Preliminary Planning Research Articles

Unlocking the Potential of Repetitive Transcranial Magnetic Stimulation in Alzheimer's Disease: A Meta-Analysis of Randomized Clinical Trials to Optimize Intervention Strategies.

Repetitive transcranial magnetic stimulation (rTMS) is an advanced and noninvasive technology that uses pulse stimulation to treat cognitive impairment. However, its specific effects have always been mixed with those of cognitive training, and the optimal parameter for Alzheimer's disease (AD) intervention is still ambiguous. This study aimed to summarize the therapeutic effects of pure rTMS on AD, excluding the influence of cognitive training, and to develop a preliminary rTMS treatment plan. Between 1 January 2010 and 28 February 2023, we screened randomized controlled clinical trials from five databases (PubMed, Web of Science, Embase, Cochrane, and ClinicalTrials. gov). We conducted a meta-analysis and systematic review of treatment outcomes and rTMS treatment parameters. A total of 4,606 articles were retrieved. After applying the inclusion and exclusion criteria, 16 articles, comprising 655 participants (308 males and 337 females), were included in the final analysis. The findings revealed that rTMS significantly enhances both global cognitive ability (p = 0.0002, SMD = 0.43, 95% CI = 0.20-0.66) and memory (p = 0.009, SMD = 0.37, 95% CI = 0.09-0.65). Based on follow-up periods of at least 6 weeks, the following stimulation protocols have demonstrated efficacy for AD: stimulation sites (single or multiple targets), frequency (20 Hz), stimulation time (1-2 s), interval (20-30 s), single pulses (≤2500), total pulses (>20000), duration (≥3 weeks), and sessions (≥20). This study suggests that rTMS may be an effective treatment option for patients with AD, and its potential therapeutic capabilities should be further developed in the future.

Preliminary Planning and Optimization Approach for Wastewater Infrastructure for Regions with Low Data Availability

For decades, there has been ongoing discussion about whether centralized or decentralized wastewater management systems are better. Decision-makers need to define the best option but do not always have the necessary tools to develop, compare, and identify the most appropriate solution. To address this, studies have been conducted on a settlement level. In this study, the main focus was to develop and optimize wastewater management scenarios for a region containing rural areas, where data scarcity was an issue, by extracting scenario-relevant information from the region using a satellite image and its calibration using locally available data. We selected a study region in India containing 184 villages with a total population of around 210,000 and covering an area of around 400 km2. The study considered three different scenarios for the study area: centralized, decentralized, and an optimized scenario, which consists of a hybrid system involving partly decentralized and partly semi-centralized (clustered) infrastructure. The study developed a systematic approach for defining an optimized cluster of villages by considering the cost trade-off between the wastewater treatment plant (WWTP) capacity and sewer network layout. The results showed that the clustered and decentralized scenarios were nearly equal in terms of cost (around EUR 118 million), while the centralized scenario showed a relatively high cost of EUR 168 million. Potential applications and further development of the method were also considered. The proposed methodology may aid global wastewater management by estimating and optimizing infrastructure costs needed to fulfill Sustainable Development Goal 6 (SDG#6) in rural regions.

Enhancing the moral courage of nurses: A modified Delphi study.

The urgency of ensuring adequate moral courage in clinical nursing practice is evident. However, currently, there are few formal intervention plans targeted at enhancing the moral courage of nurses. To develop a training program for improving the moral courage of nurses using the modified Delphi method. A modified Delphi study. From November to December 2022, a literature review and expert group discussion were conducted to develop a preliminary training plan framework. From January to March 2023, a two-round Delphi survey was performed, and a consensus was reached regarding the plan through online questionnaires. Descriptive statistics were used to analyze the data. This study was approved by the institutional ethics committee (No. 138, 30 August 2021). All participants provided written informed consent. Consensus was reached on eight themes and 33 items to strengthen the moral courage training program for nurses. Guided by a unified goal of moral education, a multi-level and acceptable intervention plan was designed to enhance the moral courage of nurses.

