Fast Pace Research Articles

Prior metabolic and bariatric surgery is an independent determinant of severity of decompensation in alcohol-associated liver disease.

Patients with a history of metabolic and bariatric surgery (MBS) are susceptible to developing alcohol use disorder, potentially resulting in end-stage liver disease, with a paucity of data on the evolution of cirrhosis. Our aim was to describe the demographics and mortality in hospitalizations over time in individuals diagnosed with cirrhosis due to alcohol-associated liver disease (ALD) in relation to prior MBS. We included patients hospitalized at the Ghent University Hospital between 1/1/2010 and 01/09/2023 with cirrhosis due to ALD. Data were retrieved retrospectively from all hospitalizations. 46/275 (16.7%) of individuals with cirrhosis admitted with ALD had a history of MBS; they were predominantly female (76.1%), in contrast to the non-MBS population (29.7%) (p<0.0001) and were significantly younger at the time of diagnosis (46 vs. 58years, p<0.0001). Liver disease evolved at a faster pace in the MBS group with a shorter time to first hospitalization (5 vs. 13months, p=0.036), and consecutive hospitalizations. The proportion with primary hospitalization due to acute-on-chronic liver failure (ACLF) was significantly larger in the MBS group (60.9% vs. 27.6%, p<0.0001), and throughout the following hospitalizations, ACLF remained more prevalent in the MBS group. Modeled transplant-free survival was lower in the MBS group (p=0.004), with ACLF as the main cause of death. The weekly amount of alcohol consumed during drinking periods and duration of use were significantly lower in the MBS group. MBS patients hospitalized with ALD develop acute decompensation at a faster pace, with more overall ACLF hospitalizations, and higher cumulative mortality, despite being 12years younger on average. Not applicable.

Digital Literacy and Support Available for Academics at a University (Pilot Study)

Without a doubt, technology is an integral part of the education sector in the 21st Century (Scull et al., 2020). In addition to being a subject matter expert in their specialist area of knowledge, academics are expected to possess digital capabilities that will allow them to deliver current and state of the art curriculum to their students (Newland and Handley, 2016). Digital literacy is defined as ‘those capabilities which fit an individual for living, learning and working in a digital society’ (Jisc, 2014). Incorporating digital literacy into a suitable continuing professional development (CPD) series may ensure the training and development of the academic workforce (Matthews, 2021). The importance digital literacy as a form of continued professional development (CPD) was most evident during the COVID-19 pandemic when all academics had to shift their teaching to an online environment (Antonopoulou et al., 2021). Many academics had to do a crash course in digital literacy to be able to create suitable online learning environments. Digital literacy can be indicative of teaching success and the development of professional identity in the fast-evolving education sector (Mardiana, 2020). Current literature shows that in addition to prior education and qualifications, experience with digital teaching technologies is a major influence in the development of digital literacy, which may impact their professional identity (Watts, 2018). Incorporating digital literacy into CPD and using a suitable model such as Kennedy’s model for CPD may improve the digital literacy of academics. A study conducted by Butson, 2019 revealed that newly appointed academics felt left behind due to the fast pace of technology in their workplace. Another study conducted by Sanchez and colleagues (2021) also demonstrated teachers experiencing low self- perception of their digital literacy skills during their employment. Hence, “being component” in workplace technologies is strongly connected to the construction of professional identity (Avidov-Ungar and Forkosh-Baruch, 2018). Therefore, it can be suggested the role an institution plays in developing digital capabilities of academics is important not just for successful and efficient delivery of high-quality teaching, but also for the well-being of the academics in the workplace and to develop the professional identity. Also, understanding the baseline digital capability of its employees and whether additional support is required to develop digital literacy can provide invaluable insight in professional development of an academic during its employment at an institution. The aim of this study is to evaluate the self-perceived digital literacy of academics employed at a university and the support they have received in developing their digital literacy during their employment. The aims also include to identify support that staff require to build their DL and how Kennedy’s 3 lens of CPD may assist in improving DL programs at universities (Kennedy, 2014).

