, the maximal yield were found as 74.2 t ha-1 and 72.4 t ha-1 in the E100V100Y100R100 treatments, while the minimal yield were found as 2.0 t ha-1 and 4.0 ha-1 in the E0V0Y0R0 treatments, respectively. Water- yield relationship factor (ky) in 2007 and 2008 years were found as 0.96 and 0.97, respectively.

Additive manufacturing (AM) provides customization of the microstructure and mechanical properties of components. Selective laser melting (SLM) is the commonly used technique for processing high strength Aluminum alloys. Selection of SLM process parameters could control the microstructure of fabricated parts and their mechanical properties. However, process parameter limits and defects inside the as-built parts present obstacles to customized part production. This study is the second part of a comprehensive work that investigates the influence of SLM process parameters on the quality of as-built Al6061 and AlSi10Mg parts. The microstructure of both materials was characterized for different parts processed over a wide range of SLM process parameters. The optimized SLM parameters were investigated to eliminate the internal microstructure defects. Mechanical properties of the parts were illustrated by regression models generated with design of experiment (DOE) analysis. The results reported in this study were compared to previous studies, illustrating how the process parameters and powder characteristics could affect the quality of produced parts.

In Europe we can see a change in the social structure in the last period. Average life expectancy has increased dramatically over the last 50 years. Because of the improved life situation and advanced level of health care, older people are slower. With advancing age, the likelihood of experiencing a variety of constraints such as visual impairment, reduced hearing or physical ability increases. In such a life stage tenants are often forced to leave their long-term living space because these homes can not serve "new" individual needs and the resulting personal protection goal. This transition from the privacy of their home to the new environment often appears to be a painful change. They will take their familiar and well-known surroundings, because their homes can not be adapted to serve new needs. It must be the policy’s role to create a new inclusive social space and the requirement for architects and designers to create new goals for the design of an adaptable environment. This is a comprehensive approach to the design of the outer and inner space that could serve people even if there is an unexpected situation and changes in movement and physiological limitations of older people. The contribution shows the results of the survey conducted in Germany and Slovakia. In the survey respondents expressed their opinion on what they considered important in creating an adaptive environment. Results are processed graphically with explanation. The results were mainly for designers and developers of the indoor environment. Based on the results of the questionnaire survey, studies of possible modifications in the interior of the flats were then prepared. The contribution yielded these results in three age groups of respondents; i. people aged 35, 50 and over 50.

Stress during a pandemic increased the risk of alcohol consumption, which may require pharmacological management. The characteristics of emergency calls for alcohol-related issues for patients pharmacologically treated, admitted to, or not admitted to the emergency department (ED) were analyzed. An observational single-center retrospective study was conducted from January 1, 2018 to December 31, 2021, and divided into 2-year periods (2018–2019 and 2020–2021). This study focused on calls to one of the EDs of seven hospitals in the Bari (Italy) metropolitan area for patients requiring emergency services (ES) who were either admitted or not admitted, due to their refusal. A 30% reduction in emergency calls for alcohol-related issues and a 41.17% reduction in calls for patients who refused to be admitted to the ED were observed during the pandemic. During the pandemic, a reduced rate of pharmacological treatment for calls coded green (non-critical), and an increase in calls coded yellow (fairly critical) and red (very critical) were recorded. Metadoxine was administered in almost all alcohol-related emergencies, primarily in conjunction with drugs acting on the gastrointestinal tract, irrespective of age, the period considered, and whether patients were admitted or not admitted to the ED. ES is the first and only out-of-hospital service encountered by numerous patients with alcohol-use disorders who refuse to be admitted to the ED. These patients should be directed by ES personnel to a multidisciplinary program to receive treatment for drinking, improve their quality of life, and reduce sanitation costs.

Soft materials bearing rigid, lightweight, and vibration-dampening properties offer distinct advantages over traditional wooden and metal-based fillings for spent fuel transport casks, due to their low density, tunable structure, excellent mechanical properties, and ease of processing. In this study, a novel type of rigid polyurethane foams is prepared using a conventional polycondensation reaction between isocyanate and hydroxy groups. Moreover, the density and size of the pore in these foams are precisely controlled through simultaneous gas generation. The as-prepared polyurethane exhibits high thermal stability exceeding 185 °C. Lifetime predictions based on thermal testing indicate that these polyurethane foams could last up to over 60 years, which is double lifetime of conventional materials of about 30 years. Due to their occlusive structure, the mechanical properties of these polymeric materials meet the design standards for spent fuel transport casks, with maximum compression and tensile stresses of 6.89 and 1.37 MPa, respectively, at a testing temperature of -40 °C. In addition, these polymers exhibit effective flame retardancy; combustion ceased within 2 s after removal of the ignition source. All in all, this study provides a simple strategy for preparing rigid polymeric foams, presenting them as promising prospects for application in spent fuel transport casks.

The intention to repurchase is a key component in relationship marketing. However, minimal attention has been paid to how customers’ habitual behavior moderates the relationship between customers’ evaluation of benefits received from a service provider and the intention to revisit, specifically in a personal service business where customer-service provider interactions likely constitute the core of a sustainable relationship. To address this gap, the current study proposes and tests a comprehensive model to advance the theory of relationship marketing (RM) and additionally contributes to social exchange theory (SET) as well as the theory of repurchase decision-making (TRD) in the business service context. Structural equation modeling (SEM) was employed to examine the relationships of the research model. Based on data collected from 482 customers on their perceptions of hairstylists, the empirical findings revealed that relational benefits significantly affect post-experience behavior-satisfaction, trust and relationship commitment, and subsequently boost the intention to revisit. Furthermore, habit as an unconscious factor moderates the paths between revisit intention and its determinants. Although several limitations exist, the findings practically and theoretically make a contribution to the literature on relationship marketing.

This study aimed to evaluate the impact of the COVID-19 pandemic on routine immunization (RI) programs in six Northern Nigerian states: Bauchi, Borno, Kaduna, Kano, Sokoto, and Yobe. This study compared the programmatic data of 2019 and 2020, as well as survey data collected during the pandemic. RI program variables included service delivery, leadership and governance, monitoring and evaluation/supportive supervision, community engagement, vaccine supply chain and logistics, and finance and financial management. Data were analyzed using SPSS (version 23, IBM), student t-test, and structural equation modelling. The results showed that RI programs were affected by the pandemic in terms of reduced meetings and low completion rates of action points in certain states. However, routine immunization support services increased owing to improved monitoring techniques and consistent vaccine deliveries, with fewer reports of stock-outs. The most significant impact of the pandemic was observed on activities coordinated at the healthcare facility level, whereas those at the state level were less impacted. The major challenges encountered during the pandemic included insufficient supplies and consumables, movement restrictions, shortage of human resources, and fear of infection.

Land use/cover (LULC) change is one of the most important environmental phenomena that have affected the earths’ systems and its ecosystem services. Hence, this study was conducted with the main objective of assessing LULC change, its drivers andimpactson ecosystem services in Jimma Rare district for the year 1974–2019. In order to understand the spatial and temporal changes of LULC and its drivers four satellite images for the year1974, 1991, 2005 and 2019 were obtained and respondent interviews, focus group discussions (FGD) and field observations were employed. Moreover, the ecosystem service value coefficients developed at a global level were used to assess the impacts of LULC on ecosystem service provision of the study area. The results of the study revealed that grass land and forest land decreased from 4518.87ha (13.09%) to 902.42ha (2.61%) and 3287.79ha (9.52%) to 2506.63ha (7.26%) from 1974-2019 respectively. Similarly, wetland declined from1182.08ha (3.42%) to 562.37ha (1.63%) in the stated period.The greatest expansion of cultivated land and settlement area occurred during the year 1974-1991. Agricultural expansion, deforestation, overgrazing and expansion of rural and urban settlement were among the major proximate causes. Likewise, the major underlying drivers of LULC dynamics include population increase, the presence of weak policy and institutions, poverty and lack of awareness were identified by respondents and focus group discussants. The total natural capital value reduced from 662.75 (million $/ha/yr) to 577.03 (million $/ha/yr) in the study period indicating the impacts of LULC on ecosystem services. From this study, it is possible to conclude that Jimma Rare District has experienced a significant change in LULC and ecosystem service values over the past 45 years. Hence, appropriate policy packages of land use are required to curb the negative impacts of such changes in the study district in the provision of the required services for sustainable development.

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.

Service pricing is a bottleneck in the development of innovation services, as it is the issue of most concern between the suppliers and demanders. In this paper, a negotiation pricing model that is based on the multiobjective genetic algorithm is developed for innovation service pricing. Regarding the service pricing process as a multiobjective problem, the objective functions, which include the service price, service efficiency, and service quality, for suppliers and demanders are constructed. As the solution of a multiobjective problem is typically a series of alternatives, another negotiation process is necessary for determining the final decision. A learning strategy is adopted during the negotiation process to simulate reality. Finally, the model is implemented for an innovation service transaction, the objective of which is to identify the optimal price plan. The results demonstrate that the model can provide quantitative decision support for the pricing of an innovation service and ultimately yield a win-win result for both the supplier and demander of the innovation service. Furthermore, the influence of the parameters during the negotiation process is analyzed in detail. The effects of the learning strategy on accelerating the negotiation process, as well as the chosen of reasonable parameters are given.

Introduction: Differentiated service delivery (DSD) models for antiretroviral treatment (ART) for HIV are being scaled up in the expectation that they will improve the quality and efficiency of treatment delivery and reduce costs while maintaining at least equivalent clinical outcomes. Even this minimum requirement of equivalent clinical outcomes is poorly documented for most models and settings, however. We reviewed the recent literature on DSD models to describe what is known about clinical outcomes. Methods: We conducted a rapid systematic review of peer-reviewed publications in PubMed, Embase, and the Web of Science and major international conference abstracts that reported outcomes of DSD models for the provision of ART in sub-Saharan Africa from January 1, 2016 to September 12, 2019. Sources reporting standard clinical HIV treatment metrics, primarily retention in care and viral load suppression, were reviewed and categorized by DSD model and source quality assessed. Results and Discussion: Twenty-nine papers and abstracts describing 37 DSD models and reporting 52 discrete outcomes met search inclusion criteria. Of the 37 models, 7 (19%) were facility-based individual models, 12 (32%) out-of-facility based individual models, 5 (14%) client-led groups, and 13 (35%) healthcare worker-led groups. Retention was reported for 73% of the models and viral suppression for 57%. Where a comparison with conventional care was provided, retention in most DSD models was within 5% of that for conventional care; where no comparison was provided, retention generally exceeded 80%. For viral suppression, all those with a comparison to conventional care reported a small increase in suppression in the DSD model; reported suppression exceeded 90% in 11/21 models. Analysis was limited by the extensive heterogeneity of study designs, outcomes, models, and populations. Most sources did not provide comparisons with conventional care, and metrics for assessing outcomes varied widely and were in many cases poorly defined. Conclusion: Existing evidence on the clinical outcomes of DSD models for HIV treatment in sub-Saharan Africa is limited in both quantity and quality but suggests that retention in care and viral suppression are roughly equivalent to those in conventional models of care.

