Short Schedule Research Articles

Milk Spoilage Model Predicts that Share Tables Would Not Meaningfully Increase Spoilage and Improved Storage Systems Can Reduce Spoilage

School share tables offer opportunities for food recovery and increased access to healthy foods by allowing students to donate or consume unopened items, such as cartons of milk. However, stakeholders have concerns about temperature abuse potentially causing premature milk spoilage. While previous research showed short ambient temperature abuse of milk (under conditions representing share tables) does not meaningfully impact microbial milk quality, differences across school cafeterias (e.g., ambient temperatures, storage systems, bell schedules, refrigeration temperature) may limit the generalizability of this conclusion. To address this, the overnight refrigeration temperature and the milk's initial contamination were predicted to be the main drivers for milk spoilage. Share tables were predicted to only cause inconsequential microbial quality changes (4 spoiled milk per million served, which would be ≤2 milk cartons spoiled per school year) under short and medium bell schedules (≤125 min of total service), even without temperature control during the lunch period. Under long (221 min) and very long (266 min) bell schedules, share tables with ambient temperature storage were predicted to have higher milk spoilage (19 and 42 spoiled milk cartons per million served, respectively), and adding storage systems was predicted to reduce the decline in milk quality (12 and 24 spoiled milk cartons per million served, respectively). These results provide a resource to support science-based decision-making for the inclusion of milk in school cafeteria share tables, ultimately working to reduce food waste and address food insecurity.

COTS: The Inevitable March to the Van Allen Belts

The space industry is experiencing the perfect storm - lowering customer budgets, increased competition and pressure to become more sustainable and responsible. “The final frontier” needs to rapidly clean up its act, regulate and become more responsible. This perfect storm has had an interesting effect on the demands for satellite capability, especially for small satellite providers. It has led to customers making more demanding requirements, smaller budgets, shorter schedules, and more challenging orbital environments. The rapid drive to get technology to market is creating a gradual shift away from “fully space qualified” EEE parts for low-cost missions – even for harsh LEO environments – due to their high cost and long qualification time before they reach the market. By developing “reliable COTS” systems, specifically designed for harsher LEO environments, satellite providers are able to significantly cut costs, offer customers the flexibility they need and also stay at the crest of the technology wave. Achieving this is not an easy feat - significant design effort and quality control needs to be applied to ensure safe operations within these harsh environments, to both preserve the space environment from debris and to ensure a return on investment though increased system lifetimes. Keywords: Space Sustainability, Radiation, COTS, High LEO, Low Cost

Observer-reported cognitive decline in out-of-hospital cardiac arrest survivors and its association with long-term survivor and relative outcomes

AimLong-term cognitive decline after out-of-hospital cardiac arrest (OHCA) is still poorly understood. This study describes long-term observer-reported cognitive decline among Danish OHCA survivors, including differences in years since the event, and investigates characteristics and self-reported outcomes associated with observer-reported cognitive decline. MethodsAdults who survived an OHCA from 2016 to 2019, and their relatives, completed the national DANish Cardiac Arrest Survivorship survey. Relatives completed the Informant Questionnaire on Cognitive Decline in the Elderly, Cardiac Arrest version (IQCODE-CA), the Hospital Anxiety and Depression Scale (HADS) and the World Health Organisation-Five Well-being index; and survivors completed the Two Simple Questions (everyday activities and mental recovery), the Modified Fatigue Impact Scale, HADS, and the Short World Health Organisation Disability Assessment Schedule 2.0. Potential associations between survivor characteristics and the IQCODE-CA were investigated using a multivariable logistic regression model. Self-reported outcomes among survivors and relatives, and the association with IQCODE-CA scores were investigated using separate logistic regression models. ResultsTotal median IQCODE-CA score was 3.04 (IQR: 3.00–3.27), with 47% having possible cognitive decline (score ≥ 3.04), consistent across time groups. Increasing age (OR 0.98, 95% CI: 0.97–0.99) and worse self-reported mental and physical outcomes for survivors and relatives, except ‘everyday activities’ were significantly associated with possible cognitive decline among survivors. ConclusionsNearly half of OHCA survivors may suffer long-term cognitive decline. Worse self-reported mental and physical outcomes among survivors and their relatives are associated with potential cognitive decline emphasising the need for post-OHCA care to include systematic neurocognitive assessment, tailored support and effective rehabilitation.

