Choice Of Options Research Articles

P-1633. Evaluating an Urgent Care Antibiotic Stewardship Intervention: A Multi-Network Collaborative Effort

Abstract Background Urgent care centers (UCCs) have previously been associated with high rates of inappropriate antibiotic prescribing without supporting appropriate diagnoses. Prior antibiotic stewardship studies in urgent care settings have generally been limited to pediatric clinics and diagnoses or conducted within single urgent care networks. Broadly generalizable stewardship efforts targeting common diagnoses across ages are needed. Methods This quality improvement study's participants were UCC clinicians from a national collaborative of 49 UCCs in 27 networks across 18 states within the United States. Stewardship interventions included signing of a commitment statement, and a choice of intervention options to implement during two plan-do-study-act (PDSA) cycles during the intervention period. The primary outcome was the percent of urgent care encounters (from randomly selected patient charts) for viral illness or bronchitis diagnoses with inappropriate antibiotic prescribing, stratified by whether the clinician was a direct participant in the quality improvement study and by diagnosis. A 3-month baseline and 9-month intervention period were compared using an interrupted time series with a generalized estimating equation model. Results 15,588 patient encounters were included with a diagnosis of bronchitis or viral illness. The intervention was associated with a 39% relative decrease in inappropriate antibiotic prescribing (aOR=0.61, 95%CI 0.48-0.77) among participating clinicians compared to baseline. The intervention did not result in a significant change in inappropriate antibiotic prescribing (aOR=1.08, p=0.54) for clinicians who did not directly participate. Conclusion This antibiotic stewardship intervention was associated with significant reductions in inappropriate prescribing among clinicians who directly participated. Implementing stewardship interventions in UCCs may reduce inappropriate antibiotic prescriptions for common diagnoses; however, direct clinician participation may be necessary, especially in settings with high rates of clinician turnover. Disclosures All Authors: No reported disclosures

P-1365. Cefazolin Inoculum Effect in Methicillin Susceptible Staphylococcus aureus Recovered From the Nasal Cavity of Patients in Intensive Care Units in Colombia

Abstract Background Cefazolin is an alternative for the treatment of MSSA infections and first choice option for surgical prophylaxis. The cefazolin inoculum effect (CzIE), the increase in the MIC at high bacterial inocula is associated to therapeutic failures and increased mortality in deep-seated MSSA infections. The prevalence of the CzIE among nasal colonizing MSSA from ICU patients is currently unknown. The aim of this study was to investigate the CzIE in nasal MSSA recovered from patients admitted to ICUs in Colombia. Methods We evaluated 33 MSSA isolates recovered from nasal swabs of 29 patients admitted to ICU at 6 high-complexity Colombian hospitals (2019-2023). CFZ MIC using gold standard broth microdilution at high inoculum was done. The modified nitrocefin-based rapid test to identify the CzIE was performed, and diagnostic performance metrics were calculated. Whole genome sequencing was used to characterize BlaZ types and allotypes, Clonal Complexes CC and Accessory Gene Regulator (Agr) types. Results The CzIE was identified in 54.5% of nasal MSSA isolates. A high prevalence of nasal colonization with MSSA exhibiting the CzIE was detected (59%, 17 patients). Among 18 MSSA with the CzIE, type A BlaZ was the predominant β-lactamase (61%) and BlaZ-2 was the most common allotype (50%). Whereas among 15 MSSA lacking the CzIE, BlaZ type C was the most frequent (47%) and BlaZ-1 was the allotype predominant (40%). A high diversity of genetic lineages with eight CC was detected among the 33 MSSA. CC30 was the predominant lineage in MSSA displaying the CzIE (44%), while CC5 and CC30 (27% each one) were the most common in MSSA without the CzIE. Agr-III and Agr-I were predominant Agr types in 56% and 47% of MSSA with the CzIE and lacking the CzIE, respectively. Compared to the gold standard the modified rapid test identified nasal MSSA isolates showing the CzIE with a sensitivity of 100%, specificity of 93% and an overall accuracy of 97%. Conclusion We found an unexpected high prevalence (59%) of ICU patients colonized by MSSA exhibiting the CzIE, showing similar genetic features to MSSA with CzIE from invasive infections. Furthermore, our findings suggest that the nasal cavity of ICU patients may represent a reservoir for the dissemination of MSSA showing the CzIE, highlighting the importance of screening and surveillance. Disclosures All Authors: No reported disclosures

Trigeminal Neuralgia: Disease Characterization and Prediction of Response to Surgical Intervention.

