Use Of Resources Research Articles

Multidisciplinary perspectives in Demodex blepharitis: A new view of treatment from clinical, payer, and patient perspectives.

Demodex infestation is the cause of more than two-thirds of all cases of blepharitis in the United States. Although symptoms may include crustiness, redness, or itching of the eyelids, diagnosis can be accomplished through a simple examination of the eyelashes. The presence of a waste product of the Demodex mite, known as collarettes, on the base of the eyelashes is a pathognomonic sign of Demodex blepharitis. Demodex infestation that results in blepharitis may cause blockage and ultimately atrophy of the meibomian glands, worsening dry eye disease. Until recently, management of Demodex blepharitis has been limited by a lack of approved therapy options. Lotilaner ophthalmic solution 0.25%, the first approved therapy for treatment of Demodex blepharitis, has not only been shown to eradicate Demodex mites in one-half to two-thirds of patients following short-term treatment but also demonstrated continued benefits through 1 year of follow-up. In addition to managing Demodex blepharitis, treatment with lotilaner ophthalmic solution 0.25% may aid in the management of dry eye disease and other forms of ocular surface disease caused by complications of Demodex infestation. As a result, it is possible that successful management of Demodex blepharitis may reduce chronic use of health care resources dedicated to managing other chronic ocular conditions. As eye care professionals recognize Demodex infestation as a key mediator of ocular surface disease, increasing diagnostic awareness and addressing this underlying cause of Demodex blepharitis may reduce the need for specialist follow-up care, decrease the need for chronic therapy, and improve patient outcomes. Through routine screening for Demodex infestation and Demodex blepharitis, eye care professionals can now address an underlying factor in ocular surface disease to improve use of health care resources in the community.

Embedding Multimodal Rehabilitation Within Routine Cancer Care in Sheffield-The Active Together Service Evaluation Protocol.

Approximately 3 million people in the United Kingdom are currently living with or beyond cancer. People undergoing treatment for cancer are at risk of complications following treatment. Increasing evidence supports the role of rehabilitation (including prehabilitation) in enhancing psychological and physical well-being in patients with cancer and improving outcomes. Active Together is an evidence-based, multimodal rehabilitation service for patients with cancer, providing support to help patients prepare for and recover from treatment. This paper presents the evaluation protocol for the Active Together service, aiming to determine its impact on patient-reported outcomes and clinical endpoints, as well as understand processes and mechanisms that influence its delivery and outcomes. This evaluation comprises an outcome and process evaluation, with service implementation data integrated into the analysis of outcome measures. The outcome evaluation will assess changes in outcomes of patients that attend the serviceand compare health care resource use against historical data. The process evaluation will use performance indicators, semistructured interviews, and focus groups to explore mechanisms of action and contextual factors influencing delivery and outcomes. Integrating psychological change mechanisms with outcome data might help to clarify complex causal pathways within the service. Evidence to support the role of multimodal rehabilitation before, during, and after cancer treatment is increasing. The translation of that evidence into practice is less advanced. Findings from this evaluation will contribute to our understanding of the real-world impact of cancer rehabilitation and strengthen the case for widespread adoption of rehabilitation into routine care for people with cancer.

Nitrogen Fertilization in Snap Bean Following a Legume in the Sandy Soils of North Florida

Despite being a legume, snap bean (Phaseolus vulgaris L.) lacks nodulation genes, restricting its ability for nitrogen (N) fixation through rhizobia, making N fertilization essential for maximizing yields. However, conventional fertilizer application may lead to N losses due to a lack of synchronization between plant uptake and N availability. A promising option could be controlled-release fertilizers (CRFs), which can be custom-formulated to synchronize nutrient release with plant growth needs, promoting efficient resource use. Field studies were conducted at the North Florida Research and Education Center-Suwannee Valley (NFREC-SV) in Live Oak, FL, during the spring of 2021 and 2022. The experiments also investigated broadcasting and banding application methods of the University of Florida’s recommended N rate (112 kg·ha−1). The experimental design comprised 10 treatments, including five N rates (0, 56, 112, 168, and 224 kg·ha−1 N) and two fertilizer sources (ammonium nitrate and CRF), applied to ‘Caprice’ in a randomized complete block design with four replications. Results showed a significant yield improvement with N fertilization vs. the zero-N control. However, no yield increase was observed beyond 56 kg·ha−1. This finding could be due to the residual N from a preceding peanut crop rotation in both years. No notable variation in quality metrics (pod length and width) occurred above the 56 kg·ha−1 threshold. The results also revealed that the choice between conventional or CRF did not exert any statistically significant differences in snap bean yield. In addition, fertilizer broadcast and banding treatments yielded the same results.

