A new model for international bed numbers is applied to local area populations for English Clinical Commissioning Groups (CCGs) where the Age Standardized Mortality Rate (ASMR) is used as a measure of population health and hence for total occupied hospital bed demand (elective plus emergency admission types, including acute, rehabilitation, mental health, and maternity), rather than simple bed availability. A 100-unit increase in ASMR (European Standard population) leads to a 15.3 – 30.7 (feasible range) unit increase in occupied beds per 1,000 deaths. ASMR shows why the Australian states of the Northern Territory and Tasmania have an intrinsic higher bed demand than the other states – although in both cases the bed planning methodologies failed to indicate this need and both states show a large bed deficit. Due to the high volatility in bed demand the average bed demand for 2019 was determined by a linear trend using data for 2014/15 to 2019/20 — as the pre-COVID-19 baseline. The slope of the relationship between occupied beds per 1,000 deaths and deaths per 1,000 population shows a power law function. As is to be expected there is scatter around the trend line which will partly arise from uncertainty in the expected occupied beds in 2019, fluctuations in both ASMR and deaths per 1,000 population from one year to another, changes in the number of persons on the elective, outpatient and diagnostic waiting lists, and local area variation in births and consequently upon maternity, neonatal and pediatric bed demand. Additional variation in bed demand will arise from differences in the level of funding for social care, especially elderly care, and to a lesser extent upon patients using private health care, and charitable hospices for palliative care. However, after including the change in bed demand arising from ASMR the model is sufficiently accurate to identify gross differences in bed demand as a prelude to further investigation. The model requires further extension to cover specialty-level demand, and perhaps segregation between elective and emergency types of inpatient demand. A method for benchmarking the whole hospital’s average bed occupancy is given which enables them to run at optimum efficiency and safety. Using this method English hospitals can be shown to operate at highly disruptive and unsafe levels of bed occupancy leading to deleterious ‘turn-away’. Turn-away implies bed unavailability for the next arriving patient. The problems associated with crafting effective bed planning are illustrated using the English NHS as an example.

The importance of contact with nature for human health was confirmed by numerous research. One of the sometimes neglected fields is the landscape design of hospital premises. This study focuses on the perception and preferences of prospective patients regarding the hospital site design. The methodology included anonymous survey with images and lists of adjectives. The online questionnaire was distributed using e-mails and social media from 4th May to 8th July 2024. The objective was to include all age groups. The results confirm previous studies and demonstrate the importance of landscape architecture design of hospital premises for the well-being of patients. The findings may inform the design of hospital sites.

The paper focuses on the application of a multilevel, integrative and territorial approach to the protection of cultural heritage through planning instruments in Serbia. It points out the problems of the sectoral approach and discusses international recommendations that can be integrated into the planning methodology. The case study is the area of Djerdap National Park, which has an already established international and national importance. The research suggests that the cultural heritage in the area, with the exception of the Roman limes, is still recognized at the level of individual localities. The study emphasizes the importance of aligning all levels of governance to safeguard the whole spatial entity rather than focusing solely on its particular areas. The interna-tional and national importance of the planning area contributes to the strengthening of awareness of heritage and its institutional protection. However, the vitality of the area, which is key to its sustainable development, comes from the local level. Planning documents contribute to the inte-gration of local values and local communities into development programs and projects.

Questions：SAP in mountainous cities of China serve as crucial carriers for species and wild food, constituting potential green infrastructure. These patches should be recognized as locally specific resources. This study investigates the transformation characteristics of the landscape patterns of SAP, along with their elements, across urban-rural gradients, providing foundational support for the planning of conservation and utilization strategies. Location: Yongchuan area of Chongqing in southwest China. Methods: The study investigated urban-rural gradient-based transformation of SAP. A four-direction transect space was selected and divided into uniform sample squares. Fragstats 4.3 calculated the landscape index of SAP, and Spearman correlation coefficients in SPSS were used to evaluate the influence of landform and artificial factors on agroforestry patch transformation. Results: 1) Patch area (PA), Plaque density (PD), and CLUMPY of SAP systematically transform, showing increased SAP areas and higher connectivity with greater distance from the city, resulting in reduced patch fragmentation. However, Edge density (ED) and Largest plaque index (LPI) exhibit irregular transformation patterns. 2) With increased distance from the city, woodland patch area and connectivity increase, leading to decreased fragmentation, dispersal, and lower fractal dimensions. Conversely, Cultivated land follows the opposite trend. garden land patch area, fractal dimension, fragmentation, and dispersal all increase, while connectivity decreases. 3) Landscape pattern transformations of SPA are significantly influenced by artificial factors. Woodland patches are influenced similarly by landform and artificial factors. In contrast, cultivated land and garden land patches are more significantly impacted by artificial factors. Conclusions: SAP exhibit differentiated conservation and utilization measures across urban-rural gradients. Small patches located far from urban centers may benefit from systematic conservation measures to prevent further fragmentation and erosion in peri-urban areas.

Present study on land use land cover analysis and taluka wise combination of cropped area, carried out in Beed district of Maharashtra state in India and studied 11 talukas of the district. Secondary data on land use land cover and area in various crops has been collected, compiled and analyzed from various secondary sources. Simple descriptive statistics used to examine the agricultural land use land cover and J.C. Weaver’s crop combination technique was used for taluka wise analysis of crop combinations and on the basis of highest to smallest area engaged in particular crop, crops have been ranked. The study showed that, in the district as a whole, percentage of uncultivated land other than fallow was about 46 percent as compare to net sown area is only 35 percent in total geographical area (1063855ha) of Beed district. The study further revealed that about 42 percent area engaged in food crops and about 58 percent area occupied by nonfood crops, which includes cereals (25%), cotton (19%), pulses (13%), oilseed (12%), sugarcane (5%) and fruits and vegetables (3%). Results of Weaver’s crop combination technique showed that the Wadwani taluka demarcated as most diversified taluka by means of maximum number (sixteen) of crops combinations with the lowest variance value (14) found in the present investigation. Further, the study revealed that the high crop diversity found in Dharur taluka with eighteen crop combinations and the taluka has given first rank amongst others. To derive the crop diversity ranking, taluka wise maximum to minimum number of crop combinations derived in different talukas and given ranks accordingly. The study concluded that, agricultural land use analysis is essential for solving and optimizing the land use problem, maintaining socio-ecological balance, best utilization of scarce resources. The authors enlightened that the rational use of agricultural land has important for food security and biodiversity which increase the productivity and profitability of the agriculture sector and it indicates the decision making ability of farmers in study area.

This paper is focused on typical rural settlements in the Stara Planina Mountain area in Serbia. They are distinguished by their authenticity, identity and character, and they have still not been destroyed by inappropriate development as is the case in some other mountain areas in Serbia, where the effects of urbanization, globalization and homogenization are obvious. Consequently, there is a need to prevent these effects in mountain areas where there is a threat of disbalance between development and the inherited natural and cultural values. The paper starts from several important concepts that relate contemporary approaches to cultural heritage preservation, place morphology and planning future development. The concept definitions from recent documents from related fields are used. These concepts are then applied to the area of Stara Planina Mountain and its rural settlements. The necessity for an integrative approach to planning this area with significant natural and anthropogenic potential is pointed out, including its integration into international programs of sustainable development.

This research investigates the lane width standards and guidelines implemented by various State Departments of Transportation (DOTs) to reduce vehicle speeds and enhance road safety. Lane width reduction is often perceived as a strategy to mitigate speed and improve safety. Still, its effectiveness and implications vary across different contexts, including regions, urban/rural settings, or other geometric design features. Drawing from interviews with five State DOTs and a review of their road design manuals, this study aims to identify suggested lane widths depending on the contexts, design exception process when narrowing or widening lane widths, and introduce representative before/after studies. The findings indicate that State DOTs tend to have lower recommended lane widths in urban areas than in rural areas. Moreover, lane width standards among these states vary due to several factors, including the geographical location of roadways (urban or rural areas), design or posted speeds, traffic volume, road classification, and geometric road design features. Design exceptions are required if the existing or proposed design element is incompatible with both AASHTO and department governing criteria. In conclusion, the findings will provide valuable insights and recommendations for policymakers, transportation planners, and road engineers to inform optimal lane width and decision-making processes.

Historically, urban development has always been centered on coastal areas – with access to waterbodies – seas, rivers and canals being a significant advantage for movement and trade. With most of the world’s megapolises located on coasts, land reclamation offers a solution for the expansion of city centers which are otherwise restricted by the coastline. The current understanding of urban regeneration and development on reclaimed lands is defined in this study, answering the basic questions of what, why and how. This study aims to assess the urban regeneration on reclaimed coastal land based on the principles of sustainable development defined by existing studies. The literature review establishes a theoretical framework and defines performance-based benchmarks identifying the spatial indicators of urban development. Composite indicators namely open space coverage, land use mix, percentage of coast for people, accessibility to public transportation and amenities, availability of pedestrian paths and cycling tracks and adequate road networks are considered for this framework. The conclusions are drawn based on the results of the analysis of spatial layout using GIS as a tool to map and empirically measure each indicator. The framework is validated using a major land reclamation project, West Bay, in the coastal urban area of ​​the city of Doha. The results determine that West Bay has achieved a good level of sustainability, although there are areas that could be enhanced to further improve the overall sustainability of urban development. These findings can serve as a guide for policymakers and various stakeholders for sustainable urban planning on reclaimed coastal lands.

In the last decades, the impacts of urbanization on the hydrological cycle have led to an increase in the frequency and magnitude of urban flooding events, also amplified by the effects of climate change. Sustainable Drainage Systems (SuDS) provide a revolutionary change in this field, improving the sustainability and resilience of cities. This research explores the integration of different SuDS with the aim of significantly reducing both flow volume and celerity of floods in a residual urban catchment area of metropolitan city of Querétaro (Mèxico), where extreme rainfall frequently occurs. This catchment is a representative suburb of urban pressure and environmental degradation problems. Currently, managing storm water under climate uncertainty through a multi-disciplinary approach is a major concern in this urban area. A 1D-2D coupling model of shallow water equations, finite volume method, unstructured meshing method, and hybrid parallel computing application defined the optimal configuration of SuDS at catchment scale to reduce the flood vulnerability in Querétaro. Specifically, in this paper we explore the management issues of the proposed SuDS configuration that acts as a water resource system with multiple purposes. A generic simulation model called MODSIM was applied to simulate the designed urban drainage system under a balanced IPCC future climate scenario in terms of reliability, resilience and vulnerability against water scarcity.

The risk classification of barrier lake is the key to conducting emergency treatment in a scientific manner. Such difficulties are faced as short time for risk evaluation, complex evaluation indicators, difficulty in obtaining information quickly and quantifying index weights. Based on this, this paper constructs a quantitative risk classification model for barrier lakes based on D-AHP. On the basis of studies on nearly 100 cases of barrier lakes, an 8-factor evaluation index system and quantitative classification are proposed. The methods of rapid calculation of reservoir capacity curve of barrier lake and intelligent identification of particles on the surface of barrier body were developed, which realized the rapid acquisition of 8-factor evaluation index information in emergency environment. The D-AHP method dealt with inconsistent weight assignment to evaluation factors by experts, which helped achieve weight quantification of 8 factors. The risk assessment on15 barrier lakes such as Tangjiashan barrier lake show that the conclusion drawn with risk classification method proposed in this paper is basically consistent with that of the traditional table-lookup method. However, the table-lookup method ignores cumulative loss’s impacts on the risk level of barrier lakes, and considers the extremely severe loss of barrier lakes as a sufficient condition for the evaluation level to be grade I, and thus a deviation in the evaluation. The risk classification method proposed in this paper is more reasonable and reliable.

The relentless challenges posed by the COVID-19 pandemic have placed immense pressure on densely populated regions, such as Hong Kong, particularly in the context of an aging population. The burgeoning demand for healthcare services has necessitated the optimization of resource al-location within healthcare systems. This research presents an innovative analytical queueing model specifically tailored to address the intricate gridlock dynamics prevalent in healthcare systems, with a focused application in the challenging landscape of COVID-19 management. Hong Kong, like numerous other regions, has experienced a demo-graphic transition leading to heightened healthcare demands. Traditional methodologies for scrutinizing gridlock issues in healthcare settings, including simulation models, often prove suboptimal within the context of sophisticated optimization frameworks. This study, however, delves into analytical queueing models, offering a more efficient and effective approach. These models have been underexplored, primarily due to the intricacies involved in modeling gridlock propagation within restricted capacity, a critical concern magnified by the COVID-19 pandemic. The novel Queueing Model introduced in this research incorporates the maintenance of queue capacities and topological aspects as exogenous parameters, rendering it exceptionally adaptable for diverse gridlock-related applications. This adaptability is especially pertinent to healthcare management during the COVID-19 crisis. The model meticulously integrates the concept of gridlock, furnishing a comprehensive comprehension of its origins and repercussions. Validation of this model involves rigorous comparison with established methodologies, exact results, and simulation data, consistently high-lighting its versatility and precision. By applying the model to healthcare management, we scrutinize the dynamics of patient flow within a Hong Kong hospital, placing specific emphasis on the critical issue of bed blockage, further exacerbated by the COVID-19 pandemic. The model's gridlock decomposition unearths the nuanced impact of bed blockage on distinct hospital units, addressing the imperative requirement for quantifying in-patient bed blockage within healthcare systems during a pandemic.

