Search

Background and aims: This study aimed to investigate healthcare professionals (HCPs) preparedness to continue using telehealth beyond the COVID-19 pandemic, to examine the perceived ability of HCPs to appraise the reliability of online information sources (digital literacy) and, to examine whether a relationship exists between this and preparedness to continue using telehealth. Methods: Single-site cross-sectional survey of HCPs in an outpatient and community therapy setting. The survey was based on a rapid literature review guided by the Theory of Planned Behaviour and Technology Acceptance Model. Descriptive statistics were used to summarise participant demographics, preparedness for telehealth, and digital literacy (based on confidence in appraising online information). Multivariable logistic regression assessed the associations between preparedness to continue using telehealth, the ability to evaluate online information sources, and demographic variables. Results: A total of 783 HCPs were invited, 310 responded, with 287 participants included in the final analysis (37% response rate excluding incomplete surveys). The analysis shows that 54.8% of participants preferred to return to in-person care. Preparedness to continue telehealth varied by profession and clinical activity, with medical professionals and script provision showing the highest readiness for continued telehealth use and allied health professionals the least likely to continue using telehealth (36%). Most (89%) of HCPs felt confident identifying reliable online information sources and there was no relationship between perceived ability to evaluate online information and preparedness to use telehealth. Conclusion: Results suggest hesitancy amongst allied staff toward continued telehealth use post the pandemic, which may be due to the type of care they provide. Future studies on technologies that support HCPs in providing more intensive virtual care would be of benefit.

Childhood physical activity sets the foundation for health. While we know many factors that contribute to physical activity, there are limitations in our knowledge, especially in early childhood. Through our review, we identify gaps in existing datasets to guide future research.

Abstract Aim To explore the effectiveness and acceptability of a pilot mentoring program for alcohol and other drug (AOD) nurse practitioners (also known globally as addiction nurse practitioners). Design Mixed method evaluation. Methods Two‐phase evaluation comprising survey (demographics, pre‐ and post‐program perceived competency and confidence) with 15 participants completing the pre survey and 10 participants completing the post survey, and qualitative interviews after the program with 10 participants. Results The quantitative results indicate statistically significant increases in some domains of perceived competence and confidence in treatment. Qualitative findings indicate that participants valued peer support and mentoring from experienced nurse practitioners. Where formal residency or internship programs for nurse practitioners do not exist, informal mentoring programs may address issues inherent in nurse practitioner transition that may impact retention. We recommend further exploration of mentoring programs with larger sample sizes to determine if self‐reported clinical improvements are noted. Implications for Profession and/or Patient Care Nurse practitioners are a vital part of the healthcare system; their advanced skills and knowledge place them in an ideal position to address prescriber shortages and access to care for populations underserved by healthcare. However, literature indicates that they are often underutilised, and transition to autonomous practice remains a challenge. Our exploration of a pilot mentoring program for nurse practitioners shows that their knowledge and perceived skills are high, yet peer assistance is valued in transitioning from advanced practice registered nurse to autonomous nurse practitioner. We recommend further trialling and evaluation of nurse practitioner mentoring programs to both increase supply of nurse practitioners and provide greater access to quality healthcare for underserved populations. Impact What problem did the study address? The ability of nurse practitioners to offer advanced practice interventions such as diagnosis and medication management potentially provides a solution to healthcare resource shortages. However, current literature indicates that advanced nurses transitioning to nurse practitioner roles suffer transition shock, leading to burnout and poor retention. What were the main findings? Although this pilot mentoring program shows significant improvements in survey responses on confidence and capability, qualitative data shows that neophyte nurse practitioners value peer support and mentoring from more experienced practitioners. Participants described maintaining ongoing connections with both mentors and fellow mentees, which aided transition to the role of autonomous nurse practitioner. Where and on whom will the research have an impact? The results of this pilot mentoring program indicate that there is benefit to these programs for neophyte nurse practitioners in many specialties. This paper indicates that mentoring programs for nurse practitioners may provide a community of practice and may have a positive impact on transition shock. Reporting Method Good Reporting of a Mixed Methods Study (GRAMMS) checklist. Patient or Public Contribution No patient or public contribution.

Background. This study investigated the association between periodontitis and organic erectile dysfunction (ED) in a sub-Saharan population. Methods. This multicenter analytical study lasted from April to September 2021. A total of 114 patients (38 cases and 76 controls) were recruited and matched on age, diabetes, and smoking status. Medical history and ED were recorded, as well as the plaque index, bleeding index, maximum interdental clinical attachment loss (CALmax), maximum probing depth, clinically detectable furcation involv ement, number of teeth in the mouth, number of teeth lost for periodontal reasons, and tooth mobility. The analysis was performed with SPSS 20.0 with a significance threshold set at 5%. Results. The two study groups were comparable regarding sociodemographic characteristics. Periodontitis was present in 76.31% of cases and 75% of controls without a significant difference (P=0.878). Logistic regression showed a significant association between high blood pressure and ED with an OR=4.78 (95% CI: 1.80‒12.70). Periodontitis was not associated with ED (OR=1.52, 95% CI: 0.55‒4.16); however, severe periodontitis was significantly associated with severe ED (OR=1.44, 95% CI: 1.11‒1.85, and OR=1.68, 95% CI: 1.15‒2.44, respectively for CALmax and tooth loss). Conclusion. Within the limits of this study, periodontitis was not associated with organic ED. However, the severity of periodontal disease significantly increased in patients with organic ED.

With a vibrant economic development, Greater Kampala Metropolitan Area (GKMA) would need to boast low-carbon electricity generation, reduce carbon emissions, and re-structure transportation, yet having no energy management plan. The main objective of this study is to develop a comprehensive framework for analyzing energy impacts and macroeconomic effects of low-carbon scenarios and to identify a sustainable pathway towards 2050 for GKMA. The study uses TIMES/CGE hybrid framework to address the knowledge gap in 4 scenarios. Business as usual is the reference case with Kabejja (20% CO2 abatement), Carbon-Tax (100$/ton), and Lutta (95% CO2 abatement) as alternative scenarios. The analysis shows an increase in consumption from 139.6PJ to 469.35PJ and carbon emissions from 4.6mtns to 7mtns in the reference case. However, consumption and carbon emissions decrease in all the alternative scenarios compared to the reference case. The GDP and equivalent variation (EV) in household welfare increase in all alternative scenarios compared to the reference case. Lutta promises a 60.6% reduction in the carbon emissions intensity of GDP to be realistic. Sustainability is achievable when low-carbon electricity becomes the major contributor to the demand by fuel type, optimization of the total primary energy supply, and construction of an electrified Kampala metro. Transportation, Industrial and Residential sectors are the greatest emitters of CO2 by sector in all scenarios and thus need policy interventions to realize deep CO2 emissions reductions. The study recommends that Lutta guarantee a sustainable low-carbon footprint for GKMA.

