Economic Expenses Research Articles

Comparison of fresh and frozen-thawed embryo transfer cycles in patients with low oocyte retrieval

Objective: To explore the choice of embryo transfer schemes for patients with low oocyte retrieval (≤ 3 oocytes). Methods: A retrospective analysis was conducted on patients with oocyte yields ≤ 3 undergoing in vitro fertilization and embryo transfer (IVF-ET) and frozen embryo transfer (FET) at the Maternity & Child Care Center of Qinhuangdao Reproductive Medicine Department from January 2018 to December 2022. The data included 202 fresh cycles, with 104 cycles in Group-A and 98 cycles in Group-B. Additionally, 87 cycles involved the transfer of frozen embryos from fresh cycles that could not be transplanted for various reasons, with 31 cycles in Group-C and 56 cycles in Group-D. General patient information, embryo transfer details, and clinical pregnancy outcomes in both fresh and frozen cycles were statistically analyzed. Results: No significant differences were observed between Groups A and C in age, anti-Müllerian hormone (AMH), basal follicle-stimulating hormone (bFSH), body mass index (BMI), duration of infertility, the proportion of patients with diminished ovarian reserve (DOR), oocyte retrieval count, usable embryo count, or the number of transplanted embryos (all p> 0.05). Advanced age was a risk factor for a decreased pregnancy rate, and FET significantly increased the pregnancy rate (p< 0.05, respectively). Conclusion: For patients under 35 years old with low oocyte retrieval, it is recommended to freeze all embryos when available and then proceed with FET. For patients aged 35 and above, without reducing the pregnancy rate, fresh embryo transfer is recommended to minimize treatment cycle frequency and economic expenses. doi: https://doi.org/10.12669/pjms.40.10.9269 How to cite this: Shi H, Song Q, Liu J, Li C, Liu R. Comparison of fresh and frozen-thawed embryo transfer cycles in patients with low oocyte retrieval. Pak J Med Sci. 2024;40(10):2251-2255. doi: https://doi.org/10.12669/pjms.40.10.9269 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Three-dimensional physical experimental study on mechanisms and influencing factors of CO2 huff-n-puff and flooding process in shale reservoirs after fracturing

Carbon dioxide (CO2) capture and geological storage technology is a promising strategy for enhancing oil and gas production and mitigating climate change in unconventional formations. In shale reservoirs, production decline is rapid under volumetric fracturing development. Currently, CO2 injection and huff-n-puff techniques are cost-effective methods to boost shale oil recovery. However, traditional huff-n-puff techniques are limited in capturing reservoir heterogeneity and intricate fracture conditions. This study employed a three-dimensional physical experimental apparatus to explore CO₂ huff-n-puff dynamics across six distinct fracture patterns. By implementing a real-time monitoring system with multiple pressure points, the study elucidated the impacts of varying fracture penetration levels and spacing on dynamic pressure wave patterns, mobilization extent, and development outcomes during CO2 huff-n-puff. The results demonstrate that fractures substantially improve CO₂ huff-n-puff efficiency in shale reservoirs compared to a seamless model, with Model 6 achieving the highest recovery rate of 42.38%. As fracture penetration increases, CO₂ dynamic coverage expands. However, full penetration leads to preferential flow through fractures, reducing matrix contact and diminishing huff-n-puff efficiency. Reduced fracture spacing enlarges the well's control domain, amplifies CO2 huff-n-puff dynamic coverage area, and increases oil production and recovery rate. Conversely, decreasing fracture spacing accelerates oil and gas displacement rates, leading to higher economic expenses. The study concludes that 2/3 fracture penetration in five fractures offers the most efficient recovery method. For a 500 m horizontal well, optimal fracture spacing is recommended at 125 m, with a fracture length of 145.8 m for a well spacing of 417 m.

