The study is devoted to analyzing the economic sustainability of the town of Amherst, MA. The city's top employer and core enterprise is the University of Massachusetts Amherst, with over 32,000 students and almost 2,000 staff members. Based on a literature review, a hypothesis was put forward that a university city should have a high level of economic sustainability. To assess economic sustainability, the USCESI Index was developed. It evaluates sustainability in three groups of parameters: society, economy, and ecology. The first group includes the level of racial diversity, the level of education of the population, and the access to medical services. The second group consists of the Gini coefficient by income level, the median cost of housing, and the unemployment rate. The environmental situation is assessed according to the Air Quality Index developed by the US Environmental Protection Agency. For comparison, the town of Braintree, MA, was taken. The USCESI was calculated for both locations. The analysis showed that both Amherst and Braintree have a high degree of economic sustainability. However, it was revealed that proximity to a significant economic center has a more powerful positive impact on economic sustainability than the location of a large university.

Lymphedema is a chronic and debilitating disease that affects up to 250 million patients worldwide. Recent advances in understanding its pathophysiology, along with improved diagnosis and microsurgical techniques, have enhanced our ability to cope with the challenging task of treating this disease. This review provides an overview of the disease from a surgeon's point of view, including existing imaging modalities used for preoperative assessment, as well as surgical procedures used in its treatment. Advantages and drawbacks of various existing modalities used for pre or intraoperative assessment of lymphatic vessels are discussed. Lymphedema treatment has shifted from palliative debulking procedures (liposuction and direct excision) to those aimed at restoring lymphatic flow and countering the pathophysiology of the disease (lymphaticovenous anastomosis and vascularized lymph node transfer). A combination of both approaches can result in a synergistic benefit for patients and are discussed in this review. Despite recent advances, some controversies persist, and further studies are needed to better define surgical treatment algorithms.

Post-extubation dysphagia (PED) can lead to serious health problems in critically ill patients. Contrasting its high incidence rate of 12.4% reported in a recent observational study, many ICUs lack routine bedside screening, likely due to limited awareness. This study aimed to establish baseline data on the current approaches and the status of perceived best practices in PED screening and treatment, as well as to assess awareness of PED. A nationwide cross-sectional, online survey was conducted in all fourteen adult ICUs in the Republic of Cyprus in June 2018, with a 100% response rate. Over 85% of ICUs lacked a standard screening protocol for PED. The most commonly reported assessment methods were cough reflex testing and the water swallow test. Treatment approaches included muscle strengthening exercises without swallowing and swallowing exercises. Only 28.6% of ICUs acknowledged PED as a common issue. The study identified significant gaps in awareness and knowledge regarding PED screening and treatment in Greek-Cypriot ICUs. Urgent implementation of comprehensive dysphagia education programs within the units is necessary, and interdisciplinary collaboration among nurses, intensivists, and speech and language therapists is crucial to improve the quality of care provided.

Integrated assessment modelling (IAM) has been successfully used in the development of international agreements to reduce transboundary pollution in Europe, based on the GAINS model of IIASA. At a national level in the UK a similar approach has been taken with the UK Integrated Assessment Model, UKIAM, superimposing pollution abatement measures and behavioural change on energy projections designed to meet targets set for reduction of greenhouse gas emissions, and allowing for natural and imported contributions from other countries and shipping. This paper describes how UKIAM has been used in development of proposed targets for reduction of fine particulate PM2.5 in the Environment Act, exploring scenarios encompassing different levels of ambition up to 2050 with associated health and other environmental benefits. There are two PM2.5 targets, an annual mean concentration target setting a maximum concentration to be reached by a future year, and a population exposure reduction target with benefits for health across the whole population. The work goes further, to also demonstrate links to social deprivation. There is a strong connection between climate measures aimed at reducing net GHG emissions to zero by 2050 and future air quality, which may be positive or negative, as illustrated by sectoral studies for road transport where electrification of the fleet needs to match the evolution of energy production, and for domestic heating where use of wood for heating is an air quality issue. UKIAM has been validated against air pollution measurements and other modelling, but there are many uncertainties including future energy projections. New work is beginning to link UKIAM directly with the TIMES model addressing future energy projections, to explore different uptake scenarios for hydrogen production and use with respect to air quality.

The environmental safety of a car is currently one of the most important indicators of the vehicle competitiveness and quality in the consumer market. Currently, the assessment of the ecological properties of vehicles can be made based on various criteria. In the case of combustion-powered cars, the most attention is usually paid to the values characterizing their use, and in the environmental assessment, first of all to pollutant emissions and operational fuel consumption. The proposed article considers the possibility of using the life cycle assessment to analyze the ecological properties of a passenger car during its operation. A simplified LCA method of the vehicle was presented, which in strictly defined cases can be used for the analysis of environmental impacts and the assessment of the energy analysis related to its operation. For this purpose, a vehicle life cycle model was developed. Data on the operation of 33 passenger cars of different manufacturers with similar operational characteristics, coming from different production periods, were analyzed in detail. The obtained results were found to be highly sensitive to the assumptions made in the article.

Telemonitoring and telerehabilitation have shown promise in delivering individualized healthcare remotely. We introduce STASISM, a Sensor-Based Telerehabilitation and Telemonitoring System, in this work. This platform has been created to facilitate individualized telerehabilitation and telemonitoring for those who need rehabilitation or ongoing monitoring. To gather and analyze pertinent and validated physiological, kinematic, and environmental data, the system combines a variety of sensors and data analytic methodologies. The platform facilitates customized rehabilitation activities based on individual needs, allows for remote monitoring of patients' progress, and offers real-time feedback. To protect the security of patient data and to safeguard patient privacy, STASISM also provides secure data transmission and storage. The platform has the potential to significantly improve the accessibility and efficacy of telerehabilitation and telemonitoring programs, enhancing patients' quality of life and allowing healthcare professionals to provide individualized care outside of traditional clinical settings/

The study conducts a comparative life cycle assessment (LCA) analysis to assess the environmental impact of two different manufacturing processes used to produce transparent dental aligners. The former method consists of thermoforming a polymeric disc over 3D printed, customized models, while the second, more innovative approach involves the direct printing of aligners using additive manufacturing (AM), specifically applying digital light processing (DLP) technology. The analysis results highlight how adopting direct printing through AM brings significant advantages in terms of environmental sustainability, thanks to the substantial reduction in raw materials and electricity consumption. These drops translate into decreased potential environmental impacts across all impact categories considered within the EF 3.1 method. Furthermore, lowering the amount of raw materials needed in the direct printing process contributes to a notable decrease in the overall volume of waste generated, emphasising the environmental benefits of this innovative technique.

Keywords: AI Readiness Assessment; Business Processes; and Data Infrastructure.

Abstract: Image aesthetic assessment (IAA) with neural attention has made significant progress due to its effectiveness in object recognition. Current studies have shown that the features learned by convolutional neural networks (CNN) at different learning stages indicate meaningful information. The shallow feature contains the low-level information of images and the deep feature perceives the image semantics and themes. Inspired by this, we propose a visual enhancement network with feature fusion (FF-VEN). It consists of two sub-modules, the visual enhancement module (VE module) and the shallow and deep feature fusion module (SDFF module). The former uses an adaptive filter in the spatial domain to simulate human eyes according to the region of interest (ROI) extracted by neural feedback. The latter not only takes out the shallow feature and the deep feature by transverse connection, but also uses a feature fusion unit (FFU) to fuse the pooled features together with the aim of information contribution maximization. Experiments on standard AVA dataset and Photo.net dataset show the effectiveness of FF-VEN.

Background: This study aims to set out key clinical features of different Motoric Cognitive Risk (MCR) subtypes based on individual quantitative measures of cognitive impairment and to compare their predictive power on survival over an 8-year observation time. Methods: We analyzed data from a population-based study of 1138 subjects aged 65 years and older in south Italy. These individuals were targeted and allocated to subtypes of the MCR phenotype according to the slowness criterion plus one other different cognitive domain for each characterized phenotype. Clinical evaluation and laboratory assays, along with a comprehensive battery of neuropsychological and physical tests, completed the sample investigation. Results: MCR prevalence was found to be 9.8% (N=112), 3.6% (N=41), 3.4% (N=39), and 1.8% (N=21) for the MCR, MCR-GlobalFunction, MCR-StructuredSCC, and MCR-SCC&GlobalFunction, respectively. Univariate Cox survival analysis showed an association only of the MCR-GlobalFunction subtype with a significant, 1.5-fold increased risk of overall death as compared to the other counterparts (HR 2.53, 95%CI 1.28 to 4.99, P-value<0.01) over an 8-year observation period, even after major adjustment (HR 2.02, 95%CI 1.02 to 4.02). Conclusions: MCR phenotypes assigned to the MMSE cognitive domain are more likely to have an increased risk of overall mortality, 1.5-fold higher than counterparts, over 8-year observation.

Worldwide, there is a significant increase in the use of unmanned aerial vehicles (UAVs) by emergency services. They offer a lot of possibilities during the rescue operation. Such a wide application for various purposes and environments causes many threats related to their use. To minimize the risks associated with conducting air operations with UAVs, the SORA methodology will be important. Due to its level of detail, it is a methodology adapted to civilian use. In this article, the authors' team will try to develop guidelines and directions for adapting SORA to the requirements of the operational work of emergency services. Thus following article aims to present the most important risks related to conducting operations with the use of UAVs by First Responders (FRs) and to show the sample risk analysis performed for this type of operation on the example of the ASSISTANCE project. The paper describes, on the one hand, possibilities offered by UAVs in crisis or disaster management and step-by-step Specific Operations Risk Assessment (SORA) and on the other hand, presents possible threats, consequences and methods of their mitigation during FRs missions.

In recent years, farmers and policymakers have faced ample challenges and have struggled to support the sustainability of the agricultural sector. Sustainable agriculture encompasses multiple concepts, and its performance produces extensive debate about data requirements, appropriate indicators, evaluation methods, and tools. Under the European Union (EU) financed project FLINT (Farm Level Indicators for New Topics in policy evaluation), detailed data have been collected at the farm level to provide broader coverage of sustainability indicators on a wide range of relevant topics to facilitate the assessment of sustainability performance. The approach has been applied in a pilot network of representative farms at the EU level, considering the heterogeneity of the EU farming sector to provide data infrastructure with up to date information for sustainability indicators. This study aims to assess sustainability performance at the farm level in Greece. Representative and dominant agricultural systems, such as permanent crops, olive trees, arable crops, and livestock (sheep) farms, comprise the Greek sample. It uses the analytical hierarchy process (AHP) methodology and attempts to gain insights into the sustainability performance of agricultural systems. The outcome of the sustainability assessment reveals knowledge and develops support for strategic farm choices in order to support both farmers and policymakers towards more sustainable development plans. The results indicate that three typical Mediterranean farming systems, like permanent crops, olive trees, and extensive livestock systems (sheep farms), are more sustainable in contrast to intensive and arable crop farms.

Assessing the economic supply of biomass in a geospatial context while accounting for risk from natural disasters was studied. Risk levels were estimated from a component of factors which included: population density, road density, federal ownership, U.S. Environmental Protection Agency ecoregions, and Presidential Disaster Declarations. The Presidential Disaster Declarations included risks due to: coastal storm, drought, fire, flood, freezing, hurricane, mud land slide, severe ices, severe storms, snow, tornado, and tropical storm. Presidential Disaster Declarations included summaries based on a short-term time period from 2000-2011, and on a long-term time period from 1964-2011. Risk categories were developed as a function of the number of disaster declarations, agricultural-to-forest land ratio, average road density, and average population density. A significant contribution of the research was the allocation of spatially explicit data using GIS technology at the 5-digit zip code tabulation area. The average area for 5-digit ZCTAs in the Eastern U.S. study region was approximately 169 kilometers². Long-term risk (1964-2011) from disaster declarations had a greater impact on the economic availability of biomass supply relative to short-term declarations (2000-2011). The greatest risk to biomass supply came from population density relative to the other risk factors studies. Of the 25,044 total ZCTAs, 12,256 ZCTAs were in locations that did not include population density ≥ 150/km², road density ≥ 14 km/km², federal ownership, and US Environmental Protection Agency Level III ecoregions. Of the remaining 12,256 ZCTAs, 26.8% were considered to be moderate-to-high risk based on short-term declarations (2000-2011) and 29.4% were considered to be moderate-to-high risk based on long-term declarations (1964-2011). Lower risk locations for procuring biomass supply for both short-term and long-term declarations, across all risk factors, were in southern Georgia, South Carolina, and Texas.