German noise action plans aim to reduce negative health outcomes from noise exposure and identify quiet areas free of noise pollution. Quiet area identification in German noise action plans is based primarily on noise mapping and spatial analysis and not empirical or qualitative data about acoustic environments, thus leaving a gap in the understanding of the quality of formally recognized quiet areas in noise action plans. This work presents a comparative empirical case study in Dortmund, Germany, with the aim to describe the diurnal dB(A) and biophonic properties of quiet areas versus noise 'hot spots'. Sound observations were collected (n=282,764) in five different natural or recreational land use patch types larger than four acres within 33 proposed quiet areas in Dortmund (n=70) and 23 noise hot spots between April 27^th, 2022 and March 2^nd, 2023. We find that quiet areas are on average more than 20 dB(A) quieter than noise hot spots almost every hour of the day. Forests, managed tree stands, cemeteries, and agriculture diel patterns are dominated by dawn dusk chorus in spring and summer, whereas sport and recreation as well as noise hot spots are dominated by traffic and human noise. A novel composite biophony mapping procedure is presented that finds distinct temporal distribution of biophony in forested and agriculture peri-urban locations positively associated with patch size, distance away from LDEN > 55, proximity to water, and the number of vegetation layers in the plant community. Anthrophony distribution dominates urban land uses in all hours of the day, but expands during day and evening and contracts at night and in dusk hours. The procedures presented here illustrate how qualitative information regarding quiet areas can be integrated into German noise action planning.

Mobile inspections conducted by intelligent tunnel robots are instrumental in broadening the inspection reach, economizing on inspection expenditures, and augmenting the operational efficiency of inspections. Despite differences from fixed surveillance, mobile-captured traffic videos have complex backgrounds and device conditions that interfere with accurate traffic event identification, warranting more research. This paper proposes an improved algorithm based on YOLOv9 and DeepSORT for intelligent event detection in edge computing mobile device using the intelligent tunnel robot. The enhancements comprise the integration of the Temporal Shift Module to boost temporal feature recognition and the establishment of logical rules for identifying diverse traffic incidents in mobile video imagery. Experimental results show that our fused algorithm achieves a 93.25% accuracy rate, an inprovement of 1.75% over the baseline. The algorithm is also applicable to inspection vehicles, drones, and autonomous vehicles, effectively enhancing the detection of traffic events and improving traffic safety.

Resuscitation plans (RP) are an important clinical indicator relating to care at the end of life in pediatrics. A retrospective review of the medical records of children who had been referred to the Royal Children’s Hospital, Brisbane, Australia who died in the calendar year 2011 was performed. Of 62 records available, 40 patients (65%) had a life limiting condition and 43 medical records (69%) contained a documented (RP). This study demonstrated that both the underlying condition (life-limiting or life-threatening) and the setting of care (PICU or home) influenced the development of resuscitation plans. Patients referred to the paediatric palliative care (PPC) service had a significantly longer time interval from documentation of a resuscitation plan to death and were more likely to die at home. All of the patients who died in the paediatric intensive care unit (PICU) had a RP which was documented within the last 48 hours of life. Most RPs were not easy to locate. Documentation of discussions related to resuscitation planning should accommodate patient and family centered care based on individual needs. With varied diagnoses and settings of care, it is important that there is inter-professional collaboration (particularly involving PICU and PPC services) in developing protocols of how to manage this difficult but inevitable clinical scenario.

The morphological aspects of urban growth on wetlands in Africa are under-researched. Using the Densu Delta Ramsar site in Accra, Ghana, as a case study, this paper analyses the morphological patterns and drivers of urban growth and its impact on wetlands. Data were obtained through remote-sensing, ground truthing and limited key informant interviews. The analysis combined land use/land cover, building coverage and multiple regression techniques, with the aid of GIS and STATA software. The findings reveal that urban growth at the Ramsar site follows discernible spatial patterns consistent with the spreading pancake, village magnet and ribbon development models. However, the primary force behind these patterns is growing demand for land to meet housing needs, aided by the failure of state institutions to perform their land use control and wetland protection functions. To achieve sustainable urban development, there is an urgent need to ensure effective wetland management by enforcing existing land use, development control and wetland protection measures. This calls for the strengthening, resourcing and closer collaboration between the various state agencies responsible for urban planning and wetland management. There is also the need to engage and sensitise political leaders to increase their commitment to implementing wetland protection and pro-environmental policies.

Confronting the dual challenges of rapid urbanization and climate change, although extensive research has investigated the influencing factors and practical strategies of urban carbon emissions and urban vibrancy, respectively, the unclear mutual nexus between them and the development strategy of collaborative optimization requires further in-depth analysis. This study explores the delicate balance between urban vibrancy and low-carbon sustainability within the confines of Beijing’s Fifth Ring Road. By integrating OpenStreetMap, land use, population, and building carbon emission data, we have developed a reproducible method to estimate total carbon emission and emission intensity per capita. Furthermore, we have introduced vibrancy index data to distinguish the vibrancy evaluation of residential and non-residential land and applied cross-combinational classification technology to dissect the spatial correlation between urban carbon emissions and urban vibrancy. The results reveal that the four combination typologies show more significant differences and regularity in residential land. Based on the discovery of spatial correlation, this study puts forward corresponding development strategy suggestions for each typology based on geographical location and the requirements of urban development policies of these four combination typologies. In conclusion, our study highlights the importance of integrating carbon emissions and urban vibrancy comprehensively in sustainable urban planning and proposes that various land use combinations need targeted development strategies to achieve this goal, which need to consider population, energy, service facilities, and other diverse aspects.

Globalization, knowledge economy, information technology advancements, and the rise of learning societies contribute to the concept of a learning city. The study examines the economic indicators of Yazd city, Iran, in the context of learning city development. A descriptive-analytical approach with a survey method and cluster sampling was employed. Data analysis involved Kolmogorov-Smirnov normality test, single-sample T-test, simple linear regression, and Kendall's W test. The normality test confirmed data normality. The T-test indicated that experts perceived the current state of most variables in Yazd as undesirable. Regression analysis revealed a significant positive association between the economic index and independent variables. Kendall's W test prioritized areas based on economic indicators, with the top 7 and bottom 5 areas identified for focused interventions. The study emphasizes the need to prioritize areas within Yazd based on their economic indicators. This prioritization informs strategies for enhancing social and legal aspects of Yazd's transformation into a learning city. Further research should explore effective methods to cultivate a full-fledged learning environment in the city.

To identify factors associated with interstitial lung disease (ILD) in patients with systemic sclerosis (SSc) and build an algorithm to better define this association, for a personalized application in clinical practice. Methods. 78 SSc patients underwent HRCT to assess ILD. Demographic, clinical and laboratory variables were collected, focusing on those associated either directly or indirectly with lung involvement. The discriminant value of each variable was determined using the operating characteristic curves (ROC) and included in a model to estimate the strength of ILD association in SSc. Results. Thirty-three (42.31%) patients showed ILD on HRCT. DLco, M-Borg, GERD-Q, and capillary density were significantly associated with the presence of ILD-SSc. A model including these variables had a coefficient of determination (R2) of 0.697. DLco had an AUC of 0.861 (p<0.001) with a cut-off ≤72.3% (sensitivity 78.8%, specificity 91.1%, +LR 8.86). The m-Borg scale showed an AUC of 0.883 (p<0.001) with a cut-off >2 (sensitivity 84.8%, specificity 82.2%, +LR 4.77), GERD-Q had an AUC of 0.815 (p<0.001) with a cut-off >7 (sensitivity 72.7%, specificity 86.7%, +LR 5.45). The capillary density showed an AUC of 0.815 (p<0.001) with a cut-off ≤4.78 (sensitivity 87.9%, specificity 68.9%, +LR 2.82). Based on the pre-test probability values, these four variables were applied to Fagan's nomogram to calculate the post-test probability of this association. Conclusions. Our study identified four associated clinical factors of ILD in SSc patients. Moreover, their inclusion in an algorithm for the post-test probability, tailored to the specific patients’ characteristics, significantly increases the ability to find out the presence of SSc-ILD.

European strategic policy directions towards a sustainable blue economy have strengthened interest in maritime investments, thus increasing sectoral competition for marine space. Emerging repercussions out of such a rising interest need to be handled by Marine Spatial Planning (MSP) as a means for: properly allocating marine space to diverse uses; managing conflicts and promoting synergies among them; and pursuing a multi-use perspective of this space. A critical stage of each MSP exercise is the exploration of land-based spatial/developmental directions and their current or potential repercussions in the marine environment in order for constraints but also perspectives in policy choices/maritime uses in the MSP context to be featured; and attainment of a successful coherence or coordination between land and marine spatial/developmental policies to be ensured, by analyzing Land-Sea-Interaction (LSI) and embedding it in the MSP. The latter is the focus of this paper aiming to illuminate critical issues emerging from land-based (terrestrial) policy frameworks for feeding MSP endeavors; and is accomplished in the Northern Aegean Sea, Greece. Towards this end, a multilevel approach is adopted, delving into diverse policy contexts at the local, regional and national/European level and aiming to attain more informed MSP decisions in the specific study region.

SOC stock (SOCS) changes caused by land use changes are still unclear, and understanding this response is essential for many environmental policies and land management practices. In this study, we investigated the temporal-spatial and vertical distribution characteristics of SOCS on the Western Sichuan Plateau (WSP) using the sparrow search algorithm-random forest regression (SSA-RFR) models with excellent model applicability and accuracy. The temporal-spatial varia-tions in the SOCS were modeled using 1080 soil samples and a set of nine environmental covariates. We analyzed the effect of land use changes on the SOCS on the WSP. The total SOCS increased by 18.03 Tg C from 1990 to 2020. The results of this study confirmed that the SOCS in the study area has increased significantly since 2010, with an increase of 27.88 Tg C compared to the total SOCS in 2010. We found that the spatial distribution of the SOCS increased from southeast to northwest, and the vertical distribution of the SOCS in the study area decreased with increasing soil depth. Forest and grassland are the main sources of SOCS, the total SOCS in the forest and grassland accounted for 37.53 and 59.39% of the total SOC pool in 2020, respectively. Expansion of the wetlands, forest, and grassland areas could increase SOCS in the study area.

A previous research showed the 1755 tsunami would inundate the Marginal Avenue, the railway and the low ground area of Caxias, Oeiras municipality, Portugal. Thus, in this study several proposals for coastal protection are presented. A new Lidar data of local topography allowed the construction of a more accurate DEM, including the representation of the streets of Caxias downtown, to be used in the tsunami numerical model. The results were combined with field survey on Caxias and other coastal areas of Portugal and Japan. The new calculations show the low ground areas up to 6 m in height area inundated by the tsunami. However, with the new proposal DEM the tsunami inundation is restricted to the beaches. The proposal includes the construction of a new sea wall with 7 m in height at Caxias beach, the increase in height of the Barcarena Stream levees and the elevation of the sidewalk at São Bruno beach, with a gentle slope up to 7 m in height. It is also proposed the construction of a third bridge over the Barcarena Stream for pedestrian ranging from 5 to 7 m in height that will serve as a gate for the incoming tsunami waves.

The growing concerns about floods have highlighted the need for accurate and detailed precipitation data as extreme precipitation occurrences can lead to catastrophic floods, resulting in significant economic losses and casualties. Integrated Multi-satellitE Retrievals for the Global Precipitation Measurement (GPM-IMERG) is a commonly used high-resolution gridded precipitation dataset and is recognized as trustworthy alternative sources of precipitation data. The aim of this study is to comprehensively evaluate the performance of GPM IMERG Early (IMERG-E), Late (IMERG-L), and Run Final (IMERG-F) in precipitation estimation and their capability in detecting extreme rainfall indices over southwestern Iran during 2001-2020. The Asfezari gridded precipitation data which are developed using a dense of ground-based observation were utilized as the reference dataset. The findings indicate that the IMERG-F performs reasonably well in capturing many extreme precipitation events (defined by various indices). All the three products showed a better performance in capturing fixed and non-threshold precipitation indices across the study region. The findings also revealed that both IMERG-E and IMERG-L have problems in rainfall estimation over elevated areas showing values of overestimations. Examining the effect of land cover type on the accuracy of the precipitation products suggest that both IMERG-E and IMERG-L show large and highly unrealistic overestimations over inland water bodies and permanent wetlands. The results of the current study highlight the potential of IMERG-F as a valuable source of data for precipitation monitoring in the region.

The concept of economic self-reliance, widely known by Thai people as the philosophy of sufficiency economy, has been widely promoted in rural Thai societies. By practicing this philosophy, it is expected that the citizens’ quality of life and local environments could be sustainably improved. This study aims to explore the contribution of the community practices of the sufficiency economy philosophy to rural villagers’ quality of life improvement, and to investigate potential factors that determine the trust of villagers in the philosophy. With the purpose to propose strategies which could enhance trust and promote villagers’ practices of the philosophy, the study investigated influences of three relevant factors on trust towards the philosophy. Those factors included factors related to cognitive-based trust, factors related to emotional-based trust, and factors related to demographic characteristics. Questionnaire surveys and in-depth interviews with community leaders and local villagers were conducted in the Ban Jamrung community, in Thailand’s Rayong province. The results of the statistical analysis revealed that the residents who applied the sufficiency economy philosophy in their daily lives experienced a relatively better quality of life. Additionally, it was found that trust in the philosophy could be predicted more by rational factors than by emotional factors. These findings could be utilized to develop strategies to maintain and enhance the trust of the people in the philosophy of sufficiency economy.

