Transition Period Research Articles

Transitional Care for Adult Patients with Congenital Heart Disease: A Review.

The prognosis of congenital heart disease (CHD) has improved, and most patients now reach adulthood. Owing to residual disease and comorbidities, it is recommended that adult CHD (ACHD) patients transition to adult care for lifelong monitoring and treatment. However, this transition period can be challenging for CHD patients owing to obstacles such as independence from their parents and establishing self-management. To achieve a seamless shift from pediatric to adult care and ensure continuity, it is important to educate and motivate patients appropriately, and an established transition system is needed that involves collaboration between CHD specialists and healthcare providers across medical specialties. The present review describes the epidemiology of ACHD and notable points in patient care as the background of transition. The concepts and an overview of transition systems, educational systems, and potential lapses in the care of their relevant causes are then provided with supporting evidence.

Sustainable culinary culture: gastronomic practices of locals' transitional periods in Menteşe in the context of intangible cultural heritage

Sustainable culinary culture: gastronomic practices of locals' transitional periods in Menteşe in the context of intangible cultural heritage

Creating a data collection and management platform to support measurement of adolescent HIV care transition processes within low- and middle-income countries: The GRADUATE project.

Few national programs and research cohorts within low- and middle-income countries (LMICs) document transition-related processes and outcomes for adolescents and young adults living with HIV (AYLH) transitioning to adulthood. Between 2017-2020, The Global fRAmework of Data collection Used for Adolescent HIV Transition Evaluation (GRADUATE) project convened a collaborative advisory group to identify key variables and definitions capturing the process, predictors, and outcomes across the transition period. In total, 114 variables identified as essential to measuring AYLH transition-related data were identified and formatted into a GRADUATE Data Exchange Standard (DES), which was added to and harmonized with the existing International epidemiology Databases to Evaluate AIDS (IeDEA) DES. In 2019, the GRADUATE DES was pilot tested at four IeDEA facilities in Malawi, South Africa, and Thailand through a cross-sectional study. Upon comparing the variables to routine medical records, available data were too limited to adequately capture transition-related processes and outcomes. However, additional data collection using GRADUATE tools was feasible and improved completeness. Of the 100 (52% female) AYLH included in the pilot study, 71% had transitioned/transferred to adult care, with 42% transitioning from an adolescent-specific model of care within an integrated family clinic to having their clinic visits scheduled on a different day of the week while 58% transferred from a pediatric facility to one offering adult HIV care. While almost all (94%) had a transition-related discussion with their healthcare providers prior to the transition, we found that 69% (95% CI 49-85%) were somewhat or very satisfied/comfortable with the post-transfer clinic and the staff. Utilization of the GRADUATE DES better characterized AYLH transitioning to adulthood across LMICs, and optimally measured transition preparation activities and outcomes. Utilization of the GRADUATE DES in other settings could facilitate comparisons and identify gaps in the care of transitioning adolescents that need to be addressed.

Rolf Loeber – Machteld Hoeve – N. Wim Slot – Peter H. van der Laan (eds.): Persisters and Desisters in Crime from Adolescence into Adulthood. Ashgate, Surrey, 2012, 461 oldal

The volume “Persisters and Desisters in Crime from Adolescence into Adulthood”. edited by Rolf Loeber, Machteld Hoeve, Wim Slot and Peter van der Laan, gathers an international team of academics for an interdisciplinary challenge. The authors provide an overview of the most important criminological questions and problematic issues of the transition period from adolescence to adulthood.

დინამიური კონკურენციის განვითარების პერსპექტივები საქართველოში, ევროკავშირის კანდიდატი ქვეყნის სტატუსის ჭრილში

