Powerful Option Research Articles

Hydrogen for harvesting the potential of offshore wind: A North Sea case study

Economical offshore wind developments depend on alternatives for cost-efficient transmission of the generated energy to connecting markets. Distance to shore, availability of an offshore power grid and scale of the wind farm may impede export through power cables. Conversion to H2 through offshore electrolysis may for certain offshore wind assets be a future option to enable energy export. Here, we analyse the cost sensitivity of offshore electrolysis for harvesting offshore wind in the North Sea using a technology-detailed multi-carrier energy system modelling framework for analysis of energy export. We include multiple investment options for electric power and hydrogen export including HVDC cables, new hydrogen pipelines, tie-in to existing pipelines and pipelines with linepacking. Existing hydropower is included in the modelling, and the effect on offshore electrolysis from increased pumping capacity in the hydropower system is analysed. Considering the lack of empirical cost data on offshore electrolysis, as well as the high uncertainty in future electricity and H2 prices, we analyse the cost sensitivity of offshore electrolysis in the North Sea by comparing costs relative to onshore electrolysis and energy prices relative to a nominal scenario. Offshore electrolysis is shown to be particularly sensitive to the electricity price, and an electricity price of 1.5 times the baseline assumption was needed to provide sufficient offshore energy for any significant offshore electrolysis investments. On the other hand, too high electricity prices would have a negative impact on offshore electrolysis because the energy is more valuable as electricity, even at the cost of increased wind power curtailment. This shows that there is a window-of-opportunity in terms of onshore electricity where offshore electrolysis can play a significant role in the production of H2. Pumped hydropower increases the maximum installed offshore electrolysis at the optimal electricity and H2 prices and makes offshore electrolysis more competitive at low electricity prices. Linepacking can make offshore electrolysis investments more robust against low H2 and high electricity prices as it allow for more variable H2 production through storing excess energy from offshore. The increased electrolysis capacity needed for variable electrolyser operation and linepacking is installed onshore due to its lower CAPEX compared to offshore installations.

Starch-Based Hydrogels as a Drug Delivery System in Biomedical Applications.

Starch-based hydrogels have gained significant attention in biomedical applications as a type of drug delivery system due to their biocompatibility, biodegradability, and ability to absorb and release drugs. Starch-based hydrogels can serve as effective carriers for pharmaceutical compounds such as drugs and proteins to develop drug-loaded hydrogel systems, providing controlled release over an extended period. The porous structure of a hydrogel allows for the diffusion of drugs, ensuring sustained and localized delivery to the target site. Moreover, starch-based hydrogels have been used as a powerful option in various biomedical fields, including cancer and infectious disease treatment. In addition, starch-based hydrogels have shown promise in tissue engineering applications since hydrogels can be used as scaffolds or matrices to support cell growth and tissue regeneration. Depending on techniques such as chemical crosslinking or physical gelation, it can create a three-dimensional network structure that tunes its mechanical properties and mimics the extracellular matrix. Starch-based hydrogels can also provide a supportive environment for cell attachment, proliferation, and differentiation to promote specific cellular responses and tissue regeneration processes with the loading of growth factors, cytokines, or other bioactive molecules. In this review, starch-based hydrogels as a versatile platform for various biomedical applications are discussed.

Power option pricing problem of uncertain exponential Ornstein–Uhlenbeck model

A power option is an exotic option whose nonlinear payoff is derived from the exponentiation of the price of the underlying asset. Due to its high-leverage, the power option is widely traded in the contemporary financial derivatives markets. This study examines the formulas for power call and put options based on the uncertain exponential Ornstein–Uhlenbeck model. Then the algorithms to calculate the power call and put option are designed. Furthermore, an analysis of the price sensitivity of power options is conducted.