Since electrical resistivity of concrete can be measured in a more rapid and simple way than chloride diffusivity, it should be primarily regular quality control of the electrical resistivity of concrete which provides the basis for indirect of quality control of concrete durability during the concrete construction. If this is realized, the electrical resistivity of concrete can be a crucial parameter to establish maintenance strategy for marine concrete structures. Electrical resistivity of concrete is important to estimate two processes involved in corrosion of reinforcement: initiation (chloride penetration) and propagation (corrosion rate). The resistivity of concrete structure exposed to chloride indicates the risk of early corrosion damage, because a low resistivity is related to rapid chloride penetration and to high corrosion rate. Concrete resistivity is a geometry-independent material property that describes the electrical resistance, which is the ratio between applied voltage and resulting current in a unit cell. The current is carried by ions dissolved in the pore liquid. While some data exist on the relationship between moisture content on electrical resistivity of concrete, very little research has been conducted to evaluate the effect of chloride on the conduction of electricity through concrete. The purpose of this study is to examine and quantify the effect of pore water and chloride content on surface electrical resistivity measurement of concrete. It was obvious that chloride content had influenced the resistivity of concrete and the relationship showed a linear function. That is, concrete with chloride ions had a comparatively lower resistivity. Chloride can lead to underestimate the electrical resistivity of concrete. Conclusively, this paper suggested the quantitative solution to depict the electrical resistivity of concrete with various chloride contents.

The past few decades have been characterized by a growing body of profit-seeking public service areas with the understanding that profit-seeking organizations will deliver public services more efficiently than government can. These sectors include, but are not limited to, health care, corrections and education. Governments have created quasi markets to attract private providers of services in these sectors, with varying results. Organizational economics has provided the primary explanation for quasi markets, but questions about the sought-for efficiencies actually realized through these markets persist. We integrate resource dependence theory and organizational economics to provide a more comprehensive explanation of the persistence of quasi markets.

With the advances in industry and commerce, passengers have become more accepting of environmental sustainability issues; thus, more people now choose to travel by bus. Government administration constitutes an important part of bus transportation services as the government gives the right-of-way to transportation companies allowing them to provide services. When these services are of poor quality, passengers may lodge complaints. The increase in consumer awareness and developments in wireless communication technologies have made it possible for passengers to easily and immediately submit complaints about transportation companies to government institutions, which has brought drastic changes to the supply-demand chain comprised of the public sector, transportation companies, and passengers. This study proposed the use of big data analysis technology including systematized case assignment and data visualization to improve management processes in the public sector and optimize customer complaint services. Taichung City, Taiwan was selected as the research area. There, the customer complaint management process in public sector was improved, effectively solving such issues as station-skipping, allowing the public sector to fully grasp the service level of transportation companies, improving the sustainability of bus operations, and supporting the sustainable development of the public sector-transportation company-passenger supply chain.

Nowadays, determining the socioeconomic factors' influence on environmental quality is a crucial issue for policymakers. We aim to explore the impact of socioeconomic factors i.e., ethnic conflicts inform ethnic fragmentation, institutions quality effectiveness, and energy consumption on environmental quality by testing the various hypotheses (Pollution Halo Hypothesis, IPAT, and EKC) in 40 selected Asian countries throughout 1993-2019. We also use a set of control variables which are gross domestic product per capita, foreign direct investment inflows, and population growth to determine their impact on environmental quality. We use the Panel Quintile Regression Method of 0.25, 0.5, and 0.75 to analyze the results. We find ethnic conflict negatively affects the environmental quality at all quantiles. The institution's variables regulatory quality and rule of law negatively influence the environmental quality. Our result supports Porter's hypothesis because the effect of direct foreign investment on the amount of CO2 emissions is negative and significant at 0.25, 0.5, and 0.75 quantiles which states that foreign direct investment in the host country supports environmental quality. Furthermore, our results support the IPAT hypothesis in selected Asian countries.

The success of a software product depends on several factors. Given that different organizations and institutions use software products, the need to have a quality and desirable software according to the goals and needs of the organization makes measuring the quality of software products an important issue for most organizations and institutions. To be sure of having the right software. It is necessary to use a standard quality model to examine the features and sub-features for a detailed and principled study in the quality discussion. In this study, the quality of Word software was measured. Considering the importance of software quality and to have a good and usable software in terms of quality and measuring the quality of software during the study, experts and skilled in this field were used and the impact of each factor and quality characteristics. It was applied at different levels according to their opinion to make the result of measuring the quality of Word software more accurate and closer to reality. In this research, the quality of the software product is measured based on the fuzzy inference system in ISO standard. According to the results obtained in this study, it is understood that quality is a continuous and hierarchical concept and the quality of each part of the software at any stage of production can lead to high quality products.

A global approach towards quality management highlights the need for constructing a new body of knowledge that views the field of global quality from a systems perspective. Based on the results of field experiments, and in light of the need to develop new global quality management terminology, the current article presents several key concepts in this field, with emphasis on a systems-oriented rationale and perspective. As such, the article is an important stage in building this body of knowledge, and towards the conceptualization of key variables used in global quality management, from a systems approach that interacts with the fields of international management and strategic management.

The main purpose of this study was to develop a model for predicting the quality of holes drilled in the root part of a spar of helicopter main rotor blades made of the Glass Fiber Reinforced Plastic (GFRP)-Ti multilayer polymer composite. As the main quality criterion, delaminations at the entry and exit of the drill from the hole were taken. In the experimental study a conventional drill and two modified geometry drills: a double-point angle drill and a dagger drill were used. Preliminary experiments showed the best hole quality when using modified drills, which allowed further detailed study only with both modified drills at different drilling speeds and feed rates. Its results in the form of training sets were used to build the Artificial Neural Networks (ANNs) to predict delamination at the entry and exit of drilled holes. The analysis of the fitted response functions, presented as 3D surfaces plots and superimposed contour plots, made it possible to choose the better tool - a double-point angle drill and determine the optimal area for drilling speed and feed rates, confirming that the prediction of the quality and productivity of machining composites based on ANN is an effective tool to search and quantify the quality criteria of such technologies.

Introduction: Since its discovery in late 2019, the novel coronavirus (SARSCOVID-2) that causes COVID-19 has spread fast, prompting the World Health Organization (WHO) to designate the disease a worldwide pandemic on March 11, 2020.The epidemic has profoundly altered the preexisting global sexual and reproductive health landscape .The virus’s load has put ordinary services in jeopardy and harmed other health priorities. This encompasses both the provision and the supply of contraceptives, sexual health, new born and maternal health services. This Scoping review therefore mapped the availability evidence on the impact and effects of the COVID-19 disease outbreak on sexual and reproductive health. Methods: The methodological framework by Arksey and O’Malley guided this scoping review. A literature search was conducted from the following databases: Embase, PubMed, CINAHL, Scopus, WOS, and AJOL. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow diagram and the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) checklist were used to document the review process. The Strobe critical review checklist was used to determine the quality of the included studies. Results:19 studies were reviewed, out of which 4 were cross sectional studies, 1 was an observational study, 1 was a descriptive analytical study and the rest were qualitative studies .Majority of the studies showed evidence on the impact of COVID-19 and family planning service, maternal and child services, and three studies reported on COVID-19 and sexual behaviour. Five of the nineteen included studies reported on the impact of COVID-19 and family planning service. Conclusion: This scoping review has granted the assessment of the impact of novel SARS-CoV-2 on Sexual and reproductive health services with regards to sexual behaviour, family planning and maternal, neonatal and child health. From the 18 articles identified and reviewed, the overall responses stipulated a significant reduction in client’s utilization of services due to challenges experiences in service implementation such as stock outs. In addition, low demand for reproductive health services by clients due to restrictions imposed on the movements of people to curb the spread of the virus. It is therefore important that Governments and relevant stakeholders in Maternal and Sexual Reproductive Health prioritize development of policies and practices that protect women from the impacts of the pandemic. Furthermore, regular audits to detect trends in MSRH are necessary to inform on going mitigation efforts.

The prevalence of diagnosed cases of autism has increased rapidly, which raise interest in studying the variables related to the well-being of these families. The purpose of this paper is to review recent literature on other variables related to family well-being such a parenting styles. We conducted a systematic review using PRISMA check list and bias assessment ESTROBE with the aim of analyzing if the concepts of autism, well-being and parenting style are related. We screened 753 references, 16 full text articles and abstracts were read. It was identified that authoritative parenting style, those based on warmth, establishing relationships and emotional bonding, and low expressed emotion were positively related to family well-being. On the other hand, authoritarian, permissive and overprotective styles, as well as critical, punishing and training-based were negatively associated with well-being and quality of family life.

Health-Related Quality of Life (HRQoL) encompasses the comprehensive evaluation of an indi-vidual's health and well-being across multiple dimensions. Mindfulness, recognized as a scientifi-cally supported strategy for anxiety management, plays a role in enhancing both physical and mental health. The Gut-Brain Axis (GBA) serves as the bidirectional communication link between the gastrointestinal system and the central nervous system. This study aims to explore the associa-tion between Mindfulness and factors influencing the GBA in both healthy individuals and those with Inflammatory Bowel Diseases (IBD). A cross-sectional investigation involved 338 adults, in-cluding 50 IBD patients, utilizing validated Greek scales for Mindfulness (MAAS-15), Mediterra-nean Diet (14-MEDAS), and HRQoL (EQ-5D-5L). The questionnaire gathered demographic, an-thropometric, and lifestyle data. Among healthy participants, EQ-5D-5L showed a moderate cor-relation with the MAAS-15 scale (r=0.389, p

Objective: The COVID-19 pandemic inferred on neuro-oncological patients (PTS) and the caregivers regarding tumor care and emotional functioning. This study aimed to understand how COVID-19 affects their psychological state and relations between PTS and health personnel in neuro-oncology. Methods: A cross-sectional study on neuro-oncological PTS and their caregivers. Results: A total of 162 PTS and 66 caregivers completed the questionnaire. The 37.5% of PTS perceived greater risk of contracting the COVID-19 compared to the general population. On the 0-10 scale, PTS tumor-related anxiety score was 5.8 and COVID-related 4.6. The caregivers reported 7.7 and 5.5 respectively. The QoL was described at least as good in 75% of both PTS and caregivers; the caregivers’ care burden increased in 22.7% during the pandemic, with no correlation with QoL. Future perception often changed both in PTS and in the caregivers. Cancer treatment schedule was changed in 18.5%, including for PTS decision. However, the 93.5% of PTS was satisfied with the overall care. Conclusion: A considerable proportion of PTS and caregivers still perceived the tumor disease as more burdensome than the pandemic, and perceived their future as more uncertain. Such data rinforce the need to build a proficient alliance between PTS and health personnel.