The development of reliable Food Frequency Questionnaires (FFQs) requires detailed information about the level and variation of dietary food intake of the target population. However, these data are often limited. To facilitate the development of new high quality FFQs and validation of existing FFQs, we developed a comprehensive National Dietary Assessment Reference Database (NDARD) detailing information about the level and variation in dietary food intake of people 20-70 years old in the general Dutch population. This paper describes the methods and characteristics of the population included in the NDARD database. 1063 men and 985 women agreed to participate in this research. Dietary intake data were collected using different FFQs, web-based and telephone-based 24-hour recalls, as well as blood and urine-based biomarkers. The baseline FFQ was completed by 1647 participants whose mean BMI was 26±4 kg/m2; 1117 participants completed telephone-based recalls and 1781 participants completed web-based recalls. According to the baseline FFQ, the mean energy intake was 2051±605 kcal/day. The percentage of total energy intake from protein was 15±2 En%, from carbohydrates was 43±6 En%, and from fat was 36±5 En%. This database will enable researchers to validate existing FFQs and to develop new high quality dietary assessment methods.

Introduction In 2016 the European Union setup its first structured food provision program to combat food insecurity. We aimed to measure the program’s capacity in assisting its beneficiaries to achieve a healthy diet and measure their satisfaction. Methods A computational study was carried out to calculate daily food provision per person under the program for January 2016-December 2017. A cross sectional survey in 3942 beneficiaries took place in December 2017-June 2018 collecting anthropometric, sociodemographic and program satisfaction data. Descriptive statistics were performed and reported as relatively frequencies, mean ± standard deviation. Results Dairy, fresh meat, legumes, sugar, olive oil and tomato concentrate were the most commonly procured items. The program’s contribution to vegetable, dairy and cereal intake was the lowest (3.4%, 6.1%, 6.0% respectively) as opposed to free sugars (12.2%) and oils (24.5%). The program’s algorithm favors greatly (almost 3-fold) single person applications compared to 4+ persons applications. The monetary value was estimated at 21.23±23.4 euros/food provision, however 64.4% of beneficiaries reported a high positive impact on the household budget. 50.7% and 41.6% reported high positive impact on feelings of anxiety and security, respectively. ~70% of the beneficiaries were highly satisfied with the foods provided, with lower scores for quality and shelf-life (50.7% and 58.8% high respectively). Conclusions The program is met by high beneficiary satisfaction and is perceived as a substantial assistance. Increases in the amounts and variety of foods delivered, with a focus on fruit, vegetables and fish should be considered, to further improve the program’s dietary impact.

The current research investigated the environmental risk of the polycyclic musk compounds, Galaxolide® (HHCB) and Tonalide® (AHTN), in the marine environments. These substances are lipophilic, bioaccumulated and potentially biomagnified in aquatic organisms. To understand the toxicity of HHCB and AHTN, we performed acute toxicity tests by exposing marine microalgae (Phaeodactylum tricornutum, Tretraselmis chuii and Isochrysis galbana), crustaceans (Artemia franciscana), echinoderms (Paracentrotus lividus), bivalves (Mytilus galloprovincialis), fish (Sparus aurata) and a candidate freshwater microalga (Raphidocelis subcapitata) to environmentally relevant concentrations (0.005 - 5 µg/L) following standardized protocols. The effects of both substances on microalgae growth were incipient and only I. galbana was sensitive to HHCB and AHTN, with IC10 values of 5.22 µg/L and 0.328 µg/L, respectively. Significant (p < 0.01) concentration dependent responses were measured in P. lividus and M. galloprovincialis larvae developments as well as S. aurata mortality tested with HHCB. The effect of HHCB on P. lividus larvae development was the most sensitive endpoint recorded, producing an EC50 value of 4.07 µg/L. Our results show that HHCB represents a high risk to P. lividus larvae development for early life stages in marine environments.

This paper presents the life cycle assessment results of a study of plastic recycling via hydrothermal upgrading (HTU), a chemical recycling technology. It was investigated due to its potential to address current gaps in the plastic recycling system, largely due to several plastic packaging materials and formats that cannot be processed by traditional mechanical recycling technologies (primarily due to technoeconomic reasons). As society transitions towards a net-zero-based circular economy, assessments should be conducted with a futuristic outlook, preventing costly mistakes by employing the right technologies in the right areas. HTU can generate up to 76% reduction in climate change impacts when compared with comparable end-of-life treatment technologies whilst conserving material with the system. Additionally, further reductions could be achieved by changes in electricity consumption within the study. This represents a new insight to chemical recycling of polymers by establishing a prospective life cycle assessment study that looks to introduce a step-change in the recycling system. By creating a transparent cut-off model with consistent allocation, it highlights the benefits of introducing this technology as opposed to the current model of disposal through incineration or landfill.

Sleep disturbances very common in children with autism. That is why it requires instruments that facilitate its evaluation. Goals: Perform the evaluation of sleep from a subjective prospect in a group of children with primary autism and compare to a control group, using the Sleep Habits in Children Survey (CSHQ), In order to determine sleep disturbances, according to the sub-scales results. Method: A prospective cross-sectional study of the sample was carried out. A group with primary Autism n = 21 was selected. For the assessment of the dream we chose (CSHQ). The differences between independent groups were calculated by applying a Mann Whitney U test (p <0.05). Results: The group of children with autism showed the highest values of the total scale (mean = 48.00) wish is congruent with a greate disfuntion of sleep, compared to the control group (mean = 36.47) for p = 0.00. Significant differences were found for all sub scales p = 0.00, with the exception of sub-scale number 7. Conclusions: There is a high presence of sleep disturbances in children with primary autism, which are related to multifactorial causes, with the exception of sleep breathing disorders that did not show statistically significant differences between groups.

The aim of this study was to introduce a new activity-based balance index by using accelerometer data. Twenty-seven junior soccer players from the Iranian premier league were selected. Four functional tests, consisting of one leg stance, dynamic Y balance, running and dribbling tests, were conducted to assess the players’ balance, activity and skill. During these four tests, besides their relative scores, the acceleration of their body center was also recorded. Activity-based balance index (ABI) was calculated using these acceleration data. The results showed positive correlations between ABI and both static and dynamic balance scores. Additionally, negative correlations were found between ABI and dribbling scores, which demonstrate the agility required for this skill. It seems that this new index achieves the evaluation of both the balance and the skill level of soccer players. Perhaps this is a new way of talent identification and also a re-development of balance tests from traditional to modern.

Direct assessments of executive function (EF) are increasingly used in research and clinical settings, with a central assumption that they assess “universal” underlying skills. Their use is spreading globally, raising questions about the cultural appropriateness of assessments devised in Western, industrialized countries. We reviewed multidisciplinary evidence and theory to identify sets of cultural preferences that may be at odds with the implicit assumptions of EF assessments. These preferences relate to motivation and compliance; cultural expectations for interpersonal engagement; contextualized vs. academic thinking; cultural notions of speed and time; the willingness to be silly, be incorrect, or do the opposite; and subject-matter familiarity. In each case, we discuss how the cultural preference may be incompatible with the assumptions of assessments, and how future research and practice can address the issue. Many of the cultural preferences discussed differ between interdependent and independent cultures and between schooled and unschooled populations. Adapting testing protocols to these cultural preferences in different contexts will be important for expanding our scientific understanding of EF from the narrow slice of the human population that has participated in the research to date.

Negative thermal quenching (NTQ) denotes that the integral emission spectral intensity of a given phosphor increases continuously with increasing temperature up to a certain elevated temperature. NTQ has been a subject of intensive investigation in recent years and a large number of phosphors were reportedly to have exhibited NTQ. In this paper, a collection of results in the archival literature about NTQ of specific phosphors are discussed from a macroscopic viewpoint in the following three aspects:1) Could NTQ of a given phosphor be reproducible?2) Could the associated data for a given phosphor exhibited NTQ be in line with the law of conservation of energy?3) Could NTQ of a given phosphor be demonstrated in a prototype WLED device? By analyzing typical cases based on common sense, it is hoped to increase the awareness for the issues with the papers reporting NTQ of the specific phosphors based on spectral intensity along with for the importance of keeping stability and consistency of the measurement conditions in temperature-dependent spectral intensity measurement which is a prerequisite for the validity of the measurement results.

Risk assessment management have been a hot topic for the researchers since a very long time. Software risk management is an important part of project management as it contains the identification, analysis, estimation and monitoring of different risks present in the system. This helps developers in decision making while assessing the problems that could arise in the software systems. Risk management is very complex in large scale system as these systems have very complex development. The paper describes risk management techniques for large scale system. Furthermore we have provided a detailed comparative analysis of these techniques with commonly identified risks in software systems and have provided a systematic order for risk management process to ensure risk mitigation.

The nationwide lockdown imposed to control the spread of novel coronavirus induced dramatic alterations in different sectors of the Nepalese governance, including Solid Waste Management (SWM) practices. The study identifies SW collection gaps in seven major cities of Nepal and highlights the municipal and public households on SW management practices before and during the lockdown to emphasize the linkage between COVID-19 and SWM. It includes information on solid waste status, collection frequency and coverage, workers safety practices, types of vehicles operated for collection and alternative methods adopted by households to manage SW during the lockdown. For this, 1329 households survey and key informant interviews were conducted in seven cities of Nepal during the lockdown. It was found that although the coverage of the collection service was similar during the pandemic, there was a drastic decrease in the collection frequency leading to a collection gap of around 570 tons/day. More than 50% of the surveyed households adopted no proper alternative measures as they claimed that they stored solid waste with proper management so that municipal authorities can take it. The study reveals poor occupational health and safety practices among the solid waste workers due to the unavailability of safety gears and equipment despite being aware of the modes of transmission of the virus. The pandemic exacerbated the challenges of smooth SWM as it is an essential and needy service. This study highlights the need for a timely strategic management framework to be developed by the government to continue the smooth SWM practices during the lockdown.

In time, osteoarthritis (OA) generates the misalignment of the affected joint structures. However, due to the nature of bipedal gait, OA in the lower limb can also cause pathological gait patterns, which can generate instability and falls, with great consequence, especially in the aged population. With goniometry used to evaluate the range of motion of joints (ROM), we wanted to evaluate how gender impacts gait dynamics in OA patients. For this study we have compared 106 OA patients (male=32, female=74) to age matched controls. All participants had their right leg as dominant. Video recording of normal gait was analysed with a digital goniometry tool phone application, and the knee’s ROM was measured in midstance and midswing of the gait. During midstance, significant extension and flexion of the knee excursion have been observed in both males and females. During midswing, knee OA presents more differences, whereas subjects with hip and knee OA present changes on the dominant knee. Midstance changes suggest that the knee’s joint degenerative changes can be linked to hip OA secondary changes. Midswing changes in lower limb OA suggest a connection to the activities of daily life. Gender differences generated by OA must furthermore be studied in both lower limbs so that the best therapeutic approach can be chosen.

Functional mobility assessments (i.e., Timed Up and Go) are commonly used clinical tools for mobility and fall risk screening in the aging population. In this work, we proposed a new Mixed Reality (MR)-based assessment that utilized a Microsoft HoloLens^TM headset to automatically lead and track the performance of functional mobility tests, and subsequently evaluated its validity in comparison with reference inertial sensors. Twenty-two healthy adults (10 older, 12 young) participated in this study. An automated functional mobility assessment app was developed based on the HoloLens platform. Mobility performance was recorded with the headset built-in sensor and validated with reference inertial sensor (Opal, APDM) taped on the headset and lower back. Results indicate vertical kinematic measures by HoloLens was in good agreement with the reference sensor (Normalized RMSE ~ 10%). Additionally, the HoloLens-based test completion time was in perfect agreement with clinical standard stopwatch measure. Overall, our preliminary investigation indicates that it is possible to use an MR headset to automatically guide users to complete common mobility tests with good measurement accuracy, thus it has great potential to provide objective and efficient sensor-based mobility assessment.

Changes in agricultural yields due to climate change will affect land use, agricultural production volume, and food prices as well as macroeconomic indicators, such as GDP which is important as it enables one to compare the climate change impacts across multiple sectors. This study considered five key uncertainty factors and estimated macroeconomic impacts due to crop yield changes using a novel integrated assessment framework. The five factors are 1) land-use change (or yield aggregation method based on spatially-explicit information), 2) the amplitude of the CO2 fertilization effect, 3) the use of different climate models, 4) socioeconomic assumptions and 5) the level of mitigation stringency. We found that their global impacts on the macroeconomic indicator value were 0.02 - 0.06% of GDP in 2100. However, the impacts on the agricultural sector varied greatly by socioeconomic assumption. The relative contributions of these factors to the total uncertainty in the projected macroeconomic indicator value were greater in a pessimistic world scenario characterized by a large population increase and low income (0.6%) than in an optimistic scenario (0.00%).

Measuring farms sustainable innovativeness is a big challenge for both practitioners and academics. The need of sustainable innovativeness assessment in the agricultural business is reasoned in the article. Unfortunately, the features of the farms sustainable innovativeness measurement have not yet been investigated, and any objective methodology for innovativeness assessment is not presented as well. The objective of this article is to find possibility of use some methodology for measuring farm sustainable innovativeness, which would allow ranking farms by this aspect. The article demonstrates the need for multi-criteria method of innovativeness measurement and substantiates the complex proportional assessment method (Copras) as the most appropriate for solution of indicated problem. The model for use of offered method is presented and the practical application of the model is submitted. The final result refuted the opinion that farm innovation depends only on the possibilities to invest funds in a certain area. Indeed, staff creativity and the position of the management regarding certain areas of business make an essential contribution to the sustainable innovativeness level in the agricultural organizations.