Incidence of infection rate for shunt implantation: the zero % rate is always a myth

IntroductionPaediatric CSF shunt infection rate remains a well-known complication that is not only responsible of potentially severe sequels for patients but also for economical expenses. In that study, we questioned if it is possible to attain the zero percent rate of infection that should be the goal of every paediatric neurosurgeon.MethodsWe report our series of patients treated with a CSF device from January the first 2016 to December 31 2018.ResultsIn all 147 patients treated for hydrocephalus, the follow-up was of at least of 2 years from the implantation. Antibiotic-coated tubes were always used with a differential pressure valve system. A total of 172 surgical procedures were performed for 147 patients. In the follow-up time period, 4 patients presented a post-operative infection (2.3%). Two infections appeared early after the surgical procedure one after 24 h and the other after 6 days; the other two infections were diagnosed after 53 days and the other after 66 days. The germs responsible of the infections were a Staphylococcus capitals, an Escherichia coli, a Klebsiella pneumonia, and a Staphylococcus aureus.ConclusionsShunts will always be implanted especially in new-borns and for particular aetiologies of hydrocephalus. To reduce the rate of infection, the best thing to do is to adopt adapted protocols. Our low incidence of infection rate for shunts represent a long history to research preventive factors that helped us to improve our results during the time.

SUS 2 - Routine histological examination of haemorrhoidal tissue – an unnecessary environmental and economic expense?

Abstract Background Modern, less invasive methods of haemorrhoid treatment, such as haemorrhoid artery ligation and radiofrequency ablation, are increasingly employed. These do not yield specimens for histological analysis. However, when open haemorrhoidectomy is performed, even in the absence of suspicious operative features and in low-risk patients, the haemorrhoid specimen is routinely sent. This has both environmental and financial costs in an increasingly pressured NHS, and negatively impacts sustainability with no clinical advantage. Methods We retrospectively studied 112 open haemorrhoidectomies performed at our UK hospital from February 2018 to June 2023, reviewing clinic letters, operation notes and post-operative histology. Aims To assess the frequency of incidental pathology identified during routine histological assessment, and the associated financial costs and carbon footprint generated. Results 112 open haemorrhoidectomies were performed in the 5-year study period. In total, two patients with risk factors for AIN/Anal cancer were identified. There were no documented concerns of abnormal intra-operative findings. Histology mainly revealed haemorrhoid tissue alone (103) and benign polyps (8). AIN3 was detected in one of the high-risk patients. The cost per histology specimen was £93.32 (Total cost £10,451.84). Each specimen is estimated to generate 0.29kg of Carbon Dioxide equivalents (Total 32.48kg CO2e). Conclusion Routine histological assessment of haemorrhoidectomy specimens is time-consuming, expensive and has an avoidable carbon footprint for a low detection of incidental pathology. Our study suggests that histology should be reserved for patients with risk factors for AIN/Anal cancer, or concerning intra-operative findings. Larger scale studies, and development of national guidelines would aid clinician decision-making.

The influence of the climate, the materials of the walls, and the gas effects of double and triple-glazed windows in terms of energy evaluation and economic expenses

The computation of heating and cooling loads for office buildings is influenced by the significant population and diverse occupations of the users throughout various time durations. The first step in this investigation involves using specialized software to simulate a model office structure. To improve the thermal insulation of the building's outside covering and the arrangement of the windows, modifications are performed by considering the appropriate assumptions. Furthermore, this study examined samples of double- and triple-glazed windows using argon, xenon, krypton, air, and vacuum as insulating materials. In addition, the thermal efficiency of this construction was evaluated using common wall materials such as Autoclaved Aerated Concrete (AAC), Educational Credential Assessment (ECA), and Cellular Lightweight Concrete (CLC) blocks. This research conducted a comparison and analysis of four different climates, including Canada, Saudi Arabia, Greece, Sweden, and Iran, with the climate of the study location. The aim of this study is to enhance thermal loads and energy efficiency in a simulated construction. The research demonstrates that arranging windows correctly, implementing efficient wall insulation, and ensuring appropriate climatic conditions may result in a reduction in cooling and heating loads by around 4–8 %. Finally, the economic study demonstrates that the time it takes to recoup the investment for different configurations ranges from 2.4 to 9.3 years. In summary, this research provides significant insights on how to decrease energy consumption in buildings and highlights different approaches that architects and engineers could use to build energy-efficient and sustainable structures.

