Analysis of the therapeutic effect of pestle needle & EEG biofeedback and methylphenidate in the treatment of attention deficit and hyperactivity disorder.

OBJECTIVE: This research aimed to analyze the therapeutic effect of pestle needle combined with electroencephalogram (EEG) biofeedback and methylphenidate in the treatment of attention deficit and hyperactivity disorder (ADHD) in children. METHODS: Seventy-eight children with ADHD were selected and randomized into a control group and an observation group (n = 39). The control group received EEG biofeedback and methylphenidate treatment, while the observation group received pestle needle therapy on this basis. Both groups received continuous treatment for 3 months. The clinical efficacy, scores of Conners Parents Symptom Questionnaire (PSQ), Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), Pittsburgh Sleep Quality Index (PSQI), EEG θ/ß changes in values, serum indicators such as adrenocorticotropic hormone (ACTH) and cortisol (CORT), and incidence of adverse reactions were compared in two groups. RESULTS: The total effective rate of the observation group was 92.31% (36/39), which was higher than the control group's 69.23% (27/39) (P < 0.05). After treatment, reduced PSQ scores, PSQI scores, EEG θ/ß values, and ACTH levels while elevated IVA-CPT and CORT levels were observed in both groups; the observation group had the best improvement effect after treatment (P < 0.05). CONCLUSION: Pestle needle combined with EEG biofeedback and methylphenidate in the treatment of ADHD children can elevate the IVA-CPT score, improve EEG waves, sleep quality, regulate serum indicators such as ACTH and CORT, reduce behavioral problem scores, and have high efficacy and safety.

Power system transformation in emerging countries: A SWOT/PESTLE analysis approach towards resiliency and reliability.

Most developing countries' electric power system is stressed by an unprecedented demand growth as well as obstacles that call for urgent actions. Therefore, tackling the present-day power-related challenges and ensure dependable and safe electricity may result in improving living conditions. This research aims to comprehend the primary factors that impede power companies in emerging economies and propose ways of addressing them with a focus on Togolese electricity system as a case study., The methodology utilized to study a complex and dynamic system like electricity sector is an integrated model composed of a survey and review of available literature, an interview with energy experts and the SWOT/PESTLE analysis to perform an in-depth and all-encompassing analysis. The study revealed that the electrification poverty was 39.47 % at countrywide level that requires an additional power of 220.95 MW to that of 2021 to achieve 100 % of electricity access by 2030. Moreover, the system's performance is hindered by a number of internal and external bottlenecks. They include but not limited to limitations in policies and regulations; technical difficulties in the transmission, distribution and off-grid subsystems; insufficient investments; and a lack of incentives and taxes rebates. In light of these findings, a model prioritizing a resilient power system was proposed for transforming the outdated power infrastructure in developing countries laying stress upon energy mix planning, transmission and distribution subsectors innovation and effective regional collaboration.

A multi-framework analysis of stakeholders' perceptions in developing a localized blue carbon ecosystems strategy in Eastern Samar, Philippines.

Blue carbon ecosystems (BCEs) are vital for global climate change mitigation and offer diverse local ecosystem co-benefits. Despite existing literatures on integrating national and international BCE agendas at the local level, the development and implementation of localized BCE strategies often lag behind. To provide insights on this knowledge gap, we present a case study conducted in Eastern Samar, Philippines. Employing a multi-framework analysis- encompassing DPSIR (drivers, pressures, state, impact, responses), SOAR (strengths, opportunities, aspirations, results), and PESTLE (political, economic, social, technological, legal, environmental) frameworks, stakeholder perceptions collected from focus group discussions highlight issues and challenges in developing and implementing a BCE strategy. Findings reveal that the aftermath of Typhoon Haiyan in 2013 in the study sites stimulated conservation efforts and raised awareness, but governance structures and policy enforcement influence the success and longevity of management and conservation efforts. Through the integration of multiple frameworks, this study outlined a potential localized BCE strategy, emphasizing both internal priorities such as stakeholder engagement and alternative livelihoods and external priorities related to policy and technological supports. While developed based on a specific case study in the Philippines, the proposed strategy is presented in a general manner, enabling its potential replication in other provinces in the Philippines or in countries with similar geographic settings.