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

Objective: The objective of our study was to explore the potential benefits of combining moderate alcohol consumption with regular vigorous physical activity on HDL-cholesterol levels and its potential positive impact on cardiovascular health. Material and method: The study comprised two groups: group A (102 patients) who consumed 1 gram of alcohol per day, specifically red wine, and increased their exercise levels in addition to their standard medical treatment, and group B (108 patients) who adhered only to their standard medical treatment. The patients were monitored for a year, during which various clinical parameters were observed. Results:Our study showed that moderate alcohol consumption, particularly red wine, along with increased physical activity levels, was associated with enhancements in exercise tolerance and elevated levels of HDL-cholesterol. Our findings suggest the efficacy of the intervention in improving lipid profiles, with the group that consumed alcohol as part of their treatment scheme, generally experiencing more pronounced positive effects. Statistically significant differences between groups in terms of angina evolution, AMI recurrence, or arrhythmias evolution were not found. However, there were important differences in terms of EF improvement and quality of life, with the alcohol consuming group displaying greater improvements in both aspects. Conclusions:In conclusion, our study emphasizes the potential benefits of combining moderate alcohol consumption, specifically red wine, with increased physical activity levels for improving exercise tolerance and enhancing HDL-cholesterol levels. However, further research and clinical trials are essential to fully understand the mechanisms and optimize the integration of these lifestyle elements for improved cardiovascular health outcomes.

Objective: The objective of our study was to explore the potential benefits of combining moderate alcohol consumption with regular vigorous physical activity on HDL-cholesterol levels and its potential positive impact on cardiovascular health. Material and method: The study comprised two groups: group A (102 patients) who consumed 1 gram of alcohol per day, specifically red wine, and increased their exercise levels in addition to their standard medical treatment, and group B (108 patients) who adhered only to their standard medical treatment. The patients were monitored for a year, during which various clinical parameters were observed. Results:Our study showed that moderate alcohol consumption, particularly red wine, along with increased physical activity levels, was associated with enhancements in exercise tolerance and elevated levels of HDL-cholesterol. Our findings suggest the efficacy of the intervention in improving lipid profiles, with the group that consumed alcohol as part of their treatment scheme, generally experiencing more pronounced positive effects. Statistically significant differences between groups in terms of angina evolution, AMI recurrence, or arrhythmias evolution were not found. However, there were important differences in terms of EF improvement and quality of life, with the alcohol consuming group displaying greater improvements in both aspects. Conclusions:In conclusion, our study emphasizes the potential benefits of combining moderate alcohol consumption, specifically red wine, with increased physical activity levels for improving exercise tolerance and enhancing HDL-cholesterol levels. However, further research and clinical trials are essential to fully understand the mechanisms and optimize the integration of these lifestyle elements for improved cardiovascular health outcomes.

Background: Upper extremities’ function impairments (UEFI) and gait impairment are frequently reported even in the early stages of Multiple Sclerosis (MS) disease. These motor deficits can negatively affect the quality of life (QOL) in MS patient. Exercise has been repeatedly introduced as a beneficial adjuvant therapy for MS, attenuating a wide range of physical and psychological symptoms without any side effects or increased risks of relapse or exacerbation in disease symptoms.Aim: This paper investigates the effect of multi-function swing suspension training (MFSST) program on upper and lower extremities’ function (ULEF), and QOL in MS women according to expanded disability status scale (EDSS) score.Design: Experimental method with a pre-test and post-test design with control group. Setting: The department of Sports Injuries and Corrective Exercise at the Shahid Bahonar University of Kerman.Population: Forty-seven MS women.Methods: Eligible subjects who matched the selection criteria were randomly assigned into three groups as follow: i. Intervention group A (EDSS of 2 – 4), ii. Intervention group B (EDSS of 4.5 – 6.5), and iii. Control group (EDSS of 2 – 6.5). The intervention groups have been trained by the SET program for a duration of 8 weeks. At baseline and after the intervention, the upper extremities’ function (UEF) and the lower extremities’ function (LEF) were assessed by 9-hole peg test (9HPT) and the timed 25-foot walk (T25FW) test, respectively. Moreover, participants’ QOL was measured using the Short Form questionnaire (SF-36).Results: A significant difference was found between the pre-test and post-test variables of walking speed and upper extremity endurance in intervention groups, and between the intervention groups and control group (P < 0.05). Compared to control group, both intervention groups showed improvements in all subscales of QOL, except emotional role limitation score.Conclusions: In summary, these results show that the present protocol of MFSST could be effective in improving ULEF and QOL in MS patients, showing the improvements after 4^th week. Moreover, this protocol was more useful for patients with an EDSS score of more than 4.5. Therefore, it seems that exercise therapy should be considered as a beneficial clinical intervention approach to improve ULEF and QOL in MS patients.

A discharge mixing zone (DMZ) is a defined geographical area or volume of water in the receiving environment of a discharge where initial dilution of the effluent occurs and where exceedance of water quality criteria may be permitted. DMZs are essential to inform determination of discharge consent conditions and an important element of risk management frameworks to reduce any effects of the discharges on the environment and human health. In this review, we describe the principles and technical application of DMZs. We present an overview of the physical processes that govern the dispersion and dilution of wastewater discharges and the fate of contaminants in coastal environments and define key criteria for determining the size of DMZs. We summarize DMZ requirements in international legislation and guidance and exemplify their application to different types of discharges by means of case studies. The selected case studies illustrate different modelling tools for defining DMZs and different monitoring approaches to assess their effectiveness in achieving ecological and human health objectives.

Objectives: The aim of this study was to compare the performance of the EQ-5D-Y-3L (Y-3L) and the expanded five level version, the EQ-5D-Y-5L (Y-5L). Methods: Children/adolescents with an acute or chronic health condition and from the general population completed the Y-5L and Y-3L self-report questionnaires. Performance of the Y-5L and Y-3L was determined by comparing feasibility, redistribution of dimension responses, discriminatory power, validity, and test-retest reliability. Results. Five hundred and fifty children/adolescents completed baseline measures and 173 completed repeat measures. The ceiling effect decreased by 15% from the Y-3L to Y-5L. Informativity of dimensions improved by 0.094 on the Y-5L. There was a range of 4-9% inconsistent responses moving from the Y-3L to Y-5L. Convergent validity of the Visual Analogue Scale (VAS) and Y-3L, Y-5L dimensions was similar, weak to moderate (r_s range: 0.18 – 0.38) but similar and strong on paired Y-3L and Y-5L dimensions: Kendall Tau B (range 0.69 – 0.80) and Gamma (range 0.92 – 0.98). The Y-5L and Y-3L showed moderate to substantial agreement for test-retest reliability across dimensions and VAS scores in stable chronic health conditions and fair agreement for the general population. Conclusion: The EQ-5D-Y-5L is a valid, reliable extension of the Y-3L for children/adolescents across health conditions and healthy children/adolescents. The expanded levels reduced the ceiling effect. The relative informativity of report across dimensions increased on the Y-5L compared to the Y-3L with retention of the evenness of reporting. The convergent validity and test-retest reliability of the Y-5L was comparable to the Y-3L.

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.

The bivalve mollusk, Anadara tuberculosa (Black Shell, in Spanish Concha prieta, "CP"), is found on America's Pacific coast, where it is harvested for subsistence and commercial markets. This paper aims to diagnose the performance of the black shell's value chain. We also identify several challenges that must be addressed to improve the sustainability of the black shell fishery in Ecuador. The descriptive methodology was quantitative, with a non-experimental, field, cross-sectional, and ex post facto design. Similar questionnaires were designed, validated, and applied to each link in the production chain to collect information. The performance of the value chain was diagnosed in the dimensions of productivity, competitiveness, and quality of life, reaching a 75.1% index, a result that indicates that the value chain has a moderate to good performance level. However, the value chain can be improved if the following challenges are met: 1) Restoration of the mangrove ecosystem, 2) Promotion of low-intensity shellfish aquaculture, 3) Good sanitary management and purification, 4) Promotion of value-focused ventures, 5) Strengthening of organizations and agreements for the use and custody of mangroves, and 6) Strengthening of institutions that contribute to the advancement of these challenges.

The objective of the study was to report the health-related quality of life (HRQOL) following road traffic accidents (RTAs) among children. A community-based survey using EuroQol five-dimension questionnaire (EQ-5D-5L) in Hindi was used to collected data from community. The survey included 2620 households from urban and rural areas of Ujjain, India. From these households 229 children aged 5–18 years with a history of RTA in the last 1 year were identified, with 27%, 63%, and 10% children reporting mild, moderate, and severe injury based on length of hospitalization. Motorcycles, bicycles, and pedestrians constituted most RTAs. Helmet use was low (12%). EQ-5D-5L revealed that the most severe and extreme problem was pain and discomfort, whereas the least severe problem was usual activity and self-care. The most common (65%) injuries were either abrasion or fracture and dislocation. EQ-5D-5L severity index was maximum (mean 72) for lower extremity injuries. The results of the present study highlight the ability and requirement for quality of life measurement using EQ-5D-5L among children post-RTA.

Objectives: To explore the effect of breakthrough cancer pain (BTcP) treatment on quality of sleep and other aspects of the health-related quality of life (HRQoL) in patients with cancer pain. Methods: In an observational, multicenter, cohort study, cancer patients from palliative care units, oncology departments, and pain clinics and affected by BTcP were included. Enrolled patients were assessed at the four visits: T0 (baseline), T7, T14, and T28. Well-controlled chronic background pain during the whole study period was mandatory. BTcP was treated through transmucosal fentanyl. Three questionnaires were used to measure the HRQoL: EORTC QLQ-C15-PAL, Pittsburgh Sleep Quality Index (PSQI), and the Edmonton Symptom Assessment System (ESAS). Results: In 154 patients, the HRQoL showed a significant improvement for all physical and emotional characteristics in the EORTC QLQ-C15-PAL, except for nausea and vomiting (Linear p-value = 0.1) and dyspnoea (Linear p-value =0.05). The ESAS and PSQI questionnaires confirmed these positive results (p<0.0001 and p=0.002, respectively). Conclusions: This prospective investigation by an Italian expert group, has confirmed that careful management of BTcP induces a paramount improvement on the HRQoL. Because in cancer patients there is a high prevalence of BTcP and this severe acute pain has deleterious consequences, this information can have an important clinical significance

Real data obtained from ship in operation are processed and analyzed in this paper. The intention was to provide software which would predict ship’s fuel consumption in some future time instant. It is showed that it is possible to develop such software based on numeric fitting of known data. In order to check how well the prediction of future fuel consumption is, we used only the first half of data for obtaining prediction curve. The second part of data was used to compare different prediction curves goodness. Hence, the presented research used actually a “real future data” and forecasted future data, which are used to numerically evaluate goodness of prediction. The research is of interest for companies logistics, to provide adequate fuel for fleet when and where actually needed. It is concluded that there are several prediction functions which satisfy used statistical quality measures.

Objective: The private healthcare providers (PHCP) are believed to improve access to healthcare services in Public-Private Mix (PPM) projects, as they are considered first point of contact for healthcare. The purpose of this study was to know the satisfaction level of TB patients. Design: A questionnaire-based, cross-sectional study was carried out during November and December 2017 for 572 under-treatment patients registered with PHCPs in the PPM project. Lot quality assurance sampling technique was used to randomly select 19 districts from sample frame of 75 districts. In each selected district, data collector retrieved TB register of 8 months (Jan – Aug 2017) and systematically selected patients by fixed periodic interval. SPSS (version 24.0) was used to analyze the data. Results: Study included 53% (n=301) of males and 47% (n=271) of females, with mean age of 38 years (SD, ±18). Almost half of the participants were illiterate (51%, n=289) and 64% (n=365) were non-earning members of the family. In practice, most of the participants visit private providers (71%, n=407), including private hospital/clinic (44%) and traditional practitioners (27%; n=153). 55% of participants visited the current doctor because of clinic’s proximity to residence. 82% of the participants (n=469) were satisfied with the TB care services and 85% (n=488) said that they would recommend this clinic to others. Conclusion: PHCPs are preferred providers for individuals, which is consistent with findings of other studies. Though they are satisfied with TB care and services, interventions should be introduced to reduce the financial burden on the patient. Partnering PHCP is a way forward to ensure universal health coverage, health system strengthening and better health outcomes of the population.

