Comparative life cycle assessment of integrated renewable energy-based power systems.

Integrated renewable-based power cycles should be employed to produce more sustainable electricity. This is a comparative life cycle assessment (LCA) of three combined power plants, encompassing: case 1 involving combined geothermal and wind, case 2 featuring combined geothermal and solar, and case 3 integrating wind and solar systems. The base case perovskite solar cell (PSC) modelling assumes a 3-year lifespan and a power conversion efficiency of 17 %. However, diverse scenarios are evaluated through a sensitivity assessment involving enhancements in lifetime and efficiency. The base case evaluation emphasizes that the phases with the most significant negative environmental effects which includes the drilling of geothermal wells, construction of wind plants, and manufacturing and installation of PSCs. The midpoint findings indicate that boosting the power conversion efficiency of PSC from 17 % to 35 % yields a notable decrease in environmental impact. Moreover, extending the lifetime from 3 to 15 years led to reduction in CO2 emissions from 0.0373 and 0.0185 kg CO2 eq/kWh to 0.026 and 0.0079 kg CO2 eq/kWh in cases 2 and 3, respectively. Assessing worst and best-case scenarios highlights significant declines in certain impact categories. In case 3, terrestrial ecotoxicity (TE), photochemical oxidant formation (POF), human toxicity (HT), marine ecotoxicity (ME), and marine eutrophication (MU) saw reductions exceeding 88 % compared to worst-case results. The environmental effects observed in cases 2 and 3 stem from toxicity and metal depletion, mainly linked to the PSC. Endpoint results revealed that when considering a PSC lifespan of 10 years or more, the detrimental ecosystem impacts of cases 2 and 3 become less severe than those of case 1. Uncertainty assessment has been done for different cases and impact categories. The study's results are also novel in which it evaluated the innovative PSC technology when integrated with other renewable resources, contrasting it with other integrated plants.

Forecasting the ecological footprint of G20 countries in the next 30 years.

The Ecological Footprint evaluates the difference between the availability of renewable resources and the extent of human consumption of these resources. Over the past few decades, historical records have shown an accelerated decline in the availability of resources. Based on national footprint and biocapacity accounts, this analysis aims to advance the forecasting of the G20 countries' ecological footprints over a 30-year time frame. We employed a time series forecasting approach implemented in Python, which included-modular regression (Prophet) and Autoregressive Integrated Moving Average (ARIMA & Auto-ARIMA) methods. We evaluated and combined the performance of these three methods. The results indicated that among the largest economies of the G20, only four countries are projected to have a positive ecological footprint balance by 2050. These countries share the common denominator of large land areas and a moderate population growth projection. However, the overall trend of the indicator suggests that it will continue to decline.

Optimising care: Impact of regular nephrologist appointments on clinical outcome for chronic kidney disease patients in primary care.