Evaluation of Met and Unmet Needs in Patients with Severe Psychiatric Disorders and its Relation to the Quality of Life: A Cross-Sectional Study.

Paying attention to the needs of patients with psychiatric disorders has recently come into focus. Failure to meet the needs of patients can affect their quality of life. This study aimed to determine the main areas of the needs of patients with severe psychiatric disorders and evaluate their relationship with the quality of life. In this cross-sectional study, 174 patients with severe mental illness who were referred to Iran Psychiatric Hospital for hospitalization or outpatient treatment were enrolled in this study (68 with schizophrenia and schizoaffective disorder, 106 with bipolar disorder type 1). A qualified psychiatry resident conducted interviews with each patient to determine their needs using the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) and the severity of their illness using the Hamilton Depression Rating Scale (HAM-D), Positive and Negative Syndrome Scale (PANSS), and Young Mania Rating Scale. A checklist for demographic data and the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire was completed by patients. Data were analyzed using descriptive statistics. Since the number of needs distribution was not normal, we used the Mann-Whitney, Kruskal-Wallis, and chi-square tests for qualitative variables. The total number of patient needs was 9 (mean = 9.1, SD = 3.7). The most unmet needs were intimate relationships (69.5%), sexual expression (65.5%), and information on condition and treatment (51.1%). Unmet needs showed a negative correlation with the quality of life (P < 0.001) and a positive correlation with the severity of depression (P = 0.045), negative symptoms (P = 0.001), and general psychopathology (P < 0.001). A higher number of unmet needs of severe psychiatric patients is associated with lower quality of life and more severe disorders.

Vigilance during recurrent variable and stable short sleep schedules in young adults

Vigilance during recurrent variable and stable short sleep schedules in young adults

Dementia prevalence in Southern Switzerland across community‐dwelling and institutionalised older adults – the SwissDEM study

AbstractBackgroundEpidemiological evidence on dementia prevalence is outdated and still limited, and recent estimates (including those from the Institute for Health Metrics and Evaluation, IHME) may be an underestimation. Moreover, the recent WHO blueprint exercise confirmed that the quality of data we have is poor and based on weak and non‐standardized or even flawed methods. Dementia prevalence in nursing homes (NH) is likely high but evidence is scarce. We aimed to explore dementia and compare dementia prevalence in Southern Switzerland in community and in NH settings, using standardized and previously validated procedures and assessments.MethodWe conducted a cross‐sectional study among a random sample of community dweller older adults and a convenience sample of NH residents in the Canton of Ticino. Participants were dyads formed by an older adult (≥65 years old) and an informant. We collected socio‐demographic data and assessed cognitive function using the electronic version of the 10/66 short Dementia Diagnostic Schedule, which comprises the Community Screening Instrument for Dementia (CSI‐D), the CERAD animal verbal fluency and ten‐word list learning tasks, and the EURO‐Depression scale (EURO‐D). We performed descriptives, t‐tests, and chi‐square tests.ResultWe recruited 462 participants between June 2021 and August 2022. Participants living in the community (N = 300) had a mean age of 76.11 (SD = 6.46), and those living in NH (N = 162) of 87.62 (SD = 6.44). The prevalence of dementia was 6.3% (CI: 3.56‐9.11) in the community, and 75% (CI: 68.6‐82.02) in NH. Overall, dementia caseness was positively associated with age (p‐value &lt;0.001), being a woman (p‐value &lt; 0.001), and lower educational level (p‐value &lt;0.001). However, these associations were not significant in the NH subsample (all p‐values &gt;0.05). Among community‐dwelling older adults, dementia caseness was associated with age (p‐value &lt;0.001), but not with gender, and education (all p‐values &gt;0.05).ConclusionOur study shows the marked differences in dementia prevalence between community and NH settings, expanding recent models from the IHME. It is crucial to include institutionalised older adults when measuring dementia prevalence in populations, particularly in high‐income countries, and where people with dementia are more likely to and can live in NH.