Purpose: National Institute for Health and Care Excellence (NICE) has recently published quality standards for assessment of fall risk and preventing further falls. According to the standards, multifactorial fall risk assessments should include: identification of falls history; analysis of gait, balance, mobility and muscle strength, among other factors. Despite being based on subjective analysis or simple timing and not being multifactorial, physiotherapists and physicians quite often use these tests as reference scales to differentiate between lower and higher risk of falling. Instrumented TUG has been recently reported to provide important additional information to the overall score. Objective: To explore a case-based approach of fall risk assessment to identify the most relevant and informative risk factors that in combination could better define a person risk profile. Materials and Methods: A multifactorial assessment of fall risk through questionnaires, standard functional tests, tests instrumented with inertial sensors, and force platforms has been studied within a group aged 55-80 years old. Different fall risk factors and fall risk assessment methods were analyzed in a case-based descriptive study. Results & Discussion: Subjects at higher risk of falling were identified based on their detailed profiles. A set of features were obtained from the instrumented standard tests differing significantly between subjects presenting higher or lower fall risk. Therefore, instrumenting conventional tests with wearables containing inertial sensors and force platforms gives more detailed and quantitative insights. This information can be used to better define and tailor fall prevention exercises and to improve the follow-up of the evolution of the subject.

A very important role in determining the quality of water is the assessment of its microbiological quality. Water quality control, which could pose a direct threat to human health and life, is performed in the case of water produced at the water treatment plants, tap water or water in swimming pools. However, these traditional methods used to assess its quality are laborious and time consuming. In emergency and incidental situations, in the era of terrorist threats, the need for quick, reliable and reproducible microbiological determinations seems to be essential. In this study, an attempt was made to compare various methods of assessing the microbiological quality of water. The assessment was carried out for waters with different microbiological characteristics: surface waters, rainwater, groundwater, and water supply. The evaluation was carried out using traditional culture methods and high-speed methods: flow cytometry and luminometry. The analysis of microbiological parameters were the basis for the statistical analysis. The conducted microbiological analysis of various types of water, along with their statistical evaluation, showed different dependencies for each of the analysed waters.

The pandemic of obesity worldwide has been recognized as a very important challenge. Within its complexity the identification of higher risk patients becomes essential since it seems unsustainable trying to offer access to treatment to all people with obesity. Several new approaches have recently been presented as important tools for risk stratification. This research applied some of these tools in a cross-sectional study involving adults with obesity classes I, II, III and super obesity. The participants had their cardiometabolic risk profile assessed. The study included adults with obesity, aged 18 to 50 years (n=404) who were evaluated for anthropometric, body composition, hemodynamic, physical fitness and biochemical assessments. These variables were used to identify the prevalence of risk factors for cardiometabolic diseases according to the classes of obesity, by gender and age group. The results showed a high prevalence of risk factors, especially among the upper classes of obesity (BMI &gt; 35 kg/m2) using single parameters as the waist circumference with almost 90% above the cut-off point. But there were also smaller numbers as the Glycated Hemoglobin whose prevalence was around 30%. Indexes like the atherogenic index of plasma (AIP) had the highest prevalence, with 100% of the male participants identified with increased risk for cardiovascular diseases.

The shipbreaking industry is located predominantly in South Asian countries, and dismantles end-of-life ships to meet national steel demand. There are charges that this industry exploits local environmental, economic and social conditions to boost profits. The majority of this previous research often draws from a single disciplinary point of view that ignores or downplays complexities and trade-offs, precluding realistic policy improvement. Here we review 110 shipbreaking papers published in international peer reviewed journals that are indexed in SCOPUS, Science Direct and Google Scholar. We found that to date, shipbreaking research revolves around the coastal contamination of end-of-life ships waste over many other topics, and lacks critical interdisciplinary studies that explain trade-offs between environmental, social and economic factors that would better inform policy formulations for improvement of worker safety and environmental conditions. We propose a Life Cycle Sustainability assessment (LCSA) framework that could incorporate these trade-offs in a single analysis. We hope this review guides future studies towards more comprehensive sustainability measurement of shipbreaking activities.

Background: Prismatic cover test (PCT) is a gold standard assessment of strabismus angle, however it has a significant number of disadvantages which are eliminated in Strabiscan device. Methods: Patients with strabismus (n = 30) and a group of healthy subjects (n = 30) were given a detailed history and underwent ophthalmologic examinations (best corrected visual acuity assessment, cycloplegic autorefractometry, biomicroscopic examination of anterior and posterior part of the eye). Each patient and healthy subjects were then subjected to the PCT, and then the presence of strabismus was detected, and its angle assessed using a Strabiscan demonstrator. Statistical analysis was done with Statistica software. Results: No statistically significant differences were noted in the measurements of strabismus angles made by the differing methods. Among the control group, using the Strabiscan demonstration device, low-angle latent strabismus ≤3PD was diagnosed in 83% of patients, and >3PD in 13% of patients. Those using the PCT, on the other hand, diagnosed latent strabismus ≤3PD in only 13% of patients, and latent strabismus with an angle >3PD in 13% of patients. Conclusion: The Strabiscan demonstration device provides quick and accurate assessment of the strabismus angle.

Developments in technology have enabled envisioning the derivation of materials and products from renewable biomass, as an alternative to finite fossil-based resource consumption. Therefore, bioeconomy is regarded as an opportunity for sustainable economic growth. Countries are formulating strategies in accordance with their goals to attain from bioeconomy. Proper measurement, monitoring and reporting of the outcomes of these strategies is crucial for long-term success. This study aims to critically evaluate the national methods used for the measurement, monitoring and reporting of bioeconomy contribution to the total economy. For this purpose, research and surveys have been conducted on selected countries (Argentina, Germany, Malaysia, the Netherlands, South Africa and the United States). The results reveal that the bioeconomy targets set up in the strategies often reflect country’s priorities and comparative advantages. However, comprehensive approaches to measure and monitor bioeconomy progress are frequently lacking. Most countries only measure the contribution to gross domestic product (GDP), turnover and employment of the sectors included in their bioeconomy definition, which may provide an incomplete picture. In addition, this study identifies the mismatch between the targets and measurement methods, as the environmental and social impacts of bioeconomy are often foreseen, but not measured. It is concluded that existing global efforts towards a sustainable bioeconomy monitoring can be strengthened and leveraged to measure progress towards sustainable goals.

Previous research via cell experiments has shown that ultrafine particles (UFPs, particles less than 100 nm) emitted from Three-Dimensional desktop printers (3D printers) had cytotoxicity. However, a few particles from different filaments and their cytotoxicity combinations have been tested. Here we quantify emissions of UFPs and use Air-Liquid Interface (ALI) from one commercially available filament extrusion desktop 3D printer utilizing three different filaments by controlled experiments. A549 cells were exposed at the ALI to UFPs generated by a working 3D printer for an average of 45 minutes and 90 minutes. Twenty-four hours after exposure, cells were analyzed for percent cytotoxicity grown on the 24-well ALI insert (LDH assay). UFP exposure resulted in decreased cell viability (significantly increased LDH levels). The result shows that Acrylonitrile butadiene styrene (ABS) has the most significant particle emission. ALI exposures enable in vitro testing of mixtures of particles such as UFP from a 3D printer. ABS is the only filament with a significant difference compared with the HEPA control in 90 minutes of exposure (p-value &lt;0.05). ABS and PETG we used during the experiment presented a significant difference compared with the HEPA control in 45 minutes of exposure.A screening analysis of potential exposure to these products in a typical environment suggests caution should be used when operating many printer and filament combinations in poorly ventilated spaces or without the aid of combined gas and particle filtration systems.

Groundwater plays a pivotal role as the largest potable water sources in Bangladesh. However, the quality of the groundwater faces challenges due to xenobiotic compounds in it. Excess amount of arsenic (As) has already been found in groundwater in many parts of Bangladesh. Thus, this study was conducted to assess the water quality and associated human health risk in central Bangladesh. A total of 99 groundwater samples from the central part of Bangladesh were analyzed to assess human health risk due to high level of nitrate (NO3-) and other trace elements i.e. arsenic (As), iron (Fe), and manganese (Mn). It was found that NO3- concentration (253.17 mg/L) in the groundwater samples exceeds the recommended guideline value by the WHO (50 mg/L). Moreover, this study area also characterized with elevated concentration of As (19.44 µg/L), Fe (811.35 µg/L), and Mn (455.18 µg/L) in the groundwater. Non-carcinogenic human health risk was calculated by justifying HQ (Hazard Quotient) and HI (Hazard Index) and attributed potential conjunctive human health risks due to NO3-, As, Fe and Mn in the study area. Moreover, high carcinogenic risk was found due to As contamination in the groundwater samples in the study area.

Banana plantation is an important type of agro-ecosystem in the tropics, and it is important to carry out a quantitative assessment of the carbon footprint of the banana growing process for the development of low-carbon agriculture to cope with global warming. The carbon footprint of two banana cultivation processes was assessed using the life cycle assessment method through field trials and farmer surveys in Chengmai County, Hainan Province, China. The results showed that: (1) N2O emissions caused by the application of nitrogen fertilizers and compound nitrogen fertilizers were the largest source of carbon emissions from banana plantation farmland, and the production and transportation of common compound fertilizer were the second largest source of carbon emissions. Banana fruits and plants were the main contributors to carbon fixation in banana plantation ecosystems, with about 24.72 t CO2 eq hm-2 for Musa paradisiaca AA, and 34.66 t CO2 eq hm-2 for M. AAA Cavendish var. Brazil. (2) The annual carbon emissions of Musa paradisiaca AA and M. AAA Cavendish var. Brazil farmland systems were 35.40 t CO2 eq·hm-2 and 43.83 t CO2 eq·hm-2, respectively, and the annual carbon fixation was 38.23 CO2 eq·hm-2 and 48.17 CO2 eq·hm-2, respectively. The banana plantations had a negative carbon footprint per unit area, showing a net carbon sink function. (3) Banana is a plant with high carbon emission and strong carbon fixation capacity. Scientific management in the field can achieve the decrease of agricultural inputs, high quality and abundant agricultural products, and the reduction of carbon footprint of farmland.

This study determined the temporal variation of PM2.5 in ambient air in Thohoyandou and further assessed the associated health risks. The levels of PM2.5 were quantified for a period of 1 year (April 2017-April 2018) using the gravimetric method. There was no significant difference (P-value = 0.18) in concentrations of both PM2.5 samples collected during weekdays (11.29 µg.m-3) and weekends (9.86 µg.m-3). However, higher concentrations of PM2.5 were measured in spring and the lowest was measured in summer. The cancer risk obtained for PM2.5 (2.21 × 10−5, 3 × 10-4, and 5 × 10-4 for infants, children, and adults respectively) in the outdoor air of Thohoyandou has exceeded the limit values by the USEPA and WHO, implying a significant risk for the whole population. For non-carcinogenic risks, the HQ values were 2.60, 4.81, and 2.60 for infants, children, and adults respectively. The HQ value &gt;1 indicates a non-carcinogenic risk to the residents in Thohoyandou and a higher risk to children. Moreover, PM2.5 in Thohoyandou is responsible for 0.15% and 0.13% of deaths resulting from cardiovascular disease and lung cancer respectively for adults above 30 years. PM2.5 is causing adverse health effects in Thohoyandou as deduced from the health risk assessment. Therefore, it is recommended that further epidemiological studies be conducted in Thohoyandou to estimate the burden of disease due to exposure to particulate matter and suitable controlling policies be arranged to reduce particulate matter.

The construction safety risks (such as landslides or slumps) of the high-fill subgrade are characterized by uncertainty and variability. In order to ensure the construction safety of the high-fill subgrade of the expressway, a comprehensive risk assessment model of high-fill subgrade construction according to the combination weighting method based on game theory was established. Firstly, settlement rate, lateral differential settlement, horizontal displacement at the foot of the slope, deep horizontal displacement, and excess pore pressure were selected as evaluation indicators, and an evaluation index system of high-fill subgrade was constructed. Secondly, the subjective and objective weights were obtained via the analytic hierarchy process and entropy method. Furthermore, the optimized weights were obtained by introducing game theory, and the construction risk of the high-fill subgrade was evaluated and analyzed using the fuzzy comprehensive evaluation method. Finally, based on the high-fill section of the Zhijiang-Tongren Expressway in Hunan Province (China), the evaluation model was validated through field measurement data. The results show that the safety scores obtained using the three methods of analytic hierarchy process, entropy method, and combination weighting method based on game theory are similar. The combination weighting evaluation model can correct the evaluation result error caused by a single weight and avoid information delay caused by the manual processing and analysis of monitoring data. The high-fill subgrade safety evaluation grade based on the combination weighting method and game theory is consistent with the engineering situation, and its fault tolerance range is within 20%. The evaluation model proposed in this study can scientifically and effectively evaluate the safety risks of high-fill subgrade construction, significantly improving the safety and reliability during the construction process.