Additive manufacturing (AM) offers customization of microstructure and mechanical properties of fabricated components according to the material selected, and process parameters applied. Selective laser melting (SLM) is the commonly used technique for processing high strength aluminum alloys. Selection of SLM process parameters could control the microstructure of parts and their mechanical properties. However, the process parameters limit and defects obtained inside the as-built parts present obstacles to customized part production. This study investigates the influence of SLM process parameters on the quality of as-built Al6061 and AlSi10Mg parts according to the mutual connection between the microstructure characteristics and mechanical properties. The microstructure of both materials was characterized for different parts processed over a wide range of SLM process parameters. The optimized SLM parameters were investigated to eliminate the internal microstructure defects. The behaviour of mechanical properties of parts was presented through regression models generated from the design of experiment (DOE) analysis for the results of hardness, ultimate tensile strength, and yield strength. A comparison between the results obtained and that reported in the literature is presented to illustrate the influence of process parameters, build environment, and powder characteristics on the quality of parts produced. The results obtained from this study could help to customize the part’s quality by satisfying their design requirements in addition to reducing the as-built defects which in turn reduce the amount of the post-processing needed.

Using the culture-work-health model, this study investigates the factors influencing the quality of life of maritime workers. This study conducted a survey of 320 maritime workers who have experience living and working on a ship for more than six months. This self-administered questionnaire included questions on organizational culture and support, self-efficacy, perceived fatigue, as well as the quality of work life. Organizational culture and self-efficacy were identified as factors affecting the quality of work life, while organizational support was found to have an indirect effect after passing through self-efficacy and perceived fatigue. The final model accounts for 63.1% of the variance in maritime workers’ quality of life. As such, this study shows that self-efficacy is important for the quality of life of maritime workers, having both direct and indirect effects. Moreover, organizational support may prove the primary intervention point for relieving perceived fatigue and enhancing self-efficacy, thus improving the quality of work life.

The residential built form, including open space, provides the physical environment for social interaction. Understanding urban open space, including semi-public and public domains, through the lens of physical accessibility and visual permeability can potentially facilitate the building of a sense of community contributing to a better quality of life. Using an inner-city suburb in Perth, Western Australia as a case study, this research explores the importance of physical accessibility patterns and visual permeability for socialising in semi-public and public domains, such as the front yard and the residential streets. It argues that maintaining a balance between public and private inter-relationship in inner city residential neighbourhoods is important for creating and maintaining a sense of community.

Maize silage is produced to alleviate forage shortage on dairy animals, particularly during the dry season. Microorganisms play a significant role in silage fermentation and thus determine the silage quality. Therefore, modulation of microorganisms in silage may help prohibit undesired bacteria and improve silage quality. Hence, this study evaluated the effects of tannin extract as an additive on fermentative quality, aerobic stability and microbial composition of maize silage. Therefore, a mini-silo experiment of maize with five treatments was conducted for 75 days. The results showed that additives modulate silage microorganisms. In addition, tannin extract reduced certain silage bacteria while promoting others. However, this is without affecting the silage’s fermentative quality and aerobic stability. All silage fermented well with a pH below 4.2. Tannin extract improved dry matter recovery of silage while reducing silage weight loss. Furthermore, tannin extract suppressed the establishment of undesired bacteria, such as genera Dysgonomonas, Gluconacetobacter and Clostridium, while promoting desirable bacteria, such as genera Lactobacillus and Weissella, which attributed to silage quality. Therefore, it is concluded that tannins can be strategically used as silage additives to modulate microbial composition of silage and improve silage quality by promoting the dominance of desirable bacteria in silage.

Sachet water (SW) is a major source of drinking water in most Nigerian homes, thus making it a possible conveyance medium for health risks due to contamination rather than for replenishment of the body. This study collected SW from three busy neighborhoods and investigated for the presence of indicator bacteria – Escherichia coli (E. coli), Total Coliform (TC), Total Heterophilic Bacteria (THB), and Staphylococcus – and some physio-chemical parameters – total dissolved solids (TDS), pH, electrical conductivity (EC), and salinity. Multi-variable and exploratory statistical methods were applied to the results to determine correlations between bacterial contamination levels and perceived brand reputation. Bacteriological test with raw SW samples appeared too numerous to count (TNC) and thus required serial dilutions. After seven dilutions, results obtained revealed that SW brands with good reputation had no TC and E. coli and was statistically significant with groupings of other SW brands (χ2 = 12.28; p < 0.05 and χ2 = 37.96; p < 0.05) respectively. Additionally, SW brands with poor reputation had mean values of TC (19.7X10^8 cfu/ml;14X10^8 cfu/ml1.15X10^8 cfu/ml) and E.coli (18.2X10^8 cfu/ml;38.7X10^8 cfu/ml,32.4X10^8 cfu/ml) exceeding threshold value of zero set by the World Health Organization (WHO). Only one sample from poor reputation brand tested positive for Staphylococcus and was not statistically significant (χ2 =5.2191; p = 0.074). Principal Component Analysis (PCA)/ Factor Analysis (FA) revealed that most of the SW had fecal contamination in an alarming magnitude. Therefore, this study suggests that periodic cleaning of distribution lines, location specific treatment, QC and QA measures should be taken to reduce water security risk for SW consumption in the region.

Resistance spot welding is an established joining process in the production of safety-relevant components in the automotive industry. Therefore, a consecutive process monitoring is essential to meet the high-quality requirements. Artificial neural networks can be used to evaluate the process parameters and signals to ensure the individual spot weld quality. The predictive accuracy of such algorithms depends on the provided training data set and the prediction of untrained data is challenging. The aim of this paper is to investigate the extrapolation capability of the multi-layer perceptron model. That means, that the predictive performance of the model will be tested with data that clearly differs from the training data in terms of material and coating composition. Therefore, three multi-layer perceptron regression models were implemented to predict the nugget diameter from process data. The three models were able to predict the trained datasets very well. The models, which were provided with features from the dynamic resistance curve predicted the new dataset better than the model with only process parameters. This study shows the beneficial influence of the process signals on the predictive accuracy and robustness of artificial neural network algorithms. Especially, when predicting a data set from outside of the training space.

Asphalt binder requires more investigation to be accurately and precisely extracted since it is a significant procedure for quality control quality assurance (QC/QA) and subsequent binder characterization. In this research, the authors provided a hands-on experience with binder extraction to deliver recommendations concerning the sensitive steps that may affect the outcomes (extracted binder content, P_be%). Based on the extraction by the centrifuge method, two mineral matter determination methods (ashing and centrifuge) were addressed. Field cores were investigated with comparing the P_be% to the actual binder content, P_ba%. Analysis of variance (ANOVA) and Tukey Post-Hoc statistical analyses, in addition to linear least square regression analysis, were used to show the significance of difference according to 38 variant cores randomly obtained from the field segments (in-service roads) via the first two weeks from the construction date. Such cores involved reclaimed asphalt pavement (RAP), reclaimed asphalt shingles (RAS), and a wide range of additives. The two extraction methods were compared with concluding that the centrifuge method was highly recommended based on a quantitative evaluation, which delivered the same average P_ba% based on the 38 cores. Furthermore, the centrifuge method provided much saving in the experimental time (almost half the time required for the ashing method). It was found that the ashing outcomes were equal to the centrifuge outcomes with disregarding the ammonium carbonate addition. Thus, it could be recommended to reassess the ammonium carbonate addition as it might excessively compensate for fake minerals that have not been lost by the ignition oven.

As technologies such as eco-friendly ships, electric propulsion vessels, and multi-fuel propulsion systems advance, the scope of IoT applications in maritime field is expanding, resulting in increased complexity in control factors. The gradual progression towards Maritime Autonomous Surface Ships (MASS) is further driving the evolution of ship-based IoT applications. These advancements underscore the necessity for a platform capable of ensuring reliable connectivity between ships and onshore, while also being adaptable for deployment and operation to meet the demands of service availability. The limitations of the existing single cloud architecture become evident in this context. In response to these emerging challenges, this paper presents a cloud-based horizontal data platform structure anchored in the architecture of a Multi-Region Fog Cloud. This approach is tailored to fulfill the crucial requirement of maintaining robust and seamless connectivity for vessels navigating globally. Leveraging the capabilities of the Fog Cloud, the platform enhances service responsiveness by facilitating localized data collection and distribution, complemented by efficient data caching from the Cloud Center, serving users within the same geographical region. We outline a strategic framework for enhancing and executing key ship services within the proposed architecture. These services encompass data sharing between ships to elevate collision avoidance, disseminating weather data for optimized route planning, and constructing an operator training simulator (OTS) environment through the integration of digital twin technology. After, we implement an architecture using the AWS Cloud and gauges latency and Packet Loss Rate (PLR) through connections to Seoul, California, and Frankfurt regions. The test results reveal that latency in different regions is about 2-5 times higher than that in the same region for the payload. Furthermore, packet loss occurred at roughly 2-3 Hz packet generation rate (PGR) in different regions, whereas in the same region, it commenced at approximately 10-20 Hz PGR.

In this paper, a modular wire-actuated robotic arm was designed to improve the safety and adaptability of service robots during human-robot interaction. To raise the stiffness adjustment range of the robotic arm, a symmetric variable-stiffness unit was designed based on flexure, which had compact and simple structure, and lowly nonlinear stiffness-force relationship. In this paper, we focused on the research of the symmetric 1-DOF joint module. Based on the kinematics and stiffness analysis, the pose of the joint module could be adjusted by controlling the length of the wires, and the stiffness of the joint module could be adjusted by controlling the tension of the wires. Because of the actuation redundancy, the pose and stiffness of the joint module could be controlled synchronously. Furthermore, a directly method was proposed for the stiffness-oriented wire tension distribution problem of the 1-DOF joint module. A simulation was carried out to verify the proposed method.

Urbanization-induced land use transition results in a decline in ecosystem services, which has implications for regional ecological security. In order to explore the relationship between ecosystem services and land use transition, this paper utilizes the InVEST model, geographically weighted regression model to examine the impact of land use transition on ecosystem services in the Dongting Lake area (DLA). The results showed that (1) During the period 2000-2020, the intensity and motivation of land-use transition showed obvious spatial and temporal heterogeneity with the variation of urbanization development. (2) Habitat quality and Carbon sequestrations showed a downward trend. In contrast, food supply followed an upward trend; soil conservation and water yield services initially increased and dropped later. The overall spatial changes in habitat quality and Carbon sequestration appear to be insignificant. Food supply shows significant differences in the plains compared to other areas; while soil conservation and water yield service shows significant changes in places other than the DLA. (3) From 2000 to 2020, land use transition dynamics, population density, GDP density, night lighting and transition intensity had mainly negative effects on ecosystem services. Only the Normalized Vegetation Index (NDVI) showed a positive effect on ecosystem services. The results of the research will provide valuable references for the development and implementation of spatial ecological restoration planning and land use policies in the national territory.