Advancing the initiatives of sustainable coastal and marine areas development in Pakistan through marine spatial planning.

Coastal states are currently transitioning their traditional socio-economic activities into a single platform to address the emerging issues of the coast and marine environment. For countries like Pakistan, managing multiple coastal and marine activities is a significant challenge. The lack of proper management policies and an inefficient decision-making process put various types of pressure on the ecological functions of Pakistan's coastal and marine areas. The Government of Pakistan has not yet prioritized coastal and marine affairs in its policy agenda, resulting in a halt to the process of sustainable development. Moreover, a lack of financial allocation for large-scale coastal and marine projects, a shortage of trained human resources, insufficient coordination among organizations, and unstable political decisions and governance impede the sustainable delivery of the projects. This paper discusses Pakistan's coastal and marine policy targets and highlights various issues through PESTLE analysis, which encompasses political (P), economic (E), social (S), technological (T), legal (L), and environmental (E) factors that limit the advancement of sustainable coastal and marine development. This paper aims to determine the advantages of adopting marine spatial planning (MSP) in Pakistan and how its implementation can bring social, ecological, and economic prosperity. The study provides a baseline for the country's coastal and marine policymakers regarding the advancement of a blue economy through MSP.

Extensive comparison of methods for removal of organic halogen compounds from pharmaceutical process wastewaters with life cycle, PESTLE, and multi-criteria decision analyses.

Recycling and disposing wastewater from the pharmaceutical industry are of utmost importance in mitigating chemical waste generation, where unmanaged hazardous waste fluxes could cause massive environmental damage. Air stripping, steam stripping, distillation, and incineration offer significant emission reduction potentials for pharmaceutical applications; however, selecting specific process units is a complicated task due to the high number of influencing screening criteria. The mentioned chemical processes are modelled with the Aspen Plus program. This study examines the environmental impacts of adsorbable organic halogens (AOX) containing pharmaceutical process wastewater disposal by conducting life cycle impact assessments using the Product Environmental Footprint (PEF), IMPACT World + Endpoint V1.01, and Recipe 2016 Endpoint (H) V1.06 methods. The results show that the distillation-based separation of AOX compounds is characterized by the most favourable climate change impact and outranks the PEF single score of air stripping, steam stripping, and incineration by 6.3%, 29.1%, 52.0%, respectively. The energy-intensive distillation technology is further evaluated by considering a wide selection of energy sources (i.e., fossil fuel, nuclear, solar, wind onshore, and wind offshore) using PESTLE (Political, Economic, Social, Technological, Legal, Environmental) analysis combined with multi-criteria decision support to determine the most beneficial AOX disposal scenario. The best overall AOX regeneration performance and lowest climate change impact (7.25 × 10-3 kg CO2-eq (1 kg purified wastewater)-1) are obtained by supplying variable renewable electricity from onshore wind turbines, reaching 64.87% carbon emission reduction compared to the baseline fossil fuel-based process alternative.

Drivers and challenges of off-grid renewable energy-based projects in West Africa: A review.

Off-grid hybrid power systems with renewable energy as the primary resource remain the best option to electrify rural/remote areas in developing countries to help attain universal electricity access by 2030. However, deploying these systems in West Africa faces several challenges and regularly fail to transition from pilot, donor-sponsored projects to sustainable large-scale implementations. The study examined the drivers and challenges by conducting a review of previous studies done in the region and a short survey in Ghana. Using Political, Economic, Social, Technical, Legal and Environmental dimensions, the review and survey showed that economic challenges have the worst impacts on the sustainable development of off-grid renewable energy-based power systems in WA. Further, the analysis revealed patterns and linkages among the challenges that make it detrimental to focus solely on the most pressing challenges.