Trigeminal neuralgia (TN) is a highly heterogeneous condition with a wide choice of successful treatment options. However, differences between subtypes are poorly understood and it remains unknown which patients will respond to different treatments. This review aims to summarize the current state of the TN field and explore the problem of predicting surgical outcomes. Attempts have been made to standardize classification, outcome reporting, and treatment guidelines. Identification of risk factors for poor surgical treatment outcomes has led to the development of prognostic scoring systems to predict outcomes and guide management. Advances in imaging techniques including diffusion tensor imaging show promise in better understanding the underlying pathophysiology and predicting surgical outcomes. Progress is hampered by lack of understanding of the pathophysiology in TN and differences between disease subtypes. Further work needs to be done to create accurate prediction tools for widespread use, including use of advanced imaging and computing tools, multicenter collaboration, and prospective validation.

Choosing certainty over risk: Associations of PTSD symptom severity with memory sampling during experiential decision making.

The current study sought to examine whether lifetime PTSD symptom severity is associated with a bias toward sampling extreme negative events from memory when making decisions involving uncertainty. To this end, 40 trauma-exposed warzone veterans performed a decision task in which information about outcomes was learned through experience and making choices required sampling memories of past experiences. On each trial, participants made choices between certain and uncertain gains and between certain and uncertain losses. Uncertain outcomes were equally likely to yield a relatively positive or relatively negative outcome. After accounting for overall willingness to take risks, lifetime PTSD symptom severity was associated with less frequent choice of the uncertain option for gains and for losses, a pattern consistent with a memory sampling bias for all negative experiences rather than only extreme negative experiences. The overweighting of negative experiences as a function of lifetime PTSD symptom severity, however, was not observed in a subsequent explicit memory task in which participants estimated the frequency with which different outcomes had occurred during the decision task. These findings suggest that the memory mechanism responsible for the PTSD-associated memory bias in decision making is distinct from that mediating explicit memory performance.

Mobility and living status at discharge and after three-months for extramedullary versus intramedullary fixation of AO type 31-A1 trochanteric fractures; an analysis of Dutch hip fracture audit data

PurposeThe use of intramedullary fixation of AO type 31-A1 fractures is rising, despite evidence of non-superiority when compared with extramedullary fixation. The aim of this study was to evaluate mobility and living status for extramedullary fixation (EMF) versus intramedullary fixation (IMF) in Dutch hospitals during the initial hospital stay and until three-months after trauma.MethodsData on patient characteristics, mobility, living status, complications, reoperation, and mortality were extracted from the Dutch Hip Fracture Audit Indicator Taskforce. Data were collected for patients (> 65 years) at baseline, at discharge, and at three-months follow-up. Univariate analysis was used for comparing the EMF versus IMF group.ResultsA total of 836 patients were included; 138 (16%) were treated with EMF and 698 (84%) with IMF. No significant differences were found between groups for the overall complication rate during the initial hospital stay (EMF: n = 55 (40%) versus IMF: n = 270 (39%)). Patients treated with EMF showed better mobility at discharge (mobility with frame/2 supports or better, EMF 77% versus IMF 50%), but otherwise no significant difference was found after a three-month follow-up (EMF 80% versus IMF 82%), suggesting faster improved mobility for IMF. However, matched subgroup analysis showed no meaningful differences in rates of deteriorated mobility or living status after three months.ConclusionThis study showed no meaningful differences between EMF and IMF of type 31-A1 trochanteric fractures during hospital stay and until three-month follow-up. Despite little differences in outcome and EMF being the treatment option of first choice by the Dutch Hip fracture guideline, IMF is used in the vast majority of patients.

