Entire Unit Research Articles

The psychological impact of sarcoma on affected patients

AbstractObjectiveSarcoma diagnosis and its treatment trajectory may deeply affect the somatopsychic balance of patients and their caregivers. This systematic review aimed at deepening the understanding of sarcoma's impact on the entire family unit involved in the illness experience on a physical (e.g. fatigue), psychological (e.g. mental health, affective regulation, defense mechanisms), and interpersonal (e.g. social isolation, loneliness) level.MethodsThe systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses. The literature search led to the identification and subsequent inclusion of 44 articles focused on sarcoma patients. Results were classified into seven categories: Quality of Life, worries and distress, anxiety and depression, suicide ideation, financial and occupational consequences, unmet needs, and coping strategies. Our search identified only one study focusing on informal caregivers, thus we could not perform a systematic review on these results.ResultsOur findings underlined the traumatic impact of the sarcoma diagnosis. Patients can experience an impoverished emotional life, somatization, social withdrawal, difficulty in decision‐making, increased feelings of discouragement and demoralization, and profound experiences of helplessness and vulnerability. Moreover, they seemed to display anxiety and depression and might present a higher suicide incidence than the general population.ConclusionOur review highlighted that the psychosocial aftermath of sarcoma patients should guide institutions and healthcare professionals toward the design of assessment and intervention models that could contemplate the different dimensions of their suffering. Furthermore, it points out that there is still a lack of evidence regarding the psychosocial impact affecting sarcoma patients' caregivers.

Empowering and Supporting the Families of Exceptional Children and its Positive Impact on Improving

This article explores the profound impact of empowering and supporting families of exceptional children on their quality of life and the broader society. Exceptional children, encompassing diverse abilities and challenges, require specialized care and attention. We delve into the emotional, financial, and social challenges these families often face, shedding light on their unwavering resilience. Highlighting essential support services, including early interventions, therapies, and advocacy, we emphasize how these resources transform lives. Personal anecdotes and case studies illustrate how empowered families witness significant improvements in their children's quality of life, fostering not only their growth but also the overall well-being of the entire family unit. Moreover, we discuss the pivotal role of inclusive environments, inclusive education, and personalized learning plans in unlocking the potential of exceptional children. These approaches promote acceptance, social development, and academic growth while preparing them for a more inclusive and compassionate society. Looking to the future, we anticipate innovative technologies, legislative changes, and global cooperation as catalysts for progress. Our shared commitment to empowering families of exceptional children is not merely a moral imperative; it's a societal one. By fostering their well-being and celebrating their unique contributions, we collectively work towards a brighter, more inclusive future, where every individual is valued and has the opportunity to thrive, enriching the fabric of society as a whole.

Melt-enhanced strain localization and phase mixing in a large-scale mantle shear zone (Ronda peridotite, Spain)

Abstract. Strain localization in upper-mantle shear zones by grain size reduction and the activation of grain-size-sensitive deformation mechanisms is closely linked to phase mixing. With its mylonitic grain size (50–100 µm) and well-mixed phase assemblage, the kilometer-scale shear zone at the northwestern boundary of the Ronda peridotite is, in this respect, no exception. In transects across the high-strain mylonitic into the low-strain tectonitic part of this shear zone, the following four dominant microstructural domains were identified: (1) olivine-rich matrix, (2) mixed matrix, (3) neoblast tails of clinopyroxene porphyroclasts, and (4) neoblast tails of orthopyroxene porphyroclasts. In these domains, phase mixing and its impact on strain localization were investigated by a combination of microstructural (optical microscopy), textural (EBSD), and geochemical (EPMA) analysis. The dominant microstructural domain of all samples is the mixed matrix composed of olivine, orthopyroxene, and clinopyroxene. Its homogenous distribution of interstitial pyroxenes contradicts mechanical mixing. Instead, extensive phase mixing under near-steady-state conditions is documented by the constant grain size and by phase boundary percentages > 60 % for the entire mylonitic unit and all the microstructural domains. Lobate phase boundaries, homogenous phase mixing, and secondary-phase distribution, as well as continuous geochemical trends that are independent of the microstructural domain, point to a reaction-driven, metasomatic formation of the mixed matrix and pyroxene porphyroclast tails in the entire shear zone. An OH-bearing metasomatism by small fractions of evolved melts is indicated by amphibole abundance in pyroxene neoblast tails, olivine B-type-crystallographic-preferred orientations (CPOs), and the microstructural consistency of the garnet–spinel (grt–spl) mylonites from both major peridotite massifs of the Gibraltar arc, Ronda, and Beni Bousera (Morocco). The established syn-deformational temperature of 800–900 ∘C at 1.95–2.00 GPa suggests that the metasomatism did not reset the equilibrium temperatures. Consistent geochemistry and phase assemblage in mylonites and tectonites but a change from equiaxial (tectonites) to wedge-shaped pyroxenes aligned parallel to the foliation (mylonites) point to a pre- to syn-deformational metasomatism, with the potential annealing of the tectonites. For the mylonitic mixed matrix, wedge-shaped pyroxenes, and neoblast tail formation in pyroxene porphyroclast stress shadows point to the activity of incongruent dissolution–precipitation creep. Apart from the dissolution–precipitation creep, strong CPOs of all major phases (ol, opx, and cpx) suggest dislocation creep as being the major deformation mechanism in the entire shear zone.