Background: This qualitative systematic review protocol aims to explore the experiences of African customers in white-owned restaurants and hotels in post-apartheid South Africa, focusing on the dynamics of service interactions and their implications for racial relations within the hospitality industry. Despite the end of apartheid in 1994, the echoes of historical racial disparities and power imbalances persist, potentially influencing customer experiences in this sector, particularly in establishments owned by individuals of European descent. In view of above, the research question for this study is “How do African customers in white-owned restaurants and hotels in post-apartheid South Africa perceive and experience service interactions, and what are the underlying factors influencing these perceptions, considering historical power imbalances, societal perceptions, lingering effects of apartheid, inclusive practices, and the varied experiences across different hospitality establishments? Study Objectives: Objectives include examining the dynamics of service interactions, identifying factors influencing perceptions and experiences, evaluating alignment with inclusive practices and post-apartheid ideals, and describing African customers' experiences regarding service. Methods: The study will employ the SPIDER Framework to craft a nuanced research question that seeks to understand how African customers perceive and experience service interactions in these settings, considering historical power imbalances, societal perceptions, the lingering effects of apartheid, inclusive practices, and varied experiences across different types of hospitality establishments. This approach aims to dissect the intricate interplay of historical, societal, and economic factors that shape these experiences, providing insights into the complexities of achieving a truly inclusive and equitable hospitality landscape in post-apartheid South Africa. Expected Contribution to knowledge and practice: This review will contribute to a deeper understanding of the challenges and opportunities facing the hospitality industry in fostering environments that reflect the nation's diversity and commitment to reconciliation and social cohesion. By highlighting the lived experiences of African customers and examining the extent to which white-owned establishments embody post-apartheid ideals, this study aims to offer valuable recommendations for industry practitioners and policymakers to promote cultural sensitivity, equity, and inclusivity, thus enhancing the role of the hospitality industry in South Africa's broader societal transformation.

Gene therapy is becoming increasingly prevalent, with new gene therapy medicinal products (GTMPs) being approved for use every year. Hospital pharmacists are expected to prepare and dispense these products, but there is substantial heterogeneity in the availability of up-to-date, practical guidance at a national level in Europe. Many institutions have no or very limited experience in handling GTMPs. As such, there is a need for updated, practical guidance to aid hospital pharmacy teams in developing institutional standard operating procedures (SOPs) for the safe handling of GTMPs across the entire workflow. Here, we present the European Association of Hospital Pharmacists’ updated guidance on the handling of GTMPs, developed by a team of recognised experts from around Europe. Each aspect of the GTMP handling process is addressed, including receipt and storage, dispensing and reconstitution, transportation, administration, waste disposal, decontamination of spills and accidental exposure. A series of charts are provided to aid the development of practical workflows. This guidance document is intended as a framework to help develop institutional SOPs and should always be used in conjunction with local regulations.

Biodiversity has long been the main objectives in conservation planning while protecting ecosystem services are rarely concerned with. Protecting ecosystem services are gradually recognized by researchers to be included in conservation planning as its significant benefits to human beings. Currently, the most commonly used protecting strategies only focused on high-value areas so that not all the valuable areas would be protected. Furthermore, there are correlation of trade-off and synergy between ecosystem services, aiming at protecting one ecosystem service may have to sacrifice the conservation effectiveness for others. To ensure all the ecosystem services are adequately protected, spatial explicit relations between all the paired ecosystem services were identified via the calculation of Local Moran’s I, a local scale relationship between ecosystem services were defined and they were classified into 5 kinds of cluster. To alleviate the conflict solutions for multiple ecosystem services goals, we used methodology of Systematic Conservation Planning to identify the priority areas for ecosystem service protection, which act the plan with principles of representativeness, complementarity and persistence. By setting scenarios of optimizing each and all the ecosystem services at the target level from 10% to 90%, we found that positive correlation between each of the 4 ecosystem services occupied large areas in the Yangtze River Basin and all the high-value areas were not congruence in spatial distributions. The optimal conservation spatial pattern showed that the priority areas were quite different when the target level was low. Our results implicated that an integrated conservation planning of achieving objectives of all the ecosystem services is more efficient than superposing multiple planning time after time.

A large amount of raw data collected by satellites is processed by the production chain to obtain a large amount of product data, of which the secure exchange and storage is of interest to researchers in the field of remote sensing information science. Authentic, secure data is a critical foundation for data analysis and decision-making. And traditional centralized cloud computing systems are vulnerable to attacks, and once the central server is successfully attacked, all data will be lost. Distributed Ledger Technology (DLT) is an innovative computer technology that can ensure information security, traceability and tamper-proof, and can be applied to the field of remote sensing. Although there are many advantages to using DLT in remote sensing applications, there are some obstacles and limitations to its application. Remote sensing data has the characteristics of large data volume, spatiotemporal nature, global and so on, and it is difficult to store and interconnect remote sensing data in the blockchain. To address these issues, this paper proposes a trustworthy and decentralized system using blockchain. The novelty of this paper is to propose a multi-level blockchain architecture in which the system collects remote sensing data and stores it in the Interplanetary File System (IPFS) network, after generating the IPFS hash, the network rehashes the value again and uploads it on the Ethereum chain for public query. Distributed data storage improves data security, supports the secure exchange of information, and improves the efficiency of data management.

Objective: To explore the application effect of predictive psychological nursing in the nursing of outpatients with indwelling needle intravenous infusion .Methods: Select 80 patients who received intravenous indwelling needle infusion therapy in the outpatient department of our hospital from January 2022 to December 2022 as the research objects , and divided them into observation group and experimental group according to the different nursing plans received by the patients . 40 cases in each group. The observation group received routine nursing intervention, and the experimental group received predictive psychological nursing intervention. The puncture situation, psychological state level, self-care ability, adverse reactions and nursing satisfaction were compared between the two groups of patients .Results: The puncture success rate of the observation group was 72.5% (29/40), and that of the experimental group was 95.0% (38/40). The puncture success rate of the experimental group was significantly higher than that of the observation group (P<0.05) ; The SAS scores and SDS scores of the treatment group after nursing were significantly lower than those of the observation group (all, P<0.05) ; the self-care skills, self-concept, self-responsibility, health knowledge and ESCA total scores of the experimental group after nursing were significantly higher than those of the observation group. group (all, P<0.05); the incidence of adverse reactions in the observation group was 25.0% (10/40), the incidence of adverse reactions in the experimental group was 7.5% (3/40), and the incidence of adverse reactions in the experimental group was significantly lower than that in the observation group group (P<0.05); the nursing satisfaction of the observation group was 80.0% (32/40), and the nursing satisfaction of the experimental group was 100.0% (40/40), and the nursing satisfaction of the experimental group was significantly higher than that of the observation group (P<0.05 ).Conclusion: The application effect of the predictive psychological nursing intervention model in the outpatient department for intravenous indwelling needle infusion therapy is significant. The implementation of this model can effectively improve the success rate of puncture, improve the patient's psychological state, improve the self-care ability of patients, and reduce the adverse effects of patients. Risk of reaction, so as to further obtain the satisfaction and recognition of patients and their families.

This work focused on proposing a plan for improvement and control of the customer service process in a customer service center, based on a waiting line analysis where it describes all the elements that interact in the system and a statistical analysis of processes to define the state in which it operates. Subsequently, the simulation of processes is applied to represent the system studied, and with it, to be able to evaluate different strategies for improvement and increase in productivity. The following strategies were evaluated: correction of the instability of customer service processes, establishment of new specification limits according to the promise of value to be fulfilled to customers, human resource management, administrative technical support. Finally, with the results obtained from the simulation of the system, the improvement and productivity increase plan is planned according to the DMAMC (Define, Measure, Analyze, Improve, Control, or DMAIC) continuous improvement cycle established in six sigma

To effectively estimate airport terminal area capacity and assess the maximum throughput the sector can achieve when the capacity is given, this research proposes an approach to assess the terminal area capacity from the viewpoint of service provision resources. Terminal area capacity is optimized based on the equilibrium of air traffic service resource supply and demand. The supply-demand nexus is examined in consideration of terminal area route structure, traffic flow characteristics, and safety regulations. A flight service probability matrix and a terminal area demand and supply service time model are constructed to quantify resource expenditure at varied capacity levels. A optimization model is then developed to apportion maximal capacity under resource limitations. Model computation and computation results demonstrate the deviation between estimated and amended capacities is under 0.3 flight sorties per hour. The outcomes are congruent with historical statistics, thereby validating the accuracy and reliability of the model proposed in this study. Given capacity parameters, the model can deduce the maximal aircraft quantity served concurrently in terminal areas during peak periods. These revelations indicate the submitted model furnishes theoretical foundation and reference for terminal area sector partition and traffic alerting.

Artificial intelligence, a key technological tool in the era of the 4th Industrial Revolution, is being actively applied to education beyond industry, economy, and culture. In the future society, understanding and using artificial intelligence technology will be considered an essential skill for everyone, and the professionalism of AI education for pre-service teachers nurturing future talents is also important. This study verifies the effectiveness of pre-service teachers after undergoing a 15-week extension program consisting of AI Literacy Education (10 weeks), AI-Linked Subjet Education (3 weeks), and Micro-teaching (2 weeks) which was designed to enhance the AI ​​education professionalism of pre-service teachers. The AI Literacy Education section consisted of understanding AI, AI ethics, and basic programming, and the education was conducted through both experience and practice. After that, the pre-service teachers analyzed the curriculum of the 5th and 6th grades of an elementary school, and developed a subject-related education program using AI tools in three stages. Using the developed program, micro-teaching classes were conducted twice. The study results are as follows. First, there was a change in the positive perception of AI (p<.05). Second, the understanding of AI educational technology tools was improved and the recognition of the usefulness of developing a curriculum-related program was expanded. Third, the importance of teacher competency development was learned through the micro-teaching, and the students' understanding of the learning process was expanded.

The idea of an extension of life for CubeSats is proposed to reduce space debris in a low-earth orbit. In this work, a gripper is designed for geometry-based grasping in berthing tasks. The grasping operation is outlined for square- and rectangle-profiled CubeSats. Equilibrium conditions are used to choose fingertips shape and parameters for grasping the CubeSat body. A design scheme is proposed to provide the required accuracy. A design concept is developed into a lab prototype by using low-cost 3D printing technique, and a mock-up grasping task that is representative of the berthing operation is evaluated with the lab prototype. Center-mass hanging setup for the prototype and grasped body is used to evaluate the impact of grasping, partially replicating the conditions in space by reducing the effect of gravity on the system.

The Portuguese health system has a universal, public, general National Health Service (NHS), tending towards free healthcare access. Created in 1979, this delivery model developed from the integration and complementarity between the different response levels (primary, hospital, continuing, and palliative care). However, over these 40 years, the initially centralized system underwent a decentralization process with the creation of Regional Health Administrations in the five mainland administrative regions. Since then, the entire NHS has settled around this new organization. The most recent step started in 2018 with decentralizing primary health care skills to 190 municipalities. This paper presents the various critical issues involved in the latest gradual decentralization process in health, intending to bring services closer to the citizens, and more focused on their needs. The article identifies and discusses the implications of this experience based on the steps foreseen in the already published legal texts.