European stakeholders' perspectives on implementation potential of precision weed control: the case of autonomous vehicles with laser treatment.

Weed control is a basic agricultural practice, typically achieved through herbicides and mechanical weeders. Because of the negative environmental impacts of these tools, alternative solutions are being developed and adopted worldwide. Following recent technical developments, an autonomous laser-based weeding system (ALWS) now offers a possible solution for sustainable weed control. However, beyond recent proof of performance, little is known about the adoption potential of such a system. This study assesses the adoption potential of ALWS, using a mixed-method approach. First, six macro-environmental factors regarding the adoption of ALWS were determined. This assessment is referred to as a Political, Economic, Social, Technological, Legal, Environmental (PESTLE) analysis and is conducted in a form of a literature review initiated by expert consultations. Second, a range of European stakeholders' perceptions of ALWS was evaluated in four focus-group discussions (n = 55), using a strengths, weaknesses, opportunities, threats (SWOT) analysis. The factors identified in the PESTLE and SWOT analyses were subsequently merged to provide a comprehensive overview of the adoption potential of ALWS. Labour reduction, precision treatment and environmental sustainability were found to be the most important advantages of ALWS. High costs and performance uncertainty were identified as the main weaknesses. To promote the adoption of ALWS, this study recommends the following: (1) Concrete performance results, both technical and economic, should be communicated to farmers. (2) Farmers' knowledge of precision agriculture should be improved. (3) Advantage should be taken of policies that are favourable towards non-chemical methods and the high demand for organic products. This article also extensively discusses regulatory barriers, the risks posed to the safety of both humans and the machines involved, technological challenges and requirements, and policy recommendations related to ALWS adoption.

Rethinking of the future sustainable paradigm roadmap for plastic waste management: A multi-nation scale outlook compendium.

The myriad consumption of plastic regularly, environmental impact and health disquietude of humans are at high risk. Along the line, international cooperation on a global scale is epitomized to mitigate the environmental threats from plastic usage, not limited to implementing international cooperation strategies and policies. Here, this study aims to provide explicit insight into possible cooperation strategies between countries on the post-treatment and management of plastic. First, a thorough cradle-to-grave assessment in terms of economic, environmental, and energy requirements is conducted on the entire life cycle across different types of plastic polymers in 6 main countries, namely the United States of America, China, Germany, Japan, South Korea, and Malaysia. Subsequently, P-graph is introduced to identify the integrative plastic waste treatment scheme that minimizes the economic, environmental, and energy criteria (1000 sets of solutions are found). Furthermore, TOPSIS analysis is also being adapted to search for a propitious solution with optimal balance between the dominant configuration of economic, environmental, and energy nexus. The most sustainable configuration (i.e., integrated downcycle and reuse routes in a closed loop system except in South Korea, which proposed another alternative to treat the plastic waste using landfill given the cheaper cost) is reported with 4.08 × 108 USD/yr, 1.76× 108 kg CO2/yr, and 2.73 × 109 MJ/yr respectively. To attain a high precision result, Monte-Carlo simulation is introduced (10,000 attempts) to search for possible uncertainties, and lastly, a potential global plastic waste management scheme is proposed via the PESTLE approach.

A New and an Eco-Friendly Approach for the Construction of Multi-Functionalized Benzenes with Computational Studies.

The new path chosen is more appropriate in the context of green chemistry. This research aims to construct 5,6,7,8-tetrahydronaphthalene-1,3-dicarbonitrile (THNDC) and 1,2,3,4-tetrahydroisoquinoline-6,8-dicarbonitrile (THIDC) derivatives via the cyclization of three easily obtainable reactants under an environmentally benign mortar and pestle grinding technique. Notably, the robust route offers an esteemed opportunity for the introduction of multi-substituted benzenes and ensures the good compatibility of bioactive molecules. Furthermore, the synthesized compounds are investigated using docking simulations with two representative drugs (6c and 6e) for target validation. The physicochemical, pharmacokinetic, drug-like properties (ADMET), and therapeutic friendliness characteristics of these synthesized compounds are computed.