INTRODUCTION: The rise in the cases of chronic kidney disease (CKD) with the increasing prevalence of non-communicable diseases such as type 2 diabetes mellitus and hypertension is a major public health concern in Malaysia. This results in the many cases of chronic kidney disease being managed in primary healthcare clinics. This study examines the pre- and post-clinical outcomes of scheduled nephrologist visits on CKD patients in a primary health care clinic in Ipoh, Perak. MATERIALS AND METHODS: This is a retrospective crosssectional study reviewing the medical records of patients seen by visiting nephrologists from January 2019 to December 2021 in Greentown Health Clinic. The study population are patients with CKD stage 3b, 4 and 5 who are followed up in Greentown Health Clinic. Universal sampling was done, a total of 87 patients reviewed at least once by the visiting nephrologist and with retrievable medical records were included in the study. Those whose medical records were irretrievable were excluded. Blood pressure, urine protein, fasting blood sugar (FBS), glycated haemoglobin (HbA1c), serum creatinine, eGFR and fasting lipid profile (FLP) pre- and post-visits were collected by reviewing patient medical records and laboratory results. The results were then analysed and compared using SPSS version 26. RESULTS: The median age of patients in this study was 66 years of age, the majority were male patients (54%) and Malay ethnicity (62.1%). Absence of urine microalbuminuria pre and post referral remain the same (n = 11). During prenephrologist visits, a higher percentage of patients exhibited moderate (30-300 mg/g) and severe (>300 mg/g) increase in urine albuminuria (15.7% and 7.2%, respectively) compared to the post-referral period. In patients with significant urine protein pre-referral, patient group with urine protein 3+ showed the highest increment of 30.1% (n = 22), in comparison to 19.3% (n = 16) observed during prereferral. Statistically significant clinical outcomes between pre- and post-referral to the nephrologist include reduction of systolic blood pressure [141±15 mmHg versus 135 ±12 mmHg, p = 0.001] and diastolic blood pressure [median = 80 mmHg (IQR: 10) versus median=71 mmHg (IQR: 17), p < 0.001]. Similarly, total cholesterol [median = 4.4 mmol/L (IQR: 1.4) versus median = 4.0 mmol/L (IQR: 1.5, p = 0.001] and LDL [median = 2.5 mmol/L (IQR: 1.2) versus median = 2.2 mmol/L (IQR: 1.2), p < 0.001)] exhibited statistically significant differences between pre- and post-referral. However, HDL remained unchanged and other outcome variables showed no significant differences. CONCLUSION: Incorporating nephrologist visits in primary care seems to have positive impact towards patient clinical outcomes. Results shown in this study can aid other primary care clinics in the decision to initiate nephrologist services in the primary care setting as a multidisciplinary approach to managing CKD patients.

Heat pump supply chain environmental impact reduction to improve the UK energy sustainability, resiliency and security.

Various heat pump technologies are examined from an environmental perspective using a life cycle assessment approach. The investigated heat pump systems utilize air, ground, and water as their energy sources. Additionally, an innovative heat pump powered by green hydrogen is investigated in this study, to evaluate its environmental impacts and potential to commercialise on a large scale. A range of supply chain scenarios is explored, considering the main suppliers of the UK market. The reshoring heat pump industry and supply chain are evaluated to enhance energy resilience and security within the UK. The findings indicate that the hydrogen-based heat pump presents a promising option for the UK market, offering the advantages of reducing stress on the national grid network and minimizing the environmental impacts associated with the supply chain. Furthermore, a forecasting analysis is conducted based on the UK's net-zero emission plan to provide insight into future developments.

Evaluating sustainable development practices in a zero­carbon university campus: A pre and post-COVID-19 pandemic recovery study.

This paper aims to understand the critical areas for sustainable behavioural change on a university campus in order to achieve the net zero­carbon ambition pre- and post-COVID-19 pandemic recovery. For this purpose, the current empirical study is the first attempt to statistically examine the whole campus as a system, considering staff and student views (campus users), by developing an index measuring propensity for sustainable behavioural change to achieve a net zero­carbon campus. The novelty of this study is based on the following: (i) The impact of environmental sustainability measures due to COVID-19 is examined on three themes: physical activity routines on a daily basis, research, and teaching and learning, and (ii) the index that is compatible with quantifying the behavioural change. A multi-indicator questionnaire is used to collect empirical data for each of the three themes. Based on 630 responses, descriptive statistical analysis, normality tests, significance tests, and t-tests are performed using statistical and graphical software, and conducting uncertainty and sensitivity analyses on this quantitative data. The study found that 95 % of campus users agreed to use reusable materials on campus, and 74 % were willing to pay more for sustainable products. In addition, 88 % agreed to seek alternative and sustainable transportation for short research trips, while 71 % prioritised online conferences and project meetings for sustainable hybrid working. Moreover, the COVID-19 pandemic had a negative impact on the frequency of reusable material usage among campus users, as indicated by the index analysis, which showed a significant decrease from 0.8536 to 0.3921. The statistical findings show that campus users are more likely to initiate and endorse environmental sustainability measures in research and daily life than in teaching and learning, and there is no difference in their propensity for change. This research provides net zero­carbon sustainability researchers and leaders with a crucial baseline for scientific advances in the sustainability field. It also offers practical guidelines for implementing a net zero­carbon campus, engaging users from various disciplines, which has important implications and contributions.