Views of speech pathology educators on a learning resource for cognitive-communication disorders: a user survey of TBIBank Grand Rounds.

Background Cognitive-communication disorders are highly prevalent after traumatic brain injury and have significant impacts on rehabilitation outcomes. TBIBank Grand Rounds was developed as an online multimedia resource to support clinical education about cognitive-communication disorders. The objective of this study was to survey speech pathology educators to establish their views towards TBIBank Grand Rounds. Method An online survey with 37 items was distributed internationally to obtain a cross-section of international educators. The survey consisted of five sections covering (1) participant details; (2) awareness, interest, and use; (3) interface design and delivery; (4) content; and (5) overall impressions. The question formats included yes/no questions, multiple choice options, rating scales, and free text questions. Survey responses were analysed descriptively, with free text supporting interpretation. Results Twenty-five participants completed the online survey. Overall, most users agreed that the design and content of TBIBank Grand Rounds met their needs for supporting education about cognitive-communication disorders. The survey identified high interest but limited prior awareness of the resource. Survey respondents identified useful directions for updates, future enhancements, and dissemination of TBIBank Grand Rounds. Conclusions Incorporating feedback from educators has identified priorities for future enhancements, such as improving cultural diversity. High interest and positive feedback indicate that the TBIBank Grand Rounds is a valuable resource for education about cognitive-communication disorders. However, limited awareness internationally suggests the need for improved dissemination. Enhancing speech pathologists' knowledge about cognitive-communication disorders after TBI may lead to improved clinical care and outcomes.

On Grade Option Choice and Grade Performance Expectation When Instruction Goes Virtual - the Role of Peers at a Distance

On Grade Option Choice and Grade Performance Expectation When Instruction Goes Virtual - the Role of Peers at a Distance

The Selection of Li-Ion Batteries Used in Electric Vehicles (EV)'s Using the TOPSIS Method

This study focuses on choosing lithium-ion cells for electric vehicles in order to increase its functionality and effectiveness. In the selection process, variables including energy density, longevity, cost, or environmental impact are considered. To determine which battery technology is best for EV applications, many different types of batteries and their properties are examined. The research intends to increase EV performance overall, decrease charging time, and increase driving range. The research advances environmentally friendly transport options and broadens the shift to electric mobility. For decision-makers, producers, and other industry participants, the study offers useful insights. Introduction: Lithium-ion battery selection for electrically powered cars is a crucial choice that has an impact on both the individual vehicle's efficiency and overall performance. The selection of battery technology has a direct impact on variables like Distance, charging time, and longevity because batteries are the main source of power for EVs. Power weight, cycle life, safety, price, and environmental effect are important factors to consider when choosing a battery. To achieve optimal performance, a longer driving range, and customer happiness, these aspects must be in balance. The choice of lithium-ion batteries will have a significant impact on how sustainable transportation develops in the future as the EV industry grows. Research significance: The ability of Li-ion batteries to increase overall performance and dependability as an environmentally friendly transport solution underlies the research significance of choosing them for electric vehicles. Effective battery selection can address major issues with EV adoption by increasing driving range, cutting down on charging time, and improving overall energy efficiency. Additionally, improvements in battery technology help to lessen environmental impacts and carbon emissions. The choice of affordable and dependable battery options is also essential to the commercial viability and general acceptance of EVs. The advancement of technology, innovation, and the shift to a more environmentally friendly transportation system can all be sped up by this kind of research. Method: A multi-criteria decision-making process called TOPSIS (process of Prioritisation through Similarity to Ideal Solution) is used to assess and rank alternatives depending on many factors. To evaluate their relative proximity, options are compared with a superior option and a worse solution. a combination of similarity to the most effective answer and closeness to the worst solution, the approach determines an evaluation of performance for each alternative. The option with the greatest score is regarded as the best option. In difficult decision-making scenarios, TOPSIS offers a methodical method for objectively assessing and ranking alternatives. Alternate parameters: Lithium- Cobalt Oxide Battery (LiCoO2) – LCOB, Lithium-Manganese Oxide Battery (LiMn2O4)- LMOB, Lithium-Nickel Manganese Cobalt Oxide Battery (LiNiMnCoO2)-LNMCOB, Lithium Iron Phosphate Battery (LiFePO4)-LFPB, Lithium-Titanate Battery (Li4Ti5O12) LTOB. Evaluation parameters: Reliability, Safety, Specific power, Specific energy density, Price. Result: Lithium- Cobalt Oxide Battery (LiCoO2) – LCOB is in 5th rank, Lithium-Manganese Oxide Battery (LiMn2O4)- LMOB is in 4th rank, Lithium-Nickel Manganese Cobalt Oxide Battery (LiNiMnCoO2)-LNMCOB is in 3rd rank, Lithium Iron Phosphate Battery (LiFePO4)-LFPB is in 1st rank, Lithium-Titanate Battery (Li4Ti5O12) LTOB is in 2nd rank. Conclusion: the selection of li ion batteries used in electric vehicles (ev)'s Lithium- Cobalt Oxide Battery (LiCoO2) – LCOB is in 5th rank, Lithium-Manganese Oxide Battery (LiMn2O4)- LMOB is in 4th rank, Lithium-Nickel Manganese Cobalt Oxide Battery (LiNiMnCoO2)-LNMCOB is in 3rd rank, Lithium Iron Phosphate Battery (LiFePO4)-LFPB is in 1st rank, Lithium-Titanate Battery (Li4Ti5O12) LTOB is in 2nd rank.