The paper discusses the theoretical foundations of dynamic competition in terms of the opportunities for innovative development at the expense of intellectual property protection and quality management, the benefits of society under the conditions of dynamic competition within the framework of the Nash equilibrium, the financial problems of establishing societies, the study of the dynamics of employment in Georgia during the transition period, the definition of corporatism and brandism, and development perspectives. The legal framework will also be studied, including the Association Agreement, the candidate statute and the negotiation phase requirements for employers, and the general content of the socially oriented economy of the European Union. The authors conclude that dynamic competition is being established in Georgia on a large scale, which contradicts the principles of free entrepreneurship, economic "freedom", laissez-faire of Schumpeter, Weber, Hayek and others, and opposes the concept of responsible consumer, and which can be perceived as a form of additional regulation in the conditions of overproduction of the market economy. In the West, in the Pareto equilibrium, on average, about 80% of GDP comes to only 20% of the population, while 80% of the population creates only about 20% of GDP on average, and the dilemma of the self-employed becomes more and more relevant in terms of socio-economic development of countries, which the development of nanotechnologies, artificial intelligence (neural networks) and robotics is also increasing. Also, based on accounting and financial reporting approaches, the principles of recognition of innovation research and development costs in the modern economy will be discussed, indicating the compatibility of their content with dynamic competition and the possibility of the state's potential role in stimulating this area. In the end, according to the authors' conclusion, only those nations that promote innovative development and which need to be stimulated in conditions of real annual economic growth of up to 4% have a future arising from evolutionary economics perspectives.

Can we do better supporting young adults with cerebral palsy as they navigate adulthood? A review of current and future transitional practices.

Patients with cerebral palsy (CP) face lifelong consequences of their condition, and their healthcare needs evolve as they age. Transitional care for these patients is not universally available and various models have been described. In this article, the authors review the current literature surrounding transitional care for patients with CP, focusing predominantly on the neurosurgical aspects of transitional care, and they describe current approaches adopted by programs in North America. They further describe their own experience developing a transitional care clinic for patients with CP, as well as the integration of this program with a multidisciplinary clinic to address the specific challenges that growing patients face in our region. The authors performed a literature review to identify models, barriers, and assessments of effective transitional care for CP patients. They also reviewed the recommendations of various professional societies regarding transitional care practices. They performed qualitative analysis of the relevant literature. Transitional care has been broadly categorized into transitional care clinics with multidisciplinary teams and facilitator-led transitional care. CP patients have to overcome a variety of barriers, including those from within the healthcare system as well as environmental and personal, during the period of their transition. These challenges are all interconnected, and navigation requires healthcare professionals to work closely with patients and their caregivers. Multiple instruments are described to measure successful transition, which is likely a reflection of the unique needs that a patient may require. Current guidelines recommend that neurosurgeons select a suitable model of care based on their own local practice and available services, develop a well-defined transition plan, and identify a primary transition facilitator or care coordinator. Providing effective transitional care to CP patients remains challenging given the different models of care and the barriers faced by them during the period of transition. In developing a transitional care program for these patients, attention must be given to the resources that are available regionally, with an effort to incorporate the best practices from successful transitional care programs.

Production Responses of Multiparous Dairy Cattle with Differing Prepartum Muscle Reserves and Supplementation of Branched-Chain Volatile Fatty Acids

Periparturient dairy cattle undergo physiological adaptations to support fetal growth and colostrum synthesis in late gestation and milk production in early lactation. To support energy and protein demands dairy cattle mobilize body tissue reserves. The objective of this study was to determine the effects of prepartum skeletal muscle reserves and supplementation of branched-chain volatile fatty acids (BCVFA) on body composition measurements, metabolic markers related to health, protein, and energy status, and subsequent milk yield in multiparous dairy cows. Skeletal muscle reserves were assessed by 3 ultrasounds of the longissimus dorsi muscle depth (LDD) measured 42 d before expected calving (BEC), and cows (n = 48) were assigned to either high muscle (HM; > 4.6 cm) or low muscle (LM; ≤ 4.6 cm) groups. Cows were then randomly assigned to either control (CON) of soyhull pellets (80 g/d) or BCVFA treatment which contained isobutyrate (40 g/d), isovalerate (20 g/d), and 2-methylbutyrate (20 g/d) calcium salt products. Treatments were top dressed from 42 BEC until parturition, resulting in 4 combinations of muscle groups and treatments: HM-CON (n = 13), HM-BCVFA (n = 13), LM-CON (n = 11), and LM-BCVFA (n = 11). Measurements of the LDD, BW, and BCS were taken on the following days relative to calving -42, -35, -21, -7, 0, 7, 14, 21, 28. Weekly blood samples were taken to measure glucose, BHB, and insulin concentrations, and 5 of the blood sample time points were utilized to determine 3-methylhistidine and creatinine blood concentrations. Milk yield was recorded daily for the first 28 d of lactation, and samples were taken from both milkings once a wk for the first 4 wk to determine components. The statistical model included the fixed effects of treatment, group, time, their interactions, and the random effect of cow nested within group and treatment. Prepartum muscle mobilization varied between muscle groups, as LM cows accreted muscle prepartum, and HM cows mobilized muscle. The HM cows had higher milk fat, protein, lactose, and energy corrected milk yields. The BCVFA supplementation tended to increase blood glucose concentrations both prepartum and postpartum and decreased milk urea nitrogen concentrations. Higher prepartum skeletal muscle reserves improve productivity of early lactation cows likely due to differences in muscle mobilization, and BCVFA supplementation improves glucose dynamics during the transition period, which may improve the metabolic health of the periparturient dairy cow.