Modified Pedicled Internal Mammary Osteomyocutaneous Chimeric Flap for Salvage of Mandibular Reconstruction

Summary: The modified pedicled internal mammary osteomyocutaneous chimeric flap is a powerful option for head and neck reconstruction in patients not suitable for free tissue transfer. In this article, the senior author’s (K.C.) technique for flap elevation is described in the context of a patient with mandibular osteoradionecrosis resulting in severe crossbite and trismus after multiple failed attempts at reconstruction with free tissue transfer. The modified pedicled internal mammary osteomyocutaneous chimeric flap was chosen as it offered intraoral lining, extraoral soft tissue, and vascularized bone for mandibular reconstruction without requiring free tissue transfer. The flap dissection as well as the risks, benefits, and indications for this flap are described herein. The modified pedicled internal mammary osteomyocutaneous chimeric flap is a technically complex reconstructive option reserved for situations in which conventional methods have been exhausted. It offers an eloquent solution for patients who otherwise may have no options.

Correlates of Presence in a Virtual Reality Gamification Environment for Rehabilitation after Musculoskeletal Injury

Abstract Virtual reality (VR) has emerged as a powerful option for rehabilitation by providing real-time performance feedback and a safe and customized training environment. This study aimed: (1) to investigate the association between presence in the virtual environment, usability of the system, intrinsic motivation, and immersion in VR gaming designed for rehabilitation after musculoskeletal injury; and (2) to examine the users’ emotional response in terms of pleasure, arousal, and dominance after participating in VR gaming. Thirty-seven individuals aged 23.69 ± 6.98 years participated in five customized VR games designed to provide a complete rehabilitation session after a musculoskeletal injury. Pearson product-moment correlation coefficients and multiple regression analyses were used to investigate the relationship between presence in virtual environments and immersive tendencies, the usability of the system, and intrinsic motivation. The Wilcoxon Signed Rank Test was conducted to evaluate the impact of participation in VR gaming on participants’ presence in virtual environments. Significant correlations were found between presence and immersive tendencies (r = −.40, p = .017), intrinsic motivation (r = .42, p = .013), and usability of the system (r = .64, p < .001). The linear regression model explained 59% of the total variance in the presence of virtual environments. There was a statistically significant increase in the pleasure scores from the beginning to the end of the session. Our results indicate that VR may be useful in increasing adherence to treatment to recover from musculoskeletal injuries.

X-Ray Energy Deposition Model for Simulating Asteroid Response to a Nuclear Planetary Defense Mitigation Mission

In the event of a potentially catastrophic asteroid impact, with sufficient warning time, deploying a nuclear device remains a powerful option for planetary defense if a kinetic impactor or other means of deflection proves insufficient. Predicting the effectiveness of a potential nuclear deflection or disruption mission depends on accurate multiphysics simulations of the device's X-ray energy deposition into the asteroid and the resulting material ablation. The relevant physics in these simulations span many orders of magnitude, require a variety of different complex physics packages, and are computationally expensive. Having an efficient and accurate way of modeling this system is necessary for exploring a mission's sensitivity to the asteroid's range of physical properties. To expedite future simulations, we present a completed X-ray energy deposition model developed using the radiation-hydrodynamics code Kull that can be used to initiate a nuclear mitigation mission calculation. The model spans a wide variety of possible mission initial conditions: four different asteroid-like materials at a range of porosities, two different source spectra, and a broad range of radiation fluences, source durations, and angles of incidence. Using blowoff momentum as the primary metric, the model-initiated simulation results match the full radiation-hydrodynamics results to within 10%.

A novel method that can be used in both the diagnosis and treatment of peripheral arterial disease in diabetics: vibration-mediated dilation.