Optimizing waste leachate treatment for environmental and economic sustainability: Insights from a bottom-up study of over 300 cities

Municipal waste incineration in China reached 232 million tonnes in 2022, with increasing problems in treating waste leachate (WL). However, significant uncertainty exists in the emission performances, cost, and optimization strategies of city-level WL treatment. Herein, a bottom-up approach is utilized to investigate the WL status across over 300 cities and a life cycle thinking is employed to compare the environmental and economic effects of various WL and waste leachate concentrate (WLC) management options. Analysis reveals national production of WL has reached 57 million tonnes, with the top ten cities, including Guangzhou, Shanghai, and Chongqing, contributing 20.6 %. Biological coupled chemical treatment (BCT) demonstrates the best environmental performances in WL treatment technologies, while biologically coupled membrane treatment (BMT) offers the lowest economic expenses, and Mechanical Vapor Recompression (MVR) evaporation excels in treating WLC. In a business-as-usual scenario, the national carbon emissions, energy consumption, and economic costs of WL treatment are 24 million tonnes CO2 eq, 264 million GJ, and RMB 19 billion, respectively. Under the WL and WLC technology optimization scenarios, estimations indicate a reduction in carbon emissions by 80.7 % (equivalent to 55.1 million trees) and 19.7 % (equivalent to 13.5 million trees), respectively. Viewed holistically, replacing BMT with BCT emerges as the optimal mitigation strategy, with the synergistic optimization of BMT and MVR evaporation systems following closely. In the formulation of the technology transition strategies, the urban economy, strategic positioning, and geographic location also should be considered apart from the technological aspects, to steadily achieve sustainable co-benefits across environmental and economic dimensions.

Repurposing of Nano-Engineered Piroxicam as an Approach for Cutaneous Wound Healing

Drug repurposing is a potential strategy to overcome the huge economic expenses of wound healing products. This work aims to develop a topical gel of piroxicam encapsulated into a nanospanlastics vesicular system as an effective, dermal wound dressing. Firstly, piroxicam was entrapped into nanospanlastics formulations and optimized utilizing 23 full factorial experimental designs. The scrutinized factors were Span 60: Edge activator ratio, edge activator type, and permeation enhancer type. The measured responses were vesicle size (VS), polydispersity index (PDI), and% entrapment efficiency (EE). The optimized formula was further adopted into an alginate-pectin gel matrix to maximize adherence to the skin. The rheology and in-vitro release were studied for the developed nanospanlastics gel. Cytotoxicity and wound healing potential using scratch assay were assessed on human adult dermal fibroblast cells. The optimal piroxicam nanospanlastics formula demonstrated a VS of 124.1 ± 1.3 nm, PDI of 0.21 ± 0.01, and EE% of 97.27±0.21%. About 70.0 ± 0.9% and 57.4 ± 0.1% of piroxicam were released from nanospanlastics dispersion and gel within 24 h, respectively. Nanospanlastics gel of piroxicam flowed in a non-Newtonian pseudoplastic shear thinning pattern. It was also biocompatible with the human dermal fibroblast cells and significantly promoted their migration rate which suggests an auspicious cutaneous wound healing aptitude.

A reliable knowledge processing framework for combustion science using foundation models

This research explores the integration of large language models (LLMs) into scientific data assimilation, focusing on combustion science as a case study. Leveraging foundational models integrated with Retrieval-Augmented Generation (RAG) framework, the study introduces an approach to process diverse combustion research data, spanning experimental studies, simulations, and literature. The multifaceted nature of combustion research emphasizes the critical role of knowledge processing in navigating and extracting valuable information from a vast and diverse pool of sources. The developed approach minimizes computational and economic expenses while optimizing data privacy and accuracy. It incorporates prompt engineering and offline open-source LLMs, offering user autonomy in selecting base models. The study provides a thorough examination of text segmentation strategies, conducts comparative studies between LLMs, and explores various optimized prompts to demonstrate the effectiveness of the framework. By incorporating an external vector database, the framework outperforms a conventional LLM in generating accurate responses and constructing robust arguments. Additionally, the study delves into the investigation of optimized prompt templates for the purpose of efficient extraction of scientific literature. Furthermore, we present a targeted scaling study to quantify the algorithmic performance of the framework as the number of prompt tokens increases. The research addresses concerns related to hallucinations and false research articles by introducing a custom workflow developed with a detection algorithm to filter out inaccuracies. Despite identified areas for improvement, the framework consistently delivers accurate domain-specific responses with minimal human oversight. The prompt-agnostic approach introduced holds promise for future improvements. The study underscores the significance of integrating LLMs and knowledge processing techniques in scientific research, providing a foundation for advancements in data assimilation and utilization.