This study is an attempt to create a framework, using the best available inventory data, to perform lifecycle assessment (LCA) on asphalt pavement production. In particular, the use of reclaimed asphalt pavement (RAP) as an end-of-life product of deteriorated pavements is under consideration. Following ISO 14000 series standards, the framework constitutes the four major LCA steps in defining goal and scope, lifecycle inventory analysis, environmental impact assessment, and results interpretation. Three different scenarios in which varying portions of RAP are incorporated into hot mix asphalt production are to be compared. The system boundary of this study is limited to the construction and rehabilitation phases and ignores the vehicular use phase. It was found under this study that since high RAP mixtures require more frequent and aggressive maintenance activities, the overall footprint of asphalt pavements constructed with higher RAP contents is also higher. This would necessitate more efficient design procedures and protocols for mixtures produced with high RAP contents to compensate for their lack of long-term performance.

Defectively manufactured and deliberately damaged composite laminates fabricated with different continuous reinforcing fibres (respectively, carbon and glass) and polymer matrices (respectively, thermoset and thermoplastic) were inspected in magnetic resonance imaging equipment. Two pulse sequences were evaluated during non-destructive examination conducted in saline solution-immersed samples to simulate load-bearing orthopaedic implants permanently in contact with biofluids. The orientation, positioning, shape, and especially the size of translaminar and delamination fractures were determined according to stringent structural assessment criteria. The spatial distribution, shape, and contours of water-filled voids were sufficiently delineated to infer the amount of absorbed water if thinner image slices than this study were used. The surface texture of composite specimens featuring roughness, waviness, indentation, crushing, and scratches was outlined, with fortuitous artefacts not impairing the image quality and interpretation. Low electromagnetic shielding glass fibres delivered the highest, while electrically conductive carbon fibres produced the poorest quality images, particularly when blended with thermoplastic polymer, though reliable image interpretation was still attainable.

Since the energy sector is the main source of greenhouse gases, it has the highest potential for improvement. Improvements can be achieved by generating energy from renewable sources. Combined with thermal energy storage, concentrating solar power plants represent a promising technology for dispatchable renewable energy, ensuring a stable energy supply even in remote areas without contributing to greenhouse gas emissions during operation. However, it is important to note that greenhouse gases and other polluting emissions may occur during the manufacturing process of concentrating solar power plant components. This work analyses the design of the receiver to produce thermal energy for the existing solar dish CSP plant at the Energy Center of the Politecnico di Torino. The objective of this plant is to produce hot water for a small case study. Considering the average solar irradiance for Turin equal to 800 W/m2, the surface heat flux was obtained from the first part of the analysis, which was used to obtain the maximum internal temperature in the receiver equal to 873.7 °C. The maximum temperature obtained was a constraint for the selection of the material for the solar receiver. Of the various possibilities, copper was chosen. In the second part of the work, a Life Cycle Assessment was carried out to compare the emissions generated during the production of the main components of the CSP plant with the emissions generated by the methane-fuelled water heater that produces the same amount of water as the CSP plant. It can be concluded that the manufacture of the main components of the CSP plant results in lower greenhouse gas emissions than the operational phase of a conventional natural gas-fired water heater (1.6 kg CO2/day).

Pufferfish (Tetraodontidae) inhabiting the Mediterranean Sea can represent an emerging public health risk due to the possible accumulation of marine neurotoxins (TTXs and STXs) in their tissues. In this study, the presence of pufferfish species in the Strait of the Sicily (Lampedusa Island, Italy) was investigated using a Citizen Science (CS) approach involving local fishermen. A sub-group of specimens collected were sent to the National reference Laboratory on Marine Biotoxins for de-termining the presence of TTXs using a validated HILIC-MS/MS method on fish tissue. The STXs presence was also screened in some specimens. Overall, 56 specimens, identified as Sphoeroides pachygaster (Müller &Troschel, 1848) were collected. Data on specimen total length, body weight, fishing method, catch area (with relative depth temperature and salinity) were analyzed and compared with the S. pachygaster records reported in Guardone et al. (2018), which were appro-priately updated until 2022. All the analysed tissues were found to be negative for both TTXs and STXs. The key role of the CS in monitoring potentially toxic marine species was proved. Outcomes from this study, the first investigating the toxicity of S. pachygaster in Italian waters, may provide useful data for the proper assessment of this emerging risk

Temporomandibular disorders (TMDs) refer to a group of conditions that affect the temporomandibular joint, causing pain and dysfunction in the jaw joint and related muscles. The diagnosis of TMDs typically involved clinical assessment through operator-based physical examination, self-reported questionnaire and imaging studies. To objectivize the measurement of TMD, this study aims at investigating on the feasibility to use machine-learning algorithms fed with data gathered from low-cost and portable instruments to discriminate the presence of TMD in adult subjects. Through this aim, the experimental protocol involved fifty participants, equally distributed between TMD and healthy subjects, acting as control group. The diagnosis of TMD has been performed by a skilled operator through the typical clinical scale. Participants underwent to a baropodometric analysis by using a pressure matrix and the evaluation of the cervical mobility through inertial sensors. Nine machine-learning algorithms belonging to support vector machine, k-nearest neighbours and decision tree were compared. The k-nearest neighbours based on cosine distance was found as the best performing, achieving performance of 0.94, 0.94 and 0.08 for the accuracy, F1-score and G-index, respectively. These findings open the possibility to use such methodology to support the diagnosis of TMDs in clinical environments.

Safety assessment of structures can be obtained employing limit design to overcome uncertainties concerning actual response due to inelastic constitutive behavior and more generally to non-linear structural response and loads’ random variability. The limit analysis is used for evaluating the safety of the structures directly starting from load level without any knowledge of the load history. In the paper, the lower bound calculation is proposed where a new strain-based approach is used that allowed describing the residual stress and displacement in terms of permanent strain. The strategy used the permanent strain as the effective parameters of the procedure so that it was possible to assess the ductility requirements for the complete load program developed till collapse or shakedown. The procedure is compared to experimental results obtained on aluminum beams in shakedown.

General–purpose automatic speech recognition (ASR) systems have improved their quality and are being used for pronunciation assessment. However, the assessment of isolated short utterances, as words in minimal pairs for segmental approaches, remains an important challenge, even more for non-native speakers. In this work, we compare the performance of our own tailored ASR system (kASR) with the one of Google ASR (gASR) for the assessment of Spanish minimal pair words produced by 33 native Japanese speakers in a computer-assisted pronunciation training (CAPT) scenario. Participants of a pre/post-test training experiment spanning four weeks were split into three groups: experimental, in-classroom, and placebo. Experimental group used the CAPT tool described in the paper, which we specially designed for autonomous pronunciation training. Statistically significant improvement for experimental and in-classroom groups is revealed, and moderate correlation values between gASR and kASR results were obtained, beside strong correlations between the post-test scores of both ASR systems with the CAPT application scores found at the final stages of application use. These results suggest that both ASR alternatives are valid for assessing minimal pairs in CAPT tools, in the current configuration. Discussion on possible ways to improve our system and possibilities for future research are included.

Background: Accurate estimation of dietary intake is challenging. But whilst some progress has been made in high-income countries, low- and middle-income countries (LMICs) remain behind, contributing to critical nutritional data gaps. This study aimed to validate an objective, passive image-based dietary intake assessment method against weighed food records in London, UK for onward deployment to LMICs. Methods: Wearable camera devices were used to capture food intake of eating occasions in 18 adults and 17 children of Ghanaian and Kenyan origin living in London. Participants were provided pre-weighed meals of Ghanaian and Kenyan cuisine and camera devices to automatically capture images of the eating occasions. Food images were assessed for portion size, energy, and nutrient intake, and relative validity of the method compared to the weighed food records. Results: Pearson and Intra-class correlation coefficient of estimates of intakes of food, energy and 19 nutrients ranged from 0.60 to 0.95 and 0.67 to 0.90, respectively. Bland-Altman analysis showed good agreement between the image-based method and weighed food record. Under-estimation of dietary intake by the image-based method ranged from 4 to 23%. Conclusions: Passive food image capture and analysis provides an objective assessment of dietary intake comparable to weighed food records.

The emergence of novel pathogens is a well-known epidemiological risk, however, the unexpected emergence of a truly novel coronavirus-mediated pandemic, SARS-nCOV2 (COVID-19), underscored the significance of understanding this contagion. The COVID-19 pandemic caused unprecedented social, economic, and educational disruptions on a scale never seen before. In addition to social protocols, the development of safe, effective, affordable COVID-19 vaccines was developed within months, the cornerstone to mitigating this pandemic. We present an overview of the evolution of the SARS-nCOV2 pandemic from a historical perspective and describe its biology and behavior, especially the immunological aspects of the disease. We further provide an overview of COVID-19 therapeutics, treatment, and vaccine development. It is critical to understand the transmission mechanism of the disease to control and mitigate its progression. We describe cohort studies to identify secondary and tertiary syndromes. The transmission characteristics help its diagnosis and detection. During the pandemic, a lot of emphasis was placed on personal protection equipment. It is now concluded that the virus particles spread by aerosol dispersion. While the recommended distance may not be sufficient, the use of personal protective equipment and social distancing may be helpful in close-quarters environments. Such protocols in conjunction with safe and effective vaccines and personal hygiene are among the safe practices. While we learn from our experience, this review provides a holistic view of COVID-19, so we are better prepared for a future pandemic. In addition to a wide-spectrum automated analytics system, we also suggest that the use of artificial intelligence in conjunction with data analytics can further reduces the risk of speculatively diagnosing agents incorrectly, to eliminate future pandemic, where the novelty can be the cloud-based presumptive diagnosis.

The development of mobile technology and internet mobile offers new possibilities in both rehabilitation and for patients’ assessment in a longitudinal and MS management perspective. However, because the mobile health applications (mHealth) have only been developed recently, the level of evidence supporting the use of mHealth in patients with multiple sclerosis (pwMS) is currently unclear. Therefore, this study aims to list and describe the different mHealth available for rehabilitation and self-assessment of pwMS and to define the level of evidence supporting these interventions for functioning problems categorized within the International Classification of Functioning, Disability and Health (ICF). 36 studies, performed with 22 different mHealth, were included in this review, 30 about rehabilitation and 6 for self-assessment, representing 3,091 patients. For rehabilitation, most of the studies were focusing on cognitive function and fatigue. Concerning the efficacy we found a small but significant effect of the use of mHealth for cognitive training (SMD = 0.28 [0.12 ; 0.45]) and moderate effect for fatigue (SMD = 0.61 [0.47 ; 0.76]). mHealth is a promising tool in pwMS but more studies are needed to validate these solutions in the others ICF categories. More replications studies are also needed as most of the mHealth have only been assessed in one single study.

The prevalence of back pain (BP) among children and adolescents has increased over recent years. Some authors advocate promoting back-health education in the school setting. It is therefore important to adopt a uniform suite of assessment instruments to measure the various constructs. The present study aimed to perform a cultural adaptation of a validated measurement instrument (BackPEI), beginning with a translation and cultural adaptation phase, followed by a second phase to test reliability using a test-retest design. The translation and cross-cultural adaptation were performed based on the guidelines. Reliability was tested by applying the questionnaire to 224 secondary school students, at two different times with a 7-day interval between the tests. In general, the Spanish version presented adequate agreement for questions 1–20, with only question 9 achieving a low Kappa range of .312 [-.152- .189]. The question about pain intensity did not show differences between the averages for the test (4.72 ± 2.33) and re-test (4.58 ± 2.37) (p = .333), and the responses for these two tests were highly correlated (ICC= .951 [.928- .966]; p= .0001). Psychometric testing indicated that the Spanish version of the BackPEI is well-adapted and reliable, based on the test-retest design, providing similar results to the original Brazilian version.