Epidemiology of Traditional Cigarette and E-Cigarette Use Among Adolescents in Poland: Analysis of Sociodemographic Risk Factors

Background: E-cigarettes are electronic nicotine-dispensing systems in the form of an aerosol. Their popularity among adolescents is growing at an exceedingly fast pace. Methods: This study aimed to determine the prevalence of the use of traditional cigarettes and e-cigarettes and identify demographic risk factors for the use of these products by adolescents in large and small cities and rural areas in Poland. This cross-sectional study conducted in 2021 aimed to assess the prevalence of traditional cigarette and e-cigarette use among adolescents aged 12–18 in Poland, while identifying demographic risk factors associated with their usage. A total of 10,388 adolescents participated, predominantly from rural areas. Results: Findings revealed that 12.3% were traditional cigarette smokers, with 90% smoking in the past month, while 14.9% were e-cigarette users, with 84.7% using them in the past month. Dual users accounted for 6.4% of respondents. Non-smokers were younger, and e-cigarette users were more likely to be boys from larger cities. Moreover, mothers of non-smokers tended to have higher education levels than those of traditional cigarette smokers. Conclusions: This study provides important new insights into demographic predictors associated with the use of specific devices, which can help inform targeted interventions to reduce e-cigarette use.

Biomedical Engineering Literature: Advanced Reading Skills for Research and Practice

Medical engineering is a field of study that combines biological and medical sciences with engineering to develop improved healthcare technologies. It is imperative that you possess a deep understanding of both the material and the technical language used in this rapidly advancing field in order to effectively grasp key topics and navigate the rapidly expanding literature. This paper examines the future of the biomedical engineering profession through the lens of advanced reading strategies. It starts with the assertion that biomedical engineering literature presents three challenges: the level of density is technical, the area is interdisciplinary, and the growth of knowledge is exponential. In the view of the above challenges, the paper discusses various advanced reading skills in relation to biomedical engineers. These skills include the ability to critically read scientific texts, both at a fast pace for an overview and in detail for deeper understanding, to identify key ideas and methodologies relevant to the field, and to assess the validity of scientific claims and data representations. The paper also aims at pointing out how separate elements like the use of systematic reviews, of meta-analysis, of data visualization tools that complement reading, help the researcher in the process of managing gathered information from various sources. This paper describes teaching these skills for both academic and professional practice, with examples of how improved reading competencies can enhance research quality and contribute to innovations in medical technologies, tissue engineering, and clinical trials. Furthermore, the paper aims to discuss the future trends due to the increasing incorporation of continuous learning for addressing the challenges posed by novel technologies including artificial intelligence and nanotechnology that define the future of biomedical engineering. biomedical engineering students require the acquisition of higher order reading skills in preparation for information reading: national and international publications in the engineering profession, policy and technology in support of health care delivery systems, product development, and other purposes. The ideas stated and demonstrated in this paper should be practical to both beginning scholars and veteran professionals in the biomedical engineering field as well as useful for seminar and workshop participants in seminars and workshops on biomedical engineering literature.

DevSecOps practices and tools

Nowadays, software development happens at a fast pace. At the same time, Information Technology organizations face higher demands and competition while struggling with external threats such as cyberattacks. Therefore, many organizations adopt DevOps as a working culture to improve their Software Development Lifecycle (SDL). However, the success of DevOps adoption remains inconsistent, and recently, IEEE introduced a DevOps standard that might help improve DevOps adoption. The standard mentions DevSecOps as the security aspect of DevOps, adding security practices to the SDL from inception, but what are these practices or capabilities? Which tools can be used to implement these practices? Therefore, a Multivocal Literature Review was performed to identify DevSecOps practices and their definitions, and which tools can be used to implement them.

Urban agriculture and urban planning: a case of Bangalore between the 1950s and the 1970s

With urbanisation moving at a faster pace than ever before, discussions on Urban Agriculture (UA) and its role in sustainable development have taken centre stage. The implementation of UA has its challenges, one of them being how urban development frameworks view it. This paper examines the disappearance of a historic UA landscape in Bangalore, India between the 1950s and the 1970s, a period of post-independence urban planning. Using historical records including urban planning documents, government files, and oral histories that I recorded with a traditional community of UA practitioners—the Vahnikula Kshatriya—in Bangalore on their memories of the 1950s–1970s, I argue that colonial frameworks in post-independence urban development plans not only displaced UA but also continues to affect it. This paper highlights the urgent need to change how urban planning in formerly colonised places approaches UA.