Effectiveness and safety of early lens extraction during par plana vitrectomy for proliferative diabetes retinopathy with mild cataract: a randomized clinical trial.

To evaluate the effectiveness and safety of early lens extraction during pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) compared to those of PPV with subsequent cataract surgery. This multicenter randomized controlled trial was conducted in three Chinese hospitals on patients with PDR, aged >45y, with mild cataracts. The participants were randomly assigned to the combined (PPV combined with simultaneously cataract surgery, i.e., phacovitrectomy) or subsequent (PPV with subsequent cataract surgery 6mo later) group and followed up for 12mo. The primary outcome was the change in best-corrected visual acuity (BCVA) from baseline to 6mo, and the secondary outcomes included complication rates and medical expenses. In total, 129 patients with PDR were recruited and equally randomized (66 and 63 in the combined and subsequent groups respectively). The change in BCVA in the combined group [mean, 36.90 letters; 95% confidence interval (CI), 30.35-43.45] was significantly better (adjusted difference, 16.43; 95%CI, 8.77-24.08; P<0.001) than in the subsequent group (mean, 22.40 letters; 95%CI, 15.55-29.24) 6mo after the PPV, with no significant difference between the two groups at 12mo. The overall surgical risk of two sequential surgeries was significantly higher than that of the combined surgery for neovascular glaucoma (17.65% vs 3.77%, P=0.005). No significant differences were found in the photocoagulation spots, surgical time, and economic expenses between two groups. In the subsequent group, the duration of work incapacity (22.54±9.11d) was significantly longer (P<0.001) than that of the combined group (12.44±6.48d). PDR patients aged over 45y with mild cataract can also benefit from early lens extraction during PPV with gratifying effectiveness, safety and convenience, compared to sequential surgeries.

CVaR Quantitative Uncertainty-Based Optimal Dispatch for Flexible Traction Power Supply System

The flexible traction power supply system (FTPSS) integrating a photovoltaic (PV) generation system, an energy storage system (ESS), and a railway power conditioner (RPC) is a promising solution for future railways. However, the volatilities and random uncertainties of PV and traction load negatively impact the ability of FTPSS to operate safely and economically. A dispatch method combining conditional value-at-risk (CVaR) and probabilistic scenarios is proposed for FTPSS to quantify uncertainties into the risk cost. To reconcile economy and robustness, a flexible optimization dispatch model that considers the economic expense and risk cost is built. Finally, this optimization problem is formulated as a mixed integer quadratically constrained programming (MIQCP) model and solved by the GUROBI solver. Based on a genuine instance in China, the method’s validity has been demonstrated. The validity of the method is verified based on a real case in China. The essence of the proposed method is to mitigate the risks related to PV and traction load changes to some extent during the day-ahead dispatch stage by taking into account potential fluctuations in the real-time operating stage. The proposed method can help dispatch decision-makers create effective dispatch strategies and is conducive to FTPSS energy savings and risk avoidance.

Life cycle assessment of direct recycling hot press forging of aluminium AA7075 metal matrix composite

The primary objective of this research is to investigate the process of direct recycling of AA7075 aluminium alloy, which is extensively utilised in the aerospace and flight sectors due to its exceptional strength and lightweight characteristics. Alumina (Al2O3) is used as a reinforcing agent and the effect of hot press forging (HPF) parameters on the mechanical characteristics and surface integrity of the metal matrix composite (MMC) constructed of AA7075 alloy with 1% Al2O3 has been studied. Furthermore, the utilisation of an integrated life cycle assessment (LCA) approach is implemented to assess the environmental impacts and economic expenses associated with the recycling of aluminium via high-pressure forming for both the metal matrix composite and AA7075 alloy. Response surface methodology (RSM) is applied to ascertain the optimal parameters for high-performance filtration. The findings suggest that employing a forging temperature of 532.34 °C and a holding time of 60 min produces favourable results. When comparing the characteristics of the MMC and recycled aluminium, it can be observed that they both demonstrate similar essential process attributes. The utilisation of HPF in conjunction with the Multi-Material Composite has the potential to yield a reduction of up to 24.97% in Global Warming Potential (GWP). This research demonstrates the efficacy of HPF as a viable approach for environmentally conscious and economically efficient recycling of AA7075 aluminium scrap, thereby improving product performance and promoting sustainability.