Penyelesaian Pelanggaran Kode Etik Profesi Bagi Anggota Kepolisian Yang Melakukan Tindak Pidana Penganiayaan (Studi Kasus Pada Polda Maluku)

Introduction: The National Police is an agency that protects public safety, but now many people are caught committing acts that disturb security and even abuse the community. The existence of these violations adds to the long black list of increasing violations of discipline and the code of ethics committed by members of the National Police.Purposes of the Research: know the procedures for the judicial process and settlement of violations of the Professional Code of Ethics against members of the Ambon City Police who commit criminal acts of persecution. As well as to find out the form of sanctions against members of the Ambon City Police who committed criminal acts of persecutionMethods of the Research: The type of research used in this study is empirical juridical. The research location is the Maluku Regional Police. The population is the entire research unit that will be examined and then analyzed.Results of the Research: There is a Court Decision No.29/Pid.B/2021/PN.Amb which handed down the TK Iptu with criminal decisions and other cases of abuse committed by the TK Iptu. Disciplinary Sanctions that do not cause a deterrent effect and the implementation of the KKEP trial have followed the procedures as in Police Regulation Number 7 of 2022 concerning the Professional Code of Ethics and the Code of Ethics Commission, so the KKEP Decision (Professional Code of Ethics Commission) in the case of PTDH examined Iptu Kindergarten is in accordance with procedures within the National Police as well as in a code of ethics hearing by the Professional Code of Ethics Commission (KKEP) decided that the Iptu TK was dismissed with a dishonorable discharge decision (PTDH). The violators are now making an appeal by submitting it to the appeals commission and are currently in the administrative process.

Synergetics Versavit 2.0 Vitrectomy System

The Synergetics VersaVIT 2.0 (Bausch and Lomb) unit has been introduced as a portable system that can be easily moved from the operating room to the office environment and can also run on battery power. Although the VersaVIT 2.0 system is frequently preferred for uncomplicated and long-lasting cases such as vitreous hemorrhage, vitreous condensation, epiretinal membrane, and macular hole, especially in private practice and outpatient surgery centers, complicated vitreoretinal surgeries can also be performed with the system. The installation of the system is provided in a very short time, such as 10 seconds, and due to its simplicity of use, it is possible to perform surgery with personnel who do not have vitrectomy training. VersaVIT 2.0® is a unique portative vitrectomy system that has a cut rate of 6000 cpm. The entire unit is quite light. It can run on electric current power or up to 60 minutes on a rechargeable internal battery. This system includes the entire vitreoretinal product line, including endolaser probes, endoilluminators, chandeliers, and packs. It allows working with 23, 25, and 27g trocar systems and product bases. Illuminated options of laser probe, vitrector, and infusion cannula are available. Endoilluminators have options that provide both focal, Middlefield, and widefield panoramic lighting. Unlike the first model, VersaVIT 2.0 also has the option of silicone injection and removal features. It has a new trocar system for faster and more practical application. Special trocars are available for pediatric cases. VersaVIT 2.0 is a vitrectomy machine that is portable due to its small size and is preferred in selected cases and also allows advanced vitreoretinal surgeries with its sufficient fluidity and good cutting properties.