Life Cycle, PESTLE and Multi-Criteria Decision Analysis of Membrane Contactor-Based Nitrogen Recovery Process.

Nitrogen is one of the most critical nutrients in the biosphere, and it is an essential nutrient for plant growth. Nitrogen exists in the atmosphere vastly as a gaseous form, but only reactive nitrogen is usable for plants. It is a valuable resource and worth recovering in the wastewater sector. The aim of this work was to prepare a comprehensive environmental analysis of a novel membrane contactor-based process, which is capable of highly efficient nitrogen removal from wastewater. Life cycle assessment (LCA), PESTLE and multi-criteria decision analysis (MCDA) were applied to evaluate the process. The EF 3.0 method, preferred by the European Commission, IMPACT World+, ReCiPe 2016 and IPCC 2021 GWP100 methods were used with six different energy resources-electricity high voltage, solar, nuclear, heat and power and wind energy. The functional unit of 1 m3 of water product was considered as output and "gate-to-gate" analysis was examined. The results of our study show that renewable energy resources cause a significantly lower environmental load than traditional energy resources. TOPSIS score was used to evaluate the alternatives in the case of MCDA. For the EU region, the most advantageous option was found to be wind energy onshore with a score of 0.76, and the following, nuclear, was 0.70.

Impact of market constraints on the development of small-scale biogas technology in Sub-Saharan Africa: a systematic review.

The sustainable production and use of small-scale biogas energy are required to ensure clean household energy access in developing countries, including the Sub-Saharan Africa (SSA) region. This is influenced by market risks, which can be identified as political, economic, social, technical, legal, and environmental (PESTLE). This study examines peer-reviewed and grey literature for the period from 2000 to 2020 to identify the PESTLE constraints and assess their impact on the sustainable development of the technology in the SSA region. The production of biogas with small-scale plants is commonly done by rural and peri-urban households. Results show that economic constraints are the most dominant and reducing at a slow pace. This is followed by political constraints, which have received much attention in the last two decades. Despite the policy improvements, broader national bioenergy policies and interventions are still to make significant gains, especially in the Central African region. In order of significance, the Southern, East, and West Africa regions have made greater progress in reducing the constraints. To achieve the sustainable development of the technology, there is a need to further address the PESTLE constraints at national and regional levels. This study partly deduces that the unsustainable production, use, and inadequate regulation of the small-scale biogas sector are delaying its transition in the SSA region.

The sustainability of emerging technologies for use in pharmaceutical manufacturing.

INTRODUCTION: Sustainability within the pharmaceutical industry is becoming a focal point for many companies, to improve the longevity and social perception of the industry. Both additive manufacturing (AM) and microfluidics (MFs) are continuously progressing, so are far from their optimization in terms of sustainability; hence, it is the aim of this review to highlight potential gaps alongside their beneficial features. Discussed throughout this review also will be an in-depth discussion on the environmental, legal, economic, and social particulars relating to these emerging technologies. AREAS COVERED: Additive manufacturing (AM) and microfluidics (MFs) are discussed in depth within this review, drawing from up-to-date literature relating to sustainability and circular economies. This applies to both technologies being utilized for therapeutic and analytical purposes within the pharmaceutical industry. EXPERT OPINION: It is the role of emerging technologies to be at the forefront of promoting a sustainable message by delivering plausible environmental standards whilst maintaining efficacy and economic viability. AM processes are highly customizable, allowing for their optimization in terms of sustainability, from reducing printing time to reducing material usage by removing supports. MFs too are supporting sustainability via reduced material wastage and providing a sustainable means for point of care analysis.

Pestle Needle (Chu Zhen)Treatment for Low-Back Pain and Sciatica.

