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Understanding system interdependencies in sustainable paper production from residue grass biomass: Insights from fuzzy cognitive mapping

Abstract This research investigates the pulp and paper industry's transition to sustainability by valorizing unused roadside and natural grasses for paper production. Large-scale production from residual grass poses multifaceted challenges, requiring collaboration across stakeholders, from biomass collection to manufacturing. To understand key drivers and barriers within this complex system, experts from various fields, including local farmers, researchers, policymakers, and industry executives were interviewed, leading to the development of a Fuzzy Cognitive Map (FCM). The analysis explores various scenarios to assess how socio-economic, technological, and political factors influence the transition to low-carbon practices. These scenarios highlight the effects of varying levels of technology development, economic conditions, and policy support on the transition's progress and outcomes. Results show that the system is highly sensitive to shifts in socio-economic and political conditions. Political interventions play a crucial role, especially during energy crises and increased public demand for sustainable solutions. Grass-based paper production is seen as a viable pathway, but challenges such as the economic feasibility of emerging technologies remain. We recommend targeted policies to improve the economic viability of grass-based products and optimize biomass allocation between energy and bio-based products, ensuring a more balanced and sustainable transition.

Shaping a low-carbon future: Uncovering the spatial-temporal effect of population aging on carbon emissions in China

Background With the accelerated development of the aging trend in Chinese society, the aging problem has become one of the key factors affecting sustainable economic and social development. Given the importance of controlling carbon emissions for achieving global climate goals and China’s economic transformation, studying the spatial and temporal effects of population aging on carbon emissions and their pathways of action is of great significance for formulating low-carbon development strategies adapted to an aging society. Objective This paper aims to explore the spatial-temporal effects of population aging on carbon emissions, identify the key pathways through which aging affects carbon emissions, and further explore the variability of these effects across different regions. The findings will provide theoretical support and empirical evidence for government departments to formulate policies to promote the coordinated development of a low-carbon society and an aging society. Methods Based on the panel data of 30 provinces in China from 2004 to 2022, this paper systematically investigates the impact of population aging on carbon emission intensity from both spatial and temporal dimensions by using the spatial Durbin model and the mediating effect model. The direct effect of aging on carbon emission intensity, the spatial spillover effect, and the indirect effect through mediating variables such as residents’ consumption, environmental regulation, and new urbanization are analyzed in depth. Results The study found that population aging in China has significant spatial and temporal effects on carbon emissions. From the spatial dimension, there is a significant spatial spillover effect of the effect of aging on carbon emissions, and aging reduces local carbon emissions but increases carbon emissions in adjacent regions. From the time dimension, the effect of aging on carbon emissions shows a stage characteristic, initially it will reduce carbon emissions, but with the deepening of aging, its effect may tend to weaken. In addition, this study identifies a number of key pathways through which aging affects carbon emissions, including reducing residential consumption, promoting new urbanization, and increasing the intensity of environmental regulations. Finally, this study explores the regional heterogeneity of the impact of aging on carbon emissions and its mechanism of action. Conclusion This study is instructive: first, the complex impact of population aging on carbon emissions should be fully recognized to formulate a comprehensive low-carbon development strategy; second, attention should be paid to the spatial spillover effect of aging on carbon emissions to strengthen inter-regional cooperation and coordination; and lastly, differentiated low-carbon policies should be formulated to address the characteristics of aging in different regions and stages in order to promote the synergistic development of a low-carbon society and an aging society.

Optimization of parallel coiled cavities of different depths in microperforated panel sound absorbers