This research addresses the inefficiencies of manual garbage data management by developing a dual-platform system: a website-based application for Garongan Asri Garbage Bank staff and a mobile application for customers. Utilizing the waterfall method for systematic development, the project involved stages of analysis, design, coding, testing, support, and maintenance. Key technologies used include the Bootstrap framework, Visual Studio Code, Android Studio, and MySQL database. The resulting website application enables staff to efficiently manage garbage data, while the mobile app allows customers to access their disposal history. The effectiveness of these applications was confirmed through black box testing, demonstrating their functionality and suitability for improving garbage data management and customer service.

Background: Age-related macular degeneration (AMD) is a complex eye disorder with an environmental and genetic origin, affecting millions worldwide. The study aims to explore the association between retinal morphology and the polygenic risk score (PRS) for AMD using fundus images and deep learning techniques. Methods: The study used and pre-processed 23,654 fundus images from 332 subjects (235 patients with AMD and 97 controls), ultimately selecting 558 high-quality images for analysis. The fine-tuned DenseNet121 deep learning model was employed to estimate PRS from single fundus images. After training, deep features were extracted, fused, and used in machine learning regression models to estimate PRS for each subject. The Grad-CAM technique was applied to examine the relationship between areas of increased model activity and the retina’s morphological features specific to AMD. Results: Using the hybrid approach improved the results obtained by DenseNet121 in 5-fold cross-validation. The final evaluation metrics for all predictions from the best model from each fold are MAE = 0.74, MSE = 0.85, RMSE = 0.92, R2 = 0.18, MAPE = 2.41. Grad-CAM heatmap evaluation showed that the model decisions rely on lesion area, focusing mostly on the presence of drusen. The proposed approach was also shown to be sensitive to artifacts present in the image. Conclusions: The findings indicate an association between fundus images and AMD PRS, suggesting that deep learning models may effectively estimate genetic risk for AMD from retinal images, potentially aiding in early detection and personalized treatment strategies.

A precursor feeding strategy was used for the first time in agitated microshoot cultures of Aronia × prunifolia. This strategy involved the addition of biogenetic precursors of simple phenolic acids (phenylalanine, cinnamic acid, and benzoic acid) and depsides (caffeic acid) into the culture media, with an assessment of its effect on the production of these bioactive compounds. The in vitro cultures were maintained in Murashige–Skoog medium (1 mg/L BAP and 1 mg/L NAA). Precursors at five concentrations (0.1, 0.5, 1.0, 5.0, and 10.0 mmol/L) were fed into the medium at the time of culture initiation (point “0”) and independently on the 10th day of growth cycles. The contents of 23 compounds were determined in methanolic extracts of biomass collected after 20 days of growth cycles using an HPLC method. All extracts contained the same four depsides (chlorogenic, neochlorogenic, rosmarinic, and cryptochlorogenic acids) and the same four simple phenolic acids (protocatechuic, vanillic, caffeic, and syringic acids). Chlorogenic and neochlorogenic acids were the predominant compounds in all extracts (max. 388.39 and 263.54 mg/100 g d.w.). The maximal total contents of all compounds were confirmed after feeding with cinnamic acid (5 mmol/L, point “0”) and caffeic acid (10 mmol/L, point “0”), which caused a 2.68-fold and 2.49-fold increase in the contents of the estimated compounds vs. control cultures (603.03 and 558.48 mg/100 g d.w., respectively). The obtained results documented the efficacy of the precursor feeding strategy in enhancing the production of bioactive compounds in agitated cultures of A. × prunifolia and suggest a potential practical application value.

Large scale changes in biodiversity and conservation management require long-term goals and planning across multiple sectors in the face of increasing global change. Major trends in land use and management interventions, species additions or losses, and climate are well recognized, but responses are still often short-term and fragmented across agencies and sectors. Scenario-building can be a powerful tool to imagine possible futures, integrating across sectors and disciplines and promoting long-term thinking and planning. As an interdisciplinary team of experts, we developed potential scenarios for a range of future environmental conditions. The scenarios explored: increasing land ownership and stewardship of land by indigenous peoples (Māori); widespread afforestation using native tree species; national-scale eradication of invasive mammalian predators; and increasing frequency of extreme weather events. We explored the implications of these globally-relevant trends at a national scale using Aotearoa New Zealand as our study system. Detailed descriptions of these scenarios were developed by experts using environmental, economic, social science and policy lenses. Across scenarios several common themes were consistently highlighted, including the importance of land use in driving other conservation outcomes. How the value of ecosystem services is recognized and prioritized was also important to a wide range of outcomes. Furthermore, each scenario presented both opportunities and risks to equality, indigenous empowerment and human capital, emphasizing the importance of good policy responses to maximize benefits and minimize unintended harm. These scenarios will be used to stimulate new questions and ideas for biodiversity conservation and management, such as considering the implications of different potential futures for the management of biological invasions. This approach is explicitly designed to be generalisable across different sites or regions and provides a method for considering the implications of potential future changes for a broad range of disciplines or needs.