LABOUR MARKET IN A TIME OF CRISIS. WHAT DO HR EXPERTS SAY ABOUT THE IMPORTANCE OF DIGITALIZATION IN THE POSTPANDEMIC CONTEXT

For several years we are facing the Fourth Industrial Revolution, or Industry 4.0 as it is also called, which puts its mark across every aspect of our societies. The job market is probably the sector which mostly has to defy the challenges imposed by new technologies and digitalization. Moreover, the COVID-19 pandemic majorely impacted the world and, implicitly, the work and the labour market. In order to keep their jobs safe, in a post-pandemic digitalized world people need to focus more and more on developing 21st century skills. The present paper presents an image of a digitalized labor market before and after COVID-19 pandemic, and focuses on how new technologies, which are more and more integrated into the labor market, affect jobs and force people to shift their attention over again to the development of new skills and competences. Qualitative research data was collected from HR experts in private companies from Oradea. We aim to outline the changes occured on the labour market before and after COVID-19 pandemic with focus on the digitalization of work. We investigate how much emphasis companies put on digitalizing the work, which are the new skills that managers are interested in for their employees, and also what is the strategy managers follow in order to train a highly qualified human resource for a digitalized world. Our results show that there are significant changes on the labor market due to digitization which has accelerated after COVID-19 pandemic, however the changes depend on the field of activity. Companies needed to adapt to the new post-COVID-19 context on the labor market and they restructured their way of organizing their work: technical unemployment, short work schedule, flexible work schedule, remote work. Employers are increasingly looking for candidates who have a good level of training in terms of their digital skills and the candidates themselves are more open to different forms of activities in the digital sphere. The technological evolution which defines the features of Industry 4.0 cannot and should not be stopped while the future of our society encompasses digital and technological development in a higher extent.

A Web-based Point of Sales for Automotive Component Industry using Rapid Application Development model

This research aims to increase efficiency in Micro, Small, and Medium Enterprises (MSMEs) in the automotive components industry, focusing on CV Bengkel Megamakmur. This workshop is one of the MSMEs engaged in Indonesia's car spare parts industry. In the ongoing business process, these MSMEs need some help in inventory management, stock of goods, and less integrated sales transaction recording. The main problem identified was the discrepancy between the number of products sold and sales transaction reports. A web-based Point of Sale (POS) application was implemented, which allows the integration of inventory data and sales transactions. The method used in this research is Rapid Application Development (RAD), suitable for projects with limited resources and short work schedules. This research results in a Point of Sale application that can optimize business processes for managing inventory by monitoring stock and recording sales transactions in an integrated manner. This application has been tested using the System Usability Scale (SUS) method and obtained an average score of 86.6, included in the "very good" category. The test results show that this application has good functionality and can optimize MSME business processes in the automotive components industry.

Phase 1/2 Trial to Jointly Optimize Dose and Administration Schedule of Evomela in Newly Diagnosed Multiple Myeloma Patients Undergoing Autologous Hematopoietic Cell Transplantation