Impact of liminality and rituals on professional identity formation in physician training.

The transition from medical student to practicing physician affects the complex processes of professional identity formation and professionalism, which have a lasting effect on the physician's career development. This study explored two different transitional processes of medical students in Taiwan, the associated rituals during this transitional period (the 'liminal phase') and their effect on the formation of professional identity. Using snowball sampling, we recruited 13 medical students from two training systems: six from the traditional postgraduate year programme and seven from the accelerated postgraduate year (A-PGY) programme. Semi-structured interviews were thematically analysed to identify significant themes that encapsulated trainees' experiences. A consistent and mutually confirmed discussion ensured the identification of robust recurring themes. A comparative analysis of the two training modalities provided critical insights into the relative impact of the training dynamics. The A-PGY cohort, subjected to an altered 'incorporation' ritual, encountered an influx of unexpected symbolic social power, complicating their transformation within the liminal phase. Without a defined internship like in the PGY system, A-PGY trainees exhibited confusion and inconsistencies in professional identity formation marked by conflicting internal and external perceptions. This ambiguity affected their clinical training, social integration and overall development of professionalism. The absence of a structured, sequential liminal phase increased conflict and diminished motivation, culminating in an incomplete self-crafting journey for A-PGY trainees. This study highlights the impact of the well-sequenced implementation of rituals in liminality on professional identity formation. A good transition training programme for medical students should compass sequential rituals in the liminal phase, including clear starting and ending points, supervision by seniors, guided reflection and plenty of opportunities for observation and imitation in context. Optimal training and pivotal elements in a medical training system warrant delicate design and further research when developing and changing the structure of the training programme.

The dynamic distribution of the rectal microbiota in Holstein dairy calves provides a framework for understanding early-life gut health

The posterior intestinal microbiota plays a vital role in the growth and health of Holstein dairy calves. However, its establishment and dynamic changes during early development remain unclear. The aim of this study was to investigate microbial colonization and development in the rectum of calves within the first 70 d after birth. Here, 96 rectal content samples were collected from 8 Holstein dairy calves at 12 time points and analyzed using 16S rRNA gene sequencing. The microbial alpha diversity increased with age. The bacterial community displayed a distinct dynamic distribution. The phylum Proteobacteria was replaced by Firmicutes and Bacteroidetes after d 3. The colonization process of bacterial genera in the rectum of neonatal calves can be divided into 2 periods: the colonization period (stage 1: d 1 and stage 2: d 3) and the stable period (stage 3: d 7 to 14, stage 4: d 21 to 42, and stage 5: d 49 to 70). The fermentation pattern and metabolic function changed from propionate fermentation dominated by Shigella to lactic acid fermentation dominated by Lactobacillus, Blautia, and Oscillospira. The stable period was more comprehensive and complete than the colonization period. This study revealed the dynamic changes in the posterior intestinal microbiota of Holstein dairy calves during early development. The transition period (d 7 to 14) was identified as a key stage for early nutritional intervention, as the abundance of Lactobacillus increased and the abundance of harmful bacteria (such as Proteobacteria and Shigella) decreased. This study provides a framework for understanding early-life gut health and offers theoretical guidance for future research on host–microbe interactions and early nutritional interventions. It is suggested that nutritional interventions based on microbial characteristics at different stages be implemented to improve calf growth performance and immune function, which may contribute to the reduction of diarrhea and other gastrointestinal disorders during dairy production.