Wastes from social economic activities had great impact on water quality thereby limiting water usability for domestic purposes. Sewages discharge from people activities, usually consist of undesirable concentrations of soluble chemicals that infiltrate into the surrounding surface and underground water, and then constitute health risk to the populace. In order to investigate the concentration characteristics and health risk for the local residents in Nandong Underground River Watershed (NURW), eleven common heavy metals in the water body analysis were conducted. Health risk assessment (HRA) was taken to analyze eleven heavy metals of 84 water samples from surface and underground waters in NURW: 36 samples underground water and 48 samples surface water. Our results showed that the heavy metals concentration order is that of Fe > Al > Mn > Zn > As > Cd > Pb > Cr > Ni > Cu > Hg. Correlation analysis indicates that these eleven metal elements have certain similarity on material source and migration transformation. The health risks for local residents exposed to metal elements in the water of NURW mainly from carcinogenic risk (10−6～10−4 a−1) through drinking way, and the health risk of heavy metals exposed to children through drinking way was much higher than adults. The maximum exposing health risks of Cr in both underground and surface water were higher than the recommendation standard (5.0×10-5 a-1) from ICRP, and all the values over the standard (5.0×10-6 a-1) recommended by the Swedish Environmental Protection Agency and the Dutch Ministry of Construction and Environment and the British Royal Society. The results of health risk assessment shows that Cr in the water of NURW was the mainly source of carcinogenic risk for the local residents, following by Cd and As. Consequently, it is necessary to control the three carcinogenic metals when the water was used as drinking water source.

Background: Affective states play a role in dietary behaviors. Yet, little research has studied within-subjects associations between affect and diet during pregnancy. We examined the acute bidirectional relationships between affect and food intake and moderation by pre-pregnancy body mass index (BMI) in low-income, Hispanic pregnant women using ecological momentary assessment (EMA). Methods: Women (N=57) completed four days of EMA during their first trimester. Women responded to five random prompts per day about their current affect and past two-hour food intake. Results: Higher positive affect (PA) or lower negative affect (NA) predicted greater likelihood of fruit/vegetable consumption in the next two hours in women with lower pre-pregnancy BMI and lower likelihood in women with higher pre-pregnancy BMI. Higher PA predicted less likelihood of fast food consumption in the next two hours in women with lower pre-pregnancy BMI and slightly higher likelihood in women with higher pre-pregnancy BMI. Women with lower pre-pregnancy BMI had higher PA when they reported consuming chips/fries in the past two hours, and women with higher pre-pregnancy BMI had lower PA when they reported consumption of chips/fries in the past two hours. Conclusions: Results showed differential relationships between affect and food intake as a function of pre-pregnancy BMI.

Safety management assessment systems for national level units’ in South Korea focus on responding capacity to cope with impending accident occurrence and danger occurrence. Since the four stage systems for prevention-preparation-response-recovery, which are core elements of national disaster management, assess the capacities by item such as those of individuals, disaster management departments, institutions, and management networks, there is no assessment function for the organic operation states of the entire systems. Therefore, for efficient disaster management, systematic evaluation indices that will enable active pre-checks in departments in organizations should be developed in place of the existing simply checking methods. In this study, an assessment model that will enable active disaster management centered on practice was developed using resilience engineering techniques. This model consists of disaster management items from the viewpoint of proactive responses instead of prevention. A total of 56 items that constitute four capacities; which are prediction (13 items), monitoring (14 items), proactive response (15 items), and safety learning (14 items) capacities were adopted in this model through Delphi analysis. Institutional capacities for infectious disease disaster management were evaluated based on this model and the resultant scores were prediction 4.41, monitoring 4.63, proactive response 4.69, safety learning 4.56 out of the full score of 5.0 points with an overall average of 4.51. This is an excellent capacity management score comparable to the score 4.57 of diagnosis of similar capacities by the WHO\_JEE (The Joint External Evaluation) in 2017. In fact, in 2015, when infectious disease capacity management was poor, in case of MERS (Middle East Respiratory Syndrome) infectious disease spread in South Korea, 36 patients died and 6,729 patients were isolated. However, through capacity reinforcement, in the case of MERS occurrence in South Korea in September 2018, a management capacity that prevented spread was shown as one confirmed case was completely cured in 10 days and 21 contacts were isolated and tested negative. Therefore, this capacity management assessment model is judged to be usable in enhancing disaster response and management capacities.

In this study, by using Least Square Method, the dataset for the Gross Domestic Product per capita is modeled as a function satisfying the fractional differential equation. The function itself is assumed to be the finite summation of its previous values and the derivatives with unknown coefficients. Then, the prediction for the upcoming years is done by having an approach dividing the dataset into 4 regions corresponding to four different tasks. The mathematical model of the Gross Domestic Product (GDP) per capita of the countries (and union) which are Brazil, China, European Union (EU), India, Italy, Japan, UK, the USA, Spain, and Turkey is constructed with a new methodology called as the deep assessment method which comes from the expressing an arbitrary function modeling the dataset as the finite summation of its previous values and the derivatives with unknown coefficient. The method uses the fractional calculus properties combining with Least Square Method and is compared to Long short-term memory (LSTM) algorithm which is a special type of neural network used for time sequences in general.

Viral pathogens pose a substantial threat to public health and necessitate the development of effective remediation and antiviral strategies. This short communication aimed to investigate the antiviral efficacy of disinfectants on the surface proteins of human pathogenic viruses. Using in silico modeling, ligand binding energies (LBEs) of selected disinfectants were predicted and combined with their environmental impacts and costs through eco-pharmaco-economic analysis (EPEA). Results revealed the binding affinities of chemical disinfectants to viral proteins varied significantly (p

Breast self-Examination (BSE) is the cheapest most recommended Breast Cancer (BC) preventive tool for resource-deprived settings. There is paucity in the attitude research domain and comparative gender assessments of the BSE knowledge, attitude and performance (KAP) literature. Purpose: The purpose of this study was to assess the combined and exclusive gender BSE attitude of undergraduate health trainees and to determine significant differences between scores of both genders. Methodology: participants included 5 undergraduate health trainee classes purposively sampled from 2 faculties. Online cross-sectional method was used to assess BSE attitude of 336 purposively sampled Kwame Nkrumah University of Science and technology (KNUST) College of Health Sciences (CoHS) students. Data was analyzed using descriptive and inferential statistical analyses. Main findings: Compared to the construction groups’ average norm of 101.17 (SD = 9.55), our study participants’ (SPs) BSE attitude was lower (92.51; SD = 11.80). However, using popular mid-point and 3- part attitude scoring methods, our SPs’ attitude scores were comparable to sub-regional and national findings. Moreover,the male participants scored a generally high BSE attitude but significantly lower compared to their female counterparts (p < 0.5). Recommendations: There is the need to adjust the curriculum of all health trainees in developing nations to reflect relevant BC preventive measures. Furthermore, BSE research, education as well as advocacy should involve more males as important BC BSE stake holders.

Conventional MRI sequences are standard methods to monitor patients with brain tumors but have significant limitations especially after irradiation. Currently, the role of FET-PET in radiotherapy of glioblastoma is emerging, starting from target definition, response assessment and in distinguishing progression from post-irradiation changes. Recently a PET RANO criteria have been published providing optimal strategy for treatment evaluation with amino-acid PET. Earlier, a PET/RANO group reported contribution of PET imaging to radiotherapy planning and monitoring in glioma patients. Also, increasing evidence have showed advantages of amino-acid PET vs. RANO MRI for prediction of overall survival. In this narrative review we aimed to summarize published data on FET-PET based treatment response assessment to radiotherapy and focused on details in protocols.

Gas turbine installations (GTIs) are widely used to generate electrical and thermal energy mainly by burning gaseous fuels. The use of GTIs to burn hydrogen as part of the development of hydrogen energy technology is currently of particular interest. In order to assess the prospects of using GTIs in such a way, it is necessary, among other things, to understand the carbon footprint of the gas turbine as part of the carbon footprint of the entire life cycle of hydrogen. The article provides an overview of the results of previously published studies on life cycle assessment (LCA) of technically complex devices associated with the production and consumption of fuel and energy, which, from the point of view of the complexity of LCA, are most similar to gas turbine installation. The characteristics of the considered stages and resources used in the assessment of the stages of the life cycle of technically complex equipment are presented, including an analysis of the amount of materials used in production and construction. Taking into account its specific application in Russia, an assessment of greenhouse gas emissions at the stages of the GTI life cycle per MWh of produced capacity was carried out.

Surgical smoke is produced by energy-based surgical instruments. The airborne volatile organic compounds (VOCs) from surgical smoke may have potential health risk. This study aimed to evaluate the evidence for the harmful effects on the operating theater staff. An internationally recognized evaluation model of health risk assessment (HRA) was adapted to preliminarily assess the health risks caused by VOCs in surgical smoke. Results of HRA indicated that non-carcinogenic risk indexes of VOCs did not exceed one, indicating that these pollutants didn't cause significant non-carcinogenic harm to the health of the operating theater staff. But the cancer risk indexes exposed to formaldehyde and benzene all exceed 10-5, which was higher than the suggested value of USEPA (10-6) and might cause potential harm to the health of the operating theater staff. Long-term exposure of such surgical smoke will be harmful to the health of the operating theater staff and have a great risk of cancer.

Background: Chronic kidney disease, one of the most common diseases in the world, is characterized by irreversible impairment of the kidney’s metabolic, excretory, and endocrine functions. During end-stage renal disease, patients require renal replacement therapy, such as hemodialysis (HD). Protein-energy wasting is a common health problem among HD patients. However, this study aims to assess the nutritional status of HD patients at two HD centers in Jeddah, Saudi Arabia, and to determine its associated factors. Methods: A cross-sectional study was conducted at two different Dialysis Centers in Jeddah, Saudi Arabia; 211 female and male HD patients. Malnutrition was recognized using the Modified-SGA (M-SGA) comprising two parts: medical history and physical examination. Sociodemographic and health status for all patients were also determined. Patients were classified based on their M-SGA score into two groups: normal and malnourished. Results: Overall, 54.5% of the participants showed malnutrition. Unemployment, low muscle strength and mass, high level of medication use, and high dialysis vintage were positively (P&lt;0.05) associated with malnutrition. Conclusion: The M-SGA score indicates a high prevalence of malnutrition among HD patients. These results show the importance of regular assessment and follow-ups for HD patients ensuring better health and nutritional status.

There are not many exhaustive works emphasizing the amount of genetic diversity among the strawberry tree (Arbutus unedo L.) genotypes in Morocco. This work aims to assess the biochemical composition of strawberry tree fruits, as well as to establish the variation of this composition among them. In this study, total phenols, total flavonoids, condensed and hydrolyzable tannins, total anthocyanins and free radical scavenging activity through ABTS were investigated in strawberry tree fruits. Furthermore, qualitative and quantitative analyses of individual phenolic compounds by high-performance liquid chromatography (HPLC) were carried out. Color parameters such as lightness (L*), Chroma (c*) and hue angle (h°) were also investigated. All studied variables showed highly significant differences among all samples with the exception of hydrolyzable tannins and chromatic coordinates. Total phenolics varied from 22.63 ± 1.74 to 39.06 ± 2.44 mg GAE/g dry wt, total flavonoids varied from 3.30 ± 0.60 to 8.62 ± 1.10 mg RE/g dry wt and total anthocyanins ranged between 0.12 ± 0.06 and 0.66 ± 0.15 mg cya-3-glu/100g dry wt. In addition, condensed and hydrolyzable tannins amounts were in the range of 10.41 ± 1.07 - 16.08 ± 1.50 mg TAE/g dry wt and 4.08 ± 2.43 - 6.34 ± 3.47 respectively. Moreover, the IC50 value (ABTS) ranged between 1.75 and 19.58 mg AAE/g dry wt. 17 phenolic compounds were detected in strawberry tree fruits. Gallocatechol and catechin were the most abundant phenolic compound. Matrix of correlations revealed significant positive and negative correlations among variables particularly c*, a* and b*. Principal component analysis showed that the first three components formed than 68% of the total inertia. The following variables gallic acid, protocatechuic, gallocatechin, gallic acid derivative, chlorogenic acid, syringic acid, ellagic acid derivative II, L* and h* were the most involved in the total variance explained. Hierarchical clustering classified samples into one main cluster, with a single branch. The results highlight a high biochemical diversity within studied strawberry genotypes, which is probably more genetically related

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

The aim of this study is (a) to develop, test, and employ a combined method of unsupervised machine learning to objectively assess the condition of sports facility in primary schools (PSSFC) and (b) examine the examine the geographical and typological association with PSSFC. Based on the Sixth National Sports Facility Census (NSFC), six PSSFC indicators (indoor and outdoor facility included) were selected as the measurements and decomposed by using the t-stochastic neighbor embedding (t-SNE). Thereafter, the Fuzzy C-mean (FCM) algorithm was used to cluster the same type of PSSFC with selecting the optimum numbers of evaluation level. Overall 845 primary schools in Shanghai, China were recruited and tested by this combined approach of unsupervised machine learning. In addition, the two-way analysis of covariance was used to examine the location and types of school associated with PSSFC variables in each level. The combined method was found to have acceptable reliability and good interpretability, differentiating PSSFC into five gradient levels. The characteristics of PSSFC differ by the location and school type of individual school. Our findings are conducive to the regionalized and personalized intervention and promotion on the children’s physical activity (PA) upon the practical situation of particular schools.