Pregnancy planning and genetic testing (PPGT) has emerged as a tool in reproductive healthcare, offering parents-to-be insight in their risks of having a child with a genetic disorder. This paper reviews the advantages, drawbacks and challenges associated with PPGT, providing some practical guidance for health care professionals. Advantages include identification of genetic risks, a possibility to informed reproductive decision-making, and the potential to reduce the parents-to-be risk for an affected child. Challenges and drawbacks include provision of service, ethical considerations, genetic counselling complexities, and the need to increase public and professional awareness by comprehensive education and accessibility. Practical guidance involves considerations for selecting appropriate candidates, counselling strategies, and how to integrate PPGT into existing healthcare frameworks. By addressing these factors, PPGT can offer an increased reproductive informed choice for the individual and the couple reducing the burden of disease in the family.

Lake sediment records are of great importance for understanding the evolution of watershed environments. Various studies have been carried out to constrain the depositional ages of lake sediments and examine their physical, chemical, and biological characteristics, aiming to construct historical vegetation, environment and climate patterns in Chinese lake watersheds. In this study, we obtained relevant literature on lake sediment records by searching the key word 'age-depth' from the databases – Web of Science and China National Knowledge Infrastructure (CNKI, the largest Chinese academic database). We analyzed the literature based on its type (published in a Chinese/English journal or as a Master’s/PhD thesis), period of publication, journal (if published in a journal), key authors, study area, dating scale, and main aims. The results suggest that the lakes in the plateau regions are the most popular research topic typically covering 100–200 years (short-term) and 500–30,000 years (long-term). The literature focuses on a wide range of topics, from past environmental evolution in the watershed to lake ecology, and provides a solid foundation for better understanding regional climate change and the preservation of lake environments and ecosystems. In the future, resulting data from environmental reconstruction with lake sediments will be needed to integrate with emerging information processing technologies (e.g., artificial intelligence and meta-analysis), to disentangle the complex interplay between Earth surface processes and global climate change; furthermore, strengthening interdisciplinary collaboration will deepen our comprehension of man-land relationship and promote the sustainable management of lake ecosystems in the context of global climate change.

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

Today's city needs more than ever methodological devices that ensure a specific urbanism, in keeping with the complexity of relationships that occur in the urban space. Networks or systems of diverse nature must be activated to achieve a certain success of the city, even more so in its fragile central fabrics. The study is focused on the historic neighborhoods of the city of Jaén (Spain), which have a high vulnerability index. The aim is to establish a strategy to revitalize their urban and social capital and improve their articulation with the rest of the urban and territorial structure. A methodological proposal for the analysis of vulnerability factors and an urban and cartographic analysis of the public space is addressed through an interweaving of a triple network: environmental, social, and urban. For this purpose, the configuration of this overlapping network of analysis and formulation of criteria is presented, which considers the urban multiplicity and promotes new dynamics for the integrated urban regeneration of the area and for the activation of public and collective urban spaces.

The Upper Hunter Valley is a major coal mining area containing approximately 40% of the currently identified total coal reserves in New South Wales (NSW), Australia. Due to the ongoing increase of mining activities, PM10 (air-borne particle with an aerodynamic diameter less than 10 micrometres) pollution has become a major air quality concern in local communities. This paper summarises the spatial and temporal variability modes of PM10 pollution in the region, based on long-term multi-site monitoring data and the application of the rotated principal component analysis (RPCA) and wavelet analysis techniques. RPCA identified two distinct air quality clusters/subregions in the valley, one in the west/northwest, the other in the southeast. Wavelet analysis revealed the annual cycle to be most persistent temporal mode of PM10 variability in both subregions, with intermittent signals observed at time scales of around 120, 30~90 and under 30 days. How these variation modes are related to the effects of local PM10 emissions and the influence of meteorology at different time scales deserves further attention in future work. The findings will be used in air quality reporting and forecasting in NSW. The methodology and results can also be useful for air quality research in similar regions elsewhere.

Antimony (Sb) has gained significance as a critical raw material (CRM) within the European Union (EU) due to its strategic importance in various industrial sectors, particularly in the textile industry for flame retardants and as a component of Sb-based semiconductor materials. Moreover, Sb is emerging as a potential alternative for anodes used in lithium-ion batteries, a key element in the Energy transition. This study focused on exploring the feasibility of identifying and quantifying Sb mineralizations through the spectral signature of soils using reflectance spectroscopy, a non-invasive remote sensing technique, and by employing deep learning algorithms such as Convolutional Neural Networks (CNNs). Common signal preprocessing techniques were applied to the spectral data, and the soils were analyzed by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Despite achieving high R-squared values, the study faces a significant challenge of generalization of the model to new data. Despite the limitations, this study provides valuable insights into potential strategies for future research in this field.

Extracting the economic value by integrated utilization of space in old communities is crucial for encouraging independent participation from enterprises and residents, reducing reliance on government leadership and fiscal investment. This study starts from the active perspective of spatial assets, constructs a value activation framework for old community spatial assets by balancing "endogenous demand" and "exogenous opportunities." By enhancing "economic value" through "use value," five methods for value extraction and overall project utilization paths are proposed, guided by a dynamic "cost-revenue" balance. Using multi-source data, we identify the spatial assets of 1,096 old communities in central Guangzhou and apply a market comparison method for economic value assessment. Additionally, the study offers recommendations on timing and project portfolios for regeneration efforts, along with strategies for establishing a coordinating implementation entity and fund account. This research provides strategic insights for advancing the regeneration of old communities by tapping into their macro-level economic potential.

In order to quickly develop a multi ship collaborative collision avoidance plan in multi ship encounter scenarios, a multi ship collision avoidance decision model is proposed in accordance with the requirements of the International Maritime Collision Avoidance Regulations, taking into account the collision avoidance operations in multi ship encounter scenarios. Firstly, the collision risk between ships is determined by the closest encounter distance (DCPA) and closest encounter time (TCPA). Secondly, a decision objective function is established based on rules, degree of ship deviation, and ship risk. Finally, the prediction mechanism is used to calculate the minimum value of the objective function and complete the collision avoidance decision. The simulation results show that in the scenario of multiple ship encounters, the collision avoidance model can achieve safe collision avoidance with a smaller steering frequency and a shorter col-lision avoidance time. The proposed multi ship collision avoidance model can provide reference for collision avoidance decision-making in multi ship encounter scenarios, which helps to im-prove the collision avoidance efficiency in multi ship collision avoidance

The resilience of towns and cities refers to their ability to adapt and recover when confronted with pressures or challenges. This study employs ten variables as indicators to assess the resilience of urban areas by analyzing official data and constructing a multilevel mixed-effects structural equation model. The empirical findings demonstrate that enhancing resilience significantly influ-ences urban service functions, such as strengthening healthcare systems, stabilizing the real estate market, and addressing socio-economic challenges. Specifically, factors such as healthcare re-sources, housing demand, population structure, and social security exhibit varying levels of resil-ience, which profoundly impact the spatial distribution of these factors and socio-economic de-velopment. Disparities in healthcare resource allocation, demographic aging trends, and shifts in the housing market closely correlate with resilience levels in different regions. Additionally, the study emphasizes that improving resilience not only boosts the reliability and security of urban services but also ensures that communities receive necessary support and protection during times of adversity. Consequently, policymakers should recognize the pivotal role of urban resilience in resource allocation and social equity, devising corresponding strategies to enhance the resilience of these areas.

Background: Land use and land cover change (LULCC) in the Ruhuhu River Sub-Basin (RRSB), a crucial watershed within the Lake Nyasa Basin in Tanzania, poses a significant threat to water resource sustainability and ecological integrity. However, a lack of comprehensive data on long-term LULCC trends has hindered effective conservation efforts. Methods: This study utilized Landsat 5 TM and Landsat 8 OLI data within Google Earth Engine to quantify LULCC dynamics from 1990 to 2023. Six land cover classes were analyzed: water, forest, barren land, grassland, shrubland, and farmland. Results: Results revealed a substantial decline in forest cover (56.92% to 28.60%), primarily converted to farmland (2.99% to 20.22%). Shrubland expanded initially but then declined, while barren land steadily increased. These changes have profound implications for water resources, biodiversity, and ecosystem services within the RRSB and the broader Lake Nyasa Basin. Conclusions: This research highlights the urgency of implementing sustainable land management practices to mitigate the adverse impacts of LULCC in the RRSB. The high classification accuracies achieved (90.9% to 98.7%) validate the robustness of the methodology. This study provides crucial insights for policymakers, land managers, and conservation practitioners, emphasizing the need for targeted interventions to promote sustainable land use and ensure the long-term resilience of the RRSB ecosystem.

This study was conducted to identify the actual degree of underdevelopment and spatial characteristics of rural areas in Korea, which are expected to face extinction due to population decline and aging. For this purpose, the spatial scope was set to Eup and Myeon areas classified as rural regions. To assess the degree of underdevelopment, previous studies were reviewed and analyzed to develop a comprehensive underdevelopment index, which was then applied to Eup and Myeon areas to classify them into growth regions, general regions, and depressed regions. Mapping the classified regions revealed that both growth and general regions were concentrated in the metropolitan area and southeastern regions, where Korea's population and resources are densely clustered. In contrast, depressed regions were found primarily in areas where agriculture is the main industry and in regions with unfavorable geographical conditions. This study is significant as it covers the entire nation of Korea, providing a method for identifying depressed regions and highlighting the regions that are developing. The findings can serve as fundamental data for the development of policies to address population decline in the future.

Environmental, social, and governance (ESG) investment has become a common trend in capital markets, and many institutional investors have publicly declared their long-term ESG investment target (ESGIT). This study focuses on investors who conduct strategic asset allocation (SAA) using composite indices but establish their ESGIT outside the SAA process. A mismatch could arise between investors’ planned and actual portfolios because they must pursue their ESGIT by asset selection, which inevitably makes the constituents of their portfolios different from those of composite indices. To scrutinize the potential existence of a misalignment between their SAA and ESGIT, this study analyzes actual stock and bond indices over the past decade using traditional mean-variance optimization. The results reveal significant differences between the expected and realized performances, and the misalignment is more significant when the analysis period is divided into two sub-periods: stable and volatile. Specifically, the results indicate that the efficient frontier constructed using ESG indices significantly differs from that constructed using composite indices, and that the difference between these two efficient frontiers becomes more significant during volatile periods. Furthermore, the results show that investors cannot meet their targets if their ESGIT is established outside the SAA process.

This study aims to spatially analyze the distribution characteristics of vacant homes in Asan-si, Chungcheongnam-do, and understand the differences in factors causing vacant homes by type. We use a variety of statistical methods to examine these factors and identify key influencing factors such as the number of vacant stores, changes in overall population, land use complexity, and physical characteristics of land and buildings. The findings reveal that the factors contributing to the occurrence of vacant homes vary significantly by region and property type, highlighting the need for region-specific policies. For instance, in old town areas, small lot ratios and land use complexity are significant, while in rural village, the average number of floors and land use complexity play a major role. This study underscores the diversity of factors influencing vacant homes, suggesting that policies should be tailored to the unique characteristics of different regions to effectively address this issue.

To promote of the rural revitalization strategy in China, this study attempts to summarize the gains and losses by the review of the design practice of rural buildings of the People's Commune in the late 1950s. Firstly, from the macro perspective, this paper gleans the relevant commune housing design cases in the Architectural Journal from 1958 to 1960 and summarizes the overall common design policies. Secondly, from the micro perspective, the paper analyzes the process of the investigation and creation through a concrete case. The paper concludes that the actual production and living needs of farmers must be taken into consideration in the process of the implementation of rural modernization, instead of simply putting the focus on standardized construction. Finally, the article points out the two characteristics of "rural modernity" reflected in the process of promoting rural modernization during the early stage of modern China: 1) collective wisdom and efforts; 2) combining local and foreign cultures. This article aims to provide a historical reference for current architects to carry out effective design practices in combination with rural development.

Despite various interventions in road safety work, fatal and severe road traffic accidents (RTAs) remain a significant challenge leading to human suffering and economic costs. Understanding the multicausal nature of RTAs, where multiple conditions and factors interact, is crucial for developing effective prevention measures in road safety work. This study investigates the multivariate statistical analysis of co-occurring conditions in RTAs, focusing on single-vehicle accidents with single occupancy and personal injury on Austrian roads outside built-up areas from 2012 to 2019. The aim is to detect recurring combinations of accident-related variables, referred to as blackpatterns (BPs), using the Austrian RTA database. The study proposes Fisher’s exact test to estimate the relationship between an accident-related variable and fatal and severe RTAs (severe casualties). In terms of pattern recognition, the study develops the maximum combination value (MCV) of accident-related variables, a procedure to search through all possible combinations of variables to find the one that has the highest frequency. The accident investigation proceeds with the application of pattern recognition methods, including binomial logistic regression and a newly developed method, the PATTERMAX-method, created to accurately detect and analyse variable-specific BPs in RTA data. Findings indicate significant BPs contributing to severe accidents. The combination of binomial logistic regression and the PATTERMAX-method appears to be a promising approach to investigate severe accidents, providing both insights into detailed variable combinations and their impact on accident severity.