AbstractThis paper presents a microperforated panel (MPP) sound absorber with parallel coiled-up-cavities of different-depths (PCD) and the corresponding optimization on their cavities. In this study, an analytical model is initially proposed for estimating the cavity depths of the PCD-MPP absorber upon normal incidence absorption coefficient evaluation at given resonance frequencies. Cavity effective depths and normal incidence absorption coefficient are evaluated after coiling up cavities for a compact structure. Numerical simulations with the finite element method and experiments are conducted for validations. Subsequently, a design process is suggested on the basis of the proposed model for sound absorption optimization. Results show that, absorption coefficient from the proposed analytical model agrees well with finite element simulations and experiments. It is also shown that, for the effective depth evaluation of the coiled-up cavities of PCD-MPP absorbers, the diagonal lines of subchannels of coiled-up cavities with a coiled-up angle of 180° can accurately represent the effective depths, while the combination of centerlines of subchannels and quarter arc inside the coiled-up area is more suitable for those with a coiled-up angle of 90°. Optimization investigation shows that, PCD-MPP absorbers can have high absorption performance with the averaged and maximum absorption coefficient of 0.91 and 0.98 within the target bandwidth of 400–1600 Hz, where the absorber thickness can stay below 65 mm. This work can provide valuable guidelines for the design of sound absorbers for broadband absorption.

“If my husband was in the labor ward with me, my baby wouldn’t have died”; experiences on birth companionship from a tertiary health facility, Tanzania

Background Despite existing policies promoting companionship, it remains uncommon in Tanzania. Pregnant women select a trusted individual to accompany them during childbirth, providing emotional, physical, and spiritual support. The World Health Organization recommends birth companionship as integral to intrapartum care for positive maternal and fetal outcomes. Objective This study aimed to explore the experiences of pregnant women and healthcare providers regarding childbirth companionship at a tertiary health facility in Tanzania. Methods Participants were purposefully selected for qualitative exploratory interviews. Focused group discussions were conducted with pregnant women attending antenatal clinics, and in-depth interviews were held with healthcare providers at Mbeya Zonal Referral Hospital in Tanzania. Braun and Clarke’s six-step thematic analysis approach was used to analyze the data. Results Three major themes emerged: "Bonding and Learning with Spouse/Partner," "Assurance of Maternal Safety," and "Fear of Blame and Breach of Confidentiality." These themes highlight a strong desire among both pregnant women and healthcare providers for companionship during labor, particularly from male partners. Emotional support and safety were cited as key reasons. Fear, however, was identified as a major obstacle, with providers concerned about potential exposure of mistakes and pregnant women fearing a violation of their privacy rights regarding health matters. Conclusion Pregnant women expressed a strong desire for companionship throughout labor. However, companionship faced challenges due to staff shortages and inadequate privacy in labor wards. There is a pressing need to enhance childbirth companionship practices and policies in low-resource settings.

Development of deep-underground engineering structures via 2D and 3D RQD prediction using non-invasive CSAMT

Effects of aerobic and resistance training on walking and balance abilities in older adults with Parkinson’s disease: A systematic review and meta-analysis

Objective To explore the impact of aerobic and resistance training on walking and balance abilities (UPDRS-III, Gait Velocity, Mini-BESTest, and TUG) in individuals with Parkinson’s disease (PD). Method All articles published between the year of inception and July 2024 were obtained from PubMed, Embase, and Web of Science. Meta-analysis was conducted with RevMan 5.4. Result Research from 15 randomized controlled trials, comprising 792 older patients with a diagnosis of PD, was included in the analysis. Aerobic training (AT) and Resistance training (RT) significantly improved UPDRS-III (AT, SMD = -5.69, 95% CI: -8.67 to -2.71, p = 0.0002, I2 = 82%; RT, SMD = -3.01, 95% CI: -4.89 to -1.12, p = 0.002, I2 = 0%) and Gait Velocity(AT, SMD = 0.88, 95% CI: 0.58 to 1.18, p < 0.00001, I2 = 42%; RT, SMD = 0.52, 95% CI: 0.10 to 0.94, p = 0.01, I2 = 55%). AT showed no difference in Mini-BESTest (AT, SMD = 2.12, 95% CI: -0.70 to 4.94, p = 0.14, I2 = 90%). RT showed no change in TUG (RT, SMD = -0.03, 95% CI: -1.60 to 1.54, p = 0.97, I2 = 63%). Conclusions Resistance training stood out as the most effective approach to boost performance on the mini-BESTest. Conversely, aerobic exercise proved to be superior for improving the UPDRS-III, gait velocity and TUG scores.