The growing incidence of diabetes and the increasing life expectancy of the diabetic population worldwide has increased the number of diabetic vascular complications occurring in cardiology practice. As current treatment and prevention methods are less effective in this patient group, there is a need for new treatment methods in this area. Exercise, which reduces metabolic and vascular problems associated with diabetes, often becomes impossible, especially in advanced-stage patients who need exercise the most. Since exercise and flow-mediated dilation (FMD) are effective by stimulating mechanotransduction mechanisms on the endothelium, it can be expected that the same mechanisms could also be stimulated by direct vibration. In order to test this hypothesis, in this study, a group of 20 type 2 diabetes patients (11 males, age 56.80 ± 11.05 years and diagnosed for 15.35 ± 8.61 years) were examined via the application of FMD and vibration-mediated dilation (VMD). We performed vibration for five minutes with 20-Hz frequency and 3-mm vertical amplitude, to the same side forearm, with a 30-minute interval. Using a 10-MHz linear echo probe, brachial artery diameter and flow velocities were recorded for 10 minutes before and at two-minute intervals after the FMD and VMD applications. Then brachial artery flow and resistance were calculated at each stage. In the first minute after FMD and VMD applications, brachial artery diameter and flow velocities increased significantly, and vascular resistance decreased significantly. None of the corresponding FMD or VMD parameters in the first minute was different. The artery diameters in the first minute after FMD and VMD were increased by 6.04 ± 5.29 and 5.49 ± 5.21%, respectively. At the tenth minute, these values decreased to 1.73 ± 3.21 and 2.05 ± 3.31%. In the FMD series, all parameters except brachial artery diameter returned to their baseline values after the fourth minute. After VMD, all parameters also decreased after the first minute, but the recovery was much slower. At each stage after the first minute, the VMD averages were higher than the baseline value and their corresponding FMD values. The results of this study indicated that vibration may be a powerful, long-lasting and feasible treatment option in patients with peripheral perfusion failure, developed due to diabetic macro- and microvascular complications.

Investigation of the Effects of Recreational Football on Some Functional Movement Skills in Older Men

This study aimed to examine the effects of recreational football on functional movement skill (FMST) levels of elderly men. 57 (65.05 ± 2.5) elderly men who participated in the study were randomly divided into the football group (FG, n= 28) and the control group (CG, n= 29). Data were collected with the FHTT scale and investigeted via mixed design ANOVA. The data were analyzed considering the significance level of p<.05. There was no statistically significant difference between the groups in the deep squatting movement (p>.096), and there was a statistical difference between the times (p<.002). Statistically significant differences were observed between groups, between times and group*time interaction at high stepping, respectively (p<.008, p<.001, p<.035). Statistically significant differences were observed between groups in a single-line move and in group*time interaction, respectively (p<.008, p<.006). There was a statistically significant difference between the groups in shoulder mobility (p<.001). There was no statistically significant difference between the times and in the group*time interaction, respectively (p>.98, p>.44). Statistically significant differences were observed between groups, between times and in group*time interaction in active straight leg raising, respectively (p<.004, p<.001, p<.035). There was no statistically significant difference between the groups in trunk stability movement (p>.089). There was a statistically significant difference between the times and in the group*time interaction (p<.024). Statistically significant difference was observed between groups and between times in rotational stability movement, respectively (p<.001, p<.001). There was no statistically significant difference in the groups*time interaction (p>.065). Statistically significant differences were observed in FHTT total scores between groups, between times and in the interaction of groups*time, respectively (p<.001, p<.001, p<.001, p<.001). The results show that recreational football is effective on FHTT and is a powerful exercise option in improving mobility, which is important for elderly individuals to maintain their quality of life.

The spatial and single-cell analysis reveals remodeled immune microenvironment induced by synthetic oncolytic adenovirus treatment