Recent Trends in Academic Vs Non-academic Radiologist Compensation and Clinical Productivity.

Recent radiologist compensation and clinical productivity trends have not been well characterized, especially across academic vs. non-academic practice settings. To assess recent trends in in financial compensation and clinical productivity between academic and non-academic settings in diagnostic (DR) and interventional radiology (IR). We studied deidentified data from the Medical Group Management Association (MGMA) for both DR and IR radiologists in academic and non-academic practices from 2014 to 2023. Median, 25th and 75th percentile, and mean values were analyzed for compensation, collections and work relative-value-units (wRVUs). Compensation and productivity data were compared by radiology subspecialty (DR vs IR), practice type (academic vs non-academic provider), geographical region of the US, and practice size. Trends in absolute changes were analyzed with linear regression. The MGMA Survey data for 2023 included responses for 3769 radiologists (2883 in DR and 886 in IR). In 2023, non-academic radiologists had greater total median compensation than academic faculty in both DR (by 27%) and IR (by 32%). From 2014 to 2023, median compensation increased faster for academic DRs (3.2% annually) than for non-academic DRs (1.9% annually). In 2023, DRs produced greater median wRVUs than IRs (by 53 % for non-academic and 46 % for academic radiologists) with higher collections, but IRs had higher compensation (by 16% in non-academic and 10% in academic settings). Over the last decade, IR physician compensation increased by 3.9% and 3.4% annually for non-academic and academic IR physicians respectively while median work RVUs trended downward (by -1.5 % for non-academic and -2.4 % for academic physicians) with declining collections (by -4.4 % annually for non-academic and -2.1 % for academic physicians). Over the last decade, the salary gap between academic and non-academic radiologists has narrowed. Physician compensation has increased at a faster pace in IR, despite relatively lower clinical productivity and declining collections.

Triazole scaffold-based DPP-IV Inhibitors for the management of Type-II Diabetes Mellitus: Insight into Molecular Docking and SAR.

Diabetes mellitus, characterized as a chronic metabolic disorder or a polygenic syndrome; is increasing at a very fast pace among every group of the population worldwide. It arises due to the inability of the body to produce enough insulin (the hormone responsible for controlling blood sugar levels) or inability to utilize the insulin, leading to hyperglycaemic condition, which, if left uncontrolled gives rise to chronic microvascular and macrovascular complications like retinopathy, neuropathy, nephropathy, coronary artery disease, cognitive impairment, etc. Several therapeutic approaches are available for the treatment of diabetes; among which dipeptidyl peptidase (DPP-IV) inhibitors (gliptins) hold a significant place. DPP-IV is a multifunctional enzyme or a serine exopeptidase that plays an imperative role in cleaving bioactive molecules. DPP-IV causes the breakdown of incretin hormone (GLP-1: Glucagon-like peptide 1 and GIP: Glucose-dependent insulinotropic peptide) that is essential for controlling glycaemic levels in the body. Inhibition of DPP-IV enzyme (DPP-IV inhibitors: Sitagliptin, Saxagliptin, Linagliptin, Alogliptin) prevents this breakdown, thereby controlling blood glucose levels and saving the patients from deleterious effects of prolonged hyperglycaemic conditions. Triazole-based DPP-IV inhibitors are a significant class of drugs used to treat Type 2 diabetes mellitus in a dose-dependent manner. Clinical trials have demonstrated their efficacy as monotherapy or in combination with other antidiabetic agents. This review highlights the molecular docking studies and structure-activity relationship of potential synthetic derivatives that may act as lead molecules for future drug discovery and yield drug molecules with enhanced efficacy, potency and reduced toxicity profile.