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

Ecological city is currently a hot topic in urban planning research. How to balance urban development and ecological environment protection has become a focus and difficulty of research. Traditional urban planning is mainly based on experience, but its disadvantage is that it is easy to overlook key geographical factors such as terrain and vegetation, and cannot fully reflect the actual spatial characteristics of the city. Therefore, this article applied the combination of urban and rural planning and environmental remote sensing technology to urban planning and design, obtaining a massive amount of data. Through the actual analysis of Langfang, this paper monitored the vegetation, water, land and landscape data of Langfang through environmental remote sensing technology. By using these data to identify existing problems, this article proposed reasonable planning for the problems, in order to achieve the effective goal of ecological city planning and design. It provided a more accurate analysis of urban structure, including urban planning and urban ecological landscape planning. Among them, ecological landscape planning includes renovating ecological embankments, protecting ecological green belts around the city, and creating characteristic landscape areas, thereby providing more scientific basis for urban planning and design, making urban planning and design more reasonable and scientific. This paper investigated the planned Langfang City, and the average errors of vegetation, soil, water quality, and landscape data obtained from traditional field surveys were 0.35, 0.33, 0.34, and 0.31, respectively. The average errors of remote sensing technology in obtaining vegetation, soil, water quality, and landscape data were 0.16, 0.15, 0.17, and 0.15, respectively. The total suspended solids content of waterscape 1-10 before planning was 5.51mg/L and 7.41mg/L, respectively. After planning, the total suspended solids content of waterscape 1-10 was 3.60mg/L and 4.47mg/L, respectively. From this, it can be seen that the error in obtaining data after planning has decreased, and the total suspended solids content has also decreased.

Synergistic control of emissions of air pollutants and CO2 is critical to the dual challenges of air quality improvement and climate change in China. Based on the emission inventories of thermal power units in Beijing, Tianjin, and Hebei, this study analyzes the CO2 and NOX emission characteristics of these units, identifies and quantifies the synergistic drivers affecting these emission trends. Inventory data show that between 2010 and 2020, NOX emissions were reduced by 86.1%, while CO2 emissions were reduced by only 29.8%. Although significant progress has been made in reducing NOX emissions through measures such as end-of-pipe treatment, controlling CO2 emissions remains a difficult task. The index decomposition analysis reveals that economic growth is the main driver of CO2 and NOx emission growth, energy intensity reduction is the main driver of CO2 emission reduction, and end-of-pipe treatment is the main driver of NOX emission reduction. Currently, coal occupies about 87% of the energy consumption of thermal power units in the Beijing-Tianjin-Hebei, and remains the main type of energy for synergistic emissions, and the potential for emission reduction in the energy structure remains huge. For NOX emissions, it is expected that 90% of the reduction potential can be achieved through energy restructuring and end-of-pipe treatment. In conclusion, the high-precision unit-by-unit emission study confirms the effectiveness of the control policy for thermal power units in the region and provides some scientific reference for future policy formulation.

The land use land cover (LULC) map is extensively employed for different purposes. The LULC maps provided by the Portuguese National Geographic Information System (SNIG) are not ideal for continuous assessment and regular scrutiny. Machine learning (ML) algorithms applied in remote sensing (RS) data has been proven effective in image classification, object detection, and semantic segmentation. Previous studies have shown that Random Forest (RF) and Support Vector Machine (SVM) consistently achieved high accuracy for land classification. In this study, the application of RF and SVM classifiers, and object-based (OBIA) and pixel-based (PBIA) approaches with Sentinel-2A imagery was evaluated using Google Earth Engine (GEE) platform for land cover classification of a burned area in the Serra da Estrela Natural Park (PNSE), Portugal. This aimed to detect the land cover change and closely observe the burned area and vegetation recovery after the 2022 wildfire. The combination of RF and OBIA achieved the highest accuracy in all evaluation metrics. At the same time, a comparison with the Normalized Difference Vegetation Index (NDVI) map and Conjunctural Land Occupation Map (COSc) of 2023 year indicated that the SVM and PBIA map resembled the maps better.

Despite the growing adoption of Mobility as a Service (MaaS) in urban transportation systems, standard monitoring methods for evaluating its impact and effectiveness still need to be developed. This study proposes a quantitative state of MaaS analysis based on mobility market indicators and macroeconomic metrics to generate a MaaS Status Index (MSI). The intention is to introduce a standardised quantitative methodology for systematically assessing and comparing the state of MaaS in urban mobility systems. The MSI aims to quantitatively capture the economic, social, technological, and infrastructural conditions relevant to MaaS implementation. The methodology includes four steps: identifying relevant mobility markets, defining mobility market metrics, integrating macroeconomic metrics, and deriving the MSI formula. We apply the MSI methodology to the Austrian mobility market as a case study, demonstrating its practicality in assessing MaaS readiness and highlighting specific challenges and opportunities within the Austrian mobility system. The analysis covers the present (2017-2022) and the projected future (2023-2028). The findings indicate that the proposed MSI is an effective tool for evaluating MaaS implementation readiness.

This study investigates the spatial and temporal dynamics of Paomo restaurants in Xi'an's central urban area from 2012 to 2023, leveraging Point of Interest (POI) data through a series of sophisticated analytical techniques. Methods including nearest neighbor distance, kernel density estimation, and band set statistical analysis were employed to thoroughly examine the evolutionary patterns and key drivers influencing the spatial distribution of these eateries. Our results highlight a notable trend of expansion from the central city to the periphery, characterized by significant spatial agglomeration. Initially concentrated in the city center, the distribution of Paomo restaurants has progressively shifted towards multiple distinct cores, reflecting the dual influence of urban policy initiatives and the dynamics of market competition. Furthermore, the research identifies several pivotal factors shaping this spatial distribution, particularly transportation access, residential quality of life, and the availability of commercial services. These findings demonstrate the profound effects of urban spatial reconfiguration and socioeconomic development on the specialized catering industry. The insights gleaned from this analysis offer valuable guidance for urban planners and policymakers, providing strategic recommendations for the spatial planning of specialty catering services to optimize urban layouts and foster sustainable economic progress.

Due to constraints in launch platform and cost, the maneuverability of gliding-guided projectiles is limited, necessitating a rational design of their trajectory schemes. To reduce the sensitivity of trajectory schemes to uncertainties while ensuring compatibility between flight schemes and guidance control systems, and fully exploiting the control capability of the projectile, a closed-loop robust trajectory planning method is proposed. Models of major uncertain factors and states deviation at the control-start point are established. Based on the NIPCE method, the stochastic dynamic model is transformed into a high-dimensional deterministic model with PCE coefficients as state variables, and the uncertainty propagation law is obtained. A PID algorithm is employed to design a tracking guidance law based on position error feedback, and open-loop and closed-loop robust trajectory planning models are established accordingly. The optimal control problem is solved by transforming it into a nonlinear programming problem using the direct shooting method. Simulation results indicate that the NIPCE method can significantly improve the computational efficiency of uncertainty propagation while ensuring accuracy. Open-loop robust planning can effectively mitigate the sensitivity of gliding trajectories to uncertainties but cannot completely eliminate terminal dispersion. Closed-loop robust planning effectively improves control effort consumption on the basis of open-loop planning.

Based upon 30-years of research by the author a new approach to hospital bed planning and international benchmarking is proposed. The number of hospital beds per 1000 population is commonly used to compare international bed numbers. This method is flawed because it does not consider population age structure or the effect of nearness-to-death on hospital utilization. Deaths are also serving as a proxy for wider bed demand arising from undetected outbreaks of 3000 species of human pathogens. To remedy this problem a new approach to bed modelling has been developed which plots beds per 1000 deaths against deaths per 1000 population. Lines of equivalence can be drawn on the plot to delineate countries with higher or lower bed supply. This method is extended to attempt to define the optimum region for bed supply in an effective health care system. England is used as an example of a health system descending into operational chaos due to too few beds and manpower. The former Soviet bloc countries represent a health system overly dependent on hospital beds. Several countries also show evidence for over-utilization of hospital beds. The new method is used to define a potential range for bed supply and manpower where the current most effective health systems currently reside. The method is applied to total curative beds, medical beds, psychiatric beds, critical care, geriatric care, etc., and can also be used to compare different types of healthcare staff, i.e., nurses, physicians, surgeons. Issues surrounding the optimum hospital size and the optimum average occupancy will also be discussed. The role of poor policy in the English NHS is used to show how the NHS has been led into a bed crisis. The method is also extended beyond international benchmarking to illustrate how it can be applied at a local or regional level in the process of long-term bed planning. Issues regarding the volatility in hospital admissions are also addressed to explain the need for surge capacity and why an adequate average bed occupancy margin is required for an optimally functioning hospital.

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

Amid escalating urbanization, devising rational commercial space layouts is a critical challenge. Leveraging machine learning, this study uses a Back-propagation (BP) neural network to optimize commercial spaces in Weinan City's central urban area. The results indicate an increased number of commercial facilities with a trend of multi-centered agglomeration and outward expansion. Based on these findings, we propose a strategic framework for rational commercial space development emphasizing aggregation centers, development axes, and spatial guidelines. This strategy provides valuable insights for urban planners in small and medium-sized cities in the Yellow River Basin and metropolitan areas, ultimately showcasing the power of machine learning in enhancing urban planning.

On February 28th, 2023, Spanish Royal Decree 150/2023 as published, approving the plans for the management of the maritime space of the five Spanish marine demarcations. This Royal Decree Law inaugurates the Planning of the Maritime Space in Spain. Terrestrial Space Planning is very advanced, both in the legislation and in the instruments that are enabled to organize this space, from the national scale to the municipal scale, passing through the regional, provincial, and supra-municipal scales. Naturally, both Planning must converge and thus speak of an Integrated Space Planning. In some of the countries that we can take as global references, this convergence in the form of integration is taking place. On the other hand, and within the context of climate change, coastal cities will be the most affected, both by the potential rise in sea level and by the increasingly continuous and greater extreme events. Integrated Space Planning is postulated as the most effective tool to carry out adequate territorial and urban planning of our coastal cities, as well as to analyse the influence and possible corrective measures to apply against the effects produced by climate change.

The Mediterranean Diet, characterized by high intake of plant foods and unsaturated fats, has been suggested to improve assisted reproductive technology (ART) outcomes. This literature review aimed to summarize the evidence from observational studies on the associations between preconception Mediterranean Diet and ART outcomes. PubMed/MEDLINE, Embase, ScienceDirect, and Google Scholar databases were searched to identify relevant studies. Seven observational studies (n=2,321 women on ART) were included. Adherence to the Mediterranean Diet was assessed by food frequency questionnaires with 6-195 items. Three studies found that higher Mediterranean Diet scores improved Clinical Pregnancy or Live Birth rates, while two studies showed a positive effect on ART eggs and embryos. However, two studies reported no significant associations with ultimate ART success, and four studies found no effects on oocyte and embryo number or quality. Evidence for the effects of greater adherence to the Mediterranean Diet on ART outcomes is limited but promising. Additional rigorous research is needed to clarify and weigh the degree of association between the Mediterranean Diet and ART success.

In modern warfare, the diversified tasks can sometimes be challenging to fulfill with a single projectile, necessitating the incorporation of cooperation constraints in trajectory planning. Limited by the stringent requirements of the launch platform and lower costs, the maneuverability and ability to adjust the flight time range of projectiles are weak. Therefore, the rationality of performance indicators and flight time coordination strategies is especially critical. To fully exploit the control capabilities of projectiles, a battlefield area segmentation method is proposed, differentiated performance indicators and a cooperative trajectory planning model that considers the entire range of projectiles are established. Considering the limitations of existing flight time coordination strategies in applications, targeted improvements have been made in different cooperation scenarios, and a bi-level adaptive cooperation strategy(BACS) with both optimality and flexibility is proposed. To rapidly determine feasible conditions, a simple and universal method for obtaining the capability ranges of cooperation is introduced. The multi-phase optimal control problems are transformed into nonlinear programming problems using the Radau pseudo-spectral method, and simulation results show that the proposed methods are capable of handling trajectory planning tasks in different cooperation scenarios. The improved strategies effectively enhance the planning success rate under relatively harsh conditions and BACS demonstrates good compatibility with the problems studied.

Introduction: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection may cause acute respiratory failure but also remains responsible for many other pathologies, including electrolyte disorders. SARS-CoV-2 infection can cause dysfunction of the renin-angiotensin-aldosterone system and disrupt water hemostasis with thirst and appetite abnormalities. Dysnatremia affects prognosis and may be associated with mortality in patients admitted to SARS-CoV2 intensive care. Patients and Methods: The study included 209 patients admitted to the Intensive Care Unit between April 12, 2021, and March 1, 2022 who were over 18 years old and diagnosed with SARS-CoV-2 infection by clinical and thoracic tomography findings or with a positive reverse transcription polymerase chain reaction (RT-PCR) test result. The laboratory markers, treatment modalities, nutritional, and respiratory support also for outcome evaluation, length of stay in the ICU, total hospitalization duration, and mortality in ICU were recorded.The laboratory marker comparison was made admission with the final assessment performed before the time of mortality in ICU or discharge. Results: Inotropic requirements among patients were high which was reflected in the first-month mortality. Hypernatremia presence was associated with an increase in enteral support and inotropic support requirement and mortality. Hypernatremia was correlated with diabetes mellitus, chronic renal failure, and a longer duration under mechanical ventilation. Discussion: Hypernatremia was an important risk factor in ICU patients hospitalized for SARS-CoV-2 infection, which was also affected by the treatment regimens given itself. This complex relationship underlies the importance of proper electrolyte management, especially in patients who were under severe stress and organ failure.