Oncolytic viruses are multifaceted tumor killers, which can function as tumor vaccines to boost systemic antitumor immunity. In previous study, we rationally designed a synthetic oncolytic adenovirus (SynOV) harboring a synthetic gene circuit, which can kill tumors in mouse hepatocellular carcinoma (HCC) models. In this study, we demonstrated that SynOV could sense the tumor biomarkers to lyse tumors in a dosage-dependent manner, and killed PD-L1 antibody resistant tumor cells in mouse model. Meanwhile, we observed SynOV could cure liver cancer and partially alleviate the liver cancer with distant metastasis by activating systemic antitumor immunity. To understand its high efficacy, it is essential to explore the cellular and molecular features of the remodeled tumor microenvironment (TME). By combining spatial transcriptome sequencing and single-cell RNA sequencing, we successfully depicted the remodeled TME at single cell resolution. The state transition of immune cells and stromal cells towards an antitumor and normalized status exemplified the overall cancer-suppressive TME after SynOV treatment. Specifically, SynOV treatment increased the proportion of CD8+ T cells, enhanced the cell-cell communication of Cxcl9-Cxcr3, and normalized the Kupffer cells and macrophages in the TME. Furthermore, we observed that SynOV could induce distant responses to reduce tumor burden in metastatic HCC patient in the Phase I clinical trial. In summary, our results suggest that SynOV can trigger systemic antitumor immunity to induce CD8+ T cells and normalize the abundance of immune cells to remodel the TME, which promises a powerful option to treat HCC in the future.

Combination therapy of acute myeloid leukemia by dual PI3K/mTOR inhibitor BEZ235 and TLR-7/8 agonist R848 in murine model

BackgroundDue to the high relapse rate and toxicity of the common therapies in patients with acute myeloid leukemia (AML), modifications in the treatment strategies are required. The present study was conducted to determine the effects of combinational therapy with a dual PI3K/mTOR inhibitor, BEZ235, and TLR7/8 agonist, R848, on murine AML model. MethodsBEZ235 and R848 were administered to AML leukemic mice in either a single or combination treatment. Frequency of T-CD4+, T-CD8+, MDSCs, NK, exhausted T cells and the degranulation levels was measured via flow cytometry. The cytotoxicity and proliferation levels were evaluated by MTT assay. Then, the expression of iNOS, arginase-1, PD-L1, Gal-9, PVR, IFN-γ, TNF-α, IL-4, IL-10, IL-12 and IL-17 was investigated by Real-Time PCR. Organomegaly, body weight and survival rate were also monitored. ResultsFollowing combinational therapy with BEZ235 and R848, increasing in the frequency of anti-tumor immune cells including T-CD4+ cells and M1 macroghages, and decreasing in pro-tumor immune cells including MDSCs, exhausted T-CD4+ and T-CD8+ cells and also M2 macrophages were observed. The functional defects of immune cells in term of proliferation, cytotoxicity, degranulation, and cytokines expression were improved in leukemic mice after treatment with BEZ235 and R848. Finally, organomegaly, body weight and survival analysis showed significant improvements after treatment with BEZ235 and R848. ConclusionTaken together, we indicated that the combinational therapy with BEZ235 and R848 could be considered as a potential and powerful therapeutic option for AML patients. Further clinical studies are required to expand our current findings.

Evaluation of a comprehensive power management system with maximum power point tracking algorithm for multiple microbial fuel cell energy harvesting

This study presents a comprehensive power management system (PMS) capable of tracking the maximum power point (MPP) and harvesting the energy from up to five microbial fuel cells (MFCs). The harvested energy from the MFCs was used to power the electronics, and in cases where this power was insufficient, alternative backup power options can be used. The voltage can be increased up to 3.3 V, and a hysteresis-based control approach was utilised to regulate the output voltage. The MPP of each MFC was determined using a variable step size incremental conductance algorithm that controls the duty cycle of the synchronous boost converters. No additional electronic components are necessary for the operation of the N and P-channel MOSFETs. The efficiency of the PMS relies on the target output voltage and the power output characteristics of the MFCs. Efficiencies of up to 87 % were achieved by combining the outputs of each MFC boost converter. To save energy, some electronic components are disabled when not in use, and the maximum power consumption of the PCB is below 5.8 mW at an output voltage of 3.3 V. The PMS is applied to simulated and real tubular MFCs under various operating conditions.