High-Density Lead Germanate Glasses with Enhanced Gamma and Neutron Shielding Performance: Impact of PbO Concentration on Attenuation Properties

Lead germanate glasses, improved with lead oxide (PbO), have emerged as effective materials for radiation shielding due to their increased density and structural robustness. The goal of this study is to find out how well lead germanate glasses with PbO concentrations between 20 and 55 mol% can block gamma rays and neutrons. The Phy-X/PSD software was used to obtain important numbers like the mass attenuation coefficient (MAC), the linear attenuation coefficient (LAC), the half-value layer (HVL), the mean free path (MFP), and the fast neutron removal cross section (FNRCS). The results show that the 55PbGe sample, which has the most PbO, has better gamma-ray attenuation and a low energy absorption buildup factor (EABF). This makes it a good choice option for locations requiring compact but efficient radiation shielding. The 50PbGe sample, on the other hand, demonstrates effective neutron shielding capabilities, suggesting it may be suitable for applications requiring protection against both gamma and neutron exposure. Higher PbO content is linked to better radiation blocking, which supports the idea that lead germanate glasses could be used instead of traditional lead-based shielding materials.

Metrology and economics: on the choice of the best options for the development of metrology systems by the criterion of minimum necessary costs – a review

A general approach to substantiating the best ways to develop national metrology systems based on minimizing the financial investments needed is formulated. The methods that have been developed at the NSC “Institute of Metrology” for estimating the effectiveness of investments for different possible options of functionality of metrological infrastructure elements related to certain types of measurements are analysed. In particular, the following options have been considered: a state primary (national) measurement standard of a unit that has passed international comparisons; there is no primary measurement standard yet, but it is being developed; there is no primary measurement standard yet and it is not being developed; a calibrated abroad secondary measurement standard used as a reference standard in the absence of a primary one. The paper presents mathematical algorithms for analysing the economic feasibility of investments, which allow choosing the least costly solutions. An approach to calculating the payback period of the investments that takes into account inflationary processes is proposed. Examples of application of the developed algorithms to analyse the economic feasibility to establish measurement standards, specifically, state primary measurement standards of the unit of volume activity of radon-222 and luminous intensity, are given. The algorithms presented in the paper for selecting the best options for the development of metrology system and increasing the efficiency of investments in metrology are especially relevant for countries with limited financial resources.