Background: Eligible patients with multiple myeloma (MM) are offered autologous hematopoietic cell transplantation (auto-HCT) in their first remission. The usual conditioning regimen consists of melphalan (Alkeran) 200 mg/m 2 infused over ~ 30 minutes due to its limited stability. Evomela is a newer formulation of melphalan, which is stable at room temperature for ~ 24 hours. The current trial studied the dose escalation and compared the short versus extended infusion time of evomela used as a conditioning regimen before auto-HCT. Methods: Patients with newly diagnosed MM, age ≤ 70, were eligible. Two dose levels, 200 and 225 mg/m 2 were studied. Patients were randomized between two infusion schedules: 30-60 minutes (short) and an extended infusion of 8-9 hours. Disease response was measured using IMWG criteria. Minimal residual disease (MRD) was measured by flow cytometry at 10 -5. Results: Sixty patients were enrolled. The first 3 patients in each arm were treated at evomela 200 mg/m 2. Since no dose-limiting toxicity (DLT) was observed, all subsequent patients (n=54; 27 in each arm) were treated at evomela 225 mg/m 2. The results are presented for patients treated at evomela 225 mg/m 2. Patient characteristics were evenly distributed (Table 1). The median age was 58.6 years (range: 42.6 -70.3). Twelve (22%) patients had high-risk cytogenetics (4 [15%] in the short infusion; 8 [30%] in the extended infusion arm), p-value 0.19. There were no deaths, and no patient experienced grade &amp;gt; 3 adverse events (AE). Grade 2-3 AEs were seen in 53 (98%) patients (26 [96%] in the short infusion; 27 [100%] in the extended infusion). Twenty-four (44%) patients experience grade 2-3 diarrhea (16 [60%] in the short infusion; 8 [30%] in the extended infusion). Grade 2-3 esophagitis was seen in 3 (6%) patients overall (0 in the short infusion; 3 [11%] in the extended infusion). Atrial fibrillation was seen in one patient (grade 2, extended infusion). Before transplant, six (22%) patients were in stringent complete remission (sCR) or CR in the short infusion arm vs. 4 (15%) patients in the extended infusion arm. At day-90 post-transplant, 13 (48%) patients in each arm were in sCR/CR, and 17 (63%) patients in each arm achieved MRD-negative status. Overall, 23 (43%) patients achieved MRD-negative plus sCR/CR status at day-90 (11 [41%] in short and 12 [50%] in the extended infusion arm). The median follow-up was 14.5 (range: 6-40) months (13.8 months in the short infusion and 14.8 months in the extended infusion arm). The median progression-free survival (PFS) was not reached in the overall trial population (Figure). The median PFS in the short infusion arm was not reached vs. 28.2 months in the extended infusion arm. The 2-year progression-free survival (PFS) was 91% in the short infusion arm vs. 77% in the extended infusion arm (hazard ratio (HR)=9.5 with 95% CI: 1- 91.2), p-value=0.022. On multivariate analysis, controlling for age and cytogenetic risk category, the extended infusion arm was associated with a shorter PFS (HR 10.96; 95% CI 1.18 - 102.02), p-value 0.0355, although the range for HR was notably wide, which could be attributed to a small number of events in each arm. Conclusions: Dose escalation of evomela to 225 mg/m 2 is safe and associated with an acceptable toxicity profile and a high response rate. Short and extended infusions of evomela are well-tolerated and associated with high response rates. The PFS is longer with the short infusion schedule, however, to affirm these preliminary observations, additional follow-up is needed.

Chinas Employment Market during Covid-19 Pandemic: Stylized Facts, Policies and Prospect

With the outbreak of COVID-19, the world labour market had been seriously affected, especially in China. This essay is written aims to analyse reasons that give rise to various types of unemployment by elaborating specific economic phenomenons relating to them and the possible government policies that can relieve the difficulties of employment. From discussing the general trend of the market behavior and the problems derived from it, on the whole, consequence caused by frictional unemployment has the biggest scope. The research significance of this essay is to offer a better understanding of factors that play a vital role in creating the unemployment. In this way, knots of the matter are able to be distinguished clearly, which is beneficial to help government to design a more appropriate policy. Generally speaking, statistics during this pandemic depicts a relatively low rate of occupational mobility in China and the monotony of major industries. To alleviate the situation, government should pay attention to the training of reemployed labour such as providing a short stern schedule suitable for actual circumstances. In the meantime, a readjustment on the market to improve the efficiency of resource exploitation should also be taken into account.

Quality of life comparison based on testosterone recovery after androgen deprivation therapy in patients cured from high-risk prostate cancer: Long term data from a phase III trial.