Background: In 2020, the incidence of cancer was 844,778 cases among the population aged 0 to 19 years. Ninety percent of the population under 18 years of age lives in low- and middle-income countries, where cancer survivors report adverse outcomes. disease, which negatively impacts individuals’ general health, emotional state and external factors such as academic performance. Therefore, the objective of this article was to report the performance of the WCST and the sociodemographic characteristics of oncopediatric patients from Cali, Colombia. We report the reliability of the WCST instrument and indicate the association between the type of cancer and executive functioning in patients. Methods: In a cross-sectional observational study, 24 oncopediatric patients were interviewed and evaluated via the WCST. Results: The mean age was 12.08 years (3.98), 20.8% were women, 70.8% had a diagnosis of leukemia, 8 patients had acquired brain deficits, and more than 75% had adequate functioning in terms of the indicators of executive functions. Robust statistics were used to explore the differences between the types of diagnoses and performance in executive functions, and no statistically significant differences were found (p = 0.156). We accumulated evidence that the WCST has a reliable Cronbach's α of 0.804 and that oncopediatric patients without brain deficits had high scores for executive functions (p = 0.002) with a moderate effect size (0.727). Conclusions: The WCST is reliable for discriminating executive function among pediatric cancer patients. The evidence suggests that there are no differences between the types of cancer evaluated and executive functioning in the participants.

E-commerce has gained increased popularity over the last decade. To date, there is an open debate as to whether e-commerce or brick-and-mortar shopping is environmentally less sustainable, especially due to the growing mobility resources needed for e-commerce distribution. The analysis at hand compares the CO2-equivalent emissions of e-commerce and brick-and-mortar shopping of pharmaceutical products considering spatial aspects and the typical transport modal mix of consumers when doing online and offline shopping. The object of analysis is a retailer of pharmaceutical products, more precisely medicines, which offers, both, brick-and-mortar shop and online shopping possibilities. The results show that spatial aspects concerning the residential location of consumers, the vehicles used for shopping trips, the shopping basked size, and trip-chaining effects have a crucial impact on the mobility demand and CO2-equivalent emissions of the two commerce forms. In general, for rural and sub-urban areas, e-commerce results in lower CO2-equivalent emissions, while in urban areas, brick-and-mortar shopping is the favourable solution, if the consumers walk or cycle to the next pharmacy.

Certain services can help avoid environmental impact in larger contexts. However, there is no commonly agreed bottom-up methodology for calculation of the total net reduction effect of specific digital services. Life Cycle Assessment (LCA) is a common denominator for most methodologies. The most common method is the Attributional LCA (ALCA), and recently the emerging handprint ALCA estimating so-called positive environmental impacts. Moreover, Consequential LCA (CLCA) can be used to capture market effects. The third conceptual approach is Input-Output LCA. The purpose is to propose and test a new method based on some of the existing ones. The existing concepts are compared and a synthesis is made to create a practical but still useful method. The new method is applied to two illustrative cases in the Information and Communication Technology (ICT) domain; the introduction of a 5G enabled drone for pipe inspection and the 5G enabled health consultation. Compared to simplified ALCA, the difference between the absolute score for the baseline system and the target system changes up to 15% when the proposed simplified CLCA (SCLCA) method is used. The results show that SCLCA, when combined with analytical methods for expressing digital ICT services’ own impact, is a fruitful approach which is both practical and feasible.

The rapid expansion of livestock production sector to meet the world population demand is posing a big challenge to environmental sustainability. Plant-based feed additives extracted from food by-products could potentially result in a double outcome: improving animal zootechnical performances and mitigating environmental impacts of meat production chains. This presented study was carried out to assess the environmental impacts of the supplementation of a commercial Citrus extract feed additive (CEFA) in swine and broiler farming. Life cycle assessment (LCA) was applied to assess the impact of manufacturing and distributing 1 bag of 25 kg of CEFA and its use in feed in broiler and swine productions. With regard to CEFA manufacturing and distribution, results showed that the majority of impact came from the production of CEFA ingredients, accounting for 70% impact generated. The remaining 30% effect was divided to transportation to customer (25%), CEFA packaging (3%), CEFA manufacture, and production loss (2%). When enlarging the scope, the use of CEFA in piglet and broiler diets showed improving the measured environmental indicators, compared to such standard systems. Indeed, feed supplemented CEFA have demonstrated in elevating zootechnical performances, hence saving feed consumed. Consequently, that helped reduce environmental issues from animal feed ingredients’ agriculture. To be more specific, the supplementation of 25 kg of CEFA in feed led to a reduction of 6 tons of CO2 emitted along the life cycle of broiler production and 5 tons in the case of fattening pig. 0.7 hectares of land used had been saved as well as, 201 m3 of water (broiler) and 82 m3 (swine) were economized. Environmental performance assessment showed the interest in using this CEFA in swine and broiler diets to mitigate the environmental impacts.

The contractual relationship between the processing firm and the broiler smallholder presents incessant conflicts of interest and inequality due to technical and economic discrepancies, leading to an undervaluation of the producers' remuneration. This study aims to deepen the discussions in searching for a more balanced monetary exchange between processing firms and broiler smallholders based on scientific aspects. For this, the Emergy theory and its concepts were used in considering a representative broiler production system at Concórdia, Santa Catarina, Brazil. This study suggests the inclusion of cultural information in the Emergy-based model calculation. For the broiler smallholder, cultural information showed the highest Emergy contribution (62.95%; transformity = 1.73 ×10^8). However, only considering cultural information was not sufficient to increase the sustainability of the broiler production system. The results highlight an imbalance of the monetary exchange between agroindustry and broiler smallholder payment for both the economic and Emergy-based payment. Both estimated payments were higher than the practiced payment value (0.24 USD/broiler as well as 0.32 USD/broiler and 1.62 EmUSD/broiler, respectively). Thus, evaluating the “(eco)cost” in Emergy-based accounting recognizes that production depends not only on tangible physical resources but also on knowledge, skills and information (“iceberg of value” thinking). Policy and decision makers must, therefore consider the promotion of public policies that subside initiatives, including social and environmental welfare programmes.

Since the global request for freight transportation is continuously increasing to face the requirements of the modern economy, 5G infrastructures and companion technologies are becoming essential to support the digital transformation in logistics and transportation, in particular for their capability to allow data collection through a multitude of different sources across the supply chain, improving the connectivity and making more effective the secure and reliable data sharing. The objective of this work is to assess the penetration and implementation levels of innovative technologies to optimize port operations, by interviewing a set of actors and stakeholders directly involved in the logistics chain of ports.

The Attentional Networks Test for Interactions and Vigilance–executive and arousal components (ANTI-Vea) is a computerized task of 32 min duration in the standard format. The task simultaneously assesses the main effects and interactions of the three attentional networks (i.e., phasic alertness, orienting, and executive control) and two dissociated components of vigilance with reasonable reliability (executive and arousal vigilance). We present this free and publicly accessible resource (ANTI-Vea-UGR; https://anti-vea.ugr.es/) developed to easily run, collect, and analyze data with the ANTI-Vea (or its subtasks measuring some attentional and/or vigilance components embedded in the ANTI-Vea). Available in six different languages, the platform allows for adaptation of stimuli timing and procedure to facilitate data collection from different populations (e.g., clinical patients, children). Collected data can be freely downloaded and easily analyzed with the provided scripts and tools, including a Shiny app. We discuss previous evidence supporting that attention and vigilance components can be assessed in typical lab conditions as well as online and outside the laboratory. We hope this tutorial will help researchers interested in measuring attention and vigilance with a tool useful to collect data from large sample sizes and easy to use in applied contexts.

Community co-creation is increasingly crucial to the building of sustainable societies. Communities must proactively and independently create value chains in the face of many wicked problems. However, practical frameworks and tools for facilitating community co-creation require further development. As such, for this paper, we propose a theoretical framework for analyzing community co-creation value chain mechanisms based on a narrative review of literature on Collective Impact, social impact assessment, and Community Capital from the perspective of collective impact, a framework with a fair amount of previous research. We argue for the importance of applying knowledge of social impact assessment, particularly for the collective impact conditions of common agenda and shared measurement system. We discuss its relationship with the Theory of Change and the use of systems thinking to mitigate the subjectivity and arbitrariness of design thinking. Furthermore, we emphasize the value of employing the community capital concept as a framework for analyzing interrelationships among elements. By integrating multiple concepts, we enhance the collective impact framework and outline potential avenues for future research on analyzing and effectively implementing co-creation value chain mechanism in a community-based approach.

Despite laws and directives for the regulation and restriction of pesticide in farming, the large use of Plant Protection Products (PPPs) in paddy fields is a relevant worldwide cause of contamination of the environment. The aim of this work is to evaluate the environmental impact due to the use of PPPs by using an integrated approach based on chemical analyses and ecotoxicological hazard assessment, supported by statistical tools, in order to overcome the issues related to the traditional tabular evaluation. Samples of soil and water of seven conventional and organic paddies located in Northern Italy have been examined for two years by extensive chemical and ecotoxicological analyses. The results evidenced a direct relationship between the presence of Oxadiazon in water and bioassays responses as the main cause of the toxicity measured. This phenomenon affected both biological and conventional rice fields, due to the free circulation of water through irrigation canals. Therefore, the implementation of organic districts with a water circulation isolated from conventional fields represents a simple and effective countermeasure to safeguard the agricultural practices of organic crops.

Tinnitus is a phantom sound perception in the ears or head and can arise from many different medical disorders. Currently, there is no standard treatment for tinnitus that reliably reduces tinnitus. Individual patients reported that acupressure at various points around the ear can help to reduce tinnitus, which was investigated here. With this longitudinal observational study, we report a systematic evaluation of auricular acupressure on 39 tinnitus sufferers, combined with a self-help smartphone app. The participants were asked to report about tinnitus, stress, mood, neck and jaw muscle tensions twice a day using an ecological momentary assessment study design for six weeks. On average, 123.6 questionnaires per person were provided and used for statistical analysis. The treatment responses of the participants were heterogeneous. On average, we ob-served significant negative trends for tinnitus loudness (Cohen’s d effect size: -.861), tinnitus dis-tress (d = -.478), stress (d = -.675), and tensions in the neck muscles (d = -.356). Comparison with a matched control group revealed significant improvements for tinnitus loudness (p = .027) and self-reported stress level (p = .003). The positive results of the observational study motivate fur-ther research including a randomized clinical trial and long-term assessment of the clinical im-provement.

BACKGROUND: To present a new method of urethral pressures examination, and to evaluate diagnostic capabilities of three dimensional profilometry , as an alternative to classical urethral profile (UPP) .Using four channel catheters and dedicated software global urethral pressures image is obtained. The method eliminates the main limitation of classical urethral profilometry where the catheter orientation determines the pressures picture limited to only one point in the uretral circumference while we observed even 50% differences in pressure measures depending on the point of measurement. METHODS: This is a preliminary study containing method presentation and analisys of the use in varied clinical cases of either healthy patients and patients with LUTS. The article includes technique and equipment decription, full evaluation of selected cases, including three dimensional urethral pressures distribution graphics. RESULTS AND CONCLUSIONS:Three dimensional profilometry compared to classical technique is comparable regarding the time, cost, technical difficulty and patient discomfort. At the same time we obtain much more data on the urethral pressures and its distribution.The results are easy for interpretation due to 3D movable graphics created automatically through the dedicated software.

Even though the rules for free movement of machinery within the European Union market have existed for more than 30 years, accidents related to their activities have constantly been achieving significant value. When designing the machine, a designer must stem from risk assessment, whereas all stages of its life cycle and ways of its use must be taken into consideration. In industrial operations, there is old machinery, which, although fulfilling its function reliably, the safety level is not in accordance with the developing requirements for their safe operation. The proposed methodology of assessment of the machinery safety condition comes out from the presupposition of the right application of steps of risk assessment and their reduction mainly by means of implementation of both effective and efficient preventive measures. The aim of the research applied in 3 operations, was to verify the method of machinery safety management. The created methodology based on 19 requirements for safety evaluates the level of the actual measures by means of the so-called criterion of current status and total efficiency of measures. Its output is the assessment of the efficiency level of implemented safety of each machine as well as of the whole operation.

Currently there is no multi-hazard risk assessment tool for determining the level of complexity to swiftwater and flood rescue incidents. Traditionally, the International Scale of River Difficulty is used but it is primarily for paddlers for use in a recreational context, without much consideration to the multitude of hazards faced in swiftwater and flood rescue environments. In response to this gap, the ECHO risk assessment tool has been developed and undergone initial testing. This tool provides for simple and rapid codification of multiple hazards and response considerations and is globally applicable. The tool also assigns a final risk assessment colour making the interpretation of the assessment easy to understand and communicate. Though the proposed tool shows potential, further research is needed before it should be operationalised.