In this study, MBBR, utilizing kaldnes as a media to attach and grow microorganisms, was used to treat organics in a Compact Septage Treatment Plant (CSTP). Seeding and acclimatization processes were done initially to ensure the microorganisms were able to grow and adapt well within their environments. This research was done to determine the time required for those processes, the optimum conditions, and the growth mechanism of microorganisms during the acclimatization process. Both processes were run in a batch mode. Changes in colour and weight of kaldnes were analyzed for the seeding stage; while COD, MLVSS, pH & temperature were observed for the acclimatization stage. Seeding and acclimatization were run for 6 and 16 days respectively. Acclimatization stage was halted when MLVSS, pH, temperature and COD reduction efficiency were stable. Three phases of microorganism growth were clearly observed in the end of the acclimatization stage, i.e., lag, constant increasing and declining rates. This indicated that microorganisms could adapt well with the MBBR system, and were ready to be utilized further to treat septage in the MBBR of the CSTP. Further research is required to investigate the efficacy of the MBBR with the acclimatized microorganisms in the CSTP.

Annually, the oak forests of the Zagros Mountain chains, in western Iran and northeastern Iraq, face recurring challenges posed by forest fires, particularly in the Kurdo-Zagrosian forests situated in western Iran and northeastern Iraq. Assessing fire susceptibility relies significantly on vegetation condition. Integrating in situ data, Remote Sensing (RS) data, alongside the integration of Geographical Information Systems (GIS), presents a cost-effective and precise approach to capturing environmental conditions before, during, and after fire events, minimizing the need for extensive fieldwork. This study refines and applies the Zagros Grass Index (ZGI), a local vegetation index tailored to discern between grass-covered surfaces from tree canopies in Zagros forests, identifying the grass masses as the most flammable fuel type. Utilizing Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index (NDVI) product as input, from 2013 to 2022, the ZGI aims to mitigate the influence of tree canopies, isolating NDVI values solely attributable to grass cover. By incorporating phenological characteristics of forest trees and grass species, the ZGI outperforms NDVI in mapping grass-covered areas that are crucial for fire susceptibility assessment in the study region. Results demonstrate a strong overlap between ZGI-based maps and recorded fire occurrences, validating the efficacy of the index in fire susceptibility estimation.

Research into lightweight structural concrete using volcanic tuff is of great importance to the construction industry. These materials have excellent thermal insulation properties, which helps improve the energy efficiency of buildings. A three-factor experimental design was used to build the statistical model. The test methods used were methods for determining the crushability of volcanic tuff, determining the average density, compressive strength and thermal conductivity of lightweight structural concrete. The influence of basalt fiber on the properties of lightweight structural concrete has been determined. The optimal compositions of lightweight structural concrete using tuff have been selected. The compressive strength of lightweight structural concrete reached 32.0 MPa. The average density range is 1754.6-2114.0 kg/m³. Good thermal conductivity values ​​were obtained in the range of 0.653-0.818 W/m·K. The article obtained the optimal compositions of lightweight structural concrete using volcanic tuff as a filler.

To further enhance the intelligence level of coal mining faces and achieve autonomous derivation, learning, and optimization of shearer navigation cutting, this paper proposes the methods of shearer digital twin navigation cutting motion planning based on the concept of shearer autonomous navigation cutting technology and intelligent coal mining face digital twins. The study includes the digital twin theory and the construction method of the shearer digital twin navigation cutting motion planning system based on this theory. Based on the digital twin theory, a shearer digital twin navigation cutting motion planning system was constructed. This system supports the service functions of shearer cutting digital twin, dynamic navigation map digital twin, reinforcement learning environment construction, and motion planning through the physical perception layer, comprehensive data layer, and digital-model fusion analysis layer. Finally, by comparing the effects of the DQN-NAF and DDPG deep reinforcement learning algorithms in the shearer motion planning task within the constructed digital twin environment, the results show that the DQN-NAF algorithm demonstrates better performance and stability in solving the shearer digital twin motion planning task.

Background/Objectives: Nail technicians frequently have musculoskeletal pain, which impairs their job performance. A high-risk profession linked to back discomfort that causes morbidity is nail technician. QEC is a tool used for observing and assessing risks in a work environment. The goal of this research is to assess the ergonomic risks, pain, and their relationship with posture among manicurists. Methods: The 35 nail technicians filled the assessment form which consists of occupational information, pain, European Community Respiratory Health Survey, Nordic Musculoskeletal Questionnaire and QEC worker part. Physicians assessed nail technicians’ workspace and QEC outcomes. Results: It was stated that they worked an average of 61.92±11.09 hours per week, served an average of 11±5 customers per day, and their condition lasted 53.96±36.51 months. There is a strong significant correlation between discomforts, time spent in occupation (p=0,000) and working hours. Manicure, pedicure, unwanted hair removal, correction of eyebrow were considered for ergonomic risk evaluation. Each occupation accompanied repeated bad postures. Most of them were scored in very high risk categorization for back static positions (more than 29 point). Conclusions: This study may be useful for nail technicians seeking ergonomic improvements in the areas of engineering, administration, behavior, or personal.

Obesity is a risk factor for the development of gestational diabetes mellitus (GDM). However, the most optimal type of nutritional intervention to prevent GDM in high-risk women is not clearly defined. This study investigates if nutritional treatment based on the Mediterranean diet (MedDiet) before 12th gestational week (GW) in women at high risk due to a body mass index (BMI)≥25kg/m2, reduces the rate of GDM and metabolic syndrome (MetS) at 3 years postpartum. We performed a post-hoc analysis of the San Carlos Gestational Prevention Study. A total of 735 women with BMI≥25kg/m2 were evaluated between 2015-2018, 246 in standard diet control group (CG) and 489 in MedDiet intervention group (IG). The rate of GDM was significantly lower in IG compared to CG (25.1%vs31.7%;p=0.037). Postnatal follow-up was completed by 141 women in CG (57%) and 312 women in IG (64%). At 3 years postpartum, we observed a reduction (relative risk 95% confidence interval) in the rates of impaired fasting glucose (IFG) (0.51 (0.28-0.92);p=0.019), obesity (0.51 (0.28-0.92),p=0.041), waist circumference (WC)≥89.5cm (0.54 (0.31-0.94);p=0.022) and MetS (0.56 (0.33-0.94);p=0.003). MedDiet reduces the rate of GDM and postpartum MetS in women with BMI)≥25kg/m2, suggesting that its implementation should be routinely recommended from the first GWs.

Background: Bariatric surgery (BS) has a significant impact on body composition (BC) and con-sequently may affect established sarcopenic obesity (SO) in candidate patients. The aim of this study is to assess the utility of muscle ultrasound (MUS) of rectus femoris thickness (RFT) for the evalua-tion of BC and skeletal muscle function in patients undergoing BS compared to bioimpedance analysis (BIA), dual-energy X-ray absorptiometry (DEXA) and dynamometry. On the other hand, we aim to demonstrate how MUS of RFT correlates better with the quality of life (Qol) in this population, likely because it enables the detection of regional quadriceps muscle sarcopenia, in comparison to the other mentioned methods. Methods: This is a prospective pilot study including 77 subjects (64.9% female, mean age: 53.2 ± 8.67 years) who underwent BS. Handgrip strength was measured using a dynamometer, fat-free mass index (iFFM) was assessed by BIA, appendicular muscle index (AMI) was calculated using DEXA and RFT was measured by MUS. Moreover, Homeostasis Model Assessment of Insulin Resintance (HOMA-IR) was calculated. All these measurements were conducted 1 month prior to BS and at the 12-month follow-up. QoL was as-sessed using the Moorehead-Ardelt questionnaire. Results: The mean BMI decreased by 12.95 ± 3.56 kg/m2 (p=0.001). Firstly, we observed positive correlation pre-surgery between HOMA and: RFT (r=0.27, p=0.02), iFFM (r=0.36, p=0.001), AMI (r=0.31, p=0.01) and dynamometer (r=0.26, p=0.02). In addition, we found correlation between RFT and iFFM (pre-surgical: r=0.31, p=0.01; post-surgical: r=0.25, p=0.05) and between RFT and lower extremities AMI post-surgical (r=0.27, p=0.04). Secondly, we observed significant reductions in iFFM, AMI and RFT (p=0.001), but not with dynamometer (p=0.94). Finally, a tendency to a positive correlation between QoL question-naire and RFT post-surgery (r=0.23, p=0.079) was observed. Conclusions: Our results suggest that RFT measured by MUS for the evaluation of SO and the follow-up after BS of these patients. Moreover, RFT can provide relevant information about regional sarcopenia and probably has an accurate correlation with QoL in comparison with the other methods.

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

EUS–TA in unresectable pancreatic cancer requires not only a tissue diagnosis but also tissue collection in anticipation of comprehensive genomic profiling. However, the optimal puncture target remains controversial. Therefore, the Primary and Metastatic Lesions in Pancreatic Cancer (PRIMATE) study was designed to clarify the optimal target by comparing the success rates for meeting OncoGuide NCC Oncopanel (NOP) analysis criteria on pre-check primary and metastatic lesion specimens obtained during the same EUS–TA session in patients with invasive pancreatic ductal adenocarcinoma. In this ongoing prospective study, two specimens, each from primary and metastatic lesions, are obtained by EUS–TA (typically using a 19G fine-needle biopsy needle) in patients with invasive pancreatic ductal adenocarcinoma. The primary endpoint is the proportion of EUS–TA specimens that meet NOP analysis criteria during pre-check (i.e., tumor cellularity ≥ 20% and tissue area ≥ 4 mm2), which are then compared between primary and metastatic lesions. This study has been approved by the National Cancer Center Institutional Review Board (Research No. 2022-168). The results of this study will be reported at an international conference and published in an international peer-reviewed journal. The trial registration number is UMIN 000048966.

Background/Aim: Stool gluten immunogenic peptides (GIP) determination is now considered a valuable tool for detecting dietary lapses in treated celiac disease (CeD) patients. Our study aims to explore the diagnostic performance of a qualitative lateral flow immunoassay point-of-care test (LFIA/PoCT) compared with a qualitative enzyme-linked immunosorbent assay (ELISA) for detection of stool GIP. Methods: The study is a post hoc analysis of stool samples collected in the real-life conditions from a cohort of gluten-free diet-treated CeD patients. Stool GIP was measured in µg/g of stool using an ELISA kit (iVYLISA GIP S®, Biomedal SL). For the qualitative evaluation of stool GIP, a LFIA/PoCT test (GlutenDetect®; Biomedal S.L) was employed, which reported results as positive or negative. The LFIA/PoCT performance was evaluated against ELISA, considered as the gold standard. GIP concentrations

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

Background: In response to inflammation, the absorption of nutritional iron is restricted. Multiple inflammation-related signaling pathways can lead to ferroptosis, an iron-dependent mechanism of programmed cell death. Since the pathophysiological significance of the presence and uptake of iron in chronic inflammation is still unknown, we tested the effect of a low iron diet on the clinical course of arthritis in the mouse model of collagen-induced arthritis (CIA). Methods: Six- to eight-week-old male DBA/1 mice were fed either a normal or a low iron diet starting three weeks before arthritis induction. From day four after the collagen-booster made on day 25, the development of arthritis was regularly monitored until the end of the experiment (day 34), using a standard clinical arthritis score. The complete blood count was determined as well as Fe2+, Fe3+, oxidized and reduced glutathione (GSH and GSSG) and malondialdehyde (MDA) in whole paw tissue by ELISA. Quantitative PCR was performed from whole paw tissue for glutathione peroxidase 4 and other key regulator genes of iron metabolism and ferroptosis. We used nonparametric tests to com-pare markers of iron metabolism and ferroptosis as well as nonlinear regression models for longitu-dinal data for signs of arthritis. Results: Mice fed a low iron diet showed a significantly less severe course of arthritis compared to mice fed a normal iron diet (p

Background/Objectives:The first attempts of posterior lumbar interbody fusion can be traced back to the 1940s, where their performance was marked by animosity due to high rates of failure. Nowadays, the use of interbody fusion involves a much more complicated consideration of factors such as global alignment, disc height, fusion rates, and operative risk, all combined at once.Our study aims to examine all these effects using Flarehawk 9 as a means of interbody fusion.Materials and methods: A total of 58 patients underwent open posterior lumbar surgery using Flarehawk 9 between September 2021 and February 2023 with a mean follow up of 1 year.The mean age was 59.8 years old ( range between 33 and 79 years old), 36 of them are males while 22 of them are females. The diagnostic groups included spinal canal stenosis (n=40), failed back surgery syndrome-revision surgery (n=5),spondylolisthesis with slip percentage 25% (n=4),recurrent herniated disc (n=7) and adjacent segment disease (n=2). Results: The majority of patients demonstrated remarkable improvement based on ODI scores.The rate of union varied based on the fused levels and whether the patients had previous surgery or not.The amount of lordosis postoperatively is increased by 2±0.4 degrees.Conclusions: Even though anterior approaches become more and more popular and advanced nowadays, posterior fusion with interbody cage still remains a safe and effective method to treat various spine surgical pathologies with optimal results.