Assessment of Textbook Content and Teachers’ Competence in Climate Change Education at the Primary Level

Abstract This study aims to examine the climate change education (CCE) provision in grade 5 textbooks (science and social studies) and the competence of teachers in teaching CCE in a primary girls’ schools in Skardu, Baltistan, Pakistan. It employs mixed-method research that uses both qualitative and quantitative approaches to gather data. The first phase of the study involved collecting qualitative data to examine the provision of CCE content in selected textbooks taught in grade 5. The researcher adapted an interview questionnaire to assess the competence of teachers teaching in 38 schools. The provision of themes and topics based on the seven principles of climate literacy given by the U.S. Global Change Research Program was identified by using latent content analysis (LCA). The study concludes that science and social studies textbooks lack the incorporation of CCE content of principles 1, 4, 6, and 7. Furthermore, the majority of teachers have not received training to use digital media and apply activity-based methods to engage campus and community support for CCE. The study also found that the selected schools lack school planting campaigns, CCE committees, and CCE walks. Above all, the respondents possess conflicting views about whether climate change is a natural or human-contributed phenomenon. Significance Statement Like other countries around the globe, Pakistan is the victim of climatic disasters which have disastrous effects on the economy, agriculture, healthcare, and weather conditions. These effects are exacerbated by lacking awareness, attitudinal issues, and poor pro-climate-supported practices at the academic and societal levels (Asian Development Bank 2022). Awareness, knowledge, and a supportive environment during childhood form attitudes and promote practices that have lasting impacts throughout the life of the individual (Gulraiz and Ali 2021). Therefore, children need to learn and adopt proclimate lifestyles, such as observing cleanliness, practicing planting, and judicious use of energy resources. With this background, we assessed the textbooks based on seven principles of climate literacy given by the U.S. Global Change Research Program (USGCRP 2009) and observed that principles 1, 4, 6, and 7 are not adequately addressed in science and social studies textbooks taught in public schools. Moreover, teachers have not received training to use digital media and gather campus and community support, and they have a stereotypical understanding of climate change. The study possesses significant implications for curriculum revisions and elementary education management to address the gaps relating to climate change education (CCE).

Introducing circularity in early architectural design education

PurposeWith around 40% of global waste attributed to the built environment sector, architects play a significant role in how resources are consumed, produced and wasted. UK architectural educators have made good progress to embed climate emergency issues in design curricula but the challenges of resource use and waste, and the opportunities afforded by circular economy design principles are less well-considered. The purpose of this paper is to provide new insights on how to introduce circular design principles to early-stage architectural design students within university curricula.Design/methodology/approachThe study described took an experimental approach to designing design project briefs across several interlinked studio design projects for 1st-year Architecture students. Structured as a case study, each section describes the project, learning objectives, teaching methods and project reflections informed by a qualitative assessment of student development, outputs and feedback gathered through a questionnaire and focus group.FindingsIntroducing circular design early is highly beneficial to the development of knowledge on sustainability issues, critical design thinking and creative solution generation. Examples of beneficial teaching approaches include building systems thinking, facilitating collaboration, supporting learning-through-making, using simple analogies and referencing best-practice examples.Originality/valueThis research builds on limited existing circular design literature for built environment fields and through practical insights fills a significant knowledge gap on ways to introduce a complex and dynamic topic such as the circular economy to early-stage architectural design students as they develop fundamental discipline-specific knowledge, skills and competences.

Resource Use and Care Quality Differences Among Medicare Beneficiaries Undergoing Chemotherapy