Perennial Fodder Crops as a Tool for Soil Carbon Management in Agroecosystems

Carbon sequestration, typically referred to as carbon storage is defined as the “long-term storage of carbon in plants, soils, geologic formations and the ocean, which occurs both naturally and as a result of anthropogenic activities”. With respect to agricultural sector, carbon sequestration is viewed as the capability of agriculture lands to absorb carbon dioxide from the atmosphere. Out of the different ways in play, cultivation of fodder crops turns out to be promising due to its high biomass production, root proliferation, mostly perennial nature, suitability for wastelands and most importantly as the feed for livestock. Restoration of degraded lands, adoption of pasture-based agroforestry systems, inclusion of grasses, sowing of improved forage species, grazing management, nutrient and water management are strategies that aid in improving carbon sequestration in fodder production systems. Perennial fodder grasses and fodder legumes such as alfalfa are excellent for carbon storage as they do not require replanting after each harvest which avoids soil disturbances that usually associate with annual crops. Carbon neutral methods of cultivation is greatly hoped to convert agriculture from a source of carbon to a permanent sink of carbon at a faster pace.

Is biomechanical loading reduced in individuals with unilateral transtibial amputation during fast-paced walking when using different ankle/foot prostheses? A pragmatic randomized controlled trial.

Sound side loading is a risk factor for osteoarthritis development, which has been noted to reduce when using advanced prostheses during normal-paced walking in individuals with unilateral transtibial amputation (UTTA). However, descriptions of loading during fast-paced walking remain relatively unreported. Therefore, the aim of this study was to describe the biomechanical loading of individuals with UTTA while using different ankle/foot prostheses during fast-paced walking. A blinded, randomized control trial was conducted in a group of K3-K4 ambulators, who used 3 different prosthetic feet (1. a solid ankle cushioned heel foot prosthesis [SACH], 2. a standard energy storage and return foot prosthesis [ESAR], and 3. a novel ESAR foot prosthesis [N-ESAR]) in a 2-week randomized crossover design. The spatiotemporal and kinetic data of the participants' fast walking pace were collected. Data were analyzed using a mixed model and one-way analysis of variances (p < 0.05) and Cohen d. Twenty individuals with UTTA (age: 40 ± 16 years; height: 1.76 ± 0.09 m; and BMI: 24.72 ± 3.63 kg/m2) participated in this study. There were minimal changes in the spatiotemporal data between the different prosthetic feet. When the participants used the N-ESAR feet, they had a lower peak vertical ground reaction force (p = 0.02) and external knee adduction moment (p = 0.02) on the sound side, as well as a higher distal shank power on the prosthetic side (p < 0.01). Overall fast-paced walking resulted in higher sound side loading forces compared with normal-paced walking. However, use of the N-ESAR prosthesis reduced the biomechanical loading on the sound side in individuals with UTTA while walking at a fast pace compared with the ESAR and SACH prostheses. The percentage change in the biomechanical loading from normal- to fast-paced walking of the N-ESAR foot was also larger compared with the other prostheses, perhaps because of the individuals' ability to achieve a faster walking pace when using the N-ESAR prosthesis. Longitudinal intervention studies should be performed to further investigate the possible benefits of using advanced prostheses.

Is Schistosoma mansoni playing a part in liver carcinogenesis?

The relationship between Schistosoma mansoni (Sm) and hepatocellular carcinoma (HCC) has been evaluated by many studies that point towards a co-relation between schistosomal infection and HCC. While many such studies demonstrated that Sm infection in the presence of another carcinogenic factors leads to HCC, none of these studies could conclusively prove the cancer-inducing ability of Sm in humans, independent of other carcinogenic factors. The aim of this work is to present the current understanding on the association of Sm with HCC. Many epidemiological, pathological, and clinical studies have shown the role of multiple events like chronic inflammation and fibrosis as well as hepato-toxic agents like soluble egg antigens (SEAs), which help in creating a micro-environment which is suitable for HCC development. The role of Sm infection and deposited eggs in causing persistent inflammation, advanced fibrosis, and the role of SEAs, especially IPSE/alpha-1, is emphasised. This work concludes that Sm infection has the potential to induce cancer independently but the same has not been reported in humans to date. Extensive research is required to establish a causal relationship between Sm infection and HCC induction, or a complete lack thereof. However, Sm infection definitely acts along with other carcinogenic factors to induce HCC at a much faster pace and also leads to an aggressive form of liver cancer, which the other carcinogenic factor could not have achieved alone.