Heat Transfer Enhancement by Hybrid Nano Additives-Graphene Nanoplatelets/Cellulose Nanocrystal for the Automobile Cooling System (Radiator).

A radiator is used to remove a portion of the heat generated by a vehicle engine. It is challenging to efficiently maintain the heat transfer in an automotive cooling system even though both internal and external systems need enough time to keep pace with catching up with evolving engine technology advancements. The effectiveness of a unique hybrid's heat transfer nanofluid was investigated in this study. The hybrid nanofluid was mainly composed of graphene nanoplatelets (GnP), and cellulose nanocrystals (CNC) nanoparticles suspended in a 40:60 ratio of distilled water and ethylene glycol. A counterflow radiator equipped with a test rig setup was used to evaluate the hybrid nano fluid's thermal performance. According to the findings, the proposed GNP/CNC hybrid nanofluid performs better in relation to improving the efficiency of heat transfer of a vehicle radiator. The suggested hybrid nanofluid enhanced convective heat transfer coefficient by 51.91%, overall heat transfer coefficient by 46.72%, and pressure drop by 34.06% with respect to distilled water base fluid. Additionally, the radiator could reach a better CHTC with 0.01% hybrid nanofluid in the optimized radiator tube by the size reduction assessment using computational fluid analysis. In addition to downsizing the radiator tube and increasing cooling capacity over typical coolants, the radiator takes up less space and helps to lower the weight of a vehicle engine. As a result, the suggested unique hybrid graphene nanoplatelets/cellulose nanocrystal-based nanofluids perform better in heat transfer enhancement in automobiles.

Towards a machine-readable literature: finding relevant papers based on an uploaded powder diffraction pattern.

A prototype application for machine-readable literature is investigated. The program is called pyDataRecognition and serves as an example of a data-driven literature search, where the literature search query is an experimental data set provided by the user. The user uploads a powder pattern together with the radiation wavelength. The program compares the user data to a database of existing powder patterns associated with published papers and produces a rank ordered according to their similarity score. The program returns the digital object identifier and full reference of top-ranked papers together with a stack plot of the user data alongside the top-five database entries. The paper describes the approach and explores successes and challenges.

Shorter acute hospital length of stay in hip fracture patients after surgery predicted by early surgery and mobilization.

Time to surgery, early mobilization, fracture type, and ASA grades independently affect acute hospital length of stay after hip fracture surgery. Modifiable factors can be audited to reduce length of stay, and non-modifiable factors can be used for consideration of a tiered bundled payment reimbursement model. INTRODUCTION: As hip fracture incidence rises with our ageing global population, there will be an increase in consumption of healthcare resources. We hypothesized that hospital management and patient factors can affect healthcare burden load. Using length of stay (LOS) as a surrogate for consumption, the aim of this study is to elucidate the effect of hospital management and patient-related factors on length of stay (LOS) for patients after hip fracture surgery. We studied modifiable and non-modifiable factors influencing LOS, and identification of these modifiable factors accords opportunities for mitigating these factors. METHODS: This retrospective study examines hip fracture data from a large tertiary hospital in Singapore over the period of 2017 to 2020. Data collected on the electronic medical record included age, gender, race, marital status, payer type, ASA score, TTS, type of surgery, fracture type, POD1 mobilization, discharge position, and presence of pressure sores, and they were correlated with LOS using binary logistic regression on SAS. RESULTS: A total of 1045 patients were included in this study with 704 females and 341 males. The mean age was 79.5 ± 8.57 years (range 60-105) with an average LOS 13.64 ± 10.0 days (range 2-114). On binary logistic regression, ASA and trochanteric fracture remains a significant non-modifiable factor for LOS with OR = 1.486 (95% CI 1.106, 1.996, p = 0.0086) and OR 1.522 (95% CI 1.149, 2.015, p = 0.0034) respectively. Significant modifiable factors were TTS > 48 h (OR = 1.819, 95% CI 1.205, 2.746, p = 0.0044) and POD1 mobilization (OR = 0.441, 95% CI 0.257, 0.756, p = 0.0029). CONCLUSIONS: Our analysis showed TTS and POD1 are significant modifiable factors for LOS, and resources can be diverted towards them for the management of hip fracture patients and pre-empting the increasing load on our healthcare system.