ImportanceMedicare Advantage (MA) has grown significantly over the last decade; however, MA’s performance for patients with serious conditions, such as cancer, remains unclear.ObjectiveTo compare resource use and care quality between MA and traditional Medicare (TM) beneficiaries undergoing cancer chemotherapy.Design, Setting, and ParticipantsThis cohort study used TM claims and MA encounter records from January 2015 to December 2019. Participants were MA and TM beneficiaries who initiated cancer chemotherapy between January 2016 and December 2019. Inverse probability of treatment weighting balanced characteristics between MA and TM beneficiaries, and regression estimation was used. The analysis was conducted between August 2023 and May 2024.ExposureChemotherapy initiation after a 1-year washout period.Main Outcomes and MeasuresResource use and care quality were measured during a 6-month period following chemotherapy initiation. Resource use was measured using standardized prices for services in both MA and TM, covering hospital inpatient services, outpatient care, Part D drugs, and hospice services. Chemotherapy utilization was examined for Part B chemotherapy, Part B supportive drugs, and Part D chemotherapy. Quality measures included chemotherapy-related emergency department (ED) visits and hospitalizations, avoidable ED visits, preventable hospitalizations during the 6-month episode, and survival days up to 18 months from chemotherapy initiation.ResultsThe study comprised 96 501 MA enrollees contributing to 98 872 episodes (mean [SD] age, 72.9 [7.6] years; 55 859 [56.5%] female; 7371 [7.5%] Hispanic, 14 778 [14.9%] non-Hispanic Black, and 75 130 [75.0%] non-Hispanic White participants) and 206 274 TM beneficiaries, contributing 212 969 episodes (mean [SD] age, 72.7 [8.3] years; 121 263 [56.9%] female; 8356 [3.9%] Hispanic, 16 693 [7.8%] non-Hispanic Black, and 182 228 [85.6%] non-Hispanic White participants). Adjusted total resource use per enrollee during the 6-month episode was $8718 (95% CI, $8343 to $9094) lower in MA than TM ($62 599 vs $71 317). Part B chemotherapy resource use accounted for most of the difference in total resource use, with MA enrollees having $5032 (95% CI, $4772 to $5293) lower use than TM beneficiaries. Lower resource use for Part B chemotherapy in MA was associated with both fewer chemotherapy visits (−1.06 visits; 95% CI, −1.10 to −1.02 visits) and less expensive chemotherapy per visit (−$277; 95% CI, −$275 to −$179). Findings on quality were mixed, but importantly, survival did not differ between MA and TM patients who initiated chemotherapy.Conclusions and RelevanceIn this cohort study of Medicare beneficiaries with cancer undergoing chemotherapy, MA enrollment was associated with lower resource use but not shorter survival.

The omitted variable: musical bamboos, environmental sustainability, and the ecological implications of an intangible cultural heritage in the Bolivian Andes

ABSTRACT This article examines the heritagization process of the highland flute-making community of Walata Grande, focusing on the environmental sustainability of native woody bamboos used in flute making in the Bolivian Andes. It explores how Aymara flute makers’ involvement in national cultural heritage politics intersects with broader ecological issues of resource use and environmental sustainability from an ecomusicological perspective. Through ethnographic fieldwork among flute makers, bamboo traders, and cultural heritage state officials, I analyse how Walateño flute makers view their cultural heritage as a means of decolonisation, economic protectionism, and tourist promotion. Simultaneously, they avoid discussions about musical bamboos due to concerns over losing autonomy in the management of an essential resource. I conclude that the intangible cultural heritage initiative in highland flute making offers only a limited solution to the challenges of sustaining musical bamboos. Although UNESCO’s Convention for the Safeguarding of the Intangible Cultural Heritage (ICH) advocates for the constant recreation of ICH by heritage communities, it is crucial to consider the material economic structures in which these cultural recreations are embedded and their ecological and environmental implications, especially given the current context of musical bamboo unsustainability.

Balancing Economic Growth, Carbon Emissions, and Sequestration: A Multi-Objective Spatial Optimization in Zhengzhou Metropolitan Area in China

As China’s “Dual Carbon” strategy is implemented and the new urbanization advances, balancing economic development, emission reduction, and carbon sequestration has become an important issue during the growth of emerging metropolitan areas, and it is also important for achieving high-quality urban development. Therefore, this study had three major objective functions: economic growth, carbon emission reduction, and increased carbon storage. The multi-objective land use quantity structure was solved using the Non-dominated Sorting Genetic Algorithm II (NSGA-II), and the best solution in the solution set was introduced using the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) for evaluation. Finally, combined with the Future Land Use Simulation (FLUS) model, the low-carbon evolution of the metropolitan area was predicted on a spatial scale. The trade-off plan results show that by 2035, the economic benefits will reach CNY 7.65 trillion, carbon emissions will be kept under 99.24 million tons, and carbon storage will steadily increase by 15.2 million tons. Therefore, optimizing land use from the perspective of balancing carbon emissions, carbon sequestration, and economic development can provide valuable references for planning low-carbon development and the rational use of spatial resources in future metropolitan areas.