Agricultural intensification is considered essential for meeting growing demand for food and biomass for energy and material purposes. Intensifying grasslands is a so-far under-represented although promising option, given their large land area and relatively low management levels. This study quantifies the bioenergy potential from intensifying temporary grasslands in Europe and the integral greenhouse gas emission effects in 2030. We first conduct a literature review of intensification options for European grasslands and then apply the environmental impact assessment model MITERRA-Europe to implement the key intensification option of using multi-species grass mixtures. The results show that 853 kha (or 8%) of temporary grassland could be made sustainably available for additional biomass production. This can be translated into a bioethanol potential of 23 PJ/yr and an emission mitigation potential of 5.8 Mt CO2-eq/yr (if conventional grass mixture from surplus temporary grassland is used for energy) or 72 PJ/yr and 4.0 Mt CO2-eq/yr (if surplus temporary grassland is used for grassy energy crops). Although the bioenergy potential is limited, the intensification measure’s key advantage is that it results in a better environmental performance of temporary grasslands. This makes it a key option for sustainably producing bioenergy in areas with high shares of temporary grasslands.

Substantial studies have focused on early detection of Alzheimer's disease (AD). Cerebral amyloid beta (Aβ), is hallmark of AD, can be observed in vivo via positron emission tomography imaging using amyloid tracer or cerebrospinal fluid assessment, but costly expensive. The current study aims to identify and compared predictability in magnetic resonance imaging (MRI) markers and neuropsychological markers to predict cerebral Aβ status in AD cohort using machine learning (ML) approaches. The predictability in candidate markers for cerebral Aβ status was examined by analyzing 724 participants from the ADNI-2 cohort. Demographic variables, structural MRI markers, and neuropsychological test scores were used as input in several ML algorithms to predict cerebral Aβ positivity. Out of five combination of candidate markers, neuropsychological markers with demographics showed the most cost-efficient result. A feature selection model could distinguish abnormal levels of Aβ with the predictability of 0.85, indicating the same performance with MRI-based models. The result has first to identified the predictability in MRI markers using ML approaches, and secondary to demonstrate the neuropsychological model with demographics could predict Aβ positivity, suggesting a more cost-efficient method for detecting cerebral Aβ status compared to MRI markers.

The importance of the contribution from tourism to climate change was pointed out by the International Tourism Organization (UNWTO). By combining process-based Life Cycle Assessment (LCA) and Input-output analysis, several researches have tried to evaluate the impacts of the tourism industry as well as its products and services. Indeed, the tourism sector has a wide range of industries including travel and tour, transportation, accommodation, food and beverage, amusement, souvenirs etc. However, the existing cases did not show a breakdown of the impact on climate change. In this paper, the carbon footprint (CFP) of the Japanese tourism industry was calculated based on tourist consumption, using the Japanese Input-output table and the Japanese tourism industry. It was shown that the total emissions were approximately 136 million t-CO2 per year. The contribution ratio of each stage is as follows: Transport 56.3%, Souvenirs 23.2%, Petrol (direct emissions) 16.9%, Accommodation 9.8%, Food and Beverage 7.5%, Activities 3.0%. Then, in the breakdown, the impact is high in the following order Air transport 24.7%, Petrol (direct emissions) 16.9%,Accommodation 9.8%, Food and Beverage 7.5%, Petrol 6.1%, Textile products 5.3%, Food items 4.9%, Confectionery 4.8%, Rail transport 3.9%, Cosmetics 1.9%, Footwear 1.8%, etc. In addition to transportation, this research also highlighted especially the contribution from souvenirs, accommodation, food and beverages.

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

The shoulder region has the highest incidence of acute injuries in the sport of surfing. Little is known about the strength profile at the shoulder in a surfing cohort. The primary aim of this study was to establish the reliability of a rotator cuff strength testing procedure for surfers with a secondary aim of providing a profile of internal (IR) and external rotation (ER) strength in a competitive surfing cohort. Shoulder IR and ER isometric strength was measured using a hand-held dynamometer in 13 competitive surfers. Intra-class coefficient values ranged from 0.97 to 0.98 for intra rater reliability and were lower for inter rater reliability ranging from 0.80 to 0.91. Normalised force (N/Kg) for IR strength was significantly greater than ER strength bilaterally (dominant, p= 0.007, non-dominant, p<0.001). No significant differences (p< 0.79) were found in IR strength (N/Kg) between the dominant and non-dominant arms. ER strength (N/Kg) was significantly weaker on the non-dominant arm compared with the dominant arm (p<0.02). The non-dominant arm ER to IR ratio (0.82 ± 0.15) was significantly (p=0.025) lower than the dominant (0.88 ± 0.14) The current procedure is reliable with the same clinician, results indicate musculature asymmetry specific to the external rotators.

SLEUTH Model (slope, landuse, exclusion, urban extent, transportation and hillshade) is an important tool for landuse planning and land policy. To evaluate the performance of SLEUTH model, implementation of Sensitivity Analysis (SA) is essential. The main limitation of SA in SLEUTH application is a lack of insight into model input self-modification parameters (SMPs) variation, namely, uncertainty involved in the model transfer metrics and model presumptions, which often misled the decision makers and model users. To address this issue, this study divided the forward process into two stages. Firstly, during the transfer process ①, the contribution scores of five SMPs were drawn, and parameters highly sensitive to model output were given. Apart from that, the recommended initial value for SMPs of 0.11, 0.2, 0.87, 1.13, 15, 1.01, 0.49 were found to be subordinated to such a heterogeneous urban area simulation. Secondly, during the transfer process ②, SMP caused imagery metrics indicated the disparity between parameters with Fixed Reference and with Successive Reference. Reversely, it derives reasonable threshold for the best fit values of five prediction coefficients’ initialization by comparing the real image with the predicted one. The framework of SLEUTH model transfer mechanism not only could distinguish highly sensitive SMPs with higher contribution scores, but also could give parametric analysis for simulation imagery based on metrics. The study was found to be a practical tool for quantization response of model input variables for modelling complex urban systems. So, this insight can help geographic information scientists decide how to find out the inner forward transfer mechanism of SLEUTH model for further make good use of it and improve the model.

A proposed animal welfare assessment protocol for semi-arid rangeland-based cow-calf systems in Namibia combined 40 measures from a protocol developed for beef cattle in New Zealand with additional Namibia-specific measures. Preliminary validation of the protocol had been undertaken with five herds in one semi-commercial village. The aim of the current study was to apply this protocol and compare animal welfare across three cow-calf production systems in Namibia. A total of 2529 beef cows were evaluated during pregnancy testing in the yards of 17 commercial, 20 semi-commercial and 18 communal (total: 55) herds followed by an assessment of farm resources and a questionnaire-guided interview. Non-parametric tests were used to evaluate the difference in the welfare scores between the production systems. The results indicated a discrepancy of animal welfare between the three farm types, with a marked separation of commercial farms from semi-commercial, and communal village farms in the least. The differences in these production systems was mainly driven by economic gains through access to better beef export market for commercial farms and semi-commercial villages, as well as by the differences in the available grazing land, facility designs/quality and traditional customs in the village systems. The results indicate an advantage of commercialisation over communalisation.

Supermarkets in Port Harcourt (PH) city, Nigeria, predominantly rely on diesel electricity generation due to grid instability, leading to high cost of electricity prices. Although solar photovoltaic (PV) systems have been proposed as an alternative, these supermarkets have yet to adopt them, mainly due to high investment costs and a lack of awareness of the long-term financial and environmental benefits. This paper examines the technical and economic practicality of a PV system for these supermarkets using the PVsyst software and a spreadsheet model. Solar resources showed that PH has a daily average solar radiation and temperature of 4.21 kWh/m2/day and 25.73℃, respectively. Market Square, the supermarket with the highest peak power demand of 59.8 kW, and a 561 kWh/day load profile, was chosen as a case study. A proposed PV system with a power capacity of 232 kW, battery storage capacity of 34,021 Ah, a charge controller size of 100 A/560V, and an inverter with a power rating of 60V/75 kW has been designed to meet the load demand. The economic analysis showed a $266,936 life cycle cost, $0.12 per kWh levelized cost of electricity (LCOE), 4-year simple payback time, and a 20.5% internal rate of return (IRR). The PV system is feasible due to its positive net present value (NPV) of $165,322 and carbon savings of 582 tCO2/year.

The province of Jaén (Andalusia, Spain), despite being declared the European territory with the largest number of defensive constructions (castles and fortifications), has few conservation plans, with many remains included on the Red List of Spanish Heritage lying abandoned. This presents a problem for the conservation of the landscape and the optimal use of the province’s tourism potential. Through the study case of Magaña hamlet two actions are proposed to alleviate this situation: The creation of an archaeological and environmental risk chart with which to answer such questions as “How have climate change, anthropic alterations and environmental charac-teristics affected the state of conservation of certain heritage sites?” and to put forward proposals for improving their protection using as a basis digital and technological tools, such as remote sensing (SAR), taking advantage of data from the Sentinel 2A and 2B satellites, HBIM, RPAS and GIS. To foster the promotion of smart tourism by digitalising and virtualising tourist routes and archaeological remains by building a Smart Tourism App for mobile devices. Finally, public administrations will be apprised of the need to implement a conservation policy for cultural as-sets and their surroundings in a simple, quick and cost-effective manner.

In 2014, the International Union for Conservation of Nature adopted the Red List of Ecosystems (IUCN RLE) criteria as the global standard for assessing risks to terrestrial, marine, and freshwater ecosystems. Identifying and quantifying the impacts of biodiversity assessments on the status of nature is key to justifying continued investment in assessments and enabling strategic planning to maximize future impact. In this policy perspective, we use an established impact evaluation framework to identify the impacts of the IUCN RLE since its inception. To date, 1,397 ecosystem units in 100 countries have been assessed following the IUCN RLE protocol. Systematic assessments are complete or underway in more than 25 countries and two continental regions (the Americas and Europe). Countries with established ecosystem red lists have already used them to inform legislation, land-use planning, protected area expansion, monitoring and reporting, and ecosystem management. IUCN RLE indices based on systematic assessments have high potential to inform global biodiversity reporting for the Aichi Targets and the United Nations Sustainable Development Goals. Expanding the coverage of IUCN RLE assessments, building capacity to undertake them, and establishing stronger policy instruments to manage red-listed ecosystems will be key to maximizing conservation impacts over the coming decades.

The paper focuses of the interaction between tungsten (W) wire and microwave field in carbon dioxide (CO2) atmosphere. Our experimental set-up uses a microwave plasma generator in order to generate the plasma from the metallic wires. The microwave plasma generator contain a cylindrical cavity - TM_011 propagation modes, commercial source (magnetron) having the 2.45 GHz frequency at 800 W microwave and power supply. In the focal point of the cylindrical cavity we have a high energy of the electromagnetic radiation. The metallic wires from this area will be vaporized and ionized having as effect CO2 dissociation. The electron temperature regarding metallic plasma produced was estimated using the ratio of atomic emission lines acquired by a high definition of the optical multichannel spectrometer. Determination of the CO2 dissociation quantity was estimated measuring of the carbon monoxide (CO) resulting of the CO2 dissociation process. We obtained a high electron temperature of the plasma and a strong dissociation of the CO2.

Contemporary architects and the construction industry are trying to cope with increasing requirements concerning energy efficiency and environmental impact. One of the available options is the active utilization of energy gains from the environment, specifically solar energy gains. These gains can be utilized by, for example, solar walls and facades. The solar façade concept has been under development for more than a century. However, it hasn’t achieved widespread use for various reasons. Rather recently the concept was enhanced by the application of transparent insulation materials that have the potential to increase the efficiency of such façades. The presented study evaluates the environmental efficiency of 10 solar façade assemblies in the mild climate of the Czech Republic, Central Europe. The evaluated façade assemblies combine the principles of a solar wall with transparent insulation based on honeycomb and polycarbonate panels. The study applies Life-Cycle Assessment methodology to the calculation of environmental impacts related to the life cycle of the evaluated assemblies. The results indicate that even though there are several limiting factors, façade assemblies with transparent insulation have lower environmental impacts compared to a reference assembly with standard thermal insulation. The highest achieved difference is approx. 84% (in favour of the assembly with transparent insulation) during a modelled 50-year façade assembly service life.

The assessment of Photovoltaic (PV) systems, a key component of sustainable energy solutions, is of paramount importance in the pursuit of a greener future. This abstract provides an overview of environmental assessments associated with PV systems, considering their life cycle, energy production, and ecological impact. The study explores various methodologies and tools employed in the evaluation of PV systems’ environmental performance, addressing issues such as material sourcing, manufacturing, installation, and end-of-life disposal. Additionally, it delves into the trade-offs and challenges in achieving sustainability objectives in the solar energy sector. By critically examining the environmental implications of PV systems, this research contributes to informed decision-making and the sustainable integration of solar power into our energy landscape.