Low conduction velocity is a key factor for localisation of reentrant drivers for atrial fibrillation

Abstract Background Atrial Fibrillation (AF) is a prevalent cardiac arrhythmia globally, associated with heightened risks of stroke, dementia, and heart failure. Catheter ablation, the sole curative therapy for AF, yields suboptimal success rates for persistent AF cases. Understanding the mechanisms and dynamics of AF remains challenging, hindering treatment advancements. Novel ablation strategies aimed at targeting substrates harbouring AF reentrant drivers (RD), such as low-voltage ablation and rotor-based ablation, have yet to demonstrate superiority over the gold standard ablation strategy – pulmonary vein isolation. Purpose The purpose of the study is to integrate in-silico 3D left atrial (LA) simulations and explainable artificial intelligence (AI) to pinpoint key factors for RD localisation in persistent AF, aiming to improve the mechanistic understanding of AF and help develop a more effective ablation strategy. Methods 3D LA models were derived from magnetic resonance images of 41 patients and combined with atrial cell electrophysiology models. Persistent AF was initiated in each patient-specific LA model with fast pacing, and five functional features (action potential duration (APD), conduction velocity (CV), wavelength, APD spatial gradient, CV spatial gradient, and wavelength spatial gradient) and three structural features (fibrotic density, fibrotic entropy, and image intensity ratio) were evaluated. A random forest AI model was trained to classify phase singularities corresponding to the RDs (PS-RD) in five distinct tissue classes (total LA tissue, healthy tissue, fibrotic border zone, dense fibrotic tissue, and PS-RD tissue) based on the functional and structural features. Shapley additive explanations (SHAP) analysis was then used to find the most influential feature in the AI model’s decision process. Results Simulations of the patient-specific LA models revealed that RDs were typically localised in regions with the lowest atrial CV, which often coincided with patches of dense fibrotic tissue. In a five-fold cross-validation, the random forest AI model achieved high accuracy in classifying PS-RD regions: a mean ROC AUC of 0.99 ± 0.010, a mean F1 score of 0.86 ± 0.034, a mean recall of 0.95 ± 0.058, and a mean precision score of 0.79 ± 0.085. The further SHAP analysis revealed that low CV was the key determinant in classifying the PS-RD regions. Conclusion Our study combined AF computational modelling and explainable AI to identify the key factors in RD localisation. Both the computational and AI models concluded that low CV was the most important determinant in localising RDs. These findings provide mechanistic evidence for the efficacy of ablation strategies that target low CV atrial areas for persistent AF patients.

Using 3rd -Party Logistics Services OR Developing Own Capability to Cater to ECommerce Demands - A comparative Analysis

Ecommerce is an inseparable part of modern global lifestyle, connecting people across international borders and enabling sellers to access global. Despite growing massively over the last couple of decades, its growth is far from over. In fact, the pandemic has acted as an accelerator and the growth momentum is continuing despite people returning to the conventional brick and mortar shops. Ecommerce innovations are constantly being rehashed and improved – especially after the global pandemic this transition is now innovating at a much faster pace. For responding to the ever-increasing demand for swifter yet efficient fulfillment of customer order along with timely shipment, a larger number of e- commerce businesses are turning towards third-party logistics or 3PL providers. While it offers them the freedom from the hassles of storing and delivering finished products to the end-users, the human resource that is therefore freed, can then focus on core competencies of the business thus allowing them to give attention to product development, innovation along with marketing and sales. There is always the risk of poor fulfillment and delayed shipments or goods getting damaged in transit which deteriorates customer satisfaction and company profitability. This article compares the use of third-party logistics (3PL) against building in-house capabilities and highlights the virtue of careful selection and employment of experienced 3PL in helping an enterprise ride the anticipated growth wave by offering cost advantages and flexibility.