Quantifying the Effects of Interwell Communication Using Dynamic Fluid-in-Place Calculations

Summary Multifractured horizontal wells (MFHWs) completed in the same reservoir layer, or different reservoir layers, commonly experience interwell communication through hydraulic fractures. For example, after a well is placed on production, its production performance can be impacted by communication with an offsetting well placed on production after it. The degree of communication between wells is important to quantify for the purposes of well production forecasting, reserves estimation, completions, and well spacing design optimization. In this study, dynamic fluid-in-place calculations, performed using the impacted producing well rates and flowing pressures, are applied to quantify the effect of communication with an offset-producing well on the impacted well-contacted fluid-in-place estimates. Agarwal (2010) demonstrated that pressure transient analysis theory can be used to derive the volume of fluid in place contacted by a well (CFIP) over time during constant rate, transient production. The method was later extended to variable-rate/pressure scenarios. However, all previous applications of Agarwal’s method were for single, isolated wells and assumed single-phase flow of oil and gas. To evaluate the usefulness of the method for modern development scenarios, it is extended to allow for quantification of interwell communication during flowback, for which single-phase flow of water before the breakthrough of formation fluids may precede multiphase flow of formation and fracturing fluids, and for analysis of multiphase data. Analysis of flowback data enables early-time identification and quantification of interference effects. Multiple numerical simulation cases are generated to simulate different degrees of communication for the case of a two-phase flow of oil and water. Wells are assumed to be communicating through a hydraulic fracture with a specified transmissibility multiplier (Tmult) used to adjust the amount of interwell communication. Corrections for multiphase flow in the CFIP method are performed using two different methods—the total volumetric flow rate (combined phase) approach and the multiphase pseudovariable approach. The CFIP diagnostic plot (i.e., log-log plot of CFIP vs. material balance time) is applied to the impacted producing well to evaluate the CFIP trend before and after offset well production and the magnitude of CFIP change. The practical application of the method is demonstrated with field cases. From the simulation cases, it is observed that, after the offset well is placed on production, a reduction of CFIP for the impacted producing well occurs (rapidly decreasing at first and then stabilizing after a transition period) proportional to productivity index reduction. The loss in CFIP for the impacted producing well can be determined simply by estimating its CFIP immediately before and after offset well production. For high connectivity (Tmult> 0.25) scenarios, application of the combined phase approach resulted in estimates of the impacted well CFIP reduction of ~46–50%, whereas application of the modified pseudovariable approach resulted in estimates of ~49–51%. For the low connectivity case (Tmult = 0.001), these estimates were ~11% and ~9%, respectively, for the two approaches. Therefore, for the simulation cases studied herein, the two approaches agreed within acceptable error. Numerical simulation was also used to verify the absolute change in CFIP using these two approaches for correcting for multiphase flow. The practical application of the modified CFIP method was demonstrated using two field cases with early-time production. Both field cases demonstrated that changes in CFIP for the impacted well can be unambiguously interpreted. In the first field case corresponding to early-time production data (gas and water) associated with Well 23 of the SPE data repository, the reduction in CFIP of the impacted producing well was estimated to be ~37% using the combined phase approach. In the second field case, for which a producing well completed in a low-permeability gas condensate reservoir is impacted by placing multiple offset wells on production at the same time, the reduction in CFIP of the impacted well was estimated to be ~20% using the combined phase approach. In this study, we demonstrate for the first time that CFIP calculations can be applied to quantify interwell communication between two wells during flowback or early-time production when multiphase flow occurs in the reservoir.

Transitional and spectrum-based care for idiopathic scoliosis.