Background: Low-back pain, with or without sciatica, is the most-frequently encountered pain in clinical practice. There are many ways to alleviate this pain, but most modalities are time- or cost-consuming. Cases: This report describes how pestle-needle therapy was used to treat low-back pain and sciatica in 3 patients. Results: The 3 patients had much relief of their low-back pain and sciatica after their first sessions of pestle-needle therapy. Conclusions: Pestle-needle therapy is safe, simple, and effective for treating low-back pain and sciatica, and can be considered as a first-line treatment for low-back pain and sciatica.

3D-printed electrochemical pestle and mortar for identification of falsified pharmaceutical tablets.

Falsified medicines and healthcare supplements provide a major risk to public health and thus early identification is critical. Although a host of analytical approaches have been used to date, they are limited, as they require extensive sample preparation, are semi-quantitative and/or are inaccessible to low- and middle-income countries. Therefore, for the first time, we report a simple total analysis system which can rapidly and accurately detect falsified medicines and healthcare supplements. We fabricated a poly-lactic acid (PLA) pestle and mortar and using a commercial 3D printer, then made carbon black/PLA (CB/PLA) electrodes in the base of the mortar using a 3D printing pen to make an electrochemical cell. The pestle and mortar were able to crush and grind the tablets into a fine powder to the same consistency as a standard laboratory pestle and mortar. Using melatonin tablets to characterise the device, the 3D-printed pestle and mortar was able to detect the concentration of melatonin in the presence of insoluble excipients. The calibration plot showed a linear response from 37.5 to 300 µg/mL, where the limit of detection was 7 µg/mL. Electrochemical treatment was able to regenerate the CB/PLA working electrode allowing for repeated use of the device. In a blinded study, the device was able to accurately determine falsified melatonin tablets with recovery percentages between 101% and 105%. This was comparable to HPLC measurements. Overall, these findings highlight that our 3D-printed electrochemical pestle and mortar is an accessible and effective total analysis system that can have the ability to identify falsified medicines and healthcare supplements in remote locations.

Pestle Needle (Chu Zhen) Treatment for Neck Pain.

Background: Neck pain-called Jing Bi or Neck Bi-syndrome in Traditional Chinese Medicine (TCM)-is frequently treated with various TCM modalities. Pestle needle (Chu Zhen) is a unique noninvasive treatment method that originated from the Sichuan province in China. This therapy is a combination of acupuncture and massage. There is little research on the clinical use of pestle needle, and detailed case reports are few in number. Cases: This report describes 3 patients' neck pain-treatments via pestle needle; the patients were from Denmark, Indonesia, and China. Results: Each author treated 1 of the patients; 1 patient had a significant reduction of his neck pain and 2 patients had successful resolution of their neck pain. Conclusions: The clinical experiences of the 3 authors showed that pestle needle therapy could be an effective and simple noninvasive technique to relieve neck pain.

Esterification of Cellulose with Long Fatty Acid Chain through Mechanochemical Method.

Mechanochemical reaction, a green synthetic esterification route was utilized to prepare long-chain cellulose esters from microcrystalline cellulose. The influence of reaction conditions such as reaction temperature and time were elucidated. Only low dosage of oleic acid, 1-butyl-3-metylimidazolium acetate, and p-toluenesulfonyl chloride were required. The success of modification reaction was confirmed by Fourier transforms infrared spectroscopy as a new absorbance peak at 1731 cm-1 was observed, which indicated the formation of carbonyl group (C=O). Solid-state nuclear magnetic resonance was also performed to determine the structural property and degree of substitution (DS) of the cellulose oleate. Based on the results, increasing reaction temperature and reaction time promoted the esterification reaction and DS. DS values of cellulose oleates slightly decreased after 12 h reaction time. Besides, X-ray diffraction analysis showed the broadening of the diffraction peaks and thermal stability decreased after esterification. Hence, the findings suggested that grafting of oleic acid's aliphatic chain onto the cellulose backbone lowered the crystallinity and thermal stability.

Stakeholders' Interest and Attitudes toward Genomic Medicine and Pharmacogenomics Implementation in the United Arab Emirates: A Qualitative Study.