333 Background: Using data from a randomized Phase III trial and based on testosterone recovery after androgen suppression therapy (ADT), we compared quality of life (QOL) between patients (pts) considered cured of high-risk prostate cancer (HRPC). Methods: 630 pts with HRPC were randomised to pelvic and prostate radiotherapy plus either 36 or 18 months (m) of ADT (10-2000 / 01-2008). Serum testosterone (T) was measured at baseline then at each visit. Abnormal T was defined as below the normal level. We considered cured pts those with a PSA nadir &lt; 2 ng/ml, QOL was assessed by the validated EORTC30 (30 items). Patient-reported outcomes were filled out before treatments, every 6 m during ADT, 4 m after ADT and then once a year for 5 years. The 30 items were regrouped into 9 scales. All items and scales scores were linearly transformed to a 0-100 points scale. We analysed all items and scales scores with general linear model and repeated measures to evaluate changes between pts who did versus those who did not recover normal levels of T over time. Effect of T recovery was adjusted in multivariable model including age, initial normal/abnormal T and ADT duration (18 or 36 m). P-value &lt; 0.01 was considered statistically significant to account for multiple comparisons and a difference in mean scores of ≥ 10 points was considered clinically relevant. Results: We selected those pts considered cured to avoid subsequent T variations due to reintroduction of ADT for recurrence. We excluded 361 pts: not receiving exactly 18 or 36 m of ADT (63), survival &lt; 1 year (15), no T measured at baseline or during follow-up (55), biochemical failure (105) or evidence of metastatic/recurrent disease (92), no QOL questionnaire (31). 269 pts were retained for the analysis. With a median follow-up of 14 years, 140/269 (52%) pts recovered T to a normal level: 94/166 (56.6%) in 18 m and 46/103 (44.7%) in 36 m ADT, p=0.056. Among pts regaining a normal T, the median time to recovery was 3 years (IQR: 2.5 to 3.6) for 18 m vs. 5 years (IQR: 4.5 to 6.0) for 36 m, p&lt;0.001. The global adherence to QOL questionnaires was 83.9% (2649/3156) and it was higher for 36m than for 18 m [86.4% (1255/1452) vs. 81.8% (1394/1704) p&lt;0.001]. When comparing EORTC30 between pts who recovered with those who did not recover T, pts with T recovery had a better QOL: 15/30 items and 6/9 scales were statistically significant principally scale and items related to physical, role, emotional, fatigue, pain, dyspnoea, insomnia, diarrhoea, and financial difficulties. 2 items were also clinically relevant, trouble to take a long walk and feeling tense. Conclusions: In pts cured from HRPC, T recovery is associated with a betterQOL. 18 m of ADT should be the preferred duration since a significantly faster and a higher proportion of pts recover a normal T level with the shorter schedule without detriment in long term outcomes, as previously reported.

Evaluation of Low-dose Buprenorphine Initiation With Buprenorphine Buccal Films in Hospitalized Patients: A Retrospective Cohort Study.

Low-dose buprenorphine initiation (LDBI) strategies to transition patients from full opioid agonists to buprenorphine have previously been described using sublingual films, intravenous solution, transdermal patches, and, more recently, buccal films. The objective of this study was to describe the effectiveness of LDBI using novel titration schedules with buccal films. This is a retrospective cohort study of hospitalized patients with opioid use disorder (OUD) or physiologic dependence to opioids who underwent LDBI with buprenorphine buccal films at NYU Langone Health. Two LDBI protocols were evaluated, including a short titration schedule over 4 days and a long schedule over 7 days. The primary outcomes of interest included LDBI completion rates and incidence of opioid withdrawal. Forty-two patients underwent 46 LDBIs at NYU Langone Health between October 2020 and April 2022. The cohort comprised patients with OUD (57%), chronic pain with OUD (33%), and chronic pain without OUD (10%). Indications for LDBI most commonly included co-occurring pain precluding discontinuation of full opioid agonists (72%), prior history of precipitated withdrawal (30%), and methadone use (23%). The overall completion rate of LDBI was 78%. Withdrawal was encountered in 33% of patients; however, only 2 patients required LDBI discontinuation as a result. On multivariate analysis, a diagnosis of OUD was independently associated with withdrawal during LDBI. Buprenorphine buccal films can successfully be used off-label to facilitate LDBI in the hospital setting. We present 4- and 7-day titration protocols, which were well-tolerated, and provide practical considerations for use.

Evaluating the Effects of Rewards and Schedule Length on Response Rates to Ecological Momentary Assessment Surveys: Randomized Controlled Trials.