In the article a statistical approach to the assessment of the emission rates discharged by the road traffic in a spatial context is proposed. It exploits an indicator, the Yearly Average Vehicle, representing the pollutant emission rate of the average vehicle belonging to a specific category, and considers the statistical variability of most of the involved traffic parameters: vehicle speed and mileage travelled in the considered time period. Finally, indicators, assessing both the most probable value among the possible emission rates and the extent of their variability range, are proposed. They may also be used to underpin decision making-processes, when the effects of different policies addressing air pollution issues, are to be evaluated. Therefore, they are suitable for the analysis supporting urban planning activities, with a view to addressing and mitigating the effects and the consequences of pollution due to the transportation sector of the urban context.

The COVID-19 outbreak has severely affected the social and economic conditions across this globe. Little is known about the relationship of COVID-19 with countries’ economic and socio-demographic status. Publicly available data on COVID-19 test rate, attack rate, case fatality rate, and recovery rate were analyzed in relation to country’s economic status, population density, median age, and urban population ratio. We also conducted multinomial logistic regression analysis to predict the influence of countries’ social and economic factors on COVID-19. The results revealed that the median age had significant positive correlation with attack rate (r=0.2389, p=0.003), case fatality rate (r=0.3207, p=0.000) and recovery rate (r=0.4847, p=0.000). The urbanization has positive significant correlation with recovery rate (r=0.1957, p= 0.016). The multinomial logistic regression analysis revealed low-income countries are less likely to have an increased recovery rate (p=0.000) and attack rate (p=0.016) compare to high-income countries. The lower-middle-income and upper-middle-income countries are less likely to have an increased recovery rate (p=0.000 and p=0.001, respectively) compared to high-income countries. Based on the result of this study, these economic and socio-demographic factors should consider in designing appropriate preventive measures as a next step. The low and lower-middle-income countries should invest more in health care services to lower the case fatality rate and increase test and recovery rates as part of pandemic preparation like COVID-19. As the number of COVID-19 attacks, death and recovery rates are constantly changing; however, the intensive study is required to obtain a clear picture.

Since the exploitation of mineral resources results in the release of radionuclides, and consuming radionuclides affects public health in the short and long term. A case study of the environmental radiation impact from coal mining and germanium processing was carried out in southwest China. The coal mines contain germanium and uranium and have been exploited for more than 40 years. The farmlands around the site of coal mining and germanium processing have been contaminated by the solid waste and mine water in some extend since then. Samples of crops have been collected from contaminated farmlands in research area. The research area covers a radius of 5 km, in which there are 2 coal mines located. 210Pb and 210Po have been analyzed as the key radionuclides during monitoring program. The average activity concentrations of 210Pb and 210Po in the crops were 1.38 and 1.32 Bq/kg in cereals, 4.07 and 2.19 Bq/kg in leafy vegetables and 1.63 and 1.32 Bq/kg in root vegetables. The annual effective doses due to the ingestion of 210Pb and 210Po in consumed crops have been estimated for adult residents living in research area. The average annual effective dose was 0.336mSv/a, while the minimum was 0.171 mSv/a and the maximum was 0.948 mSv/a. The results show that crops grown on contaminated farmland contained an enhanced level of radioactivity concentration. Ingestion doses of local residents in research area were significantly higher than the China average level of 0.112 mSv/a, and the world average level of 0.042 mSv/a through 210Pb and 210Po in crops intake respectively.

Animal welfare assessment protocols are important for identifying welfare problems in conservation programs. This study aimed to develop a baseline welfare protocol for the assessment of welfare in huemul (Hippocamelus bisulcus) in conservation centers. This protocol is based on the Welfare Quality® (WQ) framework for cattle, considering the available literature on the behaviours, ecology, conservation plans, captive management of this species, and welfare assessment protocols for other ungulate species. As a result, the protocol was specifically developed for huemuls and included four principles, 12 criteria, and 23 animal- and resource-based indicators. The 12 criteria of the WQ protocol were reduced to nine, and three new criteria were added because they were both feasible and essential for welfare assessment in captive huemuls. This protocol is mainly intended to identify welfare problems in endangered species in the context of conservation centers (reproduction, rescue, rehabilitation, or treatment centers). Thus, aggregation of different measures to obtain a global score has not been proposed. However, a scoring system that assigns a value on a 0-2 scale (0= No welfare concern; 1= welfare concern; 2= urgent welfare concern) is proposed for each category. Although further research is still needed to fully validate the protocol, this is the first development of a completed protocol for huemul welfare assessment.

CONTEXT– Energy is widely involved in human activity and corresponding emissions of SOX, NOX and CO2 from energy generation processes affect global climate change. Clean fuels are desired by society because of their reduced greenhouse gas emissions. Hydrogen is once such candidate fuel. Much hydrogen is produced from fossil fuel, with biomass being an alternative process. OBJECTIVE– The project compared the environmental impact of hydrogen production by natural gas steam reforming vs. biomass gasification. METHOD–Environmental impact was calculated from the input and output data from life cycle inventory analysis. The impact assessment was focused on greenhouse gas emission, acidification, and eutrophication. Models of the two processes were developed and analysed in OpenLCA. The agribalyse database was used to connect inventory flow data to environmental impacts. FINDINGS– For all three metrics, biomass gasification had lower impacts than natural gas steam reforming, sometimes by large margins. For biomass gasification the silica sand production contributes most to all three impact categories, whereas for natural gas steam reforming it is the LPG extraction.

Main purposes and research question: Wheat is the second largest grain crop by tonnage in the world and the largest in Denmark. Given the observed, adverse impacts on wheat yields of climate change and the importance of wheat in the human diet, the purpose of this study was to use life cycle assessment to compare conventional wheat farming with indoor vertical farming using hydroponics. Methods: Life Cycle Assessment was used to assess the base case systems up to the “farm gate” for 1 tonne of wheat grain. The processes contributing most of the impacts were identified, and scenarios were assessed to determine how much the impacts could be reduced. Results: The conventional system outperformed the base case vertical system in every impact category, due to the electricity consumption in the lighting system. The scenarios included increasing the efficiency of the LED lighting and using 100% wind energy, but the conventional system still outperformed the vertical system by significant margins in all impact categories. This was due to the low photosynthetic conversion efficiency and the high energy density of wheat. Conclusions: Until significant improvements are made to lighting efficiency, the photosynthesis conversion efficiency of wheat, new wheat variants designed for vertical gardens and the sustainability of electricity supply, conventional wheat production will be environmentally preferable and vertical gardens would be advised to focus on food products with low energy densities.

Background: Sickle cell disease is a major public health issue in the DRC while it is still poorly understood by health professionals. The objective of this study was to assess the knowledge and practices of Congolese physicians treating sickle cell disease (SCD) in order to identify areas for improvement in clinical care. Methods: This is a descriptive observational study conducted on Congolese physicians using a questionnaire. Participants were evaluated on a pre-established answer grid. Results: A total of 460 physicians participated, including 81 women (18%) with an average age of 35 years (range 25–60 years). Most physicians were general practitioners. Although self-assessment of their level of knowledge on SCD was estimated as average to good, less than half of the participants (n= 460; 46%) reported adequate management of vaso-occlusive crisis but only 1% of them had received specific training on SCD. Most physicians reported difficulties both in terms of diagnostic (65%) and management (79%) options of SCD patients. This study showed also that 85% of them did not have access to diagnostic tools for SCD. Conclusions: Insufficient knowledge on SCD, poor diagnostic and treatment options may contribute to morbidity and mortality of patients living in the DRC. Interventions aiming at improving physician’s knowledge, patient’s follow-up and treatment access are needed. Specific training alongside existing programs (HIV, malaria), early diagnosis of the disease, and creation of patients’ advocacy groups should improve SCD patient’s care.

To compare the quality of low-energy VMIs obtained with three DECT platforms according to phantom diameter. Three sections of the Mercury Phantom 4.0 were scanned on two generations of split-filter CTs (SFCT-1st and SFCT-2nd) and on one Dual-source CT (DSCT). Noise power spectrum (NPS), task-based transfer function (TTF) and detectability index (d’) were assessed on VMIs from 40 to 70keV. Highest noise magnitude values were found with SFCT-1st and noise magnitude was higher with DSCT than with SFCT-2nd for 26-cm (10.2±1.3%) and 31-cm (7.0±2.5%), and the opposite for 36-cm (-4.2±2.5%). The highest average NPS spatial frequencies and TTF values at 50% (f50) values were found with DSCT. For all energy levels, f50 values were higher with SFCT-2nd than SFCT-1st for 26-cm (3.2±0.4%) and the opposite for 31-cm (-6.9±0.5%) and 36-cm (-5.6±0.7%). The lowest d’ values were found with SFCT-1st. For all energy levels, d’ values were lower with SFCT-2nd than with DSCT for 26-cm (-6.2±0.7%), similar for 31-cm (-0.3±1.9%) and higher for 36-cm (5.4±2.7%). In conclusion, compared to SFCT-1st, SFCT-2nd exhibited lower noise magnitude and higher detectability values. Compared with DSCT, SFCT-2nd had lower noise magnitude and higher detectability for the 26-cm but the opposite was true for the 36-cm.

Genome-based testing in oncology is a rapidly expanding area of health care which is the basis of the emerging area of precision medicine. Efficient and considered adoption of novel genomic medicine testing is hampered in Canada by the fragmented nature of health care oversight as well as by lack of clear and transparent processes to support rapid evaluation, assessment and implementation of genomic tests. This article provides an overview of some key barriers and proposes approaches to addressing these challenges as a potential pathway to developing a national approach to genomic medicine in oncology.

(1) Background: The CEECCA questionnaire assesses the ability to communicate among individuals with aphasia. It was designed using the NANDA-I and NOC standardised nursing languages (SNLs), reaching high content validity index and representativeness index values. The questionnaire was pilot-tested, demonstrating its feasibility for use by nurses in any healthcare setting. This study aims to identify the psychometric properties of this instrument. (2) Methods: 47 individuals with aphasia recruited from primary and specialist care facilities. The instrument was tested for construct validity and criterion validity, reliability, internal consistency, and responsiveness. The NANDA-I and NOC SNLs and the Boston test were used for criterion validity testing. (3) Results: 5 language dimensions explain 78.6% of the total variance. Convergent criterion validity tests showed concordances of up to 94% (Cohen’s κ: 0.9; p&lt;0.001) using the Boston test, concordances of up to 81% using DCs of NANDA-I diagnoses (Cohen’s κ: 0.6; p&lt;0.001), and concordances of up to 96% (Cohen’s κ: 0.9; p&lt;0.001) using NOC indicators. Internal consistency (Cronbach’s alpha) was 0.98. Reliability tests revealed test-retest concordances of 76%-100% (p&lt;0,001). (4) Conclusions: The CEECCA is an easy-to-use, valid, reliable instrument to assess the ability to communicate among individuals with aphasia.

Background: The cumulative number of patients during the COVID-19 pandemic led to a significant shortage of hospital beds. Many patients may not require hospitalization and can be clinically observed in home settings. However, some psychosocial factors are correlated with unsuccessful home isolation (HI), which might negatively affect the transmission control in the community. Therefore, we developed a new psychosocial screening tool (CCPHIET) for assessing HI suitability and examined its validity and reliability.Methods: This cross-sectional descriptive study included COVID-19 patients who were deemed to be medically safe for 14 days of HI. The CCPHIET is comprised of 8 clinical domains pertinent to HI behavioral compliance and risk. We explored its statistical validity and reliability and discussed the potential utility of this tool. Results: A total of 65 COVID-19 patients participated in this study. Most patients (58.5%) were evaluated as good candidates for HI. The CCPHIET has an acceptable content validity (IOC index > 0.5), moderate internal consistency (Cronbach’s alpha = 0.611) and substantial to excellent inter-rater reliability (Intraclass correlation coefficient = 0.944, Cohen’s kappa= 0.627).Conclusions: To compromise between strict and costly absolute institutional quarantine and the potentially unsuccessful absolute HI, the CCPHIET may help to identify good candidates for HI in mild and asymptomatic COVID-19 patients. This psychosocial information would support the physicians in matching each patient to the most suitable setting. Therefore, safe medical care is provided, unnecessary use of medical resources is spared, and local transmission is contained.

Efforts to quantify and reduce greenhouse gas (GHG) emissions of the built environment often neglect embodied emissions, instead focusing on reducing emissions from building operations. Utilizing sustainably sourced mass timber offers low embodied carbon alternatives to traditional concrete and steel structural systems, however the variability in embodied carbon for different mass timber approaches remains understudied. In this study, we used life cycle assessment (LCA) to compare the whole building embodied carbon of nine mass timber design options and two typical concrete and steel reference cases for an eight-story mixed-use building, ensuring structural, acoustic, thermal, programmatic, and fire-rating equivalence between the designs. The study found that the mass timber designs vary significantly, ranging between a 14-52% reduction in whole building embodied carbon from the most impactful reference case, and a 31-73% reduction when considering the structural systems alone. This study demonstrates the value that whole building LCA (WBLCA) provides as a primary driver for low-carbon structural system design and architectural development of mass timber buildings, beyond that of single material comparisons using environmental product declarations (EPDs).