Assessing the Impacts of Migration on Land Degradation in the Savannah Region of Nigeria

Migration-induced land degradation is a challenging environmental issue in Sub-Saharan Africa. The need for expansion due to urban development has raised the question of effective sustainable measures. Understanding migration and land degradation links is paramount for sustainable urban development and resource use. This is particularly true in Nigeria, where elevated migration levels frequently result in accelerated land degradation due to urban expansion. Given the need to understand the impact of migration on land degradation in the Savannah Region of Nigeria (SRN), this study introduces a novel approach by integrating remote sensing data (NDVI, NDBI) with local community perceptions (mixed-methods approach) to assess the impact of migration on land degradation in four migration destination communities located in two local government areas (LGAs) (Sabon Gari East and Sabon Gari West of Fagge LGA; Zuba and Tungamaje of Gwagwalada LGA). We conducted focus group discussions and a semi-structured survey with 360 household heads to obtain a comprehensive view of perceptions. Our findings revealed that 41.1% and 29.5% of the respondents agreed and strongly agreed that migration significantly contributes to land degradation. We analysed the spatiotemporal patterns of the Normalised Difference Vegetation Index (NDVI) and the Normalised Difference Built-Up Index (NDBI) acquired from Landsat 8 datasets for 2014 to 2023. While increasing NDBI values were observed in all communities, a slight decrease in NDVI was noted in Sabon Gari East and Tungamaje. Our analyses highlighted activities leading to land degradation such as land pressure due to built-up expansion at Sabon Gari East, Sabon Gari West, and Tungamaje, and deforestation at Zuba. Based on the varying challenges of migration-induced land degradation, we recommend adequate community participation in suggesting targeted interventions and policies to foster various adaptive capacities and sustainable environments within SRN communities and Sub-Saharan Africa.

Human Rights in Science: Observations From Ethics Committees on Medical Research Protocols

Objective: To determine the frequency with which Research Ethics Committees (RECs) identify breaches of ethical principles in research protocols. Theoretical Framework: Ethical principles in human research are established in the Nuremberg Code (informed consent and the common good), the Declaration of Helsinki (protection of vulnerable groups), and the Belmont Report (autonomy, beneficence, and justice). These principles are monitored by RECs to protect participants and ensure fairness in resource use. Informed consent ensures autonomy and the integrity of the research. Method: Searches were conducted in PubMed, Scopus, and Google Scholar up to November 30, 2023. A meta-analysis of single proportions was performed. PROSPERO Registration: CRD42021291893 Results and Discussion: Nine publications were reviewed, revealing violations of the principle of justice in up to 100% of protocols. In Latin America, violations were observed in 9% (95% CI: 7-12) of protocols, while in Europe, the rate was 15% (95% CI: 9-24). Autonomy was observed in 26% (95% CI: 20-33) of protocols, with 17% (95% CI: 13-22) in experimental studies. Observations on beneficence varied between 41.17% and 77.38%. Protocol-specific observations ranged between 5.26% and 27.11%, showing regional disparities among study types. RECs must ensure thorough evaluations to uphold autonomy and maximize benefits for participants. Research Implications: Provide a foundation for future investigations on the work of RECs, the implementation of ethical principles, and equity in research. Originality/Value: The publication of observations on ethical principles made by the Research Ethics Committees is essential for drafting new research protocols.

EMPOWERING END-OF-LIFE CONVERSATIONS: The Role of Specialized Nursing Teams in Facilitating Code Status Changes at Discharge.

Objectives: Hospitalized patients may require goals of care (GOC) or Advance Health Care Planning (ACP), which can be time-consuming and emotionally tolling for providers. A nursing team specializing in code status (CODE), GOC, and ACP was developed to provide meaningful support for patients and families and decrease provider burden. Interest in CODE, GOC, ACP, and effectiveness of a nursing team to lead these conversations prompted this study. Methods: A collaborative nursing team was trained to address CODE, GOC, and ACP with patients demonstrating illness or geriatric syndrome. This team conducted 3 visits per patient on average during hospitalization using structured CODE templates to establish longer term goals and document what matters in the healthcare journey. Comprehensive narratives for ACP and GOC were included in charting, syncing the medical team, nursing, patient, and family. Consults were tracked over nine months with data reviewed retrospectively from medical charts. Descriptive analyses of cohort demographics, CODE and outcomes were completed. Results: The study group comprised 3342 patients between October 2022 and June 2023. Patients ranged in age from 18-106 years, with majority (88%) age 65 years and older. Mean length of stay (LOS) was 6.8 days with CODE documented for 91% upon admission. Of the 3166 older adults with known CODE on admission, 946 (30%) changed CODE by discharge, of which 95% were de-escalated. 83% of older patients arriving with limited CODE maintained limitations at discharge, with a small portion converting to comfort (16%). Conclusion: Employing a focused nursing team to conduct CODE, GOC, and ACP conversations may be an effective use of time and resources and result in de-escalation of resuscitation orders for patients demonstrating illness or geriatric syndrome.