ALKBH5, an m6A demethylase, attenuates tumor growth and inhibits metastasis in papillary thyroid carcinoma

Patient stratification by genetic risk in Alzheimer’s disease is only effective in the presence of phenotypic heterogeneity

Case-only designs in longitudinal cohorts are a valuable resource for identifying disease-relevant genes, pathways, and novel targets influencing disease progression. This is particularly relevant in Alzheimer’s disease (AD), where longitudinal cohorts measure disease “progression,” defined by rate of cognitive decline. Few of the identified drug targets for AD have been clinically tractable, and phenotypic heterogeneity is an obstacle to both clinical research and basic science. In four cohorts (n = 7241), we performed genome-wide association studies (GWAS) and Mendelian randomization (MR) to discover novel targets associated with progression and assess causal relationships. We tested opportunities for patient stratification by deriving polygenic risk scores (PRS) for AD risk and severity and tested the value of these scores in predicting progression. Genome-wide association studies identified no loci associated with progression at genome-wide significance (α = 5×10−8); MR analyses provided no significant evidence of an association between cognitive decline in AD patients and protein levels in brain, cerebrospinal fluid (CSF), and plasma. Polygenic risk scores for AD risk did not reliably stratify fast from slow progressors; however, a deeper investigation found that APOE ε4 status predicts amyloid-β and tau positive versus negative patients (odds ratio for an additional APOE ε4 allele = 5.78 [95% confidence interval: 3.76–8.89], P<0.001) when restricting to a subset of patients with available CSF biomarker data. These results provided no evidence for large-effect, common-variant loci involved in the rate of memory decline, suggesting that patient stratification based on common genetic risk factors for progression may have limited utility. Where clinically relevant biomarkers suggest diagnostic heterogeneity, there is evidence that a priori identified genetic risk factors may have value in patient stratification. Mendelian randomization was less tractable due to the lack of large-effect loci, and future analyses with increased samples sizes are needed to replicate and validate our results.

Treatment of pseudophakic aqueous misdirection syndrome

Effects of body weight-supported Tai Chi Yunshou training on upper limb motor function in stroke patients: A three-arm parallel randomized controlled trial

Objectives To form a unique body weight support-Tai Chi Yunshou (BWS-TCY) training method, apply it to the treatment of upper limb dysfunction after stroke, and provide a new safe and effective treatment method for the clinic. Methods A total of 93 subjects were recruited and randomly divided into conventional rehabilitation treatment (CRT) group, BWS-TCY group and traditional robot-assisted training (RAT) group in equal proportions. Subjects in the CRT group received 60 minutes of CRT daily. Subjects in the BWS-TCY group received 30 minutes of CRT and 30 minutes of BWS-TCY. Subjects in the RAT group received 30 minutes of CRT and 30 minutes of RAT. All interventions were conducted 5 days per week for 12 weeks. Outcome assessments included the Fugl-Meyer Upper Extremity Motor Function Assessment (FMA-UE), Wolf Motor Function Test (WMFT), absolute angular error (AAE), joint range of motion (JMA), modified Barthel Index (MBI), and stroke-related quality of life. Table (SS-QOL). Outcome measures were assessed at baseline, 4 weeks, 8 weeks, and 12 weeks later, and statistical analyzes were performed using two-way repeated measures analysis of variance. Results After 12 weeks of intervention, significant improvements were observed in all evaluation indicators for the three groups of subjects compared to before the intervention. The upper limb motor function (FMA-UE and WMFT) and proprioception (AAE) showed time effects, time × group interaction effects, and group effects. When comparing the groups, the FMA-UE in the BWS-TCY group, as well as the WMFT and MBI, showed statistically significant differences compared to the CRT group (P<0.05), but not statistically significant compared to the RAT group (P>0.05). The AAE of the BWS-TCY group showed no statistical difference (P>0.05) when compared to the CRT group and RAT group. Furthermore, a time effect was observed on the rotation direction (P<0.05), and pairwise comparison between groups revealed that the BWS-TCY group performed better than both the CRT group and the RAT group. After 12 weeks of intervention, there were time effects and interaction effects between BWS-TCY and daily living activities (MBI) and quality of life (SS-QOL), but no group effect was observed. There was no statistical difference between the two groups in SS-QOL. However, there was a statistical difference (P<0.01) in MBI between the two groups. Conclusions The 12-week BWS-TCY intervention has been shown to effectively improve upper limb motor function. Trial registration Retrospectively registered at chictr.org.cn on August 31, 2022 [ChiCTR2200063150] https://www.chictr.org.cn/showproj.html?proj=176229.