Peranan Pendapatan Usahatani Wortel Desa Kanreapia Kecamatan Tombolo Pao Kabupaten Gowa Sulawesi Selatan

The objective of this study is to determine the magnitude of money generated from carrot farming in the research area, as well as the impact of carrot farming income on the local economy. Based on the completed analysis, carrot cultivation in Kanreapia Village, Tombolo Pao District, Gowa Regency yields an average income of IDR 80,000,000 per hectare. The respondents incurred an average of IDR 6,810,000/ha in fixed expenditures. The respondents experienced an average variable cost of IDR 7,950,000 per hectare for cultivating carrots. The primary expenses are variable costs, encompassing the expenditures on seeds, pesticides, fertilizers, and labor (including land preparation, planting, and harvesting). Among these variable costs, the biggest expense is attributed to inorganic fertilizer, amounting to IDR 2,900,000. Conversely, the most economical expenses are known as fixed costs, including the mean devaluation amount of the equipment utilized by the participants. Tractors incur the highest equipment depreciation expenses, totaling IDR 2,000,000, while sprayers and scythes have the lowest costs, totaling IDR 80,000. The respondents experienced an average production cost of IDR 14,760,000 per acre. The farmers have an average income of IDR 65,240,000 per hectare by cultivating carrots. Based on the findings of this study, the mean income per hectare earned by carrot farmers in Kanreapia Village, Tombolo Pao District, Gowa Regency is reported.

Elections under the conditions of marital state: constitution, legislation, reality

The issue of electoral legislation and its features during martial law are explored in the article. On the basis of a careful analysis of the constitutional norms, it was found that for most types of elections, the impossibility of holding them is established only in legislative acts. At the same time, it has been proven that the formal absence of a constitutional ban on launching the election process in the conditions of the ongoing large-scale invasion of the Russian Federation does not solve any real problem that currently makes democratic elections in Ukraine impossible.&#x0D; The classification of the reasons for the refusal of democratic states to hold elections during the war has been studied and proposed. In particular, such reasons as electoral (interference of an enemy state, lack of free campaigning, etc.), economic (expenses for conducting elections), security, political (moments of political instability may arise during the transfer of power from the old government to the newly elected one) etc. are highlighted.&#x0D; The concept of “rally around the flag” is described, the historical example of the defeat of the “father of victory” Winston Churchill in the post-war elections with an analysis of the reasons, and the results of a number of sociological studies are also considered. The latter demonstrate a high level of citizen support for the current President of Ukraine, in particular as the Supreme Commander. The authors concluded that there is a sufficient level of legitimacy of state authorities, which will most likely be confirmed by elections. The expediency of all risks and costs under such conditions is assessed as doubtful.&#x0D; The possibility of using electronic voting was considered. It was concluded that such proposals are premature in view of the non-acceptance by the people of Ukraine of such a way of expressing will and the technical capabilities of the state.&#x0D; At the same time, the authors point out the need to prepare a regulatory framework and develop new mechanisms, in particular, using digital technologies, both for post-war elections and for elections under martial law. The article also examines the concept of Military democracy, i.e. militarized or military democracy, i.e. a state with a democratic system operating in wartime conditions.

Development and Validation of a Nomogram to Predict the Risk of Special Uterine Leiomyoma Pathological Types or Leiomyosarcoma in Postmenopausal Women: A Retrospective Study.