ОРГАНИЗАЦИЯ УПРАВЛЕНИЯ ПОДРАЗДЕЛЕНИЯМИ СЛУЖБЫ ПРОТИВОПОЖАРНОГО И АВАРИЙНО-СПАСАТЕЛЬНОГО ОБЕСПЕЧЕНИЯ ПОЛЕТОВ ДЛЯ ВЫПОЛНЕНИЯ ЗАДАЧ ПО ТУШЕНИЮ ПОЖАРОВ И СПАСЕНИЮ ЛЮДЕЙ СОГЛАСНО ТРЕБОВАНИЯМ ПОЖАРНОЙ ЗАЩИТЫ В ЗАВИСИМОСТИ ОТ ПРИСВОЕННОЙ АЭРОПОРТУ КАТЕГОРИИ

The normative and technical requirements are considered, according to which the assignment of categories to airports according to the unified All-Russian classification – the level of required fire protection, as well as a set of measures through which staffing of fire departments and emergency rescue units with forces and means is organized, as well as, according to these categories, staffing of units with personnel according to the staff of employees fire and rescue flight support services. Both the organization of preliminary planning and the combat management system for a real fire during the conduct of combat operations to extinguish fires, as well as emergency rescue operations in an aircraft accident situation, fully depend on these factors.

The Role of Emotional and Aesthetic Factor of Perception in Making Customer Decisions

Due to the fact that the majority of goods and services are produced in the same technological environment, possess similar design and can hardly be distinguished by their technical characteristics and assessed by manufacturer and trade outlets in a similar way it becomes necessary to mention in trade offers certain non-price competitive advantages, i. e. to provide goods and services with brand – new emotional and aesthetic tint. Customer chooses the product using his/her feelings, emotions, mood, sympathy to the image, which is formed in according with metaphors, fixed images and cultural codes. It can be proved by our research (focus-group) that shows that 93 % of the audience rely on their feelings, mood and impressions in choosing goods, which can change even during the process of choosing and it can cancel preliminary plans and decisions. Percent ratio between mental and emotional decisions can differ depending on age, gender, character of customers, however today we cannot ignore emotional factor of customer perception in the process of market promotion of goods and services.

Design of a Pedagogical Model to Foster Ocean Citizenship in Basic Education

Following a design-based research methodology, this investigation develops a pedagogical model to foster ocean citizenship through the application of a design cycle consisting of four phases: (1) preliminary research, (2) planning, (3) action and (4) evaluation. This article presents the results of phases 1 and 2, which define the conceptual foundation of the pedagogical model, and the planning of actions for its implementation in the school environment. The conceptual foundation was established by drawing upon the theoretical principles of a systemic/complex approach to education, along with theoretical-methodological elements compiled from the literature in the field of ocean literacy and ocean citizenship. During the planning phase, six educational activities were defined, to be conducted as part of a citizen science project to monitor the coastal zone. This model was developed with the objective of going beyond theoretical concepts, to offer schools a practical and objective guide for fostering ocean citizenship in basic education.

A brief investigation of the dose field virtual simulation tools for reactor decommissioning and preliminary design for the HWRR reactor in China

The calculation and visualization of the dose field in the decommissioning of nuclear facilities is one of the important functions of the decommissioning virtual simulation system. The dose field simulation tools can provide radiation field distribution and play an important role in determining the decommissioning plan and protecting personnel during the engineering implementation process. This article investigates the development of dose field calculation and visualization in the reactor decommissioning virtual simulation systems. A preliminary technology plan suitable for the development of the decommissioning dose field calculation and visualization display programs of the first Heavy Water Research Reactor (HWRR) in China is proposed. The applicability of the selected scheme is analyzed. The functional requirement and development direction of the HWRR reactor decommissioning dose field tool are preliminarily determined. Furthermore, the reactor vessel of HWRR reactor is modeled, the dose field distribution is calculated and visualized based on the preliminary decommissioning code. This research can provide technical support for the development of the decommissioning simulation system for the first HWRR reactor in China.

Hidradenitis Suppurativa Patient Referrals to a Canadian Community Dermatology Practice: A Retrospective Chart Review.