The goal of this study is to discuss the transitional nature of idiopathic scoliosis and the variation in treatment and management across the spectrum of age presentation. This is a review article that discusses the evaluation, management, and classification of idiopathic scoliosis. The authors searched PubMed/MEDLINE, Google Scholar, and the Cochrane database for articles published up to April 2024. Keywords and MeSH terms relevant to the topic were used, including adolescent idiopathic scoliosis (AIS), adult idiopathic scoliosis (AdIS), adult degenerative scoliosis, young adult idiopathic scoliosis, early-onset scoliosis (EOS), classification, management, follow-up, outcomes, natural history, Cobb angle, and transitional care. Reference lists of selected articles were also searched to identify further articles. Inclusion criteria included English language articles that summarized any type of study design, including randomized controlled trials, observational studies, case-control/series, or metaanalysis, with study populations ranging from infants to > 50-year-old patients. Inter-reviewer disagreement on inclusion of particular articles was resolved through discussion. Related information was analyzed, and relevant concepts related to the transitional period dilemma have been discussed. Each idiopathic scoliosis case needs independent assessment with regard to the age, degree of the curve, and patient-specific presentation. An accurate prediction of the curve progression by considering the patient's remaining growth potential is paramount to the treatment strategy. The classification system for EOS, AIS Lenke classification, AdIS classification, and the Scoliosis Research Society-Schwab classification are important for reliable communication between surgeons treating deformities. Untreated progressive idiopathic scoliosis warrants multidisciplinary management during the transition from EOS stage to AIS and then to AdIS. Also, surgical treatment of untreated AIS transitioning to AdIS is specific and nuanced. AdIS needs to be differentiated from adult degenerative scoliosis because the latter is associated with multiple comorbidities and anatomical differences. Idiopathic scoliosis presents across the age spectrum with specific age-related decisions that transition into adulthood. Integrated models of both surgical and nonsurgical treatment of idiopathic scoliosis are warranted.

Female-specific association between the APOE E4 allele and age at diagnosis of glaucoma in UK Biobank

ObjectiveTo explore the impact of the apolipoprotein E (APOE) E4 allele in the gender-specific aging process in glaucoma by illustrating the interaction between risk factors, including the APOE E4 allele, gender and intraocular pressure (IOP), for age at diagnosis (AAD) of glaucoma. DesignA cross-sectional study included UK Biobank participants with complete data (2006-2010) for analysis. Data were analyzed in December 2023. Participants2,236 glaucoma patients and 103,232 controls. MethodsWe evaluated multivariable-adjusted associations of AAD of glaucoma, APOE E4 allele (0: absence; 1: presence), and IOP using linear mixed model (LMM) analyses across groups stratified by AAD of mean age of menopause (50 years) and gender. Main Outcomes MeasuresAAD of glaucoma, APOE E4 allele and IOP. ResultsGlaucoma patients were older and had a higher percentage of males and a higher mean IOP compared to controls (all P < 0.001). Further stratifying the glaucoma patients by AAD of 50 and gender, lower IOP (Model 1 adjusted by age, βIOP=-0.096±0.041, P=0.019) and positive APOE E4 allele (Model 2 adjusted by age and IOP, βe4=1.093±0.488, P=0.026) were associated with an older AAD in females with an AAD < 50 years under univariate LMM. In multivariate LMM adjusted by age (Model 3), the effect size of both factors increased in the multivariate model as the beta-value increased. (βIOP=-0.111±0.040, P=0.007; βe4=1.235±0.485, P=0.012) (Model 1 vs Model 3: P=0.011). In females with an AAD ≥50 years, only positive APOE E4 allele (adjusted by age and IOP, βe4=-1.121±0.412, P=0.007) was associated with a younger AAD. In males, only higher IOP was associated with an older AAD in those with an AAD ≥50 years (βIOP=0.088±0.032, P=0.006). ConclusionsAPOE E4 allele may initially delay and later accelerate the development of glaucoma in females around the transition period of 50 years, which is the mean age of menopause, and importantly, this is independent of IOP. Understanding the specific transition states and modifiable factors within each age phase is crucial for developing interventions or strategies that promote healthy aging.

Holocene paleolimnological changes in rundvågshetta lakes in the Soya Coast region and their paleoenvironmental significance with glacial isostatic adjustment in East Antarctica