Early Childhood Care in Spain before the Lockdown

It is widely assumed that every action in Early Childhood Care (ECC) must be conducted taking into consideration the well-being of the family and relying on their active involvement. It becomes essential to implement an intervention strategy that encompasses not only the children but also their immediate environment and the entire family unit. In this context, the Family-Centred Approach (FCA) has emerged as a prominent methodology. This approach can be defined as a collaborative connection between professionals and families, characterised by mutual respect and acknowledgment of their values and choices. Moreover, it entails extending assistance when required, all aimed at fostering optimal functioning of the familial core. This article aims to understand perceptions of families and professionals concerning Early Intervention in Spain before the lockdown. For this, a scoping review was conducted by mapping articles related to Spain in Scopus or Dialnet (CIRC A+, A, B, or C) before the COVID-19 lockdown. After reviewing thirty-five chosen articles, the identified topics were categorised into emotions, diagnoses, and requirements. Many of the publications fulfilled the CIRC B criterion, with a minority of articles meeting this criterion in the latter portion of the present decade. This subject matter warrants further research. There is a need for effective Early Childhood Care (ECC), characterised by early detection and diagnosis, involving well-trained professionals, and which recognises the importance of families in interventions and children development.

Multi-variable study of a novel multigeneration system using biogas separation unit and LNG cold energy utilization, producing electricity, cooling, heat, fresh water, liquid CO2, biomethane, and methanol

Biogas fuel has gained recognition as a highly suitable alternative to fossil fuels, attributed to its renewable nature and remarkable energy density. Biogas fuel utilization facilitates the integration of combined energy systems equipped with multi-generational structures, rendering them suitable for long-term planning and management. Hence, this study presents a unique approach to using biogas for multigeneration, exhibiting enhanced thermodynamic efficiencies and negative carbon dioxide emissions. To achieve the stated objective, an innovative system is devised that involves the utilization of a biogas separation unit in integration with several other components, including a LNG cold energy utilization unit, an ammonia Rankine cycle, a desalination unit, a Kalina cycle, a solid oxide electrolyzer cell, a biomethane combined cycle, and a methanol synthesis unit. The newly devised configuration is simulated through the Aspen HYSYS software and assessed from energy, exergy, environmental, and economic considerations. Based on the research findings, the suggested methodology exhibits energy and exergy efficiencies of 91% and 83%, correspondingly. Furthermore, the evaluation of the entire unit cost of the product and the levelized energy cost reveals values of 4.81 $/GJ and 0.033 $/kWh, respectively. The carbon dioxide emission intensity of the newly implemented process is calculated to be − 0.1041 kg/kWh. The economic aspects reveal a favorable net present value of 1470.6 M$ and a payback period of 5.29 years.

Exploring Leisure and Quality of Life in Parents of Children with Intellectual Disability: An Analytical Review