This study aimed to identify whether gyrate atrophy of the choroid and retina (GACR) heterozygous individuals have possible clinical manifestations and to explore the potential pathogenic mechanism. In this retrospective study, we surveyed a two-generation pedigree of an individual diagnosed with GACR. Two family members underwent ophthalmological, hematologic, and genetic tests. An arginine-restricted diet with vitamin B6 supplementation was implemented; clinical assessments were repeated every 3 months during follow-up. Relative OAT mRNA expression was determined using real-time quantitative polymerase chain reaction. The 19-year-old compound heterozygous daughter (OAT: c.1186C>T; c.748C>T), had bilateral high myopia, posterior staphyloma, chorioretinal atrophy, macular abnormalities, and elevated hematologic ornithine. The 54-year-old heterozygous mother (OAT: c.1186C>T), presented with bilateral severe myopia, asymmetric posterior staphyloma, retina and choroidal capillary layer atrophy, retinal pigment epithelium abnormalities, and mildly elevated hematologic ornithine. Compared to normal individuals, the daughter and mother had 29% and 46% relative OAT mRNA expression, respectively (P<0.001). We believe that this is the first report of a carrier of one OAT variant allele with mild phenotypes, suggesting that family members should be aware of the possible involvement of autosomal recessive conditions. Additional data suggests nonsense mediated decay-initiated mRNA degradation may cause GACR.

This study analyses regional development in one of the poorest provinces in China, Guizhou Province, between 2000 and 2012 using a multiscale and multi-mechanism framework. In general, regional inequality has been declining since 2000. In addition, economic development in Guizhou Province presented spatial agglomeration and club convergence, which shows how the development pattern of one core area, two-wing areas and a contiguous area at the edge of the province have been developed between 2006 and 2012. Multilevel regression analysis revealed that industrialization and investment level were the primary driving forces of regional economic disparity in Guizhou Province. The influences of marketization and decentralization on regional economic disparity were relatively weak. Investment level reinforced regional economic disparity and the development of core-periphery structure in the province. However, investment level actually weakened the regional economic disparity in Guizhou Province when the variable of time was considered. In addition, both the topography and urban–rural differentiation were the two main reasons for forming a core-periphery structure in Guizhou Province.

Background: Ankle fractures, comprising about 10% of musculoskeletal injuries, pose a significant healthcare burden with an increasing incidence, particularly among an aging population. This study focuses on isolated Danis-Weber type B fractures. Recent trends lean towards surgical intervention for anatomical restoration, quicker recovery, albeit with associated complications. This report aims to assess the safety and efficacy of NewClip narrow locking plate system with early weight bearing in treating isolated fibular fractures. Methods: The study includes patients with Danis-Weber type B fractures surgically treated with NewClip narrow locking plate system. Exclusions involved nondisplaced fractures, open fractures, or those requiring additional fixation.Results: Fifteen patients were enrolled in this study. Minor complications, including wound swelling, were observed in two cases. The Visual Analogue Scale (VAS) for pain exhibited a steady decline postoperatively, with almost complete resolution by the third month. At three months, the FAOS demonstrated excellent results, and final follow-up at twelve months revealed complete osseous healing without complications.Conclusions: The use of this type of plates in treating isolated fibular fractures with early weight bearing shows promising results in terms of fracture healing, pain resolution, and functional outcomes warranting further investigation with larger cohorts.

During public health events, Active Mobility (walking and cycling) plays an important role in securing residents' travel. To enhance the resilience of urban transportation, this article integrates the travel environment elements for walking and cycling and constructs a travel environment for Active Mobility evaluation index system. This article uses survey data from the main urban area of Harbin in the context of the COVID-19 pandemic in May 2022, and combines the Gradient Boosting Decision Tree (GBDT) and Impact-Asymmetry Analysis (IAA) methods to analyze the satisfaction of the travel environment for Active Mobility. It proposes strategies for optimizing the travel environment for Active Mobility, ensuring residents' travel during public health events, guiding them to adopt Active Mobility, and improving urban transportation resilience. This research shows that Active Mobility can enhance urban transportation resilience. In addition, there are differences in resident demand for walking and cycling environments in the travel environment for Active Mobility. Residents are more concerned about the comfort of the walking environment, while they prioritize the convenience of the cycling environment.

Aim: To analysis the relationship between healthy adults right ventricular diameter (RVD) and geographical factors. Location: China’s 22 provinces, municipalities and autonomous regions. Methods: Using correlation analysis the relationship between RVD and nine geographic factors, build predictive models by factor analysis. Results: There is significant correlation between RVD and geographical factors, and the annual average temperature is most relevant geographical factors, a predictive model was built by factor analysis: Ŷ = 19.46 + 0.0007072X1 + 0.001034X2 -0.05412X3 -0.001405X4 -0.0006351X5 + 0.02903X6 + 0.01243X7 -0.01033X8 + 0.03816X9 ± 0.63. Then using Kriging interpolation interpolate the geographical distribution of Chinese healthy adult right ventricular diameter reference value in ArcGIS software. Main Conclusion: If geographic factors can be derived in anywhere of China, RVD can be calculated by the model, you can also get RVD from geographical distribution.

Smith-Magenis syndrome is a complex neurobehavioral genetic disorder. The spectrum of SMS phenotype is broad but commonly includes craniofacial, neurobehavioral, and otolaryngologic features. While the etiology of SMS is commonly attributed to one copy interstitial deletion in the 17p11.2 region (90-95% of cases), variants identified by sequence analysis in RAI1 have also been reported in 5-10% of cases. The phenotypic spectrum of patients with RAI1 sequence alterations is not clear. In this study, we report a 9-year-old male with global cognitive and psychomotor developmental delay, musculoskeletal and cardiovascular abnormalities, and dysmorphic craniofacial features. Whole genome quad analysis of the proband, unaffected parent, and unaffected brother identified a novel de novo RAI1:c.2736delC variant. This is the first report of this variant in the literature. This report also highlights the details of the genome analysis and this patient's phenotypic spectrum.

Background: Chronic kidney disease (CKD) is a significant cardiovascular (CV) risk factor, with dialysis-dependent CKD (DD-CKD) patients facing high mortality rates. Hypercholesterolemia is another crucial CV risk factor, typically managed with lipid-lowering therapy, though its efficacy in DD-CKD remains uncertain. Evidence shows mixed results regarding the benefits of statins in these patients. Citrate-based dialysates are known to reduce inflammatory biomarkers compared to acetate-based ones, potentially impacting lipid profiles and immune responses. This study aimed to determine the effects of citrate versus acetate dialysate on lipid profiles and immunophenotypes in DD-CKD patients. Methods: This unicentric, cross-over, prospective study included 21 hemodialysis patients (10 males, 11 females, average age 62.25 years). Each patient underwent 24 dialysis sessions (12 with each dialysate) and acted as their own control. Lipid profiles, immunological parameters, and nutritional and inflammatory markers were measured before the last session with each dialysate. Results: Compared to acetate dialysate (AD), citrate dialysate (CD) resulted in significantly higher LDL (75.71 vs. 67.05 mg/dL, p=0.042) and HDL (51.19 vs. 47.14 mg/dL, p=0.013), and lower TG (97.86 vs. 110.38 mg/dL, p=0.046). CD also led to higher NK cells (19.24 vs. 16.95%, p=0.035), higher complement C3 levels (115.14 vs. 107.81 mg/dL, p=0.009) and lower CD3+ CD8+ and CD16+56+ lymphocytes. Finally, total lymphocytes were lower with AD than with CD. We found no difference in predialysis nutritional nor inflammatory parameters (IL-6 and hs-CRP) except for ESR, which was higher when subjects used CD than AD. Conclusion: There are significant differences in lipid and immunophenotypic profiles that should increase the CV risk of patients who use CD. However, numerous studies have shown no differences, or even a benefit in mortality in certain HD subpopulations that use CD. Further studies are needed to understand if the observed changes may be counterbalanced by other mechanisms potentially provided by citrate (e.g., reducing vascular calcification).

Aiming at effectively generating safe and reliable motion paths for quadruped robots, a hierar-chical path planning approach driven by dynamic 3D point cloud is proposed in this article. The developed path planning model is essentially constituted of two layers: global path planning layer and local path planning layer. At the global path planning layer, a new method is proposed for calculating terrain potential field based on point cloud height segmentation. Variable step size is employed to improve the path smoothness. At the local path planning layer, a real-time prediction method for potential collision area and a strategy for temporary target point selection is developed. Quadruped robot experiments were carried out in an outdoor complex environment. The experi-mental results verified that, for global path planning, the smoothness of the path is improved and the complexity of the passing ground is reduced. The effective step size is increased by a maxi-mum of 13.4 times, and the number of iterations is decreased by up to 1/6, compared with the traditional fixed step size planning algorithm. For local path planning, the path length is short-ened by 20%, more efficient dynamic obstacle avoidance and more stable velocity planning are achieved by using the improved dynamic window approach (DWA).

Introduction: Peripheral neuropathies are very common and occur due to multiple causes including diabetes, tuberculosis, vasculitis, thyroid disorders, immune mediated diseases, vitamin B12 deficiency and drugs. Drug induced peripheral neuropathy (DIPN) is potentially irreversible, resulting in sensory deficits and paraesthesia. DIPN due to anti-tubercular drugs is common and can be implicated on linezolid, cycloserine and isoniazid.Case: 40-year-old female, diabetic with MDR-TB presented with severe, sharp, burning pain in her lower limbs. The patient was on all longer acting ATT drug regimen and was suspected with drug induced peripheral neuropathy. Conclusion: Linezolid, is used in treatment of tuberculosis and one of the major side effects includes peripheral neuropathy which is usually quite severe, presenting predominantly with sensory symptoms. Cessation of linezolid and neuropathic pain medications reduced the pain of patient from VCPS 8-10 to 1-2. Treatment of DIPN can be challenging as adverse drug reactions while treating tuberculosis should be kept in mind. It also warrants earliest treatment by identification of the drug in disguise and timely discontinuation of the drug.

A useful perioperative nutritional therapy for highly invasive esophageal cancer surgical cases needs to be developed. We clarified the usefulness of amino acid-enriched nutritional therapy using glutamine (Gln)/arginine (Arg)/calcium β-hydroxy-β-methylbutyrate (HMB) products on the short-term postoperative outcomes of minimally invasive esophagectomy for esophageal cancer. Altogether, 114 patients (Gln/Arg/HMB group) received perioperative nutritional therapy with Gln/Arg/HMB products, and we retrospectively investigated the change in nutritional parameters including skeletal muscle mass, occurrence of postoperative complications, and short-term postoperative outcomes in this group. The results were compared between the Gln/Arg/HMB and control groups (79 patients not receiving the Gln/Arg/HMB products). The incidence of all postoperative complications, sputum expectoration disorder, and pleural effusion of grade ≥III was significantly lower in the Gln/Arg/HMB group (62.0% vs. 38.6%, p = 0.001; 44.3% vs. 28.1%, p = 0.020; 27.8% vs. 13.2%, p = 0.011, respectively). The psoas muscle area and postoperative body weight was significantly higher at 1 month and 1 year after surgery in the Gln/Arg/HMB group than in the control group (93.5% vs. 99.9%, p < 0.001; 92.0% vs. 95.4%, p = 0.006). Perioperative amino acid-enriched nutritional therapy may improve the short-term postoperative outcomes, nutritional status, and skeletal muscle mass of esophageal cancer surgical patients.

Introduction: The aim is to investigate the possibility of altering the delusional perceptions of psychotic patients by exposing them to a cognitively flexible virtual environment. A flexible vir-tual reality (VR) environment could challenge and enhance the ability to adapt to changing situa-tions and generate novel solutions to core psychotic symptoms. Materials and methods: A systematic review was conducted using different combinations of keywords in different databases. This study was conducted using the PRISMA statement. Results: There is a growing literature on the use of VR to manipulate and normalise perceptual distortions in psychosis. Over the last decade, the number of published studies on VR in mental health has increased 14-fold. Conclusions: A cognitive flexibility virtual environment can alter delusional perception by ex-posing the person to different scenarios that require them to question their assumptions, test their hypotheses, and revise their beliefs. Commonly used biosensors measure heart rate, skin con-ductance and body temperature in relation to different emotional states. Recently, there has been a major shift towards the use of neuroimaging techniques to better understand the pathophysiology of mental disorders. This is where the new wave of biosensor-integrated virtual reality (VR) sys-tems comes in.

In this paper, we present a full coverage path planning (CPP) algorithm for the marine surveys conducted in the convex polygon shaped search area. The survey is supposed to carry out by torpedo-type AUVs (autonomous underwater vehicles). Due to their nonholonomic mechanical characteristics, these vehicles have nonzero minimum turning radius. For any given polygon shaped search area, it can always be partitioned into one or more convex polygons. With this in mind, this paper proposes a novel search algorithm called CbSPSA (Calculation based Shortest Path Search Algorithm) for full coverage of any given convex polygon shaped search area. By aligning the search inter-tracks alongside the edge with the minimum height, we can guarantee the minimum number of the vehicle’s turns. In addition, the proposed method can guarantee the planned path is strictly located inside the polygon area without overlapped or crossed path lines, and also has the total path length as short as possible. Considering the vehicle’s nonzero minimum turning radius, we also propose a sort of smoothing algorithm to smooth the waypoint path searched by CbSPSA so as for the vehicle to exactly follow it. The smoothed path is also guaranteed to be strictly located inside the polygon. Numerical simulation analyses are also carried out to verify the effectiveness of the proposed schemes.