Awareness of hidradenitis suppurativa (HS) among non-dermatology healthcare providers is essential to facilitate prompt diagnosis, treatment, and referral to dermatology for further management. The purpose of this study was to analyze recent referrals to a Canadian community dermatology practice and compare the diagnostic concordance rates for HS between dermatologists and non-dermatologists. This study was a single-centre, retrospective chart review that was completed at Beacon Dermatology in Calgary, AB. Patients who were referred by a non-dermatologist for suspicion of HS and/or were diagnosed with HS by a dermatologist at Beacon Dermatology for the first time between May 2020 and May 2023 were included. Referral letters and dermatology clinic notes were analyzed to extract patient demographics, suspected pre-referral and post-referral diagnoses, and interim management plans that were initiated by the referring provider. A total of 451 patient charts with suspected and/or confirmed HS were retrieved from the clinic database. The median wait time from referral to the first dermatology appointment was 9.1 weeks. The average duration of HS symptoms was 7.3 years. HS was suspected by the referring provider and confirmed by a dermatologist in 286 cases (63%). Preliminary management was initiated in 60% of mild and 66% of moderate-to-severe cases. Given the prolonged time to diagnosis of HS, increasing awareness among healthcare providers is essential. Furthermore, this study highlighted the low implementation rates for evidence-based treatment options in preliminary management plans. Ultimately, this study demonstrates the need for increased interdisciplinary education on HS management in Canada.

Group Psychological Treatment Preferences of Individuals Living With Chronic Disease: Brief Report of a Saskatchewan-Based Cross-Sectional Survey.

Given that individuals with chronic diseases comorbid with psychological distress experience worse clinical outcomes than those without psychological distress, treatment of the psychological sequalae that accompanies chronic diseases is of utmost importance. Thus, the present study aimed to examine group treatment preferences among adults living with chronic disease in Saskatchewan, Canada. An online survey regarding group treatment preferences was administered to 207 participants living with chronic disease comorbid with psychological distress. The most often reported treatment scenario was virtual sessions (45%) lasting 1 h (51%) and occurring every other week (45%) in the evening (63%) for 3 to4 months (40%). Preferences included a medium group (48%), a relatively closed group nature (ie, only occasional new members; 44%), and group leadership including at least 1 professional living with chronic disease (54%). Future-oriented (81%), supportive (83%), skill-based (95%), and group discussions (78%) were desired treatment characteristics among participants. Survey results showed clear preferences on treatment content and session logistics. Slight variations exist by gender and age, but a consensus can be identified and act as a preliminary treatment plan. This study contributes to the body of literature on psychological treatment preferences for individuals living with chronic disease by outlining the preferred format and composition of groups according to those with lived experience. Group-based psychological treatment for chronic disease patients should account for these preferences to improve its acceptability and usefulness among patients.

Foundations of a Successful Site Quality Management System

<span id="docs-internal-guid-fec8079a-7fff-80b2-ae9f-69684a933f9f"><span>Abstract: </span><span>When it comes to consistently giving clients value and quality, the construction industry is essential. But the industry has been having problems with quality, which has resulted in subpar work, dangerous setups, and overspending. Establishing a Quality Management System (QMS) is important for solving these issues. The QMS offers an organized method for controlling the quality of processes and products, providing client satisfaction, adhering to legal requirements, and minimizing loss and rework. Good quality management system (QMS) implementation requires doing things like Company assessment, preliminary planning, awareness-raising, Progressive enhancement, measurement and control, auditing, specialist instruction, control of records, and distribution. Through data analysis from questionnaires and interviews with builders/contractors, consultants, and customers/building occupants, as well as an examination of small-scale building contractors' quality management practices and their effects on cost-effectiveness, organizational effectiveness, and customer satisfaction, the purpose of the research is to highlight the importance of quality management during the minimal building development the undertaker's executing stage.</span></span>

Development of Higher Order Thinking Skills (HOTS) Test Instruments on Parabolic and Circular Motion Materials in High Schools

This research intends to produce HOTS test instruments on high school parabolic and circular motion materials. The Borg and Gall model of research and development (R&D) includes six stages: (1) preliminary investigation, (2) planning and equipment preparation, (3) expert initial product testing and revision, (4) limited field testing, (5) revision based on the results field testing, and (6) broader field test. The data analysis used was qualitative and quantitative. The HOTS test instrument consists of 20 multiple-choice questions, including ten on parabolic and circular motion. According to three experts from material, construction, and language, the outcomes of HOTS instrument validation showed valid and feasible to use with an average value of 0.95 (high validity). The characteristics of HOTS questions have met the criteria of validity as many as 18 questions, high reliability with a value of 0.71, nine questions with a medium difficulty level, an average differentiating power of 0.41 with a good category, and 17 questions have the effectiveness of effective deception. This research concluded that HOTS-based parabolic and circular motion instruments are feasible. Thus, the instrument can be used as training material and assessment of students’ HOTS in high schools.