In order to increase the number of tourism in ecotourism, enhance the ecotourism attractions. It is essential to construct the ecotourism service system for the Penghu National Scenic Area because the ecology system is sensitive and frangible. This study adopts the Fuzzy Delphi method and Analytic Hierarchy Process (AHP) to establish an index framework of ecotourism service system of Penghu National Scenic Area. The results indicated that there are 4 dimensions which include 21 factors service attributes are identified as the service system for traveling. The findings are concluded as follows:(1)the security management capability is the main principle for ecotourism service system;(2)the ecological diversity is fundamental for the marine environment and the core resource for ecotourism;(3)the transportation capacity and environmental quality need to improve; (4)the marine environmental resources is the most important item for sound ecotourism development; (5)the enhancement of the operation willingness of local communities can promote ecotourism development;(6)the natural resources should be protected to provide an ideal recreational environment for ecotourism;(7)the development of ecotourism needs to support local conservation to achieve sustainability. The perspectives of sustainability and service system are involved to support the value of this study, which can continuously sustain Penghu archipelago.

Access to food systems is essential to sustain urban life. In this paper, we discuss the differences concerning accessibility levels to food systems among potential consumers in Belo Horizonte, Brazil. The goal was to characterize spatial mismatches regarding food opportunities and identify suitable areas for sustainable food mile solutions, such as non-motorized home delivery and purchase trips. For this, we have spatially related: (i) the population concentration; (ii) the income of households; and (iii) accessibility measures considering both the spatial structure of food retailers and the distance between households and stores, considering the food mile. We have then used spatial statistics and spatial analysis methods to determine the spatial pattern of variables and the cumulative opportunity measure for households. There is great spatial differentiation regarding the accessibility levels of food retailers and the results can be considered to support the development of policy and land use regulation that can stimulate non-motorized and collaborative delivery as an effective last-mile solution.

Objective: Taiwan Government’s organizations have endeavored to promote the applications of big data and open data. The “My Health Bank” is one of the measures promoted by the National Health Administration, Ministry of Health and Welfare. This study proposes the perspective of the “value co-creation” with the attempt to extend the concept of service ecosystem and apply it on the platform of My Health Bank to examine whether people (patients, families, and caregivers) can promote their health literacy? Method: This cross-sectional study, with people that have registered at “My Health Bank” as subjects. Complying with the inclusion criteria, 401 questionnaires were delivered, with 391 valid ones, excluding those incompletely and inaccurately filled. Result: That the affecting factors of the co-creation of values: age, education level, annual income, and platform operation show to be significant ( p＜0.05); and gender, occupation, and resource exchange do not reach the significant level (p＞0.1). Conclusion: We found My Health Bank changed the inertia of “value creation” in the traditional medical value, it allows the traditional medical and healthcare industry to expose to the impacts of the mega trend of the internet, the transformation of the platform in a necessary trend.

The Bologna Process and the European Higher Education area require the application of new active methodologies in the classroom that place the student at the center of his or her learning process. In the present work we analyze the application of a Service-Learning methodology in the context of a Final Degree Dissertation (FDD) in the degree in Environmental Sciences at the University of Extremadura (Spain). The project deals with an isolated Kichwa community in Ecuador and involves the development of alternative science education materials for the capacitation of in-service science teachers. This paper evaluates how an FDD carried out according to self-learning (SL) principles can help in the acquisition of so-called soft skills and how these can be focused in the promotion of the Sustainable Development Goal (SDG) knowledge and achievement. To this end, a qualitative study of the experience and a deep evaluation, followed by a final reflection, were carried out. According to the preliminary results, we can conclude that Higher Education should include SDGs in its teaching praxis and could do this successfully using the SL methodology.

In recent years, Web APIs have become a de facto standard for exchanging machine-readable data on the Web. Despite this success though, they often fail in making resource descriptions interoperable due to the fact that they rely on proprietary vocabularies that lack formal semantics. The Linked Data principles similarly seek the massive publication of data on the Web, yet with the specific goal of ensuring semantic interoperability. Given their complementary goals, it is commonly admitted that cross-fertilization could stem from the automatic combination of Linked Data and Web APIs. Towards this goal, in this paper we leverage the micro-service architectural principles to define a SPARQL Micro-Service architecture, aimed at querying Web APIs using SPARQL. A SPARQL micro-service is a lightweight SPARQL endpoint that provides access to a small, resource-centric, virtual graph. In this context, we argue that full SPARQL Query expressiveness can be supported efficiently without jeopardizing servers availability. Furthermore, we demonstrate how this architecture can be used to dynamically assign dereferenceable URIs to Web API resources that do not have URIs beforehand, thus literally ``bringing'' Web APIs into the Web of Data. We believe that the emergence of an ecosystem of SPARQL micro-services published by independent providers would enable Linked Data-based applications to easily glean pieces of data from a wealth of distributed, scalable and reliable services. We describe a working prototype implementation and we finally illustrate the use of SPARQL micro-services in the context of two real-life use cases related to the biodiversity domain, developed in collaboration with the French National Museum of Natural History.

In recent years, autonomous robots have proven capable of solving tasks in complex environments. In particular, robot manipulations in activities of daily living (ADL) for service robots have been in wide use. However, manipulations such as loading a dishwasher or folding laundry are difficult to automate robustly. In addition, manipulations of grasping multiple objects in domestic environments present difficulty. To perform those applications better, we developed robotic systems based on shared autonomy by combining the cognitive skills of a human operator with autonomous robot behaviors. In this work, we present techniques for integration of a shared autonomy system for assistive mobile manipulation and new strategies to support users in the domestic environment. We demonstrate that the robot can grasp multiple objects with random size at known and unknown table heights. Specifically, we developed three strategies for manipulation. From experimental results, we observed that the first strategy has the highest success rate (70% for random objects) up to 70 cm table height. Two other strategies perform better for 80 cm to 100 cm table height. The success rate of the second and third strategies shows an average 63.3% and 73.3%, respectively, for grasping random objects. We also demonstrated these strategies using two intuitive interfaces, a visual interface in rviz and a voice user interface with speech recognition, which are suitable for elderly people. In addition, the robot can select strategies automatically in random scenarios, which make the robot intelligent and able to make decisions independently in the environment. We obtained interesting results showing that the robot adapts to the environmental variation automatically. After these experimental demonstrations, our robot shows the capabilities for employment in domestic environments to perform actual tasks.

Flushing tap water is often promoted as a simple and low cost approach to reducing water lead exposures. This study evaluated lead reduction when prevailing flush guidelines (30 seconds-2 minutes) are implemented in a city compliant with lead-associated water regulations (New Orleans, LA). Water samples (n=1,497) collected from a convenience sample of 376 residential sites (2015-2017) were analyzed for lead in samples collected: at 1) first draw (n=375), and after incremental flushes of 2) 30-45 seconds (n=375), 3) 2.5-3 minutes (n=373), and 4) 5.5-6 minutes (n=218). There was no significant reduction when compared to the first draw lead level, until the 6 minute flush (p<0.05); but most sites (52%) still had detectable lead (≥1 ppb) after 6 minutes. Older homes (pre-1950) and low occupancy sites had significantly higher WLLs (p<0.05).Each sample type had health-based standard exceedances at over 50% of sites sampled (max: 58 ppb). While flushing is an effective short-term approach to remediate high lead, prevailing flush recommendations are an inconsistently effective exposure prevention measure that can often inadvertently increase exposures. Public health messages should be modified to ensure appropriate application of flushing for specific cities, while acknowledging its short-comings and practical limitations.

The impact of an unlicensed low-cost taxi in Bangladesh is very severe, especially in municipal cities. Day by day the numbers of unlicensed low-cost taxi are increasing by jumping up and creating pressure on traffic and transportation system. The aim of this study is to find out the causes of increasing illegal taxi and the extent of this vehicle in the municipalities of Bangladesh. Pabna municipality is used as a case study due to the more activeness of illegal taxi then the other municipalities. To achieve the objectives, the researcher used a qualitative approach to acquire more depth about the problems. Besides a direct observation of the study area, an open-ended questionnaire survey and HIS survey were conducted. The illegal low-cost taxi is very active it was analyzed through the field survey. A statistical model was developed to understand the actual causes of increasing illegal low-cost taxi, where ten predicted hypotheses (age, education level, marital status and family member support of illegal drivers, and the variable of commuter satisfaction e.g. safety, comfort, continuous service, affordability of service, reliability of service and driver behavior) were tested. The model was run through the multiple regression analyses technique in SPSS and the result proved that education level of illegal low-cost taxi drivers, and the commuter satisfaction variable (safety and comfort) had a positive and significant effect of increasing illegal low-cost taxi in the study area. However other variable had no significant effect in case of increasing illegal low-cost taxi. Besides the safety and comfort, steady job for the operators, provision of continuous, individual and door to door service system are the main reasons for increasing the illegal low-cost taxi in the study area. Finally, the researcher concludes with the requirement of some necessary action from the responsible authority on vehicular regulation for the improvement of the local public transport system in Bangladesh.

Groundwater represents a pivotal asset in conserving natural water reservoirs for potable consumption, irrigation, and diverse industrial uses. Nevertheless, human activities intertwined with industry and agriculture contribute significantly to groundwater contamination, highlighting the critical necessity to appraise water quality for safe drinking and effective irrigation. This research primarily focused on employing the Water Quality Index (WQI) to gauge water's appropriateness for these purposes. However, the generation of an accurate WQI can prove time-intensive owing to potential errors in sub-index calculations. In response to this challenge, an artificial intelligence (AI) forecasting model was devised, aiming to streamline the process while mitigating errors. The study collected 422 data samples from Mirpurkash, a city nestled in the province of Sindh, for a comprehensive exploration of the region's WQI attributes. Furthermore, the study probed into unraveling the interdependencies amidst variables in the physiochemical analysis of water. Diverse machine learning classifiers were employed for WQI prediction, with findings revealing that random forest and gradient boosting eclipsed other algorithms, achieving an accuracy rate of 99%. In close pursuit were SVM and XGBoost, registering accuracy scores of approximately 95% and 93%, respectively, while KNN and Decision Trees garnered accuracy rates of 88% and 87%, respectively. In addition to WQI prediction, the study conducted an uncertainty analysis of the models using the R-factor, providing insights into the reliability and consistency of predictions. This dual approach, combining accurate WQI prediction with uncertainty assessment, contributes to a more comprehensive understanding of water quality in Mirpurkash and enhances the reliability of decision-making processes related to groundwater utilization

Computer systems are involved in many critical human applications today, so that a small error can lead to serious and dangerous problems. These errors can be from an error in the incorrect design of the user interface to an error in the program code. The success of a software product depends on several factors. Given that different organizations and institutions use software products, the need to have a quality and desirable Software according to the goals and needs of the organization makes measuring the quality of software products. an important issue for most organizations and institutions, To be sure of having the right software. It is necessary to use a standard quality model to examine the features and sub-features for a detailed and principled study in the quality discussion. In this study, the quality of Word software was measured by Adaptive Neural Fuzzy Inference System. In recent years, powerful systems called fuzzy inference systems on The basis of adaptive neural network (ANFIS) has been used in various sciences. Using the power of neural network training and the linguistic advantage of fuzzy systems, these types of systems have been able to realize the advantages of the two in terms of analyzing very powerful complex processes. Considering the importance of software quality and to have a good and usable software in terms of quality and measuring the quality of software during the study. It was applied at different levels to make the result of measuring the quality of Word software more accurate and closer to reality. In this research, the quality of the software product is measured based on the adaptive neural-fuzzy inference system in ISO standard. According to the results obtained in this study, it is understood that quality is a continuous and hierarchical concept and the quality of each part of the software at any stage of production can lead to high quality products.