Purpose: This analysis based on review aims to explore the correlation between leisure pursuits and the quality of life experienced by parents raising children with intellectual disabilities. The review aimed to synthesize existing literature to explore how engagement in leisure pursuits affects various aspects of parental well-being, including physical health, mental health, social connections, and overall quality of life. The methodological approach involved a systematic review of published studies, qualitative research papers, and theoretical perspectives on the topic. Design/Methodology/Approach:The study design employed a comprehensive literature search across various databases, including PubMed, PsycINFO, and Google Scholar, using relevant keywords related to leisure, quality of life, parents, and intellectual disability. Inclusion criteria encompassed studies published within the last decade, focusing on the experiences of parents with children diagnosed with intellectual disabilities and examining the impact of leisure activities on their well-being. A total of 40 articles were selected for the review, encompassing diverse study designs and participant demographics. Findings/Result: The results of the analysis, which was based on reviewing various studies, unveiled a noteworthy connection between engagement in leisure activities and the overall quality of life for parents of children with intellectual disabilities. Taking part in leisure pursuits had a favorable impact on the well-being of parents by offering chances to alleviate stress, engage in social interactions, and enhance physical health. Moreover, inclusive leisure activities that encompassed both parents and children with intellectual disabilities played a pivotal role in nurturing a sense of familial unity and enhancing the well-being of the entire family unit. However, the review also identified challenges related to limited access to leisure opportunities, financial constraints, and time constraints, which could adversely impact parental well-being. The examination highlighted the significance of integrating leisure-based interventions and support structures into the care strategies designed for families raising children with intellectual disabilities. Through the promotion of leisure activities that are both accessible and inclusive, professionals in the field, educators, and policymakers have the potential to elevate the quality of life for parents within this demographic. Moreover, the findings highlighted the need for further research to explore specific leisure needs and preferences of parents and children with intellectual disabilities, allowing for the development of tailored strategies to optimize parental well-being and overall family functioning. Originality/Value: By offering a thorough investigation into the correlation between leisure activities and the quality of life for parents of children with intellectual disabilities, this analysis conducted through review contributes a fresh perspective and valuable insights to the existing body of literature. By emphasizing the importance of leisure engagement in promoting parental well-being, this study contributes to a deeper understanding of the unique experiences and challenges faced by parents in this specific context, ultimately guiding the development of effective support and intervention strategies.

Short-term Rentals and Disorder in a Cannabis Tourism Destination

Short-term rentals (also referred to as “home sharing” or “vacation home rentals”) are a form of temporary housing in which units are leased to travelers for a limited time. Theories such as social disorganization and routine activities suggest possible connections between short-term rental presence and crime or disorder, and existing studies have confirmed that relationship under certain circumstances. However, there are unexplored questions about whether the findings hold true in places with novel demographic, cultural, or touristic features. The present study contributes to this literature by considering the relationship between short-term rentals and disorder across census block groups in a cannabis tourism destination (Denver, Colorado), while controlling for hotel presence, sporting venues, cannabis dispensaries, liquor establishments, and other socio-demographic features. The effects of short-term rental density varied by listing type (entire unit or private room) and were diminished by the inclusion of usage (guest reviews) in the models. Also considered are Denver regulations that may contribute to the limited effects of short-term rentals observed here, as are directions for new research.

67 Audit of discharge summaries on a geriatric ward against the Health Information and Quality Authority (HIQA) National Standard

Abstract Background Discharge summaries are integral for safe transition of patient care. Complete, precise and succinct documentation can ensure improved quality of care and patient safety. Methods Retrospective data were collected from e-discharge summaries that were generated over a 7-month period from June-Dec 2022. A total of 20 samples were selected at random and assessed against the HIQA National Standard. The samples were compared to the physical medical records to countercheck if relevant information were present or omitted. There was a total of 78 outcomes measured as per the national standard. Results There were 8 (40%) discharge summaries with the complete clinical courses, in that they contained the main complaint, relevant clinical findings, relevant investigations results and the complete treatment courses. There were 4 (20%) summaries that had omitted documentation of inpatient complications or adverse events and 8 (40%) summaries had omissions present on medication prescriptions. There were 5 (25%) summaries whereby the list of stopped medications and the reasons for stopping the respective medications were omitted. There were 5 (25%) summaries with incomplete documentation of future plans. Only 4 (20%) discharge summaries had all the relevant information present. Conclusion Efforts to implement E-prescribing and electronic health records should be prioritised. The Irish Medical Council plans to introduce Entrustable Professional Activities (EPA), which are essential tasks that a trainee can be trusted to perform without direct supervision, once sufficient competence has been demonstrated. An entire EPA unit is dedicated to competent patient handover and discharge. A Discharge Summary Flowchart which highlights the inclusion of all the essential components of a complete discharge summary was introduced as a guide for the team. Finally, there is an ongoing continuous audit by Senior House Officers and Interns to assess the quality of discharge summaries after the recommendations have been implemented.

Improving NICU staff decision-making with parents in medical rounds: a pilot study of reflective group dialogue intervention.