Efficacy of alveolar mandible tunnel bone grafting

BACKGROUND: The development and implementation of novel bone grafting approaches to prevent surgical injuries, improve bone conglomerate stabilization, reduce the incidence of postoperative complications, and minimize the severity of postoperative clinical signs remain relevant. AIM: To assess the efficacy of the proposed tunnel bone grafting technique in patients with mandibular ridge atrophy. MATERIALS AND METHODS: The study included 60 patients with distal mandibular ridge atrophy. The study subjects were divided into two groups. Treatment group underwent distal mandibular surgery using the patented tunnel bone grafting technique. Control group underwent conventional open guided bone regeneration. RESULTS: The study found that the proposed alveolar mandible tunnel bone grafting technique improved wound healing and decreased the incidence of complications. After 4 months, histopathological examinations of regenerated bone samples in both groups revealed that the treatment group had more mature regenerated bone than the control group. CONCLUSION: Tunnel bone grafting may become the option of choice in the treatment of distal mandibular ridge atrophy.

Four or five years: An examination of the motivations for selecting undergraduate engineering program length and impacts on student wellness.

The University of Prince Edward Island’s (UPEI) Faculty of Sustainable Design Engineering (FSDE) is unique in offering the undergraduate curriculum in both Four- and Five-Year degree plan lengths. The purpose of this study is to examine 1) the motivations for selecting and 2) impacts of degree plan length on UPEI FSDE student wellness. An anonymous, voluntary survey (REB approved) was developed and administered to approximately 200 undergraduate students during the Fall 2023 semester. Preliminary analysis found approximately 75% of undergraduate FSDE students follow the Five-Year degree plan option. Further, approximately 50% of respondents selected academic workload as the primary driver for their degree plan choice. The Five-Year degree plan length was the option of choice for UPEI FSDE students, with workload being the primary motivation for the selection. These findings help provide insight into how to better serve students and provide meaningful evidence to support curriculum design for fostering student wellness.

Non-surgical management of BPH: An updated review of current literature and state of the art on natural compounds and medical therapy.

Benign prostatic hyperplasia (BPH) is a common urological disease that is strongly associated with the aging process and can lead to lower urinary tract symptoms (LUTS). LUTS due to BPH can significantly affect the quality of life of many patients. Among the treatments available for BPH to improve symptoms and functional outcomes, drug therapy and surgical therapy are the options of choice. However, for most patients with symptomatic BPH, medical management remains the cornerstone of treatment. Pharmacologic interventions are often preferred as a first approach, being less invasive compared to surgery. Although the medical treatment of BPH is currently defined by the algorithms of international guidelines, the need for a more personalized approach is increasingly recognized given the wide and heterogeneous range of therapeutic options available. A review of medical therapy for BPH was conducted using relevant articles in PubMed, Scopus, and the Cochrane Central Register of Controlled Trials. In this review, all drug treatments currently available on the international market whose efficacy is scientifically proven are reviewed and described (phytotherapy, alpha-blockers, muscarinic receptor antagonists, 5-alpha-reductase inhibitors, combination therapies, etc.). A total of 17 randomized clinical trials were selected for review. Further, 75 studies were included for analysis and discussion. As the treatment landscape continues to evolve, tailoring therapy to individual patient needs and preferences is likely to become increasingly important to ensure that treatment strategies are both effective and meet patient expectations.

Biased expectations about future choice options predict sequential economic decisions

Considerable research has shown that people make biased decisions in “optimal stopping problems”, where options are encountered sequentially, and there is no opportunity to recall rejected options or to know upcoming options in advance (e.g. when flat hunting or choosing a spouse). Here, we used computational modelling to identify the mechanisms that best explain decision bias in the context of an especially realistic version of this problem: the full-information problem. We eliminated a number of factors as potential instigators of bias. Then, we examined sequence length and payoff scheme: two manipulations where an optimality model recommends adjusting the sampling rate. Here, participants were more reluctant to increase their sampling rates when it was optimal to do so, leading to increased undersampling bias. Our comparison of several computational models of bias demonstrates that many participants maintain these relatively low sampling rates because of suboptimally pessimistic expectations about the quality of future options (i.e. a mis-specified prior distribution). These results support a new theory about how humans solve full information problems. Understanding the causes of decision error could enhance how we conduct real world sequential searches for options, for example how online shopping or dating applications present options to users.