Analysis of Gender and Mental Health Differences

With the rapid development of modern civilization, the increasing pressures of contemporary life, the fast pace of living, and the influence of social media, an increasing number of people are suffering from mental health issues. Mental health is an important aspect that everyone should be concerned about. Research has revealed that depression can significantly impact a person's professional and interpersonal skills, potentially affecting ones career trajectory. However, while both men and women face mental health issues, gender differences persist. Numerous studies have indicated that disparities exist in both brain structure and function between males and females. For instance, females may exhibit a greater advantage in emotional processing and social cognition, whereas males may demonstrate enhanced spatial cognition abilities. This study aims to explore gender differences in mental health across four factors. The result shows that, family intergenerational relationships have a greater impact on girls than boys. During their student years, interpersonal relationships within dormitories have a greater influence on boys. In the social sphere, women are more prone to depression than men. From a personal perspective, females are also more likely to experience negative emotions compared to males.

The window of opportunity: a case study of the battery electric vehicle in Thailand

Purpose Thailand, although a late entrant, has emerged as a significant center for the production and export of internal combustion engine (ICE) vehicles in Asia. With the arrival of a disruptive battery-electric vehicle (BEV), this study aims to investigate whether Thailand can exploit this window of opportunity to leapfrog. Design/methodology/approach This paper uses data sourced from Thailand’s Department of Intellectual Property to analyze electric vehicle (EV) patent applications. This paper collected qualitative data and conducted interviews with several EV manufacturers. Findings Although Japanese automakers dominate essential EV technology patents, they trail behind Chinese automakers, which benefited from the Free Trade Agreement (FTA) in EV sales. The incumbents, Japanese and Western, choose to expand their production of hybrid electric vehicles (HEVs) and plug-in hybrid vehicles. ICE technology does not constrain new entrants, such as Chinese automakers, Japanese newcomers and Thai newcomers. Compared to Japanese carmakers stuck with ICE and HEV technologies, they have been transitioning to BEVs at a faster pace. BEV has opened the door for large Thai indigenous energy corporations to enter the automotive industry by focusing on niche areas (nonfour-wheel vehicles) and supporting businesses like charging stations. In summary, Thailand has successfully attracted foreign direct investment (FDI) into the EV sector, but it has not yet succeeded in developing indigenous technologies related to EVs. The Thai automobile sector fails to leapfrog because it is too tied up with Japanese automotive production networks and has an unfavorable FTA with China. Originality/value This study sheds light on the limitations of an industrial development strategy relying on openness to trade and FDI without adequately strengthening indigenous technologies and firms, as the country adopting the strategy fails to leapfrog when the window of opportunities created by disruptive technologies arrives.

Efficacy of Yoga in Reducing Depressive Symptoms: A Systematic Review

Introduction: The fast pace of changes in contemporary life increases the need to adapt, which leads to depressive pathologies due to psychological suffering. Yoga has therefore emerged as a complementary approach to the treatment of depression. Objective: To analyze the efficacy of yoga in reducing depressive symptoms. Materials and methods: This is a systematic literature review, which followed the Joanna Briggs Institute methodology for systematic reviews of efficacy, with the review protocol registered on Prospero under the code CRD42023448158. To devise the research question, the Pico strategy was adopted, in which “P” stands for people with depression, “I” for yoga; “C” for people who have not been submitted to yoga, and “O” for improvement/reduction of depressive symptoms. The requirements of the Prisma flowchart were followed and the search was conducted in the Medline/PubMed, Web of Science, Lilacs, BDEnf, Ibecs, PsycINFO, and Cinahl databases. The Jadad scale was used to assess methodological quality and the Cochrane Risk of Bias 2 to assess the risk of bias. Results: A total of 1138 studies were found, of which 10 were selected for data extraction, detailed reading, and qualitative synthesis. Yoga, especially mindfulness yoga, has been shown to be an effective intervention for various conditions, including depression. Its benefits include significant improvements in depression severity, health-related quality of life, motor dysfunction, mobility, spiritual well-being, and parasympathetic nervous system activity. Conclusion: The studies highlight the efficacy of yoga in reducing depressive symptoms in various populations and contexts, highlighting its effectiveness as a complementary therapeutic approach in the management of depression.

Influence of musical training on temporal productions when using fast and slow counting paces.