Optimization of Secondary Chlorination in Water Distribution Systems for Enhanced Disinfection and Reduced Chlorine Odor Using Deep Belief Network and NSGA-II

This research explores the strategic optimization of secondary chlorination in water distribution systems (WDSs), in order to enhance the efficiency of disinfection while mitigating odor and operational costs and promoting sustainability in water quality management. The methodology integrates EPANET simulations for water hydraulic and quality modeling with a deep belief network (DBN) within the deep learning framework for accurate chloric odor prediction. Utilizing the non-dominated sorting genetic algorithm-II (NSGA-II), this methodology systematically balances the objectives of chloride dosage and chloramine formation. It combines a chloric odor intensity assessment, a multi-component kinetic model, and dual-objective optimization to conduct a comparative analysis of case studies on secondary chlorination strategies. The optimal configuration with five secondary chlorination stations reduced chloric odor intensity to 1.20 at a cost of USD 40,020.77 per year in Network A while, with eight stations, chloric odor intensity was reduced to 0.88 at a cost of USD 71,405.38 per year in Network B. The results demonstrate a balanced trade-off between odor intensity and operational cost on one hand and sustainability on the other hand, highlighting the importance of precise chlorine management to improve both the sensory and safety qualities of drinking water while ensuring the sustainable use and management of water resources.

“We usually use paragraph one to introduce the topic”: trust building via appraisals by practicum EFL teachers in classroom interactions

Abstract This study investigates how practicum EFL teachers build trust through appraisals in classroom interactions at a local senior high school in Mainland China. Building upon prior research on trust discourse and appraisals, we present a model of teachers’ trust discourse, which we apply to analyze six English reading lessons conducted by three young EFL practicum teachers. The findings reveal that the practicum EFL teachers construct two distinct types of trust: cognition-based trust (CBT) and affect-based trust (ABT). CBT is formed through the communication of the teachers’ epistemic and deontic authority, while ABT is fostered by emphasizing values congruence and guanxi (interpersonal connections) between the teachers and the students. Appraisals play a crucial role in the trust-building efforts of the practicum teachers. Our analysis further indicates a preference among the practicum teachers for prioritizing CBT, as evidenced by their strategic use of appreciation and judgment resources in the attitude system, as well as the application of force resources in the graduation system. This study provides valuable insights into the pivotal role of appraisals in cultivating trust between EFL teachers and students in classroom settings.