Introduction: Parkinson’s disease (PD) patients harboring recessive gene variants exhibit a distinct clinical phenotype with an early disease onset and relatively mild symptoms. Data concerning individualized therapy for autosomal recessive PD forms are still scarce. Methods: Demographic and treatment data of a cohort of PD carriers of recessive genes (9 homozygous or compound heterozygous PRKN carriers, 4 Heterozygous PRKN carriers and 3 biallelic PINK1 carriers) were evaluated. Results: The average Levodopa Equivalent daily dose (LEDD) was 806.8±453.5 (range 152-1810) in PRKN carriers and 765±96.6 (range 660-850) in PINK1 carriers. The majority responded to low/moderate doses of Levodopa. The response to Dopamine Agonists (DA) was often favorable both as initial and longitudinal therapy. 8/13 PRKN and 1/3 PINK1 carriers were treated with amantadine successfully, and this also applied to patients who could not tolerate Levodopa or DA. Conclusions: In the era of personalized treatment, the therapeutic approach in recessive PD gene carriers might differ as compared to idiopathic PD. Lower LEDD doses were efficient even in patients with a very long disease duration, while a few patients were doing well without any Levodopa treatment decades after disease initiation. DA or amantadine could be used as a first and main line treatment regimen if well tolerated. Literature data on therapeutic strategies in carriers of pathogenic mutations in recessive PD genes, including device-aided treatments will be further discussed.

Objectives: Stress urinary incontinence (SUI) negatively affects the quality of life and sexual function in women. This study aimed to evaluate the efficacy of radiofrequency (RF) therapy in reducing SUI symptoms and its impact on sexual function. Methods: Thirty-four women with SUI were enrolled and underwent a single RF treatment session using the Viveve® System (Viveve Medical Inc., USA) with parameters of 90 J/cm² and 220 pulses per hour. Assessments at baseline and 6 months post-treatment included perineal ultrasound and personal interviews to evaluate lower urinary tract symptoms and sexual function. Urodynamic studies, voiding diaries, and questionnaires such as the Female Sexual Function Index (FSFI), Overactive Bladder Symp-tom Score (OABSS), Urogenital Distress Inventory-6 (UDI-6), Incontinence Impact Question-naire-7 (IIQ-7), and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) measured outcomes. Results: RF therapy significantly improved sexual function, with higher FSFI scores in all domains except pain at 6 months. SUI symptoms were significantly re-duced, as indicated by improved scores on OABSS, UDI-6, IIQ-7, and ICIQ-SF, alongside better voiding diary results. Anatomical changes included reduced bladder neck mobility, decreased vaginal width, and a reduced rotation angle of the proximal urethra. Conclusions: RF therapy is effective and safe for treating mild to moderate SUI and enhances sexual function, potentially due to changes in vaginal topography. These results suggest RF therapy as a viable non-surgical op-tion for managing SUI and improving sexual health.

Introduction Blunt carotid injuries (BCI) in pediatric trauma are quite rare. Due to the low number of cases, only a few reports and studies have been conducted on this topic. This review will discuss how frequent BCI/ BCVI on pediatric patients after blunt trauma is, what routine diagnostics look like, if a CT/ CTA scan on pediatric patients after blunt trauma is always necessary and if there are any negative health effects? Methods This literature review includes reviews, systematic reviews, case reports and original studies in english language between 1999 and 2020 that have dealt with pediatric blunt trauma and the diagnostics of BCI and BCVI. Furthermore, publications on the risk of radiation exposure on children were included in the study. For literature research, Medline (PubMed) and the Cochrane library were used. Results Pediatric BCI/ BCVI, shows an overall incidence between 0.03 – 0.5% of confirmed BCI/ BCVI cases due to pediatric blunt trauma. 1.1 – 3.5% of pediatric blunt trauma patients underwent CTA to detect BCI. Only 0.17 – 1.2% of all CTA scans shows a positive diagnosis for BCI. In children, the median volume CT dose index on a non-contrast head CT is 33 milligray, a computed tomography angiography needs at least 138 mGy. A cumulative doses of about 50 mGy almost triples the risk of leukemia, and doses of about 60 mGy triples the risk of brain cancer. Discussion Knowing that a BCI could have extensive neurologic consequences for children, it is necessary to evaluate routine pediatric diagnostics after blunt trauma. Computed tomography scans (CT) and computed tomography angiography (CTA) are mostly used in routine BCI diagnostics. However, since radiation exposure in children should be as low as reasonably achievable, it should be asked if other diagnostic methods could be used to identify risk groups. Trauma guidelines and clinical scores like the McGovern score are reflect established BCI screening options, as well as using duplex ultrasound.

Residential segregation refers to the phenomenon where people of different socioeconomic backgrounds live in spatially separated areas. It is essential to ensure equitable access to urban amenities for all residents in pursuit of the normative values in urban planning. To achieve this planning goal, the disparity in accessibility to urban amenities needs to be appropriately diagnosed. Private apartments and public rental apartments are representative types of residences where residential segregation is likely to occur in the context of South Korea, since these two types show considerable differences in the education, income, and occupations. The objective of this study is to develop an analysis framework for diagnosing the difference in accessibility to urban amenities between the two residential types, and to empirically demonstrate their utility in the planning process. The empirical analysis conducted on Seoul revealed that not only were there significant local variations in accessibility between the two segregated residential areas, but the overall differences across the entire area were also pronounced. The proposed framework is useful in supporting decision-making processes for locating new public facilities or identifying regional priorities for guiding the placement of private amenities, with the aim of mitigating differences between segregated residential areas.

Evans' Syndrome (ES) is a rare autoimmune disorder characterized by the simultaneous occurrence of immune thrombocytopenia (ITP) and autoimmune hemolytic anemia (AIHA). Thrombotic complications in ES patients are uncommon, particularly involving Buerger's Disease (BD). We report a case of a 49-year-old male with ES and a history of diabetes and heavy smoking, presenting with a necrotic wound on his right great toe. Diagnostic evaluations revealed severe stenosis and thrombosis in the lower limb arteries, diagnosed as BD. The patient underwent successful popliteal-tibioperoneal artery bypass surgery and subsequent disarticulation and revision of the distal phalanx, followed by the application of an acellular dermal matrix (ADM) to promote healing. Post-surgery, the patient showed significant improvement in blood flow and complete epithelialization without complications. This case highlights the importance of a multidisciplinary approach in managing complex wounds in ES patients, suggesting potential treatment pathways for future cases involving BD

The interconnection between the objectives of territorial development and the agro-ecological transition highlights the value of past knowledge in the sustainable management of resources and agro-ecological systems. However, retrospection in rural areas presents difficulties due to a lack of data. This paper contributes to the search for such knowledge from the past by developing an interactive methodology capable of combining heterogeneous sources of information and the activation of local collective memory. Its effectiveness is based on ensuring the interoperability of information and communication in an environment simultaneously shaped by geoinformatics and 3D geo-visualizations. This virtual environment fosters participation and interactivity, supported by representations of the paleo-landscape. Furthermore, synergies were achieved between information sources and their integration into local spatial systems. The application example involved identifying a rice field that existed from the 15th to the 19th century in Thessaly, Greece. It is an interesting case because the location and organization of cultivation in combination with its spatio-temporal coordination ensures the sustainable use of natural resources. It appears that the interplay between information and communication facilitates community participation and the activation of its collective memory as a source of information that enriches the search and local intelligence.

Elevated serum uric acid (sUA) is associated with risk of developing cardiovascular disease (CVD). Here, we examined the prognostic significance of sUA and exercise capacity in 411 Japanese adults (age, ≥65; mean, 81 years) hospitalized for worsening CVD. Mean sUA was significantly higher in the 23% of patients on an sUA-lowering agent than in those not. When the patients were stratified by sUA into three groups (7.0 mg/dL), the high sUA group had significantly worse peak VO2 and composite endpoint (rehospitalization due to worsening CVD and all-cause mortality) compared with low and moderate sUA groups (P < 0.001). When the patients were stratified by sUA into five groups (sUA 10.0 mg/dL), the incidence of the composite endpoint was significantly higher in the highest sUA group compared with that in the reference group, but only in women. Univariate Cox regression analysis, but not a multivariate analysis, indicated that sUA was significantly associated with the composite endpoint. Although sUA and exercise capacity may have some degree of prognostic significance in older patients with CVD, this significance may differ between men and women.

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

The benefits of cycling as a sustainable transportation mode are widely recognized. Cycling to work offers numerous advantages for individuals, employers, the environment, and society, ranging from improved physical health, wellbeing, and productivity to enhanced public health and reduced carbon emissions. Many governments around the world have implemented various policy measures, interventions, and initiatives to promote cycling. Some cities and towns have encouraged workplaces to provide bike-friendly amenities, such as secure bike parking/storage and shower and changing facility (referred to as end-of-trip facilities), to accommodate cyclists and motivate more employees to embrace sustainable transportation options. However, the presence or absence of such amenities has been found to both positively influence cycling behavior or deter some individuals from cycling to work. Despite the desirability of these amenities, the number of office buildings equipped with bike storage and shower/changing facility remains small, and their economic value is not well understood. In this paper, we aim to investigate whether the presence of cycling-supportive facilities could add value to office buildings. Specifically, we conduct a study using data from office buildings across England as of the end of 2021. We employ hedonic techniques to examine whether office buildings with bike storage and/or shower facility command a rent premium and whether the existence of a rent premium for bike storage and/or shower facility vary by location and across regions in England, independently from any premium associated with BREEM certification. We find that the buildings with bike storage and shower facility secure rent premiums respectively. The level of rent premiums varies with location and regions. The variations of premium are driven by the shortage of the supply of these facilities.

Patients with inflammatory bowel diseases (IBD), including both ulcerative colitis (UC) and Crohn's disease (CD), are at a higher risk of developing colorectal cancer (CRC). However, advancements in endoscopic imaging techniques, integrated surveillance programs, and improved medical therapies have led to a decrease in the incidence of CRC among IBD patients. Currently, the management of patients with IBD who have a history of or ongoing active malignancy is an unmet need. This involves balancing the risk of cancer recurrence/progression with the potential exacerbation of IBD if the medications are discontinued. The objective of this review is to provide an updated summary of the epidemiology, causes, risk factors, and surveillance approaches for CRC in individuals with IBD, and to offer practical guidance on managing IBD patients with history of previous or active cancer.

The persistence of symptoms following COVID-19 infection represents a significant challenge in healthcare management. During the outbreak, tele-rehabilitation emerged as a new tool to support healthcare structures in providing rehabilitation services. This study assessed the effectiveness and the feasibility of a 3-week home-based motor and respiratory rehabilitation program for long COVID-19 individuals after traditional rehabilitation. Twenty-three patients completed the program and underwent functional tests at different time points (i.e. baseline, after hospital discharge, and after tele-rehabilitation). Motor function was evaluated using the instrumented Six-Minutes Walking Test (i6MWT), with monitored heart rate and oxygen saturation. Conversely, respiratory function was measured via forced vital capacity (FVC) and maximal voluntary ventilation (MVV) tests. Significant improvements (p &lt; 0.05) in motor and respiratory function were observed throughout the intervention, including an 18.3% increase in walked distance from the baseline. The findings suggest that a home-based tele-rehabilitation can enhance motor and respiratory function in post-COVID patients. Despite limitations such as sample size and lack of control group, the positive outcomes seem to support the feasibility of the proposed tele-rehabilitation program in managing long COVID symptoms and promoting functional recovery. Further research is needed to validate these findings and explore tele-rehabilitation’s potential in broader patient populations.

The targeted compounds in this research, resveratrol analogs 1–14 were synthesized as mixtures of isomers by the Wittig reaction using heterocyclic triphenylphosphonium salts and various benzaldehydes. The planned compounds were those possessing the trans-configuration as the biologically active trans-resveratrol. The pure isomers were obtained by repeated column chromatography in various isolated yields depending on the heteroaromatic ring. It was found that butyrylcholinesterase (BChE) was more sensitive to the heteroaromatic resveratrol analogs than acetylcholinesterase (AChE), except for 6, the methylated thiophene derivative with chlorine, which showed equal inhibition toward both enzymes. Compounds 5 and 8 achieved the highest BChE inhibition with IC50 values of 22.9 and 24.8 μM, respectively. The same as with AChE and BChE, methylated thiophene subunits of resveratrol analogs showed better enzyme inhibition than unmethylated ones. Two antioxidant spectrophotometric methods, DPPH and CUPRAC, were applied to determine the antioxidant potential of new heteroaromatic resveratrol analogs. Molecular docking of these compounds was conducted to visualize the ligand-active site complexes' structure and identify the non-covalent interactions responsible for the complex's stability, which influence the inhibitory potential. As ADME properties are crucial in developing drug product formulations, they have also been addressed in this work. The potential genotoxicity is evaluated by in silico studies for all compounds synthesized.