Background: Age-related macular degeneration (AMD) is a multifactorial disease encompassing a complex interaction between aging, environmental risk factors, and genetic susceptibility. The study aimed to determine whether there is a relationship between the polygenic risk score (PRS) in patients with AMD and the characteristics of the retinal vascular network visualized by optical coherence tomography angiography (OCTA). Methods: 235 patients with AMD and 97 healthy controls were included. We used data from a previous AMD PRS study with the same group. The vascular features from different retina layers were compared between the control group and the patients with AMD. The association between features and PRS was then analyzed using univariate and multivariate approaches. Results: Significant differences between the control group and AMD patients were found in the vessel diameter distribution (variance: p = 0.0193, skewness: p = 0.0457) and fractal dimension distribution (mean: p = 0.0024, variance: p = 0.0123). Both univariate and multivariate analyses showed no direct and significant association between the characteristics of the vascular network and AMD PRS. Conclusions: The vascular features of the retina do not constitute a biomarker of the risk of AMD. We have not identified a genotype–phenotype relationship, and the expression of AMD-related genes is perhaps not associated with the characteristics of the retinal vascular network.

Plant hypocotyl elongation response to light and temperature. Here the authors show that shade combined with warm temperature synergistically enhances the hypocotyl growth response via the PIF7 transcription factor, auxin, and as yet unknown factor.

Abstract PCR-based diagnostics generally require nucleic acid extraction from patient specimens prior to amplification. As highlighted early in the COVID-19 pandemic, extraction steps may be difficult to scale during times of massive demand and limited reagent supply. Forgoing an extraction step, we previously reported that the N1 primer/probe-set of the widespread CDC COVID-19 assay maintains high categorical sensitivity (95%) and specificity (100%) with direct inoculation of viral transport media (VTM) into qRT-PCR reactions. In contrast, the N2 set demonstrated a prominent Ct delay and low sensitivity (33%) without extraction. In the current study, we have improved the performance of this modified CDC assay (in particular the N2 set) by incorporating N1/N2/RNase P multiplexing and dissecting the effects of annealing temperature, VTM interference, and inoculum volume. The latter two factors exerted a more prominent effect on the performance of N2 than N1, although these effects were largely overcome through elevated annealing temperature. This unextracted/multiplex protocol was evaluated with 41 SARS-CoV-2 positive and 43 negative clinical samples, demonstrating a categorical sensitivity of 92.7% and specificity of 100% versus the unmodified CDC methodology. Overall, this work offers a generalizable strategy to maximize testing capabilities for COVID-19 or other emerging pathogens when resources are constrained.

This paper builds upon qualitative research in El Museo del Bucardo – The Bucardo Museum – an exhibition space in the village of Torla, high in the Spanish Pyrenees. The bucardo was declared extinct on 6 January 2000 and rose to international fame three years later when scientists in Zaragoza delivered a bucardo clone; this event is commonly portrayed around the world as ‘the first de-extinction’. Taxidermic remains of the last bucardo were absent from public view for years, yet they finally returned to Torla in 2013 following years of campaigning from local activists, and El Museo del Bucardo was founded. I draw upon interviews and archival material to present an environmental history of the bucardo as told through the lens of the museum, one which sets out to ‘recover memory’ and institutionalize the bucardo’s legacy. In the museum, bucardo afterlives continue to shape understandings of situated Pyrenean wildlife. I examine El Museo del Bucardo’s role in generating meaning in an epoch characterized by mass extinction and the spectacle of technofixes in the form of de-extinction science.

Bony stabilization procedures are a reliable solution for recurrent shoulder instability, but have a steep learning curve due to technical difficulties. Meticulous capsular closure is critical and can be augmented with suture anchor constructs. In addition, although fracture or fragmentation of the coracoid graft is relatively uncommon, it is devastating. Here, we describe the use of additional circumferential suture fixation to improve compression across the graft/glenoid interface and help mitigate the risk of fracture bony augmentation procedures

The rapid development associated with Next Generation Tobacco Products (NGTP) has necessitated the development of high throughput methodologies to test their genotoxic potential in vitro when compared to conventional cigarette smoke (CS). An assessment of two Vitrocell® Mammalian 6/48 exposure modules in three independent experiments was made by comparing results from multiple dosimetric techniques applied to aerosol generated from 3R4F Kentucky Reference cigarettes, commercially available electronically heated tobacco product (eHTP) and Electronic Nicotine Delivery System (ENDS) using the Vitrocell® VC10®. Real-time aerosol particle concentration was assessed by means of light scattering photometers and expressed as area under the curve (∑AUC). Nicotine concentrations were determined analytically by LC/MS. Humectant amount and distribution was assessed for eHTP and ENDS by the quantification of free glycerol in a phosphate buffered saline (PBS) trap, whereas total particulate matter (TPM) was assessed in the 3R4F cigarettes by the fluorescence of the particulate at 485 nm in anhydrous dimethyl sulfoxide (DMSO) trap within the exposure. Dose was adjusted by means of the addition of ambient air to dilute the whole smoke/aerosol in L/min and sampled into the system at a rate of 5 mL/min. Dilution of CS ranged from 8.0 to 0.5 L/min and for the eHTP and ENDS ranged from 4 to 0 L/min (undiluted). Dosimetric analysis of the system showed good concordance within replicates (p-values ranged from p = 0.3762 to p = 0.8926) and showed that the Vitrocell® Mammalian 6/48 is a viable means for genotoxic assessment of aerosol generated from both conventional cigarettes and NGTP. Results demonstrate the need to tailor dosimetry approaches to different aerosols due to variations in the physio-chemical composition, with a multi-dosimetry approach recommended.

We introduce and discuss the concept of n-ary K-increasing fusion functions and n-ary K-increasing aggregation functions, K being a subset of the index set {1,…,n} indicating in which variables a considered function is increasing. It is also assumed that this function is decreasing in all other variables. We show that each n-ary K-increasing aggregation function is generated by some aggregation function which enables us to introduce and study the properties of n-ary K-increasing aggregation functions related to the properties of their generating aggregation functions. In particular, we also discuss binary K-increasing aggregation functions, including fuzzy implication and complication functions, among others.

With steadfast economic development, the Greater Kampala Metropolitan Area (GKMA) faces increasing pressures to raise low-carbon electricity in the energy consumption by fuel type, abate CO2 emissions, and also restructure transportation for sustainability. GKMA is Uganda’s capital with rampant anthropogenic interference that causes climate change. A sustainable energy portfolio is a low-carbon scenario endowed with CO2 emissions abatement strategies for GKMA towards 2050. Using TIMES-VEDA to address the knowledge gap, the study develops and examines a sustainable energy portfolio for GKMA. TIMES-VEDA is an engineering model generator with a bottom-up approach, paying in-depth attention to low-carbon themes while optimizing energy management systems. The analysis shows that sustainability is plausible by optimizing the total primary energy supply, electrical power production from PV-solar & hydropower technologies, and switching 90% of passengers of the road category to the Kampala metro.