Contributions of attention to learning in multidimensional reward environments.

Real-world choice options have many features or attributes, whereas the reward outcome from those options only depends on a few features or attributes. It has been shown that humans learn and combine feature-based with more complex conjunction-based learning to tackle challenges of learning in naturalistic reward environments. However, it remains unclear how different learning strategies interact to determine what features or conjunctions should be attended to and control choice behavior, and how subsequent attentional modulations influence future learning and choice. To address these questions, we examined the behavior of male and female human participants during a three-dimensional learning task in which reward outcomes for different stimuli could be predicted based on a combination of an informative feature and conjunction. Using multiple approaches, we found that both choice behavior and reward probabilities estimated by participants were most accurately described by attention-modulated models that learned the predictive values of both the informative feature and the informative conjunction. Specifically, in the reinforcement learning model that best fit choice data, attention was controlled by the difference in the integrated feature and conjunction values. The resulting attention weights modulated learning by increasing the learning rate on attended features and conjunctions. Critically, modulating decision making by attention weights did not improve the fit of data, providing little evidence for direct attentional effects on choice. These results suggest that in multidimensional environments, humans direct their attention not only to selectively process reward-predictive attributes, but also to find parsimonious representations of the reward contingencies for more efficient learning.Significance Statement From trying exotic recipes to befriending new social groups, outcomes of real-life actions depend on many factors, but how do we learn the predictive values of those factors based on feedback we receive? It has been shown that humans simplify this problem by focusing on individual features that are most predictive of the outcomes but can extend their learning strategy to include combinations of features when necessary. Here, we examined interaction between attention and learning in a multidimensional reward environment that requires learning about individual features and their conjunctions. Using multiple approaches, we found that learning about features and conjunctions control attention in a cooperative manner and that the ensuing attentional modulations mainly affects future learning and not decision making.

SURGICAL INTERVENTION IN SEVERE POSTPARTUM HAEMORRHAGE

Postpartum haemorrhage (PPH) is one of the major causes of maternal mortality and morbidity, defined as haemorrhage occurring within 24 h of childbirth. Postpartum haemorrhage can be categorized into primary, which takes place within the first one day after childbirth, and secondary, which happens anytime from 24 hours after birth up to six weeks after delivery. Among the cases of PPH, some are severe and fatal and hence need to be treated effectively and on time. Conservative methods are to some extent useful in controlling PPH but surgical management involves the use of special operations to address the problem. Objective: This proposed study aims to finally summarize the evidence about surgical interventions in the management of postpartum haemorrhage, including the effectiveness and side effect profile of various surgical techniques. Methods: This study type used a retrospective cohort design and the sample consisted of patients with severe PPH that needed surgical management. This paper used quantitative data and the data was gathered from the records of hospitals for five years. Some of the surgical management activities considered in the study were uterine artery ligation, B-Lynch suture, and hysterectomy. The variables measured were success rates, early clinical outcomes, late clinical recovery and early complications. Quantitative methods of data analysis used in this study include survival analysis tests and chi-square tests. Results: The study enrolled 150 patients with severe manifested PPH; 60% of the patients underwent uterine artery ligation; 25% of the patients required a B-Lynch suture performed; and 15% of the patients required a hysterectomy. Short-term effects revealed that both techniques provided effective control of bleeding, in 85% of cases did not require additional surgery in the form of a B-Lynch suture. It was also shown that 70% of the cases with uterine artery ligation were associated with long-term preservation of fertility. Hysterectomy had the highest complication rates; infection, organ damage, and higher maternal mortality of 5%. Conclusion: Uterine artery ligation as well as B-Lynch suture should be used in cases of severe PPH because during this procedure no tubal sterilization occurs and fertility can be preserved when selecting the right cases. Although hysterectomy remains the surgical option of choice, the procedure is fraught with some significant risks. The study confirms the necessity for early surgical management and the collaboration of multiple specialists to optimise maternal results in grave cases of PPH. More clinical research is required to optimize surgical approaches and to define the role of non-operative interventions to improve the patient’s prognosis.