Developing smart fractions as a learning media assisted by ispring suite 9 and geogebra for escalating students’ computational thinking skills

In the era of the Industrial Revolution 4.0, learning mathematics puts more demands on students’ computational thinking skills. This research responds to this challenge by developing learning media assisted by iSpring Suite 9 and GeoGebra Software, known as the Smart Fractions. This development method employed Borg and Gall’s ten-stage method. These stages included preliminary research, product planning and development, preliminary product design, product validation, preliminary product revision, user trial, product revision, effectiveness tests, final product and mass production, and product dissemination and implementation. The research data corroborated the validity, effectiveness, and practicality of the Smart Fractions interactive learning media. Media experts, material and learning experts, and students as users have acknowledged these properties. A validity test demonstrated a value of V_a = 3.53, which implied a decent extent of validity. The practicality test through questionnaire and observation generated a practicality score of 86.67%, another decent product property. The product's effectiveness was tested by assessing students’ learning outcomes, which indicated an N-Gain score of 0.8. This inferred a noteworthy increase in computational thinking skills after implementing learning media. A t-test (2-tailed) also confirmed a significant difference in students' computational thinking skills before and after using learning media, as indicated by p = 0.000. The findings have concluded that Smart Fractions is a highly appropriate learning medium to improve students' computational thinking skills and help them visually understand fractions. The recommendation is to encourage students to use the learning media with the aid of manuals and tutorials on using the media. Teachers are also advised to combine the media with appropriate models, methods, strategies, and approaches.

Exploration of Adaptable Protection Transformation and Vitality Regeneration Path for Old Boiler Houses in Universities

This project is located within the residential area of Dongda Town in Chang'an District, Xi'an City, China. The project involves the old boiler room supporting the original building, which has been completed for 15 years. With the gradual development and formation of surrounding conditions, the functions of this building have gradually retired from the historical stage and become vacant. The original building's buildings, large equipment, process flow lines, trace environment and other facilities remain intact. Based on the protection and preservation of the original state-owned assets, while also reactivating the functions, supporting facilities, and related auxiliary values of the land, it is planned to carry out protective improvement and renovation on the industrial building and surrounding environment of this equipment, and provide a preliminary design plan.

Clinical Nurse Specialists: Professional Framework and Qualifications

Achieving enhanced healthcare quality by participating in cross-disciplinary medical teams and providing specialized, precision nursing are core professional values of clinical nurse specialists (CNSs). Although CNSs are crucial in the healthcare field, the development of CNSs in Taiwan remains in its infancy. The Taiwan Nurses Association has already announced regulations related to professional frameworks and scope of practice for advanced practice nurses and has reached a preliminary consensus and plans on the definition, qualifications, and indicators of care for CNSs. The clinical application, job titles, and certification of the professional core values of CNSs require continuous and joint deliberation and development by professional nurse organizations. In this study, the results of empirical research into professional organizational frameworks and certification of CNSs in Europe, the United States, and Australia were used to derive a reference model for CNS education and training development for advanced practice nurse specialties in Taiwan. The fundamental elements of the roles and professional frameworks and feasible qualification certification systems were also explored.

Fiscal Moderating Effect for Sustaining the Upstream Petroleum Field Economics and Profitability: Inventory and Purchasing Performance