PiCAM: A Raspberry Pi‐based open‐source, low‐power camera system for monitoring plant phenology in Arctic environments

Abstract Time‐lapse cameras have been widely used as a tool to monitor the timing of seasonal vegetation growth. These simple, relatively inexpensive systems can provide high‐frequency observations of leaf development and demography which are critical data sets needed to characterize plant phenology from species to landscapes. This is important for understanding how plants are responding to global changes, as well as for validating satellite‐derived phenology products. However, in remote regions including the high‐latitude Arctic, deploying time‐lapse cameras could be challenging. The remoteness and lack of widespread power and telecommunications infrastructure limit options for the installation, maintenance and retrieval of data and equipment, and make it difficult for cameras to survive in extreme weather (e.g. long cold winters). To improve our understanding of Arctic phenology, new technologies are required to address these challenges. Here, we present a novel, low‐power, compact, lightweight time‐lapse camera system, called power‐interval camera automation module (PiCAM). The PiCAM was designed with explicit consideration to simplify deployment (i.e. without a need for external power supplies) of camera systems and to address the challenges of camera survival in harsh Arctic environments. In this paper, we describe the design, setup and technical details of the PiCAM and provide a roadmap for how to build and operate these systems. As proof of concept, we deployed 26 PiCAMs at three low‐Arctic tundra sites on the Seward Peninsula, Alaska in early August 2021 for characterizing Arctic plant phenology. Of the 26 PiCAMs, 70% remained active at the point of our revisit in late July 2022 despite the extreme winter temperatures they experienced (< −30°C, heavy snow cover). We extracted key plant phenology metrics from the PiCAMs and captured strong differences across key Arctic plant species. We showed that the PiCAM has the potential to be widely used for monitoring plant phenology across the broader Arctic region, addressing the need for ground‐based understanding of Arctic phenological diversity to develop knowledge of plant response to climate change and to validate remote sensing products.

Veno-Arterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock.

Cardiogenic shock (CS) is a clinical condition characterized by inadequate tissue perfusion in the setting of low cardiac output. CS is the leading cause of death following acute myocardial infarction (AMI). Several temporary mechanical support devices are available for hemodynamic support in CS until clinical recovery ensues or until more definitive surgical procedures have been performed. Veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) has evolved as a powerful treatment option for short-term circulatory support in refractory CS. In the absence of randomized clinical trials, the utilization of ECMO has been guided by clinical experience and based on data from registries and observational studies. Survival to hospital discharge with the use of VA-ECMO ranges from 28-67%. The initiation of ECMO requires venous and arterial cannulation, which can be performed either percutaneously or by surgical cutdown. Components of an ECMO circuit include an inflow cannula that draws blood from the venous system, a pump, an oxygenator, and an outflow cannula that returns blood to the arterial system. Management considerations post ECMO initiation include systemic anticoagulation to prevent thrombosis, left ventricle unloading strategies to augment myocardial recovery, prevention of limb ischemia with a distal perfusion catheter in cases of femoral arterial cannulation, and prevention of other complications such as hemolysis, air embolism, and Harlequin syndrome. ECMO is contraindicated in patients with uncontrolled bleeding, unrepaired aortic dissection, severe aortic insufficiency, and in futile cases such as severe neurological injury or metastatic malignancies. A multi-disciplinary shock team approach is recommended while considering patients for ECMO. Ongoing studies will evaluate whether the addition of routine ECMO improves survival in AMI patients with CS who undergo revascularization.

Design and implementation of Hybrid Renewable energy (PV/Wind/Diesel/Battery) Microgrids for rural areas.