Tennis expert-novice difference in motion-in-depth perception is associated with early inhibition of invalid attention

In silico drug repurposing at the cytoplasmic surface of human aquaporin 1

Aquaporin 1 (AQP1) is a key channel for water transport in peritoneal dialysis. Inhibition of AQP1 could therefore impair water transport during peritoneal dialysis. It is not known whether inhibition of AQP1 occurs unintentionally due to off-target interactions of administered medications. A high-throughput virtual screening study has been performed to investigate the possible binding of licensed medications to the water pore of human AQP1. A complete model of human AQP1 based on its canonical sequence was assembled using I-TASSER and MODELLER. The model was refined via the incorporation of pore water molecules from a high-resolution yeast aquaporin structure. Docking studies were conducted for the cytoplasmic domain of the AQP1 monomer against a library of all compounds listed in the British National Formulary (BNF), using the PLANTS software with the ChemPLP scoring function. The stability of the best docked conformations within the intrinsic water pore was assessed via short 15 nanosecond molecular dynamics (MD) simulations using the GROMACS-on-Colab utility. Of the 1512 compounds tested, 1002 docking results were obtained, and 198 of these conformations occupied a position within the intrinsic water pore. 30 compounds with promising docking scores were assessed by MD. The docked conformations for dopamine, gabapentin, pregabalin, and methyldopa were stable in these short MD studies. For furosemide and pravastatin, the MD trajectory suggested a binding mode different to the docking result. A small set of compounds which could impede water transport through human AQP1 have been identified in this computational screening study.

Driving force analysis and multi-scenario simulation of landscape ecological risk in the Jianghan Plain, China

Clinical control in COPD and therapeutic implications: The EPOCONSUL audit

Objective This study aimed to evaluate clinical control in chronic obstructive pulmonary disease (COPD), the consequences in terms of treatment decisions, and their potentially associated factors during follow-up of patients in real-life clinical practice. Methods EPOCONSUL 2021 is a cross-sectional audit that evaluated the outpatient care provided to patients with a diagnosis of COPD in respiratory clinics in Spain and multivariable logistic regression models to assess the relationships between clinical control and clinical inertia. Results 4225 patients from 45 hospitals in Spain were audited. Clinical control was analyzed in 1804 (42.7%) patients who met all the Spanish COPD Guidelines (GesEPOC) criteria. 49.1% of patients were classified as uncontrolled, and 42.2% of patients disagreed with the level of control determined by their doctor, which was reported as good during the visit. There was therapeutic inertia (TI), in other words not making any change or taking any action in the treatment of COPD, in 68.4% of uncontrolled patients and no action was taken during the visit for 9.1% of uncontrolled patients. Factors associated with TI in uncontrolled patients were disagreement with the degree of control reported by the doctor who performed the examination ☯physician classifies and reports disease as controlled versus uncontrolled, OR: 3.37 (2.33–4.88), p<0.001] and having a lower burden of associated comorbidities ☯Charlson comorbidity index ≥3 versus <3, OR 0.8 (0.1–3.0), p = 0.014]. The probability of disagreeing with the physician’s classification of the degree of COPD control in uncontrolled patients was lower in patients with severe exacerbations ☯OR 0.3 (0.17–0.78), p = 0.009] and those with more exacerbations in the last year ☯OR 0.6 (0.4–0.9), p = 0.019]. Conclusions Therapeutic inertia exists in more than half of uncontrolled patients and is more likely when there is disagreement with the assessment of the physician responsible for the visit, who reported there being good disease control, a situation that was more likely in patients with less history of exacerbations.