Introduction: The study literature's obvious limits with a complete fiscal term model for moderating variables are crucial to our investigation. In order to preserve petroleum field economics and profitability in Indonesia's petroleum business context, this study examines the relationship between material inventory performance, purchasing performance, and fiscal term moderating influence with an agglomeration approach. Theoretical Framework: Industry character strongly influences the inventory and purchasing performance relationship (Basu & Wang, 2011); Hofer et al., 2012); (Priniotakis & Argyropoulos, 2018). Despite circumstances and fiscal terms that were not adaptive to environmental dynamism (Acquah-Andoh et al., 2019), Production Sharing Contract (PSC) Contractors' upstream field economics deteriorated compared to the initial (Paramita, 2022). Financial term in fossil sector draws investors, ensuring fair economic performance and cost balance (Mardiana et al., 2019; Yun et al., 2020). Methodology: Cross-sectional time series data were collected over five years from 26 Production Sharing Contract (PSC) Contractors from Indonesia's upstream oil industry in the preliminary Plan of Development (POD) phase. Econometric analysis using multivariate structural equation modeling will test the model. Results and Discussions: The results showed that different financial performance agglomerations showed an inconsistent relationship between inventory performance, petroleum field economics, and profitability, but purchasing performance showed a positive relationship in any scheme, and fiscal terms significantly strengthened the relationship between variables. Conclusion: This study sheds light on whether fiscal term strengthening variables in the upstream petroleum company affect decision-making.

Upaya Peningkatan Pemahaman Teks Arab Pada Pembelajaran Maharah Al-Qiroah Melalui Media Quizizz

This research is related to the application of interactive quizzes through the Quizzz media in the learning of Maharah Al-Qiroah or reading skill. The purpose of this study is to increase students' understanding of Arabic texts in Al-Qiroah's Maharah learning through the application of interactive quizs with the media quizizz. This study includes classroom action research with two cycles and each cycle is applied to the preliminary stage, planning, action, observation and reflection. The subject of this study was 41 students of PS 2 at PKPBA (Special Program for Development of Arabic Language) UIN Maliki Malang in 2021. The data was obtained from the observation of the Al-Qiroah Maharah Learning Process, Documentation and Test in the Learning of Al-Qiroah Maharah. The results of this study indicate: (1) Increasing the average value and percentage of student learning completeness in the learning of Al-Qiroah Maharah, there is an increase from cycle I to cycle II, (2) Students have given a positive response to the use of the quiz Interactive Helper Media Quizizz in Learning Al-Qiroah Maharah. Thus, the application of an interactive quiz to the Quizizz media can increase students' understanding of Arabic texts in learning Al-Qiroah Maharah for students.

Outpatient education, a momentous in clinical education: a qualitative study of medical students’, faculty members’, and residents’ perspectives

BackgroundEven though a lot of scholars have been looking at outpatient education lately because it has become more popular and they want to know about its successes, failures, and problems, we have not been able to find a complete study. Therefore, our study aims to gain a deeper understanding of the various aspects of outpatient education based on the actual experiences of medical students, faculty, and residents.MethodsFace-to-face and semi-structured interviews were used to collect data for this qualitative study. Until data saturation was reached, the interviews continued. A total of 21 participants from Shiraz University of Medical Sciences, including medical students, residents, and teachers, were enrolled. The Guba and Lincoln-first written standards for scientific accuracy in qualitative research were used to figure out how reliable the data were.ResultsFourteen categories were extracted from four main themes. The results show that four categories: “physical space and equipment,” “prerequisites related to the curriculum,” “teaching skills development,” and “near-peer teachers” should be considered for outpatient education preparation. Theme 2, “implementation requirements,” included “student dimension,” “faculty’s commitment to planning,” and “program supervision.” Theme 3, “challenges of outpatient education,” was described by five related categories, including “curriculum implementation challenges,” “student challenges,” “faculty challenges,” “system-related challenges,” and “patient-related challenges.” Finally, two categories emerged about facilitators of outpatient education: internal and external facilitators.ConclusionOutpatient clinics represent a crucial aspect of medical practice. To effectively leverage this resource, preliminary planning, considering all the prerequisites, paying attention to the implementation requirements, getting to know the challenges, and trying to solve them, especially with incentives, are essential.