This study examines the variation in sensitivity of a microgrid system comprised of photovoltaics, wind turbines, diesel engines, and batteries. The primary objective is to increase our knowledge of renewable energy resources (RERs) and their technical and economic factors in the context of the conceptual design of a microgrid system. The investigation employs Typhoon HIL software for simulation and testing, concentrating on hybrid PV/Wind/Diesel/Battery systems and devising a perturb & observe (P&O) maximum power point tracking (MPPT) strategy. Additionally, the study investigates the Optimal Power Controlling MPPT technique and the development and implementation of hybrid renewable energy resources (HRES). The Typhoon HIL system is utilized in the power, automotive, and aerospace industries, among others, to simulate and test control systems in real-time. This study presents a control strategy for a microgrid system that combines renewable energy sources such as solar and wind power with reserve power options such as diesel generators and batteries. The coordinated control technique is implemented by employing a centralized control method, effectively managing the flow of electricity from diverse distributed energy resources (DER) and ensuring the microgrid's stability. The findings indicated that the coordinated control method and dynamic models could be utilized to design and optimize microgrid systems. Future research can concentrate on refining the accuracy of the models and verifying the proposed coordinated control method in microgrid systems that operate in the real world.

Brand orientation as a marketing perspective for primary healthcare organizations

ABSTRACT Recent marketing literature suggests that brand orientation is an alternative concept for the public health because it is believed to address the shortcomings of market orientation. Brand orientation is specifically of interest to the sector of healthcare, due to the complex nature of the sector. The purpose of the study described in this paper was to find out what the possibilities are of brand orientation for local healthcare providers. The study shows that brand orientation is relevant for physical therapy primary healthcare organizations (PTPHOs), but is not always adopted effectively. PTPHOs are strongly focused on the patient as the only stakeholder. A more powerful option would be to choose a brand positioning strategy for all relevant stakeholders. PTPHOs have to design integrated marketing activities to encourage consumers directly to use our products/services, and to encourage suppliers, distributors, and other key stakeholders to promote our products/services to consumers. In order to safeguard their role and position in the context of community care for the future, the PTPHO is challenged to become more active and more visible, and must collaborate more with other (healthcare) professionals in the community, broaden their services, and focus more on the (future) needs of the citizen.

Simulating Proton Radiation Tolerance of Perovskite Solar Cells for Space Applications

Perovskite solar cell technology offers a promising power option for space applications due to its potential properties of high power‐to‐weight ratios and space‐radiation tolerance. Herein, a new simulation‐based method is introduced to predict the degradation of perovskite solar cells under proton radiation. The approach uses ion scattering simulations to generate depth‐dependent defect profiles as a function of proton energy and fluence, which are then incorporated into optoelectronic simulations to predict the degradation. The method to study the impact of perovskite compositions on radiation tolerance is applied and an inorganic perovskite CsPbI2Br and an organic–inorganic perovskite FAMAPbI3 is compared. The simulations predict that CsPbI2Br and FAMAPbI3 cells retain 62% and 65% of their initial efficiencies after a 100 keV fluence of 1e14 cm−2, respectively. For comparison, unshielded III–V solar cells display similar degradation for proton fluences 3–4 orders of magnitude lower. It is also shown that the radiation direction must be considered when interpreting and predicting radiation tolerance, as the spatial overlap between photogenerated carriers and radiation‐induced defects has a significant impact on cell performance. Finally, a method to predict mission end‐of‐life performance of perovskite cells is demonstrated, taking into account the full proton radiation energy spectrum and fluence and the incident direction.

Combining Experimental with Computational Infrared and Mass Spectra for High-Throughput Nontargeted Chemical Structure Identification.