Revolutionizing Agriculture: A Comprehensive Review of IoT Farming Technologies

IoT technology has triggered a revolutionary transformation across various industries, with agriculture being no exception. Smart farming, the integration of IoT in farming, has led to a complete overhaul of traditional agricultural practices by seamlessly combining sensor networks, data analytics, and automation. This comprehensive review aims to explore the diverse contributions of IoT in agriculture, synthesising insights from a wide range of research papers. The analysis delves into the multifaceted applications of IoT in farming, assessing its profound impact on productivity, resource management, environmental sustainability, and the challenges faced during implementation. By merging advanced sensor networks with data analytics, IoT in agriculture has given rise to intelligent farming practices, empowering farmers to make data-driven decisions and optimize their operations. Utilizing sensors to monitor soil moisture, temperature, and nutrient levels, along with advanced analytics, allows farmers to make real-time adjustments, thus maximizing crop yield and quality. Resource management has also been greatly affected by IoT in agriculture. The adoption of precision agriculture techniques enables farmers to precisely administer water, fertilizers, and pesticides, minimizing wastage and reducing the environmental footprint of conventional agricultural practices. Efficient resource use enhances agricultural sustainability and contributes to cost reduction and increased profitability for farmers. Moreover, the integration of IoT technology in agriculture holds great promise for fostering environmental sustainability. Farmers can proactively detect early signs of pest infestations or diseases by deploying IoT-based monitoring systems, facilitating timely intervention and reducing the need for excessive chemical treatments. This environmentally friendly approach helps preserve biodiversity, minimize soil and water pollution, and promote eco-conscious agricultural practices. Despite the numerous advantages, IoT implementation in agriculture does pose particular challenges. Connectivity issues, data security and privacy concerns, and the initial high costs of IoT deployment are among the primary obstacles faced by farmers. Addressing these challenges requires collaboration among stakeholders, including researchers, policymakers, and technology providers, to develop sustainable solutions that can facilitate the broader adoption of IoT in agriculture. In conclusion, this review paper sheds light on the immense potential of IoT technology in transforming the agricultural landscape. Smart farming, through IoT integration, paves the way toward sustainable food production, increased productivity, and efficient resource management. However, overcoming the challenges and ensuring seamless IoT integration is vital to fully harnessing this groundbreaking technology's benefits in agricultureIoT technology has triggered a revolutionary transformation across various industries, with agriculture being no exception. Smart farming, the integration of IoT in farming, has led to a complete overhaul of traditional agricultural practices by seamlessly combining sensor networks, data analytics, and automation. This comprehensive review aims to explore the diverse contributions of IoT in agriculture, synthesising insights from a wide range of research papers. The analysis delves into the multifaceted applications of IoT in farming, assessing its profound impact on productivity, resource management, environmental sustainability, and the challenges faced during implementation. By merging advanced sensor networks with data analytics, IoT in agriculture has given rise to intelligent farming practices, empowering farmers to make data-driven decisions and optimize their operations. Utilizing sensors to monitor soil moisture, temperature, and nutrient levels, along with advanced analytics, allows farmers to make real-time adjustments, thus maximizing crop yield and quality. Resource management has also been greatly affected by IoT in agriculture. The adoption of precision agriculture techniques enables farmers to precisely administer water, fertilizers, and pesticides, minimizing wastage and reducing the environmental footprint of conventional agricultural practices. Efficient resource use enhances agricultural sustainability and contributes to cost reduction and increased profitability for farmers. Moreover, the integration of IoT technology in agriculture holds great promise for fostering environmental sustainability. Farmers can proactively detect early signs of pest infestations or diseases by deploying IoT-based monitoring systems, facilitating timely intervention and reducing the need for excessive chemical treatments. This environmentally friendly approach helps preserve biodiversity, minimize soil and water pollution, and promote eco-conscious agricultural practices. Despite the numerous advantages, IoT implementation in agriculture does pose particular challenges. Connectivity issues, data security and privacy concerns, and the initial high costs of IoT deployment are among the primary obstacles faced by farmers. Addressing these challenges requires collaboration among stakeholders, including researchers, policymakers, and technology providers, to develop sustainable solutions that can facilitate the broader adoption of IoT in agriculture. In conclusion, this review paper sheds light on the immense potential of IoT technology in transforming the agricultural landscape. Smart farming, through IoT integration, paves the way toward sustainable food production, increased productivity, and efficient resource management. However, overcoming the challenges and ensuring seamless IoT integration is vital to fully harnessing this groundbreaking technology's benefits in agriculture

FEATURES OF THE DESIGN AND IMPLEMENTATION OF INVESTMENT AND CONSTRUCTION PROJECTS UNDER CONDITIONS OF BALANCED DEVELOPMENT

The development and implementation of investment and construction projects on the basis of balanced development is critical for achieving sustainable growth. This article examines the key features and challenges associated with such projects, emphasizing the importance of integrating economic, environmental and social practices into construction activities. The study provides insights into best practices and strategies for effectively managing investment and construction projects to ensure long-term success and sustainability.The main goals of this article are the definition of the fundamental principles of balanced development in the context of investment and construction projects, the analysis of features that contribute to the achievement of balanced development.The article uses a comprehensive review of the literature and case studies, which allows for a holistic understanding of the multifaceted nature of investment and construction projects in conditions of balanced development. Emphasis is placed on the integration of sustainable development principles from the initial stages of design. This includes consideration of environmental impact assessment, efficient use of resources and use of sustainable materials and technologies. Also, the goal of project implementation is that the projects are economically feasible and provide long-term financial returns. This involves careful market analysis, cost-benefit analysis and risk management strategies to mitigate potential financial problems. The importance of involving all relevant stakeholders, including local communities, government bodies and investors, in the decision-making process is emphasized. Effective communication and collaboration are necessary to address diverse interests and reach consensus. Ensures compliance of projects with national and international rules and standards. This applies to environmental regulations, building regulations and labor legislation. Compliance minimizes legal risks and increases project credibility.Focused on optimizing the use of resources such as materials, labor and time, implementing lean construction methods and advanced project management practices can increase efficiency and reduce waste.The implementation of advanced technologies such as building information modeling (BIM), automation and renewable energy systems increase design accuracy, reduce costs and increase sustainability. Conformity of construction work to established quality standards, regular inspections, testing and adherence to best practices are critical to obtaining high quality results.Constant monitoring of project progress and effectiveness is emphasized. The use of key performance indicators (KPIs) and regular evaluations help to identify problems early and make the necessary adjustments.The development and implementation of investment and construction projects in conditions of balanced development requires a complex and integrated approach. By prioritizing sustainability, economic viability, stakeholder engagement and regulatory compliance, stakeholders can ensure these projects contribute positively to long-term growth and development. The paper provides a road map to navigate the complexities of such projects, ultimately contributing to a more resilient and sustainable human-made environment