The communication skills of healthcare professionals play a crucial role in successful shared decision-making with parents in neonatal intensive care. Improving communication skills can be achieved through practice and reflection on personal experiences after authentic interaction events with parents. The process of reflection typically involves three phases: description, reflection, and critical reflection. In this study, our aim was to explore the acceptability of the Reflective Group Dialogue intervention and its effectiveness in supporting the reflective process. This qualitative pilot study was conducted in the neonatal intensive care unit at Uppsala University Children's Hospital, Sweden. The sample consisted of nine medical rounds with seven families, five neonatologists, seven registered nurses, and five assistant nurses. Purposive sampling was used to collect the data. The intervention comprised four elements: (1) before the intervention, a recorded presentation on shared decision-making was given to the entire unit staff, (2) an observation of a normal medical round discussion with parents, (3) an interview with parents about their experience after the same round, and (4) a reflective discussion with the participating health care professionals after the round. The parent interviews and reflective discussions were audio-recorded and transcribed verbatim. They were analyzed using thematic analysis as a theoretical strategy. Both parents and staff widely accepted the intervention and found it beneficial. We identified four discussions that remained in the descriptive phase of the reflection process, four that reached the reflective phase, and one that reached the critical reflection phase. The descriptive discussions were characterized by using a single perspective to reflect, often based on personal opinions. The reflective discussions included analyzing interaction sequences from both staff and parent perspectives and were primarily based on actual observations of communication during medical rounds. The critical discussion led to a new awareness of current practices concerning parental involvement in decision-making. These discussions also utilized "what-if" thinking to evaluate potential new practices and their pros and cons. The intervention seems promising as it was perceived as beneficial by the recipients and facilitated reflection in most cases. However, to enhance the feasibility of the intervention, some improvements are discussed.

(Invited) Investigation on Dynamics of Expansion Forces and Dimensions Changes of the Pilot Scale Electrodialysis Stack

Electrodialysis (ED) represents a matured and well-established desalination and electromembrane separation technology with typical plate-and-frame configuration. In order to satisfy application demands, there is a trend for an increasing dimension and operating temperature of the industrial ED capable of high performance and efficiency in view of process time and system volume. These activities are motivated mainly by process cost reduction and exploiting new application fields benefiting from higher operating temperature and higher performance-to-volume ratio. This is also the case of reverse electrodialysis, currently meeting a growing popularity as a promising green energy source. However, experiences in a development of larger scale electromembrane devices show that scale-up from laboratory or pilot system to industrial ones is not straightforward. The scale-up simply based on increasing membrane active area or number of membranes, without appropriate modifications of entire unit design, often lead to accentuation of negative effects that are normally negligible on a small scale.One of the critical issues in larger scale represents dimensional changes of the ED stack, mainly due to membranes swelling and changes of mechanical properties of the stack materials as a respond to variation of operating conditions (temperature, electric current, salt concentration). When a robust rigid frame is used for stack assembly, such stack expansion may lead to an increase of the internal expansion forces causing irreversible mechanical damage of the materials used (membranes, spacers). On the contrary, the stack shrinking (e.g. due to membrane drying and deswelling) negatively affects the tightness. Consequently, the performance, reliability and lifetime of the apparatuses can be significantly exacerbated. Therefore, an autonomous (passive or active) system of compression force control has to be employed, which at each moment spontaneously adapts to stack dimensions keeping compression/expansion force at an optimal value. However, prior to a development of such system a deeper fundamental understanding of the stack behaviour is required. We are mainly interested at a) a qualitative and quantitative respond of the stack internal forces upon variation of different operating parameters, b) uniformity of distribution of internal expansion forces, c) dynamics (characteristic times) and reversibility of the stack dimensional changes, d) effect of different compression forces and stack compression-expansion cycles to longer-term operation of the stack and also e) stack tightness.In the first part of presented contribution the basic principle of electrodialysis process, system design and critical aspects of the ED process operation in industrial practice will be discussed. Next, the results of the research aimed at investigation of the dimensional and expansion forces changes in the pilot electrodialysis stack will be presented. The pilot-scale ED unit consists of 100 membrane pairs equipped by heterogeneous anion- and cation-selective membranes. Working area is of 0.4 × 0.1 m2. The stack is orientated horizontally assembled into the robust frame made of aluminum Item® profiles. A rigid endplate is attached to one side of the stack, whereas the opposite end-plate is segmented and equipped by 6 tensiometers measuring local stack expansion force. This compression force is applied to the stack by six pneumatic cylinders with equal pressure pressurized by a one standard compressor. The aspects of the stack behavior mentioned above are investigated as a dynamic respond of the stack to sudden changes in operating temperature (20 – 65 °C), electric current, salt concentration (0 – 160 g/dm3) and compression force (up to 45 kN). Different regimes are investigated: a) a regime with constant compression force in the pneumatic cylinders, or b) constant stack dimension (rigid compression frame) during the entire experiment. It was found that the effect of temperature was significantly more pronounced than the effect of salt concentration and electrical current. Moreover, up to 3 different characteristic times in the stack dynamic respond to temperature change were found.The financial support from grant agency of Ministry of Trade and Industry of the Czech Republic within program TRIO (project TOM2022 no. FV40053) is gratefully acknowledged.