The inability to identify the structures of most metabolites detected in environmental or biological samples limits the utility of nontargeted metabolomics. The most widely used analytical approaches combine mass spectrometry and machine learning methods to rank candidate structures contained in large chemical databases. Given the large chemical space typically searched, the use of additional orthogonal data may improve the identification rates and reliability. Here, we present results of combining experimental and computational mass and IR spectral data for high-throughput nontargeted chemical structure identification. Experimental MS/MS and gas-phase IR data for 148 test compounds were obtained from NIST. Candidate structures for each of the test compounds were obtained from PubChem (mean = 4444 candidate structures per test compound). Our workflow used CSI:FingerID to initially score and rank the candidate structures. The top 1000 ranked candidates were subsequently used for IR spectra prediction, scoring, and ranking using density functional theory (DFT-IR). Final ranking of the candidates was based on a composite score calculated as the average of the CSI:FingerID and DFT-IR rankings. This approach resulted in the correct identification of 88 of the 148 test compounds (59%). 129 of the 148 test compounds (87%) were ranked within the top 20 candidates. These identification rates are the highest yet reported when candidate structures are used from PubChem. Combining experimental and computational MS/MS and IR spectral data is a potentially powerful option for prioritizing candidates for final structure verification.

Analysis of atmospheric attenuation of a FSO–WDM system for long-range communication

Abstract An FSO system can provide a solution to the problem of last-mile connectivity while also offering a high degree of security and a large capacity for high-speed information transmission, making it a versatile and powerful option for data communication. Despite the above-mentioned advantages, some factors have to be considered when establishing long-range communication, one such factor is atmospheric turbulence (haze, light fog, moderate fog) which degrades the ideal characteristics of the FSO channel and causes a loss in the signal’s power. This loss of power during transmission can be improved by using suitable amplifiers (hybrid optical amplifier, semiconductor optical amplifier) to provide better performance. The next-generation networks must be capable of supporting a significant amount of backhaul data traffic, accommodating a larger number of users, and increasing channel capacity to meet the demands of modern data communication. By implementing wavelength division multiplexing (WDM) and free space optical (FSO) communication techniques, the capacity of the channel can be increased, and more users can be accommodated. The maximum link length offered by the FSO–WDM system has been investigated with hybrid optical amplifier considering the minimum bit error rate, which can provide reliable and long-distance communication.

The Pocket Guide to Classic Monoamine Oxidase Inhibitors for Treatment-Resistant Depression

Treatment-resistant depression (TRD) remains a significant challenge for clinicians and patients alike, necessitating exploration and understanding of potent but underutilized antidepressant options, such as classic monoamine oxidase inhibitors (MAOIs). This article presents a condensed overview of the fundamental principles outlined in the international consensus guideline on using MAOIs in TRD (the Prescriber's Guide), explicitly focusing on phenelzine and tranylcypromine. These drugs are powerful treatment options for severe depression, including atypical and melancholic subtypes, that have insufficiently responded to first- and second-line treatments. MAOIs are generally indicated before electroconvulsive therapy due to their favorable side-effect profile. However, several contraindications and drug interactions must be considered. This article aims to provide clinicians with a practical, accessible resource for implementing classic MAOIs in the management of TRD. [ Psychiatr Ann . 2023;53(8):347–352.]

Virtual small business entrepreneurship opportunities

For small business entrepreneurs in rural areas to survive in the digital contexts, research is essential on the challenges they face and how these challenges can become opportunities for other entrepreneurs. In this study, small business entrepreneurship opportunities at a township in the Eastern Cape were explored. The basis of the study was that entrepreneurship opportunities are embedded in business challenges and entrepreneurs who can provide services or products that address identified challenges can have viable entrepreneurship ventures. The study used two-phased sequential interviews to collect data to address the purpose of the study, which was: to explore the small business entrepreneurship opportunities in the Eastern Cape in the context of digitalisation. In the first interview challenges, faced by 60 entrepreneurs at an identified small business Mall, were recorded, and the most common challenges were noted. After noting the most common challenges and suggestions for possible business opportunities, associated with addressing the challenges, interviews with eight entrepreneurs in the Mall were then undertaken to gather more information. The study found evidence that small business entrepreneurship opportunities existed in areas related to providing essential support services, such as small business education and training, infopreneurship, and digital infrastructure retailing including providing alternative power options, such as solar power for the enterprises. With the high unemployment and high rate of small business failure, the study recommends the effective exploitation of the identified business opportunities to ensure that existing enterprises survive and new ventures also arise.