Ecological momentary assessments (EMAs) are short, repeated surveys designed to collect information on experiences in real-time, real-life contexts. Embedding periodic bursts of EMAs within cohort studies enables the study of experiences on multiple timescales and could greatly enhance the accuracy of self-reported information. However, the burden on participants may be high and should be minimized to optimize EMA response rates. We aimed to evaluate the effects of study design features on EMA response rates. Embedded within an ongoing cohort study (Health@NUS), 3 bursts of EMAs were implemented over a 7-month period (April to October 2021). The response rate (percentage of completed EMA surveys from all sent EMA surveys; 30-42 individual EMA surveys sent/burst) for each burst was examined. Following a low response rate in burst 1, changes were made to the subsequent implementation strategy (SMS text message announcements instead of emails). In addition, 2 consecutive randomized controlled trials were conducted to evaluate the efficacy of 4 different reward structures (with fixed and bonus components) and 2 different schedule lengths (7 or 14 d) on changes to the EMA response rate. Analyses were conducted from 2021 to 2022 using ANOVA and analysis of covariance to examine group differences and mixed models to assess changes across all 3 bursts. Participants (N=384) were university students (n=232, 60.4% female; mean age 23, SD 1.3 y) in Singapore. Changing the reward structure did not significantly change the response rate (F3,380=1.75; P=.16). Changing the schedule length did significantly change the response rate (F1,382=6.23; P=.01); the response rate was higher for the longer schedule (14 d; mean 48.34%, SD 33.17%) than the shorter schedule (7 d; mean 38.52%, SD 33.44%). The average response rate was higher in burst 2 and burst 3 (mean 50.56, SD 33.61 and mean 48.34, SD 33.17, respectively) than in burst 1 (mean 25.78, SD 30.12), and the difference was statistically significant (F2,766=93.83; P<.001). Small changes to the implementation strategy (SMS text messages instead of emails) may have contributed to increasing the response rate over time. Changing the available rewards did not lead to a significant difference in the response rate, whereas changing the schedule length did lead to a significant difference in the response rate. Our study provides novel insights on how to implement EMA surveys in ongoing cohort studies. This knowledge is essential for conducting high-quality studies using EMA surveys. ClinicalTrials.gov NCT05154227; https://clinicaltrials.gov/ct2/show/NCT05154227.

Optimal use of electric propulsion for drag compensation in very low earth orbit on satellites with deployable solar panels

In recent years, thanks to advancements in commercial hardware technology miniaturization, small satellites have become more and more important and effective in the Space ecosystem. In previous papers it has been demonstrated that future smallest observation systems, operating at a lower altitude than traditional systems, have the potential for comparable or better performance, much lower overall mission cost, lower risk, shorter schedules, lower up-front development cost, more sustainable business model, mitigating the problem of orbital debris. Flying in very low Earth orbit requires the addition of a propulsion system capable of providing drag compensation. Thanks to its high specific impulse, electric propulsion is potentially well suited for this task. However, the use of an electric thruster often requires significant power that can be provided only with deployable solar panels. To minimize the drag, the solar panels should be aligned with the satellite orbital velocity. At the same time, to maximize the power input, the solar panel surfaces should point toward the Sun. In the majority of cases these two conditions are not met simultaneously, so an optimal trade-off is needed. This topic is investigated in this paper by the use of an orbital model of a generic satellite with deployable solar panels. The model is able to simulate any circular orbit of the satellite in any day of the year and calculate both the power input and the drag from the solar panels based on their inclination. An equivalent specific impulse is also defined taking into account the thrust that the electric thruster has to provide only to push the area of the solar panels required to power the propulsion system. The results show, as expected, that the sun-synchronous Dawn-Dusk (or Dusk-Dawn) orbit is the preferred one for the electric propulsion as the velocity vector and the Sun vector are almost orthogonal. In the other cases, at very low Earth orbit, even relatively small inclinations of the solar panels respect to the velocity vector have a significant impact on the drag produced, increasing the propellant consumption and the required power. Nevertheless, it is shown also that if the solar panels are aligned with the velocity, the power lost can be kept reasonable. The same analysis could also apply to a satellite in low Earth orbit that does not employ an electric thruster but still needs deployable solar panels because of other sources of high power consumption (e.g. the payload).