Preoperative severe vitamin D deficiency is a significant independent risk factor for poorer functional outcome and quality of life 6 months after surgery for fragility hip fractures.

Hip fractures are common in the elderly, and many patients with hip fractures have low vitamin D levels. This study found that severe vitamin D deficiency is linked to poorer recovery of function and quality of life after hip fracture surgery. INTRODUCTION: Vitamin D deficiency is prevalent in hip fracture patients and associated with increased mortality and complications. However, there is limited long-term data on how vitamin D levels affect functional outcomes after hip fracture surgery. The aim of this study is to ascertain the association between vitamin D levels and recovery from hip surgery. METHODS: Patients who underwent hip fracture surgery from January 2012 to December 2016 and had vitamin D levels assessed during admission were included. Retrospective analysis was performed on patients' demographic data such as age, gender and clinical parameters such as preoperative vitamin D, haemoglobin levels, Charlson Comorbidity Index (CCI), and type and site of surgery. Patients were divided according to four different vitamin D levels-severe vitamin D deficiency (≤10 ng/mL), mild deficiency (10-20 ng/ml), insufficiency (20-30 ng/ml), and normal (>30ng/ml). Functional outcomes were measured by Harris Hip Score (HHS), Parker Mobility Score (PMS), and individual domains of 36-Item Short Form Health Survey (SF36). Univariate and multivariate analyses were conducted to examine the association between vitamin D deficiency and functional outcome scores. RESULTS: Out of 664 patients identified, 9% had severe vitamin D deficiency and 39% mild deficiency. Patients with severe vitamin D deficiency had significantly poorer baseline and 6-month PMS and SF36 Physical Functioning (PF). In multivariate analysis, severe vitamin D deficiency was associated with lower 6-month PMS and SF36 PF. CONCLUSION: Preoperative severe vitamin D deficiency is an independent risk factor for poorer recovery of function and quality of life after hip fracture surgery.

Rinsing with water for 1 min after milk formula increases plaque pH.

PURPOSE: Parents find it challenging to follow recommendations to brush young children after feeds at night despite the increase caries risk. This study compared three clinical recommendations (dilution, rinsing and wiping) on plaque pH after formula consumption. METHODS: Eighteen subjects were recruited. The five interventions with 2-week washout between visits included: Rinse with undiluted formula for 30 s (UF); rinse with 50% diluted formula for 30 s (DF); rinse with undiluted formula for 30 s, followed by rinsing with water for 1 minute (UF/R); rinse with undiluted formula for 30 s, followed by wiping (UF/W); rinse with 10% sucrose for 30 s as control (C). Plaque samples were collected at baseline, 2, 5, 10, 20 and 30 min after the intervention and pH measured using the plaque sampling method. RESULTS: UF/R resulted in significantly smaller pH drops at 5, 10 and 20 min compared to UF. It also resulted in higher minimum pH (UF/R: 6.34 ± 0.36 Vs UF: 6.06 ± 0.40, p = 0.02), smaller maximum pH drop (UF/R: 0.63 ± 0.35 Vs UF: 0.90 ± 0.49, p = 0.03), smaller sum of change of hydrogen ion concentration (UF/R: 9.22 × 10-7 ± 7.8 × 10-7 Vs UF: 2.30 × 10-6 ± 2.6 × 10-6, p = 0.04), and smaller area under the curve (UF/R: 7.70 ± 5.44 Vs UF: 13.44 ± 9.44, p = 0.02). DF and UF/W did not result in any significant pH change compared to UF. CONCLUSIONS: Of the three clinical recommendations, only rinsing with water for 1 min after undiluted formula reduced plaque acidogenicity. Teeth wiping with a moist cloth and 50% dilution of infant formula did not have an effect on plaque acidity.

A critical analysis of the impacts of COVID-19 on the global economy and ecosystems and opportunities for circular economy strategies.