Adolescents and Young Adults With Respiratory Failure in U.S. PICUs: A Pediatric Health Information System Database Study, 2011–2022

Objectives: To examine the clinical characteristics, outcomes, and resource use of adolescents and young adults (AYAs) admitted to PICUs in the United States with respiratory failure. Design: Retrospective cohort study. Setting: De-identified data from 48 U.S. children’s hospitals contributing to the Pediatric Health Information System (PHIS) database. Patients: All patients older than 30 days old with respiratory failure, defined as encounters with clinical transaction codes for noninvasive or invasive mechanical ventilation, admitted to PHIS database PICUs from January 2011 to December 2022. Patients were categorized into five cohorts (< 15, 15–18, 19–21, 22–25, and > 25 yr old). Interventions: None. Measurements and Main Results: A total of 430,238 patients were identified. AYA (≥ 15 yr old) accounted for 15% (65,740) of all PICU admissions with respiratory failure. Forty-nine percent (32,232/65,740) of AYA older than 25 years had medical technology dependence compared with 39% in those younger than 15 years (p < 0.001). Sixty-one percent of AYA older than 25 years had a cardiovascular comorbidity compared with 35% of those younger than 15 years (p < 0.001). Forty percent of AYA older than 25 years had a neurologic comorbidity, and 27% a gastrointestinal comorbidity, compared with 27% and 31%, respectively, in those younger than 15 years (all p < 0.001). Compared with those younger than 15 years, AYA median hospital crude mortality rate was higher at 7.7% compared with 5.2%, as were median hospital charges per encounter at $163K (interquartile range [IQR], $77K–$350K) vs. $121K (IQR, $53K–$278K; all p < 0.001). Median ventilator days and hospital length of stay in survivors were similar for all age cohorts. Conclusions: AYA represent a substantial proportion of patients admitted to the PICU with respiratory failure. These individuals have unique comorbidities and are at risk for increased mortality and resource utilization compared with younger patients during hospitalization. Medical complexity and sequelae of pediatric illness may delay the transition of AYA to adult care, necessitating collaboration between adult and pediatric critical care physicians to increase research across the age spectrum and develop and implement appropriate evidence-based guidelines.

A Comprehensive Evaluation of Water Resource Carrying Capacity Based on the Optimized Projection Pursuit Regression Model: A Case Study from China

The Han River Ecological Economic Belt (HREEB) has a substantial amount of water resources; however, its distribution is uneven, and issues such as seasonal and engineering water shortages are prevalent. This necessitates a thorough assessment of the current water resource situation and trends in water resource carrying capacity (WRCC) to provide scientific support for the rational allocation of water resources. This study employed the RAGA-PP model to establish a WRCC evaluation index system composed of four subsystems: water resources, economy, society, and the ecological environment. The WRCC of the 17 major cities in the HREEB was evaluated from 2008 to 2022. The differentiation method was introduced to compare the reliability of the RAGA-PP model with three evaluation methods: the entropy weight TOPSIS method, the rank sum ratio method, and the principal component analysis method. In addition, an obstacle degree model was introduced to analyze the factors influencing WRCC enhancement. The results indicated the following. (1) In the differentiation test of the four models, the RAGA-PP model was found to have the highest differentiation value, and the results showed that it was more reliable in the WRCC evaluation of HREEB. (2) WRCC in the HREEB underwent significant changes between 2008 and 2022. (3) The WRCC in Shiyan and Wuhan, which are located in the eastern part of the HREEB, were high in Hubei, low in four cities in Henan, and satisfactory in three cities in Shaanxi. (4) The carrying capacity of the subsystems of the cities in the HREEB exhibited fluctuating changes with obvious internal variations. (5) The problems in the WRCC guideline layer were consistent across all cities in the HREEB, with limited per capita water resources being the primary issue in the indicator layer. Assessing WRCC is essential for achieving sustainable water resource use and high-quality regional development.