A longitudinal observational study on the epidemiology of painful procedures and sucrose administration in hospitalized preterm neonates.

Although sucrose is widely administered to hospitalized infants for single painful procedures, total sucrose volume during the entire neonatal intensive care unit (NICU) stay and associated adverse events are unknown. In a longitudinal observation study, we aimed to quantify and contextualize sucrose administration during the NICU stay. Specifically, we investigated the frequency, nature, and severity of painful procedures; proportion of procedures where neonates received sucrose; total volume of sucrose administered for painful procedures; and incidence and type of adverse events. Neonates <32 weeks gestational age at birth and <10 days of life were recruited from four Canadian tertiary NICUs. Daily chart reviews of documented painful procedures, sucrose administration, and any associated adverse events were undertaken. One hundred sixty-eight neonates underwent a total of 9093 skin-breaking procedures (mean 54.1 [±65.2] procedures/neonate or 1.1 [±0.9] procedures/day/neonate) during an average NICU stay of 45.9 (±31.4) days. Pain severity was recorded for 5399/9093 (59.4%) of the painful procedures; the majority (5051 [93.5%]) were heel lances of moderate pain intensity. Sucrose was administered for 7839/9093 (86.2%) of painful procedures. The total average sucrose volume was 5.5 (±5.4) mL/neonate or 0.11 (±0.08) mL/neonate/day. Infants experienced an average of 7.9 (±12.7) minor adverse events associated with pain and/or sucrose administration that resolved without intervention. The total number of painful procedures, sucrose volume, and incidence of adverse events throughout the NICU stay were described addressing an important knowledge gap in neonatal pain. These data provide a baseline for examining the association between total sucrose volume during NICU stay and research on longer-term behavioral and neurodevelopmental outcomes.

Creating a sustainable rural general surgery workforce: what enables fellows to return as rural general surgeons?

In the context of shortfalls in rural general surgeon supply, this research aims to explore why rural general surgical Fellows returned and remained after fellowship at a single rural centre in Victoria, Australia. Fellowship positions post achievement of Fellowship of the Australasian College of Surgeons are traditionally not funded by government because they currently fall outside the accredited rural training post funding provided by the federal government. This article aims to explore if fellowship positions can be an important part in sustaining the rural general surgery workforce. Semi-structured interviews were conducted with nine former general surgery Fellows from a single rural Australian institution. Interviews were recorded, transcribed, coded and themed to undertake analysis according to thematic analysis. This research demonstrates that consultant rural general surgeons can be recruited from a fellowship year when emphasis is placed on: (1) creating a positive workplace culture with safe working hours, (2) ensuring diversification of the general surgical case mix, (3) facilitating opportunities for schooling and work for the surgeon's family, and (4) preferentially selecting for those who identify as rural general surgeons. Rural towns can effectively recruit general surgeons when families are supported with career and school opportunities, and the newly qualified surgeon can initially commit to a 12-month position so that opportunities can be assessed by the entire family unit. Fellowship positions (post completion of general surgical training) allow young surgeons to 'try before they buy' prior to moving to a rural area. Ensuring a sustainable general surgical workforce in a rural community requires employee and surgical leadership to ensure a collaborative and progressive culture, which offers work diversity, supports the family lifestyle and petitions for selecting those who embody the rural general surgeon identity. Post-fellowship positions can enable young general surgeons to have exposure to the realities of a rural lifestyle, which is likely to have a positive effect on recruitment. Due to the return investment of the fellowship program, we propose that the federal government should look at funding post-fellowship positions to improve rural recruitment.