A common forgery technique is to use molds to create a suite of objects. This article introduces a new technique to identify objects made with the same mold through the comparison of 3D models created using structured light scanning (SLS). SLS data, when analyzed with CloudCompare or other point cloud processing software, provides quantitative data on the variation between models that can be visualized in scalar fields. Inexpensive, adaptable, and non-destructive, the technique produces a digital signature for a mold that can be used to identify matching examples within a collection and be circulated between institutions. We demonstrate this technique on three forgeries of Zapotec urns from Oaxaca, Mexico, in the collection of the Royal Ontario Museum that were created in the early twentieth century AD.

Greater Kampala Metropolitan Area (GKMA) is Uganda's capital facing increasing pressures to raise electricity generation and also mitigate CO2 emissions. A low-carbon electrification of the GKMA energy policy is proposed for sustainability. But the macroeconomic effects of this policy are unknown. The study uses a multi-sector, single region, static GKMA-CGE model to address the knowledge gap in 4 scenarios. BAU is the baseline against which comparisons with Kabejja (20% CO2 abatement); Carbon-Tax ($100/ton) and Lutta scenarios (95% CO2 abatement) are made. The results indicate GDP increased by Kabejja:0.7%; Carbon-Tax:1.3%; Lutta:1.56% with respect to BAU. Equivalent variation also increased compared to BAU. Energy & CO2 intensities of GDP decreased in all scenarios. The study recommends Lutta for a sustainable 2050.

Abstract Purpose To determine the clinical and radiological profile of periodontitis according to the 2018 NCPD, in a Dakar (Senegal) based periodontal clinic. Methods This is a descriptive study based on patient’s records in the periodontology clinic. The study was conducted between November 2018 and February 2020 (15 months). All periodontitis cases were included in the study. Incomplete records (due to lack of radiographic workup or unusable periodontal charting) were excluded. Periodontitis diagnosis was established based on criteria used in the 2018 NCPD. Statistical analysis was carried out using SPSS version 20.0, with the significance threshold set at 0.05. Results A total number of 517 patient records were collected during the study period but only 127 periodontitis records were complete. The mean age of participants was 46.8 ± 13.8 years and 63.8% of participants were males. The mean plaque index and bleeding on probing (BOP) were 74% ± 21.3 and 58.1% ± 25.1, respectively. The mean maximum clinical attachment loss was 8.7 mm ±2.7, with a probing depth greater than 6 mm present in 50.4% of the sample. The median number of missing teeth was 3 (interquartile range 5–1). Pathological mobility was present in 60.6% of the patients and 78.0% had occlusion problems. Bone crest defect at the most affected site was moderate in 52.8% of cases. The ratio of bone loss to age greater than one concerned 66.1% of the sample. Generalised (81.9%), Stage IV (70.1%) and grade C (69.3%) were the most encountered diagnosis. The disease severity was associated with age (r = 0.241; P

Purpose: Current developments due to ongoing socioeconomic transformations have increasingly boosted the digitalisation process and thus, have shifted the work domain closer to the internet. This includes the education sector, which results in the rising demand for suitable online learning opportunities. In the university context, students are frequently challenged with test performances based on collaborative work in joint research projects. The paradigm shift also affects the tutor turning him into an e-tutor. In the scope of e-tutoring, tracking and assessment of group-specific or individual-based work performance can be guaranteed by a suitable social analytics solution. Study design/methodology/approach: In this work, the design and implementation of a learning analytics dashboard tool for Online Collaborative Whiteboards, especially Miro, is presented. Findings: The requirements were derived from focus group interviews with key users. Originality/value: The tool features real-time tracking and quantitative evaluation of group and individual user actions.

Existing plant pan-genomic studies usually report considerable intraspecific whole gene presence-absence variation. Here, the authors use pan-genomic approach to reveal gradual polyploid genome evolution by analyzing of Brachypodium hybridum and its diploid progenitors.

Abstract Background By 2021, 10 cases of fibrosis, neurodegeneration, and cerebral angiomatosis (FINCA, MIM #618278) syndrome have been reported, and five causative variants in the NHLRC2 gene (*618277) have been identified. First reported patients presented with recurrent respiratory distress, leading to death before the age of 3. In the recent publication by Rapp, Van Dijck, and Laugwitz et al., six more patients were described. The authors underlined the possibility of survival beyond infancy and neurodevelopmental delay occurrence. Methods Our goal is to characterize further neurobehavioral phenotype of patients with the NHLRC2 gene variants. Therefore, we describe three previously unreported patients with FINCA's clinical features who survived into late childhood and reviewed the neurobehavioral phenotype of all known cases. Results We identify the so far unfamiliar neurological features of FINCA syndrome and a novel variant in the NHLRC2: c.977G>T, p.(G326V) detected in one of the patients.

Computational methods play a significant role in reducing energy consumption in cities. Many different sensor networks (e.g., traffic intensity sensors, intelligent cameras, air quality monitoring systems) generate data that can be useful for both efficient management (including planning) and reducing energy usage. Street lighting is one of the most significant contributors to urban power consumption. This paper presents a summary of recent attempts to use computational methods to reduce energy usage by lighting systems, with special focus on graph-based methods. Such algorithms require all the necessary data to be integrated, in order to function properly: this task is not trivial, and is very time-consuming; therefore, the second part of the paper proposes a novel approach to integrating urban datasets and automating the optimisation process. In two practical examples, we show how spatially triggered graph transformations (STGT) can be used to build a model based on the road network map, sensor locations and street lighting data, and to introduce semantic relations between the objects, including utilisation of existing infrastructure, and planning of development to maximise efficiency.