Fatigue and dyspnea are the most commonly presented long-term complaints in individuals previously infected with SARS-CoV-2. The purpose of the study was to comprehensively evaluate diaphragm muscle function in COVID-19 survivors, as well as investigate whether potential diaphragm dysfunction will contribute to physical functioning impairment. 46 patients qualified to pulmonary rehabilitation were examined. Diaphragm muscle function parameters were evaluated using ultrasonography, while severity of dyspnea, aerobic capacity and amount of energy used by the body during physical activity were assessed by 6-minute walk test, mMRC scale and Metabolic Equivalent Task (MET), respectively. We identified 69.5% patients with diaphragm atrophy and 6.5% with diaphragm paralysis. Percentage of atrophy was not related to age, gender, BMI index, oxygen therapy use during COVID-19 infection course and severity of disease. Patients with presence of cough, fever and without loss of smell during COVID-19 course had a significantly greater values of diaphragm inspiratory thickness, while patients with cough and no smell disorders had a significantly lower percentage of diaphragm atrophy. Diaphragm functional parameters were strongly associated with selected variables of person's exercise tolerance, such as distance in 6-minute walk test, saturation level, fatigue and exertion in Borg scale. In conclusion, diaphragm muscle dysfunction is a serious long-term post-COVID aftermath and can be viewed as a major contributing factor of prolonged functional impairments.

Background: We evaluate the genetic and phenotypic features of a cohort of 12 Italian patients affected by Retinitis Pigmentosa (RP) associated with RP1 sequence variants.; Methods: Retrospective, single center study (Careggi Hospital, Florence), including a cohort of twelve Italian patients (Five male and seven female) affected by RP carrying pathogenic variants of the RP1 gene. A complete ophthalmic assessment and pedigree analysis was conducted with focus on the onset of disease symptoms, the patient’s age at the first diagnosis, the follow up duration and the possible presence of comorbidities; Results: The mean age at onset of symptoms was 31,0 ± 24,1 years old, with a mean follow-up period of 9,1± 2,4 years. The main symptoms at presentation were hemeralopia and visual field constriction. Fundus evaluation revealed a classic type of RP. Fundus autofluorescence (FAF), Optical Coherence Tomography (OCT), Electroretinogram (ERG), and visual field confirmed in most of the cases the typical features of classic retinitis pigmentosa.; (4) Conclusions: This single-center cohort of Italian patients provided information on the clinical and genetic features of RP1-associated RP. By comprehensively clarifying the genetic variations and their associated clinical manifestations, we can better tailor therapeutic interventions aimed at targeting specific genetic abnormalities. This ultimately promises to improve the prognosis and quality of life for individuals with RP-associated RP1.

Agriculture is a vital component of Egypt's economy; therefore, using Digital Elevation Models (DEMs) in agricultural planning in Egypt has significant benefits regarding water management, site appropriateness assessment, flood risk mitigation, and infrastructure construction. It is also essential for planners to make more informed decisions, optimize resource allocation, and support sustainable farming practices. This research paper investigates the accuracy of obtaining DEM data from four free global models (STRM30, ALOS30, COP30, and TanDEM-X90). The global DEM data has been compared to an actual GNSS-RTK DEM data surveyed onsite for two agricultural block areas in Aswan, the southern Government of Egypt. The two blocks are a part of a national project. For Block I and II, the RMSE of the Model STRM30 was 2.92 m and 3.59 m, respectively, indicating a poorer solution. Regarding accuracy, the ALOS30 model ranks third, reporting an RMSE of 2.58 m for block II and 3.30 m for block I. COP30 has an RMSE value of 1.06 m for blocks I and II and.91 m overall. TanDEM-X90 is the most accurate model in this investigation; block I provided an RMSE of 0.90 m with an SD of 0.58 m (SD95% = 0.38 m). After removing the anomalies, the model's stated RMSE for block II was 0.34 m, with an SD value of 0.62 m and 1.03 m. According to the classification using machine learning algorithms, with an accuracy of 84.7% for block I and 85% for block II, TanDEM-X90 is the best solution.

Adenomyosis, a benign gynecological condition characterized by the infiltration of endometrial tissue into the myometrium, poses significant challenges to women's reproductive health. Recently, the landscape of adenomyosis diagnosis transformed significantly, thanks to advancements in imaging technologies such as transvaginal ultrasound and magnetic resonance imaging. This lead to a noticeable shift in the demographic profile of patients diagnosed with adenomyosis, including younger women of reproductive age who frequently present with a diverse array of symptoms. Approximately 20% of women are affected by adenomyosis. Adenomyosis manifests with various subtypes, distinct epidemiological profiles, symptomatology, and treatment responses, necessitating tailored approaches for optimal management. Despite its clinical significance, adenomyosis remains understudied, resulting in a significant disparity in research and literature compared to other gynecological conditions. The severity of adenomyosis is compounded when coexisting with endometriosis, particularly deep infiltrating endometriosis (DIE), leading to exacerbated fertility issues and severe symptomatology. The wide range of symptoms, including adverse pregnancy outcomes such as pre-eclampsia, highlights its wider impact and emphasizes the need for increased awareness of the condition. Furthermore, Adenomyosis is frequently associated with treatment failure in endometriosis, contributing to dienogest resistance, elevated discontinuation rates, and persistent pain post endometriosis surgery. Additionally, the lack of specific treatments tailored to adenomyosis poses a considerable challenge in clinical management.

(1) Background: As part of the Scottish Governments five-year recovery plan to address the backlog in NHS care following the COVID-19 pandemic, community pharmacies in Scotland are planned to provide a Hospital Discharge Medicines Supply and Medicines Reconciliation Service. We aimed to qualitatively explore patients’ experience of this new service; (2) Method: Adult patients (≥18yrs age) who consented to participate in the Community Pharmacy Hospital Dis-charge and Medicines Reconciliation Service were invited for interview within 21 days of dis-charge from hospital. Qualitative, one-to-one, semi-structured, patient interviews were conducted by telephone and audio-recorded using Microsoft Teams®. The interview audio recordings were transcribed verbatim and underwent thematic analysis; (3) Results: 12 patients were inter-viewed, evenly split by sex and with a median age of 62 years (range; 36 to 88 years). Analysis generated main five themes; Patient Engagement, Stakeholder Communication, Practical Factors, Human Factors, and Comparative Experiences. Many of these were interdependent; (4) Con-clusions: Patients appreciated that the service ensured a quicker discharge from hospital. Good stakeholder communication, practical factors (including choice, location, and the realities of ob-taining their medication from the community pharmacy), and a pre-existing and trusted rela-tionship in their usual community pharmacy were the key factors that regulated the patient ex-perience. In the main, patients were positive about the introduction of this new service. However, a lack of previous relationship or trust with a community pharmacy, and previous experiences with medication supply problems were factors which had the potential to negatively impact on patient experiences.

The marine region of the Zhongjieshan Islands is an essential component and location for enhancement and release in Zhoushan Fishing Ground. The scientific assessment of the target species' ecological carrying capacity serves as the foundation for augmentation and release efforts. Based on data from the 2021-2022 survey of biological resources in the waters of Zhongjieshan islands, the Ecopath model was built to analyze the trophic structure, energy flow, and overall characteristics of the ecosystem, as well as the ecological carrying capacity of the main enhancement and releasing species, Larimichthys crocea and Sepiella maindroni. The ecosystem's functional groups had trophic levels ranging from 1 to 3.48, with an average energy transfer efficiency of 8.11% and total flow of 2125.905 t·km-2. The ratio of total primary output to total respiration is 1.713. Zhongjieshan Islands' ecosystem was currently at an embryonic stage. The ecological carrying capacity of Larimichthys crocea and Sepiella maindroni was calculated to be 0.2325 t·km-2 and 0.1617 t·km-2, separately or individually. Larimichthys crocea and Sepiella maindroni showed enormous potential for development and release. The findings offered essential data for ecological studies on the waters of Zhongjieshan Islands, as well as a reference for enhancement and release efforts in this area.

The RECONNECT project tackles the fragmentation in Ireland's public healthcare systems, aiming to improve service planning and delivery. It integrates complex systems within the Health Service Executive (HSE) for chronic disease management, prioritizes data privacy, and supports future digital resource integration. The methodology includes: (1) structural integration via a Federated Database design to maintain system autonomy while ensuring privacy; (2) semantic integration through a Record Linkage module to enable integration without individual identifiers; and (3) adoption of the HL7-FHIR framework for high interoperability, aligning with the national electronic health record (EHR) and the Integrated Information Service (IIS). The RECONNECT system is unique in Ireland, featuring a generic architecture for loosely coupled systems, adherence to HL7-FHIR for interoperability, efficient reuse of digital assets, and a robust privacy layer. A demonstration system using synthetic data from the Hospital Inpatient Enquiry (HIPE) and Chronic Disease Management (CDM) systems is implemented on Neo4j for visualization.

Water networks are critical infrastructure components, ensuring the continuous supply of high-quality drinking water to consumers. To secure such water supply, regular maintenance, including the replacement of deteriorating pipelines, is essential. In this study, a methodology has been developed for determining optimal pipeline replacement solutions in water supply systems at water utilities with limited data availability. Hydraulic analysis has been conducted on the segment of 25 km of the water supply network using the free software EPANET. Applying water network optimization, eight pipeline replacement projects according to 13 pre-defined criteria have been identified and evaluated. The paper outlines the methods for evaluating the criteria, including defining specific quantitative limits. The Analytical Hierarchical Process (AHP) method was used in the paper to determine the weights of the criteria. The reason for applying this method refers to problems that involve a set of criteria with a mixed structure, including both quantitative and qualitative aspects. Also, the paper describes the steps of the multi-criteria optimization method VIKOR, used to select the optimal project. This paper, considered as case studie, describes a method, i.e. application of a new principles and an innovative way to solve a problem for developing countries.

Background: This study attempted to construct musculoskeletal JEM using KWCS data and use it to evaluate the burden of these disorders in Korean workers. Methods: This study was conducted using data from the second to the sixth KWCS, and a total of 210,500 people were included. The jobs of the subjects were reclassified based on the unit groups of the 7th Korean Standard Classification of Occupation (KSCO). The intensity of exposure to work-related risk factors for musculoskeletal disorders was classified into ‘high’, ‘moderate’, and ‘low’ for the body segments involving the ‘upper extremities and neck’, ‘lower back’, and ‘lower extremities’. Results: The time of exposure was longest in the standing posture and repetitive hand and arm movements. An analysis of the intensity of exposure by body segments revealed that the highest intensity of exposure was to the upper extremities. For the upper extremities and neck, and the lower back, there was a exposure-response relationship in the association between intensity of exposure and musculoskeletal symptoms. However, for the lower extremities, there was a exposure-response relationship only at high exposure. Conclusion: In this study, a JEM for work-related risk factors for musculoskeletal disorders was constructed for the first time in Korea. The intensity of exposure to musculoskeletal risk factors was estimated for each occupation. The JEM constructed in this study is expected to have high applicability for assessing the risk of musculoskeletal disorders for each job with respect to the upper extremities and neck, and lower back.

Introduction: Treating elbow fracture-dislocation is a challenge, especially in the situation of basal-coronoid trans-ulnar fracture. The study ams to explain whether or not the minimal invasive surgery (MIS) would be feasible in elbow dislocation with coronoid fracture. Materials & Methods: At Taipei Veterans General Hospital, patients who had elbow dislocations with coronoid process fractures underwent single one surgeon’s MIS techniques which included the fluoroscopy-guided ulnar anteromedial (FGUAM) approach in the stage of reducing coronoid process. When there is a proximal ulnar fracture, the posterior incision should be necessary, followed by the incision over the lateral or medial elbow in treating radial fractures or ligament injuries. Results: The Flow Diagram about approach recommendation was established in base of defining MIS as not to do cross-plane dissection. Anteriorly rigid fixation for the coronoid process was also emphasized. Conclusions: MIS can be achieved by multiple limited surgical incisions. However, if there is an unstable ulnar metaphysis or ligament avulsion fracture, the posterior approach has to be extended and the so-called MIS fails to be established.

Methylmalonic acidemia (MMA), propionic acidemia (PA), and cobalamin C deficiency (cblC) share a defect in propionic acid metabolism. In addition, cblC is also involved in the process of homocysteine remethylation. These three diseases produce various phenotypes and complex downstream metabolic effects. In this study we used an untargeted metabolomics approach to investigate the biochemical differences and the possible connections with the pathophysiology of each disease. Untargeted urine metabolomic profiles of 21 patients (7 MMA, 7 PA, 7 cblC) were identified through statistical analysis (p&lt;0.05; log2FC &gt;|1|) and then used for the annotation. Annotated features were associated with different metabolic pathways potentially involved in the diseases development. Comparative statistic showed markedly different metabolomic profiles between MMA, PA and cblC, highlighting characteristic species for each disease. The most affected pathways were related to the metabolism of organic acids (MMA, PA, cblC), amino acids (MMA, PA, cblC), glycine and its conjugates (PA), transsulfuration pathway (cblC), oxidative processes (cblC) and neurosteroid hormones (cblC). The untargeted metabolomics study highlighted the presence of significant differences between the three diseases, pointing to the most relevant contrast of cblC profile compared to MMA and PA. Some new biomarkers are proposed for PA, while novel data regarding the alterations of steroid hormone profiles and biomarkers of oxidative stress were obtained for cblC disease. The elevation of neurosteroids in cblC may indicate a potential connection with the development of ocular and neuronal deterioration.