The World Health Organization declared COVID-19 a global pandemic on the 11th of March 2020, but the world is still reeling from its aftermath. Originating from China, cases quickly spread across the globe, prompting the implementation of stringent measures by world governments in efforts to isolate cases and limit the transmission rate of the virus. These measures have however shattered the core sustaining pillars of the modern world economies as global trade and cooperation succumbed to nationalist focus and competition for scarce supplies. Against this backdrop, this paper presents a critical review of the catalogue of negative and positive impacts of the pandemic and proffers perspectives on how it can be leveraged to steer towards a better, more resilient low-carbon economy. The paper diagnosed the danger of relying on pandemic-driven benefits to achieving sustainable development goals and emphasizes a need for a decisive, fundamental structural change to the dynamics of how we live. It argues for a rethink of the present global economic growth model, shaped by a linear economy system and sustained by profiteering and energy-gulping manufacturing processes, in favour of a more sustainable model recalibrated on circular economy (CE) framework. Building on evidence in support of CE as a vehicle for balancing the complex equation of accomplishing profit with minimal environmental harms, the paper outlines concrete sector-specific recommendations on CE-related solutions as a catalyst for the global economic growth and development in a resilient post-COVID-19 world.

Epidemiology of surgically treated patient in road traffic accident with lower extremity vascular injury from a single centre in Kelantan.

INTRODUCTION: Lower extremity vascular injury can result in either temporary or permanent disability. METHODS: This is a clinical audit involving all patients admitted to our institution from January 2008 to June 2018 of those who had undergone revascularization surgery for lower limb trauma. RESULTS: Fifty-nine patients were in this study with a mean age of 28.1 years. Most of the patients were motorcyclist involved in road traffic accidents with cars (n=30, 50.8%). The popliteal artery was most commonly seen injury (n=41, 69.5%). The mean duration of ischaemia was 14.1 hours. The limb salvage rate was 89.8%. CONCLUSION: Lower extremity vascular injury caused by RTA treated in our institution predominantly involved young patients aged between 18-30 years associated with long bone fractures causing contusion and thrombosis of the popliteal artery.

Probiotic effects of mixture of Groenewaldozyma salmanticensis and Gluconacetobacter liquefaciens on growth and immune responses in Paralichthys olivaceus.

This study was performed to evaluate the effects of dietary probiotics on growth, non-specific immune responses and disease resistance in olive flounder, Paralichthys olivaceus. During 8 weeks, the fish were fed the five experimental diets such as a basal commercial diet (CON), oxytetracycline (OTC) and three basal diets containing Bacillus subtilis (BS), a commercial microbial product (CES) and a mixture of yeast and bacterium (PI), respectively. Fish fed all the probiotics diets and OTC showed a significantly higher growth than fish-fed CON (P < 0·05). Fish-fed PI had a significantly higher nitroblue tetrazolium activity, whereas fish-fed CES showed a higher lysozyme level (P < 0·05). A 7-day challenge test also showed that fish-fed PI had a cumulative survival rate equivalent to that of fish-fed OTC (P < 0·05). Moreover, the diet (PI) appeared to increase the diversity of microbial community in the fish. All these results suggest that the probiotics diet could function as a potential antibiotic replacer in the olive flounder. SIGNIFICANCE AND IMPACT OF THE STUDY: This study is unique in revealing that a diet mixture of yeast, Groenewaldozyma salmanticensis and bacterium Gluconacetobacter liquefaciens can enhance growth, innate immunity and diversity of microbial community including dominant species in the olive flounder. All these indicate that the diet mixture could function as a potential antibiotic replacer in one of the most commercially important fisheries in South Korea.

Augmented decision-making for acral lentiginous melanoma detection using deep convolutional neural networks.