Comparative analysis of the energy performance of an air handling unit with two-stage heat recovery operating in the different climatic zones of Bulgaria

A comparative analysis was carried out to establish the energy performance of an air handling unit (AHU) for two-stage heat recovery of the exhaust air. The seasonal coefficient of performance (SCOP) was calculated when AHU is operating in heating mode, as well as COP for the entire unit on an annual basis, taking into account the specific features of the different climatic zones in the Republic of Bulgaria. The results have been compared with the BIN-temperature data for an average climate provided in EN 14825 (Table 37) in order to find out how far this standard will give reliable results for the Bulgarian climate, both in terms of energy consumption and SCOP.

A Call to Validate the Stress Continuum Model.

Since the start of the Global War on Terrorism, exponential demands have been put on military personnel, their families, and the military health care system. In response to a Department of Defense Task Force on Mental Health, the U.S. military began developing and fielding programs to promote the psychological health of its personnel. As part of these initiatives, the Navy and Marine Corps developed the Stress Continuum model. The Stress Continuum is a stress classification system ("ready," "reacting," "injured," and "ill") that provides a common language for identifying, engaging, and intervening when stress reactions or stress injuries are present in military personnel. It is the foundation for resilience and prevention efforts across the Navy and Marine Corps. Although the Stress Continuum has strong face validity, is consistent with current theory, and has been agreed up by expert consensus, it has yet to be empirically validated. The goal of the current article is to begin to empirically validate the Stress Continuum using validated measures of psychological stress. We conducted a retrospective analysis of Stress Continuum data (n = 2,049) collected as part of a program evaluation of two Navy operational stress control programs. Receiver operating characteristic (ROC) curves and analyses were conducted to determine the classification quality of the Stress Continuum using a validated measure of stress (a brief version of the Perceived Stress Scale [PSS-4]). For the first ROC curve, we used the "ill" category (vs. the other three categories) to identify the cut point on the PSS-4. PSS-4 cut point values of 9 and 10, respectively, maximized sensitivity and 1-specificity values. Using the chi-square test, we further found that a more accurate prediction for those in the "ill" category was using the cut point of 9 (79%) relative to 10 (71.8%). For the second and the third ROC curves, we used the "ill" and "injured" categories (vs. the other two categories) and "ill," "injured," and "reacting" categories (vs. the "ready" category), respectively. No optimal cut points on the PSS-4 were identified for these models, indicating that the PSS-4 could not reliably differentiate true-positive and false-positive rates. We found that the "ill" category of the Stress Continuum was predictive of higher levels of stress on the validated measure of perceived stress. Thus, our findings strongly suggest that the individuals in the "ill" zone likely warrant some type of intervention by a trained professional. The Navy has recently leveraged the Stress Continuum to create the Stress-o-Meter to support the fundamental principles of early recognition, peer intervention, and connection to services at the unit level. The Stress-o-Meter serves as a prevention tool that has the capability to collect information about stress levels throughout the entire unit at any time. Continued work on validating the Stress Continuum model and making it easily accessible to military units will ensure service members get the support they need and leaders are able to address the psychological health of their units.