Intrusion Detection System (IDS) is one of the technology to ensure the security of computers. IDS is an early detection system in the event of a computer network attack. The IDS will alert the computer network administrator in the event of a computer network attack. IDS also records all attempts and activities aimed at disrupting computer networks and other computer network attacks. The purpose of this study is to implement IDS on network systems and analyze IDS logs to determine the different types of computer network attacks. Logs on the IDS will be analyzed and will be used as leverage to improve computer network security. The research was carried out using the Network Forensic Investigation Framework proposed by Pilli, Joshi, and Niyogi. The stages of the Network Forensic Investigation Framework are used to perform network simulations, analysis, and investigations to determine the types of computer network attacks. The results show that the Network Forensic Investigation Framework facilitates the investigation process when a network attack occurs. The Network Forensic Investigation Framework is effectively used when the computer network has network security support applications such as IDS or others. IDS is effective in detecting network scanning activities and DOS attacks. IDS gives alerts to administrators because there are activities that violate the rules on the IDS.

Abstract Discretion is part of the authority to act freely by government officials to ensure the implementation of public services. The instrument of discretion is attached to the functionary and used to overcome problems where there is no law. But sometimes the use of discretion causes harm to the community, so it is important to know the form of official responsibility whether it is functionary responsibility or personal responsibility. Government officials who use discretion, as long as the action is carried out within the formal environment of their authority or carried out in the context of exercising office authority, all consequences that arise will be the responsibility of the functionary. While personal responsibility is related to maladministration in the use of authority and public service. Intisari Diskresi merupakan bagian dari kewenangan bertindak bebas oleh pejabat pemerintah untuk menjamin terlaksananya pelayanan publik. Instrumen diskresi melekat pada jabatan dan dipergunakan untuk mengatasi persoalan yang tidak ada hukumnya. Namun terkadang penggunaan diskresi menyebabkan kerugian bagi masyarakat sehingga penting mengetahui bentuk tanggung jawab pejabat apakah itu tanggung jawab jabatan atau tanggung jawab pribadi. Pejabat pemerintah yang menggunakan diskresi, selama tindakan itu dilakukan dalam lingkungan formil wewenangnya atau dilakukan dalam rangka melaksanakan kewenangan jabatan, semua konsekuensi yang timbul akan jadi tanggung jawab jabatan. Sedangkan tanggung jawab pribadi berkaitan dengan maladministrasi dalam penggunaan wewenang maupun public service.

The main goal of roadway lighting design is ensuring compliance with mandatory lighting standards and thus increasing safety for all road users. On the other hand, a design process being only a part of a road investment has to be completed in possibly a short time, due to business needs. The commonly used method for reconciling both requirements is using predefined lighting projects (templates) which are matched with similar, real-life lighting situations. This approach works well for a typical roadway lighting design but not necessarily for crosswalk illumination due to different specifics of underlying calculations (they focus on the contrast of a pedestrian against its background rather than roadway illumination). As one deals with pedestrian safety here, we decided to perform extensive tests to find out whether a standard compliant lighting project prepared for a given crosswalk can be safely applied (in terms of preserving standard compliance) to another similar crosswalk. To accomplish that, we investigated nearly 900 million situations obtained as modifications of the reference template. Results proved that even a 5% change of layout sizes (crosswalk width, lamp spacing, pole height etc.) makes 40% of obtained projects violate illumination requirements. The conclusion of this result is that the template-based design approach broadly used for roadway lighting cannot be applied for pedestrian crossings as it may cause serious safety issues.

We give a simple, computationally efficient, and node-differentially-private algorithm for estimating the parameter of an Erdos-Renyi graph---that is, estimating p in a G(n,p)---with near-optimal accuracy. Our algorithm nearly matches the information-theoretically optimal exponential-time algorithm for the same problem due to Borgs et al. (FOCS 2018). More generally, we give an optimal, computationally efficient, private algorithm for estimating the edge-density of any graph whose degree distribution is concentrated in a small interval.

Objectives Prescription error rates and delays in treatment provision are high for N-acetylcysteine (NAC) when prescribed for paracetamol overdose (POD). We hypothesised that an electronic tool which proposed the complete NAC regimen would reduce prescription errors and improve the timeliness of NAC provision. Error rates and delays in the provision of NAC were assessed following POD, before and after the implementation of an electronic prescribing tool. Methods The NAC electronic prescribing tool proposed the three NAC infusions (dosed for weight) following entry of the patient’s weight. All NAC prescriptions were reviewed during a three-month period prior to and after the tool’s implementation. Error rates were divided into dose, infusion volume or infusion rate. Delays in NAC provision were identified using national Emergency Medicine guidelines. Results 108 NAC prescriptions were analysed for all adult patients admitted to the emergency department of a secondary care hospital in the UK between July-September 2017 and August-October 2018, respectively. There were no differences in the demographics of patients or the seniority of the prescribing clinician before or after the introduction of the electronic tool. The electronic prescribing tool was associated with a decrease in prescribing errors (25% to 0%, p

The Vitrocell® VC10® smoke exposure system offers multiple platforms for air liquid interface (ALI) and air agar interface (AAI) exposure that mimic in vivo conditions for assessing toxicological impact of whole smoke using in vitro assays. The aim of this study was to investigate and compare multiple dosimetry techniques that may be employed during combustible cigarette whole smoke exposure using the Vitrocell® VC10® smoking robot. The following techniques were assessed: (1) quartz crystal microbalances (QCMs), (2) aerosol photometers (using area under curve, AUC), and (3) fluorescence of anhydrous dimethyl sulfoxide (DMSO)-captured smoke constituents.Results showed that each of the dosimetry techniques was able to distinguish different levels of whole smoke airflow in a concentration-related manner. When compared to each other, the three techniques showed a high level of consistency and all were considered efficient tools in quantifying dose during an exposure, although higher variation was observed at the higher airflows tested. Overall, the dosimetry tools investigated here provide effective measures of the whole smoke concentrations tested during the exposure. Keywords: Whole smoke, Smoke exposure system, Dosimetry, Aerosol, Photometers