This study investigated Holocene paleolimnological changes inferred from a multi-proxy dataset of C, N, and S elements, biomarkers, and microscopic observations of microalgae and cyanobacteria in sediment cores from two Rundvågshetta lakes (Maruwanminami-ike and Maruwan-oike) in the Soya Coast region of Antarctica, along with sedimentary facies and accelerator mass spectrometry 14C dating. We discuss biological production and sources, the transition from marine to brackish and lacustrine environments in the lakes, paleoenvironmental changes, transition ages, and relative sea level (RSL) falls (or subsidence) from glacial isostatic adjustment (GIA) in the Soya Coast region. The ages of the Maruwanminami-ike (MwS4C-01, length 147 cm) and Maruwan-oike sediment cores (Mw4C-01, length 226 cm) were 1.4 (5.8 cm core depth)–4.9 and 2.3–5.7 cal ker BP, respectively. The local reservoir effects of the Rundvågshetta lakes were very high, possibly because of the influence of dead carbon in the glacially eroded marine sediments and bed rock. The coastal marine environments of Lakes Maruwanminami-ike (4.9–2.6 cal ker BP) and Maruwan-oike (5.7–3.3 cal ker BP) were characterized by low biological production. A transition period marked by a stratified brackish lake environment in Lakes Maruwanminami-ike (2.6–2.4 cal ker BP) and Maruwan-oike (3.3–2.9 cal ker BP) was characterized by stratified conditions with an anoxic layer at the bottom of the photic zone. The freshwater lake environment of Lake Maruwanminami-ike [(65.6–0 cm, 2.4–1.4 (5.8 cm core depth) cal kyr BP)] was characterized by high biological (cyanobacteria and green algae) production, while that of Lake Maruwan-oike (2.9–2.3 cal ker BP) was characterized by low biological production due to the influence of glacial clay. Around 7.2–3.0 cal ka BP in the Holocene was probably a warm period, and progressive glacial retreat with RSL fall occurred during the warm periods in the Soya Coast region. The RSL falls of all raised beaches and isolated basins in the Soya Coast region ranged from 0.36 ± 0.03–4.4 ± 0.5 mm/yr with an average 2.1 ± 0.2 mm/yr (standard deviation, SD). They were similar to GNSS–based GIA–induced uplift with an average of 2.4 ± 1.5 mm/yr (SD) at Soya Coast region.

Navigating the transition: the crucial shift from pediatric to adult care for individuals living with spina bifida.

Spina bifida (SB) is a complex congenital condition characterized by incomplete closure of the neural tube, resulting in varying degrees of physical and neurological impairment. Although commonly managed by multidisciplinary pediatric clinics, a substantial proportion of SB patients are now living into adulthood, necessitating the transition from pediatric to adult healthcare. This transition introduces a myriad of challenges for individuals living with SB and their families. Prior research on SB transition programs has demonstrated anecdotal success; however, minimal research has been published on early posttransition health outcomes and compliance with medical recommendations. This quality improvement study assessed early posttransition compliance with medical recommendations, adverse health events, access to medical supplies/equipment, and patient-reported health outcome and confidence in medical providers. Adult participants in the Spina Bifida Transition Clinic at the authors' pediatric institution were invited to complete a telephone survey after transition to adult care. The mean (SEM) elapsed time since transition was 1.21 (0.11) years. The survey evaluated adult provider utilization, accessibility of medical supplies and equipment, adverse medical events, compliance with sleep study acquisition, patient-reported health status, and satisfaction with providers. Of 52 eligible participants, 49 (94%) completed a telephone survey. Within the cohort, 82% had open SB (myelomeningocele), with the remaining having occult SB (lipomyelomeningocele). The mean age at transition was 26.0 years. Since transition, 78% have attended at least one primary care visit, with 76% seeking care from at least one adult care specialist (69% sought care with urologists). Forty-five percent reported an adverse medical event: 31% required an emergency department visit, 22% were hospitalized, 18% underwent surgery, and 24% had skin breakdown. Access to medical supplies varied, with patients experiencing the most difficulty obtaining wheelchairs and assistive walking devices. Patients rated pediatric provider engagement and knowledge of SB significantly higher than adult providers (mean 3.92 vs 3.32, p < 0.001). This quality improvement study evaluated the effectiveness of our Spina Bifida Transition Clinic in the early post transition period. While patients have used primary and specialty care (urology), they have experienced many adverse events and low compliance with sleep study acquisition. Continued evaluation of transition programs is required to optimize the outcome of those living with SB.

Integration of Steam Recovered from Molten Salts in a Solar Integrated Combined Cycle

In the current context of the energy transition, Integrated Solar Combined Cycle (ISCC) power plants are an alternative that are able to reduce carbon emissions from combined cycle (CC) power plants. In addition, the coupling to an energy storage system based on molten salts benefits hybridization, allowing the energy surplus to be to stored to cover peaks in energy demand. Because it is a recent technology, the determination of the optimal injection points for the solar-generated steam into the combined cycle is a critical issue. In this work, a thermodynamic model of a hybrid natural gas and solar thermal CC power plant has been developed using Thermoflex to analyze the integration effects in terms of efficiency and power. For all the steam injection candidate positions, the effects of ‘power boosting’ and ‘fuel saving’ operation modes have been simulated, considering operation conditions that are compatible with the useful range of molten salts. The results show that injection of steam at the high-pressure line before the steam turbine increases the cycle’s gross efficiency with respect to the reference case, estimating a reduction of carbon emissions of 6696 kg/h in the ‘fuel saving’ mode and an increase in gross power of 14.4 MW in the ‘power boosting’ mode. Hence, adapting current combined cycles for hybridization with solar power is a viable solution in the transition period towards more sustainable energy sources.