BACKGROUND: Several studies have achieved high-level performance of melanoma detection using convolutional neural networks (CNNs). However, few have described the extent to which the implementation of CNNs improves the diagnostic performance of the physicians. OBJECTIVE: This study is aimed at developing a CNN for detecting acral lentiginous melanoma (ALM) and investigating whether its implementation can improve the initial decision for ALM detection made by the physicians. METHODS: A CNN was trained using 1072 dermoscopic images of acral benign nevi, ALM and intermediate tumours. To investigate whether the implementation of CNN can improve the initial decision for ALM detection, 60 physicians completed a three-stage survey. In Stage I, they were asked for their decisions solely on the basis of dermoscopic images provided to them. In Stage II, they were also provided with clinical information. In Stage III, they were provided with the additional diagnosis and probability predicted by the CNN. RESULTS: The accuracy of ALM detection in the participants was 74.7% (95% confidence interval [CI], 72.6-76.8%) in Stage I and 79.0% (95% CI, 76.7-81.2%) in Stage II. In Stage III, it was 86.9% (95% CI, 85.3-88.4%), which exceeds the accuracy delivered in Stage I by 12.2%p (95% CI, 10.1-14.3%p) and Stage II by 7.9%p (95% CI, 6.0-9.9%p). Moreover, the concordance between the participants considerably increased (Fleiss-κ of 0.436 [95% CI, 0.437-0.573] in Stage I, 0.506 [95% CI, 0.621-0.749] in Stage II and 0.684 [95% CI, 0.621-0.749] in Stage III). CONCLUSIONS: Augmented decision-making improved the performance of and concordance between the clinical decisions of a diverse group of experts. This study demonstrates the potential use of CNNs as an adjoining, decision-supporting system for physicians' decisions.

Elevated plasma and synovial fluid interleukin-8 and interleukin-18 may be associated with the pathogenesis of knee osteoarthritis.

PURPOSE: Osteoarthritis (OA) of the knee is a multifactorial degenerative disease typically defined as the 'wear and tear' of articular joint cartilage. However, recent studies suggest that OA is a disease arising from chronic low-grade inflammation. We conducted a study to investigate the relationship between chronic inflammatory mediators present in both the systemic peripheral blood system and localised inflammation in synovial fluid (SF) of OA and non-OA knees; and subsequently made direct comparative analyses to understand the mechanisms that may underpin the processes involved in OA. METHODS: 20-Plex proteins were quantified using Human Magnetic Luminex® assay (R&D Systems, USA) from plasma and SF of OA (n = 14) and non-OA (n = 14) patients. Ingenuity Pathway Analysis (IPA) software was used to predict the relationship and possible interaction of molecules pertaining to OA. RESULTS: There were significant differences in plasma level for matrix metalloproteinase (MMP)-3, interleukin (IL)-27, IL-8, IL-4, tumour necrosis factor-alpha, MMP-1, IL-15, IL-21, IL-10, and IL-1 beta between the groups, as well as significant differences in SF level for IL-15, IL-8, vascular endothelial growth factor (VEGF), MMP-1, and IL-18. Our predictive OA model demonstrated that toll-like receptor (TLR) 2, macrophage migration inhibitory factor (MIF), TLR4 and IL-1 were the main regulators of IL-1B, IL-4, IL-8, IL-10, IL-15, IL-21, IL-27, MMP-1 and MMP-3 in the plasma system; whilst IL-1B, TLR4, IL-1, and basigin (BSG) were the regulators of IL-4, IL-8, IL-10, IL-15, IL-18, IL-21, IL-27, MMP-1, and MMP-3 in the SF system. CONCLUSION: The elevated plasma IL-8 and SF IL-18 may be associated with the pathogenesis of OA via the activation of MMP-3.

A virome from ornamental flowers in an Australian rural town.

Samples of leaves exhibiting symptoms resembling those caused by virus infection were collected from ornamental street flowers in a rural town in Western Australia. Thirty-seven leaf samples were collected from plants of iris, tulip, lily, daffodil, stock and grape hyacinth. Shotgun sequencing of cDNA derived from leaf samples was done, and analysis showed that about 6% of the sequences obtained were of viral origin. Assembly of virus-like sequences revealed complete or partial genome sequences of 13 virus isolates representing 11 virus species. Eight of the isolates were of potyviruses, one was of a macluravirus, three were of potexviruses, and one was of a bunya-like virus. The complete genome of an isolate originally classified as ornithogalum mosaic virus was genetically divergent and differed in polyprotein cleavage motifs, and we propose that this isolate represents a distinct species. The implications of importing to Australia live plant propagules infected with viruses are discussed.