Previous observational studies have shown that the endocrine disrupting chemical bisphenol A (BPA) is associated with type 2 diabetes, but few studies have examined direct effects of BPA on human health. The purpose of this study is to determine whether orally administered BPA at the US Environmental Protection Agency (EPA) safe dose of 50 μg/kg body weight has an adverse effect on hepatic glucose production and skeletal muscle insulin sensitivity. Forty, non-habitually active, healthy adults of normal weight will be enrolled. Participants will begin with a 2-day baseline energy balance diet low in bisphenols in which urine and blood will be collected, and standard tests performed to assess the primary outcome measures of hepatic glucose production (via [6,6-2H] glucose infusion) and skeletal muscle insulin sensitivity (via euglycemic hyperinsulinemic clamp technique). Secondary outcome measures are fasting hormones/endocrine factors (insulin, glucose, C-peptide, Pro-insulin, adiponectin, 17-beta-estradiol, free fatty acids) related to the pathogenesis of type 2 diabetes. Participants will then be randomly assigned to a 4-day energy balance diet plus oral administration of BPA at 50 μg/kg body weight (Diet + BPA) or 4-day energy balance diet plus oral administration of placebo (Diet + No BPA); all outcome measures will be reassessed after 4 days. Findings from this study will provide a framework for other studies in this area, and provide much needed experimental evidence using gold standard measures as to whether oral BPA administration over several days poses any risk of type 2 diabetes. Keywords: Bisphenol A, Administration, Diabetes, Insulin sensitivity, Glucose

Four different types of convolutions of aggregation functions (the upper, the lower, the super-, and the sub-convolution) are examined in the setting of both sub- and super-decomposition integrals defined on a finite space. Examples of the results of the paper are provided. As a by-product, the super-additive transformation of sub-decomposition integrals and the sub-additive transformation of super-decomposition integrals are fully characterized. Possible applications are indicated.

Category: Ankle, Trauma Introduction/Purpose: Walk-in and “afterhours” clinics are a common setting in which patients may seek care for musculoskeletal complaints. These clinics may be staffed by orthopaedic surgeons, nonsurgical physicians, advanced practice nurses, or physician assistants. If orthopaedic surgeons are more efficient than nonoperative providers at facilitating the care of operative injuries in this setting is unknown. This study assesses whether evaluation by a nonoperative provider delays the care of patients with operative ankle fractures compared to those seen by an orthopaedic surgeon in an orthopaedic walk-in clinic. Methods: Following IRB approval, a cohort of patients who were seen in a walk-in setting and who subsequently underwent surgical treatment for an isolated ankle fracture were retrospectively identified. The cohort was divided based on whether the initial clinic visit had been conducted by an operative or nonoperative provider. A second cohort of patients who were evaluated and subsequently treated by a fellowship-trained foot and ankle surgeon in their private practice was used as a control group. Outcome measures included total number of clinic visits before surgery, total number of providers seen, days until evaluation by treating surgeon, and days until definitive surgical management. Results: 138 patients were seen in a walk-in setting and subsequently underwent fixation of an ankle fracture. 61 were seen by an orthopaedic surgeon, and 77 were seen by a nonoperative provider. No significant differences were found between the operative and nonoperative groups when comparing days to evaluation by treating surgeon (4.1 vs 4.5, p=.31), or days until definitive surgical treatment (8.4 vs 8.8, p=.58). 62 patients who were seen and treated solely in a single surgeon’s practice had significantly fewer clinic visits (1.11 vs 2.03 and 2.09, p

Cittaslow International promotes harmonious development of small towns based on sustainable relationships between economic growth, protection of local traditions, cultural heritage and the environment, and an improvement in the quality of local life. The aim of this study was to analyze and evaluate the differences and similarities in the spatial structure of Cittaslow towns in the Italian regions of Tuscany and Umbria and the Polish region of Warmia and Mazury. The study examined historical towns which are situated in different parts of Europe and have evolved in different cultural and natural environments. The presented research attempts to determine whether the spatial structure of historical towns established in different European regions promotes the dissemination of the Cittaslow philosophy and the adoption of sustainable development principles. The urban design, architectural features and the composition of urban and architectural factors which are largely responsible for perceptions of multi-dimensional space were evaluated. These goals were achieved with the use of a self-designed research method which supported a subjective evaluation of spatial structure defined by historical urban planning and architectural solutions. The study demonstrated that Medieval urban layouts can be successfully incorporated into the modern urban fabric to promote sustainable development and slow living.

In this paper, we explore the use of aggregation functions in the construction of coherent upper previsions. Sub-additivity is one of the defining properties of a coherent upper prevision defined on a linear space of random variables and thus we introduce a new sub-additive transformation of aggregation functions, called a revenue transformation, whose output is a sub-additive aggregation function bounded below by the transformed aggregation function, if it exists. Method of constructing coherent upper previsions by means of shift-invariant, positively homogeneous and sub-additive aggregation functions is given and a full characterization of shift-invariant, positively homogeneous and idempotent aggregation functions on [0,∞[n is presented. Lastly, some concluding remarks are added.

Coherent lower previsions generalize the expected values and they are defined on the class of all real random variables on a finite non-empty set. Well known construction of coherent lower previsions by means of lower probabilities, or by means of super-modular capacities-based Choquet integrals, do not cover this important class of functionals on real random variables. In this paper, a new approach to the construction of coherent lower previsions acting on a finite space is proposed, exemplified and studied. It is based on special decomposition integrals recently introduced by Even and Lehrer, in our case the considered decomposition systems being single collections and thus called collection integrals. In special case when these integrals, defined for non-negative random variables only, are shift-invariant, we extend them to the class of all real random variables, thus obtaining so called super-additive integrals. Our proposed construction can be seen then as a normalized super-additive integral. We discuss and exemplify several particular cases, for example, when collections determine a coherent lower prevision for any monotone set function. For some particular collections, only particular set functions can be considered for our construction. Conjugated coherent upper previsions are also considered.