Author Correction: Simulation shows that HLA-matched stem cell donors can remain unidentified in donor searches

Treadmill belt accelerations may not accurately replicate kinematic responses to tripping on an obstacle in older people

Background Treadmill belt perturbations have high clinical feasibility for use in perturbation-based training in older people, but their kinematic validity is unclear. This study examined the kinematic validity of treadmill belt accelerations as a surrogate for overground walkway trips during gait in older people. Methods Thirty-eight community-dwelling older people were exposed to two unilateral belt accelerations (8 m s-2) whilst walking on a split-belt treadmill and two trips induced by a 14 cm trip-board whilst walking on a walkway with condition presentation randomised. Anteroposterior margin of stability (MoS), number of falls, and trunk and lower limb kinematics were quantified for the step prior and five recovery steps following the treadmill perturbations and the walkway trips which elicited elevating and lowering strategies. Findings Rates of falls following the treadmill accelerations and walkway trips were 0% and 13.1%, respectively. MoS was similar during the first recovery step (P>0.05) but less negative during subsequent recovery steps following treadmill belt accelerations than walkway trips (P<0.01) regardless of recovery strategy. Excluding the first recovery step in the lowering strategy, recovery step lengths, toe clearance, maximum trunk, hip and knee angles (P<0.05) were smaller during recovery on the treadmill compared to the walkway. Interpretation Destabilisation by treadmill belt accelerations quickly dissipated after only one recovery step but continued for multiple recovery steps following walkway trips. Smaller trunk displacement, step lengths, toe clearance and no falls on the treadmill indicate treadmill belt accelerations may not accurately simulate the biomechanical challenge of obstacle-induced trips in older people.

A Parametric study on the effects of winglet cant angle on wing aerodynamics and aeroacoustics

Abstract The use of winglet devices is an efficient technique for enhancing aerodynamic performance. This study investigates the effects of winglet cant angles on both the aerodynamics and aeroacoustics of a commercial wing, comparing them to other significant parameters using a parametric analysis. A Full Factorial Design method is employed to generate a matrix of experiments, facilitating a detailed exploration of flow physics, with lift-to-drag ratio (L/D) and the integral of Acoustic Power Level (APL) as the primary representatives of aerodynamic and acoustic performance, respectively. The RANS formulation, along with the $$k{-}\epsilon$$ Realizable model and the Broadband Noise Source (BNS) model, are utilized to accurately simulate subsonic flows numerically. The study begins by examining the pressure coefficient ( $$C_p$$ ) and APL distributions at various cant angles near the wingtip and root areas. The matrix of experiments is then analyzed to identify the most influential parameters based on the main effects of inputs and their two-way interactions. The results demonstrate that variations in winglet cant angle significantly alter the distribution of $$C_p$$ and APL along the span, particularly near the wingtip, and that cant angle strongly impacts overall performance, at times even outweighing atmospheric parameters such as pressure and temperature.

Broiler farming and antibiotic use through an agency theory lens. A case study from West Bengal, India

Chicken meat (broiler) production is a rapidly growing livestock sector in India, and one dominated by contract farming. Studies have reported high levels of antibiotic use in Indian broiler farms which is concerning given this is one of the driving forces for the development of antibiotic resistance. This study used the economic lens of agency theory to examine strategic decisions which occur during contract broiler production and their potential impact on antibiotic use, using West Bengal as a case study. Agency theory focuses on the informational asymmetry and opportunism between service providers and seekers and the subsequent agency cost needed to avoid aberrant outcomes. Interviews were conducted with key informants (n = 6) and stakeholders (n = 20) associated with broiler production, and broiler farmers (17 contract and four non-contract), using online and face-to-face interviews. Data were analysed descriptively using manifest content analysis and interpretatively using reflexive thematic analysis. Contract farming in West Bengal exists within a series of inter-dependent relationships, many of which contain information asymmetry and can be subject to opportunism. Positioning contract companies as principals seeking labour from agents, we see how out-sourcing of production to distal farms led to antibiotics being used as a risk mitigation strategy. This was further compounded by concerns about the Mycoplasma status of breeding stock, and a perception that broiler day old chicks were infected, resulting in use of antibiotics belonging to classes deemed critically important for human health. While antibiotic use decisions were predominately made by contract companies, they were dependent on the decisions farmers and breeding companies made concerning biosecurity and production practices. In turn, farmers’ decisions were shaped by factors such as access to financial and social capital. Thus, efforts to reduce antibiotic use in West Bengal’s broilers must not just focus on changing the prescribing behavior of individuals but more broadly consider the environment within which contracting exists.