Study of technical means for heat generation, its application, flow control, and conversion of other types of energy into thermal energy

Abstract The relevance of the study of technical means for the production, management, application, and conversion of heat is conditioned by the rapid development of the energy sector, the global challenges of climate change, and the need for sustainable and efficient solutions for providing thermal energy, in connection with the need for energy efficiency, optimization of resource use, sustainability, and environmental compatibility, as well as technological progress and innovation. The purpose of this study is to investigate the problems associated with technical means for heat generation, identify shortcomings related to the production, use, and management of thermal energy flows, and consider technical devices for converting alternative types of energy into thermal energy to identify recommendations that would allow them to be used more efficiently. The main results of the study were the analysis of technical means and devices in the field of thermal power engineering and alternative energy, the main problems and shortcomings that lead to a decrease in the efficiency of the operation of technical means, heat loss, reduced comfort, and emissions of harmful substances into the environment, which can lead to a negative impact on human health, a decrease in quality, and other environmental problems.

Megaevents of Public Selection in Brazil: a Study on the Leasing of Physicalspace in the Federal District

Objective: The study aims to investigate the leasing of physical space for the execution of public selections in the Federal District, analyzing the evolution of expenses with leasing and the revenue of CESPE-UnB between 2009 and 2014. The research seeks to understand the criteria used in the contracting of these spaces, especially in large-scale events like ENEM, and to identify the gaps in the logistics of public selection mega-events. Theoretical Framework: The research addresses the historical evolution of public competitions in Brazil, from the 1824 Imperial Constitution to the 1988 Constitution, which made it mandatory to pass a public competition for public positions or jobs. The study also considers the "public competition industry," highlighting the importance of CESPE-UnB as one of the country's main organizing boards. The literature review includes contributions on sports mega-events, programmatic requirements in public accounting, and the control of the legality of public competitions. Method: The methodology employed involved documentary and content analysis, using descriptive statistics for the presentation of results. Primary data collection was carried out through interviews with representatives of CESPE-UnB and visits to educational institutions in the Federal District. Secondary data were collected from the School Census and SIAFI databases, covering the period from 2009 to 2014. Results and Discussion: The results highlight the importance of adequate physical space for the execution of mega-events but point out the absence of formalized criteria in regulations guiding the event organizer. Despite the infrastructure of public institutions in the Federal District being above the national average, CESPE/UnB prioritized the contracting of private spaces, resulting in significant expenditure on leases. The lack of clear criteria for selecting physical spaces for public competitions was identified as a gap needing regulation. Research Implications: The research suggests that defining clear criteria and formalizing regulations for the selection of physical spaces for the execution of public competitions can bring greater efficiency and transparency to the process. Prioritizing the use of public spaces, such as educational institutions, would not only reduce costs associated with leasing private spaces but also generate additional revenue for public schools, contributing to the improvement of their infrastructure. Additionally, adopting specific legislation could encourage the creation of public policies aimed at optimizing the resources used in public selections, promoting more effective and sustainable management. Originality: The research highlights the need for specific legislation prioritizing the use of public spaces for competitions, which could reduce costs and benefit public educational institutions. The originality of the study lies in the analysis of the logistics of public selection mega-events and the proposal to optimize the use of public resources through better management of physical space leases for competitions.

OPEN SOURCE TEXTBOOK AS A RESOURCE FOR THE TEACHING-LEARNING PROCESS OF ALGEBRA IN INITIAL TRAINING OF MATHEMATICS TEACHERS

Objective: To determine the implications of the use of open source text in the teaching-learning process of algebraic structures in the initial teacher training of the mathematics specialty in a state university in Peru. Theoretical Framework: The conceptual and epistemic bases of open learning are systematically addressed through interactive texts, as well as the aspects related to the teaching-learning process in university higher education. Method: The study has a mixed approach, pre-experimental design and correlational level, the target population was mathematics education students and a sample of 46 randomly chosen students, data collection is carried out through a diagnostic questionnaire, another multiple alternative and an interview, in the study sample classes are held through the open source book; then the learning achieved at the conceptual level is evaluated. procedural of algebraic structures. Results and Discussion: In this research it is evident that students did not know the open source online text for the study of mathematics, but they have skills in the use of digital technology; but with the use of the digital book they assimilate the concepts, perform demonstrations and solve problems efficiently, raising their level of motivation towards learning. Thus, the relevant use of open source books significantly improves learning and the development of mathematical competence in students. Research Implications: Strengthening of interactive and personalized activities for a comprehensive training of mathematics content mediated by digital technology, reinforcing in a sustained way the culture and mathematical competence of teachers in initial training. Originality/Value: Implementation of an innovative approach in pedagogical practice, through the use of open resources for the assimilation of mathematical concepts and procedures in a dynamic, efficient and effective way. The value of research is evidenced in the praxis of didactic strategies in the context of the digital age, oriented to the knowledge of algebraic structures by mathematics teachers.