Background: The study was established based on the inherent challenges of traditional learning systems, which require to be addressed. Arguably, social media can address many challenges of traditional learning if used properly. On this basis, it was important for the study to determine factors associated with the adoption of social media in learning. Objectives: This study determines the relationship between the ease of use and the usefulness of social media to its adoption. Moreover, it shows whether the perceived security of social media relates to its adoption in the learning environment of higher learning students. The objectives were met through testing hypotheses. Methods: Overall, the study was objective and followed the positivism philosophical stance. It adopted the survey research design. Data were collected through the use of a closed-end questionnaire and was tested using descriptive statistics and the One-Way ANOVA model. The generalisation of the results of tested hypotheses is allowed to the population with characteristics similar to that of the study. Results: Social media offer a good platform for the learning process. Moreover, necessary efforts are required to enhance the perception of users on the usefulness of social media, and improve their awareness of security issues because they relate with the adoption of social media. Also, the complexity of social media relates with to adoption. An ease of use platform enhances the adoption. Conclusion: Social media offer a suitable platform for the extension of traditional classes. Their use would be more effective provided that users are aware of maintaining their safety, able to apply social media tools and able to share the content useful to their learning process. Moreover, the study recommends further studies in specific social media.

The online labor market Amazon Mechanical Turk (MTurk) is an increasingly popular source of respondents for social science research. A growing body of research has examined the demographic composition of MTurk workers as compared with that of other populations. While these comparisons have revealed the ways in which MTurk workers are and are not representative of the general population, variations among samples drawn from MTurk have received less attention. This article focuses on whether MTurk sample composition varies as a function of time. Specifically, we examine whether demographic characteristics vary by (a) time of day, (b) day of week, and serial position (i.e., earlier or later in data collection), both (c) across the entire data collection and (d) within specific batches. We find that day of week differences are minimal, but that time of day and serial position are associated with small but important variations in demographic composition. This demonstrates that MTurk samples cannot be presumed identical across different studies, potentially affecting reliability, validity, and efforts to reproduce findings.

At the frontline of México’s “war on drugs” is the Mexican-U.S. border city of Cd. Juárez, Chihuahua, which has become internationally known as the “murder capital of the world.” In Juárez, which neighbors El Paso, Texas, United States, estimates of the murders in Juárez are as high as 7,643 between 2006 and 2011, leaving approximately 10,000 orphans. Juárez has also experienced an exodus of approximately 124,000 people seeking safety, some migrating to the Mexican interior and others to the U.S., particularly along the U.S.-México border. Based on 63 in-depth interviews with Juárez-El Paso border residents, along with ethnographic observations, we examine the implications of the “war on drugs” on transnational movements and on the initial settlement of those escaping the violence. In particular, we construct a typology of international migrants who are represented in the Juárez exodus: the Mexican business elite, the “Refugees without Status,” and those who resided in México but who are U.S. born or have legal permanent residency in the U.S. This article highlights the role of transnational capital in the form of assets and income, social networks in the U.S., and documentation to cross the port of entry into the U.S. legally, in easing migration and initial settlement experiences in the U.S.

Seabirds have been identified and used as indicators of ecosystem processes such as climate change and human activity in nearshore ecosystems around the globe. Temporal and spatial trends have been documented at large spatial scales, but few studies have examined more localized patterns of spatiotemporal variation, by species or functional group. In this paper, we apply spatial occupancy models to assess the spatial patchiness and interannual trends of 18 seabird species in the Puget Sound region (Washington State, USA). Our dataset, the Puget Sound Seabird Survey of the Seattle Audubon Society, is unique in that it represents a seven-year study, collected with a focus on winter months (October–April). Despite historic declines of seabirds in the region over the last 50 years, results from our study are optimistic, suggesting increases in probabilities of occurrence for 14 of the 18 species included. We found support for declines in occurrence for white-winged scoters, brants, and 2 species of grebes. The decline of Western grebes in particular is troubling, but in agreement with other recent studies that have shown support for a range shift south in recent years, to the southern end of California Current.

An algorithm for distorted pattern recognition is presented. lt's generalization of M Flasinski results (Pattern Recognition, 27, 1-16, 1992). A new formalism allows to make both qualitative and quantitive distortion analysis. It also enlarges parser flexibility by extending the set of patterns which may be recognized.

Molecular circadian clocks are interconnected via neural networks. In Drosophila, PIGMENT-DISPERSING FACTOR (PDF) acts as a master network regulator with dual functions in synchronizing molecular oscillations between disparate PDF(+) and PDF(-) circadian pacemaker neurons and controlling pacemaker neuron output. Yet the mechanisms by which PDF functions are not clear. We demonstrate that genetic inhibition of protein kinase A (PKA) in PDF(-) clock neurons can phenocopy PDF mutants while activated PKA can partially rescue PDF receptor mutants. PKA subunit transcripts are also under clock control in non-PDF DN1p neurons. To address the core clock target of PDF, we rescued per in PDF neurons of arrhythmic per⁰¹ mutants. PDF neuron rescue induced high amplitude rhythms in the clock component TIMELESS (TIM) in per-less DN1p neurons. Complete loss of PDF or PKA inhibition also results in reduced TIM levels in non-PDF neurons of per⁰¹ flies. To address how PDF impacts pacemaker neuron output, we focally applied PDF to DN1p neurons and found that it acutely depolarizes and increases firing rates of DN1p neurons. Surprisingly, these effects are reduced in the presence of an adenylate cyclase inhibitor, yet persist in the presence of PKA inhibition. We have provided evidence for a signaling mechanism (PKA) and a molecular target (TIM) by which PDF resets and synchronizes clocks and demonstrates an acute direct excitatory effect of PDF on target neurons to control neuronal output. The identification of TIM as a target of PDF signaling suggests it is a multimodal integrator of cell autonomous clock, environmental light, and neural network signaling. Moreover, these data reveal a bifurcation of PKA-dependent clock effects and PKA-independent output effects. Taken together, our results provide a molecular and cellular basis for the dual functions of PDF in clock resetting and pacemaker output.

The technologies related to green energy, smart cities and similar areas being dynamically developed in recent years, face frequently problems of a computational nature rather than a technological one. The example is the ability of accurately predicting the weather conditions for PV farms or wind turbines. Another group of issues is related to the complexity of the computations required to obtain an optimal setup of a solution being designed. In this article, we present the case representing the latter group of problems, namely designing large-scale power-saving lighting installations. The term “large-scale” refers to an entire city area, containing tens of thousands of luminaires. Although a simple power reduction for a single street, giving limited savings, is relatively easy, it becomes infeasible for tasks covering thousands of luminaires described by precise coordinates (instead of simplified layouts). To overcome this critical issue, we propose introducing a formal representation of a computing problem and applying a multi-agent system to perform design-related computations in parallel. The important measure introduced in the article indicating optimization progress is entropy. It also allows for terminating optimization when the solution is satisfying. The article contains the results of real-life calculations being made with the help of the presented approach.