Examining practices and challenges of authentic learning in Mathematics lessons in upper primary schools

The study aimed at examining the practice of employing authentic instruction and identifying predictors in upper primary mathematics lessons in Bahir Dar Special Administrative Zone, Amhara National Regional State, Ethiopia. The study employed a mixed-methods exploratory sequential design. Data were collected through observation, interviews, and questionnaires from upper primary school mathematics teachers. The authentic learning questionnaire was pilot tested, and the internal consistency was found to be.766. Qualitative data from interviews and observations were analyzed using content analysis while quantitative data from observations were analyzed using a one-sample t-test; on the other hand, quantitative data from questionnaires were analyzed using a one-sample t-test and hierarchical multiple regression. The results revealed that there was lack of effort to practice authentic instruction; the instruction did not situate learning in a real-life setting. The dimension level analyses showed that all ten dimensions of the authentic instructional model were poorly practiced. The findings also revealed that among several challenges, four factors appeared to be significant predictors: lack of understanding and skills in authentic learning, less suitability of mathematics curriculum, inflexible and short schedule and period, and large class size. The researchers recommended that responsible government bodies and teacher training institutions exert greater effort to change the situation. Training should be given to teachers to improve their understanding and skills, and the curriculum should be suited for authentic learning.

Balancing Project Schedule, Cost, and Value under Uncertainty: A Reinforcement Learning Approach

Industrial projects are plagued by uncertainties, often resulting in both time and cost overruns. This research introduces an innovative approach, employing Reinforcement Learning (RL), to address three distinct project management challenges within a setting of uncertain activity durations. The primary objective is to identify stable baseline schedules. The first challenge encompasses the multimode lean project management problem, wherein the goal is to maximize a project’s value function while adhering to both due date and budget chance constraints. The second challenge involves the chance-constrained critical chain buffer management problem in a multimode context. Here, the aim is to minimize the project delivery date while considering resource constraints and duration-chance constraints. The third challenge revolves around striking a balance between the project value and its net present value (NPV) within a resource-constrained multimode environment. To tackle these three challenges, we devised mathematical programming models, some of which were solved optimally. Additionally, we developed competitive RL-based algorithms and verified their performance against established benchmarks. Our RL algorithms consistently generated schedules that compared favorably with the benchmarks, leading to higher project values and NPVs and shorter schedules while staying within the stakeholders’ risk thresholds. The potential beneficiaries of this research are project managers and decision-makers who can use this approach to generate an efficient frontier of optimal project plans.

Sentiment Analysis of Practo App Reviews using KNN and Word2Vec

The development of technology and communication is used by the community to facilitate daily activities, one of which is in the field of health services. Health services are good enough, but there are still some obstacles that are commonly found, including not allowing to leave the house or a short schedule of doctor consultations. With the presence of health service applications, one of which is Practo, it makes it easier for people to consult online. This convenience makes a lot of reviews regarding the Practo healthcare application. The diversity of opinions on the internet, makes Practo app reviews varied. Therefore, sentiment analysis of Practo app reviews is necessary. In this study, the algorithm used was KNN. The KNN algorithm was chosen because it is very effective if the amount of data is large and easy to implement. The feature extraction used in this study is Word2Vec. Word2Vec was chosen as a feature extraction because it was considered good enough to use because it represented each word with a vector. This research produced the best model built when using stemming with Word2Vec dimensions of 300 and K = 3 values on the KNN parammeter, capable of producing an f1-score of 77.30%.

Loneliness and Unmet Needs of Older Adults Living in Publicly Supported Housing.