The tiered laboratory framework for HIV viral load monitoring accommodates a range of HIV viral load testing platforms, with quality assessment critical to ensure quality patient testing. HIV plasma viral load testing is challenged by the instability of viral RNA. An approach using an RNA stabilizing buffer is described for the Xpert® HIV-1 Viral Load (Cepheid) assay and was tested in remote laboratories in South Africa. EDTA-plasma panels with known HIV viral titres were prepared in PrimeStore molecular transport medium for per-module verification and per-instrument external quality assessment. The panels were transported at ambient temperatures to 13 testing laboratories during 2017 and 2018, tested according to standard procedures and uploaded to a web portal for analysis. A total of 275 quality assessment specimens (57 verification panels and two EQA cycles) were tested. All participating laboratories met study verification criteria (n=171 specimens) with an overall concordance correlation coefficient (ρ_c) of 0.997 (95% confidence interval [CI]: 0.996 to 0.998) and a mean bias of -0.019 log cp/mL (95% CI: -0.044 to 0.063). The overall EQA ρ_c (n=104 specimens) was 0.999 (95% CI: 0.998 to 0.999), with a mean bias of 0.03 log cp/mL (95% CI: 0.02 to 0.05). These panels are suitable for use in quality monitoring of Xpert® HIV-1 VL and are applicable to laboratories in remote settings.

Groundwater is a vital resource for human welfare. However, due to various factors, groundwater pollution is one of the main environmental concerns facing. Yet, it is challenging to simulate groundwater quality dynamics due to the insufficient representation of nutrient percolation processes in the soil and Water Assessment Tool model. The objectives of this study were extending the SWAT module to predict groundwater quality. The results proved a linear relationship between observed and calculated groundwater quality considering No3 and TDS with R2, NSE and PBIAS values in the satisfied ranges, albeit underestimation and overestimation were observed due to limited data availability. These results highlight that nitrate and TDS concentrations and variability in groundwater may used as a tool in surface water quality that have to be assumed for designing adaptive management scenarios. Hence, extended SWAT model could be a powerful tool for future regional to global scale modelling of nutrient loads supporting effective surface and groundwater management.

In this article, the quality of water in the reservoirs of Lake Arpi, Lake Yerevan, Akhuryan, Azat, Aparan and Kechut was estimated with usage of the Armenian Water Quality Index. It was established that in the waters of reservoirs the the maximum permissible concentration of copper, vanadium, aluminum, chromium, manganese, iron, NH4+ and NO2- regularly increases. The following computational algorithm was used for determination of the Armenian Water Quality Index values: to determine the number of cases of MPC excess of i-substance or indicator of water –n; to estimate the total amount of cases of the maximum permissible concentration (N) – N = ∑n; to computes log2N, nlog2n and ∑nlog2n; to determine geoecological syntropy (I) and entropy (H): I = ∑ nlog2n/N and H = log2N – I. Then, Geo-Ecological Evolving Organized index index was determined: G = H/I. Further, the total amount multiplicity of MAC exceedances was estimated: (M) - M=∑m and log2M was computed. Finally, Armenian Water Quality Index was obtained: AWQI = G + 0.1log2M. It was established that the Armenian Water Qquality Index showed a linear dependence on the Water Contamination Index, the Specific Combinatory Water Quality Index, the Geo-Ecological Evolving Organized index and an inverse dependence on the Canadian Water Quality Index.

In the context of evolving perceptions of sexuality, particularly within the realm of health and disability, this study investigates the impact of multiple sclerosis (MS) on female sexual function and quality of life. A quantitative study involving 130 female MS patients aged 35 to 50 was conducted, employing measures such as The Female Sexual Function Index (FSFI), The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), and The Fatigue Severity Scale (FSS). Results indicate a significant association between greater sexual dysfunction and poorer quality of sex life, alongside the correlation of increased fatigue with diminished sexual satisfaction. Factors such as education level, time of diagnosis, and treatment regimen also influenced outcomes. Findings underscore the importance of supportive interventions, including counseling, to enhance the quality of sex life for women with disabilities, particularly those with MS.

Aims: This study aims to evaluate the impact of family-centered empowerment on Jordanian adolescents with type 1 diabetes (T1DM), focusing on their HbA1c levels, self-efficacy, and quality of life (QOL). Background: Poor glycemic management in adolescents with type 1 diabetes increases complications. Improved control is linked to various variables, but few studies focus on Middle Eastern populations. Methods: An experimental study involved 68 adolescents with T1DM visiting Jordanian Royal Medical Services' clinics. Two sets of participants were created: control (n = 34) and intervention (n = 34). Data was collected through face-to-face interviews and medical records. Results: The study found significant differences in self-efficacy scores between the intervention and control groups, with the intervention group experiencing a significant decrease in HbA1c readings and a significant difference in QOL between pre-program and post-program phases. Discussion: Family empowerment can significantly improve the lives of Jordanian teenagers with type 1 diabetes. This strategy leads to improved glycemic management, increased self-efficacy, and improved quality of life. Future treatments and health policies should recognize and value the critical role families play in the care of this population. Conclusion: The study suggests that patients with T1DM should receive continuous care education sessions, including self-care training, to improve their health. Nurses should also incorporate these training into treatment plans and educational programs for adolescents to enhance their QOL.

Quality of life (QoL) assessments are integral to cancer care, yet their effectiveness in providing essential information for supporting survivors varies. This study aimed to elucidate key indicators of QoL among colorectal cancer survivors from the perspective of healthcare professionals, and to evaluate existing QoL questionnaires in relation to these indicators. Two studies were conducted: a Delphi study to identify key QoL indicators and a scoping review of questionnaires suitable for colorectal cancer survivors. Fifty-four healthcare professionals participated in the Delphi study's first round, with 25 in the second. The study identified two primary QoL domains (Physical and Psychological) and 17 subdomains deemed most critical. Additionally, a review of 12 questionnaires revealed two instruments assessing the most important general domains. Findings underscored a misalignment between existing assessment tools and healthcare professionals' clinical priorities in working with colorectal cancer survivors. To enhance support for survivors' QoL, efforts are needed to develop instruments that better align with the demands of routine QoL assessment in clinical practice.

Abstract: (1) Background: Post-COVID syndrome is defined as symptoms that occur simultane-ously with or after COVID-19 infection, last for 12 weeks, and are not due to another diagnosis. Limited data are available on people’s long-term quality of life (QoL) following COVID-19 infection. The aim of this cross-sectional study was to investigate long-term QoL after COVID-19 among employees of the St. Josef Hospital in Paderborn, Germany, and to identify risk factors. (2) Methods: A monocentric, cross-sectional study was conducted using the validated and digitized WHOQOL-BREF questionnaire via Netigate® between 10/2022 and 02/2023. Data on QoL and global health status were collected in the following four domains: physical health, mental health, social relationships, and environment. (3) Results: The response rate was 73.84% (923/1250). Furthermore, 63.45% of hospital staff respondents reported at least one persistent symptom after COVID-19 infection, leading to significant differences in QoL. Pre-existing conditions, persistent symptoms, and disability after COVID-19 infection, as well as high BMI, no partnership, and low educational level were found to significantly contribute to long-term low QoL. (4) Conclusions: Obesity, lack of partnership, and a low level of education were independent risk factors for lower QoL post-COVID-19 infection in this cohort of hospital staff. Further multicenter studies are re-quired to validate the incidence and their suitability as independent risk factors for post-COVID syndrome.

Globally, weeds interfere with agricultural production activities and have a very serious impact on agriculture and animal husbandry. Identifying a safe and reliable weed control strategy might increase yield, production net income, and improve crop quality. A field experiment was carried out to explore the effects of weeds interference frequency on the yield and quality of Glycyrrhiza uralensis Fisch in an arid and semi-arid area of northwest China. The experiment consisted of seven treatments and were (1) no weeding, marked as WF0; (2)-(7) artificial weeding by hoe once every 1, 2, 4, 6, 8, 10 weeks after emergence, marked as WF1, WF2, WF4, WF6, WF8 and WF10, respectively. We found that the higher weeding frequency had a higher the plant height, photosynthesis, yield and quality. The highest yield was obtained in the WF1 treatment, while the cost of weeding was the highest among all treatments. The concentration of liquiritin and glycyrrhizic acid were increased by 53.24% and 36.57%, with the highest nitrogen metabolism enzymatic activities and quality in WF4 treatment. WF4 treatment exhibited the largest increases in the net income among all treatments in both growing seasons, with respective increases up to 71.39 % and 78.81%. These findings suggested that weeding once every 4 weeks would be an effective and sustainable measure to control weeds in an arid and semi-arid area.

Premenstrual syndrome (PMS) continues to impact the health outcomes and emotional well-being of reproductive-age women, globally. Several studies have provided conflicting evidence concerning the role of dietary approaches in improving PMS symptoms. Accordingly, this study aimed to evaluate the possible influence of a healthy diet and motivational strategies on PMS symptoms and health-related quality of life among Omani adolescents. This open-label, randomized, prospective controlled trial was conducted in two randomly selected secondary schools, in Al Seeb Willayah, in Muscat region. Adolescents with PMS symptoms, who were at grade 10 or 11, aged 16 years or above, had regular menstrual cycles and not known to have psychiatric disorder, were included in this study. Participants in the intervention group received an individual face-to-face dietary consultation and motivational phone consultation. The health outcomes, including the PMS symptoms in both groups, and quality of life, were recorded via a daily record of severity of problems questionnaire (DRSP) and the 14-item Self-Reporting-Based Perceived Stress Scale tools, respectively. The primary outcome was the differences in the mean premenstrual symptom scores between the two groups. Secondary outcomes included the quality of life and stress levels of participants. The study period was from 1 February and ended 30 June 2021. SPSS was used to analyze the data and intention-to-treat analysis was utilized.A total of 72 adolescents with PMS were randomized to the intervention and control groups (n=36 each). Both groups were similar at baseline (P-value&gt;0.05). No significant association was found between healthy-diet and PMS symptoms (P-value&gt;0.05). In addition, no significant association was found between healthy-diet and quality of life at follow-up (P-value=0.216). The outcomes of this study refuted any possible relationships between healthy diet and PMS symptoms. Accordingly, dietary consultations may not facilitate the clinical management of PMS symptoms in adolescent females.