Self-attention mechanism to enhance the generalizability of data-driven time-series prediction: A case study of intra-hour power forecasting of urban distributed photovoltaic systems

The emergence of small-scale urban distributed solar generation (DSG) has urged the exploration of site-adaptive forecasting models designed to accurately predict future power outputs for unseen DSGs. In such scenarios, with numerous DSGs spread across utility-scale cities and a lack of historical data, it is not economically viable to use conventional approaches that develop individual models for each DSG. Therefore, this work aims to tackle this real-world challenge by adapting the state-of-the-art, attention-based temporal fusion transformer (TFT) model to 188 real-world operational DSG data, thereby validating the generalizability of self-attention mechanism for multi-step time series forecasting. When adapted to unseen DSGs without training data, the experiment results demonstrate that the proposed solar TFT (STFT) improves by 11.07%, 17.58%, and 22.76% over the persistence model at the 10-, 20-, and 30-minute forecasts, respectively. Even when compared to representative deep-learning models, such as a long short-term memory model specialized in time series forecasting, STFT has demonstrated improved forecast accuracy, achieving 3.34%, 4.18%, and 5.85% enhancements at the 10-, 20-, and 30-minute forecast horizons, respectively. However, the model architecture of STFT is more complex, and the computational cost associated with it is relatively higher compared to other deep learning models. This trade-off between accuracy and computational efficiency should be considered in practical applications. The forecast performance is analyzed in three typical weather conditions, namely, clear, partly cloudy, and overcast. STFT demonstrates advantages in high variability periods, especially during weather transition periods, where reference models experience lagged predictions yielding relatively large errors.

Opening the “Black box” of the labor market in Macedonia: Youth unemployment

The youth unemployment in Macedonia has been high and persistent for the last three decades, despite the many active labour policies for young persons. This paper examines the determinants of youth unemployment in the Macedonian labour market using quantitative and qualitative analysis. In order to empirically estimate the relevant determinants of youth unemployment in Macedonia we employ the two-step conditional mixed processes model (CMP) using the school to work transition survey (SWTS) by the International Labour Organization. The quantitative analysis is accompanied by qualitative analysis to further explore and explain the social-economic issues. The qualitative analysis includes semi-structured interviews and focus groups conducted in different regions of Macedonia. The empirical results indicate that gender, age, the wealth of the household, the education level and regional characteristics are the main determinants of youth unemployment in Macedonia. According to the findings of the qualitative analysis, the most of the young people pursue education and live with their families who provide them with financial support to cover their expenses. Consequently, the young persons have a diminished interest to search for a job and this attitude on long run could have a dubious effect and influence on the personal choices. Overall, there is a long school to work transition period, which discourages young people to actively participate in the labor market.

The injection of maternal B complex vitamin during the transition period: The impact on performance, thyroid hormones levels and immunological parameters in the Sannen goats and their kids, as well as the faeces status of newborn kids.