BACKGROUND AND AIM: Mapping the power, interest, and stance of stakeholders is a cornerstone for genomic medicine implementation. In this study, we aimed at mapping the power/interest of various stakeholders in United Arab Emirates (UAE) and exploring their attitudes toward pressing health genomics aspects. The overarching aim of this study is to facilitate the construction of a road map for the full implementation of genomic medicine and pharmacogenomics in the UAE with potential applicability to many healthcare systems around the world. METHODS: A qualitative approach using in-depth interview was employed. Heterogeneous stakeholders were identified by experts in the field. The analysis of the data was a hybrid of deductive and inductive approach using NVivo software for coding and analysis. RESULTS: 13 interviews were conducted. Following mapping the Mendelow's matrix, we categorized the stakeholders in UAE to promoter, latent, defender, and apathetic. Most of the interviewed stakeholders emphasized the clinical demand for genomic medicine in UAE. However, many of them were less inclined to articulate the need for pharmacogenomics at the moment. The majority of stakeholders in UAE were in favor of building infrastructure for better genetic services in the country. Stakeholder from an insurance sector had contradicting stance about the cost-effectiveness of genomic medicine; the majority were concerned with the legal and ethical aspects of genomic medicine and had an opposing stance on direct-to-consumer kits. CONCLUSIONS: Implementing the Mendelow's model will allow the systematic strategy for implementing genomic medicine in UAE. This can be achieved by engaging the key players (promoters and defenders) as well as engaging and satisfying the latent stakeholder.

Which renewable energy consumption is more efficient by fuzzy EDAS method based on PESTLE dimensions?

The facilities that energy delivers to social life and economic activities render it indispensable. Hence, it is equally critical that the energy cycle must have a sustainable structure. Therefore, it is an indisputable fact that developing and performing correct and consistent energy policies is vitally necessary. Energy consumption planning includes a continuous process to reassess existing and potential alternative energy approaches and strategies. The public and private decision-makers in charge of planning and managing energy consumption policies must adapt their strategies to novel and superior alternative resources according to sustainability and efficiency criteria. In this paper, the fuzzy EDAS method is used to address the best renewable energy consumption by taking political, economic, social, technological, legal, and environmental (PESTLE) dimensions into account. The analysis of the paper indicates the most efficient renewable energy consumption is sourced by geothermal, solar, wind, hydroelectricity, and biomass, respectively. By further investigation, it is concluded that the most optimum renewable energy consumption alternatives based on PESTLE dimensions are geothermal and solar energies.

Mechanical/Physical Methods of Cell Disruption and Tissue Homogenization.

This chapter covers the various methods of mechanical cell disruption and tissue homogenization that are currently commercially available for processing small samples s < 1 mL) to larger multikilogram production quantities. These mechanical methods of lysing do not introduce chemicals or enzymes to the system. However, the energies required when using these "harsh," high mechanical energy methods can be enough to damage the very components being sought.The destruction of cell membranes and walls is effected by subjecting the cells (a) to shearing by liquid flow, (b) to exploding by pressure differences between inside and outside of cell, (c) to collision forces by impact of beads or paddles, or (d) a combination of these forces.Practical suggestions to optimize each method, where to acquire such equipment, and links to reference sources are included. Several novel technologies are presented.

Pneumoperitoneum in Rectal Polyembolokoilamania.

Foreign body insertion in the rectum is not a very common presentation in the emergency department but this is common among individuals with a history of self-harm, personality disorders, and other psychosomatic illnesses. It is often diagnosed on abdominal x-rays; however, a CT scan of the abdomen and pelvis may be warranted when perforation is suspected. To diagnose an anorectal foreign body, clinicians must maintain a high level of suspicion. Because of embarrassment or maybe psychological concerns, the patient may not be ready to share all the information. Healthcare providers must hence show empathy and compassion while being calm and non-judgmental. Here, we present a case of an 80-year-old male who underwent a laparotomy for removal of a large foreign body that was inserted in the rectum and caused a gastrointestinal perforation.