Venous leg ulcers still pose a significant medical problem worldwide. The complexity of the problem determines the need for further interdisciplinary activities that will improve the quality of life of treated patients. The study compared the quality of life of patients with venous leg ulcers who received local hyperbaric oxygen therapy or local ozone therapy procedures as a part of comprehensive treatment. The study included 129 patients (62 men and 57 women) with venous leg ulcers. Group I underwent local hyperbaric oxygen therapy (HBOT), group II - local ozone therapy (OZONE). In both groups, the patients' quality of life was assessed before the start of treatment cycle, as well as 10 weeks and 6 months after the completion of the treatment, by using the EQ-5D-5L questionnaire and the Polish shortened version of the SF-36 scale. After completing the respective therapeutic cycle, both groups showed a statistically significant (p<0.001) improvement the quality of life according to the EQ-5D-5L questionnaire and the SF-36 scale. Differences were noted between 1st examination (before treatment) and 2nd examination (10 weeks after treatment), as well as 3 examination (6 months after treatment). In the EQ-5D-5L assessment of anxiety and depression, self-care and activities of daily living 6 months after the end of treatment, better results were found in the group of patients treated with local hyperbaric oxygen therapy (p<0.001). In this group, 6 months after the end of the treatment, a statistically significantly higher result on the EQ-VAS scale was also obtained (73.09±19.8 points vs. 68.03±17.37 points, p=0.043). However, in the SF-36 assessment 6 months after the end of treatment better results - a statistically significantly lower value of the quality of life index - were recorded in the group of patients treated with local ozone therapy (103.13±15.76 points vs. 109.89±15.42 points, p<0.015). Hyperbaric oxygen therapy and local ozone therapy procedures have a beneficial effect on improving the quality of life of patients with venous leg ulcers.

Research into professionalization in health and safety has recently gained in interest. Graduate training is one of the factors that determines or conditions the role of the safety professional, thus intervene in the professionalization process. This article is the result of a workshop and the discussions of nine academic directors of safety education programs about quality evaluation. This article introduces the issue with a historic overview of safety education, presents a synthesis of nine selected education programs, discusses quality evaluation of health and safety education programs, propose a quality evaluation frame and finally, proposes a process for designing a quality safety education program with an associated model of the learning objectives. The outcomes are interesting for everyone who is interested in health and safety education and quality evaluation and will give insights into how safety professionals are educated.

It is unclear which noise exposure time window and noise characteristics during nighttime are most detrimental for sleep quality in real life settings. We have conducted a field study with 105 volunteers wearing a wrist actimeter to record their sleep during seven days, together with concurrent outdoor noise measurements at their bedroom window. Actimetry recorded sleep latency increased by 5.6 minutes (95% confidence interval: 1.6 to 9.6 minutes) per 10 dB(A) increase in noise exposure during the first hour after bedtime. Actimetry assessed sleep efficiency was significantly reduced by 2-3 percent per 10 dB(A) increase in measured outdoor noise (Leq, 1h) for the last three hours of sleep. For subjectively reported sleepiness, noise exposure during the last hour prior to wake up was most crucial with an increase in the sleepiness score of 0.31 units (95% CI: 0.08 to 0.54) per 10 dB(A) Leq,1h. Associations for estimated indoor noise were not more pronounced than for outdoor noise. Considering noise events in addition to equivalent sound pressure levels (Leq) only marginally improved the statistical models. Our study provides evidence that matching the nighttime noise exposure time window to the individual’s diurnal sleep-wake pattern results in a better estimate of detrimental nighttime noise effects on sleep. We found that noise exposure at the beginning and the end of the sleep is most crucial for sleep quality.

Alternative fuels available at low cost, friendly to natural environments and meet the energy needs and demands, have witnessed a growing demand and use today. Ethanol is an attractive renewable energy source with a high content of oxygen. Ethanol can be produced through ethanolisis, however for this work direct blending of conventional diesel, waste plastic pyrolysis oil and ethanol with commercial fuel improver CI-0808 purchased from Innospec company was attempted. The primary purpose of adding a cetane improver was to improve the combustion characteristics of the blends by at least 1- 3 ignition quality points. Five mixing ratios were chosen in the following order, 50:25:25, 60: 20:20, 70: 15:15, 80: 10:10 and 90: 5:5 for Waste Plastic Pyrolysis Oil (WPPO), ethanol and conventional diesel (CD) respectively. However, for the fuel additive mixing ratio the total volume percentage was considered and the ratio put at 0.01% of the total quantity of blended fuel. In this work WPPO, diesel blends and fuel additives improvers were used as alternative fuel. This was to evaluate their performance and emission characteristics in a stationary single cylinder water cooled experimental diesel engine. The CI-0808 was added due to its potential power to reduce emissions of CO, UHC, NO_X, PM and improved engine performance. The results obtained were compared carefully to ASTM standards and discussed using graph curves figures and tabulated values. The conclusion was that ethanol and WPPO blends can be used in diesel engines as alternative fuel without modification. Used in combination with cetane improvers the emissions reduce significantly and performance improved equalling that of conventional diesel fuel.

In light of growing concerns over water contamination, particularly in regions like Sindh, Pakistan, this research aimed to evaluate and map the groundwater quality in Taluka Larkana for both drinking and irrigation applications, addressing the expressed worries of the local community. A total of forty groundwater samples were collected from various sources such as hand pumps, taps, and tube wells. These samples underwent comprehensive analysis encompassing parameters including color, odor, taste, turbidity, pH, total hardness (TH), electrical conductivity (EC), and total dissolved solids (TDS), with comparisons drawn against WHO guidelines.Results indicated that taste, color, odor, and turbidity of the groundwater samples generally fell within acceptable ranges. However, EC levels varied from moderately elevated to excessively high. Notably, a significant proportion of samples (84% EC, 21% Cl, 30% Ca, 37% Mg, 22% TH, and 84% TDS) exceeded WHO-recommended thresholds.Assessment via the SPI model classified approximately 16% of samples as moderately contaminated, while 65% were deemed highly contaminated, and 19% were found unsuitable for drinking purposes. These findings underscore the pressing need for concerted efforts to address water quality issues in the region.

The objective of this work was to evaluate the blending and grinding influence over the nutritional, sensorial and sustainable aspects of coffee. To do so, a systematic review of the literature was accomplished. The database for the selection of relevant papers was the Portal de Periódicos da Capes, with remote access via CAFe. For the elaboration of the research, a chronological criterion with period restriction was used, considering the period between 2008-2022, to access all possible works related to the theme of this work. The following terms were used: blending; grinding; coffee; nutrition-al; sensorial; sustainability. To filter the searches, the association of these terms was also used by means of links and word associations. In the terminology, the Boolean operator AND was used to interconnect the terms used. Roasting degree, grinding, and amount of each coffee species impacts the nutritional and sensorial aspects of coffee. And the determination of each blending influences the sustainability of the environment, economic and social aspects of the coffee chain.

The purpose of this research is to determine if the tradeoffs that Kissick proposed among cost containment, quality, and access remain as rigidly interconnected as originally conceived in the contemporary health care context. Although many have relied on the Kissick model to advocate for health policy decisions, to our knowledge, the model has never been empirically tested. Some have called for policy makers to come to terms with the premise of the Kissick model tradeoffs, others have questioned the model given the proliferation of quality enhancing initiatives, automation, and information technology in the health care industry. One wonders whether these evolutionary changes alter or disrupt the originality of the Kissick paradigms themselves. Methods: Structural Equation Modeling (SEM) was used to evaluate the Kissick hypothetical relationships among the unobserved constructs of cost, quality, and access in hospitals for the year 2018. Hospital data were obtained from Definitive Healthcare a subscription site which contains Medicare data as well as non-Medicare data for networks, hospitals, and clinics (final n= 2,766). Results: Reporting significant net effects as defined by our chosen study variables, we find that as quality increases costs increase, as access increases quality increases, and as access increases, costs increase. Policy and Practice Implications: Our findings lend continued relevance to a balanced approach to health care policy reform efforts. Simultaneously bending the health care cost curve, increasing access to care, and advancing quality of care is as challenging now as it was when the Kissick model was originally conceived.

The Delaware River has made a marked recovery in the half-century since the adoption of the Delaware River Basin Commission (DRBC) Compact in 1961 and passage of the Federal Clean Water Act amendments during the 1970s. During the 1960s, the DRBC set a 3.5 mg/l dissolved oxygen criteria for the river based on an economic analysis that concluded a waste load abatement program designed to meet fishable water quality goals would generate significant recreation and environmental benefits. Scientists with the Delaware Estuary Program have recently called for raising the 1960s DO criteria along the Delaware River from 3.5 mg/l to 5.0 mg/l to protect anadromous American shad and Atlantic sturgeon and address the prospect of rising temperatures, sea levels, and salinity in the estuary. This research concludes through a marginal abatement cost (MAC) analysis that it would be cost effective to raise DO levels to meet a more stringent standard by prioritizing agricultural conservation and wastewater treatment investments in the Delaware River watershed to reduce 90% of the pollutant load 13.6 million kg/year of nitrogen (30 million lb/year) for $160 million at 35% of the $449 million annual cost. The annual least cost to reduce nitrogen loads and raise dissolved oxygen levels to meet more stringent water quality standards in the Delaware River totals $45 million for atmospheric NOX reduction, $130 million for wastewater treatment, $132 million for agriculture conservation, and $141 million for urban stormwater retrofitting. This 21st century least cost analysis estimates that $50 million/year is needed to reduce pollutant loads in the Delaware River to raise dissolved oxygen levels to 4.0 mg/l, $150 million/year is needed to reach 4.5 mg/l, and $449 million/year is needed to reach 5.0 mg/l.

Knowing the reasons for mobility choices, how users evaluate the characteristics of public transport and how satisfied they are with the travel experience is essential to promote the use of LTP (Local Public Transport), especially in rural or suburban areas where the use of private car is often prevalent. The present study aimed to investigate the mobility experience and the reasons for use and non-use of the LPT in a suburban area by the people travelling to a large Hospital Centre in a Province of the North-east of Italy. An anonymous questionnaire was completed by people from different categories travelling to the hospital (students, employees, clients), user and non-users of the LPT. The results showed that insufficient hourly coverage and accessibility of the service are the primary reasons for opting not to use LPT and together with reliability and comfort, these factors contribute to user satisfaction with their travel experience. Perceived sustainability of LPT contributes to overall travel satisfaction. However perceived sustainability alone does not appear to influence the choice of LPT if the service lacks adequate accessibility and does not meet the needs of travelers in terms of hourly coverage

Logistics industry has been found to be among the key sources of carbon emission. In Vietnam logistics industry, there is a considerable difference between the number of foreign and Vietnamese firms as well as the proportion of markets that they are taking. This study is to research the low-carbon emission measures conducted by domestic and foreign invested logistics service providers (LSPs) and compare the results of the two groups. Both qualitative and quantitative approaches are applied. Literatures in relevant fields are reviewed and expert opinions are taken for structuring a questionnaire which was later distributed to 279 LSPs, with 166 returned and 159 being valid for data calculation. The results imply that there are differences in extension of applications of low-carbon practices between foreign and domestic firms. Except for transport mode switch and energy-saving lighting, the other practices witness that adoption levels of foreign LSPs are higher than their counterparts, which is possibly thanks to their global operation, more comfortable capital resources and awareness level of green initiative necessity. In conclusion, a comparison between the application conducted by foreign-invested firms and domestic ones, which has not been investigated before, was made.