It is proven that B vitamins through promote a wide range of metabolic pathways in animals as cofactors improve animal performance. This study was conducted to investigate the impacts of maternal B complex vitamin injection on performance and plasma parameters in goats and their offspring, as well as the faeces status of newborn kids. In this research, the pregnant goats (3 years old) were randomly divided into two groups: the control group (without B complex vitamin injection) and the B complex vitamin group (5mL B complex vitamin injection per animal). The animals were injected with 5mL B complex vitamin twice during the transition period (5 weeks pre- and 5 weeks post-kidding). The goats during the transition period and kids on days 10, 20 and 30 were weighed. Feed intake by goats and consumption of milk and starter in kids were recorded daily. The dry matter digestibility by kids was tested by collecting samples of faeces and feed for 5 days in the last week. Chemical analysis was determined using the AOAC method. The kids' faeces were prepared daily during the study. The blood samples of goats and newborn kids were taken 7 days after kidding. Then, levels of B group vitamin, as well as concentrations of liver enzymes, thyroid hormones and immunological parameters, were determined in plasma of goat and their offspring. In addition, concentrations of glucose and insulin were measured in goat plasma (Asadi et al., 2024). According to results, the performances of goats and their offspring, as well as kids' faeces status, were improved by maternal B complex vitamin injection (p<0.0001). The levels of cobalamin, pyridoxine, thiamine, folic acid, nicotinic, pantothenic and unconjugated pteridine increased in the plasma of goats and their kids in the B complex vitamin group compared with the control group during the transition period (p<0.0001). Injection of maternal B complex vitamin raised the plasma levels of triiodothyronine and tetraiodothyronine, immunoglobulin G and immunoglobulin M in goats and their offspring (p<0.0001). Higher levels of glucose and lower levels of insulin were determined in the goats injected with B complex vitamin (p<0.0001). These results suggest that maternal B complex vitamin injection is required for the improvement of performance, health status and the blood plasma parameters in pregnant goats and their kids.

Evidence-Based Practices for Evaluating Preschoolers Who Are Deaf/Hard of Hearing Using Listening and Spoken Language for Special Education Eligibility

Purpose: Many young children who are deaf/hard of hearing (D/HH) using listening and spoken language (LSL) demonstrate improved spoken language outcomes. Anecdotally, one cascading effect of these improved outcomes is that many children are not qualifying for continued services at the age of 3 years during the Individuals with Disabilities Education Act (IDEA) of 2004 Part C to Part B transition due to norm-referenced language performance within the average range. Although norm-referenced performance is one metric for determining language delay and is heavily relied on by educational teams, these siloed measures do not reflect listening, language, and learning demands of a typical preschool classroom. This tutorial highlights the research-to-practice gap currently existing in school-based contexts when evaluating a young child who is D/HH using LSL for special education services. Conclusions: An evidence-based framework for ecologically valid, school-based evaluations during the transition period from IDEA (2004) Part C to Part B for young children who are D/HH using LSL between 30 and 35 months of age is presented that balances sensitivity with feasibility. With a particular emphasis on assessment practices for spoken language, the framework connects the purpose of special education eligibility evaluations with evidence-based practice guidance from the literature. Supplemental Material: https://doi.org/10.23641/asha.26359642

Anaemia among school-going adolescents in Burkina Faso: Prevalence and associated factors.

Adolescence, a stage of growth between 10 and 19 years, is a transitional period of intense cognitive, emotionaland physical development. Though iron deficiency is theleading cause of morbidity and mortality among this age group, nutritional interventions targeting adolescents are rare. To inform policy and practice aimed at adolescent health, we established the burden of anaemia among school-going adolescents in Center West Burkina Faso and investigated the potential explanatory factors. A cross-sectional survey was conducted between January and March 2021. Blood samples, socio-demographic, socioeconomic, anthropometric, dietaryand water, sanitation and hygiene data from 2947 students aged 10-18 years were collected. Anaemia was determined by the World Health Organization's sex- and age-specific haemoglobin concentrations. χ2 tests and logistic regressions were used to identify factors associated with anaemia. The prevalence of anaemia among adolescents in the sample was 36.2%, including 24.2% mild, 11.6% moderateand 0.4% severe anaemia. Compared to males, females were 19% less likely to have mild anaemia (adjusted Odds Ratio [aOR] = 0.81; 95% confidence intervals [CI]: 0.689, 0.955) but 42% more likely to be moderately or severely anaemic (aOR = 1.42; 95% CI: 1.102, 1.831). Among iron-rich foods, tamarind (aOR = 0.75; 95% CI: 0.610, 0.929) and pumpkin leaves (aOR = 0.77; 95% CI: 0.605, 0.974) were associated with lower odds of anaemia. Several water, sanitation and hygiene factors were associated with higher haemoglobin, including handwashing after toilet use (β = 0.50; 95% CI: 0.031, 0.966)andtooth brushing twice daily (β = 0.19; 95% CI: 0.030, 0.354). Anaemia among adolescents in Burkina Faso should be addressed with interventions targeting diet, sanitationand hygiene.