The aim of the study was to assess the ability to maintain a steady pace during a counting task, aloud or silently, when a fast (28 counts every 900 ms) or slow (18 counts every 1,400 ms) pace is adopted (target = 25,200 ms), and to test whether ability is the same for musician and nonmusicians. The study analyzes the mean and variability of 30 temporal productions. The results show more variability (a larger coefficient of variation: standard deviation/mean production) in the condition where the pace is slow, a finding consistent with previous reports with this task. This finding applies here in both the aloud and silent counting conditions and, most importantly, applies to both musicians and nonmusicians. The results also indicate that there is no significant difference for the absolute error (|mean production - target duration|). In brief, the capacity to keep variability low when maintaining a pace seems to gain benefit from musical training, and this training difference does not depend on counting aloud versus silently and is not restricted to brief intervals.

COMPARATIVE ANALYSIS OF INDOOR AND OUTDOOR EMPLOYEE BALANCE AT MUHAMMADIYAH UNIVERSITY OF MALANG

Background: Balance disorders in indoor and outdoor employees have an impact on decreased work performance, fatigue in the body, and can cause work-related illnesses. Making work not optimal and having an impact on daily life becomes disrupted. Working environmental conditions such as wet floors, uneven ground, non-sloping ground contours, insufficient lighting, excessive light glare, weather, and work that is carried out at a fast pace with heavy loads can affect balance disorders which can cause employee falls. Objectives: The purpose of this study was to find out the difference in balance between indoor and outdoor employees at the University of Muhammadiyah Malang. Methods: This study used a quantitative research design with this type of observational research using the one leg balance test and the time up and go test. Results: This study obtained results with the normality test obtaining a p value (&gt; 0.005) and the Spearman test static test obtaining a value of 0.800 p (&gt; 0.05) and the Spearman test dynamic test obtaining a value of 0.777 p (&gt; 0.05). Conclusion: In conclusion, there is no difference in balance between indoor and outdoor employees at the University of Muhammadiyah Malang.

Industrial symbiosis as enabler and barrier for defossilization: The case of Höchst Industrial Park

Höchst Industrial Park (IPH) was founded in 1863. Over the years, a network of symbiotic relationships has developed between the companies in the park, the park, and the Rhine-Main region, resulting in the efficient use of resources. However, while this industrial symbiosis reduces greenhouse gas (GHG) emissions, a shift towards more sustainable energy and raw material supplies is required to meet climate goals. Options include renewable electricity, heat electrification, green hydrogen, carbon capture and utilisation, biomass, and recycling. Such a transformation is challenging because it requires the application of highly innovative technologies on a large scale, the cooperation of many public and private actors, a fast pace to achieve GHG reduction targets, and a high degree of structural complexity due to the need to adapt the infrastructure. This need must be managed amid considerable regulatory uncertainty, a lack of infrastructure for producing and transporting green hydrogen and electricity and increasing international competition between production sites. We analyse how established symbiotic relationships affect the transformation of an existing industrial park using the case of IPH and focus on the manufacturing companies at this site. In addition, we show how a defossilised energy supply in IPH could look and which new symbiotic relationships could develop. We also discuss the role of stakeholder management in achieving coordinated action.

Fitting the mixed Rasch model to the listening comprehension section of the IELTS: Identifying latent class differential item functioning

This study applied the Mixed Rasch Model (MRM) to the listening comprehension section of the International English Language Testing System (IELTS) to detect latent class differential item functioning (DIF) by exploring multiple profiles of second/foreign language listeners. Item responses of 462 examinees to an IELTS listening test were subjected to MRM analysis. Three classes emerged: (1) ‘Medium-level Stimulus Processors’ who can somewhat synchronize top-down and bottom-up processing, handle multitasking to a certain extent, comprehend moderately complex items, and manage input delivered at a relatively fast pace; (2) ‘High-level Stimulus Processors’ who have greater abilities in synchronizing top-down and bottom-up processing, multitasking, understanding complex items, and handling fast delivery input and more paraphrased content; and (3) ‘Low-level Stimulus Processors’ who rely more on bottom-up processing, have limited lexico-grammatical knowledge, struggle with multitasking and complex items, and find fast delivery input and paraphrased content challenging. Differences across the classes were further explained.