The aim of this study was to investigate the risk factors of postmenopausal special uterine leiomyoma pathological types or leiomyosarcoma and to develop a nomogram for clinical risk assessment, ultimately to reduce unnecessary surgical interventions and corresponding economic expenses. A total of 707 patients with complete information were enrolled from 1 August 2012 to 1 August 2022. Univariate and multivariate logistic regression models were used to analyse the association between variables and special uterine leiomyoma pathological types or leiomyosarcoma in postmenopausal patients. A nomogram for special uterine leiomyoma pathological types or leiomyosarcoma in postmenopausal patients was developed and validated by bootstrap resampling. The calibration curve was used to assess the accuracy of the model and receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were compared with the clinical experience model. The increasing trend after menopause, the diameter of the largest uterine fibroid, serum carcinoembryonic antigen 125 concentration, Serum neutrophil to lymphocyte ratio, and Serum phosphorus ion concentration were independent risk factors for special uterine leiomyoma pathological types or leiomyosarcoma in postmenopausal patients. We developed a user-friendly nomogram which showed good diagnostic performance (AUC=0.724). The model was consistent and the calibration curve of our cohort was close to the ideal diagonal line. DCA indicated that the model has potential value for clinical application. Furthermore, our model was superior to the previous clinical experience model in terms of ROC and DCA. We have developed a prediction nomogram for special uterine leiomyoma pathological types or leiomyosarcoma in postmenopausal patients. This nomogram could serve as an important warning signal and evaluation method for special uterine leiomyoma pathological types or leiomyosarcoma in postmenopausal patients.

Fabrication and Compression Properties of Reinforced Epoxy Syntactic Foam With Basalt Fiber

Deep‐sea equipment is generally made of lightweight and pressure‐resistant materials in order to meet the requirements of the actual work. In order to explore marine resources better, it is necessary to research lightweight buoyancy materials for loading on mining equipment. These buoyancy materials contribute not only to providing adequate buoyancy to the mining equipment but also to reducing economic expenses. In this paper, hollow glass microspheres reinforced epoxy hollow spheres (HGMSs‐EHSs) were prepared by the rolling ball method using expanded polystyrene (EPS), epoxy resin (EP), and HGMS as raw materials. Epoxy syntactic foam (ESF) was manufactured by blending EP, curing agent, HGMS, and HGMS‐EHS with molding method. Basalt fiber (BF) reinforced ESF was fabricated by adding BFs to form a fiber network inside the syntactic foam. The results revealed that the density and compressive strength of ESF increased progressively with the number of HGMS‐EHS layers. The density and compressive strength of ESF decreased prospectively with the increase of the stacking volume fraction of HGMS‐EHS. The density and compressive strength of ESF increased gradually with the enlargement of the length and content of BF. In the range of influencing factors mentioned above, the density of ESF remains around 0.3 g/cm3, which has a low density. When the number of layers of HGMS‐EHS was two, the stacking volume fraction was 90%, the length of BF was 12 mm, the content of BF was 4%, the density of BF‐ESF was 0.316 g/cm3, and the compressive strength was 6.93 MPa. The compressive strength of prepared buoyancy material can meet the pressure resistance requirements for operations in waters of a certain depth. With a density of only 0.316 g/cm3, it provides sufficient buoyancy to balance the gravity of the equipment. Compared with the current study, in this paper, BFs were used as the reinforcing phase to prepare solid buoyancy foam with low density and high compressive strength. The experimental results demonstrate that this economical fiber material can effectively improve the compressive strength of buoyancy materials. This buoyancy material may be suitable for loading on small equipment for extracting marine resources. This work provides a reference for the preparation of low‐density solid buoyancy materials.

Thermal properties of new ceramic biomaterial for building façades

The selection of materials for a building facade is based on the dimensions of sustainability: environmental, economic and social dimensions, which form the basis of design and construction in terms of environmental conservation and energy efficiency. Furthermore, this implies the formula for maintaining balance: comfort in the indoor environment, care for nature, minimal economic expenses. This paper focuses on the investigation of a new material composed of bio and recyclable materials: clay, sawdust, and slag, i.e. materials found in abundance in nature as well as materials left out of use. The selected materials offer significant potential for use in construction industry, for building façades. Laboratory testing of the thermal properties of the new material, particularly of the thermal conductivity λ (W/m·K) that is crucial for thermal comfort in buildings to promote energy efficiency, has been performed. Three sets of samples (9 samples in total) with different proportions of the constitutive materials were tested using the Heat Flow Meter (HFM) instrument. Based on the results obtained, several conclusions have been drawn to demonstrate the potential for interaction among used materials, offering advancements in terms of thermal properties. Namely, thermal conductivity of the tested samples varies between 0.14 W/m·K and 0.18 W/m·K, depending on the density of the samples. This value is 7-9 times lower than the thermal conductivity value of traditional clay full bricks without voids and cavities and indicates new possibilities for energy efficient facades, promising environmental preservation, harmonization with nature, offering the solution with the slag and sawdust deposition.