Aim: Characterize the logistical challenges faced by healthcare professionals (HCPs), patients and caregivers during the chimeric antigen receptor T-cell (CAR T) treatment process for non-Hodgkin lymphoma patients. Materials & methods: HCPs in the US and UK experienced with CAR T administration participated in interviews and completed a web-based survey. Results: A total of 133 (80 US, 53 UK) HCPs participated. Two or more logistical challenges were identified by ≥60% of respondents across all stages of the CAR T process. Commonly reported challenges were lengthy waiting periods, administrative and payer-related barriers, limited healthcare capacity, caregiver support and (particularly in the US) patient out-of-pocket costs. Conclusion: The CAR T treatment process presents numerous challenges, highlighting an unmet need for more convenient therapies.

Background: Mental disorders are the leading cause of disability for youth worldwide. However, there is a dearth of validated, brief instruments to assess mental health in low- and middle-income countries (LMIC). We aimed to facilitate identification of mental disorders in LMIC contexts by adapting and validating measures of internalizing and externalizing disorders for adolescents in Mozambique, an LMIC in southeastern Africa., Methods: We selected instruments with good support for validity in high-income and other LMIC settings: the Patient Health Questionnaire Adolescent (PHQ-A), Generalized Anxiety Disorders 7 (GAD-7), and Strengths and Difficulties Questionnaire (SDQ). Instruments were adapted by local and international mental health specialists followed by cognitive interviews (n = 48) with Mozambican adolescents. We administered the instruments along with the Miniature International Neuropsychiatric Interview for Children and Adolescents (MINI-KID)to 485 adolescents aged 12-19 years attending two secondary schools in Maputo City, Mozambique. One week later, we re-administered instruments to a randomly selected sample of 49 adolescents., Results: Participants were 66.2% (n = 321) female and the average age was 15.9 (S.D = 1.7).Internal consistency (alpha = 0.80, PHQ-A; 0.84, GAD-7; 0.80, SDQ) and test-retest reliabilty (ICC = 0.74, PHQ-A; 0.70, GAD-7; 0.77, SDQ) were acceptabe for the PHQ-A, GAD-7, and the full SDQ. The SDQ internalizing subscale showed poor test-retest reliability (ICC = 0.63) and the SDQ externalizing subscale showed poor internal consistency (alpha = 0.65). All instruments demonstrated good sensitivity and specificity (> 0.70). Youden's index identified optimal cutoff scores of 8 for the PHQ-A, 5 for the GAD-7, 10 for the SDQ internalizing and 9 for the SDQ externalizing subscales, though a range of scores provided acceptable sensitivity and specificity., Conclusions: Our data supports reliability and validity of the PHQ-A, GAD-7, and SDQ instruments for rapidly assessing mental health problems in Mozambican adolescents. Use of these tools in other contexts with limited specialists may asist with expanding mental health assessment. Specific instrument and cutoff selection should be based on screening goals, treatment resources, and program objectives., (© 2022. The Author(s).)

Artemisia abyssinica leaves, a traditional medicine for the treatment of various disorders, were fed to male Wistar rats at 2% and 10% of the standard diet for 6 weeks. A 2% A. abyssinica leaf diet was not toxic to rats. Depression in growth, hepatopathy and nephropathy were observed in rats fed a diet containing 10% of A. abyssinica leaves. These findings were accompanied by leukopenia, anaemia and alterations of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) activities with changes in concentrations of total protein, albumin, cholesterol and urea.

Six out of 15 Nubian goats kids were given single oral doses of metolachlor (Dual 720 EC) at 2,000 or 500 mg/kg liveweight and died within 1 h of the dosing. Other 6 goats were given daily oral doses at 200 or 25 mg/kg and died or were slaughtered between days 8 and 25. In goats receiving single doses, the signs of poisoning were convulsive episodes, incoordination of movement, tremors, severe muscular spasms, stiffness, profuse salivation, respiratory distress, abnormal posture and recumbency. In goats receiving metolachlor at daily doses, the signs were similar, but developed slowly. Increases in the activities of serum AST and GGT and in the concentration of urea, and decreases in total protein concentration were correlated with clinical changes and lesions.

Twelve Nubian goats were given single or repeated oral dosages of mercuric chloride at 10, 20 and 40 mg/kg and died or were killed in extremis at various times after dosing (18 hours-18 days). The main signs of poisoning were anorexia, frothing at the mouth, respiratory distress, epistaxis, bloat, diarrhoea, abnormal posture and recumbency. An increase in the activity of GOT and in the concentrations of urea and inorganic phosphate and a decrease in total protein and calcium concentrations in the serum were detected. The main lesions were dilatation and necrosis of the proximal convoluted tubules, shrinkage and disappearance of the glomerular tufts, varying amounts of acidophilic homogenous material in the lumens of the affected tubules of the kidney, enteritis, hepatocellular degeneration and/or necrosis and pulmonary congestion, haemorrhage, oedema and emphysema. The changes in the red blood cells indicated anaemia.

A single oral administration of chlorpyrifos to Nubian goats at 1200, 600 and 300 mg/kg caused nervous signs and death within 15 minutes to 2 days of treatment. An oral dose of the compound at 150 mg/kg was toxic, but not fatal to goats. Animals given chlorpyrifos orally at daily doses of 300, 150 and 75 mg/kg showed signs of toxicity and died within 2 to 7 days of treatment. Pathological, biochemical and haematological changes are described.

Samorin (isometamedium chloride) was effective against T. evansi in mice given in single i.p. doses of 1 to 10 mg/kg. The administration of 40 mg/kg of samorin or above caused rapid death of mice and there were severe haemorrhages, degeneration and congestion in the liver, heart and kidney. The lesions in the liver and kidney were accompanied with reduced activities of ATP-ase, 5-nucleotidase, succinic tetrazolium reductase and glucose-6-phosphatase.