Pengaruh Pemahaman Akuntansi, Sistem Informasi Akuntansi, dan Sistem Pengendalian Intern terhadap Kualitas Laporan Keuangan

The purpose of this study is to test and analyze how the influence of accounting understanding, accounting information systems, and internal control systems on the quality of financial statements. This study used a quantitative approach with a causal type of research. The population in this study is the entire Regional Apparatus Work Unit (SKPD) within the Pasuruan City Government. The sample in this study used Financial Administration Officials (PPK) at the Pasuruan City Regional Government SKPD totaling 32 respondents from 32 SKPD using multiple linear regression analysis techniques and processed using the help of the IBM SPSS Statistics 25 computer application program. The output of this study is that the internal control system has a significant influence on the quality of financial statements, while partially the understanding of accounting and accounting information systems does not have a significant influence on the quality of financial statements. And simultaneously understanding accounting, accounting information systems, and internal control systems affect the quality of financial statements.

High-temperature behaviour and interfacial damage of CGI: 3D numerical modelling

Superior mechanical and thermal properties, high wear resistance and a competitive price of compacted graphite iron (CGI) have made it an integral part of industry worldwide. In its applications in automotive engines, high-temperature environments cause thermal expansion that can result in emergence of interfacial damage in CGI. Although graphite-matrix interfacial damage is considered the main damage mechanism that can lead to total fracture of CGI, extensive research on CGI has not yet fully investigated this phenomenon at the microscale, especially under pure thermal loading. This paper focuses on the high-temperature performance of CGI and the onset of damage in graphite in thermal cycles. Three-dimensional numerical models are developed, with a single graphite inclusion embedded in a unit cell of the metallic matrix. Elastoplastic behaviour is considered for both phases in simulations. The effects of morphology and orientation of graphite inclusions on a response of an entire unit cell to thermal loading are investigated. Also, the influence of periodic and fully-fixed boundary conditions on the damage behaviour of CGI is discussed. The results can give a better understanding of the fracture mechanisms of CGI exposed to elevated temperatures.

An exact spectral formulation for the wave characteristics in an infinite Timoshenko-Ehrenfest beam supported by periodic elastic foundations

Periodic structures have been widely used for vibration reduction and wave control. In the present work, an exact spectral formulation (ESF), being capable to evaluate the dispersion spectra for the bending and shear waves in an infinite Timoshenko-Ehrenfest beam supported by periodic elastic foundations, is proposed, considering the finite length and periodic interval of the distributed elastic supports. First, the frequency-domain displacement function of a unit cell is solved analytically by considering the continuity and equilibrium conditions at the interface between the supported and unsupported parts. Such displacement is formulated as the interpolation of the displacement responses at the end points of the unit cell, and in particular, a compact form is obtained by employing the Hadamard product. Based on this, the spectral matrix for the entire unit cell, involving a total number of 4 degrees of freedom, is derived from the Hamilton’s principle, where the referred matrices are all explicitly given. The dispersion spectra can then be evaluated by solving the eigenvalue problem formulated from the Bloch-Floquet theorem. From a benchmark example, the bandgap characteristics indicated from the proposed ESF have been validated by comparing to the frequency response function of a spectral element model including ten unit cells. Lastly, the distributions of the bandgaps, with respect to the length, the transverse and rotational stiffnesses of the elastic foundation, are investigated based on the defined dimensionless parameters, having potential value to the optimal design of periodic supports for long-span beam structures.

Efficient structure-factor modeling for crystals with multiple components.

Diffraction intensities from a crystallographic experiment include contributions from the entire unit cell of the crystal: the macromolecule, the solvent around it and eventually other compounds. These contributions cannot typically be well described by an atomic model alone, i.e. using point scatterers. Indeed, entities such as disordered (bulk) solvent, semi-ordered solvent (e.g. lipid belts in membrane proteins, ligands, ion channels) and disordered polymer loops require other types of modeling than a collection of individual atoms. This results in the model structure factors containing multiple contributions. Most macromolecular applications assume two-component structure factors: one component arising from the atomic model and the second one describing the bulk solvent. A more accurate and detailed modeling of the disordered regions of the crystal will naturally require more than two components in the structure factors, which presents algorithmic and computational challenges. Here an efficient solution of this problem is proposed. All algorithms described in this work have been implemented in the computational crystallography toolbox (CCTBX) and are also available within Phenix software. These algorithms are rather general and do not use any assumptions about molecule type or size nor about those of its components.