Development of Fe/SiBr/Si₃N₄/silica fume nanocomposites from recycled metal waste for industrial applications

AbstractDue to the high cost of raw materials, this work aims to benefit from metal waste, especially iron (Fe) and silicon bronze, which results from turning workshops and recycling them to obtain nanocomposites for industrial applications. In this respect, Fe/SiBr/Si3N4/silica fume nanocomposites possessing superior mechanical, wear, and magnetic characteristics have been produced using powder metallurgy (PM) technology. Milled sample particle size, crystal size, and phase composition were investigated using X-ray diffraction (XRD) technique and transmission electron microscopy (TEM). The powders were compressed and sintered in argon to get excellent sinterability. The sintered nanocomposites’ physical, mechanical, wear, electrical, and magnetic properties were investigated. The microstructure was also examined using field emission scanning electron microscopy (FESEM). The results showed a noticeable decrease in the size of particles and crystallite size after adding reinforcements, reaching 22 nm for the sample improved with 5 vol% silica fume and 5 vol% Si3N4 (FS4). In addition, after adding reinforcements, there was a clear improvement in the microhardness, Young’s modulus, and wear rate of Fe-SiBr, reaching 58, 27.89, and 43.21% percent for the sample FS4. Adding reinforcements harms the electrical conductivity of Fe-SiBr, as it decreases to 8.64 × 106 S/m for the same previous sample. Finally, adding reinforcements slightly affects the decrease in magnetization of the nanocomposites.

Widespread use of ChatGPT and other Artificial Intelligence tools among medical students in Uganda: A cross-sectional study

Background Chat Generative Pre-trained Transformer (ChatGPT) is a 175-billion-parameter natural language processing model that uses deep learning algorithms trained on vast amounts of data to generate human-like texts such as essays. Consequently, it has introduced new challenges and threats to medical education. We assessed the use of ChatGPT and other AI tools among medical students in Uganda. Methods We conducted a descriptive cross-sectional study among medical students at four public universities in Uganda from 1st November 2023 to 20th December 2023. Participants were recruited by stratified random sampling. We used a semi-structured questionnaire to collect data on participants’ socio-demographics and use of AI tools such as ChatGPT. Our outcome variable was use of AI tools. Data were analyzed descriptively in Stata version 17.0. We conducted a modified Poisson regression to explore the association between use of AI tools and various exposures. Results A total of 564 students participated. Almost all (93%) had heard about AI tools and more than two-thirds (75.7%) had ever used AI tools. Regarding the AI tools used, majority (72.2%) had ever used ChatGPT, followed by SnapChat AI (14.9%), Bing AI (11.5%), and Bard AI (6.9%). Most students use AI tools to complete assignments (55.5%), preparing for tutorials (39.9%), preparing for exams (34.8%) and research writing (24.8%). Students also reported the use of AI tools for nonacademic purposes including emotional support, recreation, and spiritual growth. Older students were 31% less likely to use AI tools compared to younger ones (Adjusted Prevalence Ratio (aPR):0.69; 95% CI: [0.62, 0.76]). Students at Makerere University were 66% more likely to use AI tools compared to students in Gulu University (aPR:1.66; 95% CI:[1.64, 1.69]). Conclusion The use of ChatGPT and other AI tools was widespread among medical students in Uganda. AI tools were used for both academic and non-academic purposes. Younger students were more likely to use AI tools compared to older students. There is a need to promote AI literacy in institutions to empower older students with essential skills for the digital age. Further, educators should assume students are using AI and adjust their way of teaching and setting exams to suit this new reality. Our research adds further evidence to existing voices calling for regulatory frameworks for AI in medical education.