Unanticipated subcutaneous ICD end-of-service due to premature battery depletion and occurrence of lead fracture: A single centre experience

The use of subcutaneous ICDs (S-ICD) is growing over years despite increasing alerts on premature battery depletion (PBD) and lead fractures leading to unanticipated device replacements. In our single-centre study including 192 patients, per year analysis demonstrated that incidence of PBD is higher than previously reported with overall greatest battery replacement requirements around the fifth year of follow-up. The underlying issue appears to be limited to old series devices, but only a longer follow-up will clarify the real impact of this phenomenon on patient outcomes. PBD is an underestimated S-ICDs issue and if the hereby demonstrated trend were to be confirmed in latest device series, this would bring significant concerns to patient safety and huge economic expense to health system.

THE INFLUENCE OF ACCOUNTING INFORMATION SYSTEM IMPLEMENTATION ON PERFORMANCE WITH TECHNOLOGY ACCEPTANCE MODEL (TAM) APPROACH IN PUBLIC SERVICE AGENCIES OF JAMBI PROVINCE

The financial accounting system of the Public Service Agency (BLU) is created to provide detailed information about BLU's financial situation, its capacity to obtain economic resources, expenses incurred, sources and use of funds, and compliance with regulatory standards. This research examines the impact of implementing an accounting information system on performance using the Technology Acceptance Model (TAM) approach at a Public Service Agency in Jambi Province. Employing a survey method through online questionnaires, the study focuses on variables such as perceived usefulness, perceived ease of use, and performance. The participants include 237 users of the Accounting Information System at BLU in Jambi Province, with 233 questionnaires returned and processed. The analytical tool used is SMART PLS. The results indicate that perceived ease of use, perceived usefulness, and acceptance of the Accounting Information System significantly affect its adoption, while perceived ease of use does not significantly impact performance. Perception of usefulness significantly influences performance. Individual performance achievement is linked to task completion with the support of information systems. While perception of ease of use can directly affect performance, it can also have an indirect impact through acceptance of the Accounting Information System as a mediator.

Interaction between economic actors, state and civil society regarding protected areas

This paper is devoted to the interaction between economic actors, the state and civil society regarding protected areas. Be researched the human factor, namely, the fact that the modern world has entered a new stage of its development - globalization, therefore it is important that the process of globalization serves sustainable development, and for this it is necessary that the economic expenses also depend on solutions balanced to the socio-economic problems of environmental conservation. Thus, the approach to the interaction of economic factors, state and civil society in the case of protected areas, continues to be of particular interest to contemporary researchers, considering the growth of the population, their expansion and the exploitation of forests, being a global issue and up to now.

Value of Ultrasound Diagnostics in Predicting Ischemic Stroke Outcomes after Different Reperfusion Therapies

Acute ischemic stroke (AIS) is associated with high mortality, disability and economic expenses. Despite significant progress in the treatment of AIS using endovascular methods, it is not always possible to obtain good results. In the current literature, a small number of studies are devoted to predicting outcomes in patients with AIS who received various types of treatment.This prospective cohort study included 460 patients who underwent thrombolytic therapy, thromboextraction, combination of thromboextraction with stenting or thrombolytic therapy.The relationship between clinical and functional results at the early stages after intervention was assessed with potential predictors, among which the ultrasonic characteristics of extra- and intracranial arteries were analyzed.Complete or partial reperfusion was obtained in 61,7 % of the examined patients. A higher efficiency of endovascular methods compared to thrombolytic therapy was noted (99,5 % vs 33,5 % respectively). The baseline NIHSS and Rankin scores did not show a high predictive valuey for early outcomes, that caused the necessary for searching instrumental predictors. Patients with significant stenosis of the internal carotid artery or vertebral artery had significantly worse clinical and functional outcomes, including the mRS scale. The proportion of poor early outcomes in patients with significant stenosis was significantly lower in the endovascular treatment groups compared to the thrombolytic therapy group. Multiple regression analysis showed that the outcome of AIS is influenced by the level of cerebral arterial involvement as well as lesion size with a threshold value of more than 2 cm.