Identifying and Re-Planning Challenging Retrospective SRS Patients to Evaluate the Potential for a White Matter Tract Sparing Knowledge-Based Planning Model

Diffusion tensor imaging (DTI) with automated tractography, along with auto-parcellation of volumetric MRI (vMRI), allows for reliable parcellation of critical white matter (WM) and hippocampal structures in the brain. Knowledge-based planning (KBP) may facilitate the optimization of new brain SRS plans that highly prioritize WM tracts and hippocampal sparing, allowing for cognitive preservation. However, building a high-performing model is challenging as the geometry of WM tracts and their proximity to planning target volumes (PTVs) can vary substantially. In this work we propose an iterative step for creating a KBP model where we used a preliminary model to identify challenging plans and worked on improving their dosimetry to refine the model predictions. Tractography of eloquent deep WM was obtained from high resolution DTI, along with auto-segmentation of bilateral hippocampi from vMRI and an open-source software for processing and analyzing brain MRI images. These ROIs were imported to the treatment planning system as organs-at-risk (OARsDTI). A preliminary KBP model was built from an IRB-approved cohort of 30 consecutive patients (75 plans total) treated for brain metastasis with non-coplanar SRS with total dose from 20 to 30 Gy in one to five fractions using a LINAC. This preliminary model was used to identify the 7 plans with the highest doses to the OARsDTI. These plans were re-optimized with new objectives on the OARsDTI that were partially or totally overlapped with the isodose line representing 30% of the prescription dose (as a surrogate for proximity to the PTV). The OARsDTI that were overlapping with the PTV were excluded from this analysis. We evaluated the re-optimized plans (PlanNew) by comparing maximum and mean dose (Dmax and Dmean, respectively) of OARsDTI to the initial values from the preliminary plans (PlanPre). In order to verify that the PlanNew were not compromising other structures or treatment goals, we also evaluated conformity index (CI), PTV coverage and the dosimetry of OARs included in the PlanPre. Additionally, the PlanNew were normalized to our clinical standard used for the PlanPre (100% of prescription dose to 98% of the PTV). In the 7 plans, there were 30 OARsDTI overlapping with the 30% isodose line. Refining the dosimetric objectives for the OARsDTI decreased the Dmean on average 31% when comparing PlanNew to Planpre (p<0.05, Wilcoxon rank-sum test). The CI of the PlanNew were not statistically different from the PlanPre. Although Dmax of PlanNew was 12% lower than Dmax of Planpre, the difference was not statistically different. The addition of a plan refinement step was shown to improve dose to the OARsDTI in 7 challenging SRS plans. The generation of these plans are a necessary step to creating a refined KBP model capable of accounting for the high variability in WM tracts geometry and their proximity with PTV.

Mining equipment diagnostics in a mine shaft dewatering system – case study

Maintenance issues in mines are particularly important due to the type and complexity of equipment in operation or working in hostile (even extreme) conditions. In this context, the need to ensure continuous/regular maintenance of machinery, identify potential hazards and ensure operational safety seems to be a challenge. Moreover, selecting an appropriate maintenance method is crucial for a mine, both economically and in technical/organizational terms. This study aims to present the preliminary results of diagnostic tests for pumps performing operational tasks in a mine shaft dewatering system. In addition, this study focused on a detailed discussion of the basic elements of the mine shaft dewatering system and the technical objects studied. A preliminary operational test plan for the investigated pumps operating in the mine shaft dewatering system is also presented. This enabled a discussion of the results obtained from the tests of the first quarter of 2023. The tests used three basic diagnostic methods: vibration analysis, thermal imaging and acoustic testing. Potential directions for further research in the analyzed area were also indicated.

Research on the decision framework of an energy storage traction system plan for rail transit from the low-carbon perspective—based on the interval-value Pythagorean intuitionistic fuzzy environment

Low carbonization of the traction system is the key to low-carbon rail transit operation, and its preliminary plan decision plays a decisive role in whether low carbon can be achieved in later stages. Therefore, how to achieve scientific decisions of energy storage traction systems in a low-carbon background is a problem that needs to be solved. The innovation of this paper is as follows: first, aiming at the reality of the rail transit energy storage traction system, a decision index system of the energy storage traction system which contains seven attributes and 18 criteria is constructed; second, aiming at the uncertainty of decision information and the decision makers’ aversion to risk, the decision model adapted to the energy storage traction system decision is constructed based on the interval Pythagorean intuitionistic fuzzy number and VIKOR model principle. The decision index system and decision model together constitute the decision framework. The case study results show that the decision index system can provide scientific guidance for the decision of the energy storage traction system, and the decision model can provide risk aversion type decision results with good robustness.