Predicting the parameters of reinforced concrete elements by neural network

Abstract Obtaining predictive results at planning and conceptual design phase often represents a serious problem on which the choice of design options depends to a significant extent This paper seeks solutions to the problem using neural networks and artificial intelligence and illustrates the idea by simple examples of pre-trained neural network models.

Not-so-speedy delivery: Should retailers use discounts or donations to incentivize consumers to choose delayed delivery?

Many retailers feel the pressure to provide increasingly speedy delivery, but the realities of speedy delivery logistics are costly, complicated, and uncertain. In response, retailers have been using discounts to nudge consumers’ voluntary choice of a slower delivery option, but with tepid results. The current research argues that a better incentive exists. Data from six studies demonstrate that changing from a discount (the retailer giving the consumer a $1 reward/coupon) to a donation (the retailer donating $1 to a charity) incentive significantly increases the voluntary choice of delayed delivery. Importantly, the data shows that exchange equity drives this effect. However, two boundary conditions are identified: 1) the retailer communicating a reason for the delayed delivery and 2) the type of product being purchased by the consumer. In sum, the current research provides actionable insights for retailers that offer a delayed delivery option to consumers during checkout and speaks to the current debate about consumers’ desire for speedy delivery.

What rural ecological governance goals do local residents prefer? Evidence from Hainan, China

Rural ecosystems restoration requires the joint participation of rural residents and government in governance. This study aims to analyze whether rural ecological governance goals are consistent with rural residents' preferences and how they affect rural residents' utility levels, which are key to rural residents' ecological governance participation behavior. Using survey data from 653 rural residents in Hainan Island, China, this paper applies a choice experiment method and a random parameter logit model to identify differences in rural residents' preferences for different rural ecological governance policy goals and their governance participation behaviors. The results show that increasing the coverage rate of sewage treatment facilities, reducing fertilizer and pesticide application, and increasing rural biodiversity can significantly enhance rural residents' ecological governance participation utility, thereby promoting their choice of ecological governance options. Rural residents' participation behavior in rural ecological governance is also influenced by individual and household characteristics such as ethnicity, labor size, net farm income, ICT usage, and ecological knowledge level. Based on these findings, policymakers should strengthen communication of governance policies and objectives, respect rural residents' policy goal preferences, prioritize the implementation of rural ecological governance models that increase the coverage of wastewater treatment facilities, reduce fertilizer and pesticide application, and increase rural biodiversity, and rely on ICT devices to popularize ecological knowledge among rural residents.

Identifying Practical Material Retrofit Measures for Energy Efficiency in Existing High-Rise Buildings in the Malaysian Climate

With the global focus on sustainable urban development, many cities are striving to formulate effective urban transformation strategies to transition from traditional urban structures to more sustainable ones. Enhancing the energy efficiency of buildings, particularly existing structures, is recognized as a crucial element in the fight against climate change. In the Malaysian context, improvements in energy consumption are predominantly propelled by retrofitting the country's existing building stock. However, targeted strategies are needed, especially for high-rise buildings, to address the unique challenges posed by the Malaysian climate. This study addresses this gap by focusing on retrofitting strategies specifically tailored for existing high-rise buildings in Malaysia. To evaluate energy efficiency accurately, a selected case study underwent modeling and simulation using Building Information Modeling (BIM) software for energy analysis. The simulation considered crucial aspects of window materials: U-factor, solar heat gain coefficient, visible transmittance, and emissivity. The study identified triple-glazed windows as the most energy-efficient choice, significantly outperforming single-glazed windows due to their lower U-factor and improved insulation properties. Light concrete bricks for walls demonstrated superior heat resistance owing to their lower density. Steel bar joists were found to enhance heat transfer efficiency in roofs. The recommended materials showed promising results, achieving a calculated energy consumption reduction to 266 kWh/m2/year. The study emphasizes that green consultants prioritize elements addressing excessive energy consumption during building upgrades, influencing their choice of retrofit options. Implementing energy-efficient retrofits can significantly reduce buildings' energy dependence, contributing to a substantial decrease in the country's overall energy consumption.