Guided by the RE-AIM framework, the current study sought to examine the relationship between perceived needs of older adults living in publicly supported housing and loneliness. Participants were males and females aged 70 to 83 years who identified as White or Chinese. Using the Camberwell Assessment of Need Short Appraisal Schedule and UCLA Loneliness Scale, the relationship between residents' needs and loneliness was assessed to guide the development of interventions. Results revealed residents self-reported 54% of their needs were met and rated their loneliness at a score of 36.5 (moderate level). Furthermore, there was a medium positive correlation between unmet needs and loneliness whereby high unmet needs were associated with higher loneliness scores. Findings suggest that these older adults living in publicly supported housing are vulnerable to the negative consequences of loneliness. Implementing equitable and inclusive interventions to address the impact of loneliness in the context of social determinants of health is warranted. [Research in Gerontological Nursing, 16(5), 217-223.].

The steroid-sparing effects of a mycophenolate mofetil-based regimen in the management of immunoglobulin A nephropathy in patients with histologically active lesions: A comparison with a control cohort receiving conventional therapy

IntroductionWhile the use of different immunosuppressants has been investigated in immunoglobulin A nephropathy, further investigation is needed to assess the effect of a regimen of mycophenolate mofetil combined with a short course of glucocorticosteroids in the subset of patients with histologically active features. We compared the efficacy and safety of a combined regimen of mycophenolate mofetil and glucocorticosteroids to a conventional regimen of glucocorticosteroids alone in patients with immunoglobulin A nephropathy who have active lesions and major urinary abnormalities.MethodsThis retrospective study involved 30 immunoglobulin A nephropathy patients with active histological lesions, 15 of whom were treated with both mycophenolate mofetil 2 g/day for 6 months and 3 pulses of 15 mg/kg methylprednisolone, followed by a short tapering schedule of oral prednisone. The control group was made up of the remaining 15 clinically- and histologically-matched patients treated with glucocorticosteroids alone according to a validated schedule, i.e., 1 g of methylprednisolone given intravenously for 3 consecutive days, followed by oral prednisone 0.5 mg/kg every other day for 6 months. At diagnosis, all patients had urinary protein excretion > 1 g/24 h and microscopic hematuria.ResultsAt the end of the first year of follow-up (30 patients) and after 5 years (17 patients), there were no differences between the two groups in terms of urinary abnormalities and functional parameters. Both regimens achieved a statistically significant decrease in 24-h urinary protein excretion (p < 0.001) and a reduction of microscopic hematuria. However, the mycophenolate mofetil-based regimen allowed a cumulative sparing dose of 6 g of glucocorticosteroids.ConclusionIn this single center study on immunoglobulin A nephropathy patients with active lesions and major urinary abnormalities and at increased risk of glucocorticosteroid-related complications, a mycophenolate mofetil-based regimen demonstrated similar outcomes in terms of complete response and relapse (at 1 and 5 years) compared to a conventional glucocorticosteroid-based protocol, while achieving a consistent reduction of glucocorticosteroid cumulative dose.Graphical

Comprehensive measurement of the prevalence of dementia in low- and middle-income countries: STRiDE methodology and its application in Indonesia and South Africa.

A core element of the Strengthening Responses to Dementia in Developing Countries (STRiDE) programme was to generate novel data on the prevalence, cost and impact of dementia in low- and middle-income countries, to build better health policy. Indonesia and South Africa are two middle-income countries in need of such data. To present the STRiDE methodology and generate estimates of dementia prevalence in Indonesia and South Africa. We conducted community-based, single-phase, cross-sectional studies in Indonesia and South Africa, randomly sampling participants aged 65 years or older in each country. Dementia prevalence rates for each country were generated by using the 10/66 short schedule and applying its diagnostic algorithm. Weighted estimates were calculated with national sociodemographic data. Data were collected between September and December 2021 in 2110 people in Indonesia and 408 people in South Africa. The adjusted weighted dementia prevalence was 27.9% (95% CI 25.2-28.9) in Indonesia and 12.5% (95% CI 9.5-16.0) in South Africa. Our results indicate that there could be >4.2 million people in Indonesia and >450 000 people in South Africa who have dementia. Only five participants (0.2%) in Indonesia and two (0.5%) in South Africa had been previously diagnosed with dementia. Despite prevalence estimates being high, formal diagnosis rates of dementia were very low across both countries (<1%). Further STRiDE investigations will provide indications of the impact and costs of dementia in these countries, but our results provide evidence that dementia needs to be prioritised within national health and social care policy agendas.